Sunday, August 2, 2009

Why government-run health care can be good for you

Many politicians and television commentators are making "government-run health care" sound like a string of dirty words. I have a different view. To me, government-run health care makes me think about a patient I cared for during my family medicine residency - I'll call him Ed - whom I met while volunteering at a free clinic in Lancaster, PA. Ed was a well-educated man: he had a Masters in Divinity and formerly directed a nonprofit. But at that point he was just beginning to climb out from a disastrous time in his life, having fallen victim to alcohol and heroin addiction and losing his job, home, and family. A few months earlier he learned that he had diabetes, but having no health insurance or primary care doctor, Ed let his sugar level spiral out of control until he was hospitalized in a coma from diabetic ketoacidosis, an often fatal condition when the body's metabolism, unable to turn sugar into fuel, produces waste products that dangerously acidify the blood. Fortunately, doctors were able to reverse the process in time, and Ed pulled through.

Ed arrived at the clinic for his post-hospital follow-up visit the night I happened to be volunteering. I almost couldn't believe my eyes as I reviewed the laboratory results and hospital records he brought with him. He was lucky to be alive. Unfortunately, he had been prescribed several medications that, having virtually no income and living in a homeless shelter, he couldn't possibly afford. The clinic stocked some donated medications, but not nearly enough to supply Ed's needs for more than a few days - after which his diabetes would inevitably worsen until he would be back in the hospital again, or worse. Through a social worker at our hospital, I helped Ed apply for Pennsylvania Medicaid (health insurance administered by state governments with federal government subsidies), and was able to see him in my regular office.

I cared for Ed for nearly 2 years. During that time, we not only controlled his diabetes, but he was able to get back on his feet emotionally, spiritually, and financially, eventually moving into his own apartment and holding down a paying job as a counselor. That's what "government-run health care" can do. And if you're thinking that you'll never be stuck in a situation similar to Ed's, I'd ask you to consider what you would do if you suddenly lost your job, if you were disabled in an accident, or some other financial catastrophe happened to your immediate family or friends. The "safety net" isn't enough. Several national organizations representing primary care physicians recently came to the same conclusion; you can see their powerful message on the website Heal Health Care Now.

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