August 5, 2011 | Posted By Sheila Otto, MA, BSN

A student recently shared her concerns about one of her patients, Mrs. R., a 51 yr. old woman who had multiple medical problems which landed her in the hospital but who had no insurance. It seems her husband, who is her primary caretaker at home, is disabled himself and on disability. The two of them have a joint income of $200 per week, which is too much to meet Medicaid eligibility.  With pre-existing illness and no possibility of prospects for health insurance, they are about to lose their home to foreclosure. The hospital will likely not be paid.

With all the talk of budget crisis and concerns about government spending and particularly about an expanded role of government in providing health care insurance, it is easy to lose sight of patients like Mrs. R. Everyone agrees that the US financial crisis is far from over and that health care is very expensive. However, we need to think about the role of government in helping citizens who have health problems which drastically affect their ability to live, day to day, and who currently are out of the loop for insurance. We have laws in place to insure that in an emergent situation, patients must receive life-saving treatment in the ED, regardless of ability to pay. But what good does it do to pull someone back from the brink if you can’t give them the assistance to prevent the same thing from happening repeatedly? If we were to agree to a plan to cover everyone (universal health care) because it is the “right” thing to do there is still the problem of paying for the service. Like the unpopular suggestion to raise taxes, limits to services would be difficult to put in place although essential to make a plan viable. Mrs. R is a classic teaching case for tomorrow’s physicians, who are asked to put a Band-Aid on a large and gaping wound. In a way, she is a paradigm for what ails us a country….we want a fix without paying and make “progress” by pretending that an insufficient remedy is fine for now.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.