Health Care Rights

In a previous post I posed the question of whether or not health care is a right, but I did not include my personal opinion, so here goes… I do not agree with free health care provided by the government. There are numerous reasons why socialized medicine is a bad idea, at least in this country. Let me begin by saying that I believe the current system of health care is terribly flawed. I believe that a government system would be similar to the current system, with the only difference being that everyone would have at least basic coverage. I do not believe that universal health care would, or could provide unlimited services to everyone.

First, I do not think that non-medical personnel should be making decisions and policies about health care issues. For example, where to draw the line on treatments, what medical interventions should be provided to what groups of people, etc. With the current system, there are frequently non-medical personnel making these decisions, and the results can be frustrating for all involved, especially the person who needs the treatment. In addition to non-medical personnel making health care decisions, there is the issue of bureaucracy. Valuable dollars would inevitably be spent on managing the health care machine, which seems to be an inefficient use of resources.

I am a strong believer in that people need to be held more accountable for, well, everything. This includes their health. Part of the problem with today’s system is that millions of people are receiving costly treatments for preventable conditions, and only paying a small co-pay per visit. Having worked in health care, I have seen it over and over again. There is the person with obesity who develops diabetes, continues to eat unhealthy and not exercise, and then develops further complications. There is the person who is addicted to drugs, who is in and out of the psych hospital, and who develops medical complications from the drug use. There is the avid athlete who develops numerous orthopedic injuries and requires repeated surgeries and recovery periods in a rehabilitation hospital. I can’t help but wonder, if these individuals had to pay for all, or at least more of their health care costs, would they be more motivated to take better care of themselves?

I speak from personal experience. When I was 21 I got the flu. For years my doctor had warned that I needed to get a flu shot every year because of my asthma. Being so young, I felt invincible and ignored his advice. I had never experienced asthma symptoms that did not respond to a quick squirt from my inhaler. As I developed the flu, my respiratory status deteriorated over several days until I eventually wound up in “status asthmaticus.” I was intubated for several days, and when my mother asked if I would live, the answer was “we can’t be sure.” I eventually recovered and vowed to get a flu shot every year. That particular incident included a trip to the urgent care, two emergency room visits, one ambulance ride, one week in the ICU, and one more week in a step-down unit. The bill was in excess of $40,000. The following year, feeling invincible again, I found myself short of breath one afternoon. I drove to a nearby urgent care, and sat in the parking lot. I talked myself out of going in, not wanting the hassle of nebulizer treatments or oral steroids. Plus, I had plans for that night. Several hours later, there I was at a bull ring in San Antonio, sipping on a beer, surrounded by friends who were smoking. Later that night I found myself at Brook Army Medical Center (the nearest hospital), intubated again. This stay was only a few days, and I was discharged straight from the ICU. The bill was $10,000. In one year’s time I used more health care resources than I will probably ever pay out of pocket for in my entire lifetime, and it was all preventable had I followed my doctor’s advice of getting flu shots and staying away from asthma triggers. I acted incredibly irresponsibly.

I feel that there needs to be some level of personal accountability for use of health care resources, and financial accountability is a one place to start. Additionally, there ought to be a shift toward prevention, which is much less costly than treatment after the onset of illness or injury. Another important consideration is that the health care industry needs to move away from being for profit. Insurance companies and pharmaceutical companies make billions in profits each year while people who really need treatment suffer and even die. By eliminating the profit component, the cost of health care would inevitably be driven down.

The government can play an integral role in allowing access to health care as well as promoting wellness and prevention. Regulating the industry, particularly pharmaceuticals, would encourage more affordable health care options. Healthy living could also be promoted by subsidizing organic farms, providing tax deductions for healthy foods and gym memberships, etc. What if every tax payer had the opportunity to receive a significant deduction for maintaining good health??? This might include eating healthy foods, exercising, getting early screenings as needed, and complying with medical recommendations. Imagine if it were cheaper and more convenient to get healthy food on the go than it is to get whoppers, big macs, and french fries. Our government has the power to facilitate such things. It is up to us, however, to hold the government accountable. More importantly, however, it is up to each individual to take care of their health.

