Three recent published articles about the health care crisis caught my attention while surfing the internet.
First, in the article “Forget good; any doctor is hard to find,” a mother laments because she has to drive all over the Coachella Valley in California to find a doctor to evaluate her 2 year old child with a cough. After going to four different providers, she finally went to the emergency department and was seen by a PA because “a good doctor is hard to find.”
I sympathize with her, but if you read the article, it wasn’t that she couldn’t find a physician to see her child (although a couple of the clinics she went to didn’t see children under 3 years old). The problem was that the physicians that *were* available didn’t take her insurance and she didn’t want to pay out of pocket. The article did not say what type of insurance she had, but my guess is that the insurance was MediCal. Given the low payments MediCal makes to physicians, fewer and fewer physicians are willing to accept it. This mother’s ordeal just highlights the fact that universal coverage doesn’t mean much if no one takes your insurance. Kind of like having $10,000 worth of Japanese yen in your pocket and trying to buy a hoagie in downtown Pittsburgh with them.
Another article that caught my eye was from Canada, where protesters were planning a sit-in at a hospital emergency department because the hospital will longer perform emergency surgeries and will instead ship the emergency cases to another hospital across town. If there is no incentive to provide emergency surgeries, then it is difficult to force a hospital to continue performing them. The article also notes that several other hospitals in the area have already stopped performing emergency surgeries – also deciding to ship them to different facilities. As fewer and fewer facilities perform emergency surgeries, more and more emergencies will pile up. At some point it will be a case of “when everything is an emergency, nothing is an emergency.” Think that care will be good?
But at least the care is free … right?
Then finally was the article from Florida’s Gainesville Sun, titled “ER care for kids ‘stinks’“.
Fewer and fewer specialists are willing to take call from the emergency departments and there is difficulty finding emergency specialty care for children. The unfunded federal mandate EMTALA is backfiring. If you’re an “on call specialist”, EMTALA requires you to provide emergency stabilizing treatment for any patient that needs your services – even though many patients needing emergency services will never pay their bill and can sue for millions of dollars if the care they receive is not deemed adequate.
So specialists just stop taking emergency calls. Now emergency physicians treating people with emergencies scramble to find emergency specialist care when in some subspecialties, there is little or no emergency care nearby. Neurosurgery, obstetrics, and psychiatry are just a few of the specialties in very short supply in some states.
In trying to legislate “perfect” and “equal” care for all, now more and more people are finding that there is “no” care for anyone.