The health-care reform debate has stirred strong emotions, but all
the attention has been paid to the fury and fear on the right. Take it
from me: There’s plenty of both on the other side.
The fear and rage come with the thought that desperately needed
reform may once again be subverted by the giant drug and insurance
companies, working tirelessly through paid-for congressmen and
senators, through ranting sock puppets in the media and sophisticated
advertising. It comes from watching millions of people fall, once
again, for the same old crapola.
Choice, we’re told. It’s all about choice. You want to be
able to choose your doctor, choose your hospital, choose never, ever to
die.
As if. I have told this story before, but it only seems to become
more urgent.
On a late-February day in 2004, my sister-in-law and I waited for
four hours with my 46-year-old brother, Charlie, for him to be seen in
the emergency room at Tucson Medical Center. (The wait would probably
be longer today: A recent national survey showed that in 2008,
Arizona—surprise!—had the third-longest ER waits in the
nation, with an average of more than 5 1/2 hours.)
Charlie had been diagnosed with hepatitis C more than 10 years
before; hep C leads to liver cancer if untreated. Even when it
is treated, it usually does. My brother had been feeling
increasingly unwell for six months; he’d had a biopsy at Thanksgiving
that was clear, but his blood work had been ominous. After Christmas,
he started feeling so bad that he’d missed work, and in the previous
week, he’d developed severe pain in his back and legs. The pain had
become unbearable that morning. His fierce stoicism finally collapsed,
and he’d called his internist, who told him to go to the hospital and
get admitted.
Beth and I waited helplessly with him as he sat, gray-faced and
sweaty with pain. The minutes crawled by as we watched while every last
toddler with an earache and drunk with a cut on his hand was taken back
to be treated. We complained to the ladies behind the desk, who blew us
off; we called Charlie’s doctor and were told there was nothing he
could do. We talked seriously about leaving. We despaired.
Understand that my brother was middle-class, employed, fully insured
and married to a woman who worked in administration at another
hospital. He had no choices that day. His only choice was to wait.
When he finally got an MRI, it turned out that he had stage IV liver
cancer, and that his pain was caused by a secondary bone tumor pressing
on his spinal cord. Pressing on his spinal cord. It was
dinnertime before he was given morphine, and the pain was only fully
relieved by a course of palliative radiation therapy that shrank the
tumor. There was no effective treatment, though, for the fast-growing
primary cancer in his liver. He died on March 25.
Nothing along the way was harder to take than those hours in the
waiting room. There really are no words to convey Charlie’s suffering,
or our rage and sick disbelief that this pitiless trap was the only
entrance to the glorious U.S. health-care system.
Several things were wrong, are wrong, with what happened that day,
things that would not be hard to fix. But the essential problem is one
that only sweeping reform can address: The ER was flooded, as it always
is, by poor people with urgent but relatively minor ailments and
injuries who could be treated in five minutes by a nurse practitioner
at a doctor’s office or urgent-care clinic—or these days, at
Walgreens—if they had insurance. Instead, they were jamming a
fantastically expensive critical-care facility, because that’s the only
place they could get free treatment. They’re still going there.
So here’s my advice to everyone who hates the idea of paying for
universal coverage: Support it for your own protection. Demand that
your representative vote for it because, in your hour of pain and need,
you want the hapless, the homeless and the children of immigrants out
of your way.
Because sooner or later, you will have to go to the ER. You
don’t want it to be the one my brother went to.
This article appears in Sep 17-23, 2009.
I am sorry to hear about your BIL but sadly, as he choose not to see a Doctor in the six months prior concerning his pain, why would you think ED personall would see him as an outright Emergency Situation, which although experiencing pain was not a life threatening event at that time. Your BIL could have been evaluated by any of the facilities you mentioned, himself, without involving an Emergency Department. His own Doctor could have made an appointment to see him or arrange to have him admitted to the Hospital thus bypassing the Emergency Department. That is something his Doctor could have done and choose not to do so. The fault is not that of the ED personall or the sick people with no insurance but people’s failure to see a Doctor when symptoms first appear, IMOO.
My brother-in-law had skin grafts on his feet and ankle areas from 1970 or earlier. These are always peeling.. He knows his feet better than anyone. He got an infection in one of the lesions and had no access to get the correct antibiotics, if he could have travelled h Would have gone to Mexico. Self employed. His foot had swollen so much he had to go to the emergency room in Tucson. After 3 hours waiting for triage, the nurse there freaked, said he was going to lose his foot, he told her exactly what it was and only needed the prescription.
They sent him upstairs to foot floor. He sat there for close to 8 hours. He convinced the doctor that saw him that it was a regular problem because of the skin grafts. The doctor prescribed the antibiotic, T. paid for it at the local pharmacy and all was well.
Until he got his bill. They charged him for the 3 hours in the emergency room waiting for triage (you have to sign in when you get there, then you wait while the bill charges tick tock.))
and then they charged him for the nearly 8 hours he waited upstairs waiting for a doctor to see him. He went to obmbudsman and in the end had to split the bill, $800 on his part. After the discount they gave him as a gesture of good will. Wrap that around your head.
He had an option to go to a Quick CAre for the antibiotics long before his foot got so swollen or a relative could have gone to Mexico but not as cheap as the QC. Of course, we are all charged from the get go and three hours for an ongoing peeling skin issue is not excessive. The ED personall are seeing the urgent and life threatening illness first. Its their job. Both stories revolve around folks who waited to long to seek medical assistance and then expected to be treated like a heart attack. Does not happen. I always told folks to Thank Gd they were not taken first cause those are the do or die patients. People need to establish a relationship with a clinic or Doctor, get regular check up and make arrangements to be evaluated before they become a severe case.
Some people don’t go to the doctor because they already found out their crappy insurance doesn’t cover shit. I was employed full-time and had the best insurance available through my employer, but I still ended up getting stuck with a $2000 MRI bill. And then there are those don’t have or can’t get insurance.
Imagine for a moment if you’re looking for work with serious health issues you can’t get treated–until you get a job.
A decade earlier I paid nine bucks a paycheck and rarely had out-of-pocket costs. In 2007, I paid six times that for a policy that almost delighted in limiting reimbursement.
And eveything is exponentially more expensive.
Different countries use various approaches to health care, but we are only industrialized with a disease industry. Profiting off of illness isn’t just immoral–it makes no sense. Illness is not market-driven. People don’t get their gall bladders removed just because their insurance will cover the cost.
And huge costs of allowing the sick to get sicker and sickest is not something we can keep adding to overall cost of care.
Well, this was an essai about Emergency Departments. My point was that folks can not be expected to show up with long term issues and be treated as an Emergency, like those kids with their cuts and wheezy lungs, unless there is something acute going on. Health Care is available to the poor and needly in the form of sliding scale clinics, chronic illness services at the County Hospital and most kids under 18 are covered under SCHRIP if they qualify. I want to expand services to the poor and lower the cap on Medicaid. The issue is not insurance but a safety net for all sick people, legal or illegal.
I am a heart patient that needs to have treatment immediately – I was told to fill out the paperwork, and proceeded to wait for 2 hours with chest pain before I finally went to the counter and asked when I would be seen. Oops, they forgot me~ I agree, kids with colds and splinters do not belong in an ER, and for some it is a free place to sleep at night, even if its’ in the ER hallway. I know what I am talking about, because I am a hospital employee. Imagine that~
1. Doctors can’t get their patients admitted to the ER ahead of anyone else.
2. Don’t blame the sick patient for the long wait in the ER.
3. Those that defend the status quo healthcare system are those that have not had to use the healthcare system.