Is health care a right?

[Momo]

Those who don't have loved ones in medicine might be saying: "Oh Pleeeeease" , but obviously for us and our loved ones we get this? Right? Wrong? What's your take on this issue?

http://www.ahwatukee.com/onset?id=28...e=article.html

here's the article

Is health care a right?By Dr. Eric Novak
March 27, 2007 - 10:39AM
Would it be ethical for an employer to require overtime and not pay employees for the work? What if it is just really a busy time and the public needed access to the store? What would happen if the employer instituted this policy? Would it be easier or harder for the employer to find people willing to work there?

The answer, of course, is that employers cannot force employees to work without pay. And employees would look for other places to find work and make a living – quickly!

Yet, when we talk about health care, what we know to be morally repugnant – forcing people to work without pay for fear of sanction – does not seem to apply.

Some in government – elected officials and bureaucrats – and some activists believe that health care is a “right.” They see a need for specialty coverage in emergency rooms that are currently lacking. They believe that physicians have a moral obligation to be available to provide care that is needed.

Yet the very same people generally do not believe that health care providers should expect to be paid for being available at any time of the day or night, seven days a week, for their expertise and experience.

EMTALA (Emergency Medical Treatment and Labor Act) was passed by Congress to prevent “patient dumping.” The requirements put forth in the law have had a negative effect on patient care by making specialists less likely to take emergency calls at hospitals. Some hospitals have responded by making calls mandatory.

Specialists have responded by giving up hospital privileges. The overall impact has been to make emergency specialty care more difficult to find. Nearly every hospital in the Valley today lacks specialist coverage in at least one major area, from orthopedic surgery to urology to cardiology to plastic surgery.

Some want emergency calls to be a requirement of licensing or Medicare participation for physicians. Some just want to regulate physician revenues so tightly that doctors will be forced to take calls just to make a living. These laws and regulations will only make the access problems worse.

Just as it is morally repugnant for employers or the government to require workers to work extra hours without pay, it is unethical for a society that cherishes freedom to create a system where a right to health care obligates doctors to provide care at any time, and for a price that is dictated by government.

Dr. Eric Novack is a Glendale orthopedic surgeon and an expert in health care issues. He can be heard Sundays at 3 p.m. on KKNT 960 AM.

[Meenah]

I don't have time to read the article, but I will later. I personally think that healthcare here in the US is pathetic. How is it OK to have so much excess in some places, and hardly anything in others? It is just wrong. I hope we can somehow find a national healthcare system that works. DH and I pretty much agree on this subject.

[pstone]

What is a right?
Doesn't everyone have the right to work hard, make money, and buy health care?

It would be perfect if everyone got the best care for free, or part of being a citizen, and what is great is if WE want that it can and or would happen.

If doctor salaries go down, well...either get less doctors or far worse doctors, either way we would get what we pay for, so then people that had more money would still pay for the 'better' care.

Doubt it will ever happen, and if it does it will fall apart so fast. We all know how crazy the system is, IE. lets say a burn patient with 1% chance to live gets 2 million in care and then dies 7 weeks later.

With rights come responsbilities and very tough decisions, all I can say is thank god for medicince still making good money.

[PrincessFiona]

What is a right?
Doesn't everyone have the right to work hard, make money, and buy health care?

Come ON, Peter...you know as well as I do that 80% of the uninsured and underinsured are working and many of them have middle class jobs.

You know...my chemo buddy was in the hospital getting a bone marrow transplant when his health insured cancelled him because he had been out of work too long. Thank Goodness his wife was able to cover him, BUT...the actual HIGH COST of the bone marrow transplant has resulted in him using 70% of his family's lifetime maximum already!! He was refusing to come in and get some tests done because of the costs and it turns out he had developed TPT and is now having to do plasmaphoresis...and ....he's going to max out his family's health insurance policy and then no one will have any coverage.

What should he do?

Sure there are the deadbeats out there that aren't doing anything...but should we really punish the highschool graduate who wasn't sharp enough to go to college with....less years to live? Is that what America is about? We have the *right* to have guns, the *right* to free speech, the *right* to be protected by our military and police officers....and the *right* to die early and suffer greater morbidity because our life has led us down a path that hasn't provided us with the job/education that would get us the insurance coverage?

Not everyone can or should go to college.....not everyone can go to technical school....are unskilled laborers unworthy of basic coverage? What about people with *just* bachelors degrees.

But lets add an additional wrinkle....DIVORCE. One of the greatest predictors of poverty and lack of coverage in women is...divorce...

