Is health care a privilege you earn or is it a right?
There has been a lot of talk about ObamaCare, Medicare, Medicaid, insurance and other ways we pay for medical care. What there has not been is talk about our values and ethics.
Is it OK to let someone die because they are not insured? A Harvard Health study estimates that 45,000 people die each year because they are not adequately insured. Is it OK to have to declare bankruptcy due to medical illness? A study by the American Journal of Medicine estimates that 62 percent of bankruptcies are due to medical illness and 75 percent of those people had insurance. Is it OK to have the emergency room be the only care available to millions of people? Currently 50 million people do not have insurance, that is 16 percent of the population and many more are underinsured or have interrupted insurance.
I work as a family practice physician in the front lines of medicine. I see the result of our ambiguity daily. Currently 84 percent of health care costs are due to chronic conditions: diabetes, heart disease, cancer, arthritis, asthma etc. The Robert Wood Johnson Foundation notes that half of the population has a chronic condition.
Chronic medical conditions cannot be treated in the emergency room, managed by ignoring the problem or intermittently treated due to intermittent insurance. It does not work to ignore hypertension until someone has a stroke. Chronic medical conditions are best managed in a clinic with a primary-care doctor with whom you have a long-term relationship.
I believe medical care is a right that a civilized country provides its citizens. I do not think that medical care is something you deserve if you are lucky enough to work for the right employer.
Perhaps if we start from the proposition that medical care is a right, we can design a better, smarter and more effective health care system. Perhaps we can invest in more research for diabetes, Alzheimer’s, autism, cancer and other diseases that are incredibly expensive to treat. Perhaps we can invest in better public health, including support to help people make healthier choices. Perhaps we can address our problems together as a country that cares about all its citizens.
Karen Hulstrand, M.D.