Thursday, October 11, 2012

Romney indifferent/ignorant of suffering of the uninsured

In my very first clinical rotation in med school, I encountered a 50-something woman who presented with changes to her right breast.  She had noticed a weird patch of skin a couple years prior.  Not having health insurance, and unable to afford to take days off work from her job as a hairdresser to have it checked, she decided to just hope it would go away on its own.  By the time I saw her, much of her breast was necrotic.  We diagnosed her with stage IV breast cancer, and she died a few months later.

Another patient, who I encountered on my internal medicine rotation, was admitted to the ICU with a massive stroke.  He was in his late 40's and had a history of high blood pressure.  He'd lost his job and with it his insurance, so he stopped following with his doctor and taking his medications.  Now (or, well, 5 years ago, at least), he's bedridden, non-verbal, and gets lots of expensive treatments paid for by you and me.

A Harvard study from 2009 estimated that 45,000 Americans die every year due to lack of health insurance.  The estimate should be taken with a grain of salt, as it was authored by advocates for single-payer health care, but simple medical knowledge, and my own experience, indicate that the number of Americans who die from lack of insurance certainly isn't zero.

Most of us probably know people without insurance who deal with untreated chronic illnesses, or who aren't able to afford a doctor's visit for a nagging cough or to pay for the medicines the doctor would prescribe if they were seen.  Their quality of life, and the quality of work they provide, are damaged due to preventable causes.

So I was dismayed today to read that Mitt Romney said “We don’t have a setting across this country where if you don’t have insurance, we just say to you, ‘Tough luck, you’re going to die when you have your heart attack... No, you go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital. We don’t have people that become ill, who die in their apartment because they don’t have insurance.”

Romney seems to be completely unaware of the fact that emergency rooms don't provide a whole myriad of services one might need to go on living, like chemo, regular dialysis, mammograms and blood pressure medications.  They aren't capable of long-term management of obesity and cholesterol, which would prevent heart attacks from happening in the first place.  ERs also don't provide end-of-life care like hospices provide.

This is an incredibly important issue which affects far more Americans than terrorism, against which we spend literally trillions, and is far more amenable to a government solution.  For Romney to say something so ignorant is truly shocking.

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