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Mon Jul 27 20:04:45 BST 2009

I haven't been able to keep up.

Okay.  I haven't really tried.  It's tiresome and unsatisfying.  (Sorry,
it is.)

But this one caught in my throat.

I'm used to the cynicism (and generally encourage it, if only for the
entertainment value); but I'm shocked at how NARROW the assertion seems.
Do you really believe that healthcare is nothing more or less than a
commodity?

I suppose it shouldn't be surprising that this mindset would come from a
trauma care provider.  Your customers (and mine, and those of the
hundreds of nurses and paramedics and surgeons EM physicians on the
List) float in a flood-stage risk pool that has been long abandoned by
the commercial insurance industry.  (See also MEDICARE and MEDICAID.)
Thus they are disproportionately more expensive to treat and less likely
to pay.  

The commercial insurance industry is not beholden to society, but to
executives and investors who measure success not by excellent
evidence-based services -- much less the enhanced health of the customer
-- but by financial profit.  The commercial interests have already
signed up all the responsible citizens who are aware of their morbidity
and protective of their fortunes (provided they could afford the
premiums).  

And with the focus off actual disease control (which would regrettably
run counter to marketing), then the quickest way to amplify the
quarterly net revenue is sadly predictable: by denying the illness or
delaying its treatment.  Every month a policy goes unclaimed is another
incremental accrual of capital.

These guys've got a business to run, after all.

But that's America, ain't it?  God forbid we should criticize
capitalism.  Let's instead imply that people who can't afford or qualify
for insurance are inherently undeserving and/or insufferable whiners.

Sigh.

Pret

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Gross, Ronald
Sent: Sunday, July 26, 2009 6:59 PM
To: 'Trauma-List [TRAUMA.ORG]'
Subject: FW: [MailServer Notification]Content Filtering Notification

...

Now, look at the rest of the labor force - yeah, the very same folks
that we provide health care to - and tell me how many of those that
demand and expect health care as a God given right have earned their
paychecks, and have earned the right to the same quality care that you
and I pay for.  Sorry to sound so damn cynical, but therein lay the
basic problem that has rotted the infrastructure of our society as we
know it today.  I am tired of looking at the elephant in the room and
calling it a G*$-D@*$#!' mouse!

OK - fire away.

Ron

Ronald I. Gross, MD, FACS
Chief of Trauma & Emergency Surgery Services
Baystate Medical Center
Assistant Professor of Surgery
Tufts University School of Medicine
759 Chestnut Street
Springfield, MA  01199
413-794-4022  phone
413-794-0142  fax
ronald.gross at baystatehealth.org

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