Working in the deparment of public health, i come across the inadequacies of our current healthcare system on a daily basis. It is very frustrating, and occasionally freightening from a family medicine physician's perspective. One of the reasons that i am so excited about this new healthcare reform bill is because of its improved affordability -- that means more of my patients can afford care, and in turn, it allows me to give them the care they really need and do what i need to do with them:
1. My patients without health insurance cannot be denied based on
pre-existing conditions: Not many of my patients can afford health insurance. But the few that may be able to have tried and have been denied. I just saw a patient last week with newly-diagnosed, diet-controlled diabetes with an A1C of 5.9. She got flat-out denied for health insurance entirely. Not even given the chance to pay a higher premium. The insurance companies headed for the door as soon as the word "diabetes" was uttered.
For the first time in history, slimy insurance companies can no longer say "no" based on your pre-existing health conditions. They can no longer increase your premiums just because you caught pneumonia, or drop you from your plan because you got sick.
How did we Americans allow this inhumane practice by insurance companies to continue for so long? What about the patient with newly diagnosed leukemia or cancer? Insurance companies are denying them coverage right now. How is that fair? We as a society cannot punish these patients for a diagnosis that is out of their control and which requires some sensitivity. What if this was your sister, child, or father? They need care. We have been denying them this care under our current healthcare system.
2. My patients that desperately need specialist care can have coverage: Now 32 million more Americans without health coverage today will be able to receive it. The patients i see pay $35 per visit to see me if they meet income requirements. But what if i need to do further testing, or need to send them to the specialist? i am stuck.
I just recently saw a young female with a history of brain tumor with a resection two years ago, with clear recurrent signs and symptoms. She needs imaging and specialist follow-up urgently. Well, she lost her insurance last year when she lost her job. She hasn't seen a doctor in over a year. She cannot afford private health insurance (and if she could, let's be honest, she'll be denied). She has no children, making her ineligible for medicaid. She is under age 65, and will not qualify for medicare. What can i do with her? She will have to wait until her situation is an "emergency," go to the ER, and contribute to our current health care crisis by increasing costs to the taxpayer.
These are stories of real patients deep in the trenches of our current system. We may be able to see a dim ray of light above, but we still need to keep digging for a long time to come.