Yesterday afternoon I started the ball rolling with a health care discussion on the blogs. I'd like to continue that discussion this evening and address some statements that I made previously.
The Democrats in this country say that the health care system is broken, it's terrible, it needs an overhaul. However, when it comes down to it, their main gripe is not quality of care. Their main gripe and goal driving health care reform is usually the cost and the statistic of 45 million Americans without health insurance. Before talking about the uninsured, I would point out a few things.
People in this country are not denied emergency care. If someone is rushed to the hospital, you are hard pressed to find instances where the care providers have a discussion about payment before they operate or administer medications. If someone is having a heart attack, if someone is septic with a fever and chills, if someone is in a car accident and suffers trauma... those people are treated. No questions asked. Payment plans are often worked out long after the fact, and they are often written off completely for various reasons. Hospitals often end up eating costs of treating patients who have no money to pay for their care. The reason that I bring this up is that people often imply during health care discussions that 45 million Americans without health care inherently means that there are people out there with gunshot wounds who are turned away at the door because they don't have health insurance to pay for it. That just doesn't happen, and if it does, that hospital or clinic could likely be prosecuted. In some circumstances, however, patients develop chronic illnesses that require large sums of money to pay for months or years worth of treatments. THESE are the types of circumstances that should be the focus of health care reform, and I will mention that later on.
In my last post, I said that the 45 million was a total BS number. The number is misleading. The number implies that there are 45 million Americans who can’t afford health care. What nobody ever seems to think about is that just because somebody does not currently pay a health care premium does not mean that they can’t afford one. There are several categories of people who fit this profile. Take Bill Gates for example. If I am Bill Gates and have a net worth of who knows how many millions of dollars, what do I want with an insurance plan? Do you think Bill Gates pays an insurance premium? No, he doesn’t. He pays for his health care outright. There are plenty of wealthy people in this country who are self-insured, meaning that they pay out-of-pocket for their health care needs. However, they fit the criteria of being “uninsured.” Another example… myself. I do not have anything outside of catastrophic coverage at the moment, meaning that if I get in a car wreck and break my face, that will be covered. However, if I get an upper respiratory infection, I will have to shell out probably around 200 bucks for a clinic visit and medications to treat it. That is not an accident or a life-threatening situation, so I have to finance it. I could probably afford a better health care plan if I was interested, but I’m not. I have been fortunate to be very low-maintenance in the health department. I don’t get sick except for maybe once or twice a year, so why pay an insurance company money every month for coverage I’m not using? I don’t WANT a full health care plan right now in my last months of being a student, and I know plenty of other people out there like me. Lastly, there are those who can afford health care, but they simply have a sense of entitlement that has been drilled in their brains from a young age that it is the responsibility of somebody else to provide for their needs. It is the government’s responsibility to give them health care, not theirs. I have seen this first-hand more times than I cared to see it. These are all part of the 45 million “uninsured” demographic that is so overhyped today. Am I saying that there are not people out there who need insurance and legitimately can’t get it? No. I’m not saying that, am I?
Last point to make in this post, which is already pushing my comfortable length limits… Stay with me on this, though, because this is important to consider. This is a point that I learned on clinical rotations this year and working with real patients at real hospitals. This is not something I read in an article or heard on talk radio. It is this: Access to health care does not mean better health for the patient. That was a hard concept for me to grasp until recently. However, it has been a consistent consideration in my mixed feelings over the health care issue. One site I rotated through was a mercy clinic that had set up about 50 patients who were mostly illegal immigrants. These are patients who did not have health insurance and couldn’t even speak English most of the time. This hospital financed the clinic, and it paid for about 95% of their health care. The patients with diabetes got free glucose monitoring materials and medications. The patients with hypertension got enough med samples to last them until their next clinic visit. The patients with hyperlipidemia were managed with all laboratory assessments on the house. A clean bill of health was basically offered to these people on a silver platter. There was one problem, though. Four out of five patients were a health nightmare. Their blood pressures were consistently in the 160s over 90s. They never exercised. Their glucose was off the charts. Their lipids were not under control. Many of them were heart attacks waiting to happen. How could this be? The reality is that patients in general are noncompliant. Even when GIVEN medications and free advice from professionals, they were no better for it. I bring this up to illustrate another aspect of health care to think about. Okay, so you’re going to cover all the people without health insurance. Given that a healthy portion of the “uninsured” demographic could probably get care already without the government’s help, and given that many of them will not utilize the care they are given… it makes even more sense to me that an across-the-board, complete overhaul approach that will cost the country money it doesn’t have and raise taxes on people during a recession is not the way to go right now. So much of that much-needed money will be wasted... money that could be circulating in the economy instead of taxed out of the pockets of hard-working Americans. Different, smarter approaches are warranted... Approaches that do not change the face of the country as we know it. I am not claiming to have the needed answers, but I am claiming that government does not have them.
Until Part 3…which I swear will be the final one.
Cheers
