Haiti and Health Care Reform - A Tale of Two Americas

Last week, Americans once again demonstrated our incredible generosity and kindness, giving in record numbers to support relief efforts in Haiti. As desperate images of Haitian suffering and calamity filled our television and computer screens, we donated on-line and through cell phones.

Meanwhile, images from Haiti were briefly interrupted to report that Republican Scott Brown, a vocal critic of the health care reform effort, was elected Senator of Massachusetts. Political pundits and leaders interpreted his election as a warning that Americans are not ready for health care reform or universal coverage.

Returning to the coverage of Haiti, we saw emergency responders and rescue teams dispatched from around the country to provide emergency relief. Doctors and medical teams scrambled to respond. A Haitian infant was airlifted to a Miami hospital for surgery and closer monitoring. Our shared humanity led us to act urgently. Republicans and Democrats alike gave generously, former Presidents Bush and Clinton united to encourage Americans to give generously, just as Presidents Clinton and Bush did in response to the tsunami in 2004. Watching the impassioned response to the earthquake made me proud to be an American, where people are quick to do right and lend a hand to those in need.

And while I watched the mobilization of people and resources to save lives, I couldn't help but think of the patients I treat at the Free Clinic, or others I've cared for without insurance. Some of my patients developed advanced cancer or complications from illnesses that went untreated because they had no insurance or couldn't afford care. Every day, patients in our country stop filling prescriptions or delay medical visits because they lack adequate health insurance coverage.

Unlike the Haitian crisis, there are few faces associated with the current health care debate. About 45 million people lack medical coverage. Many more have high deductible plans that mostly cover catastrophic illness. In this setting, many people avoid doctors or can't afford recommended treatments. They suffer silently, miss more days of work, and get sicker, until they come to the emergency room (and need more expensive care as a result).

I don't know one American who would tolerate that if we saw it. The majority of Americans would be outraged to learn that a diabetic was denied medication, or that a woman with a simple urinary tract infection (UTI) was hospitalized after developing a severe kidney infection because she could not afford the doctor's visit and antibiotics to treat her initial symptoms. Yet these stories are repeated every day, out of the television camera's lens.

When a bystander collapses on the street, we run to help him, not to check first to see if he has insurance. So why do we ask our physicians and hospitals to deny care? How can we fail to provide health insurance to all Americans? Why the gridlock on even modest plans to increase insurance coverage nationally?

The problem is visibility. We are a country of caring, good people. In Haiti, we saw the suffering. In health care reform, most of the suffering is hidden, problems are discussed in numbers and calculations. Unfortunately, this depersonalizes the need and softens the urgency. When we recognize faces rather than numbers, reform will be demanded and universal care will not only be possible, it will be demanded.