By Russell Noblett, M.D.
The Roanoke (Va.) Times, Letters, March 25, 2018
There is a saying that “necessity is the mother of invention.” Compassion is a form of necessity. It fosters creative thought. With compassion, even a very difficult problem, such as universal health care, can be fixed. Without compassion, it is impossible.
In 2000 the Virginia General Assembly created the FAMIS (Family Access to Medical Insurance Security) program. FAMIS provides comprehensive health coverage during pregnancy to women with incomes up to $24,887 (200 percent of poverty income). This is too high for Medicaid, but too low to purchase health insurance. FAMIS covers about 65,000 poor pregnant women in Virginia yearly.
In a recent article, a respected doctor began by describing a pregnant woman for whom he recently cared in the hospital. The reader expected to hear more about this patient. Instead, the author bemoaned being paid only $200 by Medicaid for this care. (The reader was left to imagine what $200 might mean to the poor new mother.)
We have forgotten why we are in medicine. Indeed, we have forgotten what it means to be a society. There is no better use of our last dollar than caring for each other.
Medicaid pays only 50 to 60 percent of what private insurance pays to hospitals and doctors. However, it results in a five percent decrease in childhood mortality. Still, studies show that Medicaid is associated with poorer outcomes overall, due most likely to sicker patients at entry, and to difficulty finding primary care doctors who will take Medicaid.
This situation is fixable with creative compassion: with earlier universal coverage, adequate funding and doctors in it for the care-giving.