Thread by @EpsilonTheory

A personal thread on Covid-19, healthcare consumption, and … pain.

epsilontheory.com/no-country-for…

For the past five months, ever since I published this note about the biology of the virus and the lies China was publishing about its spread in Wuhan, Covid-19 has been a daily companion.

epsilontheory.com/body-count/

My other daily companion has been pain.

I’ve got the genetics for varicose veins, and unfortunately mine manifest themselves in a nerve-rich area of the body – my ass.

Yes, I have terrible hemorrhoids.

There’s nothing for it except surgery. None of the home treatments provide meaningful relief. I’ve tried everything. Banding was successful in the past, but I’m way past that now.

There’s nothing life-threatening about this. It’s not an emergency.

There’s only the pain.

Intermittent excruciating pain has been my daily companion for the past 3 months.

It’s exactly like having a red-hot poker stuck up your ass. Or so I imagine.

Sometimes the pain is so bad that the entire situation becomes incredibly funny to me and I just start laughing.

Opiates scare me to death, plus they have digestive side effects that you really don’t want in my condition.

So I “manage” the pain with Advil, ice packs, and traditional central nervous system depressants – tequila, mostly.

Cannabis helps a bit.

Nothing helps much.

The worst part is not sleeping for more than an hour or two at a time. Hmm. Actually, the worst part is literally blinding pain. Not sleeping is the most health-damaging part, I suspect.

The weirdest part: as I write this, I can feel tissues moving inside my body. Like a worm.

We’ve all got crosses to bear, many a lot worse than mine. This thread isn't for sympathy (although now you know why I’m on Twitter so much – it’s all I can manage much of the time).

This thread is for what my situation means for healthcare consumption. Because I’m not alone.

Connecticut is opening up a bit, so I’ve got an outpatient surgery scheduled at the big local hospital next Friday. I feel lucky to get on the calendar so soon.

I also feel nervous. My dad was an ER doc. My brother is a healthcare lawyer. I know hospitals.

To be clear, my lack of healthcare options today and over the past 3 months isn’t because of the lockdown. That’s how a child would see this.

My lack of healthcare options is because of the virus.

In its acute phase, Covid-19 shuts down non-emergency healthcare provision.

In its endemic phase, Covid-19 requires enormous and costly changes in healthcare provision. There is no “v-shaped recovery” for medicine.

Covid-19 is now in its endemic phase.

epsilontheory.com/self-assured-d…

Observation #1: Endemic Covid-19 permanently reduces healthcare provision (and consumption). The days of “efficient” (ie, insanely lucrative) specialty medical clinics where docs go through 3 knee replacements or 10 lasik procedures in an afternoon are GONE.

Observation #2: Although both acute and endemic Covid-19 sharply reduce my healthcare options and healthcare consumption, my healthcare insurance costs have not gone down. They’ve gone up.

Healthcare insurance cos are a public utility. They should be regulated as such. #BITFD

Observation #3: For the past 30 years, US fiscal policy has been largely driven by Boomers’ insatiable demand for more and more healthcare, to the advantage of both the Dems AND the GOP.

Covid-19 destroys that cozy political dynamic, but neither party realizes this yet.