The Poor vs the Insured in Our Medical System

Over the past few months, I have read over 1,000 pages of medical records of various claimants seeking disability benefits, and here’s the crazy thing about our system—what you already may know.

The very poor wait until their health conditions have reached crisis stage, they go to the emergency room, they have every test known to medical science, the docs patch them up as best they can, tell them to follow up with a recommended doc, which they don’t do because then they have to pay up front and they can't afford it, the docs write them prescription for medicine they never fill, send then out into the world, until they crash again—never paying much if anything for their care.

Studies show those who follow this routine are more likely to become disabled and their work histories are more inconsistent. While the the insured enter the system gradually, their care is more precise and pin pointed and they endure chronic illnesses longer and when disability is inevitable, they enter the system much later in life.

I realize this is anecdotal, but you all would probably be alarmed at the extensive care the poor get that is untimely, ineffectual and often is probably excessive because their isn't a relationship of trust nor a foundation of care between the doc and the patient that make the art of medicine more precise. Does it make any sense?

Today I had a client on of mine on Medicaid who is in end stage renal failure who explained he can’t get on the waiting list for a transplant because Medicaid won’t pay for a dental exam. I don’t know, just seems odd.