Wednesday, October 28, 2009

Health Don't Care

Healthcare and insurance reform is a hot topic these days. It seems as though everyone has a different take on how the issue should be handled in the United States. Some people want a socialized plan much like in the United Kingdom or Canada and others like the system the way that it is. If I were a gambling man, and I am, I’d wager that the lines are split based mostly on who does and doesn’t currently have adequate care.

In April of 2005 I had a surgery that changed and saved my life. I had battled with my weight for my entire life and on the day that I went to the hospital for gastric bypass surgery I weighed 362 pounds. Nothing that I’d done to get the weight off had worked and this was a last ditch effort to, hopefully, ensure that I’d be able to live a long life and watch my still unborn children grow. The cost of the surgery was right around $35,000. Fortunately I had health insurance through my work at the time. That isn’t to say that the road from idea to operating table was smooth and downhill. When I applied for the surgery it was a covered preventive surgery. Before they made their decision, however, it was not. I had to write several appeal letters and my friends and coworkers did the same on my behalf. Finally, after months I was approved and on my way to a happier and healthier life.

Less than six months later I was unemployed and without health insurance. I should have been visiting my doctor for follow up visits but I couldn’t afford to pay the fees. When I finally did find a new job the pay was terrible but there was good health coverage for me and my wife. We were able to go to the doctor, get new glasses and have dental work done. A couple of years went by and then suddenly we found ourselves unemployed and uninsured again; victims of the new economy. But this time we had a little boy to take care of too.

My dad was never the one to go to the doctor unless he felt like he really was ill. Just a few months before he died he went to a doctor in my hometown who told him that he had bronchitis. After a while he hadn’t gotten better and knew that there was something more sinister than bronchitis eating away inside his chest but he didn’t have health insurance either. He knew that he would soon be 65 and eligible for Medicare. So he waited.

In October he was approved for Medicare and went to see a different doctor. That is when he found out that he had lung cancer. It happened fast. He was admitted to the hospital and had a lung removed but Medicare would only pay for him to stay at the hospital for a certain amount of time based on the surgery. He was sent home a short time after he was deemed stable. His time at home was short lived and he returned to the hospital where he would draw his last breath.

God has blessed me with a wonderful wife and a perfect son. We own a home, two cars and a dog. When we were working life was pretty good. It is hard to appreciate the good unless you’ve lived in the bad and we’ve had our share of that as well. I’m no longer overweight, at least not excessively, but that is not to say that I’m without health issues. I have scleroderma and a beautifully acute case of depression. There is no cure for the scleroderma and, fortunately, when I did have insurance my doctor wrote a long prescription for anti depressants which I can have filled with an inexpensive generic form of Prozac every month. There is no cure for the depression either but the drugs can help to alleviate the symptoms.

Now that I am back in school and accumulating more student debt I have access to the clinic on campus which, while it’s no substitution for health insurance, does afford me the opportunity to see a doctor. I took advantage of this last week because I’d noticed that I have an odd bulge in my abdomen. As it turns out I have a hernia. I had to do a bit of research on exactly what a hernia is. What I found is that it is when your internal organs, from stress and strain, find their way through your muscles to the outside of the cavity where they should live and lie just beneath the skin. Every strain from that point forward pushes the organs, in my case my intestine, out a bit and then when the strain is gone they retract to their new home outside the muscle. The only way to repair this is through surgery. I’ve looked but I can’t find the surgical center on campus. Must be that there isn’t one. So, here I am, thirty three years old, unemployed with a hernia and no insurance.

The doctor that gave me this wonderful news said that I shouldn’t over exert myself. I asked her what, specifically, qualified as overexertion and she told me that any lifting of over 10 to 15 pounds could cause me to have what is called a strangulated hernia. This is when the organ pushes through and doesn’t retract at all causing excruciating pain and the immediate need for surgical intervention. Great. My son weighs 20 pounds. I am the proud parent of a child that I am not supposed to pick up from the floor or his crib because doing so may land me in the hospital with a bill for a surgery that I can’t afford.

This brings me back to healthcare reform. I have stood on both sides of the proverbial fence when it comes to insurance and healthcare. As a gainfully employed member of the proletariat I thought that each person capable of work should be responsible for themselves and their own health coverage. Unemployed and unhealthy I wonder how that is possible. I am capable of work and I would greatly prefer having a job and an income to the state in which I find myself right now. That’s not to say that with insurance everything is sunshine and roses. In America we have some of the best healthcare available in the world but it is only within reach of the wealthiest and well insured among us.

So, you may be asking yourself “Where does he stand on socialized healthcare?” To tell the truth I’m asking myself the same question. I think that we should all have access to all of the medical advances and treatments that are available but then, who’s to pay for it. If everyone had open access to the same quality of care then my father wouldn’t have had to wait until he had Medicare and he may still be alive. I wouldn’t have to worry that a case of constipation would put me in the hospital with a strangulated hernia. This is a slippery and dangerous debate though. What of hypochondriacs? What about people who, inevitably, would find a way to subvert the system? There are a lot of questions that need to be addressed before any kind of “National” healthcare program can be a viable solution. What if there were less government spending on foreign matters and the military? This would, in turn, allow for lower taxes and, as a result, more of our own money in our pockets; money that would allow us to buy our own health insurance. But wait, the cost of healthcare is constantly on the rise and it still costs thousands of dollars to spend a night in the hospital. Thousands of dollars that move the insured toward his annual coverage limit or the possibility of having his coverage dropped or denied by the insurance company.

There is no clear solution and we, as a society, are in a catch 22. We can watch out for one another but we’re too busy trying to watch out for ourselves. If I look inward long enough maybe eventually I’ll be able to see behind myself. Then I can watch my own back.

6 comments:

  1. It's not even debatable.

    The best solution to our healthcare situation would be to have adopted H.R. 676, the Medicare for All bill. You say you hate to read, please look it up and read it. It's 27 pages long.

    AFTER you read it, please tweet me @wwwexler and let's discuss.

    Glad you're doing better (in general), hope the hernia gets better and that you find the right antidepressant. Wellbutrin does wonders for me and I've tried 17 other ones (never Prozac, oddly).

    -Wexler

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  2. Hi Dan,

    Sorry to hear about your hernia. I can relate to your depression as I am prone to it too. Wish I could do something to help. You're such a fantastic writer and you get to the crux of the issues immediately. You should have your own newspaper column. Hopefully some astute editor will find your blog and realize that.

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  3. Dave, that would be great. This post sounds a bit like pissing and moaning but that's just the direction that it took. It was unintentional.

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  4. No, it's good, it's honest, it's transparent! The best writing is when it comes from the heart.

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  5. I wanted to address the last paragraph. I submit that the issues you listed are inextricably tied to the issue at hand. If there is healthcare for all the hospitals don't have to foot the bill for so many, the ER visits (at thousands of dollars per each) go way, way down, people will visit their primary care physicians more often (at $150-$500) for preventative care, and the cost of healthcare can go way, way down. The cost of healthcare going down would then benefit the insurance companies and the actual cost of insuring us could go down. The result is a little more profit for the primary care physicians, more profit for the heath insurance providers, less strain on the terribly overworked ER system, and a far more balanced view of care by and for the individual.

    I would love to hear your thoughts...

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  6. Benjamin - First, thanks for reading and commenting. Please read more of my posts and if you find anything else of interest comment and even tell others about it.

    You make a good point. I was just talking with my brother last night about a similar way to ease the strain on the system. If there was more preventative healthcare and less spending on medically futile situations then we, as consumers of healthcare, would be in a much better state.

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