Thursday, September 16, 2010

John Kraintz and the issue of homeless healthcare

John Kraintz
John Kraintz, Sacramento's locally famous homeless person, was in the news, yet again.  But this time, SafeGround isn't the topic, it's the man's health.

An inside story in this week's Sacramento News & Review, "State of emergency," tells us that Kraintz was diagnosed as having a ruptured softball-sized cancerous tumor, that resulted in surgery that removed his gallbladder and part of his pancreas and colon.  A regime of chemotherapy is in the offing for him.

It's a sad state of affairs, and I certainly root for John to beat back the cancer, and to feel healthy.

But I post this news for another reason, too:  I am a little bummed by matters of health care expense that come up in the article.

For starters, if anyone comes to be as ill as Kraintz, he is going to run up a very big hospital bill.  Kraintz's bill at Sutter General was $138,938 , we're told.

Was Kraintz's bill exeptionally high because he is homeless, and thus necessarily made negligent of getting check-ups or prompt care?  Probably.  The article suggests that's the case, without documenting it.  The subheading of the article is "Sacramento's homeless often rely on emergency rooms for their medical care.  It's an expensive and dangerous system."

But I would contend that the largest part of what makes homeless medical care seem especially expensive is how the accounting for medical costs in the healthcare field are determined.  Emergency-room costs are artificially accounted for in a way to make them high. This is so to make non-regular users of a hospital's services pay more than those who are members of the hospital's provider service.

It's just like what you see in any city:  Tourists are artificially targetted to pay more than citizens who live there.  Why?  Because tourists won't stick around to complain and can't influence things, easily, by using other services.  Tourists get stuck with hotel-room taxes, taxi taxes, air-flight taxes, and high and extra charges on just about all else.

Kraintz, you see, is effectively a "tourist" at Sutter General, so he gets stuck with a bill artificially made especially high.  And there's nothing to be done about it.

But, then, all medical services provided to uninsured indigents are artificially costed out such that they are higher that what others would pay.  This is so such that the special-case providers can better cover their expenses by billing the government for more for what they provide.

It's all accounting hocus-pocus.  It's understandable, and not quite chicanery, but, then again, it is chicanery.

Ulitimately, the cure for all the nonesense is Universal Healthcare, which is in the pipeline and will be put in place, eventually, if the Republicans and Tea Partiers don't block it.   Universal healthcare will allow homeless people to get regular check-ups that will forestall some expensive very serious medical ailments.  And it will help homeless people to just generally feel better such that they are better enabled to find their way out of their homeless circumstance.  With universal healthcare, accounting trickery won't be incentivized.

Plus, we will at last, after 220 years, be meeting the constitutional mandate "to promote the general Welfare."

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