Seniors spend the equivalent of 3 weeks a year on health care, study says
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I have no GP (non accepts new patients), getting any sort of prescription or referral for a specialists is a big hustle.
It took me 5 years to find a dentist that accepted new patients. Now she is on maternity leave for a year, so I will have to do root cannal in Turkey (like 3td main reason for this trip).
I had to visit ER with a relative, we spend 12 hours waiting for treatment!
Sounds like you are living in Germany. I would consider it public health insurance but is a long way from universal healthcare. Although you may not be paying directly for a treatment, the whole medicine sector is private (I.e. there are no doctors directly working for the insurance provider). That causes some inefficiencies like hours of waiting in ER, doctors not accepting new patients etc.
Compared to other systems in the EU (where doctors work for the insurance provider, most often times the government itself) processes are way more streamlined, like getting a GP assigned depending on where you live. But “you get the healthcare that you need, not the one you want”. Other issue is that they are almost running at capacity, so things like a pandemic tip the system over quite easily…
On an personal basis the best approach is to delay the onset of chronic disease as long as possible and minimize your dependence on healthcare. While there is some luck involved, most people can achieve significant improvements.
When I become old enough to need more regular medical care, hopefully I won’t be priced out of concierge or and it hasn’t enshittified to where non-concierge is now.
You can of course be unlucky and you can obviously wreck your health. Hint, damage you do to your health after 40 doesn't go away.
They made a whole movie about it! https://www.imdb.com/title/tt0070723/
Something else I ponder, which helps, is that since life is not well-defined, then neither is death. We perceive a difference, but it is fuzzy. We're constantly dying, but also can never really die; as walking, talking sacks of chemicals there is a sense in which we were never really alive in the first place.
We sink back into the chaos that birthed us, not as finite isolated beings, but as waves that rise above the ocean for a moment before returning their water for the next wave.
"Why tiptoe through life, to arrive safely at death?"
--Christopher Brian Bridges
Last year I went on a few doctors visits with two seniors. The one lady to her visit with the substitute PA. All she got was a referral to an endocrinologist, which went nowhere, as there is no endocrinologist in our rural community. The next visit was to the practice's new MD. After a few minutes of watching the doctor's efforts to pull something meaningful out of the woman's EHR, I informed the doctor that the woman had gotten 'sad' after her partner died about a year before (stopped eating well, etc). The whole visit changed - the MD was able to acknowledge the person in front of him. Then he went back to thinking about a drug to treat the woman's complaint about anxiety, when it was perfectly obvious to me that exhaustion was her actual problem. At least he didn't put her on benzodiazepines.
The other senior's appointment was a surgery consult. The doctor considered the X-rays, said "this is exactly why you're hurting" and "surgery is the only way you'll have any quality of life". Perfectly reasonable, from his limited perspective. At the end the surgeon asked the patient if he had any other health problems. "No." I knew better, but didn't say anything.
Prasad's law [0] describes the how our health care system is incentivized to provide expensive medicine instead of interventions patients actually need.
I've been thinking about 'the predicaments of old people' for 10 years, since one of passenger delivered a lesson to me about his neighbors. The essence of seniors' predicaments is that they can't be honest with their doctors because they'll be shamed, and their doctors wouldn't know how to help them anyways.
[0] "Which Interventions Can Be Paid For: The Explanatory Power of “Prasad’s Law”" - https://news.ycombinator.com/item?id=21728864
There's also a distribution here, there's a fair amount of seniors with fairly minimal health problems at any given time, and some who are in more dire straits. You hear more from the people in dire straits.
Each one of those steps might have only been 5-10 minutes out of my day at the time, but each of those steps played out over the course of a week. Additionally, each one of those steps doesn't account for having to block out that time of my day during a time when I would be most likely to reach the people I needed to without sitting on hold for an hour. It doesn't reflect the time I spent worrying about actually being able to get the medication I needed at all. It doesn't reflect the time I spent angry and frustrated at everyone involved in the process. And it doesn't reflect just how much of an energy suck the entire thing was in the first place. Nor the depression that comes from knowing I'm about to do it all over again next week. Or the fact that the month after that, I'll probably be doing it again and dealing with the insurance company on top of it. All of it looms over me like a storm cloud you can see coming for miles.
I also spent another ~30 hours on an unrelated medical thing, but that's only the time I spent actually doing it. Not the hour+ travel time every day, the extra hours put in at the office to make up for the lost time, the changes to routines and rescheduling of other items around it and so on and so forth.
Your health is the baseline from which everything else in your life is derived. Take care of it, because when it's gone, it takes so much more from you than just the time you spend at the doctor's office.
Maybe something like 40% of all value in America is in “feeling seen and heard.” Everything helps outcomes, but feelings aren’t the highest on the list of things that help outcomes, and it’s one of the most expensive to provide, and it’s behind the proliferation of sub clinical admin and midlevel staff, but it’s also what people want.