I’ve wrestled with this question more than once. It’s the question raised on occasion by those who talk about universal healthcare, and a for-profit healthcare system. It’s a question asked by those who are concerned that not everyone in the United States has access to healthcare. It’s asked by almost anyone who asks me what I do for a living.
The question is, “Doesn’t providing private patient advocacy services only to those who can afford them, just create one more division between the “haves” and the “have nots?”
Lots of soul searching, and more than a few conversations have produced the definitive answer to that question. The answer is:
Yes and No.
Private patient advocates work directly for patients, hired by those patients or their caregivers to focus specifically on that one patient. Unlike a hospital advocate who must work with everyone in the hospital who needs his or her services, unlike a volunteer advocate who might collaborate with a disease-awareness organization (think the American Cancer Society or others) – a private patient advocate provides services to the patient or caregiver who can afford to pay for those services.
In that regard – yes – they provide their services only to the “haves.”
The gray area here is that the “haves” aren’t just those people with enormous wealth and means. Among the advocates I’ve talked to on this subject, there is agreement that sometimes they are hired by people who don’t seem to have much money at all, but realize that with their lives in jeopardy, they can’t afford NOT to hire an advocate. Put another way, what good does it do to keep your money in the bank when it’s pretty well accepted that you can’t take it with you?
This gets me thinking about other aspects of our lives where the “haves” might be defined a little differently, too. Private schools – millions of kids go to private schools, particularly religion-based parochial schools – not because their parents have a lot of money, but because their children’s educations are that important that it’s worth the extra expense to them.
The benefits to society of having private options are important, too. Millions of kids attending private schools means school districts who still get that tax money, but don’t have to pay the costs of educating those kids….
Among other scenarios, when patients have advocates then doctors will not be as stretched as they might have been, or hospital nurses will have more confidence that the patients in their charge will have an extra set of ears and eyes on them, too. That doesn’t mean either get to do their jobs with less focus. It does mean they have more energy to focus on others – perhaps those “have nots.”
Advocates frequently tell me that at some point in their careers, and many of them still today, donate their time and efforts to patients who can’t afford their services. It may not be formal advocacy, like with a written agreement or scope of work. It may be providing some suggestions in a phone conversation, or volunteering to help someone in their churches or synagogues.
The bottom line is – there’s no need to wrestle with this question. Everyone deserves the help of a patient advocate. And when it comes to prioritizing what’s important in life, most can afford an advocate, or can find one who will help them help themselves.
Or – perhaps more to the point – for many who are sick or hurt or frail – they can’t afford NOT to have a patient advocate by their side. That’s true no matter how much anyone “has.”
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