Two More Tags on the American Health Care

The greatest asset of a nation is its people. The greatest asset of a person is one’s health. Health determines productivity. Health drives the energy to contribute. Total health fuels the hope for further goals and pursuits. But sometimes, people, though of the greatest value to a caring society, may still be dangling from the scaffolding of that same society. And sometimes, when certain issues are addressed with temporary or compromised solutions, the problem only becomes more complex— like a wound, it never heals, may even acquire secondary infection. Yet sometimes, the issues are inherently complex and warrant bold leaps, brave foresight, and equally complex solutions.
 
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The seemingly complex structure that ensures the maintenance of good health of the people, one that is afforded for us in our society involves yet again more structures. Let me translate. I am referring to our own health insurance. Can we even afford it? And though we may continue to be able to afford it for now, is it really the best care a human being can be accorded? What of rising co-pays, increasing premium payments, costlier medical bills in general?
 
The chronically ill or those with chronic medical conditions—for example, a cancer patient with miles and miles to go in terms of treatments or a post-transplant individual with medical needs taking over an entire life. In both cases, in their much healthier days, they contributed well to society, paid taxes, abided by the law. At their current condition, with their current health insurance, they are fighting a big battle, not only for their recovery or continued quality of life, but also their finances. They are also laden with continuous out-of-pocket costs especially when many eventually stop working during these trying times in their lives. Insurance, especially a very good and wise plan (which of course means higher premiums), does help defray the cost of health care. But what of some cases, many cases, where the insurance packages it turns out, are not enough for addressing the diseases that have befallen them. “Not covered.” “I’m sorry but you’re insurance does not cover that.” And then, what of the totally uninsured?
 
Thus, while some spa and avail of optional ‘medical’ services, many are unable to obtain a basic health plan. Nothing wrong with the options. But some light and some examination of the reality surrounding this same society will hopefuly open personal awareness. The same society that affords the ultimate pursuits in life and happiness including all sorts of dimensional enhancements, is the same society that still has a big, big wound, one that can be potentially gangrenous if not managed carefully and humanely, and which can cause society more than an arm and a leg.
 
This is my initial understanding about some of the health care system issues in our society—but it is limited to the framework and issues currently tangible to me. I am learning, everyday. I also recognize that I have much much more to learn.
 
For now, if the words “health insurance” created a slight grimace on your face, you may be interested in these 2 articles I read this morning.
 
Reuters just reported the results of a study done by the American Cancer Society that there are “More advanced cancer seen in uninsured Americans.”

Uninsured Americans and those in a government health program for the poor are far more likely to have advanced diseases when diagnosed with cancer than those with private coverage, researchers said on Sunday.

A major factor seems to be that many of these people are not getting routine screenings for various types of cancer that could detect the disease in its early stages when it is most treatable and least deadly, according to the researchers.

Led by Dr. Michael Halpern of the American Cancer Society, the team examined data on 3.7 million Americans diagnosed with 12 common types of cancer between 1998 and 2004.

The uninsured were 2.1 times as likely and those covered by Medicaid 80 percent more likely to have advanced-stage cancer at the time of their first cancer diagnoses compared with those with private health insurance.

Read full article here.
 
The Next Generation, an online publication aiming at premedical and medical students and general interest readers, guided by the Editors of the New England Journal of Medicine, presents us with this timely Editorial, “Affordable American Health Care? More Feasible Than You Think.

According to the American Medical Association (AMA), 44 million Americans did not have health insurance at any given time in the last year. More disturbingly, the San Francisco Chronicle reports that 20.6 million of these individuals were reported as working full-time. This is a serious problem. Studies have shown that a lack of health insurance is a significant deterrent to seeking both preventative and necessary medical care. Forgoing simple preventative care can clear the way for serious health conditions, meaning that when those of the uninsured who cannot afford medical expenses out-of-pocket come down with expensive-to-treat but cheap-to-prevent illnesses, they have no other recourse but to finally seek treatment in hospital ERs rather than from a PCP (primary care physician), running up what the AMA reports as over $40 billion in uncompensated costs each year.

What is not absorbed by physicians and hospitals is shifted in the form of inflated costs to private insurance companies and federally and state-funded government programs. There is a need, both ethical and economic, to ensure all Americans are fully covered.

A tax-funded universal health care system akin to that of Canada or many European countries is unfeasible in the US, at least at the present time, given a prevailing public inertia to any form of wealth redistribution, a reluctance demonstrated time and again by voting trends and empirical studies.

In the US, then, a plausible way to ensure universal health coverage is through an expansion of the employer-based health care market and support of the individual buyer’s market coupled with a conservative extension of government programs to cover fully the neediest of the uninsured.

The rest of this Editorial is a must read. It has a well put space for the cost efficiency of the adaptation of electronic medical records in hospitals, for one.
 
I do not think that public health education lacks in effort in this part of the world. In discussions and explorations about this, the usual suspect is the cost issue. True. But curiously, what of those who can well afford but did not opt to, for a variety reasons we can think of—Less prioritization in the household or personal budget towards health? Less informed or less educated about the value of preventive care? Disinterest in health issues? Is such a population even studied? That would be one helpful angle to know, especially for those leading us in formulating the big solution.
 
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~ by Karina Descartin on 18 February 2008.

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