A service or a human right? This debate came up at work a few weeks ago and I found it interesting, and I'm curious to see what people think. I work in the medical field in the US, but I won't pretend to be all knowing when it comes to insurance policies, medicare/medicaid, etc. I'm also unfamiliar with the healthcare policies in other countries, as this is a global board I thought it'd be interesting to hear from people across the world on this issue (or non-issue depending on the country).
I've mulled this question over numerous times, and to be honest there really isn't an easy answer. At least for me. Do I think that every human being should be able to receive the same medical care regardless of income, race, sex, insured or uninsured, employed or unemployed? Of course, I do. I've seen patients receive priority due to their insurance (or lack thereof), and in some cases priority should have been the other way around. That isn't to say that if a patient were to code in the Emergency Room (or anywhere for that matter) that CPR wouldn't be started due to insurance purposes, but then again that's a life or death scenario. I digress, in the United States healthcare is treated like a business and to be honest I sometimes don't like that I am in fact a part of that business regardless of my disagreements.
To me, having healthcare set-up in such a business like manner is almost the equivalent to putting a dollar sign on someone's life; something for which I believe there really shouldn't be a price. However, on the flip-side of things I have heard the argument that if everyone were to receive equal care a person's choice of physicians wouldn't be as adequate, the standard of care might also be affected in the same manner, and even the option of seeking a second opinion might not be an option. In short, the 'services' provided might not be quite the same.
This also brings me to the other point I'd like to bring to the carpet. As I've stated previously I'm not knowledgeable on every single facet of medicare/medicaid, and state insurances and how they differ region to region. However, I am aware of the correlation between what I chart in a progress note or the coding I use in a lab slip, and how medicare/medicaid/insurance/etc. is billed by the facility. In order for a facility (such as long term care) to receive medicare/medicaid reimbursement there is a specific way we have to code/chart certain things. For example, when a facility draws routine labs on a newly admitted patient to check their kidney function: in order to get medicare to pay for the lab work we can't code the slip to say 'routine kidney function', instead the coding we use is actually for checking the kidney function for a specific reason that isn't necessarily related to the patient (eg. dialysis for example). Otherwise, medicare/insurance won't pay for the labs, it will come out of the facility's pocket; even though routine labs are often quite necessary as some patients are admitted to rehabilitation facilities from a hospital with unknown infections. When it comes down to it, yes it's fraud, but does that make it completely wrong to 'cheat the system' when lab work is necessary, yet too expensive for a facility to pay for every patient?
As you can see, there's a bit more to discuss and/or think about on this topic other than my initial question: Do you believe healthcare should be a service or a human right? Feel free to share your opinion on healthcare reform as well as it could or could not tie into my original question. I'm interested to hear from those of you in other countries to hear what some of your policies may be and how they may differ from the US. I thought this would be an interesting topic as I'm sure we may find a broad range of opinions, views, and even policies. Remember, be respectful of one another and every individual's opinion, follow the rules and by all means share information I/we might not know.
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