Chronic Care in a new Healthcare System

Today’s entry is going to walk a fine line. I promised myself when I started this blog that I would not get political: after all, a Congenital Heart Defect develops long before a person’s political philosophy does. But there is an ill wind blowing…

Laurie Edwards over at A Chronic Dose has a great post on the need for chronic illness care. A healthy person’s need for usually has a finite beginning and ending date. They fall in the bathtub, for example, and break their leg. There’s a need for surgery and rehab and pain medication, but under normal circumstances that will end. The doctor will say that your leg looks good, there is no need to come back unless there is a problem. Chronic care patients, on the other hand, make continual trips to the well. Medications, treatments, supplies, the occasional hospitalization – the costs keep coming.

Lots of ideas are being tossed around for national health care reform. Kevin, MD contends that Medicare for all isn’t the answer. One reason, according to the Happy Hospitalist, is that FREE=MORE. Put a free soda pop dispenser on every floor of your hospital, and your customer satisfaction survey numbers go up! Dr. Wes agrees with Happy – give a little, and people tend to take a lot.

The Covert Rationing Blog thinks the decision has already been made, and we’ll eventually become a single payer system. The real fight is going to be if citizens are allowed to spend their own money to pursue healthcare. Apparently the answer is “no”… the State of Maryland is already considering¬† steps to make Private Pay illegal. Kevin, MD even goes so far as to call it “Health Care prohibition.”

When you are in control of the wallet, you get to choose what the money is spent on. Think about it – your child wants a piece of bubble gum, he comes running to you to ask for a quarter for the bubble gum machine. If you don’t want your child to have gum, you say no.

Mr. Government Health Man? Sir, I need to have my pacemaker replaced, the battery is running dry. Can I have a new one?

No, I’m afraid not. You see the doctor six times a year and you take 15 different medications. You’re draining the system. I’m sorry.

I’m draining the system? Mr. Government Health Man, Bill went to the doctor for pain in his ankle last year, and he had a bone scan, and an MRI, and X-Rays, just to prove that he had twisted it! I need my pacemaker, why don’t you go yell at Bill?

Obviously, these last paragraphs are an exaggeration. And I wish I was smart enough to say “This is the way you should reform health care…” but I have no idea where to even start.

But I know what scares me.

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2 Responses to “Chronic Care in a new Healthcare System”

  1. carolyn compton Says:

    We have a Medicare system in Australia. We directly pay tax for medicare. Its a percentage of our income. If we want a slight tax reduction, we have private hospital cover. You have to get it before a certain age or you will always be paying a higher tax for it…so the incentive is to get private health insurance early and always have it.

    everyone who is eligible, (either reciprocal arrangements with another country such as britain/new zealand or aust. citizen) even if they don’t earn an income, gets medical treatment no matter what.

    It would be unusual for a company to offer health insurance. We can get bulk billing from our GP (meaning they pick up the medicare rebate) or you can pay full price and get the rebate from a family assistance/medicare office yourself. some doctors don’t do bulk billing so you choose what you want to do.

    we have a problem in australia where we don’t have enough doctors so we are flying doctors into towns (very expensive) and we are getting OS trained doctors.

    we have a long list for elective surgery; our public dental system is crap and i don’t know anyone who uses it; we have big issues with waiting time in emergency departments…but apart from that i think the way we pay and get universal free care rocks.

  2. Lisa Says:

    Steve,

    This is what really scares me about having a CHD child. Advancements in medical technology and all that is great, wonderful. My concern is for all of the adult CHD’rs who ‘drop out of health care’. Where is the safety net for the citizens who have no chance at private insurance? What do you do when your child becomes an adult and loses medical coverage?

    Thankfully, my son is only three years old. But what about the CHD’rs who are affected right now?!?!

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