In his op-ed column in the New York Times a couple of weeks ago, Paul Krugman blasted those who minimize the problem of people lacking health insurance by suggesting that all Americans have access to medical care via the emergency room. If I were a single man I would probably be in the group that Krugman criticizes. I'm generally as healthy as a horse: I rarely miss work because of illness, I rarely initiate a visit to a doctor, and the last time I had blood work done, my numbers were great. I do have a couple of health issues, but they are manageable and I get along just fine. If needed, the ER could serve as my source of health care, and I would assume the same for others.
Enter my wife. Although you would not know it by looking at her, modern medicine has been the source of her survival since she was in the womb--literally. I just made a list of her current health problems. Not counting her very poor (uncorrected) vision, or the gestational diabetes she had during her last pregnancy which required daily monitoring of blood sugar and insulin injections, I count six problems that actively require some kind of medication or other therapy. Actually, one of those is not much of a problem now because of successful physical therapy, but it isn't cured either, and hints at a comeback from time to time.
Of my wife's six health problems, none of them are candidates for ER treatment. Sure, if she had some kind of acute emergency then the ER would work, but really they are chronic problems that need sustained attention and monitoring by the appropriate health professional. Thank heaven that we have good health insurance through my job.
Recently we did make use of the emergency room. Although we did not know it at the time, our baby boy had pneumonia and we rushed to the ER (~1am) when he started having trouble breathing. They gave him several nebulizer treatments, did some blood work, and took chest X-rays. Initially they were going to admit him to the hospital, but when the pediatrician finally saw him he was discharged and all further treatment was managed by the pediatrician's office. For their services, the ER billed our insurance company over three thousand dollars, of which our insurance company agreed to pay several hundred, and we simply paid our co-pay (as well as our premiums, of course). Again, thank heaven that we have good health insurance. (And in case you were wondering, baby boy is just fine, thanks.)
I know that the problems with cost and administration of health care in the U.S. are complex, and I will not enter into what kind of policies would be best, or which political party has the best answer. However, one thing is clear to me: the ER is not the answer. When I think of my wife and those less fortunate than we are, "let them use the ER" sounds like "let them eat cake."
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