My mom is 63 years old and has no health insurance. She can't afford the >$600 it would cost her monthly...and she is a Nurse Practitioner working for a small practice...that has a crap plan. She has applied for multiple other jobs, but...she's 63..no one wants her.

If she develops breast cancer etc...she's screwed...She has rheumatoid arthritis and pays for everything out of pocket...

We get good care here...but...we aren't the only country in the world to provide top notch medical care...we just like to think that we are. I remember dh initially being disappointed after having worked in the UK and Germany and then coming here....he said "huh...you guys just cook with water too".


kris

[madeintaiwan]

I believe that with every right there is a responsibility. As in if you have the right to bear arms then you better take the steps to be freakin responsible about it so that no one is needlessly hurt. I also believe that everyone should have access to health care. How do we pay for that, I have no idea.

But with the right/responsibility issue, I believe that if it is your right to health care then it is your responsibility to take the best care that you can of yourself. Try not to smoke, try not to drink like a fish, eat healthy, exercise moderately. Pretending everyone has health care-- seek out help if you feel things aren't right (mentally, physically, and emotionally) and follow up. I understand that there are plenty of medical conditions that are completely unpreventable but for me it's like a principal. If you try your best and shit goes wrong then shit goes wrong but at least you were trying to be responsible. And aren't we supposed to be responsible for the sake of being responsible people.

And I'm not implying that irresponsible people should go without health care either. It's just frustrating when you see people with privileges (which I feel pretty much everyone in America is pretty privileged, rich and poor, especially compared to the majority of the world) taking them for granted. Privileges = obligation. In this case the obligation to take care of yourself because you do have access to decent health care ( and health awareness) unlike the majority of the world. And I'm not saying you have to take perfect care of yourself (that would be impossible), but to just be aware of the effects that some of the choices you make might have on your health, and try the best that you can.

For example, my grandma is diabetic, has high blood pressure, and high cholesterol but refuses to take any of the steps to help her conditions but complains that she is sick all the time and how the doctors are never any help. She has access to (basically free access) health care but she is still irresponsible with her health and complains about it. Anyhoo, those are my thoughts.

[DCJenn]

My opinion is that everyone should have access to health care. period.

Interestingly enough, my boss did a study with our clients to determine if providing free methadone increased compliance with treatment. and it was an inverse relationship- the more invested people were, the more compliant they were. This held true up to a certain price point at which point it became more cost effective to buy heroin.

the same holds true to housing and most other social supports.

So, I'm all for people having access to good, affordable (key point here) services. I think a co-pay is fine for doctors visits- but more like five bucks a visit, not 25 bucks a visit. and I think co-pays are fine for medications- but again, more like five bucks than the complex system of deductibles and reimbursements and co-pays at different levels.

and seriously Peter, do you honestly think that the guy painting Cheri's house or mowing my lawn or taking care of my kid are able to afford health care? Because I'd bet that NONE of them have insurance. So, dude mowing my lawn breaks his leg- he goes to the ER and the vicious circle starts- he gets treated- he can't pay his bills, etc. etc.

We're in a pretty significant health care crisis that someone is going to have to get some uh, spine to even get the discussion rolling.

Jenn

[pstone]

Oh no no,

I am not saying I think the system is working, and I certainly and not saying the guy painting the house has or can afford health care. I was saying that everyone 'can' in theory pay for their own healthcare.

Now, that being said I know it is is not like that in reality, and that many many many of the people that are uninsured work but can't afford.

So what is the way forward?
Do you have a one payer system where soon doctors get paid nothing, care gets worse, but everyone has it? The problem with the government paying for healthcare is companies will stop offering it and say "get on the government plan" and if the government is the major player then they as we all know basically say what they will pay and that is it.

What I was trying to say is it is clearly not something 'we' as a country wants or we would have it, and in part I think that is because so much of the wasted health care dollars are because people refuse to take care of themselves and because we have such a wide range of morals about things. (like my burn patient example, or say a 22 week old infant that we can now technically keep alive)

Can I say I think people in the US deserve healthcare? Yes
Do I think I know how we pay for this? No
Do I think it should be more 'tax the well off'? No

How do you deal with smokers?
How do you deal with overweight people?
People that won't do what their doctors tell them?

Problem I have is little hope for the masses, I mean what percentage of use are obese now?


I just don't see how any of it will work, and yes of course I see it as horrible that people work hard and try to support their family and can't afford health care, it is horrible.

