Manuel Laureano-Vega M.S., M.D.
Medical Homes or Medical Jails (corrals)?
It has been several years that the Government has been moving all of us in a direction that will re-establish the concept of medical homes as a way of treating the poor within the governmental health care system. This was tried before and it really did not work, I don’t know why it is being tried again. The longer I live in the United States mainland the more I realize that the system seems to recycle itself. If you live long enough you see the same old models used and reintroduced as new ones. I guess its generational amnesia.
Although I understand the concept of one stop shopping, I believe that this is in many cases, detrimental to good quality patient centered and controlled healthcare. What you end up with in the long run is a system that is full of mediocre employees that are permanent or tenured, and could care less about the client’s health. The poor patient has to face an increasingly hostile environment where they feel less and less empowered. These patients eventually stop coming to their medical home for care and end up with very expensive acute episodes of illness.
There should always be alternative systems of care in place for the population. Lack of choice just because individuals are disabled or indigent is plain wrong. Caging people into cramped unresponsive care units is just plain wrong. Freedom of choice should always move the health care market promoting ease of access and movement. Well yes, it is more difficult to track abuse and fraud, but why should choice and freedom of movement be limited or curtailed just because it’s hard for the FBI to track down the crooks.
Manuel Laureano-Vega M.S., M.D.
La nueva ley que se implementa en el 2014, le permite comprar seguro de salud porque elimina la exclusión por condición pre-existente. Esta exclusión le permite a los seguros de salud negarle entrada a cobertura medica porque su condición de salud esta comprometida. Los seguros en este momento no quieren asegurar a personas que les serán costosas durante el largo de su vida.
Se escuchan muchos chismes sobre esta ley, pero la verdad es que para las personas que tienen VIH/SIDA y otras condiciones pre-existentes que les bloquea la entrada al mercado de seguros de servicio medico privado esta ley es imprescindible.
Sin esta ley las personas con SIDA que no tienen seguro medico grupal, se ven condenadas a recurrir a los servicios médicos para indigentes, o de emergencia que subsidia el gobierno. Teniendo el dinero para poder pagar un seguro privado, la gente se encuentra en una posición donde se hacen dependiente de un sistema medico gubernamental. Tener acceso a un seguro medico privado, a un precio que no sea exorbitantemente caro es lo ideal para el pueblo que tiene condiciones que hasta ahora les previene de tener acceso por condición pre-existente.