What’s in the Glass?

The wrong question is, “Is the glass half-full or half-empty?” The right question is, “What’s in the glass and if it is something good why they hell isn’t it full?” In other words, “Who the hell syphoned off my glass of beer and how did they do that without me knowing about it?”

My 10 years in medical devices taught me a lot, probably too much, about who is sucking the glass empty in our misnamed “healthcare system.” Today, my wife is having her second radiology exam after her doctor discovered she had a rare form of cancer that was, probably, caused by her mother’s receiving a steroid/synthetic form of estrogen (DES, diethylstilbestrol) that was wrongly assumed had some miscarriage preventative effects. In the end, DES was worthless for that purpose and was repurposed without much FDA examination for increasing weight gain in cattle (“improved feed utilization”). When you attempt to buy “steroid-free” beef, pork, chicken, or other meat you are hoping to buy meat that was not fed DES.

Sitting in the Mayo Clinic’s Radiology waiting room, watching the parade of sales reps waltz in and out of doctors’ offices and departments, I’m reminded of who we can blame for our country having the most expensive, least effective system in the industrialized world: follow the fuckin’ money assholes. Everyone from the drug companies to the medical device companies to the insurance companies to doctors who game the system to the politicians these corporate criminals bribe to keep our system dysfunctional, inefficient, and incompetent are to blame. In fact, a rational nation would hold them criminally to blame and we’d empty our for-profit prisons of victimless “criminals” and pack them full of suits, CEOs, sales people, and insurance executives. Instead, the dumbest states in the country elect the worst of these characters to political office: Rick Scott (Florida Govenor), is probably the worst but he’s far from the only criminal in office. Obama’s Justice Department has been more aggressive in pursuing these criminals than any President in my lifetime, but Congress has worked hard to protect its benefactors. At least one of this season’s Republican candidates, Ben Carson, was rewarded by G.W. Bush for his creative accounting with the Medal of Freedom for pretending to be a physician while raking off more than his fair share of corporate welfare. Some people couldn’t identify a hero in a stack of actual heroes.

A few friends have been medical sales reps and they actually put their patients so far toward the front of their priorities that my fellow medical device employees hated talking to them. They were the exception, however. Most of the sales reps were so clueless that they’d call Technical Services to ask what products they had in their on-call bag. A few called to warn us that a doctor might actually be inclined to do his/her job and could be calling to ask about product failures (which in my 10 year experience never happened). Mostly, every interaction with anyone in the medical field was dissapointing. Docs didn’t worry abouts how their patients coped with the drugs they prescribed, the devices they implanted, or the incredible, bankrupting costs of having their lives saved (or not). Since the docs didn’t care, neither did anyone else in the system. The most callous group in the lineup of people with their hands out and their hearts closed were the industry executives: the multimillionares.