DRHOOK- Off-putting: Why '08 really was year of the rat

2008 was the Chinese Year of the Rat, the first of the 12 calendar animals. If I were to make my own interpretation of the year, it would be the Year of the Dirty Rat (said like James Cagney– although I just learned he never actually said that. Go figure!)

Someone explain this to me like I'm a five-year-old. How could gasoline get up to $4 a gallon and then drop to $1.50 a gallon all within a year, while gasoline companies made record-breaking windfall profits? Millions of people have become unemployed, and yet Wall Street gets hundreds of billions of taxpayers' dollars (and the CEOs still get hundreds of millions in bonuses). 

With the struggling economy and increasing health insurance premiums and deductibles, the way people seek medical attention has been changing. 

Are people putting their medical care to the side because of money?

Yes, I do think many people put at least some of their medical priorities aside because of costs. I've always known patients to not take medicines because of money. I know, I know– some people buy cigarettes, booze, and expensive cars in lieu of medicines, but there are plenty of people who struggle to put food on the table and keep the roof over their head. 

I've seen a steady decline in the way people take care of themselves. For example, if you don't have health insurance, a colonoscopy costs as much as a David Yurman bracelet. For those with a Health Savings Account for high deductibles (which are becoming the trend since health insurance premiums cost as much as the Space Shuttle), the out-of-pocket expense is considerable. The problem is: what's the price of colon cancer?

Thomas Dolby sang, "She Blinded Me with Science," but actually eye exams are very important to prevent vision loss, especially for people with diabetes, autoimmune disorders, and uncontrolled hypertension. However, many people won't see their eye doctors because of ka-ching! Glaucoma often doesn't have symptoms, so it slowly steals away vision. Unfortunately, most people without vision plans won't get their glaucoma screen and may eventually go blind.

I know some women are putting off mammograms and PAP smears because of finances. We know early detection saves lives, so delaying diagnosis can be potentially fatal.

I've known of plenty of people who have put off seeing the cardiologist for angina. You might think it's due to denial, but many times it's because of an empty wallet. I hear quite often, "I'll wait until later this year when I reach my deductible," or "Wait until I get my tax rebate." Hello! You might have a heart attack before that. 

Many good medicines have become generic, which is helping keep medical costs down. Even so, some people won't take their blood pressure or cholesterol medicines because the here and now of a bad economy makes it tempting to spend money elsewhere. But an ounce of prevention is worth a pound of cure.

The longer we wait to treat a medical problem, the more expensive it's going to become– expensive to the pocket book and costly to the body– like losing a foot, having a huge scar from removing a large skin cancer, being short of breath for life from a weak heart, or developing dementia from small strokes. 

I don't know what lies ahead for our health care. No one wants to see their loved ones fall ill. Unfortunately, I anticipate things are only going to get worse. 

Happy Holidays, everybody! Hmmm...


Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.