The Customer is NEVER Right - A Nurse Practitioner's Perspective
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Affordable Care Act (ObamaCare)

As a healthcare worker and I am sure colleagues too, I get asked by non-healthcare workers more than I like, “What about Obamacare?” However, since I wrote the book and been talking about it with healthcare workers they too ask me the same question, “What about Obamacare?” The book has nothing to do with President Obama’s initiative, the Affordable Care Act (ACA), better known as Obamacare.
 
However, as the book’s editor suggested, “This work is a useful contribution to the current healthcare debate going on at many levels in our great country.” On that suggestion, I agree, the book may be useful for that conversation. However, and I want to be clear, my book has nothing to do with the Affordable Care Act.
 
On the other hand, Thomas Doyle’s book, Suck It Up, America, (a reading I recommend for every healthcare worker and administrator, pundit or not) has a greater connection to the ACA. As for The Customer is NEVER Right, I would say the most notable association between it and the ACA is that the book gives another perspective with regard to the President’s intent, which I believe was to cover some 40 million uninsured folks with some form of healthcare.
 
While I applaud the President’s intent I disagree with his reasoning. From what I understand, although I am not sure it is correct with regard to the President, but nonetheless it is a common anecdote I have heard numerous of times yet have never seen a single documented case of such in the United States of America, that a family member died because they did not have healthcare insurance. In President Obama’s case, it was either his mother or grandmother but again I could be wrong.
 
Regardless, the intent of President Obama is a good one. However, I disagree with the reasoning and here is why. Our healthcare system is not failing because people are dying due to not having healthcare; instead, our healthcare system is failing because we give too much unneeded great medical care at great cost.
 
How is that possible? Simple, it is not that healthcare is broke; it is that people confuse access as an entitlement and it is that abuse which overwhelms our healthcare system by those with exaggerated unrealistic emotional expectations demanding resources needed for others. Not everyone needs medical attention and Doyle stated the same in his book by calling us whining hypochondriacs and I would say that that is where the problem lays. If those not needing healthcare did not reach for unneeded hand-outs there would be more for those who did have needs. It is that simple.
 
When critics hide behind the children arguing, “What about the children?” I would say, “What about the children?” Not every fever, cough, runny nose child with a rash, vomiting, diarrhea, bleeding nose, or constipation who hit his head or is pulling at her ears needs to seek medical attention. The same goes for adults with sprain injuries, sore throat, back pain, headache, yada, yada, yada.
 
As for critics who question, “If our healthcare were the greatest why does it fall behind other industrialized nations with regard to infant deaths and life expectancies? Well, our healthcare system should not be blamed for our society’s shortcomings. Unlike other nations, our nation is known world-wide for abundance and impatience, both our Achilles’ heel, and as Doyle pointed out, if we based our nation’s greatest ailments on pharmaceutical advertisement they would be erectile dysfunction and insomnia.
 
The explanations as to why the United States of America falls behind other nations in healthcare are almost endless, keep in mind not excuses but facts and facts others do not want to admit to. So think of these few facts when comparing our great nation to other industrialized nations.
 
-Allstate Insurance has run a series of commercials which depict the occurrence, frequency, and consequences of mayhem in our lives. With that idea in mind, what nation comes to mind that had 121,902 accidental deaths in 2008? The United States of America, that’s who, according to the CDC .
 
-Among them, users of prescribed opiates, which in the United States of America now lead the way of accidental deaths with over 41,000 in 2008, surpassing the previous leader, motor vehicle accidents which caused over 38,000 deaths on its own also in 2008.
 
-On top of that, that annual six-digit number of accidental deaths leaves behind, likely in the hundreds of thousands, those our great healthcare system was able to resuscitate, rehabilitate, and care for who will likely develop chronic complications running up quite a bill.
 
-Then come the bad diet choices and lack of exercise decisions not to mention the behavior and attitudes that are so difficult to change. How about this fact? For the first time ever, anywhere on the planet and the United States of America gets the honors of such, the previous generation will outlive the current generation. Talk about overachievers! How did that happen?
 
-The numbers for 2008 were 616,828 heart disease deaths, 134,148 stroke related deaths, 70,533 diabetes deaths, all CDC facts.
 
How many of those deaths due to abundance, attitude, and risky behavior, commonly not found in other industrialized nations, could have been prevented improving our nation’s life expectancy numbers? I know apples and oranges, but all fruit and more important food for thought before critics make claims that other nations have us licked in providing healthcare to our own citizens.
 
As for infant deaths (28,059 in 2008, table F), again how many not because of our healthcare’s fault but instead because of abundance, attitudes, or risky behaviors. And why all the uproar about infant mortality rates in the United States of America versus other industrialized nations when our nation has legal abortions?
 
-How about these facts? A total of 825,564 abortions were completed in the United States of America in 2008 at a rate of 16.0 abortions per 1,000 women aged 15-44 years, and at a ratio of 234 abortions per 1,000 live births.
 
I know other industrialized nations have children with runny nose and adults with back pain too, but how many overwhelm their healthcare system for limited conditions Doyle wrote about in his book. And it has nothing to do with I have mine and you are on your own to get yours, NO! We all know the path of overindulgence and irresponsibility is not good for us but only some believe it is not fair to burden our neighbors with taking care of us because of our poor decisions.
 
That is really all it has to do with, access versus abuse, and none of it should be news to anyone. We all know the truth yet chose the path of least resistance, not hoping others would care for us, as that is a given, as our nation is known world-wide for not only helping our own but for also helping others; a fact that other industrialize nations do not come close to matching. Instead, those who chose the path of least resistance do so by disregarding the burden others would have to make for those who disregard what made our great nation great.
 
The end point is, critics are right; other industrialized nation have better numbers than ours. That being said, it is likely those industrialized nations with government sponsored healthcare would not be able to care for our healthcare numbers that are swayed by abundance and impatience. On that note, our healthcare system may have its deficiencies but it is not necessarily broke but instead some who use our healthcare system are abusing a good thing and taking away from those who need more. Regardless, I would not count on our government to do a better job.

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