Monday, September 6, 2010

Why is healthcare reform important?

This posting goes with the previous posting on healthcare back one or two entries (not religious). Was the point of doing that work so I could get my blog out on a site viewed by many? No, although I was excited. But what is more exciting is seeing the GOOD in the health care reform, seeing some support, rather than just hearing the flaws of the legislation.

I went to a talk on health care reform at the National ADA Symposium this summer and the first question was for people to raise their hand if they were excited about the legislation. Not many hands were shown - no one knew what was in the bill. 2.5 hours later, everyone was excited. But where were we to take this? How were we get the word out about the GOOD parts of the legislation, of which there are many? How could people learn about it? That was one reason for my blog.

On the way to work one morning I listened as NPR dispelled myths about the legislation, one of which was that people thought everyone was getting a microchip implanted in them as part of health care reform! Not many people have read the legislation, so it is easy to start things like this. I've read it - not the whole thing, but I have read perhaps enough to be dangerous.

Why are the parts I listed important?

Coverage for people with pre-existing conditions.
I've been told I should start a consulting company. I don't think I'll ever do that, but if I wanted to do so, I couldn't. I couldn't get medical insurance. In 2014 this will change. Then people who want to open their own consulting companies can, and they will get coverage. I think I cost the system a lot less than some people who do not have a disability. My disability, however, does cost ME a lot, not the system. Braces, wheelchairs, walkers, lifts, hand controls, handcycle, skiing, etc. - not all paid by insaurance.

Independent living.
People with disabilities want to work. They want to contribute to society. Society often is not ready for this. They want to either pity people with disabilities, or think people with disabilities are just obnoxiou. People are frequently shocked that I do work and they think it's because I have to. No - I have passions I'm pursuing and I enjoy working. To work, many people may need a bit of extra help. I'm lucky to have an awesome husband who helps, but some people are not that lucky. The legislation addresses this. It's important to give people their independence. If people get a bit of help to go back to work, then they go off government assistance, contribute to society, are independent, and are much happier (and happiness is key). I have trouble seeing how this is bad. Helping people achieve independence is much less costly than the alternatives.

Accessible medical equipment.
If you do not use a wheelchair, go borrow one and take it to the doctor. Depending on where you go, you may be surprised at what you cannot access. Is there a lower exam table, because you can't get up on a higher one? Can a woman in a wheelchair get a mammogram or is the equipment too high? Is there a scale for someone who uses a wheelchair? Yes, some of this may be expensive. But what if we look at how many people do not go to the doctor, get a mammogram, or get weighed due to mobility impairments? What's the result of these possibilities? Diseases may be diagnosed later, or perhaps someone develops diabetes or a heart condition from being overweight. These things will be more expensive than getting equipment.

Cultural competent training.
This will occur - it means providers will be trained on how to interact with people with disabilities. This is huge - when providers are not trained, then do people want to go see them? No - it's uncomfortable. And what are the consequences? See the previous paragraph.

Health disparities.
Data is often collected for race, ethnicity, and language preference. What if this is coupled with disability? I bet the differences become greater. But in general, data is not collected, so we can't confirm the consequences I discuss above. It seems maybe things could be worse than we are guessing. Maybe things are better. We need data to determine this. Let's start gathering it.

Lastly, beyond the economics of everything, it just seems like the right thing to do. Medical care for everyone. Inclusion again.



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