Aug 15, 2011

To Live Or Die...A Healthcare Dilemma

by RF Schatten


Why should anyone, be allowed to have the best Medical Care possible? If you are sick, and do not have the financial means to see a Doctor...why do you believe, that you have the same right to see someone, that can take care of your problem...the same way, than those, who “can” afford the best care possible? What gives you that right?

If it takes you, more than 5 seconds, to come up with the correct answer...then, you too!! may be one of those people, in this country...who really don't care, about your fellow Human Being. Sadly, there is quite a few out there.

America, is the greatest country on this earth, as we are to believe...so why do we have, as of 2008-2009 Census...46.3 million people uninsured? That total, has obviously risen, though, some scattered early benefits of the Healthcare Reform Bill...has alleviated the situation a bit. We won't see the full impact, of the Bill, for a few more years, when it will be fully implemented.

Along, with all those millions of people, who cannot afford Healthcare...the poverty level in America has increased 13.2 %...that means, that as of 2008, 39.8 million people are living in poverty...a sad tale, for the greatest country on earth. Even worse, is the fact that many are, or will become, seriously ill...with deceases, that can only be treated by competent Physicians, and proper Health Facilities. Politicians, very arrogantly, say; “It's not a problem, let them go to the local County Health Dept...they'll be well taken cared of”.

Obviously, Politicians don't get treated at the County Health Department...if they did, they wouldn't be singing the same tune. The County Health Department Systems, in the United States, are mostly poorly equipped, poorly maintained, understaffed, underfunded...with a bureaucracy, that it's a model, for what the term, “Bureaucracy” means. Very few quality Physicians work in Health Departments, unless they Volunteer their services pro-gratis...and those, are few and far in-between. Mostly, they are run by Physician's Assistants or Nurse Practitioners, and assisted by semi retired RN’s, or RN's who prefer an office atmosphere. A Doctor, is on staff, usually to sign off, as Medical Director...which is the Law. Better come early, though...if you're one of the unfortunates, that has no alternative means, but to go there...you have to spend most of the day, waiting your turn, sometimes up to 8 to 10 hours at a time. If you bring little kids, that is 8-10 hours running after them. If you have no means of transportation, it becomes, even a bigger problem, when it gets late, no more public buses, and it's beginning to get dark. Some will say...that's not true...but, the majority of poor Americans, who have to deal with the County Health Departments...know, how true it is.

Here is a little story...a true story. I was a Respiratory Therapist, for more years, than I want to remember. Around 1977-78, can't remember the exact date...I was working in the Emergency Room of a big city, teaching Hospital...a couple of medical schools, work out of there...it's an inner city, County Facility. It was about 1:00am, when we suddenly got a couple of Trauma Cases...at first, no special attention was made, because, it was a Shock Trauma facility, where, we would get every sort of trauma imaginable to man...coming through the doors throughout the day and night...but on a Saturday Night, a lot of shootings, were always on the menu. This, was one of them...a Black female, in her 40s, with multiple .32 caliber shots to her chest...2 bullets, lodged in her Heart, the Left Anterior Wall...no time for Intubation, to pump Oxygen into her Lungs, no external CPR, was going to help her...the next step, was obvious to everyone...crack the chest open, remove the Rib Cage, and start Internal Heart Massage...I remember this incident, because, that was the first time, that I have ever performed Internal Heart Message...the feeling, of holding that Heart in your hands, and squeezing it, to pump the blood, as fast as you can...was eerie.

What was even stranger...and maybe, why working in Medicine, made me think more on the miracle of the Human Being that God created, the spirit and the will of the Human Body, was that...all along, from the time this Lady was brought in...she was conscious. “Am I going to die?”, she said, screaming and crying... “Am I going to Die?” “Where is my son?” “Is he alright?”... “Where is my son? where is my Baby?”...her son, was in the next room, having CPR administered. They were victims of a drive by “Gang Shooting”...ironically, they both, were innocent bystanders.
Her condition, was grave...99% chance of not making it...and we did, the most we could, till she was transported to OR. All the way down the hall, and on to the Elevator, I kept the massage going...till I got to OR, and relieved by the OR Team. All the way there, she kept saying “Please, take Care of my Boy, my Baby!!” “Please tell God to take Care of Him!”
For the life of me...I can't remember her name, or his...30 years of seeing thousands of people, do that to ya!...but, till the day I die, I will never forget her face. She, did not survive...her son, did...and, according to the team members, that worked on him...someone must have been looking down on him...he had multiple .32 and Gunshot (Buckshot) wounds, all over his body.

