Rush Limbaugh got released from the hospital today. On his way out he made the following statement:
I've been treated to the best health care the world has to offer and that is right here in the United States of America," he said. "Based on what happened to me here, I don't think there's one thing wrong with the American health care system
H/t Raaz
This statement as anyone could understand was a dig at Health Care Reform. The intent being that I received the best care one could receive thus there is nothing wrong with the care that people receives in America; therefore, America has the best Health Care System in the world. However, Mr. Limbaugh failed to understand that the care he received in the hospital was not the health care system. Mr. Limbaugh was taken to a private not-for profit hospital which although it has for mission to give quality care to its patients, the ultimate driver for quality care was money; not his money, but the money that it receives from the government.
The moment that 911 was called on behalf of Mr. Limbaugh, the best part of the American Health Care System was put in motion. Thanks to government regulation named EMTALA, an ambulance or hospital which receives payment from CMS (Center for Medicare and Medicaid Services) cannot refuse to take care of a patient with a medical emergency. They have to treat and stabilize a patient who presented with an emergency medical situation regardless of payment capability or immigration status. Because of that law the rescue ambulance had to take him to the nearest hospital, which luckily for him happened to be Queens Medical Center and not the Public Hospital set up to give care to patients without insurance. (I don’t know Hawaii, so if Queens Medical Center is not the nearest hospital or if you don’t have public hospitals, please let me know in the comments).
His chief complaint of chest pain then catapulted him to the front of the line. Chest pain patients get seen right away and all the necessary tests and treatments are done within a short amount of time. Hospitals have to do this if they are to keep their accreditation and keep receiving payment from CMS. There are a slew of diagnoses on which The Joint Commission requires hospitals to report their quality and performance data in order to keep their accreditation. These are called Core Measures. Hospitals do their damndest to be in the top percentile, because losing their Joint Commission accreditation means losing their ability to collect payments for Medicare and Medicaid. Thanks to the government using the power of the wallet for their beneficiaries (Medicare and Medicaid patients) everyone benefits. Try going to the emergency room with a diagnosis not included in the Core Measures and you probably would spend 3-7 hours before seeing a physician.
Once released from the hospital, the care he will receive will be dramatically different from the care someone without insurance or that of someone with crappy insurance receives. Mr. Limbaugh will be able to afford the medications that will keep him healthy; someone less wealthy or without insurance cannot. Non-profit hospitals usually give patients who are unable to afford their medications 3-30 days worth of medications for free. Hospitals will do anything to get that patient out of the bed and get into it another patient who hopefully has insurance.
Mr. Limbaugh will have no problem following up with his cardiologist within the next week; however, his uninsured counterpart has to rely on the goodness of the social worker or case manager of the hospital to make an appointment for him at either the community health center or the various church sponsored clinics for the poor if they are able to accommodate him. Follow up care will not be a problem for Mr. Limbaugh who will be able, thanks to his insurance afford all the tests necessary to find out the source of his chest pain. The uninsured or underinsured person will not be able to afford these diagnostic tests; thus will have to rely on managing the symptoms with medications until the next occurrence of chest pains sends him back to the hospital. These patients are our "frequent flyers". They come back into the hospital like clockwork with the same diagnosis and we continue this vicious cycle until the patient is either bankrupted enough that he now is eligible for government assistance or he dies.
Unfortunately for us and fortunately for him, Mr. Limbaugh will never see that side of the health care system in America. When he receives his Statement of Care in the next few weeks, he will probably not see it. His business manager or whoever pays his bill will and that person will take care of any payment due to the hospital; so he will never see how much someone without insurance would have to pay for receiving the same care he did. When the insurance sends him the statement of payment to show how much they pay as opposed to what was billed by the hospital, only his business manager once again will handle the paperwork; so he will never ask himself how can a business, yes a hospital is a business, survive on such reduced payments and is still able to take care of people who cannot pay; surely such a business will go out of business one day. The hospital where I work went from 11% uninsured in 2000 to 22% uninsured (or self pay patients) in 2009.
Unfortunately for us and fortunately for him, Mr. Limbaugh’s wealth will continue to prevent him from having empathy for the people less fortunate than him; people for whom Health Care Reform will mean that they are now able to get the same after hospital care as he will.
Unfortunately for us and fortunately for him, Mr. Limbaugh will continue to oppose HCR and go on to be the heartless Jackass that he is and always will be; except that now he can claim that he has experienced health care in America and there is nothing wrong with it. He will still fail to see that the problem is not the delivery of health care but access; specifically by those without means.