Wednesday, October 15, 2008

Equal Treatment? Not Always For the Uninsured

While many would like to pretend that this is not the case, I think we are all aware of the fact that many times work done for free tends to be of lower quality than work that one pays for. It's hardly a shocking revelation. Incentive counts for a lot, and being paid is the incentive on most American's minds when considering the work they have made their career.

This makes for disturbing contemplation when you apply that little truism to the medical field. Manoj Jain at The Washington Post takes a look at the disturbing differences in care received by uninsured patients as opposed to those with coverage:

It's not uncommon for patients with no insurance or poor insurance to receive different treatment. A 2006 study of 25 primary care private practices in the Washington area showed that in nearly one in four encounters, physicians reported adjusting their clinical management based on a patient's insurance status; nearly 90 percent of physicians admitted to making such adjustments. For patients with no insurance, alterations occurred 43 percent of the time; and for the privately insured, just 19 percent.
This brings to light an aspect of the health care equation that is oft overlooked. It is especially troubling when you consider that one out of every five patients seen by primary care physicians in a hospital setting are uninsured. From a physician's perspective, that is one fifth of their workload that goes completely uncompensated.
As physicians sometimes say, "No other professionals -- lawyers, plumbers, accountants -- provide uncompensated service to one-fifth of their clients."
There are many reasons possible for a lack of coverage, especially in times as tumultuous as these have been recently. From the workplace that does not offer insurance to sudden job loss or complications arising from pre-existing conditions the possible reasons run the gamut. It is not always a matter of husbanding one's resources or living within one's means:
My primary care friend told me about a patient who had left a boil untreated until it needed surgical drainage and intravenous antibiotics. When asked why didn't have insurance, the man said he had lost his job and was recently divorced. Stories like that helped my friend realize what injustices the uninsured face.
SOURCE: "Equal Treatment for the Uninsured? Don't Count on It. Lack of Compensation Can Tempt Doctors to Tailor Their Care to a Patient's Coverage" 10/14/08
photo courtesy of tacomabibelot, used under its Creative Commons license

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