Monday, September 05, 2011

Only The Best For American Patients

What do Representative Joe Barton of Texas, Governor Bob McDonnell of Virginia, Senator Richard Shelby of Alabama, Senator John Barrasso of Wyoming, and talk show host Rush Limbaugh have in common (here, here, and many places)?

They all have stated definitively that the United States has the best health system in the world. The family of Kyle Willis probably wouldn't agree:

A 24-year-old Cincinnati father died from a tooth infection this week because he couldn't afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.

According to NBC affiliate WLWT, Kyle Willis' wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.

When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn't afford both, so he chose the pain medications.

The tooth infection spread, causing his brain to swell. He died Tuesday.

Carrie Gann of ABC News' Medical Unit, who wrote this story, notes

Willis' story is not unique. In 2007, 12-year-old Deamonte Driver also died when a tooth infection spread to his brain. The Maryland boy underwent two operations and six weeks of hospital care, totaling $250,000. Doctors said a routine $80 tooth extraction could have saved his life. His family was uninsured and had recently lost its Medicaid benefits, keeping Deamonte from having dental surgery.

She quotes a dentist at the University of California at San Diego, who commented

When people are unemployed or don't have insurance, where do they go? What do they do?People end up dying, and these are the most treatable, preventable diseases in the world.

Gann continues

Getting access to dental care is particularly tough for low-income adults and children, and it's getting tougher as the economy worsens. In April, the Kaiser Family Foundation reported that 33 percent of people surveyed skipped dental care or dental checkups because they couldn't afford them. A 2003 report by the U.S. Surgeon General found that 108 million Americans had no dental insurance, nearly 2.5 times the number who had no health insurance.

Trips to the dentist aren't the only expenses hard-up Americans are skipping. An August report by the Commonwealth Fund found that 72 percent of people who lost their health insurance when they lost their jobs said they skipped needed health care or did not fill prescriptions because of cost.

"People want to believe there's a safety net that catches all of these people, and there isn't," said Dr. Glenn Stream, president-elect of the American Academy of Family Physicians. He noted that it is often young men who are the most likely to lack health coverage.

Dr. Jim Jirjis, director of general internal medicine at Vanderbilt University, said people, like Willis, without access to care often die of conditions that were much more common decades ago.

"He [Willis] might as well have been living in 1927," Jirjis said. "All of the advances we've made in medicine today and are proud of, for people who don't have coverage, you might as well never have developed those."

There are a number of free dental clinics in operation around the country, where dentists volunteer to provide care to those without health insurance. But even if Willis had access to a free dental clinic, Stream said he still may not have been able to get the care he needed for his infection. "The wait is often months at these clinics, and this young man died within two weeks of his problem," Stream said.

Silverstein operates three free dental clinics in the San Diego area. "We're overwhelmed right now," he said. "We can't take any new patients."

Conservatives adore arguing that when a vital and expensive medical procedure is needed, patients in some countries have to wait for an appointment. Labor Day, however, is a good time to remember that some Americans cannot afford, and cannot get, routine health care or dental surgery- which, as Willis and Driver tragically demonstrated, is health care. Or they can be treated and go without other critical health care, or food, or shelter.

It used to be said "if America can go to the moon, then why can't we...." (Insert here favorite cause.) Health care can be made available to everyone. But this President is satisfied with merely moving the country in the right direction and the Repub Party is content with the status quo. On this Labor Day 2011, it ought to be simply acknowledged that the only sure way to render medical treatment and prevention accessible to all citizens is to decouple it from the job. That is not only sensible health care policy, but also would remove an obstacle faced by many employers to hiring individuals on a full-time basis.

In a normal time, we would have a President fully committed to that goal and a Republican Party at least somewhat interested in it. But, alas, these are not normal times.



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