( - promoted by los anjalis)
[First, a disclaimer. Several details of this story have been altered so as to protect the identity of persons.]
I am going to step beyond economics of cost-containment, budgets, and the legislative process in order to break things down to a more human level. Much popular sentiment these days suggests that society should not be held responsible for 'illegal immigrants', and that these folks do not 'deserve' what we have. I want to point out how insidiously evil is this sentiment. Citizenship does not trump humanity or being humane. As a physician who treats citizens and non-citizens ('illegals') alike, I propose that it nothing short of barbaric to suggest that we can deny healthcare to a particular group of people based on their latitudinal and longitudinal position on the globe.
Consider a patient I had today. She was a young woman from El Salvador, exactly the same age as me. She came to the hospital with abdominal pain and weight loss, and today the pathologist read me her diagnosis: metastatic cervical cancer, stage 4. When I went to her bedside to give her the news, a rush of tears rolled down my face as I explained her diagnosis. I couldn't stop thinking about her two young sons who were at her bedside the day before. She has a terminal disease at age 33 that is completely preventable, and we cried together with the knowledge that her young ones will soon be without a mother.
At the end of our conversation, she thanked me. I have no idea why, because I am left with the guilt and shame that I am a part of a health care system that denies access to millions of people, citizens and non-citizens alike. Day after day I see how this results in preventable human tragedy. My patient is dying simply because we have collectively decided that we do not want to spend the trivial amount that it would have cost to prevent her inevitable and untimely death. Furthermore, we tell ourselves that people don't deserve to get healthcare because of where they were born.
I wish that those individuals who hold these sentiments would do my job for one day. Are those who wish to deny access to healthcare really asking me to selectively treat individuals based on where they were born? Who gets to decide who is a human and who is not, and who deserves to live and who deserves to die? Because this is the real issue. I believe that when faced with the reality of a sick or dying person in need, there is no other choice than to offer medical care, despite one's political philosophy or understanding of economics. The issue at stake- human suffering and the human condition- transcends politics, legislation, and the almighty dollar.
A person's citizenship has nothing to do with physiology, the pathology of disease, or clinical judgment. I wish that as a doctor, I worked in a system where I wasn't asked to think about such things. A system of universal access to health care allows such a world to be possible. For this reason and many others I propose it to be the most humane and civil approach to health care. I hope we can one day soon rethink our priorities and change healthcare for the better.
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