The Deserving Sick

(cross posted from tpm)

I second Graham.

ABC's new reality show, Miracle Workers is the wrong take on health care.   The show, following in Extreme Home Makeover's footsteps, creates a construction that Bad Things happen to people, and a choice handful will be lucky enough to come under the lens of millions and deemed worthy of assistance.  It's a revival of the notion of the deserving poor -- this family’s house is crumbling from foundation to roof, but because the mother also rescues turtles from the highway, they've done something to deserve help. 

But the Miracle Worker conception of the deserving poor is much more insidious.  As the show sets out to:

give ordinary people who do not have the network, access to the necessary medical community or in some cases the resources to these procedures. Their seemingly overwhelming medical problems will be taken in hand by a renowned team of medical specialists. The patients’ lives will be transformed before viewers’ eyes as the professionals employ cutting-edge medical technology to heal those who need it most.

It’s taking the uninsured and making them special cases to nurture and heal.  It’s ignoring the fact that 46 million people are in the same place as the two patients featured every week on this show.

It would be prohibitively expensive to rebuild every crumbling home across the nation, but the added cost of covering the uninsured is quite small.  There’s a variety of ways to go about it; some involving small changes, others monumental shifts.  But this problem isn’t uncurable; it’s not a fact of life (or doesn’t have to be).  It’s fixable.  This show could really make leaps and bounds for health care if it discussed these cases in the context of what they are: the lucky few of an addressable problem.  Every person in this nation deserves access to this kind of care, and there’s any number of ways we can go about ensuring that.  We should take that joy and hope the sick enjoy when they get adequate care, and use that as reason to cover everyone.

Instead Americans will blissfully sit in front of their television, eyes a little wet as the “miracles” progress, little thought given to the rest of the uninsured and how they’ll never see doctors like this.

Comments

[Trapier K. Michael]

Re: "It would be prohibitively expensive to rebuild every crumbling home across the nation, but the added cost of covering the uninsured is quite small."

What is your idea of "small," Kate? One of the first returns on a Google search for "cost of covering the uninsured" is this Health Affairs piece estimating that the uninsured would use an additional 30 to 70 BILLION dollars (in 2001 figures) if covered. [1] There are more uninsured now in 2006 and medicine costs more, so that is probably a low estimate.

Trapier K. Michael
www.marketplace.md

[1] http://content.healthaffairs.org/cgi/reprint/hlthaff.w3.250v1.pdf

[Adrienne]

I first posted this on Ezra's blog, but it's just as pertinent here, so:

God, I hate to agree with Fred Jones, but I might have to. Experimental medical procedures (or "medical miracles," if you prefer) cannot, by definition, be covered by insurers (HMOs, PPOs, or even high-deductible plans), because there is not enough evidence that the benefits of such interventions will, on net, outweigh the costs (unless you're willing to accept an exponential increase in premiums). Even heads of HMOs acknowledge as much.

But these incredible procedures wouldn't be covered under a single-payer plan, either. (Again, unless you're willing to accept huge tax increases to do so). Given that many Americans demand medical miracles, the thing to do is to let private charity and generous medical professionals provide/pay for such procedures (and let ABC publicize them in the hopes of attracting more charity for future cases), and focus on providing solid care for everyone else, whether you think that care should be financed through government or the private sector. "Miracle Worker" and reducing the ranks of the uninsured are, in my mind, two totally separate issues.

[Adrock]

I agree with Adrienne there about the procedures in question.

But what I think this show and this case highlights is where big business' priorities really lie, profits. We know it and to some degree it is an understandable, we can't afterall expect business to not seek profits.

But I think Kate's definition of small IS surmontable. It would require tax funded initiatives for sure, but it would also require a realignment of business and wealth priorities. Large conglomorates like the Disney Company would have to reconsider their role in American society. My guess is, they bury any guilt or responsibility by thinking of shows like this and Extreme Makeover.

[Kate]

I want to clarify here that I'm not necessarily talking single payer. There are any number of ways to provide universal coverage that are not government-run or abolish the private sector.

[Jack Lohman]

This is a tough problem. Should medical miracles be reimbursed by the taxpayers? I would say unquestionably Yes, if it is for me or one of my loved ones. :)

How do we get past this issue? At what age do we say "no more treament, you are too old and costing society too much money."

Perhaps we ought to start outsourcing surgeries to India. The round trip ticket can't cost that much.

But as it stands today, only the rich will be able to pay out-of-pocket for extraordinary medical services.

[Randy Fritz]

I am also strongly offended by the word "miracle."

Medical science works its ass off finding these cures, then it all gets summed up by the word "miracle." No, not a miracle: a result of the good, hard science the religious right chooses to denigrate in favor of their chosen favorite word. Let's also use appropriate language. The health care point is also very well taken, I'm just sick of flinging around the "miracle" word when it has no real meaning.

[The Bloviator]

Building somewhat on the idea raised by Randy, I'm also put off by the idea of "miracle," but only because the doctors involved were stupid enough to allow themselves to be placed in the position of having what they do called "miracles."

I just never want to hear these doctors whine about "unrealistic patient expectations" when they get sued because one of their future patients down the road who thought they were getting a "miracle" didn't have the same outcome the physician was more than happy to (self-)promote on this show.

[Jack Mason]

Kate:

I reblogged your post over at HealthNex, and have got one interesting comment so far. Hope you'll take a look and respond to Tony's point of view.

[FreeDem]

These smarmy makeover shows are really remakes of the old "Queen for a Day" where people competed for who got the worst treatment in life.

The real message hidden here is that they shouldn't have so many bad situations to choose from.

CBS's noting that Insurance actually pays out a tiny fraction of the advertized price, shows that the real costs of universal health care would be quite affordable if the horrific fraud and abuse by Hospitals and Insurance companies was removed.