Who Is Considered “Sufficiently Able” for Discharge

It’s been very interesting in this time since Thanksgiving. What I’m talking about is the dichotomy between evaluations and other deferences accorded to people of different races and backgrounds compared with those who are wealthy compared with those who are not and those who are White compared with those who are not. I’ve dealt with the disparate treatment all of my life by virtue of the fact that I am multi-racial. I’ve also observed it being meted out. The part of my family that is White is accorded privileges and respect whereas the exact same situations leave me abandoned, penalized, and disenfranchised. When my family members proclaim they would not tolerate a certain type of situation or treatment, they become tongue-tied and confused when I ask them why I should find it acceptable for me. They have no answer.

Chances are people who are not part of Romney’s 3% feel the same way in regard to disparate treatment. They have no answer for why they should be left lacking while being charged inordinate sums of money for services. They are probably baffled at the prospect of not receiving extra care when it comes to their rights or the type of health care they receive.

Former President Bush, the Elder, became hospitalized for bronchitis around Thanksgiving. He’s still in the hospital. His discharge from the hospital was anticipated in early December but was deferred because his medical team determined he did not have enough energy at this time.

Bush has health insurance. Part of it is provided by virtue of the fact that he has been a public servant and government worker. No doubt he has additional private health insurance that he can afford because of the salaries he earned before his retirement plus the stipend that’s paid to people of his status and his retirement benefits of various sources. He has the financial resources to entitle him to extra attention. So he should expect to be catered to by the hospital. After all, he is one of the 3% and has the reserves to keep the hospital bed occupied.

Bush is also in a financial position to afford in-home support in the form of housekeepers and various other household attendants. He can afford to hire home health support for his current needs. But the determination was made to keep him in the hospital. What’s puzzling is that there are people who are covered by Medicare and even Medicaid who do not receive this extended hospital care even though their conditions are just as compelling. They don’t have deep pockets and if they have insurance coverage other than Medicare or Medicaid, it isn’t sufficient to cover the expenses. On discharge, they will still have large medical bills facing them contrasted to marginal to sparse retirement income.

Who’s to say who is entitled to a prolonged hospital stay? In fact, the question pivots on whose insurance will pay the most for the greatest number of procedures. Life-giving and life sustaining measures will be provided for the few who can afford them. If there is no insurance, perfunctory care will be delivered and the bed will be made available as quickly as possible for the next occupant. Hospitals are businesses and do best when operated as businesses.

Perhaps it’s his advanced age that caused his doctors to decide not to send him home. Perhaps the decision was based on immediate access to necessary equipment that could be put into operation within minutes if not seconds. And as to Bush’s weakened condition, well, I have no answer for that. Again, in-home health care and household attendants could be enlisted. But for the unlucky average citizen, they’ll just have to do the best they can.

Unfortunately, some are prematurely released and then find themselves readmitted either to the hospital or to the Emergency Room.

Resources:

Sponsored Link: Resolving Ethical Dilemmas: A Guide for Clinicians

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