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Third World Medicine, First World Country

Well, the Bush adminstration doesn't want to expand children's health care because he's affraid that it would compete with private health insurers. Meanwhile, we're stuck in a country with an increasingly dire future for close to 50 million people. The New York Times Magazine paints at grim picture:

Long before the dentists and the doctors got there, before the nurses, the hygienists and X-ray techs came, before anyone had flicked on the portable mammography unit or sterilized the day’s first set of surgical instruments, the people who needed them showed up to wait. It was 3 a.m. at the Wise County Fairgrounds in Virginia — Friday, July 20, 2007 — the start of a rainy Appalachian morning. Outside the gates, people lay in their trucks or in tents pitched along the grassy parking lot, waiting for their chance to have their medical needs treated at no charge — part of an annual three-day “expedition” led by a volunteer medical relief corps called Remote Area Medical. The group, most often referred to as RAM, has sent health expeditions to countries like Guyana, India, Tanzania and Haiti, but increasingly its work is in the United States, where 47 million people — more than 15 percent of the population — live without health insurance. Residents of remote rural areas are less likely than their urban and suburban counterparts to have health insurance and more likely to be in fair or poor health. According to the Department of Health and Human Services, nearly half of all adults in rural America are living with at least one chronic condition. Other research has found that in these areas, where hospitals and primary-care providers are in short supply, rates of arthritis, hypertension, heart ailments, diabetes and major depression are higher than in urban areas.

My practice is in a rural area with lots of blue collar retirees. It is so rare to see someone come in without at least one or two chronic disease that we all remark on it. Meanwhile, when I triage in the ER -- few of the patients have a regular doctor they see. As more and more Americans either lose their healthcare, or can't afford the treatments they need, preventitive medicine goes out the window. Healthcare then gets more expensive for everyone. The system isn't breaking -- as this article shows -- it is broken.

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