Thursday, November 7, 2013

Poverty and Health Care Rationing

Because we can't manage to provide adequate healthcare to our own citizens, the less fortunate get to be rationed down to using EMTs for primary care.  At least that's a scheme being proposed by some doctors.
[T]hose who ... practice general medicine are rarely drawn to work in the rural and inner-city areas where people most lack access to medical treatment. 
What’s needed is a strategy to lure people who already live in underserved communities to practice health care there. One clever way of doing that, just proposed by a group of authors writing in the November issue of Health Affairs, is inspired by the successful model of emergency medicine -- that is, give people the level of training that emergency medical technicians and paramedics receive, but aimed at primary rather than emergency care. 
After all, what do EMTs and paramedics do but bring medical skills and equipment to places where doctors and nurses aren’t readily available? In their case, the places are wherever car crashes, heart attacks or other sudden medical catastrophes happen. EMTs and paramedics are also trained relatively quickly and paid relatively modestly, with a mean annual salary of less than $35,000.
The big difference, of course, is that emergent medicine is not the same as primary care.  And at the end of that ambulance ride is an ER stocked with doctors, nurses and technology to help you recover.

Sure, you could train a few EMTs to deal with some chronic primary care issues, but in the end, what do these people do when they need a real doctor?  Go to the ER?

A scheme like this, in the context of a comprehensive socialized healthcare system would be great, but using it as another band-aid to patch up our horribly broken healthcare delivery system is shameful.

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