I witnessed one of the most beautiful expressions of love
recently. A dear lady whom I have had
the privilege of caring for in my practice for many years had slowly declined
due to a malignancy that she had fought to the greatest extent that she
could. She had recently been told that
further chemotherapy would not benefit her and her ability to breath was slowly
worsening. Everyone gets to a point of
acceptance of their condition at different points along their path and no one
should be rushed along in the pace of their travel. Already on oxygen and hoping for anything
that would help, she and her family opted to attempt to improve her condition
even if it was temporary. After getting
a transfusion and some intravenous fluids, she felt a little better, but it was
obvious that it was not enough; she needed to see her critical care physician
and would have to be transferred to another hospital. Upon entering the room to discuss the
situation with them, the patient’s daughter was curled up in the bed holding
her mom close to her in a reversal of roles that the daughter was most likely
remembering from years ago when her mother would hold her. The love that this mother had sown over many
years was being reaped; what was given was being returned in a very touching
way. This was a precious moment not just
for this patient and this daughter, but for this physician; it is one that will
linger and be treasured for years to come.
As this scene unfolded, I couldn’t help thinking about
how this same story will unfold when it plays out later under the control of
the Affordable Care Act (“ObamaCare”).
It is already becoming apparent that the insurance being offered on the
exchanges has restricted networks which will make it very difficult for someone
who wants to be able to receive more health care, especially if it is state of
the art. Many research hospitals are
being shut out of networks across the nation because they typically cost more;
the increased cost is understandable since they are typically tertiary care
centers and also teaching institutions.
Once people start comparing their limited option policies that they will
get on the insurance exchanges with what they thought and heard they were going
to have, there will be a lot of unhappy campers out there. They are going to be more than just unhappy
if their employers drop insurance coverage for them and tell them to go to the
exchange. Be watchful for it is only a
matter of time before you see the picture of someone’s innocent child plastered
everywhere in the media as the desperate parents attempt to get their child to
a research hospital that is not covered in their network; the picture might
also be an elderly mother who is not ready to accept hospice care and is being
denied any further treatment.
Less local control and more centralized control always
results in a less individualized program that attempts to give everything
within the system a one-size-fits-all solution.
This march toward federal government control over all of healthcare has
been in progress for many years now and the newest major change in law, which
may become known alternatively as the Unaffordable Care Act, takes it a leap
forward in that direction. Good and
effective leaders will not adhere to an ideological agenda which does not work
in practice, but will keep their focus on the mission of taking good care of
patients by putting good ideas into place no matter who suggests them, whether
it comes from one’s political party or not.
In the near future, unless some negotiated changes occur, what will
linger might be some memories that will not be so precious.