Theory & Practice

I don't like discussing heathcare around my wife.  This is because I tend to take very extreme positions during a healthcare debate just to test the limits of the logic.  My wife thinks that I actually believe the extreme things that I say and am a nasty person.  I'm not, but I understand why she might think that.

This weekend I was again expounding on the question of what are we entitled to when we say we are entitied to healthcare.  I overstated the position by saying that doctors should have no obligation to treat.  That was harsh.  My friends pointed out that the Hippocratic Oath is a good thing and that the inherent mercy that doctors show in times of crisis is a wonderful thing.  I could not agree more.

And, true, we do not want doctors asking a bleeding patient if they have health insurance before they administer first aid.  No argument here.

As always with me, it is a matter of degrees.

After being treated in a crisis situation, the conversation should go something like this:

Doctor:  "Hello Mr. Patient, I saved your life.  The treatment was kinda expensive.  Here is the bill.  By the way, this is the competitive market cost to save you, not some inflated estimate for the insurance company." (I just had to get that in there).

Patient:  "Thanks Doc!  You're right that is expensive, but it was totally worth it.  I am lucky to be alive."

Then,

Patient: "Thankfully, I have XYZ insurance for just such an unlikely but devestating situation.  I will work with them to ensure you are paid."  (Notice who has primary responsibility for paying).

Or:

Patient:  "I don't have any insurance, but the fact is that if not for your efforts I would be dead.  I will pay out out of my own pocket even if that means I have no money left.  Because I can always earn more money, and I only have one life"

Or:

Patient:  "I don't have any insurance and I am indigent.  I cannot pay you."

To which the Doctor replies:  "I understand.  This hospital and the government have safety net programs to cover people in just your situation.  You will have to complete some paperwork to confirm that you qualify for this program, but if you do your expenses are fully covered."