No Tipping Fee Dumping The Indigent
By Al Cronkrite The Covenant News ~ February 14, 2007
A recent article in the Los Angeles Times exposed the growing practice of hospitals using skid row as a place to get rid of indigent, handicapped patients. Yes, you read that correctly; the hospitals actually dump these moneyless, homeless patients who require extensive care out of vehicles onto some of the worst streets in town. Read about it here.
It was 1938 and in the little town where I grew up we had two doctors who tended slightly less than two thousand inhabitants, men, women, and children. The international control freaks had managed to create a worldwide depression that was designed to bring greater control over the world population through Socialism but the medical profession was still free.
In Summer, when school was out, the local swimming pool was a gathering center for town youngsters and many of us spent most summer days swimming, ogling the girls, telling stories, and basking in the sun. The pool was 150 feet long, 40 feet wide, with 3 feet water at the shallow end and 12 feet at the deep end. At the deep end it had a high dive about 20 feet up and a springboard that was constantly broken from being used for springing rather than diving.
The end of the wooden springboard was covered with a rubber sheath to prevent slipping off. The rubber was nailed to the bottom of the board. I was a good swimmer and was able to complete both front and back flips. On this particular day I did a back flip and my head came up under the board and one of the nails tore an inch and a half gash in the top left side of my head. There was lots of blood and some excitement but the pool manager gave me a clean towel and a couple of my friends walked me about three blocks to the downtown doctors office.
It was afternoon and there were only a couple of patients waiting but since I was bleeding the nurse ushered me in ahead of everyone else. The doctors in our little town were more versatile than those in today’s emergency rooms for they doctored the gamut from emergencies to the dying. The doctor cleaned up the caked blood on my head, shaved off some hair and quickly decided that trying to sew up the cut on an alert, squeamish youngster would be next to impossible. Not wanting to perform an operation he put anti-septic on the gash and covered it with a bandage. A Tetanus shot was not necessary since I had had one recently I still have a scar but in a few days it was healed and since money was so scarce at the time keeping the cost down was important. Today, they would probably strap a young patient to a board, sew up the cut, and prescribe antibiotics.
A few years before my encounter with the springboard my Grandmother had fallen ill with pneumonia. In a couple of weeks she died in the front bedroom of our home. The same doctor who treated my scalp wound came to our home day and night while Grandmother was ill working not only to provide what little relief he could to the patient but also to calm and prepare our family as well. Although he might not have characterized it so, it was an endeavor of love and duty that involved tremendous sacrifice.
Poor people will always be with us and out little town had more than its share. The depression had allowed banks with government backing to steal the sustenance of many of our families. With fractional reserve banking the banks invested a major percentage of the money entrusted to them and when the stock market crashed the banks were not able to retrieve their funds. They closed their doors leaving many of their depositors destitute. Ironically, on top of this tragedy banks foreclosed on properties whose owners were not able to make payments because the banks had lost their funds.
In the face of all this turmoil doctors treated every patient that entered their office. They knew that many of their patients would not be able to pay but they sent them a bill anyway and never made a serious effort to collect.
Though his selection might legitimately be challenged, Hippocrates is considered the father of medicine and when I was young the Classical Hippocratic Oath was taken seriously. At the beginning it cites pagan gods and it is anachronistic in the field of surgery. However, the meat of the oath is soaked in Christian altruism and is as applicable today as it was the day it was written.
“I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.”
“I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.”
“I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.”
“Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.”
“What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.”
“If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.”
In those days, the medical profession was both noble and benevolent.
Today, the Oath has been substantially changed.
“Yet paradoxically, even as the modern oath's use has burgeoned, its content has tacked away from the classical oath's basic tenets. According to a 1993 survey of 150 U.S. and Canadian medical schools, for example, only 14 percent of modern oaths prohibit euthanasia, 11 percent hold convenant with a deity, 8 percent foreswear abortion, and a mere 3 percent forbid sexual contact with patients—all maxims held sacred in the classical version. The original calls for free tuition for medical students and for doctors never to "use the knife" (that is, conduct surgical procedures)—both obviously out of step with modern-day practice. Perhaps most telling, while the classical oath calls for "the opposite" of pleasure and fame for those who transgress the oath, fewer than half of oaths taken today insist the taker be held accountable for keeping the pledge.”
Now, let’s examine the reasons for the substantial transformation in our medical profession.
Some of the change is a result of the Enlightenment and the rise of human hubris to the exclusion of a superior being. Virtue is no longer rewarded. The noble desire to provide a sacrificial service to society was gradually replaced with a desire to harvest as much wealth as possible from the profession and this self centered intent was quickly followed by forcing the patient to conform to the convenience of the doctor, a radical change in the spirit of the profession.
Some of the change is based on technology. As the medical profession has gained in knowledge and technical ability it has become less art and more science. The intellectual assumption that the Scientific Method is infallible and capable of producing ultimate truth tended to allow doctors to usurp a strain of the divine pushing the patient even farther down the ladder of importance.
The most dangerous enemy to proper medical care is the government itself. As government programs provided a larger and larger percentage of doctor’s income and the cost of these programs becomes more and more unwieldy, the government reduces payments to doctors forcing them to see more and more patients in order to maintain their cash flow. This push to increase cash flow resulting from both personal avarice and government meddling has forced the indigent patient out of the system and is the impetus for dumping our most vulnerable onto skid row streets.
In step with the rest of our society the medical profession has enjoyed a burgeoning technical growth with many new treatment options and lots of new equipment. Sadly this has been accompanied by a sizeable dearth in the moral realm. Financial considerations have replaced the noble altruism that was the basis of medical practice in past years.
Since doctors will not tend to the indigent they are forced into hospital emergency rooms where the cost of care is several times higher but is subsidized by patients that can afford to pay. This arrangement results in dishonest billings that charge $7.00 for an aspirin tablet. While illegal aliens, the poor, and handicapped are treated without charge, a visit to the emergency room by a financially sound patient that is not in a government program might result in a billing of $2000 or more and that amount would be extracted from the patient by whatever means necessary.
Cloaked in darkness, fully formed aborted babies are discarded in dumpsters and undesirable patients are dropped off to die in squalor. The same spirits of avarice have invaded our government. With the naïve support of many of our citizens our government is in the process of building an empire by means of propaganda, military force, torture, and dishonest financial transactions.
This, dear reader, is where we stand as a nation and I’ll bet your preacher who may be doing excellent work in other realms never mentions the egregious sins going on outside his church walls or for that matter those going on within.