Title: Thoughts On Health Care for the Indigent
Category: Lagniappe - a little extra
A few weeks ago at the end of 1994, a baby in Lafayette
died because of exposure to cold weather and homelessness. The family was
traveling through town and living out of their car. The child was rushed
to Our Lady of Lourdes Hospital but was pronounced dead
on arrival. The event hit the news and both channel 3 and 10 in Lafayette
did a focused program on access to health care and asked the question "Why
Can't Kids Get Health Care?" I was asked that question without any
preparation time and my first thought was poverty, ignorance and a health care
system that is not always
friendly to the poor. On further reflection I think that immediate idea
still holds true. We have a charity hospital system available in Louisiana
and Health Units in most parishes but somehow our indigent patients are not
getting their boosters and are not getting to see doctors on a regular basis and
are coming in late
with illnesses which could be treated earlier and complications could be
prevented. In this age of cost cutting and medicaid shortfalls in
Louisiana, what can we do?
I think we need to go back to the three basic parts of the problem.
First, poverty. We need to continue working to improve jobs for all people
and encourage workfare and find a way to make it work. It won't be cheap
at first but only by teaching a person a skill and pushing them out of the nest
will they stand on their own two feet and begin to be independent. The New
Life Center concept in Opelousas is one excellent way to achieve that goal and
hopefully in the next year we will begin to service women and children at the
center.
The second part of the access to care problem in children I feel is a general
lack of understanding as to how to access the system. Patients don't seem to
realize they must keep appointments, they must follow up appointments, and
they must continue calling
offices or clinics until they get a proper appointment and then they must be
there at the time they are assigned. This general lack of knowledge
combined with a sometimes feeling of hopelessness causes a very poor accessing
of a system which in many cases is
available but which is not utilized properly. How can we help this
problem? One way would be for churches, schools and any other organized
agency to go the extra mile to route needy children to available clinics, health
units, etc so they get proper and timely care.
The third and final problem in health care is what I would call a health care
system which is not always kind to the poor. In Opelousas we are blessed
with a large number of dedicated physicians and nurses and other paramedical
professionals who are happy to work with anyone regardless of whether they have
a medicaid card or any ability to pay whatsoever. This is, however,
the exception through most of Louisiana and most of the United States.
Poor people have a very difficult time getting seen at all because of their lack
of funds. We must reach out to poor people who need health care and
provide it to them in some form or fashion. It is the morally and also the
financially correct thing to do. Patients who go untreated end up costing
much, much more when they show up in the emergency room or have major
complications which could have been prevented through simple clinic visits.
I would propose a lawsuit free community clinic in every town in America,
staffed by volunteer doctors and nurses and anyone else
who would like to see indigent patients get health care. The reason I say
lawsuit free is because a retired physician or a nurse who may want to give time
free to help the poor, unfortunately live in fear of a lawsuit if they happen to
get involved in a complex case and get sued for any form of malpractice.
Exactly how we could bring this about, I don't know but I am sure there is a
creative answer and I hope that one day as a society we realize
this is the only way to go to fill in the niches in our health care. Then
the 20 or 30 percent of our population who is not getting good health care could
come up to the high standard that the other 75 percent are getting and we would
lead the world in all the important medical statistics instead of being at the
bottom of the statistics chart in most categories.