Jack Mayer: Health care delayed is health care denied

The story of a young boy, Brian, in Vermont highlights a critical issue in American healthcare: delayed care due to cost. As recounted by Jack Mayer, a retired pediatrician and public health epidemiologist, Brian’s mother postponed seeking medical attention for her son, ultimately leading to severe consequences.

A Preventable Tragedy

Brian’s father’s job lacked health insurance, forcing the family to pay out-of-pocket for medical expenses. When Brian fell ill, his mother initially attempted home treatment but eventually contacted Dr. Mayer, inquiring about a prescription for amoxicillin. Dr. Mayer quickly recognised the severity of Brian’s condition – meningitis – and urged immediate medical intervention. However, the delay caused by financial concerns resulted in Brian suffering significant brain damage.

Did You Know? Duke University Hospital employs 1,300 billing clerks, while hospitals in Toronto, with national health insurance, employ a fraction of that number.

This case is not isolated. According to estimates, approximately 187,800 Vermonters are underinsured, with annual deductibles of $4,000 or more, leading many to forgo necessary medical care due to financial constraints.

The Broader Systemic Issues

Dr. Mayer points to the unique position of the United States among industrialized nations in not providing publicly financed, universal health care. The current system relies heavily on private insurance companies, which take approximately 30% of healthcare dollars and often create barriers to access. This contrasts sharply with systems like Canada’s, where publicly funded healthcare is the norm.

The inefficiencies of the American system are further illustrated by the high number of billing clerks employed by hospitals, compared to those in countries with universal healthcare. Dr. Mayer notes that the rising cost of healthcare also impacts school budgets, highlighting the interconnectedness of these issues.

Expert Insight: The case of Brian underscores the human cost of a healthcare system prioritizing profit over access, demonstrating how financial barriers can lead to devastating health outcomes.

Potential Path Forward in Vermont

Vermont residents in at least seven towns – Middlebury, Bristol, Weybridge, Salisbury, Cornwall, Brandon and Putney – will be voting on a resolution on Town Meeting Day, March 3, to urge the General Assembly to consider H.433. This bill proposes a phased implementation of Green Mountain Care, beginning with publicly financed universal primary care, mental health services, and substance use treatment.

While H.433 has stalled in committee, the resolution aims to encourage debate and consideration of the bill. If passed, primary care would no longer be subject to insurance company mediation, potentially lowering healthcare costs for residents. Dr. Mayer draws parallels to Saskatchewan, Canada, which successfully implemented publicly funded hospital care in 1947 as a precursor to a comprehensive universal healthcare system.

Frequently Asked Questions

What happened to Brian?

Brian suffered severe brain damage due to delayed treatment for meningitis, a condition that could have been successfully treated had he received medical attention sooner.

How many Vermonters are considered underinsured?

Approximately 187,800 Vermonters have high annual deductibles of $4,000 or more and are considered underinsured.

What is H.433?

H.433 is a bill that proposes a phased implementation of Green Mountain Care, starting with publicly financed universal primary care, mental health services, and substance use treatment.

What role do you believe accessible healthcare plays in the overall well-being of a community?