Since the passage of the health care reform bill, I've heard lots of talk about personal freedoms and how they're being infringed, often with an admonishment that "This is America, you have to work for what you get!" which distinctly implies personal responsibility, in my opinion. As the argument goes, the requirement to buy insurance or face financial consequences directly goes against one's personal freedom. Most states also require the buying of auto insurance in order to legally drive, but no one claims that to be an abridging of personal freedom, at least no one that I know of in their right mind. Left mind, maybe.
This is an imperfect analogy, I realize, because driving a vehicle is not required to live. It is, in itself, a right that is balanced with a responsibility, and that makes sense to most people in the US. If you don't want to buy auto insurance, then don't drive. Simple, in theory if not in practice in many parts of our country. But I'm not writing this to discuss public transit, I'm writing about health care, so I digress.
What seems to be left out in the current discussion is the existence of EMTALA, the Emergency Medical Transportation and Active Labor Act. This act requires a hospital to provide emergency and stabilizing care regardless of insurance or ability to pay. If you present with an emergency situation, the hospital must stabilize you (and active labor is considered an emergency under this law) FIRST, then they can worry about how or if you are going to pay.
What EMTALA does is give you the patient the right to prompt, life saving care, without the wait to check your financial or insurance status. But this right is balanced by nothing on your part. In my opinion, the health care reform law balances EMTALA by giving patients the responsibility to attempt to take care of themselves financially by having health insurance. We do have the option of balancing the equation by taking away EMTALA, but I don't want to be the one to explain to a laboring woman or a man having a heart attack "Please wait here while we check if you have insurance or can otherwise pay for our services".
Essentially, when faced with the choice between personal responsibility and social responsibility in the United States, we have chosen personal responsibility. We provide *very* little social support system, on the basis of the Protestant Work Ethic where one works for what they have, and gets what they earn. However, we require emergency medical care to be provided outside of this framework and without regard to payment ability. If we put that responsibility onto hospitals, then we need to have patients bear some responsibility as well, and that responsibility on patients is health insurance. No other profession is required to provide services in this manner.
Aside from revoking EMTALA, the only other viable option we have is single-payer health care like most other developed nations. Our choice really comes down to 1) do we want to be a civilized nation that values life, or 2) do we want everything including health care to be based upon the system of desert and assert ourselves finally and irrevocably as a country that values money.
Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts
Thursday, March 25, 2010
Monday, March 22, 2010
Broader Reach
It has of late come to the forefront of my attention exactly how much our perception of one thing can influence our evaluation of something completely different. I am as guilty of this as anyone, although I try my utmost to avoid this contamination of prejudice. Kind of like an extended negative association. Negative association is the psychological phenomenon that lead Watson to seriously damage little Albert by connecting in his mind negative consequences (in this case fear caused by a loud noise) with a benign object, in this case white fur. The child was so traumatized that the child couldn't be approached by women in fur coats for years after the experiments, so the historical story goes.
Likewise, if you are highly opposed to supplements, then you may extrapolate that dislike to other things associated with supplements, even simply items in the same aisle of the grocer's as supplements- energy drinks, Ensure-like supplements, Emergen-C, air-sickness bands, or Ora-Gel for example. There's nothing that inherently links these items other than there placement in a store, but that association with supplements creates a dislike towards the other items. That's not to say there isn't a reason to dislike some of these things; supplements especially have questionable contents, little to no regulation and are far over-marketed.Our minds play funny tricks like that. Similarly, a bad experience with Aunt Edna's* latest "low-fat, low-sugar, high-fiber" recipe may be so bad as to turn a person off any food that claims to be "healthier" or "natural".
The worst thing that I can think about in regards to this scenario is when the phenomenon leads to discrimination against a group of people. This week, it appears that our Congress will debate and possibly vote upon the biggest health care reform legislation since the creation of Medicare/Medicaid. This possibility has created serious tensions and much backlash, especially from those in the Tea Party movement. Reports in my state's capitol of Columbus this week included the heckling and harassment of a peaceful pro-health care reform protester who happened to also have a disability. The Tea Partiers went so far as to throw money at this man, and proclaim such things as "I'll decide when you get money" and "There's no handouts here- you have to work for what you get." These were not illiterate high school drop outs, either, but instead well-dressed, professional looking individuals. In our country's capitol, there were ethnic, racial, and sexual orientation slurs thrown about, and spittle hurled at some of our members of Congress.
