Saturday, November 19, 2011

You Have Already Paid!

Let's understand that we already are paying for those patients who have no health insurance and because they have no insurance, and have most likely not seen a physician for years, we are probably paying more for their care than we will under President Obama's Affordable Care Act. How could this be, you may ask?

Let's just consider a 57 yr old man who has not had health insurance for several years either because he is independently employed or because his employer has not given him sufficient hours to qualify for health benefits. He has not had the money to pay out of pocket to receive any routine care. Previously, when he he was able to afford insurance, he was being treated for hypertension and diabetes. 

Now he develops an acute chest pain and calls 911 and is taken to the emergency of the closest hospital. It is very likely, that he is in this situation in part because his blood pressure  and diabetes are completely uncontrolled and have been since he was last able to see a doctor - five or sic years ago.

He is admitted to the coronary care unit with an acute coronary syndrome. Cardiac cathiterzation is done and he is taken for  emergency coronary by-pass surgery. After five days in the surgical intensive care unit he is transferred to a step down unit and discharged three days later. He leaves the hospital with blood pressure, cholesterol, and anti platelet medications with a bill of $75,000.

Someone has to pay. It may be 'free' to the patient, but the hospital will not absorb this charge. The hospital will look to the city, county, state  to offset the charges. The city, county and state will then ook to their constituents for these funds and this is called taxes in some form or another.

Under the President's plan should this same patient get admitted to the hospital with the identical symptoms and problems, the same treatment would be given and the charges would also be $55,000. The only thing that would change is that the federal government would pay. How does the federal government obtain the money to pay? It collects taxes.

The care administered to the patient does not impact on the care available to  you. You will not pay more for this care, in fact you may pay less, because under the President's plan the patient will have insurance that will allow him  to receive ambulatory care to control the patient's risk factors and therefore reduce the chances of the patient requiring emergency cardiac by-pass surgery.

So let's understand that already, before the President's reforms go into effect,  everyone with health insurance is already paying for the hospital care of those without insurance. Let's understand that the impact on those with insurance of caring for those without health insurance is already occurring because the care is already given.

It is not an issue of paying more or getting less. Let's be honest with ourselves.

Oh, and if you say that you do not want to pay taxes to our cities, counties and states so they can pay for the care of the uninsured, think again. The hospital will still deliver  the care, at least until they have no funds and can no longer remain open. Then when it comes your time to need the hospital, it will not be there and you may have to travel longer distances to receive your own emergency care. It may take longer to get to the hospital and this may just be too long for your heart to "hold on" until the doctors and nurses can start caring for you. In the extra time it takes to get to the emergency room, your heart vessels may progress from partial to complete closure and you may not be able to benefit from bypass surgery.  Distance is time and time is critical in emergency - do you really want to even think about being in that position? 

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