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Nostalgia August 2015

The Hippocratic Oaf

Healthcare and Baseball: Welcome to the Big Leagues

By Daniel Crantz

For baseball you simply left your house and went to the local field to play, and for healthcare you stayed in your house and the doctor came to you. Nowadays, for baseball you stay in your house and watch it on TV, and for healthcare you leave your house and go the hospital which sits on the field where you used to play baseball.

Baseball and healthcare have been part of our communities in small towns and large for many generations. Baseball was a uniquely American institution and easy to play; all you needed was a stick, a ball and a field. Healthcare was community-based too; all you needed was the local doctor and patients. For baseball you simply left your house and went to the local field to play, and for healthcare you stayed in your house and the doctor came to you. Nowadays, for baseball you stay in your house and watch it on TV, and for healthcare you leave your house and go the hospital which sits on the field where you used to play baseball.

Every town had a local team and league of other towns to play. Players were local heroes and older townspeople may reminisce about glory days gone by when they had hit or witnessed a grand slam to win the county trophy.

Doctors were local heroes too. You trusted them and they personally knew you and your family. The doctor was a confidant that approached the status of relative or dearest friend. An older physician may have delivered multiple generations of the same family and this was in many ways a version of glory days as well. No contract stood between you and access to healthcare. Payment was not in copays, deductibles and coinsurance but could be by the barter system or even an IOU.

So what happened? Our local heroes have been replaced by a string of individuals that change frequently over the years. We no longer have that personal connection. Doctors have to ask you about family history because they don’t already know. You have to read up on players from many cities and even countries as they play for your team now. The feeling of community is lost amongst medical tests that cost thousands of dollars as technicians you have never met operate machines that fill entire rooms creating images for a doctor you have never met to review tomorrow. At the new baseball stadium, cheap $50 tickets seat you next to rude strangers in a peanut gallery as you sip an $8 beer.

But it’s all improved right? It just got better and better, I know it did. I know it because, well, I pay so much it must be good, even great!

Well, it’s Big Business now, and that’s very American too.

We do things bigger in America. We tend to add the “better,” that is we always say things in America are Bigger and Better. But the rest of the world may disagree. They glance over at us occasionally (we are not as interesting as we think we are) and they shake their heads. “Those crazy Americans,” they often quip.

We like new things and equate these things as better. But new things are very expensive. To compare Pittsburgh to Rome (a comparison not often made) we can see how one stadium will surely outlast four.

Hospitals are very expensive as well and construction costs are similar to stadiums. So how much? Are there billion dollar stadiums and billion dollar hospitals? Well yes – the new Yankee stadium costs $1,300,000,000. The irony of course is they lose occasionally to the Red Sox at Fenway Park which only cost $650,000 to build in 1911. ($15,900,000 in 2014 dollars, per Wikipedia.) Point being Fenway is long paid for and the World Series plays just as well at Fenway than any other park. So why spend so much – 81 times more with inflationary factors included?

No one knows, but hospital construction expense has risen dramatically as well. The first hospital in the U.S. was Bellevue Hospital built in 1736. Quoting History Magazine: As the city grew to over 8,000 in 1731, the “vagabonds and idle beggars” could not be ignored by the rest of society, and construction of a “Publick Workhouse and House of Correction” was begun in 1735. The budget for this ambitious project was £80 and 50 gallons of rum.

Although it had no name as yet, Bellevue Hospital had been born!

It is difficult to put this into today’s costs but I will try. The CS Mott Children’s Hospital & Von Voiglander Women’s Hospital/University of Michigan Medical Center cost $754,000,000 to construct in 2011. So by the same standard as Bellevue, the cost is equivalent to $500,000 and, well let’s just say, a LOT of Budweiser.

Bigger is not always better and cavernous stadiums and hospitals seem a bit cold even if they sparkle and dazzle. Doctors, too, seem more distant today and if gauged by our most famous fictitious characters, have changed over the years. Ben Casey, Marcus Welby and Joe Gannon have been replaced by House, Nip Tuck and Grey’s Anatomy. We trusted Ben, Marcus and Joe but characters on today’s TV do not trust each other or even themselves.

We may miss the kindly attention of Robert Young (Marcus Welby, MD) but let’s face it –  if you need an MRI, give me the biggest machine you’ve got and a team of white coats.

As for baseball, Jumpin Joe has gone away, but Giancarlo Stanton has just agreed to a $325 million contract to play for the Miami Marlins. Heck, that’s almost enough to build a hospital. Well, not really.

 

 

Laughter is the Best Medicine, unless you’re asthmatic!

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