oday, Rick Santorum quit the Republican race for the 2012 Presidential nomination. The decision was a wise one, given that his 3 year old child Bella was just hospitalized for pneumonia, a life threatening condition. It appears that after receiving proper medical care, that his daughter will do well and fully recover. But what if Santorum was like the millions of Americans who do not have health insurance or the means to pay cash? What would have been Bella's chances of recovery then? Or, what if Bella lived in a remote part of the country, where access to care can be greatly limited due to the closure of small, critical access hospitals?
World wide, pneumonia is the #1 killer of children under age 5, being responsible for about 1 out of every 5 deaths in this age group. Children of all backgrounds get pneumonia, and many of them die even with access to the best medical care. But the risk of death from childhood pneumonia greatly increases when access to care is limited. Children with pneumonia need access to intravenous fluids, antibiotics, and advanced respiratory support. Without these, the risk of death greatly increases.
In the case of Santorum's daughter Bella, several things improved her chances for a full recovery. First, the child had an attentive care giver, who brought her to medical attention promptly. Secondly, Bella had access to advanced medical care, including the best medications, the best equipment, and fully trained doctors, nurses, and respiratory technicians. In spite of all of these advantages, Bella still required a 3 day stay in the hospital for her pneumonia. Pneumonia is really serious in such a young child.
Santorum had all of the advantages, and his daughter lived. But what about the underserved in the U.S. who have poor access to proper medical care? A family without insurance, for example, may delay going to the pediatrician because of financial concerns. Another family may lack the proper knowledge on how to navigate an increasingly complex health care system, which can also delay access to proper medical care. In some parts of the country, there are large geographic barriers to getting medical care, especially with the closing of smaller hospitals in rural areas. Steadily declining Medicare revenues have resulted in the closure of many hospitals and clinics all over the country. And when they close, access to care falls. The equipment and the trained providers leave. Universal health care means access to proper, advanced medical treatment. It is more than just having health insurance, and it is more than just having a hospital close by. You need both.
The problem with large government run health care monopolies is that they often decrease access to care. Having insurance is not enough. For example, Obamacare, if implemented as written, would dramatically cut payments to hospitals and providers, and as a result cause many hospitals to close and many providers to quit and find a different line of work. This means decreased access to care, and a higher risk of premature death from childhood pneumonia.
The ultimate solution to improved access to health care in the U.S. is a hybrid approach combining sufficient resources with universal insurance coverage. Given the limited amount of money available to pay for health care costs, government needs to work smarter, not just reflexively write complex and incomprehensible new laws. Clean up some of the old laws first. Simplify the system, and reform tort laws. Streamlining the system will allow more resources to go to the actual provision of health services, and reduce the current excess amount of money being diverted away into an insatiable bureaucracy and a capricious legal system. Universal insurance coverage is also mandatory. This would create more certainty in the health care market, and let hospitals and providers will know what to expect from year to year. This certainty will help hospitals and clinics properly manage their finances, so they can remain open to see patients.
Tom Heston is a practicing physician specializing in family medicine and molecular imaging. He received his medical degree from St. Louis University and completed Fellowship training at Johns Hopkins Hospital.
