I have spent the last few days in the bowels of the American Medical system as Bob, my partner, took a fall and has been experiencing the noxious gases of this infernal system.

The profit motive is a terrible way to make decisions about a person’s health. What may be the cheapest way to handle a problem may not be the best. Bob took a fall and damaged both legs. He can’t put pressure on either leg for now. This means that the simplest task is virtually impossible for him to perform. We are out of town in Modesto and need to get home for his surgery because the recovery could take up to three months. It makes sense to send him back to San Diego where we live.

The solution they are purposing, however, is ridiculous. They want me to pack the very injured Bob into our car and drive for 7 and a half hours to San Diego. Right now, he can’t get into a wheelchair without the help of two medical professionals. Yet they want me, a 68 year old man alone with a 76 year old physically incapacitated man, to make this car trip.

Now this is where things get interesting. When we balked at this suggestion, the case manager at the hospital decided to argue that it was cheaper for a medical vehicle to take him back San Diego than for Bob to stay in the hospital until he is physically able to make the trip. Brilliant right.

Brilliant and horrifying. The thing that is deciding how to proceed is the cost to the insurance company (in this case Medicare) and not the health of the patient. Even more horrifying is that the people who look at spreadsheets could decide that it still makes more economic sense for me to drive him home.

Now I get it, money has to be taken into consideration at some point but it seems like this is not one of them. The bean counters are weighing the economic cost of two options — paying for an ambulance or paying for a hospital stay. The deciding factor isn’t the health of the injured man. And, more importantly, why do the bean counters seemingly have the final decision. And don’t say the doctor has the final say. The case worker’s argument is financial because he knows the bean counter has the deciding vote. If Bob’s health mattered, the argument would be it is better for his health to be driven home in a car with medical professionals. Right?