Theres a suggestive piece by Abby Goodnough and Robert Pear in this mornings issue of The New York Times on the ways that high deductibles discourage people from seeking out medical care even if theyre insured. I keep waiting for someone to make the obvious link between insurance coverage and our current anxieties about Ebola. It has long been a persistent feature of medical coverage in the United States that it attaches principally to individuals, so that costs and benefits follow the individual patient. Yet Ebola (like epidemic diseases in general) reveals all too strikingly that health is far from an individual characteristic. Much more than we typically recognize, it inheres in populations, so that the health of our fellow citizens (our fellow humans, to say nothing of our fellow animals) determines the risks of infection to which we ourselves are exposed. Thomas Eric Duncan presented himself to the ER at Texas Health Presbyterian with no insurance. Does anyone doubt that the uninsured are likely to seek out--and receive--care less quickly than the rest of us? Or that hospitals respond differently to would-be patients who have no coverage? Duncans care eventually cost more than half a million dollars, even if we dont take into account the two nurses who became infected and everyone else who has been touched by his tragic illness. Because we in the United States refuse to treat health as a common good, we are more vulnerable than we realize to fast-moving pathogens that refuse to recognize the boundaries between insured and uninsured about which we argue so much. I fear that someday we may come to regret just how dangerous these strange ways of individualizing shared health and illness may prove to be for all of us. nyti.ms/1rkL6OX
Posted on: Sun, 19 Oct 2014 01:02:37 +0000
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