Monday, February 16, 2009

Equality Before the Doctor?

NPR reported yesterday that Justice Ginsburg's chances of surviving pancreatic cancer are much better than most of those who suffer from it because doctors ignored an initial test that showed a benign tumor and pushed on to discover cancer in her pancreas. I thought good for them. I also wondered if they would they have done such a test if under pressure from an HMO, if they were only receiving medicare payments, if they were performing the same test on you or me?

Hearing about pancreatic cancer again made me remember that last year, the criminal defense bar lost a true champion, Don Fiedler, to it. He dedicated his life to criminal defense, teaching each year at the National Criminal Defense College and sponsoring scholarships for young lawyers to attend the college in Macon, GA each summer. I wouldn't have gotten there if not for his help and I doubt that anyone from Nebraska would have done so either. (I don't know how many NCDC grads now live here, but I think it's close to 20!)

I know it's useless to ask such questions, but hearing the report about Justice Ginsburg, made me wonder if such rigorous tests would have made a difference for Don. I also wondered if any of Don's clients, or mine, would have had access to basic tests for cancer? Or how many have access to health insurance at all?

Atticus Finch said that "We know all men are not created equal in the sense some people would have us believe--some people are smarter than others.. But there is one way in this country in which all men are created equal--there is one human institution that makes a pauper the equal of a Rockefeller, the stupid man the equal of an Einstein, and the ignorant man the equal of any college president. That institution, gentlemen, is a court."

But those who sit on the Court, under the banner of equality under the law, enjoy access to elite-level health care while millions lack access to the most basic kind. Sadly, an old phrase rings true, at least among industrialized countries: Only in America.

It's terribly sad that, for Justice Ginsburg, despite the "luck" of an early diagnosis, has only increased her chance of surviving it to around 50%. Still, it's even more sad to consider how many people's chances of surviving it are increased because they have no health insurance and no chance to speak to a doctor until their symptoms bring them into the emergency room, and "treatment" becomes nothing but a pain killer.

1 comment:

Bill O'Brien said...

i'm not crazy about the way that the american health care system is set up, either. but in j ginsburg's case the early detection of her pancreatic cancer probably has to be chalked up largely to luck. i just don't think treatment decisions are influenced by financial factors relating to particular patients in the way you suggest. but i could be wrong.

i knew don fiedler in the last few years of his life. he was a good guy. very sad.