and a hard place

Pasatiempo - - In Other Words -

I had a pa­tient who was a med­i­cal stu­dent. A lot of stu­dents don’t have health in­surance, so this med­i­cal stu­dent could not af­ford re­ally good med­i­cal in­surance. At some point, his health-in­surance com­pany de­cided not to pay me, so I asked my clinic if I could I see him for a re­duced rate for a while. This was the way I was taught to prac­tice — when a pa­tient loses their job, in­surance, it’s un­eth­i­cal to dump them. Hope­fully, some­day they will pay you, but you don’t leave them stranded. But my clinic told me I would be vi­o­lat­ing fed­eral Medi­care law. I still con­sid­ered do­ing that. I think that’s just hor­ri­ble. This is when the pa­tient needs care the most. Ul­ti­mately I de­cided I could not risk my in­sti­tu­tion with me vi­o­lat­ing fed­eral Medi­care law. Pasa: What hap­pens to doc­tors who can no longer af­ford to prac­tice medicine? Wang: Some of them go to work for in­surance com­pa­nies; some go to work for phar­ma­ceu­ti­cal com­pa­nies. The for­mer edi­tor for The New Eng­land Jour­nal of Medicine talks about how our aca­demic med­i­cal cen­ters have ba­si­cally been bought by phar­ma­ceu­ti­cal com­pa­nies. Har­vard med­i­cal stu­dents say their lec­tures are sound­ing like drug ads, be­cause so many of their pro­fes­sors are spokes­men for drug com­pa­nies. Pasa: What do you think of the re­cently passed na­tional health­care bill? Wang: Even Pres­i­dent Obama’s mother [Ann Dun­ham] — she was a very per­sua­sive per­son, but she could not get her can­cer treat­ment cov­ered and died as a re­sult. I’m ec­static that pre-ex­ist­ing con­di­tions can no longer be ex­cluded. Pre-ex­ist­ing con­di­tions are what we used to call ill­ness. I’m very happy that un­der the new health­care re­form, health­care com­pa­nies will have to treat ill­ness. I don’t know how we got so far gone that with health­care in­surance it be­came stan­dard form for them to ex­clude ill­ness by call­ing it pre-ex­ist­ing con­di­tions.

How­ever, the health­care re­form ba­si­cally still leaves Amer­i­can medicine in the free mar­ket. Your health­care cor­po­ra­tions are still in charge, which is why their stock prices have risen since we got health­care re­form. They make money when they don’t pro­vide care. When they deny life-sus­tain­ing treat­ments, the in­surance com­pa­nies

Dora Calott Wang

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