Tuesday, August 5, 2008

Stating the obvious...

I'm always amazed at medical studies which seem to state the obvious. And, I'm always wondering, "Who didn't know that"?

The most likely to elicit a response of "Duh" are the articles like "Childhood obesity linked to eating too much and not exercising enough." Gosh, that's all it would have taken for me to get published?

But, when it comes to healthcare policy, it becomes apparent that many of my friends and neighbors don't have the same experience of the needs in our community, and frankly don't believe that things are as difficult as they really are. That might be reflected in blaming the uninsured for being "lazy", or thinking that all Medicaid recipients are just "welfare moms", who will keep having kids so that the State will pay them more money. Or simply that the elderly Medicare patient can't be underserved; after all, they have insurance.

My favorite example of an unbelievable situation is that of the GAU system in our state. (If "favorite" is the right word ...) In our state, we have a public program to provide support for those who are disabled, referred to as "General Assistance for the Unemployable ". Well, that makes sense - if we have citizens who are unable to provide an income for themselves, I would argue that our rich society has an obligation to help them in meeting their daily needs.

But, listen to these words that one of my patients read on the letter which announces her enrollment:
We have decided that you are unable to work at this time based on Mental Health Disorder. ... You do not qualify for medical that covers mental health treatment and so, you must find a primary care doctor to help you explore possible medications for your mental health disability.

So, did you catch that? You are disabled. So, you deserve medical insurance coverage. But, we're providing you with insurance coverage which does not have the benefit of coverage for care for the condition which causes your disability. (And, then, goes on to suggest that your PCP just give it a whirl and see if he/she can help you, without benefit of specialty consultation, if indicated.) Incredible. But, true.

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