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Awareness can help avoid expensive medical bills

A felon gave me reminders I shouldn't have needed.

This was no two-legged gangster.

Rather it was a medical felon, and not the type Steven Brill wrote about in his mind-boggling article "Bitter Pill: Why Medical Bills are Killing Us" in the March 4 issue of Time.

The article is a must read, even if it is a long one, with more than 24,000 words.

Find a copy. Read the multitude of responses at

Brill spent seven months in research, revealing how Medicare keeps costs on doctor and hospitalizations under the billed price for its enrollees, yet leaves younger insured and uninsured out of the loop and often facing huge bills.

But even Medicare is hamstrung by regulations from doing the same with prescriptions and medical devices (think knee and hip replacements) for enrollees.  

If that suggests an unwillingness in Congress to change regulations and brings "lobbyists" to mind, you're probably correct.

"According to the Center for Responsive Politics, the pharmaceutical and health-care-product industries, combined with organizations representing doctors, hospitals, nursing homes, health services and HMOs, have spent $5.36 billion since 1998 on lobbying in Washington," Brill wrote.

"That dwarfs the $1.53 billion spent by the defense and aerospace industries and the $1.3 billion spent by oil and gas interests over the same period. That's right: the health-care-industrial complex spends more than three times what the military-industrial complex spends in Washington."

He convinced me to reconsider the possibility that expanding Medicare to younger people rather than raising the eligibility age might just cut health costs.

Brill covers a great deal more ground, every bit worthwhile, that I devoured after a trip to the doctor.

The doctor identified the painful red swelling in my thumb as a felon or paronychia infection caused by bacteria sneaking in through a puncture wound. Sounds innocuous. The pain that shot up my arm was not.

According to The National Institutes of Health and the Cleveland Clinic websites, such infections generally are caused by one of two bacteria that sneaks in through a skin break. A felon infection is on the tip, while paronychia is around the nail and often linked to biting fingernails or hangnails or around ingrown toenails.

I don't bite my nails, but as I've aged, those nasty cracks around the nails seem to be more frequent and persistent each winter.

The doctor pointed out some barely visible punctures in the top of the thumb, a crack at the nail edge and maybe a sliver underneath. Wherever bacteria got under my skin remains a mystery.  But the cure was not. The doctor drained the swollen thumb and ordered 10 days of an inexpensive antibiotic.

Fortunately, this was not the bacteria-resistant infection the federal Centers for Disease Control warned of almost hours after I took the first capsule. Nor did the doctor prescribe Azithromycin, sold as Zithromax or the "Z-Pak, an antibiotic the federal Food and Drug Administration last week linked to serious heart risks and sometimes used for skin infections.

But the announcements combined with my infection seem another clarion call for caution in antibiotic use. It didn't occur to me to ask if there was an alternative.

In the scale of medical problems, mine was relatively minor and inexpensive. But it was a reminder that as we age, we have to be aware of changes, even down to the increasing thinning of skin and slower healing. The prescription: caution and more awareness.   

Perhaps I could have prevented a trip to the clinic if I started soaking the offending thumb in warm salt water when the pain and discoloration first occurred. It usually works with mild infections.

I eat plenty of vegetables and whole grains, limit meat, exercise daily and yes, I'm soaking the still-healing thumb.

Even my favorite doctor once told me, "Try to avoid doctors and hospitals." I'm trying.

Contact writer Evadna Bartlett at



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