Sorry, but there are just some things that individuals, businesses, churches, non-profits and civic organizations cannot handle. I wish it weren't so, but it is.
Some problems are just too big. Some issues demand a solution of the whole, from the whole, for the whole.
The moral dilemma is easy to outline.
Modern science can control diabetes. Modern medicine can successfully treat kidney stones, colon cancer and coronary artery disease--just to name a few of the more common maladies that need not snuff out life prematurely these days.
Not everyone can afford to pay for the treatments that can effectively address these health problems. Not everyone has insurance.
People who cannot afford the care end up in the emergency departments of our hospitals. Often these patients receive less than state-of-the-art care. Many receive stop-gap service that includes pain killers before being sent home. Others must wait in line for weeks before consulting with an appropriate specialist. Many times the treatment comes to late to save or even extend life.
The fact is if you can't pay, you don't receive equivalent care.
Is it moral for a nation to have the tools of healing, but to then apply them primarily based on income or ability of a patient to pay? Is it moral to build a healing system primarily on the back of market forces?
In our community-based clinic we see many patients who cannot pay. We treat hard working men who have been sent home from emergency rooms loaded up with antibiotics and pain killers to treat kidney stones. I recall one man who finally lost all kidney function thanks to the inadequate treatment he received only because he was poor.
Many otherwise kind individuals consider healthcare a luxury, a privilege and not a fundamental human right. I've had more than one person deliver this message in almost exactly those words. Each claimed to be a person of deep faith and serious piety.
The faith taught by the Hebrew prophets and Jesus ought to lead us in a very different direction. Their teachings have led previous generations down a completely different path, all in the name of faith.
Health, wellness and healthcare present us with huge and very expensive challenges today.
Our common challenge calls for a collective response. What is needed is an enormous new strategy. What is called for is honesty and realism. What is called for is leadership, unselfishness, community development and courage in the face of greed and discrimination.
Withholding care when it is available is not only unfair and cruel, it is immoral.
Life is a fundamental human right.
Here is a thought-provoking article about the success of socialized medicine here in the U.S.: http://slate.msn.com/id/2114554
ReplyDeleteIn Dallas there are several clinics connected to Parkland that requires no insurance or payment. You can make appointments so the wait time is not bad. I have taken several people to these clinics for appointments and the wait time was no longer then my own doctor’s office. Am I to believe this medical treatment is not available to everyone?
ReplyDeleteI saw a 7 year old child get a liver at Children's in the last 2 weeks and she has no health insurance and rcvd GREAT care.
I do not want to argue but I believe that if needed medical care can be provided to anyone and that includes the medicines.
Have I been misled?
LKM
What you say is true, but your analysis is incomplete. So, to a large extent you have been misled. For example, the appointments, how long were they made before the actual visit? What conditions were needing treatment? Specialty appointments for many conditions call for a wait of 8-10 weeks. Most people in these situations go to the ER since by law no one can be turned away without some level of attention. The case of Children's Medical Center is true and Children's writes off millions in care annually, as does Parkland. The fact is the Parkland system can handle only about 1/2 of those who are eligible for care. Medicines can be provided if persons/families are signed up for Medicare or CHIP--both programs currently on the budget chopping block. Not everyone who qualifies is on Medicaid or CHIP--the process to get on is very difficult--far from automatic. Then, there are fewer and fewer physicians who will take Medicaid or CHIP patients. We are really talking about apples and oranges here. The fact that you accompanied patients to the COPC clinic may have also been a factor in the patient's experience. Don't get me wrong, the care inside the public health system in Dallas County is wonderful. The problem is there is not enough of it to cover the need. Then we have the factor of people from outside Dallas County using the system here. There is also the matter of immigrants who don't qualify for the public system, even though Dr. Anderson has vowed to turn no one away. My day-to-day experience tells me the system is not working for everyone and it is primarily a matter of poverty, access and funds. By the way, I would be interested to know which COPC clinic you visited. The wait time you describe is really news to me as I think about my many experiences in both the clinics and the hospital. How long do you normally wait for your own doctor?
ReplyDeleteI have been to 3 clinics, the ped one on Harry Hines, several times to the Garland one on Hopkins and one to the clinic on west Moreland. The person that I took there was needing to seek medical care quickly but not an Emerg situation and when we called the clinic they called the other clinics and got us in the same day at the clinic that had an opening and it was Westmoreland. You are probably correct my doing the calling and setting up the appts. might have made a difference.
