Wednesday, August 19, 2009

Is there/should there be a right to health care?

To answer this question, let’s look at some examples of rights that we have, starting in the Bill of Rights. We may practice our religion, speak freely, publish what we want to, bear arms, go to trial speedily, and be represented by counsel, but nowhere does it say that government shall pay for our churches, provide us with microphones, pay for publishing our writings, provide us with guns, or pay for our attorneys!

When people speak of a basic right to health care, what they often mean is a right to receive medical treatment with someone else paying the bill. However, health care has a cost–for salaries, capital expenses, and consumable goods. SOMEONE has to pay for these, or health care will cease to be available. If I shouldn’t be held responsible for the cost of my health care, then who should?

With rights come responsibilities. If I am supposed to pay for your health care, I want to minimize what I have to pay. This may involve my imposing rules on your behavior to limit your demand for health care and restricting your access to health care. Should I not be able to require you to exercise, eat healthy, maintain a healthy weight, wear seat belts, wear helmets when riding in/on any vehicle or animal, avoid all dangerous substances (tobacco, drugs, alcohol) and hobbies (car racing, motorcycle riding, playing football, hang gliding, etc.), avoid traveling to potentially dangerous regions, go for regular preventive checkups, and maintain tight control over your blood pressure, blood sugar, and cholesterol (regardless of side effects of treatment)? Should I be allowed to decide which doctors and hospitals you may use and at what point in the course of your illnesses or life you will stop receiving curative treatments and receive comfort measures only? Is this what you REALLY want, especially if you replace “I” with the government?

In summary, yes, you have a basic right to all the health care that you are willing and able to pay for; that someone else with deep enough pockets is willing to pay for; or that a physician or other provider is willing to voluntarily provide for you on a charitable basis.

Florida actually has a patient bill of rights and responsibilities:

SUMMARY OF THE FLORIDA PATIENT'S BILL OF RIGHTS AND RESPONSIBILITIES

Florida law requires that your health care provider or health care facility recognize your rights while you are receiving medical care and that you respect the health care provider's or health care facility's right to expect certain behavior on the part of patients. You may request a copy of the full text of this law from your health care provider or health care facility. A summary of your rights and responsibilities follows:

A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.

A patient has the right to a prompt and reasonable response to questions and requests.

A patient has the right to know who is providing medical services and who is responsible for his or her care.

A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.

A patient has the right to know what rules and regulations apply to his or her conduct.

A patient has the right to be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.

A patient has the right to refuse any treatment, except as otherwise provided by law.

A patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.

A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.

A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.

A patient has the right to receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have the charges explained.

A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.

A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide treatment.

A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.

A patient has the right to express grievances regarding any violation of his or her rights, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.

A patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.

A patient is responsible for reporting unexpected changes in his or her condition to the health care provider.

A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.

A patient is responsible for following the treatment plan recommended by the health care provider.

A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.

A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider's instructions.

A patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.

A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.

(http://www.doh.state.fl.us/mqa/profiling/billofrights.htm)