Twas the night before dentist...

Twas the night before dentist...

Yesterday I saw a young woman in her twenties with toothache.  Indeed, her tooth was decayed and probably quite painful; I was happy to treat her discomfort.  She had attempted to go to an urgent care, but could not be seen without a co-pay.  Her father, in attendance, was angry that Medicaid patients could be seen at the urgent care without any co-pay.  So far, so good.  I understood his frustration.  It seems the reward for obtaining insurance is more delays and a kind of subtle prosperity punishment.

However, what caught my attention was her father’s subsequent remark:  ‘I mean, especially now, after Christmas, it’s hard to pay a co-pay!’

Let that sink in for a moment.  Granted, I love to spend money on gifts.  At Christmas, I probably spend too much, as many Americans do. But the implication of my patient’s father was that when one desires to spend discretionary income, it shouldn’t be impeded at all by the necessity of spending money on mundane issues like co-pays.  And providers should understand that!

Where did we get that idea?  I don’t know, but the philosophy seems to lie beneath so much of our discussion of reform.  No one should have to spend ‘their own money,’ on healthcare.  That’s the general belief.  Patients have said as much to me.  ‘I had to spend my own money on my prescription, can you believe it?’

It’s always better, I suppose, to spend someone else’s money on healthcare.  Or to receive healthcare from doctors who are understanding enough not to expect you to spend your own money on healthcare.  Especially doctors nice enough, in their obviously vast wealth, to give healthcare for free.

I’m happy with the living I make.  I’m enormously blessed on many levels, including the material.  But I am troubled by the direction we are taking as a nation when we consider discretionary income, income spent on entertainment or pleasure, to take priority over money spent for necessities.

Toothache versus Christmas presents?  Tough call.  But let’s be reasonable.


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