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Equitable Healthcare Is A Human Issue

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The Tampa Tribune

Published: October 17, 2007

Updated: 10/15/2007 10:11 pm

When 'Mark' drove his wife to a local emergency room at 2 in the morning, he was seriously concerned. She was in pain and it looked to be a long night. What he wasn't worried about was insurance.

He called his provider and confirmed that the hospital was on its plan.

Six weeks later, he received a bill from the physician demanding payment in full. 'Your insurance declined the invoice,' he was told.

Three hours and several phone conversations later, the young man learned that - although the hospital was covered - the physician who treated his wife had stopped participating in No-Name Indemnity 18 months earlier.

'So,' Mark asked the claims agent, 'No-Name expects me to walk around the emergency room with a clipboard at 2 in the morning interviewing doctors to determine which ones are eligible to help my wife?'

If you think that sounds absurd, consider the 75-year-old woman with a faulty heart valve. Halfway through an invasive diagnostic procedure, the doctor is stymied by an unexpected anomaly.

'Let me refer you to my colleague,' he said helpfully. 'He's right here on-site.'

Anxious for answers, the woman and her husband complete more paperwork.

'I'm sorry,' the specialist responded. 'I dropped out of that plan; it doesn't work for me.'

Both families have health insurance. They accept the inevitable out-of-pocket costs of several thousand dollars each year and understand the necessary price of quality interventions. Yet they and their health are treated like tradable commodities, and they're sick and tired of being maneuvered like pawns in the profiteering games the health industry plays.

These are families with 'good' insurance. Meanwhile, the uninsured and their children press their faces against the glass and wonder whether they will ever be allowed to come in.

So they ignore mounting problems, encumber themselves with unremitting medical debt, clog the charity clinics, put additional stress on social services or knock on the doors of churches.

'But we have the best healthcare in the world,' some say. Well, yes, if we can afford it, if we are lucky enough to have insurance that fits.

The most pressing questions are not limited to universal insurance so much as they are applicable to well-organized equitable healthcare. We all would benefit from treatment delivery systems that work.

We have got the hospitals. We have got the clinics. We have got the expertise. We have cutting-edge research, and we're blessed with brilliant minds. Here in the Tampa area, we're potentially world leaders when it comes to diabetes, cancer, heart disease and Alzheimer's.

Creative energy flows. At the University of South Florida, the student-directed BRIDGE Healthcare Clinic has been designed to address the needs of the uninsured.

Doctors get paid. Insurance companies aren't hurting. Americans need to take more preventive responsibility for their health, yes, but we also need to match people with services regardless of their ability to pay.

We have cutting-edge resources, yet tens of thousands rely on missions such as the Judeo-Christian Health Clinic and the Brandon Outreach Clinic to fill the gaps. We're not even beginning to scratch the surface of the need.

Sadly, the escalating politicization of public health is viral and deadly.

Market dynamics have no place in the realm of any individual's health: not for our children, not for the poor and not for a 75-year-old woman with a paid-up insurance plan who simply needs the right doctor to take a look at her broken heart.

Columnist Derek Maul can be reached at derekmaul@gmail .com.

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