by Karen WinsteadĀ
Winstead, of Rocky Mount, is a certified nurse midwife working as a nurse at a local hospital.
I agree with Dr. Eric Swisher, whose commentary was published Dec. 30 regarding malpractice insurance premiums. As more obstetricians get out of the business, the few left have to pay out even more money for premiums to cover the cost of malpractice claims.
I attended many of the sessions of the Governor’s Working Group on Rural Obstetrical Care and was disappointed with the amount of discussion and ideas regarding malpractice insurance. For some, the crisis is here, and we see little help from government.
However, I disagree with Swisher about the American health-care system being the best in the world. Malpractice insurance is just part of the picture. Swisher apparently has been covered by decent health insurance or has been healthy most of his life.
There are more Americans than ever without the means to pay for health care and going without health care. Free clinics and indigent services, while valuable, are often like treating a bleeding artery with a Band-Aid. We have more obesity, diabetes, heart disease, depression, preterm babies, etc., than ever.
We have a system that treats every pregnant woman as if she is sick, and does not utilize the resources we have wisely. We have a system where healthy, well-off people and some poor get medical treatment, but the working middle and lower classes often do not.
According to Dr. John Bower, a member of Physicians for a National Health Programwho presented at Carilion Health Care Systems Annual Ethics Conference last fall, one-half of all bankruptcies in the previous year were due to a medical reason or large medical debts. Most of us are just one major illness or injury away from bankruptcy.
Look at Canada’s national health-care system. Who gets more kidney transplants, Canadians or Americans? Well, to my surprise, it’s the Canadians. They found it more cost-effective to pay for transplants than to keep people tied to a dialysis machine. Private companies in America make big bucks on dialysis, so Americans stay on dialysis.
And guess what? Canadians can choose their own doctor, midwife, chiropractor, etc. No insurance company tells you whom you have to see. Payments are made in two weeks to the health-care provider. No waiting for months for insurance companies to pay. Liability insurance rates are much lower because the government health system pays for future medical needs.
Who has better maternal and neonatal outcomes? Places like Germany, Sweden, Britain and other developed countries that utilize midwives to care for pregnant women. In the United States, however, attempts were made to systematically eliminate midwives. And, despite decades of research showing their benefits, the Virginia Medical Society continues to work against midwives, who could alleviate some of the shortages of maternity care in Virginia.
The United States spends double the money of other countries on health care and gets half the benefit. To say we have the best health-care system in the world is to be out of touch with reality and the majority of Americans.
There must be fundamental changes in the health-care delivery system that benefit everyone, not just physicians, hospitals, lawyers, insurance companies and drug companies. We all want a better health-care system and less litigation. Let’s use this malpractice crisis to get the ball rolling toward a better system that works for us all.
