The Avoidable Death of Deamonte Driver

Earlier this week, I was invited to post a comment on the Guardian of London's website after the Washington Post reported on the avoidable death of Deamonte Driver from untreated tooth decay. You can read it here, but I suggest you go to the Guardian's site to read the substantial commentary that poured in after my posting.

How can the US spend 40% more per capita on healthcare than any other advanced industrial country in the world and still have worse outcomes than most?

Just ask 12-year-old Deamonte Driver of suburban Washington, DC.

Actually, you can't ask Deamonte anymore. He's dead. According to a story that appeared in this morning's Washington Post, he died of complications of a brain infection caused by untreated tooth decay.

Because he lacked health insurance, Deamonte couldn't see an oral surgeon before it was too late. The so-called safety net for uninsured poor people (his mother worked but none of her employers provided health insurance) utterly failed this bright boy, who enjoyed doing math. Medicaid, which is supposed to provide health care for the uninsured poor, may have sent his paperwork to the homeless shelter where the family briefly lived before his destitute single mother sent the kids off to grandma. His mom had to cancel his appointment with the oral surgeon, who wouldn't see him without insurance.

When his toothache worsened, the infection spread to his brain. The second week in January, he was rushed to the hospital where he received an estimated $250,000 in emergency care. After two brain surgeries and a temporary recovery, he relapsed and died.

If the US had universal insurance that covered dental care, the system would have paid under $1,000 for Deamonte's routine dental visits and he would still be alive.

If the current Medicaid system functioned properly, the boy would have received a more timely appointment with an oral surgeon, for under $10,000, and would still be alive.

If the states (which administer Medicaid) had a proper Children's Health Insurance Plan that was sufficiently funded and organized to reach all children, Deamonte would still be alive.

Instead, the hospital that treated Deamonte will collect the quarter-million dollars spent on his failed care by raising rates on its insured patients, and Deamonte's mother will pay for his funeral.

In his state of the union address and in subsequent public relations events, President Bush has touted tax breaks as the way to get the poor to buy "catastrophic" health insurance policies and set up individual health savings accounts to pay for routine care. Well, we can see what catastrophic coverage did for Deamonte. And how much money do you think his hard-working mother, who couldn't even afford rent on her low-salaried jobs, would have socked away for routine dental care?

Just this week, the president and Health and Human Services Secretary Mike Leavitt told the nation's 50 governors that the growing shortfalls in their CHIP programs could be solved with "better management". Meanwhile, states like Maryland (where Deamonte lived) are scrambling to raise cigarette taxes as part of an effort to shore up their faltering programs.

The death of Deamonte Driver is a testimony to the moral bankruptcy of these piecemeal efforts to salvage a collapsing US health insurance system. Medicaid pays the least of all the nation's safety-net programs, and, as a result, doctors and dentists don't want to participate. Programs like CHIP, which rely on aggressive outreach to find uninsured kids, inevitably miss many of the needy - especially if they are tough-luck cases, like Deamonte.

These programs are part of the problem, not the solution. Let's get on with the business of reforming the entire system. As the Deamonte Driver case dramatically demonstrates, comprehensive reform wouldn't necessarily cost more money, since a health insurance plan that delivers timely, preventive care will avoid many monstrous catastrophic expenses.

California Congressman Pete Stark, for instance, has introduced legislation that would expand Medicare to cover everyone without insurance - a plan that would institute a small tax employers who don't provide insurance in an attempt to cover the costs. And if Deamonte Driver tells us anything, it's one place to start.

Posted by gooznews at March 2, 2007 08:10 AM