Thursday, July 31, 2008

"A Moral Imperative"

In the August 4 edition of American Medical News, a publication of the American Medical Association, I find some hope...

The headline reads: Ethics panel may back universal coverage, ponders access as a "moral imperative".

The article reviews the ponderings of a panel of ethicists appointed by President Bush, and "appears set to endorse some sort of societal obligation to provide health care access to all."

Gosh, isn't that what we've been saying?!?!,,

As I read the article a bit further, I must admit that this cynical old guy is disappointed that "A report is likely to be issued after the November election." And, the article goes on to talk about the panel having exceeded its expertise to attempt an analysis of our healthcare policy from this ethics viewpoint.

This is exactly the place to start a review of our healthcare "system". It really is a simple analysis. Do you agree that access to health care is a fundamental human right? If so, then society has an obligation to ensure that this right is made real to all of its citizens. The mechanism for making that right real certainly is complicated by many competing interests - political, social, economic, etc.

But, if we start at the beginning, we can figure out the rest!

Friday, July 25, 2008

Power for change?

As I look over my microwave lunch today, I'm glancing at the headlines on the American Medical News for July 21, 2008.  The headline says: "Health Care Access Problems Surge Among Insured Americans."  

So, my first reaction was - "Duh".   Just ask my partners - we are seeing more and more insured patients in our practice, particularly Medicaid, Medicare and Tricare.  Tricare is the public insurance program to support our retired military and dependants.  And, they are our community's newest "underserved" population.  These fine Americans carry an insurance card with a great slogan - "The Best Health Care in the World".  That's certainly the topic for another entry...

But, after reading the story a bit more closely, I see that the article is not about the insured among us.  Rather, it reviews access for all of us - insured or uninsured.  The article reviews the report from the Center for Studying Health Systems Change, which has been tracking access for the past ten years.  And the report shows a marked increase in delaying and deferring care due to growing access barriers.

But, why the emphasis in the headline on the insured?  Ah, that might just be the power for change... Larry Seaquist noted that 97% of voters have medical insurance.  The uninsured, therefore, have little political clout.  Why would they?  They are typically poor or young or immigrant.  But, when the headlines start talking about the "Haves" rather than just the "Have-Nots", maybe that will lead to enough power to effect true change. 

At least, we can hope so.  And, soon.  It would be immoral for us to watch even more people die during this crisis:  Uninsured People Ages 50 to 64 Have 43% Higher Death Risk Than Insured, Study Finds

Thursday, July 24, 2008

Community Comment...

Earlier this week, I had a wonderful opportunity to sit with a group of people in my community to discuss the state of health care.

It was an evening hosted by Gail Ross, co-founder of America in Solidarity. And, I was asked to join Larry Sequist, a State Representative for the 26th District, in talking about the state of our current system, and how we might consider moving forward. Foremost in our discussion was the enhancement of the "medical home" model, and reducing administrative costs of our disjointed "system".

The stories around the table included many who currently had healthcare insurance, but were afraid that the future would see them unable to find adequate coverage for healthcare costs. That is actually a common finding, it turns out - many Americans have seen the trend, and are concerned that employee-sponsored health insurance will become unaffordable, and that they will not be able to find coverage for their family. In fact, the coverage offered by my own employer has premiums of over $20,000/year to cover my family.

I'm encouraged that more people are becoming concerned about our failing system.

And, I would certainly agree with the editorial piece in the Seattle Post Intelligencer, co-authored by someone I'm proud to consider a colleague in this work. Teresita Batayola is the Executive Director of International Community Health Services, the nonprofit agency serving the healthcare needs of the many of the residents of the International District in Seattle. The theme of this editorial is that our priority would be to ensure that all Washington's citizens have access to affordable healthcare coverage.

For me, it always comes back to the basic question - do you believe that access to health care (not health care insurance, by the way), is a basic human right? Do you agree with the World Health Organization that health care is a fundamental human right? Do you agree with the motto literally etched in stone at the Harvard School of Public Health - "The highest attainable level of health is one of the fundamental rights of every human being"?

If you do, then all the other issues seem to fall into place...