My Country, In Sickness and in Health…

OK, I’m feeling marginally better a week after my foray to the ER. The headache has retreated to a dull roar and the stomach pains hurt, like the Neil Simon title, only when I eat. That’s it for the medical update—the minute this blog turns into a blow by blow of my abdominal pain, I’ll roll it up like a carpet and leave it by the side of the road.

Had an interesting chat with my home nurse while she was changing my PICC dressing. She used to be a floor nurse, back in the day when that position was little more than indentured servitude to the hospital you worked for in the guise of a “training program”. The nursing industry managed to get out from under the thumb of the hospitals, from what I could gather, while student doctors are still expected to put in insanely long, sleep-deprived hours in order to keep their spot in the program. What they are preparing doctors for, exactly, I have never been sure. I mean a doctor, especially a surgeon, has to have great powers of concentration and physical stamina. But I don’t think they’ve ever had to work twenty-eight hours, sleep for fifteen minutes, then have somebody shove them awake and throw a scalpel in their hand to perform an appendectomy. The conclusion we came to was inevitable I suppose—students are cheap labor and when it comes right down to it a hospital is a business. Businesses make money. If they happen to give you good care as a patient, good for you. If not, go find another hospital, because the bed you’re in is waiting for another insured patient. Good things are done in hospitals, don’t get me wrong, by dedicated, good people. But your well-being is not why the bricks and mortar were laid, that’s all.

Anyway. We continued to talk about how someone in my situation might fare in a different country, with a different government and a different health care system. The conclusion was not well. There are holes all over the system we’re currently in, and I’ve lived through many of them. For better or worse what insurance will cover is meant to keep a patient stable, not really get them better—by that I mean they will not pay for anything exploratory when sometimes that is exactly the kind of imaginative medicine that is needed. Also, in this age of specialization, there is little or no coordination of care. I have a different doctor for my stomach, my blood, my nutrition, my headaches, my depression and my general health, and none of them would know each other if they were in line at a grocery store. Each one is primarily concerned about their own specialty, so if you happen to have an illness that involves multiple systems you’re spit out of luck. It’s like going to a restaurant and having to order each element of your meal from a different waitress. Then if the steak is undercooked and the corn is cold you have to send them back to two different cooks in different kitchens. Start calculating your odds on this meal turning out well.

But it could be worse. I paid into this system that is now supporting me since I was sixteen. There were years when I contributed more than others, but for the most part I was a steady customer. A few years ago it was decided between my doctor and the government that I was physically incapable of working, so I became part of a controversial safety net in this country. When some people hear “disability”, they hear “lazy”, “scam-artist”, “fraud”, etc. I’m sure there are those people out there—hell, I’ve known some of those people who want nothing more than to milk whatever they can out of the system. I had to overcome that notion of myself, since I was always the type who didn’t want to take a nickle from anybody. It’s quite a blow when you realize than not only will you be taking that nickle, you’ll be taking enough to keep your family’s head above water every month. And the whole world can tell you rationally that you paid into it, that this is what the system was made for, that if you were healthy you wouldn’t need it so it’s a just a matter of necessity. You still feel like a beggar.

But if the worst thing I have to deal with is a blow to my ego, I can take it. I have little choice, really. In another country we’d be living on the street. My son asked me if I’m still proud to be American, even though other countries see us as greedy, fat and militaristic—he didn’t say those exact words, but that was the gist. I was actually very proud of HIM for asking such a thought-provoking question. I told him that yes I am still proud, that even with all our sins we are still the greatest, most free country in the world. It’s hard sometimes to be an American when we rush to war without purpose, or fail to care for those among us who need the most. The difference between the haves and have-nots is deep and wide, and it is a source of embarrassment to me that we can’t handle that disparity better. The line between democracy and capitalism has blurred, and the notion of public responsibility seems to have been dealt a death-blow because of it. It scares me what we’ve become, what we’ve devolved into.

Yet, out of nowhere we go and elect an African-American president, and people start to care again, or at least it seems that way. Politics in this country will always be frustrating, and change will always come slowly, but it does come after much hand-wringing, hair-pulling and sometimes awful behavior. And like I said, a person in my situation might not fare nearly as well in most health-care systems. I owe the well-being of my family to the fact that I am an American, and that is a loyalty I find hard to dismiss.  Perhaps that’s not a ringing endorsement, but it’s honest.

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    • Kae
    • May 6th, 2011

    I’m not familiar enough with the systems in Canada or Europe– I’m thinking of little, homogenized places like Denmark– to say I think their health care is better than ours; I do know there’s no such thing as a free lunch anywhere, and they pay for their health care out of their taxes. I do think, however, that the insurance companies in this country have made it almost impossible for the “middle-class” person who isn’t well enough to work (fibromyalgia), but doesn’t have enough money to pay for medical insurance.

    My granddaughter *is* covered by insurance, and the day before yesterday, when she was out of her medicine for GERD, the insurance company refused to pay for her prescription, claiming it was too expensive. So she’s been without her medicine for three days while this matter is being disputed.

  1. The poor thing. Give Laura our love, there’s nothing worse than your infant getting sick.

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