Property Taxes

The city in which I live is beautiful with perfect weather.  It is also quite backward, with corrupt politics (rampant with nepotism and a good ol’ boys club mentality), terrible public schools, and a complete lack of planning and forward thinking.  That is why I should not have been shocked to receive a property tax bill that is up 47% from last year, when market values in my neighborhood are down 10%.  I researched the tax records for my entire neighborhood, and ours is the only one that went up so much.  Most only went up 3% (there is supposed to be a 3% cap), and some even went down 5%.  I have since learned that everyone who bought a house in 2006 (that would be us) had a tax hike of nearly 50%.  Well, that makes perfect sense, now doesn’t it?  Only here, and in Alice’s Wonderland.

Birth Control

The story of schools issuing oral contraceptives to middle schoolers in Portland, Maine has been a hot topic in the media over the past several weeks. As a new parent of a baby girl, this certainly evokes strong opinions from both my husband and me. We also have the medical perspective, since we both work in health care and particularly with Darren being a physician.

In general, it is probably safe to say that “the pill” is relatively low risk. It is not completely without risk, however. One major risk is that of blood clots. I remember when I was in high school, a friend of mine was rushed to the hospital with calf pain. She did have a blood clot, which doctors said had the potential of being fatal. She was ordered to quit taking birth control pills, and informed that she should never take them again. What if she had been issued those pills without her parents’ knowledge or consent? And what if she had chosen to keep them a secret upon arrival at the hospital?

Medical risks are only one area of concern with giving children medications without parental knowledge or consent. Is it really okay for us to hand over such decisions to complete strangers? Children are not equipped to make these decisions on their own. Granted, some of them do, and some children will have sex “no matter what.” That is not the case with all children. As a society, we continue to diminish and invalidate the powerful role that parents can play in the lives of their children. We also continue to de-emphasize parental accountability. Case in point: the 10 year old boy in California who was playing with matches unsupervised, which resulted in catastrophe, death, injury, and enormous loss for thousands of people. Not once in the media have I heard mention of parental accountability in this case.

Another area of concern with schools issuing oral contraceptive is the fact that it does not protect from disease. It may protect against pregnancy, if taken correctly. Let’s be honest…how many 11 year old girls are mature and responsible enough to manage a medication regiment? And while it may be beneficial that pregnancy is avoided, what happens when she gets HIV, chlamydia, crabs, or any of the other sexually transmitted diseases?

One woman on the Portland school board who was a proponent of this bill stated that only about five girls per year were asking for birth control. Since when is legislation passed, and laws changed, in response to five pre-adolescent girls’ wishes?

The most I can say is that this is complete absurdity. Both my husband and I agree that if we lived in that school district, or if something like this were passed where we live, that we would be moving. Marina is our daughter. Not the school’s, the city’s, the county’s, the state’s, or the country’s daughter. She, her well being, and her best interest, are ultimately our responsibility.

Is health care a right?

The concept of health care as a right has become an increasingly hot topic, particularly with presidential elections around the corner. There are many legitimate arguments to be made on both sides of the fence. First, we must clarify what that question means. Does it really mean “is FREE health care a right?” When something is determined to be a “right,” does that mean it becomes the responsibility of the government to provide, uphold, and enforce that right? Rights are dynamic and subjective. Therefore, the answer will largely depend on current cultural trends.

Health care is an area that is very near and dear to my life. I have worked in health care for most of my adult life, as has my husband. I have also been a lifelong consumer of health care, including several hospital stays. Let’s assume, for the purposes of this blog entry, that we are talking about “universal health care.” That is, health care that is managed by the government, funded by tax dollars, and equally available to all citizens.

There are numerous questions to consider related to the concept of free health care as a right. Most rights have responsibility attached to them. There has been an increasing trend in this country, however, to emphasize rights while simultaneously de-emphasizing individual responsibility. When imagining a United States with universal health care, I cannot help but wonder whether there would be limits, or whether it would be an “anything goes” system.

Is it society’s responsibility to provide free health care to the drug user who has overdosed for the fifth time in her life? What about providing a free leg amputation, free prosthetic leg, and a year of free rehabilitation to the diabetic who chose not to correctly manage their disease? What about providing ongoing prescription sleep medication for the person who has a hard time falling asleep at night? Or how about providing free viagra for the man with erectile dysfunction so that his self-esteem will not be eroded?

Where should the lines be drawn, and who should be in charge of making such decisions? In this post I present questions. I am refraining from including any personal opinions, as I feel that warrants a separate post.