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Health Care in America: Mating for MRI's

By Dr. Zaneb Beams

I was sitting in Starbucks with a graduate student, planning out some back to school activities for my kids, when she brought up the topic of health care. She told me a story about her friend, who suffered a hip injury, and needed evaluation, but didn’t have health insurance. Here in Maryland, it’s not so hard to get coverage on the individual market. The average cost of an individual plan is $215/ month. Then again, your average adult between the ages of 19 and 29 earns $44K annually.  

(My grad student friend buys hers on the individual market and spends lots of time worrying about deductibles and calling insurance companies and fighting over bills, but that’s a different story). Her friend decided it would be a good idea to meet doctors on, and date them, until she found one who would get her a hip MRI for free. Dating for health care.

How far can our great nation fall?

Access and affordability are two major concerns driving health care reform, crushing our health care system and bruising the national budget. We all know that there are young folks out there with no primary care doctors, and that often the transitional, and very necessary,  jobs that young adults take on to develop their career, don’t offer employer based health insurance. We all know that creative work rarely comes with built in health care benefits.

We also know that young adults aged 19-29 are most likely to “go bare” as they say. Many calculate that it’s okay for these young adults to go without health insurance, since they are pretty healthy. If you want to hear some horror stories about uninsured young adults in New York City, just ask someone you know who lives there, or take a look at this compelling “reality show” of health care nightmares: a young woman takes the bus to a public clinic because her cough won’t go away and finds out it’s tuberculosis, (there’s a public health disaster…)  a bike messenger gets hit by a car and limps home to recover without any evaluation. Etc. Etc. When did we become a country that allows, even relishes, this brand of “individual freedom and responsibility”?

In 2006, Kaiser Family Foundation reported that about 1/5 of young adults had forgone needed care because of lack of coverage, and 1/3 skipped required prescription medications for the same reason. We all know it’s much worse in 2011. As recently as 2010, I myself demanded that an ER doctor release my sister without any kind of laboratory evaluation after she had a seizure at work, because she was uninsured.

My own cousin went to the ER when his asthma got too bad to ignore, got the emergency care he needed and filled the prescriptions for his rescue inhalers, then nodded agreeably when the ER doc recommended he see a primary care provider and a pulmonologist. Instead, he put a Vicks vaporizer in his apartment. Far more cost effective than maintenance medication and spirometry, one must admit!

Health care reform became a reality in March of 2010, so why all the concern today?   Opponents of reform are still trying to repeal the Affordable Care Act, or build barriers to its implementation and success. Some states have refused desperately needed federal health care grants. By making plans and premiums more comprehensible and transparent, the exchanges will drive down costs of expensive individual plans, making it easier to identify and purchase affordable plans. This will build an American future founded in hard work, innovation, creativity, and true individual freedom and responsibility.

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