St. Louis doc to patients: hope you don't live in Missouri. You're better off coming from the Illinois side of the river.

Instead of all of those stories about blue M&Ms for spinal cord repair, journalists should be spending more time addressing the kinds of issues Ford Vox does on Salon.com. Excerpts:

If Congress passes Barack Obama's healthcare plan, the Affordable Health Choices Act, states will lose a lot of their influence over healthcare administration and adjudication. Doctors across the country are outraged, invoking the specter of Big Brother and socialism. I on the other hand call the president's plan progress. If it passes, it will lead to a greater equality and a higher quality of healthcare for patients nationwide.

Let me explain. In the medical field called Physical Medicine and Rehabilitation, I work as part of a team trying to put lives back together after disabling injury and disease. We've got a Rolodex of world-class colleagues in all the specialties you'll need at my medical center. But if you're struck by a calamity sufficient enough to enter our care here in St. Louis, I hope you don't live in Missouri. You're much better off being one of my patients from the other side of the river in Illinois.

That's because there's a desperate truth lurking behind our efforts in rehabilitation medicine. Unless our intricate plan of family assistance and state services works out just so, many of our patients are at risk of becoming homeless or permanently shuttled off to a nursing home. In 2005, Missouri's then-Gov. Matt Blunt slashed Medicaid, the federally mandated, state-run insurance designed for poor families. We see a lot of Medicaid in rehabilitation, thanks to young invincibles who meet their match, and those with brewing problems that go untreated for too long for lack of insurability or a good job. Think you'll never need Medicaid? I've seen brand-name private insurance exsanguinate by the first week of rehab, leaving young professionals with nothing more than Medicaid.

And if you've got a new spinal cord injury and we've taught you to catheterize yourself, good luck getting those catheters if you're on Medicaid. Medicaid will cover the antibiotics for the urinary tract infections you'll acquire from recycling your only catheter and the urologic interventions you'll need to remove bladder stones. If your kidneys fail altogether, the federal government will step in with dialysis. And if your electric wheelchair breaks down or needs a new battery, we'll have no problem moving you into a nursing home. You'd prefer a new battery so you can continue living at home? You picked the wrong state.

As a poor Missourian, you'll have no more than 30 days for your rehabilitation. Not quite ready to go home? Need a few more days of intensive therapy? Again, you picked the wrong state. ...

With comprehensive national standards, states will not be able to dodge their responsibilities. Their disparate health insurance regulations and Medicaid administrations will no longer trample basic human rights. So let's stop what doesn't work and go forward together.

About this Entry

This page contains a single entry by Gary Schwitzer published on July 29, 2009 12:38 PM.

More conflict of interest issues for Minnesota med school to address was the previous entry in this blog.

Do we need a shot clock on conflict of interest policy deliberations? is the next entry in this blog.

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