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Follow up: Scott’s Story and the Election

By Vanessa Radatus

After last week’s article, “A Possibly Fatal Mistake,” by Nicholas Kristof, a number of responses prompted further discussion on the issue of health reform and our upcoming election.

In a follow-up column, “Scott’s Story and the Election,” Kristof provides two counter arguments acknowledging those who do not agree that it is the government’s (or their) responsibility to take care of the millions who are unable to do so themselves.

His first argument reflects the basic idea that we must accept that imperfection as not only our present reality, but our human destiny. That is why our government has created safety nets in our laws and institutions to prevent and mitigate human error. Kristof states:

“First, a civilized society compensates for the human propensity to screw up. That’s why we have single-payer firefighters and police officers. That’s why we require seat belts. When someone who has been speeding gets in a car accident, the 911 operator doesn’t sneer: “You were irresponsible, so figure out your own way to the hospital” — and hang up.

To err is human, but so is to forgive. Living in a community means being interconnected in myriad ways — including by empathy. To feel undiminished by the deaths of those around us isn’t heroic Ayn Rand individualism. It’s sociopathic. Compassion isn’t a sign of weakness, but of civilization.”

Kritsof’s point should not be neglected. Does not every American citizen feel that our government is somewhat responsible for keeping our nation’s people safe? Why then, do we have government-created agencies like the FDA, the FDIC, and Social Security?

Because we as a nation have learned from our past and humans make mistakes. And if we have these institutions to act as safety nets for our food, medicine, and money, shouldn’t there be something to act as a guard rail to protect our nation’s health?
Kristof’s second argument is that if you don’t believe in universal healthcare because you don’t want to pay for the mistakes of the uninsured, you are already paying for them, only, at a higher rate.

“My second argument is that if you object to Obamacare because you don’t want to pay Scott’s medical bills, you’re a sucker. You’re already paying those bills. Because Scott wasn’t insured and didn’t get basic preventive care, he accumulated $550,000 in bills at Seattle’s Swedish Medical Center, which treated him as a charity case. We’re all paying for that.” Read More…

So as our last presidential debate airs tonight, watch it. Become an informed voter. Try not to be persuaded by a candidates looks or demeanor but rather by his ideologies and how he will try to make our country better for everyone, rich or poor, old and young.

If you would like to learn more or follow Nicholas Kristof, visit him at his blog, On the Ground, or join him on  Facebook and Google+, watch YouTube videos and follow him on Twitter.

Health Reform: A Matter of Life and Death

Access to insurance is a matter of life and death for some.

In this poignant New York Times column, “A Possibly Fatal Mistake,” Nicolas Kristof tells the sad story of his childhood and college friend, Scott Androes, who made a bad choice and may pay with his life.

That choice was not purchasing health insurance when he was marginally employed and realistically able to do so. For Scott, like many Americans, the thought of buying an individual policy in a high risk market seemed too expensive and unnecessary.

But after months of warning signs and a trip to the emergency room later, Scott realized how costly taking that risk would be. This year, he was diagnosed with metastatic prostate cancer and a treatment plan that is upwards of $550,000. It would appear that his days are numbered.

In his piece, Kristof compassionately writes about the bigger picture of this issue and how health care reform and politics play a major role in individual stories like his friends. He characterizes one presidential candidate’s philosophy, opposed to most of the health care reform proposals, as seeing this outcome:

“…as I understand it, is that this is a tragic but necessary byproduct of requiring Americans to take personal responsibility for their lives. They need to understand that mistakes have consequences. That’s why, he the candidate, would repeal Obamacare and leave people like Scott to pay the price for their irresponsibility.”

Kristof goes on to say:

“To me, that seems ineffably harsh. We all make mistakes, and a humane government tries to compensate for our misjudgments. That’s why highways have guard rails, why drivers must wear seat belts, why police officers pull over speeders, why we have fire codes. In other modern countries, Scott would have been insured, and his cancer would have been much more likely to be detected in time for effective treatment. Is that a nanny state? No, it’s a civilized one.”

