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Is Healthcare A Right Or A Privilege?

Is healthcare a right or a privilege? Depending on how you view this determines how you feel about the recent healthcare reform which was signed by President Obama. As a doctor, I firmly believe that having healthcare is a right.

As a nation, we agree that individuals should be accountable for their actions. People often argue that those who are reckless with their bodies by ingesting chemicals via cigarettes or drug use and who subsequently develop cancers shouldn’t be subsidized by others’ insurance premiums as the latter group works hard at staying healthy by exercising, maintaining a healthy weight, and eating generous portions of fruits and vegetables. Some how it isn’t fair. Unfortunately, life and good health aren’t quite that easy or predictable.

Children who haven’t had time to abuse their bodies do develop cancers, type 1 diabetes requiring insulin, or are born with genetic problems, like cystic fibrosis, that require expensive medical therapies that potentially are lifelong. Once diagnosed, these children are now plagued with the “pre-existing” label and unable to get health insurance. Over the past many years, the leading cause of personal bankruptcy for individuals and families is due to medical expenses. As a parent with an ill child could you simply walk away?

Non-smokers do develop lung cancer (note Dana Reeves, Christopher Reeves’ wife). Individuals without a family history do get afflicted with other aliments. Healthy people do get heart attacks.

In other words, life happens. Good health can require a little luck as well. While individually one can decrease risk by not smoking, eating healthy foods, losing weight, and exercising, it isn’t a sure thing. Bad things can happen to good people.

About 1 in 10 Americans or thirty-two million citizens, roughly the entire population of Canada, don’t have health insurance. As a country, is it acceptable for us to walk away from them?

Even today, Americans believe in the American dream — work hard and you can be successful. The wild card is that having good health can be a finicky thing. Do everything right and you could or a family member could be stricken with a serious illness. Prior to healthcare reform, this situation not only could bankrupt you but your family.

Let’s be clear. The legislation isn’t perfect. It isn’t so much true healthcare reform, but health insurance reform. The program phases in over a number of years. It doesn’t address healthcare delivery or costs, which will likely occur in 2011. Nevertheless, it is an important start.

Despite the heated rhetoric from both parties, Americans are still a society that welcomes diversity, provides compassion and help to fellow human beings, believes in justice, fairness, and the opportunity to succeed with dogged hard work. This healthcare reform legislation, though far from ideal, is a good first step to ensure the American dream can still exist for current and generations to come.

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*

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3 Responses to “Is Healthcare A Right Or A Privilege?”

  1. Peter Wolfe says:

    I’m a college student studying in political sciene at Auurn University, so I have a little more knowledge than the average bear on the street. Okay health care is a human right due to the nurture element as well. Looking at society as a whole are we united or divided? Honestly can you help that you live in a bad neighborhood with higher levels of crime? Lody be christians largely conservatives put up the argument on how we can afford health care for all without bein bankrupt? Well, look at Matthew for your answer on this one is taking care of a sick individual or group likie a poorer family is largely our responsability.
    Furthermore, health care is an essential balance of respect of the human being as a personwho makes mistakes. People abuse their bodies by other things like perscrptions or even food in fast food restaurants who don’t properly educate us. Look prior to 1965 with tobacco products for your answer on that one. Dude man like accidents cannot also be prevented such as a car wreck so if you were in between work and home and was going to get that promotion right? Well, you need this security to achieve it as well for the safety of all americans.
    Thirdly and finally, health care is about “Life, liberty and the pursuit of happyness” that is denied. The double standard on health care on prolife issues and abortion is an oxymoron from the other side. Wecan in theory prioritize the industry on whom preys on the poor and eliminate it lik fast food restaurants from poorer areas if not completely. We could have opportunities of work for more nurses, education manditory meetings, food regulation, create food alternative incentivves for poorer areas, etc. We could evolve as a species to encompass the left rather thn purely the riht hemisphere of the brain. We could put more emphasis onthe human in humanity rather than shooting for the lowest point like using words “At least your not in Africa” and instead replace it with “I’m in America the land of opportunity and human rigts of the dignity ofthe individual”. Its a moral impairative, security, and doesn’t unduely discriminate on tindividual either. Right now we are prforming euthanasia and no religion would agree with thi, nevertheless, we do cause we are a nation of unlimited materialism and false religions. Time to change this system from top downward to show mercy, love and compassion to our fellow man. Personally I wouldpay higher if I had a business, worked in the government, etc. We could fund it by elimination of nonessential Social Security, tightened codllege loans and grants, electroncalizing paperwork, cutting the military, elimination of public retirements, etc. Come on guys do it for yourselves an your loved ones and put aside your prides.

  2. Lynn says:

    It’s a privilege. As a healthcare worker I’ve seen first hand what no responsibility has done to healthcare.

  3. guest says:

    All those that say Healthcare is a privilege are down right living in a fantasy world! When they lose their job or life circumstances are good for them and they are left without CARE! I WILL BE THE FIRST TO SAY TOO BAD FOR YOU! NOW YOU HAVE NO HEALTHCARE AND YOU CAN GO BROKE DROWNING IN MEDICAL BILLS! THEIR OUTLOOK WOULD BE TOTALLY DIFFERENT! OF COURSE ONLY WHEN IT EFFECTS THEM PERSONALLY OR IT IS THEIR FAMILY MEMBERS!

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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.


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