Getting Active - Politically

I hesitate to post this next entry because I know not everyone will be happy to read it. You can either ignore it, or let me know how you feel. But to me, there is no middle ground to be found. As long as people are falling into the fissure that this middle ground has become, there is none.

We see mostly insured people in our practice. They either have Medicare, some form of medical assistance, or commercial insurance. Part of my job is to check each patient's eligibility before their upcoming appointment. Most of the time, everything is fine. I don't even have to bother checking Medicare eligibility, since everyone over 65 is eligible. Once I find a patient, usually using an insurance company's online website, I check them off my list and go on to the next patient. But sometimes there's more to the story.

What if a patient "has" insurance, but has a huge deductible? What if a patient "has" insurance, but no mental health coverage? What if the patient is responsible for supporting a family? And what happens when that patient becomes depressed, through no fault of his/her own? They fall into a crack...

A patient "has" insurance but just barely. What happens when this patient who is trying desperately to get over a drug dependency loses employment? The patient has successfully kicked the habit; the job was lost through company downsizing. The health insurance can be continued through COBRA, but the premiums are becoming too much for the meager unemployment to pay for. The patient doesn't know how much longer they can continue paying. Maybe another job will come through, but it's a toss-up whether the new company's insurance will cover the patient, given the "pre-existing condition."

Those patients "have" insurance. What  happens when a man is found on the street and brought into our practice, found to have a horribly debilitating chronic condition, but has no health insurance at all? What happens when he is taken care of initially, sets out to get the medical assistance that he surely qualifies for, applies for it, but then finds out that it's going to take 4 months to get the card? (Hint: he died. Another hint: Poor people have pride too. They don't want to come if they can't take care of their bill).

These are three typical scenarios that play over and over again in some form at our little family practice office every week. Today our government will try to come to some resolution over the healthcare reform bill. I don't have a lot of confidence that the bill they come up with is going to help our patients. It will require that more people buy insurance. If "having" insurance can yield the results we see, it doesn't seem like such a bargain. 


Think of yourself. You may be covered by a great plan by your employer. Next time you get your paystub, look at how much your employer is paying for your coverage, and add in what you contribute. Try to imagine paying that whole thing yourself, especially if you were to lose your job (God forbid).  What is your biggest health problem? What if you found out your insurance company wouldn't pay for it?


Until we are willing to stand in each other's shoes, and agree that we are here to take care of each other, nothing meaningful is going to happen with healthcare reform. I like to compare the right to healthcare to education. As a nation, we have agreed, more or less, that every single child in our country should be educated through the 12th grade. We test our kids to make sure they're learning at least the minimum required. This is good for the whole country, and we are mostly happy to pay the taxes that make it possible. Imagine if families had to pay tuition? I think we'd be a pretty sorry country. And I think, as far as healthcare is concerned, we are currently a pretty sorry country. Having healthy citizens is good for the whole country, and I personally would be happy to pay the taxes to make sure we were all healthy. Of course, this would be in lieu of the $600 a month I'm currently paying for my family's  health insurance, so I would probably not even notice it. 


Something has got to give.