Thursday, February 25, 2010

Ignoring The Obvious

I found myself chuckling at this Washington Post article about former Vice President Dick Cheney's fifth heart attack. I wasn't laughing at the fact that America's Darth Vader had had another myocardial infarction: that would be mean spirited. Rather, I was wryly amused at the chest-thumping by the WaPo reporter with respect to the advances by the mighty American medical establishment.

Here's what it said:

Richard B. Cheney's fifth heart attack may add to the lore surrounding the seemingly indomitable former vice president. But his ability to survive repeated coronaries is more a testament to modern medicine's advances in detecting and treating the leading killer than any supernatural powers.

Many people think of heart attacks as inevitably dramatic events involving chest-grabbing emergencies. But many attacks identified today, although potentially serious, can cause little if any damage to the heart -- and may go unnoticed. ...

Cheney, 69, who was released from the hospital Wednesday two days after suffering chest pain and a "mild" heart attack, has benefited from a steady improvement in the ability to diagnose heart disease and treat it, which has sharply reduced the death toll and improved the longevity and quality of life for survivors.

I do not dispute the improvement in the treatment of heart disease, nor do I downplay its importance for those who suffer the disease. I just think the article overlooks a few key factors. Mr. Cheney is still alive after those five heart attacks because he could take advantage of those medical improvements. He had access to the best health care money and insurance could buy.

He didn't have to worry about how to pay for an emergency room visit and then days or weeks in a cardiac care unit, followed by months of follow-up treatment. He didn't ignore the signal of potentially lethal cardiac event, chest pains, he went to a hospital. He had health insurance coverage. He didn't have to worry about that access.

Nor did he have to worry about how close he was to the dollar limit of his coverage, the "stop loss" provision. Presumably he is wise enough to make certain that limit is extremely high, given his medical history. That is no doubt expensive, but Mr. Cheney is wealthy. He can afford it. Yes, his service in government probably means his insurance coverage is a combination of a government pension benefit, Medicare, and a supplemental benefit which he pays for, but it presumably is still expensive even if a significant portion of it is paid by taxpayers.

Moreover, as a politically powerful man, he didn't have to worry about his insurance company denying authorization for the kind of magnificent treatment he received. There was probably no delay in his receiving that state of the art implanted defibrillator when his doctors recommended it because he and his doctors had to appeal an adverse decision.

Like I said: he had access to the best health care money and insurance could buy. The rest of us, however, don't have that kind of access. In fact, many of us don't have any access whatsoever. That's what this round of health care reform was supposed to address in a meaningful way.

It hasn't.

And no well-orchestrated summit in the White House is going to change the fact that Dick Cheney is alive because he is wealthy and powerful, something the WaPo article didn't even mention.



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