That incident, has stood in my mind forever...and I've seen quite a few more, than that. But, it also introduced me, to the Cynicism of Medical Administrative Bureaucracy. About a month or two later, talking to a Medical Clerk, he said “Remember that Guy who came in with his mom, both shot, and she didn't make it?” I said, “yea, I worked on the mom...what about him?” Well! said the clerk... “he is going home today...but, after seeing the Medical Bill, for Him and his Mom, he probably wishes, that he was dead”. The size of that Bill, was horrendous, and no way, a poor, Black 18 or 19 year old kid, from the Ghettos of South Central LA, could have ever, paid it off. Now, that was over 30 years ago...what happens, to these people today?...with the price in Medical costs, so very much higher. Who gets stuck with the Bill??? You guessed it!

This case was in California, and even, though in a County Hospital, where Medicaid or “MediCal”, as was the case in California, at that time...would cover portions of the costs, it's still a huge amount, that is left uncovered, and the burden on families is tremendous...even more, if they don't have, or qualify for that medicaid. You are always, going to have cynics who like to say; “They are not going to pay, nothing!! they don't care...we end up paying their bills, all the time”...or, “They just let the state, take care of it, these people don't give a damn”. The reality of the matter is...that the majority of poor people, do have Values, Pride, and Honor...they don't want hand outs. But they need a little help. And, with the Cost of Living, continually rising...it's not just the lower class, but the middle class too, that is feeling the pinch.

There is just, too many people in this country, who can die...because of not having Medical Coverage...in fact, they are dying!...recently, Alisa Wilson, of Jacksonville, FL. was denied care, after her Medicaid, was outsourced to a Private Insurer...she needed a Liver Transplant...she died. I cannot understand, that, in a country as rich as the United States...people are dying, because, they simply, cannot afford the Medicine to live...that is a travesty, a black mark...in our Nation's history.

My question is: Why does anyone have to die...because, they cannot financially afford, to live? Healthcare Reform, was instituted, not too long ago. It has been proven, that Universal Health, has been a success, everywhere, that it has been implemented...the entire world has it!!

In a recent article, by the BBC News... a study made of the 7 most industrialized nations' Health Care Systems... The United Kingdom rated 1st as the most efficient. They were rated on; Efficiency, Access to Care, Quality, Equity, and Healthy Lives. Overall, The Netherlands, came in 1st, followed by the UK, Australia, Germany, New Zealand, Canada, and the United States last...not last in the world, but last, among the most Industrialized nations. The United States, consistently underperformed in most areas of Health Care relative to other countries... and includes, access to care and quality of care, whatever the background or income of the patient, despite the fact, that the US Health System is the most costly in the world. Pundits believe, that “since the US, instituted Universal Care, it will start to address this problem, and should begin to improve the affordability of Health Insurance and access to care when fully implemented by 2014”.

Until it was passed successfully, in Congress...the United States, was the only Civilized Country in the World, that lacked Universal Health...the only one!!! Why!!! Why!! has it taken so long, for America to follow, the rest of the World? This, I'm afraid... is where we begin to deal with Social Issues, and Class Issues... and where Political Demagogues and Business Opportunists, begin to stick their ugly heads, and turn an Ethical and Moral Issue, into an immoral rhetoric, for selfish financial greed, and/or political gains.

Nothing on Health Care Reform, will ever get accomplished...till we as a Nation decide, to abandon the Political Demagoguery, while putting out in front, and equate, all Medical Ethics and Moral Issues, with the Sanctity of Life.