I just came across a great article from Midwife With A Knife (The RHI Health Blog of the Week on Regulating Health Insurance). It’s about the frustration felt by a doctor dealing with non-compliant patients – in this case, pregnant diabetics who don’t manage their blood sugar and insulin during pregnancy, and end up with dead babies. What do you tell these women? It’s not your fault? But what if it is? How frustrating to know what needs to be done to give these women and their babies the best shot, but to recognize that another person’s behavior is somewhat beyond your control.
This doc’s patients are mostly on Medicaid and poor enough to receive their insulin and treatment for free. But what about the women who earn too much for Medicaid and don’t have group health insurance from an employer? In Colorado – as in most states – both pregnancy and diabetes are cause for decline with individual health insurance carriers. And the vast majority of individual health insurance policies in Colorado do not cover routine prenatal care, which could lead some women to delay or completely skip medical care during pregnancy. So a woman who is uninsured and does not qualify for Medicaid will be unable to apply for individual health insurance while she is pregnant. If she is diabetic, she would never qualify for individual health insurance – pregnant or not. And if she has individual health insurance in place before she gets pregnant, chances are it won’t cover routine prenatal care and screening.
Midwife With A Knife has highlighted the problem that occurs when patients are simply non-compliant. Since the patients she’s referring to qualify for free care, the problem there seems to be with the patient rather than the health care system. But the same problem could also stem from a lack of accessible and affordable health care for patients who would otherwise be willing to make an effort to comply with medical orders. Dead babies… just one more reason why we need a universally available health care system that provides medical care to everyone, regardless of income or pre-existing conditions.
