For months, the patient – a 41-year-old father of three – was fine, except for “an occasional headache.” On the morning he came to the hospital, the headaches were severe and his blood pressure was skyrocketing. I met him at 3 a.m. as a part of the emergency response team; he had stopped breathing. We attempted to resuscitate him for 40 minutes, but it was useless; he was dead.
When we spoke to his wife, she said that he had known of high blood pressure for years and had been complaining of “an occasional headache” for several months. He could not go to the doctor because of money. After the initial shock of his passing, her anger surfaced and she asked if we had not given him the best care because he “had no insurance.”
At autopsy, we discovered that the interior lining of the aorta had torn and blood had traveled into the walls of the arteries that fed both his brain and heart, causing them to collapse. This is a deadly complication of extremely high blood pressure. Had his blood pressure been treated earlier, he likely would not have died.
As a new physician practicing medicine in the most “developed” country in the world, I find myself increasingly disgusted at the health care system of the United States. Recently, the World Health Organization placed the United States 37th among other countries on standard measures such as infant mortality and life expectancy. People like my patient lower our country’s life expectancy primarily because of a scarcity of affordable health care. A recent study from Harvard demonstrated that 50 percent of all bankruptcies in the United States were due to medical expenses. Why would anyone go to the doctor for “an occasional headache” when it could cost them their house if a serious condition is found? Many Americans are forced to make wrenching financial choices, and health care often loses out.
Some would argue that such people are at fault for not having insurance or not having money tucked away in a health savings account. They argue that a free market would save those people.
In a free market, consumers shop. If consumers can buy a better car, they buy the better car; if they can’t, they buy a lesser car, or none at all. This makes perfect sense in most markets and helps regulate the price and supply of goods. In contrast, consumers of health care are rarely in a position to shop. Many don’t have the ability to navigate the complicated health care market, many are too sick when they go to market, and many didn’t know it was time to go to market until it was too late. How can a health care system expect a consumer to know it’s time to go to market for “an occasional headache” if the price is too dear?
If the market is failing, should the government provide a solution? Thomas Jefferson said, “The first duty of government is the protection of life, not its destruction.” In America, we consider a few things to be self-evident; among these are life, liberty and the pursuit of happiness. For many, America has failed to protect life. I think the government can provide the only equitable solution.
The government already pays for more than 60 percent of this country’s health care, and business is crippled with most of the rest. I am not raising the specter of socialized medicine, but simply some form of national insurance to provide a basic, life-sustaining level of health care for all. Market forces would still exist. Consumers would have their choice of physicians, and providers would compete for patients. Most important, however, it would eliminate deadly barriers and make it feasible for people to get their “occasional headaches” checked out.
Life, liberty and the pursuit of happiness – Americans deserve nothing less.
Daniel Matlock is a third-year resident in internal medicine at the University of Colorado Health Sciences Center.
