Wednesday, June 17, 2009

The 4 C's And 1 B

I came across this quote from Professor Mark J. Perry of the Carpe Diem blog. I have often thought similar things.

Dr. Perry writes:

"Bottom Line: If you can afford a cell phone or cable TV, you can afford basic health insurance. In Michigan, you can get basic health insurance through Blue Cross Blue Shield starting at $47.14 per month for those 18-30 years old (about the cost of a basic cell phone plan), and starting at $168.13 per month for another plan for individuals under 65 and families (not too much more than a cable TV plan with premium channels, and about the same as two cells phones at the monthly average of $77)."

Now I have spent over 20 years in health care and over 80% of my time has been spent taking care of indigent patients - i.e., people who cannot afford health care. I have never once denied care because a patient couldn't pay, and I have never seen my colleagues do the same. In fact, I have never, ever seen any health care person not do the very best they could because a patient was unable to pay. It doesn't happen. As much money as I have written off over the years, I have never ever understood the concept that Americans don't have health care. It can be found, and it is always rendered by very capable practitioners. No questions asked.

Yet, while no patient is denied on my watch, one does question the sanity of system that does guarantee certain inalienable rights for patients while casting aside certain personal responsibilities to care for themselves. So Dr. Perry's remarks often remind me of what we use to think and see everyday. Patients couldn't afford their medicines or to pay their medical bills, but they could afford cell phones, cars and cable TV. In fact, we use to state that as an American citizen you were guaranteed the 4 C's and 1 B even if you could not afford health care.

The 4 C's are: 1) you have the right to smoke Cigarettes; 2) you have the right to own a Cell phone; 3) you have the right to Cable television; 4) you have the right to own a Car.

What was the 1 B? Of course, you have the right to get Body piercings and tattoos!

As an American citizen, these are your rights even if we cannot afford health care.

Seriously, folks we have tough choices to make. More personal responsibility would be welcomed; sacrifices and choices need to be made. And I would agree with Dr. Perry if you can afford anyone of the 4 C's and 1 B, then you can afford to pay for your health care. It is your choice.


Openmind said...

If everyone in Utopia just was slightly more responsible...

But now, we don't live in Utopia where ideology rules behaviour. It's an imperfect world where people make irrational or at least irresponsible choices.

If someone payed for a cellular and cable TV but not health insurance, should that person suit herself? Well, that is one simple way to look at the problem. Another view is to consider the cost of emergency care due to negligence of the individual, waiting too long to seek medical care, loss of productivity, social stress, etc, etc. I'm not too sure that the "everyone for himself" doctrine is the overall most efficient in the long run.

I wouldn't have any problem with some kind of basic health cover. If you want more/better/faster, you pay for it yourself.

Anonymous said...

Responsibility would be great if only the insurance companies would actually offer health insurance. The reason many people don't have health insurance is not because they don't want it or can't afford it---the reason is that the insurance companies have determined that they just won't sell insurance to a significant percentage of the population.

Guy M. Lerner said...

Openmind: I agree it is not utopia; I am just saying I have never refused to provide care for anybody or try my best; I know what I wrote is about as controversial as I get --- there are no good answers but no doubt there is an expectation in America that we are guaranteed some things and take others for granted; as far as I am concerned everyone has healthcare and I would tend to agree with you as well that we are probably headed for a 1st class and coach class kind of health care

Mr. Carver: I am a consumer too; I would agree the insurance companies are not our allies and will do whatever they can to befuddle; I never know what I am paying when I go to the doctor; as far as being a patient in the hospital, I don't know how the uninformed navigate the system

Guy M. Lerner said...

Openmind: one more thing...I agree we are never going to stop providing care for everyone; it just isn't possible; if we go to a 2 tier system you have to wonder if that is fair as well