Saturday, September 22, 2007

Health care - a right or a privilege?

When a person becomes injured or ill, how is their ability to heal enhanced or harmed by their personal status? If they are wealthy, if they have status in the community, if they are rallied about by well-wishers? And for those who have a base of support, whether financial, social, or both, what is the influence of this support?

When an NFL player is injured, is it any more different than if a young man in a similar situation is injured? If someone has insurance and a way to navigate the health care system, does that mean that he or she is a "better person"?

I have found it amazing in the past several years to look at healthcare disparities. As a society, we value health more as an afterthought. You don't typically appreciate it until it is gone or diminished.

The injured young man is in my prayers, and I truly hope that he makes a wonderful recovery. But whenever I see an article like this, I wonder about the thousands like him who don't have insurance or a way to navigate the health care system.

Ever since my father's injury, I've thought more and more about what would have happened "if". My father had car insurance and good health insurance. My uncle has been providing some economic support. I've tried to provide guidance from afar and because of my work I was able to get things in motion for a possible transfer to a rehabilitation facility that was not considered an option by his hospital.

My dad has received good care in a good hospital, although I wonder at times if he is receiving the best care considering his age. Is he being written off because he is almost 64? One of the docs didn't want to refer him to rehab because he thinks that it isn't worth it. I wouldn't know that comment if I didn't hear it from a friend who is involved in the rehab transfer game. The funny thing? The doc who made the comment isn't in physical medicine and didn't provide a referral to physical medicine. It would be like a pediatrician treating infertility. Yes, there is some overlap and yes, it is medical knowledge, but I would rather hear the information from a specialist.

No matter what anyone says, agism, racism, classism all exists in medical facilities. I have seen people treated abysmally for being poor or being very young parents or having no insurance. I have seen people with Medicaid struggle to find a pediatrician who will see their infant after discharge, because so few doctors take it anymore. I have heard about people without insurance who have to wait in a clinic all day because they don't make appointments. You have to sit until your name is called. Kind of hard to hold a job like that, isn't it?

Insurance is great and everyone should have access to it. I am not advocating a universal plan like Canada or Great Britain - those have their short sides and the American insured public won't settle for longer waiting times for necessary treatments. But why can't we have some sort of system for those falling through the cracks? And why do we treat people differently because their insurance comes from Medicaid instead of a private source? As a nurse, I didn't get paid any differently if the people I worked with were rich or poor. But I saw people clamor to care for the rich babies. Why?

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