I'm A Doctor. Greedy Health Care Failed My Father | Opinion

Oleh Admin 23 Mei, 2023 Posting Komentar

At 02:00 I heard one beep indicating that the IV pump was off. I was waiting with my father in the emergency room of the hospital where I worked. My father, who had a history of metastatic prostate cancer, had bloody stools and abdominal pain for 48 hours. My mother admitted him to another hospital, where there was a restraining order. He waited alone for six hours without taking vital substances and without examination. The symptoms continued, but he went home.

A recent study found that 10 percent of patients in some hospitals leave the emergency room unattended. It is more likely to occur in hospitals that serve low-income Medicaid patients. And with the end of continued coverage, millions of Americans stand to lose the Medicaid coverage they gained during the Covid-19 pandemic. Community-serving, mission-driven hospitals and clinics are under enormous pressure.

The hospital where my father waited six hours contracts out its emergency medical staff to a private medical company. The company has growing emergency rooms and high profits. This is happening in the United States as the health care system cuts costs and margins. Now that Medicaid enrollment is steadily ending, millions remain uninsured.

The Families First Coronavirus Response Act allowed low-income families and individuals to maintain Medicaid coverage without becoming eligible. Millions of Americans lost their jobs and lost insurance during the pandemic. Medicaid coverage has grown, with more than 93 million Americans using Medicaid, compared to 63 million people using Medicare. 15 million people are expected to lose Medicaid coverage next year, further straining an already overburdened system.

Hospitals feel hot. Atlanta Medical Center closed last year in Atlanta, leaving Grady Memorial Hospital as Atlanta's only Level 1 trauma center. Hahnemann Hospital in Philadelphia was closed by its parent company, for-profit Tenet Healthcare, because it was deemed financially unviable.

There are reasons why the United States ranks last among its peers in terms of health care affordability. In 2021, US health care spending was $4.3 trillion, or 18 percent of our gross domestic product. Private and venture capital have invested billions in the healthcare system. However, more than 100 million Americans are in medical debt.

The Wall Street Journal recently compared New York's administration to Florida's and criticized New York's large Medicaid budget. However, Florida has twice the number of uninsured people as New York. Ultimately, the small Medicaid budget shifts the responsibility onto the individual, driving America's medical debt to astronomical levels.

The uninsured are less likely to benefit from Medicaid, and the uninsured avoid seeking care, leading to poorer health. As Don Berwick, former administrator of the Centers for Medicare and Medicaid Services, writes, greed and perverse incentives are harming our patients and our health.

The reality is that healthcare is big business and the ultimate goal is not necessarily the best patient outcomes. Until we align the key drivers—improvement in quality of life, health outcomes, life expectancy, with profits—we will continue to look at the health care system.

One solution that could help millions of Americans is to end the Medicaid "tap" that was cut off during the pandemic. This refers to the temporary loss of Medicaid coverage while eligibility is determined. It's a process that has denied millions of Medicaid eligibles because of administrative and paperwork errors. Incorrect address and contact details, change of job and employment (especially for those without a fixed salary) lead to loss of insurance. The latest increase in Medicaid coverage starting in 2020 is partly a temporary end to administrative cuts.

Another solution is to expand Medicaid in the 10 previously selected states. North Carolina recently expanded its program after years of debate. Expanding Medicaid eligibility will help reduce the billing and financial burden on individual states for these struggling hospitals, especially rural hospitals. Additionally, this expansion will help reduce medical debt. Although 90 percent of the Medicaid expansion will be paid for by the federal government, these states continue to opt out, largely for political reasons.

When my father was finally seen at another hospital (where I worked and was able to wait with him), he had an abdominal x-ray and was diagnosed with diverticulitis. He was sent home on an IV dose of antibiotics and within hours he was feeling better. What if he stays at another hospital and waits to be seen? It's time for a change. Every time we make a deal that favors profits and financial incentives in our health care system, more people are hurt because the few in power get more dollars.