By Steve Brawner
© 2014 by Steve Brawner Communications, Inc.

It was Saturday morning, March 29, and the pain in my lower back was growing more intense. I knew what was happening. It was not my first kidney stone.

If you’ve ever had one, you know the drill: the writhing, the fruitless shifting of positions hoping to find relief, the heaving. When I could take the pain no more, I shakily told my wife to wake the kids and drive me to the emergency room. When we arrived, I begged the admittance clerk to hurry. I underwent a CT scan and was given drugs that, blessedly, took away most of the pain. Surgery removed the stone a week later.

I’m grateful for modern health care, but no consumer product is free. The total out-of-pocket cost for that episode so far is nearing $6,000, including a big hospital bill that recently arrived – six months after the surgery. I’m hoping there will be no more surprises. My insurance company was billed more than $12,000 for the surgery alone and paid about $10,000 of that.

Ask me about health care reform, and I’ll generally say the system doesn’t function enough like a free market. Patients don’t act like consumers, and medical providers don’t act like a business. We must encourage patients to be more price-conscious so they’ll shop around and refuse unnecessary care. That kind of behavior will force medical providers to become more efficient and cheaper.

That’s Steve the political philosopher talking, and I’m not saying it’s wrong. But what did Steve the kidney stone patient do? Certainly not call the various emergency rooms at 6 a.m. on a Saturday looking for the best combo deal. I went to the only one in my hometown. There I was at the provider’s mercy not only as a patient but also as a consumer. I would have bought whatever service the hospital was selling in order to take away that pain.

Over the course of a week, my kidney was scanned numerous times, including the day before the surgery and the day of. At the hospital, already wearing my gown, I finally asked if it was really necessary to do it again. I was told the doctor liked to see if the stone had moved overnight. What would you do – refuse the scan? Of course I did what the doctor, who is also the seller, told me to do. I had no buying power in that situation.

Health care reform – that’s a hard one. Try as one might, it doesn’t fit neatly into any political ideology, including my fuzzy one. The mandate by the Affordable Care Act (Obamacare) that all Americans must have insurance, which conservatives argue is an unconstitutional edict – it once was a conservative idea. A major issue in this year’s legislative races is the private option, which uses federal dollars to buy private insurance for poor people who make too much money for Medicaid. It was created by Republican legislators and Democrat Gov. Mike Beebe’s administration and now provides insurance to 200,000 people. Other Republicans say it’s just Obamacare by another name.

OK, it is more government, at least on the front end. But uninsured people generally wait until they are very sick to seek care, and then they go to the emergency room, and they can’t afford to pay for their care, so the rest of us pick up the tab. So what’s the easy answer on that one?

No matter how health care is reformed, there will be winners and losers. During Monday’s AETN debate, Sen. Mark Pryor described a church meeting with a diabetic constituent thanking him for voting for the Affordable Care Act. Because it made it illegal for insurance companies to reject his pre-existing condition, the diabetic has coverage for the first time in 15 years. On the other hand, Pryor’s opponent, Rep. Tom Cotton, had his own story: a dentist and his wife lost their insurance because it didn’t comply with all of the act’s mandates. Libertarian Nathan LaFrance said doctors are telling him their attention is now focused on entering computer codes instead of caring for patients.

Take the words “Obama” and “Obamacare” out of the picture. Whose story is more compelling? The diabetic’s, the dentist’s, or the doctors’?

Aren’t they all? Health care reform – that’s a hard one. I don’t know the right answer, but anyone who tells you there’s an easy one is probably wrong.