What madness has possessed people to sink to such blatant straw-man attacks rather than discuss the merits and drawbacks of the legislation at hand? It hurts to see humanity sink to this level. It hurts more to see this happen in my own country, and my own time. This is not the Spanish inquisition. This is not Selma, Alabama in the 1960's. This is not the McCarthy hearings of the 1950's. This is 2010, in the United States- a country founded by rational thinkers of the Enlightenment period.
*For the record, I have no Aunt Edna of which I know. There might be a great-aunt with that name somewhere, but no aunt, so I'm not actually libeling anyone. :)
Likewise, if you are highly opposed to supplements, then you may extrapolate that dislike to other things associated with supplements, even simply items in the same aisle of the grocer's as supplements- energy drinks, Ensure-like supplements, Emergen-C, air-sickness bands, or Ora-Gel for example. There's nothing that inherently links these items other than there placement in a store, but that association with supplements creates a dislike towards the other items. That's not to say there isn't a reason to dislike some of these things; supplements especially have questionable contents, little to no regulation and are far over-marketed.Our minds play funny tricks like that. Similarly, a bad experience with Aunt Edna's* latest "low-fat, low-sugar, high-fiber" recipe may be so bad as to turn a person off any food that claims to be "healthier" or "natural".
The worst thing that I can think about in regards to this scenario is when the phenomenon leads to discrimination against a group of people. This week, it appears that our Congress will debate and possibly vote upon the biggest health care reform legislation since the creation of Medicare/Medicaid. This possibility has created serious tensions and much backlash, especially from those in the Tea Party movement. Reports in my state's capitol of Columbus this week included the heckling and harassment of a peaceful pro-health care reform protester who happened to also have a disability. The Tea Partiers went so far as to throw money at this man, and proclaim such things as "I'll decide when you get money" and "There's no handouts here- you have to work for what you get." These were not illiterate high school drop outs, either, but instead well-dressed, professional looking individuals. In our country's capitol, there were ethnic, racial, and sexual orientation slurs thrown about, and spittle hurled at some of our members of Congress.
What madness has possessed people to sink to such blatant straw-man attacks rather than discuss the merits and drawbacks of the legislation at hand? It hurts to see humanity sink to this level. It hurts more to see this happen in my own country, and my own time. This is not the Spanish inquisition. This is not Selma, Alabama in the 1960's. This is not the McCarthy hearings of the 1950's. This is 2010, in the United States- a country founded by rational thinkers of the Enlightenment period.
*For the record, I have no Aunt Edna of which I know. There might be a great-aunt with that name somewhere, but no aunt, so I'm not actually libeling anyone. :)
Tuesday, December 22, 2009
Bugs and Germs
Germs really bug me. I have to say it. Not themselves, mind you, but more people's reactions to germs. Like this year, with the H1N1 scare on top of the usual seasonal bug issues. Germophobia is running rampant, and it's getting out of control.
According to the CDC, as of November 14th 2009 there were between 7,070 and 13,930 deaths from H1N1 in the 7 months since it started showing up. Nothing to sneeze at, granted, but in a similar time frame over 70,000 deaths due to a stroke occur (from the CDC also). My point is, there are bigger issues to be worried about than novel H1N1.
And yet, it's become a perfectly good reason to act rude and treat humans as walking germs. This week especially, I've had the wonderful experience of having some customer service person see me waiting, look me in the eye, stop, incessantly slather their hands in Purell, and then finally address me. Because, yes, I am obviously a walking, talking, culture of H1N1 or some other bug du jour. Thanks. There's cleanliness and hygiene, but for freaking sake there's also courtesy. I am not sneezing. I am not coughing. I do not have oozing pustules. My eyes are not watering, red, puffy, blood-shot or anything out of the ordinary. I even bathed today. So can everyone please stop acting like they're going to die if they touch anything I've had in contact with me.
I think we have to fear this current fanaticism of physical seclusion far more than any influenza.