Aren't co-pays the difference between what the ins. co. will pay and what doctors bill? or at least used to help close the gap?

[PrincessFiona]

Well, I do know that the german system works in two ways...

you can either get govt insurance or private insurance...you pay a portion every 2 weeks from your check and your employer pays another part.

I never had trouble getting same day appointments, ultarasounds, etc.

The german system is struggling though right now due to huge organizational and money issues....so who knows....

There are no easy answers, but we just have to do something.

kris

[Bluejay]

What is a right?
Doesn't everyone have the right to work hard, make money, and buy health care?

Come ON, Peter...you know as well as I do that 80% of the uninsured and underinsured are working and many of them have middle class jobs.

You know...my chemo buddy was in the hospital getting a bone marrow transplant when his health insured cancelled him because he had been out of work too long. Thank Goodness his wife was able to cover him, BUT...the actual HIGH COST of the bone marrow transplant has resulted in him using 70% of his family's lifetime maximum already!! He was refusing to come in and get some tests done because of the costs and it turns out he had developed TPT and is now having to do plasmaphoresis...and ....he's going to max out his family's health insurance policy and then no one will have any coverage.

What should he do?

Sure there are the deadbeats out there that aren't doing anything...but should we really punish the highschool graduate who wasn't sharp enough to go to college with....less years to live? Is that what America is about? We have the *right* to have guns, the *right* to free speech, the *right* to be protected by our military and police officers....and the *right* to die early and suffer greater morbidity because our life has led us down a path that hasn't provided us with the job/education that would get us the insurance coverage?



kris

Obviously, one reason people lack healthcare is money. Whether that be their lack of insurance, or lack of sufficient income or other causes.

Canada is a country with government healthcare, where no citizen is left out for lack of money. However, people do lack some types of healthcare in Canada anyway. For example, I had a friend living in the Maritimes who was diagnosed with osteoperosis after the birth of her fourth child. Her husband gave her a hug after the birth and cracked a rib. The glitch was that she had NO ACCESS to a bone scan. In her area, there simply was no such machine available to her. She did not find out how serious her condition was for several years until she had moved to another area of the country where she could have the necessary test.

I say this to illustrate that Canada also has barriers to care. In Canada, what you need may be too expensive for the government to provide it at all, or have such long wait times that it essentially does not exist. In the States, the care is available, but you may not be able to afford it. Both situations are bad. :|

[pstone]

It was just this last week they recommended MRI for women with certain types of breast cancer screenings, and the big deal was that there were not enough machines nor radiologists to read the images anyway. I can assure you this won't be fixxed by our governement that can't even get water to storm victims.

sad yes.

Ummm, I find the story about the lady with cracked rib strange! That must have been terrible for her...we are in the maritimes and I know that we have multiple bone scan machines, MRI's and cat scan equipment in every province. She might not have lived near one of the hospitals, but at most it would have been a 5 hour drive? (ortho hubby) I do agree that our wait lists in Canada are pretty long though...2-3 months for a cat scan and 4 months for an MRI!!!

[Deebs]

When the Iraqi Constitution was written, this was a huge issue (since Americans were helping write their Constitution, and healthcare is not a provision in the US Constitution). They did include healthcare as a "right" in Iraq, mainly because it was viewed as easier to make it a right to begin with than to try to go back after the fact and determine how to make it a right.

IMO, the German system is the closest system that would work in the US, but still not perfect for this country. I studied quite a bit of international health policy in my undergrad, and have come to the conclusion (as have many others) that there is no perfect solution in the US. But, I'm definitely in favor of trying out other options. If I ran the country (and no, I don't plan to try), I have a whole system worked out in my head that includes letting individuals buy into Medicare. It is the cheapest insurance to administer, and letting people buy in (if done right) could allow for higher reimbursements to providers.

I do know that Mayo Clinic has more CTs than the entire country of Canada - just an interesting little fact. We have several friends who are Canadian citizens practicing medicine in the US now. Many of them have said they feel their patients get better access to treatments here than they would in Canada (however, this doesn't speak to those that don't come in as patients).

Part of the reason DH is staying in academic medicine is that we both feel there is more of a chance that the ED he is working in will not be forced to shut its doors. He is seeing more and more patients who use the ED as their primary care (and we live in a state where it is fairly easy to qualify for Medicaid). And the no-pay rate in his ED continues to climb.

I do think we should have healthcare providers and administrators involved in the solutions, and not just lawyers. There are many issues that we can see from the "inside" that aren't so easy to address.