In an earlier blog I described the differences between first, second and third class patients. I remembered that I had done a similar piece when Mickey Mantle (October 20, 1931 – August 13, 1995), a famous baseball player, died. The story about his death appeared in the New York Times and is summarized below. It seems appropriate to place him in the Patients Hall of Fame along with Mr. Tillery, a patient whose first name we don’t have, but whose story was presented in Teddy Kennedy’s book about the American health care system. The contrast between the two cases is what should make these two patients famous. In the American health care system, almost 30% of the nation’s entire Medicare budget is spent during patients’ last years of life. (This is probably also true in Canada, lest we become complacent.) Mickey Mantle’s doctors decided to give him a second liver transplant at the age of 63, because they believed there was a 55% chance of Mantle surviving three more years.
The hospital fee for 11 days before the operation was $32,500 (not including doctors’ fees), for assessment of his condition and for cancer tests. The results were negative and it wasn’t until the operation did doctors notice that the cancer had spread dramatically leaving Mantle only a few weeks or a couple of months to live. Had they been aware of the advanced stage of the cancer, the doctors say they wouldn’t have operated. Instead, $20,000 was spent to buy a fresh human liver, plus another $5,000 or more for the
chartered plane. Mantle spent two days in intensive care, probably costing several times the usual $1,000 a day or more that hospitals charge, then another 18 days in the hospital. With anti-rejection drugs and other medication running well into five figures, the hospital bill rose by another $116,000. More tests, drugs and a return to the hospital followed.
Mantle chose to die in a standard hospital room, virtually free of tubes and wires, so the total hospital charge therefore stayed under $200,000. But separate bills for surgeons, pathologists, radiologists, oncologists and gastroenterologists probably equaled the hospital expenses, said Michael Murphy, a health care consultant.
Although it is unclear who paid (Mantle could afford it), keeping Mickey Mantle alive for two and a half months probably exceeded $300,000, (Paraphrased from “Mantle’s Last Medical Bills” by Allen R. Myerson. The New York Times,
Sunday, August 20, 1995.) A companion in the Patient Hall of Fame is Mr. Tillery whose story is taken from Teddy Kennedy’s book on health care in the United States. We don’t have his first name or his date of birth. Nor do we have a photo of him, so we have inserted a drawing of an unknown man, but we do have the story and it is enough to put him in our Hall of Fame alongside Mickey.
Mr. Tillery, who lived alone, had a complete laryngectomy at the age of fifty-six. He was left unable to speak. Just over two weeks after the operation, Mr. Tillery was sent home from the hospital. He was given a list of specific equipment necessary for his care; namely, a humidifier and a tracheal suction. Given a list of agencies where he could find the equipment, Mr. Tillery was only able to acquire a humidifier, and not a very effective one at that. The suction, he was told, would have to be rented at a cost of $20 a month. Not two days later, Mr. Tillery unable to breathe, woke a neighbor and was sent to emergency. Financially, Mr. Tillery did not have much savings, enough to last him 2 or 3 months, and the $20 necessary to rent the equipment was too much for his stretched budget which already included doctors’ bills. (Paraphrased from In Critical Condition: The Crisis in America’s Health Care, Edward M. Kennedy
Pocket Books New York, 1973.)