By James Fieseher, M.D.
Letters, Portsmouth (N.H.) Herald, June 23, 2011
Recently, a patient told me he was against a government-run health care system because it meant he would be paying for “deadbeats” who sponge off of hard-working people to get free health care. He had a point. He had a difficult job, and worked hard to make ends meet and pay for his own health care. Why should he pay for someone “too lazy to work and take care of himself?”
Unfortunately, he is already paying for health care for the uninsured and indigent, and at a very high rate. People without health insurance tend to avoid any sort of health care, especially preventative care, because they can’t afford it. When they get sick or injured, most will try to take care of things on their own until the problems becomes so bad that they have to go to the Emergency Department. At that point, their care becomes so expensive that they are unable to come close to paying the bill. When this happens, the hospital picks up the cost of care and passes it along to other patients, with usually a 20 percent “administrative fee.” For those of us who are insured, our insurance then pays that cost, but they pass that along to us the policy holders with an additional 30 percent “administrative charge.” So, in fact, we are paying the most expensive care (emergency room charges) for the uninsured with a 50 percent administrative fee tacked on. Ouch!
Remember the parable of the Good Samaritan? The victim was beaten and robbed and left to die at the side of the road. A doctor and a clergyman chose to ignore him, but a foreigner (a Samaritan) picked him up, cared for him and paid to nurse him back to health. Ironically, this is an example of a more economical delivery of health care than we have today in the United States! The Samaritan incurred no emergency room expenses, no hospital fees and no administrative charges. Of course, there were no hospitals, emergency departments and health insurance companies back then, but that makes the Samaritan’s actions all the more remarkable.
If my practice is any indication, most of my uninsured patients are hard-working people who have jobs that don’t offer insurance or have lost their jobs due to the economy or because of an injury they incurred when they were working. The term “deadbeat” is not only an inaccurate characterization, it is an injustice.
A system of health care that depends upon employment puts a burden on businesses (especially small businesses), the self-employed and people with a pre-existing medical condition. From a purely preventative care point of view, it is counterproductive to try and prevent illness in one pocket of society while living in a country with a sizable population that gets no preventative care at all. In the 1950s and ’60s, we were able to eradicate smallpox because we vaccinated everyone whether or not they had private health insurance.
If we truly want to save money on health care, we would be wise to follow the example of the Good Samaritan. Generosity in health care will actually save each of us money in the long run.
If you are not prepared to have a nonprofit or government-run system distributing our health care dollars for a universal health care system, then you should give generously to private organizations such as SeaCare, Families First or Avis Goodwin to ensure that these organizations continue to give care to our family members, friends and neighbors without insurance. The alternative method to save money is to walk away from the uninsured and give no care at all as the clergyman and doctor did in the original Good Samaritan story. In that case, let us hope we don’t become the victim.
Dr. James Fieseher practices family medicine in Portsmouth, N.H.