Medicine, as I’m sure you realized before this whole Affordable Care Act was even conceived in the minds of politicians, was in need of improvement. But why? What exactly was broken, because we all looked at it from the patient’s side and hoped it would get better.
Things were broken, just like a human who survives a horrible car crash – there were dozens of types of injuries to a dozen different body parts, all of which must work in harmony. Break a rib, and the person doesn’t breathe well, so then the lung may suffer pneumonia. With pneumonia, the lung may not exchange enough oxygen into the bloodstream, so the heart is stressed. When the heart doesn’t pump and there isn’t enough oxygen in the blood, the brain and kidneys begin to suffer. And so on it goes until the body is severely crippled in its day-to-day functions.
Same goes for healthcare. I can’t even guess whether the egg came before the chicken in many of these cases, but the effects are like ripples in water left by a stone. First is the insurance games, where not only do these vendors take money from insured persons for care, then they mandate certain brands of medicine or limit the amount of money they’ll spend for a procedure, or might just not cover it at all. And an insurance company previously could exclude someone for previous medical conditions, which made getting or keeping health insurance expensive or impossible. Then there came the limits they paid for certain care, such as a doctor’s office visit for a sore throat, for which they would only pay the doctor a percentage of the amount he charged for seeing you. And then that insurance company expected the doctor, in order to make up for this financial shortcoming, to see six more patients a day.
And then there came the lawyers. Litigation for obvious malpractice was swallowed by litigation for almost any sort of care. For example, many obstetricians left their practice when lawyers began alleging that any sort of birth injury was the fault of the doctor and not the patient or just life in general. The premise was that SOMEONE had to take the blame, because certainly those incidents were the fault of someone besides the mother or baby.
And then came the politicians into healthcare. The government designed programs like Medicare and Medicaid to help seniors and the less financially fortunate healthcare. Then, like many other government programs, the program structure itself became a monster, with abuses of its proceeds and bulk in its operations. There came a segment of our society that believed it was entitled to those benefits for free and for life, no matter the cost to anyone else.
So the Affordable Care Act really had a lot of fixing to do, but as we’ve watched these last weeks, its first steps are like that of a baby learning to walk – quite often stumbling and falling. Yes, it does have some good intentions, like preventing insurance companies from excluding customers with pre-existing conditions, but the act doesn’t say that the insurance to cover these people will be something they can actually afford.
I have begun to wonder if the “affordable” part of this is only for those who have excluded themselves from its clutches.
Val Conrad, RN, BS, BSN
Author: Blood of Like Souls, Tears of Like Souls, Promises of Like Souls the newest release, Secrets of Like Souls. www.valconrad.com and Surviving American Healthcare – Advocating for Yourself or Someone You Love www.surviving-healthcare.com
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