Last week, I sent the following letter to the editor of the Florida Times Union, Jacksonville's newspaper. It appeared in the paper August 22, 2012. Although it makes a case for having health insurance, its most important aspect in this blog is to point out another Red Flag, one I had not foreseen, have never seen before, or put in my book. I don't have a preference as to how everyone gets health care, just that they get it. (Romney's plan in Massachusetts or Obama's plan for the country aren't that different, and there may be others that work better.) There is no reason for anyone to die of a preventable or treatable disease in the United States. I admit, none of us are going to live forever, so the care of terminally ill people needs to be addressed. Those expenses shouldn't bankrupt the country, but preventive care, vaccines, and treatment for significant illnesses and trauma need to be taken care of in order to prevent the premature death of individuals.
Letter to the editor, Florida Times Union:
Dear Sir;
The following is a case for the Affordable Health Care Act.
I am a physician. I work in an urgent care in Jacksonville part-time. A patient came in complaining of back pain for a week after working on a friend’s car. This 48 year old gentleman is normally an auto mechanic, but has been out of work and is uninsured. He paid the urgent care fees out of his pocket – about $85 for the visit.
His story was a little unusual in that his pain was so bad that his legs buckled three times in the previous week and he had fallen to the ground. I am usually very skeptical of patients complaining of back pain because of previous patients who have been drug seeking. However, his pain was new, not chronic. As part of my back pain exam, I look for aortic aneurysms by checking for aortic and femoral pulses. He had neither. Neither did he have pulses in any other place I checked on his legs or feet.
I did not know the exact source of his back pain, but there was a good chance he had obstructed his aorta, which can be fatal. The patient needed an MRI or other imaging to determine why he had no pulses. I sent him to an ER in Jacksonville and I called the physician there to tell him he was coming. They did the MRI and determined he had a large blood clot in his aorta. Then they told the patient he needed surgery and discharged him. When he balked at leaving the hospital with a potentially fatal medical problem, someone on staff allegedly told him, ‘You would not put a transmission in someone’s car unless he paid you, would you?’
Fortunately, the patient’s family took him directly to Shands Hospital, where he underwent a 7 hour surgery and had the blood clot removed. His prognosis is good. He will not be paralyzed; his kidneys continue to function, and he will eventually return to being a productive member of society.
A 48 year old man should not die of a surgically treatable medical problem. As a tax-payer, I am going to pay several times for his care, because it took two ER visits (they sent him to the fast track and tried to discharge him with pain medication when he first went to the hospital) and two hospital admissions, emergency surgery, and recovery. If he had become paralyzed or his kidneys had shut down, tax-payers would be supporting him for the rest of his life. Of course, it would have been cheaper if he had had the common sense to just die.
Under the Affordable Health Care Act, this man would have had insurance and probably a primary care physician. He would not have been discharged untreated. His surgery might have been unnecessary or if not unnecessary, maybe elective and not emergent. This will be a more efficient system and overall will cost the taxpayer less. Also it tells the medical providers that the days of unlimited greed are over, which will also lower costs. Maybe if we get rid of some hospital, insurance, and HMO CEOS who make multiple millions of dollars while auto mechanics die, people’s perspective on medical care will change. We all are entitled to Life, Liberty, and the Pursuit of Happiness. I think Life includes treatment for medical problems.
Update: September 4, 2012
After several replies on the Times-Union web site suggested that the patient was at fault for not having health insurance, I responded with this:
I guess I didn’t get my point across. Preventive medicine saves a lot of money. Going to the ER to have delayed definitive care when you could have prevented the problem (in this case a hypercoagulable state that led to the blood cot – which still needs to be addressed and treated in this patient) is way too expensive. This whole problem might have been prevented by taking an aspirin per day, pennies versus thousands of dollars. With 50 million people without health insurance and avoiding doctor visits and preventive care, you end up with millions of diabetics, hypertensives, and others who then go on to have very expensive strokes, heart attacks, cancer, etc. Taxpayers support all these people through Medicare, SSI, Medicaid, and other programs. And people with health insurance pay much higher premiums to cover losses generated by the uninsured. These problems are much easier and less expensive to treat early rather than later. When 1/6th of the nation is without health care, and people die from preventable or treatable diseases, something is out of whack. This is not a third world country; in fact it is the richest country in the world.
I don't have a preference as to how everyone gets health care, just that they get it and preferably before it is the expensive, last ditch version. (Romney's plan in Massachusetts or Obama's plan for the country aren't that different, and there may be other plans that work better and less expensively.) There is no reason for anyone to die of a preventable or treatable disease in the United States. I admit none of us are going to live forever so the care of terminally ill people needs to be addressed. Those expenses should not be allowed to bankrupt the country. Preventive care, vaccines, and treatment for significant illnesses and trauma are relatively inexpensive and need to be taken care of in order to prevent the premature death of individuals.
Who among you would condemn a teenager to death because he chose to ride a motorcycle, or chose to ride a bicycle without a helmet? Didn't wear her seat belt? An unemployed adult who chooses to feed his family or pay rent instead of buy health insurance? It happens too often. People sometimes make bad choices or have bad gambles forced upon them by circumstances beyond their control.
We have the best medicine in the world, and the worst delivery system.
Update: September 4, 2012
After several replies on the Times-Union web site suggested that the patient was at fault for not having health insurance, I responded with this:
I guess I didn’t get my point across. Preventive medicine saves a lot of money. Going to the ER to have delayed definitive care when you could have prevented the problem (in this case a hypercoagulable state that led to the blood cot – which still needs to be addressed and treated in this patient) is way too expensive. This whole problem might have been prevented by taking an aspirin per day, pennies versus thousands of dollars. With 50 million people without health insurance and avoiding doctor visits and preventive care, you end up with millions of diabetics, hypertensives, and others who then go on to have very expensive strokes, heart attacks, cancer, etc. Taxpayers support all these people through Medicare, SSI, Medicaid, and other programs. And people with health insurance pay much higher premiums to cover losses generated by the uninsured. These problems are much easier and less expensive to treat early rather than later. When 1/6th of the nation is without health care, and people die from preventable or treatable diseases, something is out of whack. This is not a third world country; in fact it is the richest country in the world.
I don't have a preference as to how everyone gets health care, just that they get it and preferably before it is the expensive, last ditch version. (Romney's plan in Massachusetts or Obama's plan for the country aren't that different, and there may be other plans that work better and less expensively.) There is no reason for anyone to die of a preventable or treatable disease in the United States. I admit none of us are going to live forever so the care of terminally ill people needs to be addressed. Those expenses should not be allowed to bankrupt the country. Preventive care, vaccines, and treatment for significant illnesses and trauma are relatively inexpensive and need to be taken care of in order to prevent the premature death of individuals.
Who among you would condemn a teenager to death because he chose to ride a motorcycle, or chose to ride a bicycle without a helmet? Didn't wear her seat belt? An unemployed adult who chooses to feed his family or pay rent instead of buy health insurance? It happens too often. People sometimes make bad choices or have bad gambles forced upon them by circumstances beyond their control.
We have the best medicine in the world, and the worst delivery system.
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