I'm working triage today. The emergency department has become the defacto primary care facility. The few patients that do have a primary doctor can't get an appointment to see them. Two people today were actually at their doctor's office and left to come to the ER after waiting for hours in the waiting room. Talk about a love hate relationship. This is their caregiver. They went to the office and waited and waited and finally just got up to take their chances at the ER.

Here in the ER we have been attempting to step up to the challenge but the deal is that the healtlhcare system in the US is sadly broken. You can't measure the human tragedy that is the outcome of this mess.

Let me tell you about a patient. John D. is a fourty two year old African American. He dropped out of highschool to care for his first child and has been working ever since. In order to keep from paying healthcare benifits, his TWO employers keep his hours under part time. He has a long history of coming into the ER for various small complaints. Each time his blood pressure is elevated. The ER docs won't treat his blood pressure because it's a "Primary Care Issue". Their policy is that if the patient can't get in for follow up they don't want to write for a medicine that he can't be followed up for.

His kidneys have failed from the hypertension. He no longer works. He is on disability. His dialyisis costs over a thousand dollars a visit and that's three times per week. NOW all is medicine is paid for. NOW he has a primary care doctor. For less than fifty cents a day his blood pressure could have been treated. If a father has to choose between his healtcare and his children's he will always pick the children's.

This same sad story is repeated a million different ways. Each time we loose a tax payer and gain a dependant. Each time we loose a healthy adult in favor of paying the healthcare system for his treatment after he becomes unable to be a productive citizen. Don't even try to comprehend the suffering of these people and their families because you can't do it.

You see, we are already paying for healthcare for everyone. But we are wasting money paying for profit corporations to perform what amounts to paliative care for people who fall through these HUGE cracks.

Guess what happens if you get sick? I'll tell you what happens, you loose your job and with it goes your health insurance. Now in order for you to get care, you sell everything in a mad scramble to preserve some function or dignity.

You lose your job, your insurance and what do you use to pay for your medicines in a country where the profit margins of the drug companies is protected by law? And why do we pay more for drugs here? Why are drugs less expensive in Canada? In the US we pay more for healthcare than any other nation yet we are no where near the top in life expectancy. We have a higher infant mortality rate than any other first teir country. Women can't find a doctor to take care of them during pregnancy. A pregnancy they probably didn't intend but no one ever told them how to use a condom because of abstinance based education in the school system.

Dead babies and people on disability is the wages of our healthcare system. The VA, the nationwide system of government sponsored, one payer healthcare system has the highest quality of healtcare demonstratably superior outcomes for less money. Why is that I wonder? Because the profit goes to caring for sick humans instead of making the rich richer.