End the scourge of preventable illness

January 17, 2003|By Daniel Munoz and Alexander A. Khalessi

FOREIGN POLICY has dominated much of the national debate recently, but the security of the American people rests equally on our government's attention to domestic concerns.

Our country faces a future in which a generation of Americans will contend with illness compounded by inadequate access to necessary health care. For an aging population confronted with the specter of disease, prescription drug coverage through Medicare could offer a timely helping hand.

Modern medicine often relies on heroic, resource-intensive measures in life-threatening situations. But pharmaceutical advances now allow effective treatment in the early stages of disease. We must collectively decide the method and manner of our intervention.

Unfortunately, we encounter daily the scourge of preventable illness, and appreciate the grave danger to American health and well-being posed by inadequate access to prescription drugs.

We entered medical school to treat people limited by disease, to improve and extend their lives. Medical students serve as advocates for their patients and receive the technical training required for optimal care. Regrettably, the realities of our health care system too often limit our ability to avail patients of essential drugs, and we are left with the frustration of unnecessary suffering.

Beyond patients' well-being, prescription drug coverage under Medicare offers other clear benefits. Prevention of downstream complications obviates the premature need for specialized hospital care, thereby partially defraying Medicare program cost.

Across the spectrum of illness, countless studies demonstrate the ability of timely pharmaco-therapy to realize these dividends. Moreover, the availability of prescription drugs in the clinic reverses Medicare's current financing bias toward inpatient medical care. "Tune-up" hospital admissions and the exclusive inpatient coverage of drugs represent an inefficient method of treating patients with chronic disease. The setting of care must not dictate medical need.

The victims of political inaction on health care do not suffer amid the kind of heart-wrenching images that can galvanize a nation. Rather, they do so quietly in hospital beds and nursing homes across America. To continue politicizing the current national debate over prescription drugs and Medicare reform only denies elderly Americans the coverage they desperately need.

Our intensely personal experience with patients does not afford the luxury of disengagement. After years of political jockeying for "the health care issue," the White House and Congress must elevate their stated commitment to one of substantive policy discussion. Instead of permanent tax cuts that largely benefit the wealthy, why not make a long-term investment in the health and security of millions of Americans?

Effective prescription drug coverage under Medicare would help prevent untimely death and disability, reduce significant expenditure on the treatment of preventable complications and correct current financing incentives that necessitate inpatient treatment for the management of chronic disease.

The medical profession stands ready at the cliff's edge, but we need more hands and fewer helicopters.

Daniel Munoz and Alexander A. Khalessi are medical doctor candidates at the Johns Hopkins University School of Medicine. They can be reached at dmuno1@jhmi.edu and khalessi@jhmi.edu.

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