ReplyDeleteAll but one of the people had Medicaide. One did not but he was still treated with an appt and had lots of diagnostic testing. He made to much money to be on Medicaide but not enough for health insurance. That is the majority of the people I am sure you are talking about. That is who I thought the clinics were there for.
I had a foreign exchange student from Canada which has socialize medicine and his experiences with it were not positive at all.
I agree we need to get medical care to EVERYBODY and I thank you for bringing that to our attention.
LKM
I have to say I read the attachment Greg Brooks attached and I think that article was tongue in Cheek talking about socialized medicine working because the VA hospitals work so well and they are ran by the Government. He says they are doing very well. Has he ever been to a VA hospital? The ones I have been to have been horrible, not the ones that treat active duty like Balboa in San Diego they are great but the VA that treats our retired military. They are horrible. If that is the argument for socialized medicine, no thanks.
ReplyDeletelkm
Of course, the Terri Schaivo case is tragic. First, I understand that her husband spent the first five years after her injury going all over the nation seeking care to restore her life. Every reputible medical resource reached the same conclusion--vegetative state that was permanent. Second, it seems clear from a legal standpoint that Ms. Schaivo had made her personal wishes known prior to the injury--she did not want to be kept alive in the fashion that she has been. Third, politicizing her case is sad and absurd. Fourth, we have courts for the very purpose of making terribly difficult decisions like this--not legislatures. Fifth, there is rich irony in the fact that the same Congress that passed the law and the same President who signed it are also wanting to cut the Medicaid funding that pays for Ms. Schvaio's care! Finally, life as we know it today, thanks to medical science, has at times become a technicality. What is death? No brain function with no hope of recovering any qualifies to me. This is a matter for her closest family to decide--that would be Mr. Schvaio. My opinion.
ReplyDeleteThe article at Slate magazine is not tongue-in-cheek. The author refers to a 2003 study published in the New England Journal of Medicine which reported that in 2000 the VA system of care outperformed the Medicare fee-for-service system of care on 12 out of 13 quality-of-care indicators, and VA outperformed Medicare on all indicators from 1997 to 1999 (only 11 indicators were used in that period).
ReplyDeleteI'm not referring to my experience; I've never been in a VA hospital and I've never used Medicare. But the authors found that a system of government-funded health care that was administered by government employees provided better care in the period from 1997-2000 than a system of government-funded health care that was administered by private organizations and individuals.
The article at Slate magazine is a little disingenuous, I think, because the author implies that this study found the VA system to be superior to private health care at large. He actually states, "Socialized medicine has been tried in the United States, and it has proven superior to health care supplied by the private sector." While this statement is technically true, in fact the study only refers to the Medicare fee-for-service program, and not to other types of 'health care supplied by the private sector'.
Still and all, the article and the study it cites provoke me to think.
Here is the URL for the NEJM study (you have to register, but it's free): http://content.nejm.org/cgi/content/full/348/22/2218
I've read that within 5 years time, more than 50% of all Americans will be enrolled in some kind of government health care -- Medicare, CHIPS, Medicaid, VA, etc.
ReplyDeleteErgo, we already have a socialized system of medicine. The question is how to extend it to all who need care.
Interesting that just at a moment when our corporate and poltical leaders are saying we cannot afford pensions, cannot afford health care, cannot afford to build SRO's for the homeless, etc. corporate profits are at a 75 year peak. See this article from the Economist: http://tinyurl.com/4h8y5 Moreover, inequality of pay and wealth are also near a historical high: http://tinyurl.com/3oqhy
Here is data on assets by race / ethnicity: http://tinyurl.com/4u39p
It's pretty clear that we can afford to tackle all these problems, plus international poverty and disease. So long as the bulk of this wealth remains locked into the hands of a powerful few; however, the challenge will remain high indeed. If that few had vision, will and munificence, it would help. Failing that, government should tax corporations and the wealthiest stratum in particular, and then use the money to do community development and to meet other humanitarian an moral ends. Government is not some alien entity, let us recall. Nay, it is "we the people". Ideally, in a true democracy, an expression of our common will. Many of our social ills are traceable to our having bought into the notion that government is malign. That's partly where the ground must be cleared.