Oh, and a belated blessed Solstice! May the new solar year bring many great things!
According to the CDC, as of November 14th 2009 there were between 7,070 and 13,930 deaths from H1N1 in the 7 months since it started showing up. Nothing to sneeze at, granted, but in a similar time frame over 70,000 deaths due to a stroke occur (from the CDC also). My point is, there are bigger issues to be worried about than novel H1N1.
And yet, it's become a perfectly good reason to act rude and treat humans as walking germs. This week especially, I've had the wonderful experience of having some customer service person see me waiting, look me in the eye, stop, incessantly slather their hands in Purell, and then finally address me. Because, yes, I am obviously a walking, talking, culture of H1N1 or some other bug du jour. Thanks. There's cleanliness and hygiene, but for freaking sake there's also courtesy. I am not sneezing. I am not coughing. I do not have oozing pustules. My eyes are not watering, red, puffy, blood-shot or anything out of the ordinary. I even bathed today. So can everyone please stop acting like they're going to die if they touch anything I've had in contact with me.
I think we have to fear this current fanaticism of physical seclusion far more than any influenza.
Oh, and a belated blessed Solstice! May the new solar year bring many great things!
Friday, July 10, 2009
Thoughts on shrinkage
More on health care reform, so if you don't want to hear it- this is your warning.
Right now, there's a lot of talk about rationing of health care. Not in any positive way, more as a threat. "If the government gets involved with health care, they'll ration it!" And I have to wonder about this. What does it mean to ration health care? The talk I hear from so many of the proclaimers that the government will ration seems to revolve around long waits, and some procedures being denied to people. They cite Canadians coming to the US for cosmetic surgery as a result of rationing in Canada.
But what about the insurance company that denies a claim to an insured person? Isn't that rationing, just after the fact? Only now, the person has had the medical procedure, and owes the bills, that they had been expecting to be paid. What about insurance companies refusing to cover individuals due to pre-existing conditions? Isn't that rationing of insurance? And doctors that won't take Medicare or Medicaid patients?
Wake up, people, we already have rationing of health care. I highly doubt a public option or single payer plan could ration medical procedures much more. As for long wait times for cosmetic surgery or elective procedures- why not? Shouldn't resources first be put into necessary treatments, before electives? Should any procedure be available to any person just because they want it and have the money for it?
Gah. This world is up side down some times.
Right now, there's a lot of talk about rationing of health care. Not in any positive way, more as a threat. "If the government gets involved with health care, they'll ration it!" And I have to wonder about this. What does it mean to ration health care? The talk I hear from so many of the proclaimers that the government will ration seems to revolve around long waits, and some procedures being denied to people. They cite Canadians coming to the US for cosmetic surgery as a result of rationing in Canada.
But what about the insurance company that denies a claim to an insured person? Isn't that rationing, just after the fact? Only now, the person has had the medical procedure, and owes the bills, that they had been expecting to be paid. What about insurance companies refusing to cover individuals due to pre-existing conditions? Isn't that rationing of insurance? And doctors that won't take Medicare or Medicaid patients?
Wake up, people, we already have rationing of health care. I highly doubt a public option or single payer plan could ration medical procedures much more. As for long wait times for cosmetic surgery or elective procedures- why not? Shouldn't resources first be put into necessary treatments, before electives? Should any procedure be available to any person just because they want it and have the money for it?
Gah. This world is up side down some times.
Tuesday, July 7, 2009
A little bit of frustration
There's a lot of talk concerning health care reform going on in the world right now. I'm happy about that. I like the discussion that is happening. I like that people are thinking in new ways. I think the cooperative effort that we're seeing is what is needed in this world.
I don't like the push back from the status quo.
Currently, the health care industry is spending around one and a half million dollars *per day* just in extra lobbying efforts against real health care reform. That's not counting the regular lobbying they do, or the direct to consumer marketing, or all the perks and schmoozing that they keep with in their little group (like a drug company sponsoring resort conferences for doctors, e.g). And then there's the huge waste in other areas of medicine, like the 25-30 cents on the dollar that insurance companies spend on administrative costs. I know there's plenty to complain about in government waste, but when the government medical plans spend 12-15% in administrative costs, I think we need to applaud them and try to get business to follow the government's model a bit closer. And for the sake of my blood pressure, I won't even start talking about executive pay and what utter BS that expenditure has become.
