Tuesday, December 20, 2016

In The Republican Health Care Plan Parents Are To Be The Diagnosticians!

Because if they have to weigh the out-of-pocket costs of taking a sick child to the ER against the potential an ER visit might have, well, they might delay that visit and save us all loads of money:

A Republican congressman outlined the way he would like to see the health care system operate if Obamacare is repealed, as GOP lawmakers are promising. It is a brave new world in which parents would wait and think about it before bringing in their sick or injured kids for costly treatments.
The example Rep. Bill Huizenga (R-MI) gave in an interview with MLive.com was from his own experience when he waited until the morning after to take his youngest son to the doctor with an injured arm, because he did not want to waste money on an expensive emergency room visit. The arm, it turned out, was broken.
"We weren't sure what was going on. It was in the evening, so I splinted it up and we wrapped it up, and the decision was, okay, do we go to the ER? We thought it was a sprain, but weren't sure," Huizenga said, adding that he and his wife "took every precaution and decided to go in the next morning."
"When it [comes to] those type of things, do you keep your child home from school and take him the next morning to the doctor because of a cold or a flu, versus take him into the emergency room? If you don't have a cost difference, you'll make different decisions," he said.

Isn't that just precious?

Let me respond by giving you my own experience about something where Rep. Huizenga probably would have recommended waiting:

One Sunday, when my sister was still a baby, she began crying and would not stop.  She was also feverish, but her fever wasn't terribly high.  My parents thought that she might have caught a cold and took terms carrying her to soothe her.

But her crying would not stop, so very late that night my father took her to the ER.  She was diagnosed with bacterial meningitis, and the doctors told my parents that had they waited until Monday to see the family doctor, my sister would have died.  Even as things were, she almost didn't make it.

Now Rep. Huizenga would have recommended that my parents wait, because ER care is expensive?  That they are good enough diagnosticians to know when a fever is caused by, say, teething and when it is a sign of something very serious?

The basic problem in his recommendations is this: 

When we consume health care we don't always know what treatments, exactly, we might require.  That's why physician visits are called consultations:  It's not only the treatment we wish to buy, but also the diagnosis. 

When out-of-pocket health care costs are raised, poorer families are going to delay the seeking of care for financial reasons.  And some people will die because of that choice to make us all into medical diagnosticians.

This doesn't mean that unnecessary care shouldn't be curtailed, to save money overall*.  What it does mean is that it's not the initial consultation we wish to curtail, because that's where we learn if care is necessary or unnecessary.


*There are many ways of doing that, including urgent care centers as an alternative to emergency rooms during weekends, weekend 24/7 phone services which attempt to tell the caller if an ER visit is necessary and so on.  But to argue that bigger monetary costs is the answer totally ignores the basic aspect of medical care: It is a form of consumption where we learn what we should consume.