NicNDuB
Ok I know I’m preaching to the choir, but as someone who worked at Harborview with the uninsured and later assisting HIV+ individuals to obtain insurance, I feel the need to point out that too often we frame the health coverage issue as an individual problem, instead of the public health issue it actually is. While I agree that we should be concerned about the most vulnerable populations in our society, not everyone shares this belief, but I haven’t met too many individuals who aren’t concerned about their own health and safety.
And this is where I believe the conversation needs to move away from “the most vulnerable” to “our collective well being”. Viruses and other communicable diseases love densely populated areas because their ability to live and “procreate” is dependent on hosts. When communities have a high percentage of individuals with compromised immune systems (e.g. children, elderly, and the disabled), diseases will setup residence in these hosts as they learn how to get around the immune systems of the healthy. If contagious individuals do not have access to healthcare, they essentially become a carrier which impacts everyone in the community.
This is where I like to use an actually case to illustrate. At Harborview I worked with an individual who was the sole supporter of their family of 4 (them-self, a spouse and two children). This individual worked as a cook in a nice restaurant that didn’t offer health benefits. Therefore, when they got sick, they continued to go to work since they couldn’t afford medical care or to take time off and still feed and shelter their family. This individual also expressed a strong value of being self sufficient versus being a “welfare family”. I met this individual when they were admitted to the hospital after being immobilized by tuberculosis. Moral of the story: If you think healthcare is an individual’s responsibility ask yourself how many others you encounter in your daily life and how strong your immune system really is.
Finally, this is how the proposed Medicaid cuts could impact all of us:
• Cuts to outpatient Rx benefits: MRSA and other diseases that are “highly resistant” have developed in big part because of a lack of adherence that allows disease strains to become immune to existing treatments. So we can expect to see a rise in “super-viruses” if individuals can’t afford to complete some Rx treatments
• On average Medicare takes two years to make a disability determination. In WA the Disability Lifeline (or GAU as I knew it) offered medical coverage during this determination process. So even if you’ve worked your whole life and believe you have a safety net should you develop a chronic condition or get seriously injured, ask yourself if you have saved enough to cover medical and living costs for 2 years while waiting for the government to process your claim.
• Hospice services and emergency medical funding: do we really want to stop providing emergency and end of life care? Because if so we’d all better get accustomed to watching individuals die on our streets.
Thanks for reading and now I’ll step off my soap box.