Would Obamacare Fix This?
A young man was seen at another hospital in our fair city for a nasty jaw fracture. His jaw was broken in multiple pieces and needed to be surgically put back together. Without surgery, his jaw almost certainly would not heal correctly. One possible outcome was that he might heal with an abnormal alignment, preventing his teeth form coming together correctly. Another possible complication of such a fracture is that it might never heal at all. We call that a non-union. In such a case, he would be left with a loose jaw that would cause him pain every time it wiggled. Because this patient had no insurance, the other hospital arranged for him to be seen in the Plastic Surgery clinic at our county hospital to arrange for his needed surgery.
When he arrived for the appointment, the clinic discovered a big problem – he was not a resident of our county. He was here for work but his residence was still in another county. Not only had he no insurance, he was not eligible for any county-sponsored charity program. Before the man could get a much-needed surgery, he would have to come up with $10,000 cash.
Understandably discouraged, he went back to where he was staying and, I think, accidentally, took too many pain pills along with some Valium a friend gave him. When he went unconscious, his friends freaked and called the ambulance. He ended up in our emergency department.
I kept an eye on him all night as he gradually woke up. When I finished my shift in the morning, I asked a Customer Service representative, to come see him. This patient and his situation took up a good part of her day. She tried every possible way to arrange for him to get surgery, either at our hospital or back in his county of residence. She tried to get him qualified for Medicaid. She tried to see if he could somehow qualify as a resident in our county. She explored with him ways he might be able to come up with the $10,000. He finally left with information on how to try to get the care he needed when he got back home.
This is a great example of just why we should quit pretending the government is not already running healthcare and get rid of this ridiculous double standard in our medical care payment system. The man had to have surgery on his jaw. We, as a society, are not comfortable relegating people who can’t pay for needed surgery to a lifetime of permanent disability. If he had been a resident of our county, they would have operated on him and the taxpayers of the county would have paid for it. Out of our county? No way! Go to your own county and have your county’s tax payers pay for it! What kind of a crazy system is that? One way or the other, he will eventually get the care he needs and the taxpayers will pay for it. Why not come up with some system that is fairer in regards to who pays and who gets treated? That is what we need but would Obamacare fix this problem?
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You tell us! Would Obamacare fix this problem?
When I first wrote this story, I finished with the comment that Obamacare would not fix a problem like this. My editor (my wife) challenged me for proof that it would not. Since I had no proof and it is really too early to see what the effect of Obamacare with eventually have on our healthcare non-system, I removed my negative comment. I think that if it doesn’t fix this sort of problem, it is not because it is a bad idea. Rather it is because it doesn’t go far enough. I am pretty sure that most emergency physicians would prefer a single-payor system since we disproportionately care for the under-trodden of society and provide more care to those who are unable to pay than any other medical specialty.