Recently, 60 Minutes heard about an American relief organization that airdrops doctors and medicine into the jungles of the Amazon. It’s called Remote Area Medical, or “RAM” for short.
As correspondent Scott Pelley reports, Remote Area Medical sets up emergency clinics where the needs are greatest. But these days, that’s not the Amazon. This charity founded to help people who can’t reach medical care finds itself throwing America a lifeline.
I especially commend the video report to you (a little over 12 minutes). I do not know how anyone can watch this and not be concerned about medical care in this country. We can and we must do better–KSH.
The person that “I learned medical missions from” was my dentist in Missouri. He would shut down his practice for a week every year and take all his staff on a mission trip, paying their expenses and salaries. Now that I have a solo practice, I realize the cost of my downtime, my staff’s downtime and salary is astronomical. (I don’t make as much as a dentist, so when I go on missions, I merely take one of my staff, don’t pay them salary but don’t count it as vacation time, either).
When the local paper in Missouri did an article on this very generous dentist, a reader asked in a snide way why we weren’t taking care of our own, first.
We are talking about “local” medical missions here in my hometown, but there are problems. If I provide free care or discounted below medicaid rates (which is below my costs), Medicaid will accuse me of fraud and demand that I give them the same rate. This is retroactive, so I must refund the pittance that they have paid me for the previous three years.
Now, I can do the surgeries for free, but I am required to bill the patient three times and then write it off. In fact, I have done hundreds of thousands of dollars worth of free surgeries in this manner. But it irritates me, because it ends up costing me a lot to pay for this accounting game.
Many medical liability insurance providers also will not allow local medical missions. Even though you are not charging anything, one can still get sued. The good Samaritan laws apparently do not apply.
I don’t know how the organizers of this local medical mission get around these hurdles.
robroy is right – between the insurance industry and the trial lawyers (and the idiot juries), the burden on practicing doctors is intolerable. This is the main reason I could never vote for a John Edwards, one of the principle architects of the two Americas.
This is a topic that makes me spitting mad – we have to stop the trial lawyer’s lobby and the insurer’s lobby and return sanity to medicine.
I saw this piece and agree completely with Kendall. We can and must do better. Health care is one of my “litmus test” issues in this year’s campaign.
millions more are underinsured, unable to pay their deductibles
But they all somehow manage to own cars, Tv’s and cell phones. And have an entertainment budget.
A physician can do free care and enjoy doing it. All physicians that I know do. However, we are trained to use high tech tools. The day of the black bag and house call are a thing of the past because of the requirment to do it to the standard of care. I can give my time, but I can’t provide the labs, CT scans, MRI, and the expensive medications. In the US the problem is not the availability of care but rather regional poverty so often due to pagan culture and choice. In foreign countries simple first aid, clean water, and adequate nutrition and hygene education will do multiple times more good. Also, getting rid of the corrupt governments that opress or simply neglect their own people would help, but that may be looked on as colonialism and western meddling. While much more is needed, I believe the medical profession is doing about all that is feasable. In a complex and advanced world, it is difficult to get by in a primitive lifestyle. I have practiced medicine in both cultures. There are no simple answers, but a lot of ways to make it worse.
Sidney, deductibles are becoming a big problems. You are correct that probably the lion’s share of my medicaid patients have cars and cell phones. But there is rapidly growing group where there the deductible is so high that they might as well not have insurance. If someone has a deductible is $500 and has $400 in the bank, then he has no insurance for all intents and purposes. Decrying his fiscal irresponsibility doesn’t really help.
And co-pays are becoming a big problem. I have lots of no shows because of $50 copays.