The key point that Kristof makes is how crucial it is to put our partisan bias aside and consider the millions of U.S. citizens who are currently affected by our broken health care system. Which presidential candidate will actually work to fix and prevent stories like this after the election?

“So as you watch the presidential debates, as you listen to those campaign ads, remember that what is at stake is not so much the success of one politician or another. The real impact of the election will be felt in the lives of men and women around the country… Our choices this election come too late for Scott, although I hope that my friend from tiny Silverton, Ore., who somehow beat the odds so many times already in his life, will also beat this cancer. The election has the potential to help save the lives of many others who don’t have insurance.” Read more…

 

 

A Global Health Issue: America’s Health Workforce & Countries Without Doctors

By Vanessa Radatus

The New York Times issued an Op-ed article last week that brings both good and bad news about our current healthcare employment dilemma. While jobs in the health care sector have increased by more than 1.2 million this year, there seems to be an imbalance in our medical education model and the number of foreign physicians we import.

The article “America’s Health Worker Mismatch” addresses the fact that despite increased demand for their graduates, medical schools have done little to expand their output and therefore must turn away hundreds of thousands of qualified medical school applicants. What’s more, our medical school tuition costs have increased by 312 percent in the past 20 years and some health specialties have raised the bar for education credentials – meaning more years of school, higher attrition rates, higher debt, higher wage demands and fewer workers from low-income areas.

The author of the op-ed, Kate Tulenko, is the senior director of health system innovation at IntraHealth International and author of “Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad.” She explains that the United States dependence on foreign-trained health-care workers is creating a mismatch in our health care work force.

“It’s no surprise, then, that the response to this self-made labor shortage has been to recruit inexpensive workers from abroad, including the 57 poor countries defined by the World Health Organization as having significant shortages of their own. Among them is India, America’s largest source of foreign-trained doctors. A special visa program has made hiring these workers even easier… Today about 12 percent of the health work force is foreign-born and trained, including a quarter of all physicians…That’s bad for American workers, but even worse for the foreign workers’ home countries, including some of the world’s poorest and sickest, which could use these professionals at home.” Read More…

This trend is worrisome as most foreign-trained physicians applying to U.S. residency programs come from countries that are suffering a severe health service shortage. It raises the question: Does recruiting an imported physician workforce create more problems than solutions?

 

Book Review: Reefer Madness

Too High to Fail by Doug Fine

Noted comedian, pundit and provocateur Bill Maher wrote a review in the New York Times on Doug Fine’s book “Too High to Fail,” which addresses the marijuana economy. The matter is gaining considerable public momentum. Several states permit so-called “medical marijuana” and have passed or have proposed referendum and laws to lower sanctions or decriminalize possession. The failure of drug laws as public policy are legion and a growing number of American’s, perhaps the majority, are not interested in pursuing further failed policies, and instead seek rational approaches to marijuana. The days of the drug being viewed as a gateway to narcotics and a life in society’s shadows are long past. If the ability to prosecute or judge offenders required prosecutors and judges who have themselves used marijuana to recuse themselves from the proceedings, many would be disqualified.

The U.S. has the highest percentage of individuals incarcerated in the world as this map shows. Among the reasons for incarceration, drug related offenses are a significant portion of these.

There is a disconnect between the significant criminal sanctions for marijuana use, possession, sale and growing and the actual risks and danger of the substance. While nothing in excess is without risk, any healthcare professional can easily recount the dangers of alcohol on the body, on violence rates, accidents, crime, trauma and social disruption. Tobacco and firearms, both decidedly legal, cause untold deaths.

Medical marijuana is a back-door entry and access point to something that may have medicinal impact for some, but is clearly being used by many as a legal way to get high. The indications for medical marijuana prescriptions are so varied and non-specific in practice as to put the lie to those who would claim it has limited application to cancer-related nausea, glaucoma and the like. Medical marijuana has become a cottage industry where legal, diverting attention from the big picture of whether it warrants continued criminal treatment. Local governments are in conflict with states and the Feds. Medical data supporting the severe sanctions and disparate treatment is lacking. Many in society, including law enforcement experts are questioning the status quo and attempting to seek rational, realistic, and economical solutions.