I've been out of medical school for a few years now and am on the frontlines of American healthcare. With every passing day, I see more and more the drag that is healthcare in America, where the insured and the rich get the fruits of the best medicine in America and the uninsured and non-wealthy folks get "cursory" medicine with poor follow-up care. There is nothing more frightening to me than a McCain administration in terms of where healthcare is headed in this country.
3am here at Bellevue....the stroke pager beeps me out of the few minutes of slumber I get during a night on call. A 63 year old man with hypertension comes in with sudden onset right sided weakness and a sudden inability to talk. Its a new onset stroke, less than 3 hours after symptom onset. I get a CT scan of his brain to check for any hemorrhages. Phew.....no bleeding. Great, his blood pressure is not skyrocketing, his blood glucose level is okay. I give tPA (tissue plasminogen activator), a medication we use to dissolve clots that may be obstructing blood flow to the L side of the brain through the middle cerebral artery. Several hours later, the patient miraculously recovers.......permanent deficits have been avoided. He can move his right side once again and no longer is ravaged by aphasia, the inability to communicate vocally.
Now the real horror begins for the patient, who happens to be uninsured and completely dependent on his next paycheck. He ends up having a 3 day hospital stay to try to find out why he had a stroke. 3 days in the hospital during the weekdays and 3 days off of work. 3 days off work and with no remorse, this man is fired from his job for getting sick. To top it all off, he'll end up with a bill of $40k to pay in total costs! I think to myself, "if he got through a stroke initially when he came here, he sure wont get through the stroke he'll have when he receives the hospital bill." This scenario is shameful and unfortunately, happens more often than not, especially in the hospital I work in, which caters to the poor and uninsured.
As the only industrialized nation without guaranteed health coverage for all of it's citizens, the United States pales in comparison to the health care received and available to citizens in our neighboring country of Canada. We have one of the highest mortality rates in the medical setting for all specialties when compared to those in other industrialized countries. The Canadians, the French, the British, the Danish and Dutch as well as a whole slew of other nations have better average healthcare outcomes than we do here and the cost of medical care in all of these countries is just a fraction of what it is here.
Why are we in such dire straits? Greed, pure and simple. The same philosophies which drove our markets to teeter on the brink of complete collapse are the same driving principles that run our healthcare system. The idea that healthcare is just like any other business where competition and free markets drive advancement is a failed idea and wrong for our citizenry. Health is not a commodity that can be put on the line for the highest bidder. Health is a privilege that we as American citizens are all entitled too, just like freedom of speech, just like freedom of religion.
Obviously I am apalled by McCains half-measures to "fix" our healthcare system.....yeah, buddy, $5000 credit is really going to help people when health plans cost on avg more than $10000 yearly. Obama has a better plan to mandate that everyone should be covered if they are not covered by an employer-based program. But why are our politicians still so scared to outright say and fight for a fundamental revision of our whole healthcare system from top down. What is needed is a single payer system that pays for all healthcare costs.
Anyway, my two cents.