Volume 56, Number 1 - Winter 2010

 

By Helen Biren, MD

I am writing this as I sit at home with the flu. What could I have done to prevent this illness? I could have washed my hands more often, eaten five servings of fruits and vegetables per day to improve my immune system, and gotten daily exercise to reduce my stress level. Those are my responsibilities as a physician and patient, even though they are often difficult to achieve.

Everyone deserves good health care, but with that right comes responsibility. Likewise, our founding fathers gave us the Bill of Rights but also reminded us that we have responsibilities as citizens. We need to pay our taxes and perform jury duty to maintain our democracy. 

What are the responsibilities of our patients? They need to:

• Wash their hands often
• Maintain a healthy diet
• Exercise daily
• Avoid illegal drugs
• Limit their intake of alcohol
• Educate their children not to share food and drinks with others
• Get recommended immunizations for themselves and their children 
• Pay for health insurance if their income is above the poverty level

People cannot work and provide for their food, clothing and shelter without good health. Yet our society and government place a low value on health care. Congress had no problem passing trillions of dollars in stimulus and bailout funds for insurance and finance companies, but the House took nearly a year to pass the trillion-dollar health care bill, and Senate action is still pending. Congress has lost sight of the fact that a healthy populace is essential for good commerce, good education and good democracy.

Healthy people in their twenties and thirties often do not get insurance because they believe they don’t need it or they can’t afford it. While they may be less likely to have hypertension, diabetes or cancer, they are just as likely to be in motor vehicle accidents as everyone else (more likely if they are male and under 25). Everyone needs to be included in the health insurance pool in order to reduce the premiums. 

Sen. Max Baucus wants to tax so-called “Cadillac” health plans that cost more than $8,000 per individual per year ($21,000 per family). Yet in California, some basic individual plans with limited benefits cost $8,400 per year. These plans are Hyundais with Cadillac prices. Taxing health care benefits will simply encourage patients and employers to cut those benefits. In turn, cutting benefits will encourage people to go to the doctor less often while going to work sick more often. The end result could be pandemics and a sharply decreased workforce. 

Meanwhile, pet owners may soon have a $3,500 tax deduction to subsidize health care for their dogs and cats. Rep. Thaddeus McCotter, a Republican from Michigan, has introduced the Humanity and Pets Partnered Through the Years (HAPPY) Act, which would allow taxpayers to deduct up to $3,500 per year for “amounts paid in connection with providing care for a qualified pet.” The proposed pet deduction is just $150 less than the current deduction for children.

Some in Congress seem to believe that health care for dogs and cats is more important than health care for children. They should stop worrying about dogs and cats and start worrying about the millions of children who will get mumps, measles and other communicable diseases if parents scrimp on basic immunizations. 

Physicians and organized medicine need to educate the public about taking responsibility for their own health care. More importantly, we need to educate Congress about the need for good health care for children and adults. Health care is not free. It requires a lot of effort and education for both doctors and patients.

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Dr. Biren, a Larkspur psychiatrist, is president of MMS