Unexpectedly Intriguing!
05 February 2007

Ready for a quiz? Let's get right to it:

A retired elderly woman in very good health lives in a developed country in which all health care services for individuals are provided for by the national government. She has cataracts in both her eyes, with one somewhat more advanced than the other. She is scheduled for a surgical procedure to correct the condition. Which of the following do you believe will happen?

  1. She will have both her eyes corrected at the same time, with the procedure scheduled sometime within the next two weeks.

  2. She will only have the eye with the more advanced cataract corrected first, with the procedure scheduled sometime within the next two weeks. She will be scheduled for a second surgery to correct the less severe cataract in her other eye two months later (two months from when the procedure is first scheduled).

  3. Same as B, except her first surgery will be scheduled sometime in the next two months, and the second procedure will be scheduled to occur four months later (six months from when the procedure is first scheduled).

  4. Same as B, except her first surgery will be scheduled sometime in the next six months, and the second procedure will be scheduled to occur six months later (one year from when the procedure is first scheduled).

The correct answer, at least for now, is B. The reason stated by the health care professionals in the country in question is that B best describes the patient's medical necessity for the procedure. The real question is why is the correct answer not A? Consider the following:

  1. Both eyes have the condition, the only difference is in how advanced the condition is one eye over the other.

  2. Once you've assembled all the necessary resources and individuals required to perform the surgery for correcting a cataract in one eye, there is very little additional cost in correcting a cataract in the patient's other eye.

  3. By comparison, scheduling a second surgery incurs all the costs of the first procedure. Again.

  4. The elderly woman is retired. She will not suffer any loss of income resulting from in not being able to return to work quickly in having the procedure performed on both eyes simultaneously. She also has suitable support to see her through the procedure's typically short recovery period.

Given these circumstances, what possible reason would any medical professional have in determining that the surgical procedure should only be limited to just one eye?

The answer: "medical necessity" has likely been defined down to accommodate available funding for the procedure. Not because the procedure isn't needed, but because some government bureaucrat somewhere has made a determination that only "X" amount of money will be spent on health care this month, which means that costs have to be controlled to fit the available budget. And perhaps the only reason the answer isn't C or D is because it's been a good month for the health care bureaucrats.

Because everybody in this country is served by this single payer system for health care, that means that choices are going to be made like this to ration the amount of health care provided to individuals. In this case, that means delaying a needed procedure by months just for the sake of saving a small amount of money today in favor of spending substantially more later to accomplish the same task. So much for achieving a high quality, low cost system of national health care.

At least, that's what the politicians guaranteed that they would deliver. Good thing that the definition of what constitutes medical necessity is apparently up to the same people, otherwise it's possible that they never would!


About Political Calculations

Welcome to the blogosphere's toolchest! Here, unlike other blogs dedicated to analyzing current events, we create easy-to-use, simple tools to do the math related to them so you can get in on the action too! If you would like to learn more about these tools, or if you would like to contribute ideas to develop for this blog, please e-mail us at:

ironman at politicalcalculations.com

Thanks in advance!

Recent Posts

Stock Charts and News

Most Popular Posts
Quick Index

Site Data

This site is primarily powered by:

This page is powered by Blogger. Isn't yours?

CSS Validation

Valid CSS!

RSS Site Feed

AddThis Feed Button


The tools on this site are built using JavaScript. If you would like to learn more, one of the best free resources on the web is available at W3Schools.com.

Other Cool Resources

Blog Roll

Market Links

Useful Election Data
Charities We Support
Shopping Guides
Recommended Reading
Recently Shopped

Seeking Alpha Certified

Legal Disclaimer

Materials on this website are published by Political Calculations to provide visitors with free information and insights regarding the incentives created by the laws and policies described. However, this website is not designed for the purpose of providing legal, medical or financial advice to individuals. Visitors should not rely upon information on this website as a substitute for personal legal, medical or financial advice. While we make every effort to provide accurate website information, laws can change and inaccuracies happen despite our best efforts. If you have an individual problem, you should seek advice from a licensed professional in your state, i.e., by a competent authority with specialized knowledge who can apply it to the particular circumstances of your case.