August 24, 2009

Celebrity Doctors and the Health Care Crisis

author_karen By Karen Sternheimer

This summer has presented an interesting contrast regarding health care in the United States: those who have excessive access and those who have none.

The investigation into the sudden death of Michael Jackson has led to questions about doctors who bend over backwards to please their wealthy patients—sometimes living with them, being on call 24 hours a day, and allegedly overprescribing medication. This discussion is taking place while the nation is trying to figure out how to provide basic health care to millions of uninsured Americans.

Think about how many details from the Jackson investigation you know: the name of the drugs he allegedly used, names of former doctors, and his medical conditions. Now think about how many details of the proposed health care legislation come to mind….Judging from the breadth of misinformation out there (like the canard that the plan promotes "death panels" to kill the elderly), I’m guessing that most people are clearer on the problems that come with having a celebrity “doctor feel good” than they are on the more common problem of having no doctor at all.

We’ve heard the reports alleging that Jackson's doctor was paid $150,000 a month and was living in his house, and that Jackson supposedly had prescriptions filled by numerous doctors, sometimes under false names. Because of my research on celebrity culture, I have been asked to comment on this issue several times this summer, mainly on why a doctor might compromise ethical (and in some cases legal) standards when their patient is a celebrity.

Doctors are like anyone else who can be lured by the excitement of joining a celebrity’s inner-circle. Certainly not all doctors or even all who treat celebrities would feel this way, or would let such feelings violate good medical practices, but there can be huge financial rewards in doing so. Other wealthy people might be excited to seek this doctor’s care if he or she becomes known as a “doctor to the stars,” and this perceived exclusivity can mean a lot of money, even if the doctor is no better (or is even worse) than the average physician. A celebrity’s doctor can even become a celebrity themselves, with a reality show or their own product line and speaking engagements that keep the money coming in as insurance reimbursements decline.

When the potential for money and fame enter into the medical decisions a doctor makes, trouble can follow. Most of us who need to see a doctor go to their office; they don’t come to us. They see us on their schedule and often keep us waiting well beyond the agreed upon appointment. By contrast, celebrity doctors might see the patient whenever the celebrity needs them, thus realigning the balance of power normally maintained in a doctor-patient relationship. Celebrities could become clients before patients; if they don’t receive the services they believe they are paying for the doctor might risk a large income decline.

The vast majority of us will never have the problems that result from a doctor trying too hard to curry favor with us because of a big payday. In the same city where celebrities can have doctors living in their homes, thousands recently waited in long lines to see a doctor during a week long free clinic set up by the Remote Area Medical Foundation, a non-profit agency that was first created to treat people in developing nations and remote rural areas. In the nation’s second largest city the uninsured often get no treatment on a regular basis.

If we are insured, either through private insurance, Medicare or Medicaid, doctors receive pre-negotiated and shrinking reimbursements for the services they perform. Some doctors have even stopped treating patients with Medicare or Medicaid because they cannot afford to stay in business if they do so. Still others are no longer “in network” providers for any insurance company, meaning that even insured patients have to pay the difference between the insurance reimbursement and the doctor’s bill.

Celebrities serve as visible representations of wealth in America. Rather than thinking about these differences in health care as only between celebrities vs. non-celebrities, it’s important to consider how social class more generally predicts the amount of access to health care we receive. And increasingly, this lack of access is not just a problem of the poor.

image A growing number of people considered middle income have no health insurance; according to The Commonwealth Fund Biennial Health Insurance Survey, 50 percent of low-income families, 41 percent of moderate income households and 18 percent of middle-income families went without health insurance for part or all of 2007. Fewer employers offer health insurance, according to a 2008 report by the National Coalition on Healthcare.

Traditionally, middle income families have received health insurance from their jobs. But that is changing. According to the Commonwealth Fund’s survey, in 2000, 70 percent of employers offered insurance; in 2007 just 60 percent did. For employers that do offer insurance, premiums have also skyrocketed from an average of just over $7,000 a year in 2001 to over $12,000 in 2007, making health insurance increasingly unaffordable to many working families who earn too much for state or federal aid. According to a 2008 report by the National Conference of State Legislatures, the number of uninsured Americans rose by 8.6 million between 2000 and 2006.

The Jackson investigation reveals more than a single human tragedy; it also exposes some of the inequities in our health care system. Ironically, having too much attention from doctors probably contributed to Jackson’s demise and the coroner’s decision to rule his death a homicide, while many millions more suffer from too little medical attention, negatively impacting their health and well being.

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Comments

This is a good post. Thank you for sharing.
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As an employee of the largest health care facility in town, I have witnessed the inequalities among the poor and those with social class or celebrity status. The people that come in to my place of employment come from all backgrounds, ranging from the homeless man that you may see laying on the Street; the gardener who maybe works on your street; the man who owns his own company, or the rich and famous. All are seen and taken care of within the emergency room, but because of the health crisis, many have to walk away with a prescription for medications to get them by, because they can’t afford surgery and they must wait, apply for some type of government assistance, then come back once they have it.
Many patients that are seen in the Emergency Room are so sick that they must be admitted and cared for. Before leaving the hospital, they are told that they must make follow-up appointments with specialists, purchase medications, and at times medical equipment. Most cannot afford any of this. The problem with these patients is that when they walk out the door, they go home, never picking up their medications or making those follow-up appointments. Then within a few weeks they are back sicker than before, all because no one’s taking the time or making an effort to guide these individuals who are in need of good health care.
I have also seen the other side, when a call comes in saying that a “Benefactor” is on their way in or a celebrity walks in. They are escorted right in while other patients sit and wait, some having been waiting for hours. If a benefactor is admitted to the hospital, everyone starts running around, getting their double sized room ready, with fancy linens, a terry cloth robe, crystal glasses, silverware, and china plates.
This seems unfair to me and I frown upon it. I believe everyone should receive the same care and attention that these “Benefactors” receive. It’s sad to believe that there will always be different treatment for the haves and have-nots.

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