Health Care as a Commodity

National Public Radio (NPR) is featuring a series on health care systems around the world. Today's segment, which I listen to as I drive home from work, is about how health care is rationed in Britain in order to afford universal coverage. The interviewee, Sir Michael Rawlins, Chairman of the National Institute for Health and Clinical Excellence comments,

"And we, in Britain, as in most of Europe, actually, have a health care system, based on a principle of social solidarity, that we look after each other in times when we’re sick. And that’s very precious to us. And I think that’s what we find so difficult to understand about your health care system (in
America). You don’t have that."

I agree.

Why don't we have a system of social solidarity? Why don't we look after each other more when we're sick? And why isn't this precious to American society?

Is it greed?

Is it because we treat health care as a commodity?

If you've got deep pockets, you can buy some. If not...well...too bad for you and your children. Do without. Sorry.

Well, the difference is we're not talking about buying a new car here. We are talking about access to a quality service that has the potential of preserving life!

Does my life have a price point? What is it?

I personally struggle with the reality that throughout much of human history, human life has been regarded as cheap. Even expendable. In fact, even today, in many parts of the world, it still is. Somehow though, post-World War II, I thought our country was different. This is the United States of America, by God! I grew up with the Declaration of Independence etched in my brain:

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness."

Life? Could that be construed to suggest that we are entitled to the security of knowing we have access to life-preserving health care if we need it? Is health care an unalienable right endowed by our Creator that our government assures us?

Hubert H. Humphrey once defined the moral test of a government as:

"how that government treats those who are in the dawn of life- the children, those who are in the twilight of life-the elderly, those who are in the shadows of life-the sick, handicapped, and the needy. "

Who are the needy?

With the way our health care system is sucking the life blood out of the working family with its crushingly high premiums, 5-figure deductibles and $100+ medications, the needy is now the middle class...the heart of American society.

Today that heart is broken.

Today would our government pass Hubert Humphrey's moral test?

Medicarelessness

Today our R.N., who cares for all our patients as if they're her own family members, reached into her purse and handed me her personal VISA card. Out of frustration, she decided to pay for a patient's Plavix because he's run out of pills and he's run out of money...and Medicare won't pay for his meds now. Remember that darn Medicare doughnut hole? The one you sink or swim in when you've spent x-amount of dollars on medications in a given year? When it's your time to swim in the doughnut hole, you have to pay 100% out-of-pocket for awhile. Otherwise, you sink.

Sammy, who has been a patient of ours for 30 years, is in his 60's. He lives with his mom, Gladdy, who is in her 90's. She keeps calling us crying because she can't find a way to pay for Sammy's pills. Safeway Pharmacy already called us that he owes them $400. Who knew Safeway took pity on poor people and allowed them some slack paying for their meds. Sammy is out of slack. The R.N. is desperate to find him some medication. She calls his cardiologist and begs for samples. (They’re rationing.) They reluctantly allow one week's worth. They, in turn, promise to apply for Plavix assistance through the generous folks at Bristol Myers. I agree to try to apply for emergency assistance from Medicare...on Monday.

I take the R.N.'s VISA card and click on the link to my favorite Canadian pharmacy and order 3 months worth of Clopidogrel, generic Plavix, which isn't even available in the United States. It's $77.00. In the U.S., the brand name stuff would have cost Sammy about $270. Eventually, the medical practice will end up reimbursing the R.N. and paying for Sammy's Clopidogrel because we don't want him to die.

Lately, we've been paying for some patient lab tests and not charging the health care workers who come in to see us because they work hard and take care of our patients in the nursing homes. Most of them are overworked, underpaid, and underinsured. So, we try to take care of them when they ask, so they are healthy enough to take care of our Medicare and Medicaid patients who reside in those pathetic warehouses that you never want to send your family member to if you can possibly avoid it.

Anyhow, Sammy needs more than Plavix. His mother needs her medications too.

There are a lot of Sammy's and Gladdy's now. Many are just not getting their medications...and ending up in the E.R., where they get meds for a while and recover, which Medicare will pay for. Then they're discharged.

Once back home, some still won't have found a way to pay for their medications and will just sink down into the doughnut hole...never to come up.

MediCARE? or Medicarelessness?