Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A physician’s response to Jimmy Kimmel’s monologue

Jonathan Kohler, MD
Policy
May 13, 2017
Share
Tweet
Share

Jimmy Kimmel recently delivered a 13-minute monologue that transfixed the nation.  He told the story of how his newborn son, Billy, was diagnosed with a potentially fatal cardiac anomaly, tetralogy of Fallot, and had undergone emergency surgery. He painted the picture of a sick child and a terrified family, who have the benefit of excellent care that ends well. He complimented the nurses and physicians who had cared for Billy, and encouraged donations to the hospital.

Most importantly, Mr. Kimmel put a face on the importance of health insurance and the inhumanity of not providing it to those who need it most: those with pre-existing conditions.  He suggested that without good insurance, Billy would have been abandoned by the health care system. It was a moving story, that was immediately viral on the internet.  It was also not completely accurate. And the way that it’s wrong tells us a lot about what’s wrong with the health care debate today.

There’s a strange anomaly about the American view of health care. We are nice people who don’t like to pay for other people’s stuff.  We don’t want to pay for everyone to have health care, but we won’t abide the consequences of people not having access to care. That means that the reality of Billy Kimmel’s care — or any baby born with a surgical emergency, or for that matter anyone who presents to an emergency room — is that health care providers will take care of them. It’s what we do. But it keeps the implications of not having health care hidden.

What if people who didn’t have health insurance and couldn’t afford care simply didn’t get it? What if emergency rooms demanded proof of insurance or a credit card at the door? What if hospitals didn’t provide millions of dollars in charity care? What if people without health care actually died on the sidewalks outside hospitals, in plain view of the people who don’t agree with making health insurance available to all?  My bet: We’d have universal health care immediately.

Instead, we have a safety net. Hospitals do provide emergency care, and charity care. There are free clinics and GoFundMe campaigns. Uninsured people who are sick spend down their savings, lose their homes, and declare bankruptcy. Then, impoverished and unemployable, they qualify for Medicaid and get some measure of care.  They do this out of sight. We can tell ourselves that our fellow citizens are getting care.  But it is care that comes at an extraordinary cost — lost productivity, lost hospital revenue, and ultimately lives lost in quieter, subtler ways.

Because the reality is that not having health insurance doesn’t mean that the Billys of the world die on the street. Instead, they die of poverty. They take health care system down with them, because physicians and the hospitals they work for are committed to — and mandated to — care for people regardless of ability to pay. This preserves the illusion that health care is a luxury; that, as George W. Bush famously said, people can always just go to the emergency room. But it doesn’t keep people healthy and productive. Driving people into bankruptcy and ER visits for chronic conditions costs more to our society than any health insurance plan.

How do we fix it? We cannot let people die in the streets, in full view of the voters, martyrs to the fundamental inequity of our society. But we can tell the stories of the people hurt by the health care system as it exists now and as it seems destined to change under the new administration. We need to tell the stories of 1,000 Billys. Not the ones with famous, millionaire parents, but the ones we see in our clinics every day whose parents face the choice of keeping a low paying job or losing it to qualify for government assistance, or whose mortgages are three months late in the face of crippling bills. Without names and faces, affordable health insurance is just another entitlement, given — and taken away — by a government whose own access to insurance is never in doubt.

Jonathan Kohler is a pediatric surgeon.

Image credit: Shutterstock.com

Prev

MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasis

May 13, 2017 Kevin 0
…
Next

Tomorrow, we may fail you: Vignettes of pre-existing conditions

May 13, 2017 Kevin 0
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
MKSAP: 28-year-old man is evaluated for recurrent nephrolithiasis
Next Post >
Tomorrow, we may fail you: Vignettes of pre-existing conditions

ADVERTISEMENT

More by Jonathan Kohler, MD

  • Thank you for letting us be a part of your child’s life. You truly are the heroes of medicine.

    Jonathan Kohler, MD
  • Doctors need to vote. And doctors need to help them.

    Jonathan Kohler, MD
  • A modest proposal in response to eliminating the individual mandate

    Jonathan Kohler, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • Why this physician teaches health policy in medical school

    Kenneth Lin, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • Why this physician supports Medicare for all

    Thad Salmon, MD
  • A physician contemplates Medicare blended rates

    Ira Nash, MD
  • A physician’s take on thoughts and prayers

    Earl Stewart, Jr., MD

More in Policy

  • Why the U.S. Preventive Services Task Force is essential to saving lives

    J. Leonard Lichtenfeld, MD
  • Brooklyn hepatitis C cluster reveals hidden dangers in outpatient clinics

    Don Weiss, MD, MPH
  • Why nearly 800 U.S. hospitals are at risk of shutting down

    Harry Severance, MD
  • Innovation is moving too fast for health care workers to catch up

    Tiffiny Black, DM, MPA, MBA
  • How pediatricians can address the health problems raised in the MAHA child health report

    Joseph Barrocas, MD
  • How reforming insurance, drug prices, and prevention can cut health care costs

    Patrick M. O'Shaughnessy, DO, MBA
  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • How federal actions threaten vaccine policy and trust

      American College of Physicians | Conditions
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • An addiction physician’s warning about America’s next public health crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Gen Z’s DIY approach to health care

      Amanda Heidemann, MD | Education
    • What street medicine taught me about healing

      Alina Kang | Education
    • Smart asset protection strategies every doctor needs

      Paul Morton, CFP | Finance
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • How IMGs can find purpose in clinical research [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 35 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • How federal actions threaten vaccine policy and trust

      American College of Physicians | Conditions
    • What street medicine taught me about healing

      Alina Kang | Education
    • Are we repeating the statin playbook with lipoprotein(a)?

      Larry Kaskel, MD | Conditions
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Past 6 Months

    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • A physician employment agreement term that often tricks physicians

      Dennis Hursh, Esq | Finance
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
  • Recent Posts

    • An addiction physician’s warning about America’s next public health crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Gen Z’s DIY approach to health care

      Amanda Heidemann, MD | Education
    • What street medicine taught me about healing

      Alina Kang | Education
    • Smart asset protection strategies every doctor needs

      Paul Morton, CFP | Finance
    • The silent cost of choosing personalization over privacy in health care

      Dr. Giriraj Tosh Purohit | Tech
    • How IMGs can find purpose in clinical research [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A physician’s response to Jimmy Kimmel’s monologue
35 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...