Tuesday, July 10, 2012

A sane healthcare system?

The specifics of this outbreak, published, oddly, in the American Journal of Psychiatry are the same as every other outbreak: A patient, in this case a homeless African-American man, has a cough. His cough is mostly ignored because people cough all the time and the clinicians are focused on his schizophrenia. Eventually, someone gets an X-ray (In Jacksonville it was eight months into the illness), TB is diagnosed and then public health workers scramble to locate the hundreds of people he might have exposed. In an adequately funded and sane healthcare system, information from previous visits, including old chest X-rays, might have been available; so too any relevant information about his TB status; perhaps an X-ray would have been easier to obtain (outpatient mental health facilities don’t often have the equipment) – all aspects of the “medical home” at the center of the ACA. Which is why it’s so distressing to see governors like Scott turn away additional Medicaid funding in order to make a political stance against President Obama.

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