Finished my first test of med school, nbd.
Surprisingly ethics/professionalism/principalism/law making can be interesting. Very interesting. Depends on how it's presented or taught. This week had a mix of both, obviously.
But here is the thing that I cannot understand about our health care system.
If there is someone on the verge of dying and requires an ICU bed, the hospital is legally required to let that person stay in the ICU indefinitely, even without means of paying or insurance.
What?
If an illegal immigrant jumps the border and ends up nearly dying and is sent to the hospital, the hospital might decide that it's cheaper to just send him back to Mexico with a ventilator that costs 20 grand. (real story at SA). But it's cheaper because a stay in the ICU is 5 k/day.
What?
I don't freaking understand how this can happen.
Well, actually, ethically I understand how it happens. Because the moment you remove these patients from their machines, they will die. And in America, nope nope nope. Doesn't work like that. Here, we can't put a price on someone's life. Except, when they aren't close to death or in an emergency -life, limb, eyes, labor- then sure we can slap on a bill that is insanely high to cover the unpaid cost.
Now, I am not saying that anyone's life can be measured in importance comparatively to anyone else's life. But when I view these types of situation, it just doesn't make sense to me, practically speaking. So, who is deserving of health care? What if someone were to try to go through legal channels and get health care in America? Nope, we'll make you wait, and then ask you pay through your nose for this stuff. But in this, it's almost as if we're rewarding people who collapse at your front door. I just think that all of health care in America is short sided and very emotional. You want to save the person at the doorstep no matter the cost, rather than the millions of people with close to the same exact condition.
It shouldn't be about the money. I didn't go into med school for the money, I don't think health should be contingent on money or insurance.
But it is.
Because some hospitals are for-profit, because there are bills to pay, because there are HMOs, and there are bills that never get paid and has to be made up somewhere else.
The numbers will all have to balance sometime and I think most of the American health care system is deluding itself in thinking it'll all work out in the end somehow.
You have a right to health care. But do you have a right to unlimited health care? I really don't think so. There is such thing as limited resources and justice for the many. Maybe this is a little too utilitarianism, but it is just so much more rational - so much more sensible.
Like food banks. I think this is almost a near perfect analogy. When you give money to charity, food banks ask you to donate to them because they can stretch the dollar so much further due to their connections with grocery stores or whatnot. But instead, most people give to the person who approaches them on the street. Which is great and fine and not a bad thing. But really, that money could rationally be better spent at the food bank. Okay, yes I'm discounting the emotional benefits and the human connection - but that's my point. It's so much more efficient! But it's not the response a empathetic human being would give when a dying person is sitting at your door. We want to help and saying, sorry that goes beyond our budget allocated for this sort of thing doesn't cut it for the policymakers. Instead, we say that was a person, a mother a father a daughter a son and how can you dare put a price on human life?! This goes to show you what horrible people doctors are because they are more concerned about the money than helping people.
It almost makes me want to go into policy and shake a couple people really hard until something makes sense.
But that's the problem - it's not a couple of people. It's a whole bunch of randomly created rules that somehow manages to exist because it's harder to change for the better than just deal with the strangeness that is our health care.
I do acknowledge that I have not done enough research to be able to understand all the ins and outs of current hospitals rules or Obamacare that will be implemented soon. But that is also pretty telling... if someone who is invested in this system is already a little uncertain of exactly where money is coming and going in the healthcare system, then how would anybody really know?
I think it's a strange matter of too much/too little information. There is so much information that it's hard to sift out the relevant material. I hardly have the time to read through all of Obamacare legislation. Sure, I know the jest of it, but I couldn't recite dates of change each specific change. So then, without this knowledge, how do we even know how to fix things for the better?
Going off on this too, it brings up the consideration that as a person in the health care world, are we allowed to have opinions?
Ha, my first response to that was duh, of course I'm going to have opinions.
But then, if you start speaking publicly about your opinions on what the limitations of health care you can give to people, patients might not trust you as much. Because here, health care -unlimited health care- is a right.
I'm already starting to wonder if this post is okay to go public or not. Mrk. I might switch it to private if I get a little too concerned. But for now it'll be okay?
Sigh. After going to the UK to see how their health care works, I just can't help but get frustrated at America. It's so disorganized, but it stays that way because it benefits certain groups - and those groups definitely have power in Congress. Well, that and also it's kinda hard to cut something off entirely and implement something new. Hence why Obama is doing the slow transition and by 2014 everyone must have some sort of health insurance. Stuff like that.
It's a system that's broken, but pieced together by duct tape and fraying strands of money and debt. But people hate change. And heh.
One thing is for certain. I need to know more about policy in the future.
No comments:
Post a Comment