Archive for August, 2009

22
Aug
09

Another Perspective on Health Care

My lifelong best friend recently wrote this essay in response to the health care debate. I liked it so much I asked her if I could repost it here. She very kindly gave me her permission.

Let me tell you a story.

It is 2 July 2003. I am in bed, doubled over in pain. My skin is yellow, I can barely swallow and haven’t eaten anything in two days. Suddenly, I can no longer breathe. I try to scream, gasping. I can’t make a sound – there’s no air. I pound on the floor, falling out of my bed, tears streaming down my face. The noise thankfully wakes my father, who wakes my mother. In five minutes I am in an emergency room.

It’s sometime after midnight. I still cannot breathe, and the pain in my abdomen is so bad I cannot lie down. I beg for someone to help me in my mind, trying to get the words out. I am in critical condition – in 15 minutes the doctor has seen me, and I am now hooked up to an IV and oxygen mask. The pain is subsiding, but I still cannot breathe.

I am taken all around the hospital. Ultrasound. MRI. Chest x-ray. By dawn, the doctor comes into my room and says that I will not survive without emergency surgery, and that I am to be prepped immediately. There is a large gall stone stuck in a duct near my pancreas. It is infected, and the infection has spread to other organs, including my lungs. The ultrasound showed something else as well – blood-filled cysts on my ovaries, uterus, and intestines. If they burst, I may die of internal bleeding.

I am only 21 years old.

My mother asks about the risks. Things could go wrong, says the doctor. Bleeding might occur. There is fluid in my lungs and scar tissue around the gall stone. It is dangerous.

I am prepped for surgery. I don’t remember much about that.

While I go through surgery, my parents are fighting with the hospital administration. They have to meet with the insurance liaison. There is concern about the costs, whether or not I will be covered. Have I been diagnosed? Do I have cancer? Do I have the proper referral?

Thankfully, I have a referral, called in by my family doctor just before we arrived at the ER. I had not yet been formally diagnosed with endometriosis, and my biopsies for cancer came back negative. Still, I would spend two weeks in post-surgical critical care, another week in the hospital, and be back again the next month for another surgery to remove my gall bladder and the cysts.

Two months later, statements start arriving. My father has one of the best insurance plans in the city, through his employer with added benefits that we pay for out of pocket. There are some costs that must be paid – $50 emergency room co-pay, $300 surgical consult, $200 specialist consult, testing fees. But that pales in comparison to the final amount for my summer of hospitalization – around $300,000.

I think about that summer a lot when I hear about the health insurance debate. After the surgery, my attending asked why I waited so long to come to the hospital. I told her I was afraid of doctors and I thought I would get better on my own. She told me that, had I waited one more day, I would have died.

22 January 1982 – 3 July 2003.

What is I had been afraid of the costs? What if the doctors had stabilized me and sent me home that day, as they do with charity care cases? What if the insurance company had dumped me, leaving me with $300,000 worth of hospital bills?

Would I be alive today? I think the answer is a definite NO.

A year and a half later, I would be back in the hospital, with another specialist. The cysts have come back, as has the pain. I’m back in surgery. The diagnosis is made final: I have endometriosis.

I’m afraid of that diagnosis, because I know I can be denied private health insurance now on the grounds of a “previous condition.” I know that I am very, very lucky to have excellent insurance through my employer.

But what about the unlucky ones? And there are so, so many now… what will happen to them? When they get sick, will they die? What about their children?

I know there is a lot of anger and fear surrounding the health care debate – that a lot of people think it is a government take-over that will lead to rationed care and federally-sponsored human euthanasia. I don’t know what the best answer is – I don’t know enough about medicine to form a best opinion.

All I know is that I don’t want to be one of the few lucky ones.

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