Rationing health care

— John Costa / The Bulletin /

Over thirteen years ago, I ran into a significant health challenge.

I was in my mid-fifties with access to excellent health care and a superb company-based medical insurance plan.

I liked — still do — to run and hadn't inhaled a cigarette in over three decades.

But something was wrong.

I had run comfortably on a treadmill all winter, but when I went outdoors in the spring, I hit a wall.

No pain, no shortness of breath, no pressure in my chest, but I simply couldn't go as far as I normally did.

It was as though I had, painlessly, collided with an energy wall.

To shorten a long story, I went to the doctor several times over a few months and was told there was nothing seriously wrong.

So I kept running and bouncing off the same wall.

Finally, however, my doctor told me to have a stress test.

That was on a Tuesday, and on Saturday I had heart bypass surgery at St. Charles.

But what if I hadn't been insistent through multiple, insured visits that something was off?

One doc put it succinctly: You'd go running one day and you wouldn't come back.

But that was then, and now we are about to venture into the brave new world of Affordable Health Care or, in Oregon, Coordinated Care Organizations. There are differences between the two, but they spring from the same well.

Health care costs are excessive — even exploitative — and not enough needy folks are covered.

Get the privately insured costs for the privileged under control, so the reasoning goes, and more people without care will have something other than a hospital emergency room to depend on.

How controlling the costs for one group, which inevitably reduces its access to some treatments, increases the access for another group is hard for me to understand.

It seems less a health care solution than a political or social one, based on a belief that we all should share the shortages of the system and that all should only have what the least of us can afford.

It has echoes of the wartime convoy system. The fleet can only sail at the speed of the slowest ship.

Moving forward, after my surgery, I was back to running again — and no wall.

It was a new lease on life.

I watched my three kids grow up, go to college, graduate school and law school and all get married.

And most importantly, I listened to my granddaughter, now six, draw the line at pre-schools without good snacks, and pre-judge her new elementary school as “so-so.”

“We'll see,” she called and told me last week.

Throughout this incredible period that American medicine gave me, I have had several periods when vague symptoms recurred.

Given my experience, and given that one symptom of heart trouble is death, I raced for the great docs I rely upon.

They have had me undergo several stress tests, echocardiograms, EKGs and chest X-rays.

All have been negative.

My disciplined diet and exercise have been successful, and I have had the privilege of helping my children into better lives and being a productive citizen.

But, I have thought, what reaction would I have gotten from the medical community, living and working under CCOs and the ACA, to my initial complaints or my later concern over perceived symptoms that turned out to be nothing?

Would they have been allowed or encouraged to order the tests in a system that stresses cost reduction, even for those with good insurance?

I hope so, but I'm not so sure.