Lesson #8: Our health care system is not fair.

This past semester I took a class about administration and management of occupational therapy services. Among other things, this class helped me confirm that what I believed about our health care system is true; it isn't fair. Occupational therapy is such a diverse profession, that we can almost always do something  to help the patients (even if it's just education or prevention).  The ugly truth is that the medical system (at least where I live) doesn't support bringing services to everyone who could benefit from them. I would say that only a few are the privileged ones who can pay, or their insurance pays, for occupational therapy services. Even if the services are covered, this coverage doesn't include prevention and health promotion interventions. So often, conditions that could have been prevented have to become serious in order to be allowed to receive the appropriate attention.  It's frustrating to know that there are solutions available to a large number of health conditions but must people don't have access to them.

As part of this administration and management class, my classmates and I participated in a health fair . We had to practice marketing skills by promoting our profession. I was showing people different devices that helped with daily living activities. When we were about to leave, a man with ALS came looking for something that could help him eat by himself. He was alone and looked desperate. He walked using a walker with wheels that he could barely push. He told us that he wasn't receiving any type of therapy, and since he only had the public health care insurance plan and no transportation, was looking for a therapist that accepted this insurance and that he could access by public transportation. His doctor never referred him to occupational therapy or told him about the assistive technology devices that he would soon need to accomplish daily tasks as a result of his condition. 

I don't know all the details in this case, or if what the patient told us is completely true. But still, it made me sad and angry at the same time to know that there were solutions to some of this man's problems, but he wasn't receiving them. Maybe because his lack of resources, the lack of the doctor's knowledge about occupational therapy, or a combination of the two. I know things like this happen all the time, but seeing it in person gives you a bigger impression. I  hope that someday everyone has the right to receive the best health care available for their situation.

This experience also made me think about how many health professionals ignore the benefits that OT could bring to people with progressive diseases. But I think I'll discuss this in the next post....