Health Insurance Subsidies

There has always been one thing that bothers me about the health care reform debate - when people argue against reform on the basis that they don't feel like they should have to pay for someone else's health insurance through government subsidies.

But before everyone reads this and gets angry at me, I want to point out that I am in NO WAY pretending that I am an expert on health care reform; this post is merely my opinion on one simplified aspect of an incredibly complex topic. Take it as you want, and feel free to argue with me in the comments or in person (if I know you). I do love arguing.



Right now, in pre-Obamacare times, we ALREADY treat the uninsured, and those unable to pay for their health care. If someone shows up at an emergency room, they are treated regardless of their ability to pay. They will, of course, be billed after the fact, but if they can't pay, then who does? The hospital has to eat the cost - but many hospitals receive subsides from the government (read: taxpayers) for this type of charity care. So lots of people who otherwise can't afford any health care at all end up at the emergency room either for problems that could have been prevented or that could have been treated much less expensively in a doctor's office.


One of the ideas with health care reform is that by offering subsidies to people so that they can afford insurance, they will be able to see doctors for preventative care. This would ideally lower overall health care costs for these charity patients for a few reasons:

• the patients' overall health would be better, requiring less care
• preventative care would keep many chronic diseases at bay instead of declining to a crisis stage that MUST be treated in an emergency room (ex: diabetes)
• non-emergency health issues and even many crises could be treated in their doctor's office.

Either way, we the taxpayers are paying for this person's health care, but we will be (hypothetically) paying less when we pay for someone's health insurance rather than for their emergency room visits.

So when people argue and say, "Why should I have to pay for someone else's insurance?" I want to respond, "Fine, don't - but if there's a plane crash and people are brought into the emergency room, don't expect doctors to try and revive any of them unless they have their insurance card or a huge wad of cash accessible in their back pocket."



The problem to me is that people want to have their cake and eat it too - people don't want to pay for other people (understandable enough), but the expectation is still that no doctor is going to turn someone away in the midst of a heart attack even if they won't be able to pay for it later - altruism or not, it's also against the law to do that.

So as a taxpayer (one day, I swear I won't be in school and I'll make money and know what it's like to be a taxpayer), if you're paying anyway, wouldn't you rather pay a small amount toward someone's health insurance rather than a huge amount toward that person's emergency room bill? Or if, as a taxpayer, you still don't want to pay, would you be willing to be the one standing at the emergency room doors to turn the sick and bleeding patients away?

Spring Break

image from "Piled Higher and Deeper" by Jorge Cham
phdcomics.com

yayyy for spring break!

Oh wait, there's an exam on Tuesday? Most exciting spring break ever...

Follies

Hello all! As promised, here are some videos made by my classmates for Follies. Additionally, I put in one video from the live part of the show last year just because I thought it was great. Enjoy! Happy spring break!








And one more that I wasn't sure how to embed, but it's a great parody of the Old Spice commercial + one of our anatomy professors: "Dr. Gilani's New Day Job"

Catch-Up (Part 2 of 2)

So the other class we're taking right now is Physical Exam, or as I like to call it, the "Pretend You're a Doctor Class." This class is also TBL-based and, like physiology, TBLs actually sort of make sense for the class.

We focus on a different part of the exam (different part of the body) each week. We have an assigned reading each week that goes along with that part of the exam. Every Monday we have a short individual quiz on that reading, and then we take a new and different and longer quiz as a team, also based on the reading.

The group quiz is open book and open internet. Some questions might still be hard though if we were in any other time period other than right now. But thanks to cell phone apps like Google Goggles, there's really not that much work (or learning) involved.


One other afternoon a week, you meet with your team again plus a facilitator who's either a doctor or a fourth year med student, and you get to practice the exam on each other. Of course, because as doctors you only examine people of the same sex, our teams also split up into boys and girls to practice. Sarcasm aside, it probably is necessary to split the sexes since we do get pretty up close and personal with each other - boobs seriously get in the way of properly listening to your heart and lungs.

The most fun part of this class is that you are supposed to practice outside of class! Our facilitator told us that we should be practicing so often that every time we walk into a room, our friends, family, and pets should run out.

So far the novelty is still there for my family and friends, so people have still been very willing to let me practice (I have NOT practiced on any pets... yet). For your viewing pleasure, here are just a few of the many pictures taken during one physical exam practice session on a very patient friend (patient, get it? yuk yuk yuk).

she's a littttle impatient

i saw my first optic disc!

listening to the heart

Catch-Up (Part 1 of 2)

Thought I would do a quick little catch-up for everyone on what we're learning these days in a 2-day post.

So as you all (maybe) know, the block of classes we're in right now is Physiology with Physical Exam.

Physiology is the "biological study of the functions of the living organisms and their parts." Basically, the study of how we work. Physiology may refer to all living organisms, but we're pretty much focusing on human beings (pretty much = 100%). The class is split into three sections with an exam after each. The first section was cell physiology and the respiratory system. Our second section, which we are in right now, is the cardiovascular and gastrointestinal systems. And last will be renal and endocrinology.


The class is mostly lectures with a couple labs thrown in there and one TBL each week. As you all probably remember from Anatomy, TBL stands for Team-Based Learning, and you take an individual quiz on a set of information, and then take that same quiz again with your team.

Because physiology involves actual problem-solving, having TBLs makes SO MUCH MORE SENSE than they did in Anatomy, because we actually reason through the problems together which is very helpful for learning, as opposed to Anatomy, where all the information was just regurgitated from the textbook.

And the labs were actually pretty fun (don't judge - some people have different definitions of fun, ok?). The first was during the respiratory unit, and we did Pulmonary Function Tests on each other (where you breathe into a tube, and a machine measures how much air you can get into your lungs, how fast you can expire, stuff like that). The second lab was in the cardiovascular unit, and we all got to do an EKG. Here's mine:


Normal! Yay! I really like this block because in physical exam or physio labs, I feel like I'm just playing doctor the whole time, and in physiology, I feel like I'm finally starting to actually understand things about the way our bodies work. A scary thought though - we learn the entire heart in 2 weeks, and now I guess it's assumed that we know everything about the healthy heart. And I'm not quite sure that's true.

Follies

Sorry for the lack of post yesterday! I know most people sit on the edge of their seats all day on Tuesdays and Fridays waiting for me to put something up. Turns out med school gets kinda busy sometimes.


Last night was Follies, which is an event where students make dances, skits, videos, etc. for everyone to watch. And of course, plenty of free food and free beer. The dances were live, there was a stand-up routine, and most of the videos are either parodies of songs, or making fun of professor or ourselves.

In the next few days I'll put some videos up so everyone can see what it was like. The night was a lot of fun, the burritos were delicious (and not pizza!), and I was incredibly impressed by how funny some of my classmates are. Especially some who I never would have guessed had a sense of humor. Pleasant surprises :)

Listening to the Heart

This is too apropos not to share with everyone.

In physical exam class, each week we learn and practice another part of the physical exam. This week we learned about examining and listening to the heart.

Here's an article from the NYTimes Science Section today:
stethoscope article