Saturday, October 24, 2009

Hyper Hypertension Tensions

For the first half-century of my life, I've had pretty reasonable blood pressure. I've been pretty lucky with my health, and when I was donating blood on a regular basis, I was always told my BP was normal, usually around 110/80.

Recently, I got a physical, on the grounds that I hadn't had one for a long time. It went pretty well, but for two things. One thing was told was that I had prehypertension -  borderline high blood pressure that typically proceeds to full hypertension. The doctor recommended I up my aerobic exercise to 5 times a week of 30 minutes of elevated heart action, consider cutting back on salt and fat, and keep track of bp.

The other thing is that I had no idea how much this physical would cost. It cost a lot - and I still cannot be sure that I might not get another bill for another part of it.
If you take your car to a mechanic, you get a written estimate. If you buy a head of lettuce, you see a price attached. If you get a haircut, the rate is posted on the wall. In all these cases, you get one bill, even if several people work on you.

If you go to a doctor, you don't see any prices. No-one in the place knows anything about the price of their services; they won't give an estimate in writing; they won't give you an itemized bill. Apparently some of the work is done by one company and some of it by another, and no-one knows or cares about some sort of integrated up-front billing. To the employers of the doctors, techs and clerks, you are just a sack of blood and money, from with a little of the former will be extracted in order to get as much as possible of the latter.

The clinic I went to is still sending me bills. Now they are threatening to send me to a collection agency. Understand, these are not bills for services that I agree to buy at a price I was told before hand.

What happened was, I said that I wanted a normal physical. The staff said, fine. They didn't say how much it would cost. They did some stuff. Then, afterwards, they sent me a bill.

This is a scam. It may be legal, but it is basically like an auto shop working on your car and then saying, sorry, it's going to cost you a lot of money.

Maybe the individuals in the system are personally honest. The doctor is honest, the billing clerk is honest, maybe even the insurance executive who dreamed up this plan is personally honest.

But the system is dishonest. You cannot make a rational economic choice if you do not know the price of services.
I am extremely reluctant to talk it the bp system with a doctor a second time. What will it cost me? Even the doctors does not know.

So what are my alternatives?

Internet search on hypertension offer the helpful advice:
"In as many as 95% of reported high blood pressure cases in the United States, the underlying cause cannot be determined. This type of high blood pressure is called essential hypertension."
-WebMD: "Causes of High Blood Pressure"
So, thanks a lot, you guys; you don't know WTF ... so why should I pay you to tell me "I don't know?"

But where else can I go for advice on steps to reduce the problem, except to the same people who don't know what causes it? So I go back to the Mayo Clinic website for suggestions:
  • Cut sodium. I take in little salt; I eat less processed foods than most people I know. For a year or two, I was enjoying the extra flavor of kosher salt or sea salt, but for the past several months I've cut that out entirely. I never add salt to anything I cook or eat. When I need an extra zip of flavor, I add lemon juice or something else acidic.
  • Cut Caffeine. It seems reasonable that, as a stimulant, caffeine result in somewhat increased blood pressure; a Mayo Clinic article seems unsure but suggests cutting back as a precaution. I had a pot of coffee a day for several decades, but I think I can taper that off to zero over the course of a few months. On mornings that I exercise, I am sufficiently alert without caffeine, so I believe that I don't actually NEED it in any form (except chocolate ;-)
  • Limit Alcohol. As I've written elsewhere, I cut out alcohol a few months ago. BP has not improved. I might as well stick with the program but it's regrettable that the solution was not so easy.
  • Increase Exercise. This at least I an do. For about a year, I've been averaging four sessions a week; I schedule five a week but every now and then something comes up. Mayo says it should be everyday. This will be a biiiiiiiiig ajustment but I can do it, especially since there are huge side-benefits. Since I started exercising seriously a while back, I've noticed a lot of body improvements, and I'm eager to see what else I an attain.
But I'm not really satisfied with the health system as I am experiencing it. If this were producing any other product, I'm sure it would be approaching failure.

But just when I'm getting all grumpy and tense about health, her come Billionaires for Wealthcare with a nice show tune to sing us out....

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