He was forced to have an emergency colostomy and now has his bowel movements in a bag attached to his abdomen. His emotional condition has deteriorated to such a degree that no private vendor will treat him, and he's back in one of the few remaining state mental hospitals. Since President Clinton announced his health-security plan, public attention has focused on rising administrative costs, choice of physicians, and the potential rationing of high tech treatment. But few have focused on how the administration's fear of attacking the private insurance industry has produced a health-care proposal that, as the anecdotes above illustrate, will cut costs by jeopardizing quality and continuity of care. Treatment and care are not the same thing.
Treatment includes the tests, surgeries, and therapies that are used to diagnose and cure disease.
Care, on the other hand, comprises not only monitoring treatment, but also educating patients and families about the side effects and discomforts of treatment. Care requires attention to the patient's social context and lifestyle, and may extend far beyond medical treatment. This is unfortunate. Because they have been trained in a disease-driven model with an emphasis on specific medical interventions, physicians are generally more focused on treatment. Nurses, on the other hand, are usually more expert on issues of care.