Cheryl Miller: Deliberation about health and health care

Cheryl Miller

I don’t get sick very often. My usual health complaints are of the getting-old variety — stiff and creaky joints, diminishing auditory and visual acuity — that sort of thing. I do pay attention to those gendered tests that are recommended on a regular basis, but in general, I contend that if it ain’t broke, it don’t need fixin’.

Hence it has been a few years since seeing my primary-care provider. Newly retired, but ineligible for Medicare, I am looking at health insurance options with a keener eye. It’s easy to ignore the cost when one’s employer is subsidizing the premiums, but retirement changes that. The cost for insurance under COBRA (the Consolidated Omnibus Budget Reconciliation Act) will be several thousands of dollars. I am seriously debating joining the ranks of the intentionally uninsured.

In the back of my mind, I hear Harry Callahan’s advice: “You’ve got to ask yourself one question: ‘Do I feel lucky?’” Attempting to answer that question, it seemed like a reasonable proposition to rule out lurking calamities by way of a routine physical. My subsequent doctor’s visit spurred more deliberation about my health, and health care in general.

I hasten to declare that my doctor has all the characteristics I seek in a personal physician: He is knowledgeable, qualified, attentive and caring. But unsettling to me on my last visit were certain portions of a questionnaire I completed while waiting in the examining room; to wit, was I there to see the doctor or myself? And, among the checklist of reasons for the office visit (such as “Need a prescription refilled”) was “Need a hug.”

According to U.S. Health and Human Services, the average cost of a visit to a primary-care physician was $100 in 2007, and I’m sure the cost has increased since then. I have to ask: Are we so out of touch with ourselves that we need a doctor to tell us that we don’t need a doctor? Do insurers really cover the cost of visits to doctors for the dispensation of hugs?

I would hope that not many people see their doctor for those reasons. A much larger part of the reason health-care spending is out of control is undoubtedly that we have bought into the notion that, at any given time, our bodies are teetering on the very edge of catastrophe, in constant need of vitamin supplementation, X-ray inspection, functional analysis, tune-up, and surgical repair. It seems to me that the holistic approach — which posits that not feeling sick does not necessarily mean that one is well, but is merely between well and sick — encourages a distortion of perception.

A wait-and-see attitude with regard to minor complaints appears to be a thing of the past. For example, it used to be that a mother’s gentle hand on a forehead comforted her child and assured that he would soon be well; he usually was. She kissed a boo-boo to “make it all better,” and that kiss had healing power. Trips to the doctor were reserved for vaccinations and prolonged or serious symptoms, not sniffles, rashes and stomach bugs. For contrast, watch the local TV news feature that lists illnesses seen each week by area pediatricians.

The late Dr. Lewis Thomas, erstwhile president of Sloan-Kettering Cancer Center and dean of the medical schools at New York University and Yale, wrote in “The Lives of a Cell” in 1974, “The great secret, known to internists and learned very early in marriage by their wives, but still hidden from the general public, is that most things get better by themselves. Most things, in fact, are better by morning.”

I’m feeling luckier by the minute, Harry.

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