Saturday, April 12, 2008

Health Care Horror Stories

Health Care Horror Stories

By Paul Krugman

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Not long ago, a young Ohio woman named Trina Bachtel, who was having health problems while pregnant, tried to get help at a local clinic.

Unfortunately, she had previously sought care at the same clinic while uninsured and had a large unpaid balance. The clinic wouldn't see her again unless she paid $100 per visit - which she didn't have.

Eventually, she sought care at a hospital 30 miles away. By then, however, it was too late. Both she and the baby died.

You may think that this was an extreme case, but stories like this are common in America.

Back in 2006, The Wall Street Journal told another such story: that of a young woman named Monique White, who failed to get regular care for lupus because she lacked insurance. Then, one night, "as skin lesions spread over her body and her stomach swelled, she couldn't sleep."

The Journal's report goes on: "Mama, please help me! Please take me to the E.R.," she howled, according to her mother, Gail Deal. "O.K., let's go," Mrs. Deal recalls saying. "No, I can't," the daughter replied. "I don't have insurance."

She was rushed to the hospital the next day after suffering a seizure - and the hospital spared no expense on her treatment. But it all came too late; she was dead a few months later.

How can such things happen? "I mean, people have access to health care in America," President Bush once declared. "After all, you just go to an emergency room." Not quite.

First of all, visits to the emergency room are no substitute for regular care, which can identify and treat health problems before they get acute. And more than 40 percent of uninsured adults have no regular source of care.

Second, uninsured Americans often postpone medical care, even when they know they need it, because of expense.

Finally, while it's true that hospitals will treat anyone who arrives in an emergency room with an acute problem - and it's wonderful that they will - it's also true that hospitals bill patients for emergency-room treatment. And fear of those bills often causes uninsured Americans to hesitate before seeking medical help, even in emergencies, as the Monique White story illustrates.

The end result is that the uninsured receive a lot less care than the insured. And sometimes this lack of care kills them. According to a recent estimate by the Urban Institute, the lack of health insurance leads to 27,000 preventable deaths in America each year.

But are they really preventable? Yes. Stories like those of Trina Bachtel and Monique White are common in America, but don't happen in any other rich country - because every other advanced nation has some form of universal health insurance. We should, too.

All of which makes the media circus of a few days ago truly shameful.

Some readers may already have recognized the story of Trina Bachtel. While campaigning in Ohio, Hillary Clinton was told this story, and she took to repeating it, without naming the victim, on the campaign trail. She used it as an illustration of what's wrong with American health care and why we need universal coverage.

Then The Washington Post identified Ms. Bachtel, the hospital where she died claimed that the story was false - and the news media went to town, accusing Mrs. Clinton of making stuff up. Instead of being a story about health care, it became a story about the candidate's supposed problems with the truth.

In fact, Mrs. Clinton was accurately repeating the story as it was told to her - and it turns out that while some of the details were slightly off, the essentials of her story were correct. After all the fuss, The Washington Post eventually conceded that "Bachtel's medical tragedy began with circumstances very close to the essence" of Mrs. Clinton's account.

And even more important, Mrs. Clinton was making a valid point about the state of health care in this country.

In other words, this was a disgraceful episode. It was particularly sad to see a number of Obama supporters (though not the Obama campaign itself) join enthusiastically in the catcalls against Mrs. Clinton's good-faith effort to put a human face on the cruelty and injustice of the American health care system.

Look, I know that many progressives have their hearts set on seeing Barack Obama get the Democratic nomination. But politics is supposed to be about more than cheering your team and jeering the other side. It's supposed to be about changing the country for the better.

And if being a progressive means anything, it means believing that we need universal health care, so that terrible stories like those of Monique White, Trina Bachtel and the thousands of other Americans who die each year from lack of insurance become a thing of the past.

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