(Before or after you read this, please, please take action . Especially physicians–Congress listens to you!)

I don’t know how I missed this disaster of a possible policy decision, but luckily Kate informed me of the bill. It’s supposed to allow small businesses to band together to buy health insurance together, but in the process also cancels many states’ required coverage items –that is, areas of health care that the state requires all insurers to cover. (The thinking being that small businesses could purchase cheaper plans if the plans don’t have these required restrictions. And this is big; small businesses employ half the work force in the US. ) By a wide margin, these items are prevention programs . And what are prevention programs? Screenings that catch disease early so that it doesn’t cost us orders of magnitude more down the line–either in health care, education, long-term care, etc. Here’s how I view these programs, as a future provider (and likely future pediatrician). I’ll use California examples. If we cancel…

• Alcoholism Treatment: We have more drunk drivers, more deaths and more permanent disabilities. We have more fetal alcohol syndrome, which leads to learning disabilities and more costs for special ed. We have more lost workdays.
• Blood Lead Screening: We have more children with learning disabilities, permanent brain damage and mental retardation.
• Bone Density Screening: We have more women break their hips and require surgery.
• Colorectal Screening: More men and women get colon cancer, the second most common, deadly cancer in the US. In most cases, if you detect it early, you remove a polyp and STOP a possible cancer completely.
• Contraceptives: More teen births, more unwanted pregnancies.
• Diabetic Supplies/Education: Education and supplies are absolutely key to diabetes care. The complications: early heart attacks, amputations, blindness, non-healing ulcers, infections, more ICU stays.
• Emergency Services: People with these plans will pay 4 times as much for ER visits .
• Hospice Care: People die shitty, painful, scary deaths. Sigh.
• Mammography Screening/Prostate Cancer Screening: Hi breast and prostate cancer, the second most common of cancers in women and men, respectively.
• Metabolic Disorders (PKU): Near and dear to the Pediatrician’s heart, the newborn screening. This picks up diseases like PKU and hypothyroidism, which if caught early, can be treated and the patient can have a normal life. If not treated, kids die early, mentally retarded. (The treatment for PKU? Avoid certain foods, especially those with the artificial sweetener, aspartame–this is why diet drinks say “Phenylketonurics, contains phenylalanine.”)
• Off-Label Drug Use: This requires companies to pay for drugs that doctors prescribe for non-approved uses. For example, some drugs for seizure disorders also work for mental illness or chronic pain; doctors are allowed to prescribe it for seizure disorders as well as other diseases it might work for.
• Well-Child Care: When you take your healthy kid to the doctor to make sure he or she is growing and doing well. In these visits we look for hearing problems, cataracts, childhood cancers, hip deformities, brain problems, broken bones, child abuse, undescended testes, and other signs of possible abnormalities.

I can’t believe some of the stuff that I just wrote that Congress is considering allowing people not to cover. And I can’t believe we’re willing to go this route–allowing companies to provide crappy, inadequate insurance to maintain an already broken, patchwork, pathetic health care system.

(Before or after you read this, please, please take action . Especially physicians–Congress listens to you!)

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