Why is it that some people feel their right to profits exceeds the US citizens' right to affordable, accessible health care? Why do we feel that free market capitalism is the be-all, end-all of quality and wonderfulness? Especially when of late, we have seen exactly how horribly it can fail.
There are just some areas that should not be left to self-indulgent, profiteering entrepreneurs. Some aspects of our economy are too important to let greed ruin them. Every once in a while, we realize that people have rights too. Not just the right to make a profit, but the right to a basic education, health care, safe housing, adequate food, and a clean environment. Those things aren't luxuries, although there are plenty in the US that appear to think they are. Unfortunately, in our current system, there are far too many people for whom those things are luxuries; ones they can't afford.
For those people, I'll do some kicking and screaming. I'll make my voice heard in support of them, help them make a louder noise, or any noise at all. I'm OK with being a thorn in someone's side for them. Because I have been one of them. I come from them. I know them, love them, and see them every day. Not just in the abstract, but as family and friends. I am them. Admit it, you know them too. We all do. So let's fight with them, and when they can't fight, let's fight for them. "There but for fortune, go you or go I" is a song lyric that I love. It's true. We can make all the noise we want about self-made people, or hard work, or any of the other euphemisms for "you get what you deserve." But none of that is true, and I think deep down we know it. The US is full of luck- good and ill. Some people get good luck that don't deserve it, and others that deserve better get crappy luck. But we all deserve these basics.
Remember two other phrases, if you could. "It rains on the deserving and the undeserving equally" and "A society is judged by how it treats the least among it." Let's start showing the world that US should be judged positively, eh?
Oh, and vote for Haymaker!
I don't like the push back from the status quo.
Currently, the health care industry is spending around one and a half million dollars *per day* just in extra lobbying efforts against real health care reform. That's not counting the regular lobbying they do, or the direct to consumer marketing, or all the perks and schmoozing that they keep with in their little group (like a drug company sponsoring resort conferences for doctors, e.g). And then there's the huge waste in other areas of medicine, like the 25-30 cents on the dollar that insurance companies spend on administrative costs. I know there's plenty to complain about in government waste, but when the government medical plans spend 12-15% in administrative costs, I think we need to applaud them and try to get business to follow the government's model a bit closer. And for the sake of my blood pressure, I won't even start talking about executive pay and what utter BS that expenditure has become.
Why is it that some people feel their right to profits exceeds the US citizens' right to affordable, accessible health care? Why do we feel that free market capitalism is the be-all, end-all of quality and wonderfulness? Especially when of late, we have seen exactly how horribly it can fail.
There are just some areas that should not be left to self-indulgent, profiteering entrepreneurs. Some aspects of our economy are too important to let greed ruin them. Every once in a while, we realize that people have rights too. Not just the right to make a profit, but the right to a basic education, health care, safe housing, adequate food, and a clean environment. Those things aren't luxuries, although there are plenty in the US that appear to think they are. Unfortunately, in our current system, there are far too many people for whom those things are luxuries; ones they can't afford.
For those people, I'll do some kicking and screaming. I'll make my voice heard in support of them, help them make a louder noise, or any noise at all. I'm OK with being a thorn in someone's side for them. Because I have been one of them. I come from them. I know them, love them, and see them every day. Not just in the abstract, but as family and friends. I am them. Admit it, you know them too. We all do. So let's fight with them, and when they can't fight, let's fight for them. "There but for fortune, go you or go I" is a song lyric that I love. It's true. We can make all the noise we want about self-made people, or hard work, or any of the other euphemisms for "you get what you deserve." But none of that is true, and I think deep down we know it. The US is full of luck- good and ill. Some people get good luck that don't deserve it, and others that deserve better get crappy luck. But we all deserve these basics.
Remember two other phrases, if you could. "It rains on the deserving and the undeserving equally" and "A society is judged by how it treats the least among it." Let's start showing the world that US should be judged positively, eh?
Oh, and vote for Haymaker!
Subscribe to:
Posts (Atom)