Thursday, October 2, 2008

Never Ceases to Amaze Me

I am all for helping the poor and disenfranchised. I am all about providing health care in my field (that of emergency medicine) to any and all in need regardless of ability to pay. I can't count the number of times I have said to a patient "Don't worry about the money right now. You are very sick (or injured) and we are here to help."

I think I'm pretty liberal in my political views as it is. But when it comes to health care and money, I may lean a bit to the right. Like I said, all for helping those in need. But the words "in need" seem to need defining.

I am a paramedic. I'm good at handling medical and traumatic emergencies. I have a VERY good grasp of how "in need" should be defined.

Car crash, blood, broken bone... in need.

Headache that has been bothering you for three days... not in need.

Chest pain, left arm pain, shortness of breath... in need.

Thumb that 'hurts' after a day pounding nails on a construction site... not in need.

Diabetic and the sugar drops too low... in need.

Been feeling "sick" for the past week... not in need.

The not in need people may actually be sick mind you. But they need to schedule an appointment with their primary doctor or an Urgent Care doc, and not take up space in an Emergency Room.

We see all sorts of wacky stuff in the ED. Including people who are part of the 'Iowa Cares' program, or Title 19, who get their health care paid for for various reasons. There are, unfortunately, a few Title 19 recipients that know how to play the system to their advantage. Using an ambulance as a taxi service because you don't have access to a car...not in need.

And it is frustrating to those of us who are the care providers, because we see this waste on many occasions. Even if we report it and take it through channels the abuses continue.

So I fall in with conservatives on this one, to a point. There is little use in funding programs that are abused. But rather than cut the funding, I suggest better guidelines for the programs, and more stringent consequences for abusers. If I were King, I'd keep the Iowa Cares program, and put something in place for us health care workers to report abuses, then kick those abusers to the curb.

Harsh? Probably. But we can't help people who refuse to help themselves.

Meanwhile, while we are out, forced to play taxi service for a headache, someone on the other end of our service area has just swerved to miss a deer in the road, lost control and rammed a tree. They are broken and bloodied, definitely in need. But guess what? We're going to be ten minutes later than normal because of a "headache".

What would you change if you were King for a time? Or Queen. Or whatever leadership title you'd like. How would you fix our country? What things need fixing?

My Dad suggested I run for some office over dinner after the Rendezvous the other day. Not that I'm going to run off and try anytime soon. But the thought has occurred to me. The Wife says I'd make a terrible politician, because there are some things I'm unwilling to compromise on, and I'd have a nasty habit of firing those I deemed ineffective or unworthy of their position.

But as a voter, I do have a small voice in firing those who are unworthy. I just need to have a whole bunch of other small voices voting along with me. That's the tricky part.

Hmm. Uncommonly judgemental at work tonight. Think we've got some silly cases in here? You be the judge...

More Later

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