Prather Pediatric and Allergy Center - Ask Doctor Brent

Printer Friendly Version

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.