Our beloved eleven-and-a-half-year-old German Shorthaired Pointer has a history of being healthy as can be unless it’s really inconvenient timing for him to get sick or injured. In that case, if there’s a federal holiday that will close all veterinary offices or an out-of-state wedding we’re supposed to attend, then he can contract a mysterious illness in no time flat. Last week, while celebrating a nice and relaxing 4th of July, Jackson lost his balance and fell on the wooden floor. Unfortunately, he then had difficulty regaining his balance altogether and continued to fall while trying to get around. We called the emergency vet. We called a knowledgeable friend. We did some internet research. It was still unclear whether this was something he’d shake off or something more serious.
Just as we do with our own health care, we had decisions to make, and they’re rarely easy. Health care is costly. A full battery of tests, which is what Jackson was facing, was going to be a thousand dollars or more just to diagnose the problem—if there even was one. And that’s cheap compared to what it would cost if it were me going to the hospital. Health care is also time-intensive. An initial visit of a couple hours for tests and then any number of follow-up visits for further examination and treatment.
When it comes to our own health and the health of our families, we know we have a duty to be responsible health care consumers—to not use the Emergency Department for non-urgent care, to take care of our health so that we reduce our chances of developing chronic conditions, and to have regular preventive visits to catch developing issues early. But we also know that when we do need care, we should be able to get it at the time we need it and at a price we can afford. A health care system that works is one that both provides accessible, appropriate choices for care and the information we need to make informed decisions.
According to the US Department of Health & Human Services, in 2011, 12% of Coloradans delayed getting necessary health care due to cost. If we look at just the uninsured, that number climbs to 38%, according to the 2011 Colorado Health Access Survey (CHAS). We also know from the CHAS that 44% of Coloradans who have visited the ER in the past year did so for a condition that could’ve been treated by a regular doctor, had one been available. These are clear indicators that our health care system is not providing Coloradans with adequate and accessible options for care. Making decisions about your health and the health of your family is difficult enough when you have all the options available to you, and all the information you need to evaluate those options; it is far worse when your options and information are limited by factors of cost and availability. These decisions result in poor outcomes that hurt patients, communities, and the health care system as a whole.
As with most anything, it’s about balance. We must take personal responsibility for our health, but also work towards a system that is inclusive and fair. We must ask ourselves and our providers whether we are making good choices about which tests to have done and which medications to use (some really interesting work is being done around this idea—read more about Engaged Benefit Design), but also ensure our community members all have the ability to access necessary care when they need it. Decisions about our health care are often difficult, and we may not always choose wisely, but we should all have the opportunity to make the best ones possible.
We opted to forgo emergency care for Jackson. By the next day, it seemed to have been the right decision, and we’re cautiously optimistic. At the height of our concern, however, it was comforting to know that all options were on the table. And that’s how it should be.