Friday, September 21, 2007


My mind has been spinning around the healthcare system in the US this week. I'd call it a crisis, but that might be a bit dramatic.

My general feeling is that we as Americans need to decide that it's worth spending taxpayer money to fund affordable health care for our countrymen. We have decided that regarding education, and it's doing well for us, for the most part. How exactly this needs to get worked out isn't settled in my head - when I come up with the perfect solution I'll let you all know.


The current medicaid system is not a functional piece of the puzzle. We need some BIG changes there. And I'd start with just a small co-pay.

Virtually all patients have co-pays, to see their PCP, a specialist, or to go to the ER. Except medicaid patients.

There needs to be a small barrier to entry, to help deter overuse. I never see private pay patients who bring in two extra kids "just to get them checked" with the one that was really sick, because it would cost them an extra $40 in co-pays. I don't know about you, but I can usually find a cute pair of shoes on Zappos for $40 (OK, they weren't $40, but they are cute). But medicaid patients pay nothing to be seen, so might as well pack 'em in.

I saw a medicaid patient this morning who said she'd felt drunk ever since she woke up. She literally still had pillow marks on her face. She had been in not 14 hours before for another self-limited complaint that had - don't be shocked - resolved.

If she had just a $2 copay, I bet she would have checked her own (normal) blood sugar at home instead of having me do it.

Affordable health care, yes. Free health care, no.

And I'm all for cheap shoes.


socks said...

What a subtle plug for Zappos!

I agree that any co-pay would more of a deterrent than no co-pay.

rlbates said...

You've been tagged.

Anonymous said...

The Kite Runner.
--dinah of shrink rap

Anonymous said...

The Kite Runner.
--dinah of shrink rap

The poor said...

Yeah, lets make it so poor people can't recieve treatment so the medical profession can rid their practices of difficult and needy patients! Makes sense to me?

Dr. Smak said...

Socks - any plug is a good plug.

RLBates - My first meme. But I'm with you, I wouldn't mind waiting a few months for the next one.

Dinah - Thanks for the reference. I'll admit that it took me several minutes to figure out that you were suggesting a book to read based on my request on my home page. Kite Runner was good - haven't read his new one yet. Keep the suggestions coming, I'm needing some new material.

the poor - thanks for the insightful comment. I'm all about getting rid of difficult and needy patients.

Ten out of Ten said...

Well here we are hanging out at the end of the line. I think I see GruntDoc and MonkeyGirl way up front, but it's hard to tell, they're really far away :)

I love the idea of a copay so much. The general public has no idea how much utter nonsense makes its way thru ER's across the country everyday. Obviously we're not trying to keep the sick out, just all the crap.

Anonymous said...

I would feel better about free education than I do about free healthcare.

I definitely don't support free healthcare until we get free healthy food for everyone. Think of the healthcare savings if everyone had their 5 servings of vegetables.