We all know about the proven links between socio-economic status and health status, but I’m not sure we REALLY get it.

I finished an assignment in Aspen in late April and was working in rural Maine 7 days later. Aspen boasts the highest realestate prices in the country, Newport, Maine boast a truck stop that sells Fourloco. Making the quick move from a population of patients injured while using $100/day ski tickets to a population consisting primarily of Medicaid recipients whose back is prematurely deteriorating under their own weight has opened my eyes.

We have a huge problem that needs to be the focus of every future health care policy decision made in America. Prevention and early treatment are the answers to these people’s health problems and everyone’s pocket book. Many states’ indigent programs (Medicare as well) greatly restrict what services are covered. Frequently this means a person needs to have developed a problem and allowed it to progress to a more serious status before treatment will be covered. If the less foturnate have their early symptoms treated, they may avoid a more serious progression of their diseases, and we ALL will pay less.

For example: Medicare will not pay for a wheelchair pressure relieving seat cushion for a patient until they have a stage II ulcer (open wound). Rather than buying extra seat cushions early, we end up paying forcushions, the wound care for the ulcers, and a whole host of sequelae that result from the patient’s prolonged immobility. We’re talking TENS of THOUSANDS of dollars per patient. Prevention, people!

The other side of this issue is the lack of health care providers in the poorest of areas. Specialists have long wait times and patients get worse and worse while they wait to be seen. Again, early detection and complete treatment at the first signs of illness have the potential to unload the specialists and allow them to provide better service. Proper inital diagnosis by primary care physicians and treatment that they are appropriately reimbursed for will decrease the financial burden on us all.

I think you get the point. I’d like to say so much more but I’ve broken my own rule of keeping this blog brief. Feel free to comment for further discussion. Below is a related piece I heard on NPR yesterday, it really gets to the point.

NPR – Mississippi Losing the War With Obesity

Healthy travels,


James R Spencer, PT, DPT, OCS, CSCS

Current assignment: Newport, ME