(no subject)
Why I'm not excited about health care reform in a few sentences, off the top of my head without editing. (Alt Title: Having admitted a dozen kids to the hospital since midnight when I've been working since 7 am the day prior, I come home to hear health care has been fixed. Meh. Not impressed.)
Having spent the past 30 + hours working in pediatrics ward in LA County, Health Care Reform is often at the forefront of my head.
If she had insurance, this girl would have presented 5 days ago when her abdominal pain was really really bad, not today when it was so unbearable she couldn't walk or barely talk. Five days ago, she would have had a minimally complicated appendicitis. Now she has a complex perforated appendicitis requiring an extended hospital stay.
Because her family has no health care, she waited at home days longer than any reasonable mom would, praying that motrin will work...this time. But motrin didn't cure appendicitis. And now what would have been fast, cheap, safe hospitalization a few days ago becomes expensive, complicated, and dangerous.
What's wrong? You'd think I'd be jumping in excitement for this health care reform.
But this girl still won't be covered under Obama's Health Care Reform, because she is undocumented.
Estimating from the 100 or so patients I have admitted in the past few weeks on this rotation, about 30-40 of my patients wouldn't get insurance under new reform because they are kids in undocumented families. We would save money if we gave all these kiddos preventive health care and decriminalized their ability to get health and social services.
There's a group of patients I have who would be eligible for the new reforms, but lack the complicated set of skills required to figure out any health insurance paperwork. Think of the skills needed to fill out ... say... tax forms, give them to a population who at best reads at a 4th grade level, and imagine the chaos. These families are stressed by unemployment, domestic abuse, homelessness, overcrowded living conditions, mental illness. Many are in the grey zone barely keeping things together.
Individual mandates for health insurance propagate a neolibral mentality towards health that fails to address the complicated set of social and political needs of the families I see every day. These families don't have the education level, social capital, understanding, literacy, or understanding to leverage the benefits of these legal reforms. Will legal mandates to purchase insurance on a private market with subsidies, or else pay a fine, make their lives better? Unlikely.
Know what might work? Forget the health insurance companies. Forget them entirely. They are a group of technocratic institutions that do not fairly allocate health care services. They don't serve my needs as a physician, nor my nurses, nor my patients, nor our community. I would rather pay higher taxes, eliminate the bureaucratic redundancy of private health insurance companies, have money go to nonprofit or governmental agency to pay for health services provided by existing hospitals and clinics. Efficiency in scale would lead to more justice, more health, and better system overall.
Plus, abortion is treated as a contagious disease needing isolation precautions. The current reform seems like a nightmare for women and families in the making. Lets treat abortion as the procedure that nearly 1 in 2 women in America have in their lives. Oh and maybe if we provide real preventive health care for all, we would have a lower rate of unintended pregnancy.
OK: Yey for folks who will get insurance who are currently denied! Yey for doing something!
But, in summary: The new reform? Meh.
Having spent the past 30 + hours working in pediatrics ward in LA County, Health Care Reform is often at the forefront of my head.
If she had insurance, this girl would have presented 5 days ago when her abdominal pain was really really bad, not today when it was so unbearable she couldn't walk or barely talk. Five days ago, she would have had a minimally complicated appendicitis. Now she has a complex perforated appendicitis requiring an extended hospital stay.
Because her family has no health care, she waited at home days longer than any reasonable mom would, praying that motrin will work...this time. But motrin didn't cure appendicitis. And now what would have been fast, cheap, safe hospitalization a few days ago becomes expensive, complicated, and dangerous.
What's wrong? You'd think I'd be jumping in excitement for this health care reform.
But this girl still won't be covered under Obama's Health Care Reform, because she is undocumented.
Estimating from the 100 or so patients I have admitted in the past few weeks on this rotation, about 30-40 of my patients wouldn't get insurance under new reform because they are kids in undocumented families. We would save money if we gave all these kiddos preventive health care and decriminalized their ability to get health and social services.
There's a group of patients I have who would be eligible for the new reforms, but lack the complicated set of skills required to figure out any health insurance paperwork. Think of the skills needed to fill out ... say... tax forms, give them to a population who at best reads at a 4th grade level, and imagine the chaos. These families are stressed by unemployment, domestic abuse, homelessness, overcrowded living conditions, mental illness. Many are in the grey zone barely keeping things together.
Individual mandates for health insurance propagate a neolibral mentality towards health that fails to address the complicated set of social and political needs of the families I see every day. These families don't have the education level, social capital, understanding, literacy, or understanding to leverage the benefits of these legal reforms. Will legal mandates to purchase insurance on a private market with subsidies, or else pay a fine, make their lives better? Unlikely.
Know what might work? Forget the health insurance companies. Forget them entirely. They are a group of technocratic institutions that do not fairly allocate health care services. They don't serve my needs as a physician, nor my nurses, nor my patients, nor our community. I would rather pay higher taxes, eliminate the bureaucratic redundancy of private health insurance companies, have money go to nonprofit or governmental agency to pay for health services provided by existing hospitals and clinics. Efficiency in scale would lead to more justice, more health, and better system overall.
Plus, abortion is treated as a contagious disease needing isolation precautions. The current reform seems like a nightmare for women and families in the making. Lets treat abortion as the procedure that nearly 1 in 2 women in America have in their lives. Oh and maybe if we provide real preventive health care for all, we would have a lower rate of unintended pregnancy.
OK: Yey for folks who will get insurance who are currently denied! Yey for doing something!
But, in summary: The new reform? Meh.