Saturday, August 22, 2009

The Death Panel Will See You Now

Welcome to "The Gods Are Bored," weighing in on health care with privileged information! You think Death Panels don't exist already? Think again! They're here, and they've been here for a long time.

When I lived in Detroit in the 1980s, I had top-of-the-line health insurance through Mr. Johnson's company and yet another insurance from my own workplace. I injured myself playing volleyball. Hurt my foot. Went home after the game, iced it a little. Woke up Saturday morning, and there was still some minor swelling and bruising, and of course it hurt.

I went to the emergency room at Henry Ford Hospital. I signed in and showed them Mr. Johnson's insurance card. Within a half hour I was ushered into one of those curtained areas where the doctor sees ER patients.

As I was limping through the hallway, I passed a person lying on a stretcher. Young black male, bleeding, breathing as if in shock. He was being totally ignored, while I was given the red carpet treatment. When the doctor came in to see me about my minor foot issue, I asked her about the guy in the hallway. She just shrugged.

I've always wondered if that young man had an appointment with the Death Panel. There's no way to know for sure. The Death Panel sees to that.

Fast forward to 2008. I went to my sports medicine doctor about my ailing hip. He's a very special doctor, the kind who sits down and chats and smiles at you, and then explains very thoroughly and clearly what should be done. There's nothing "routine" about his appointments.

Just as we started the appointment, the doctor got beeped by his front desk. He apologized profusely and left the room. He was gone a pretty long time -- maybe 15 or 20 minutes. When he came back, he apologized even more profusely. Then he told me candidly why he'd been called from the room.

He had been on the telephone with the governor of New Jersey. Apparently my doctor was on some kind of panel for state health care. The governor was asking my doctor which charity hospitals to close in our area. The governor also pressed my doctor about lowering the number of emergency coronary care units. Which ones could be closed? The governor wanted to slice in half the number of units in South Jersey.

I said to my doctor, "So in essence, what you're telling me is that a person who has a heart attack in Mount Ephraim will have to be taken by ambulance to Camden, rather than to Cherry Hill, which is much closer to Mount Ephraim."

He said yes.

I said, "So the resident of Mount Ephraim is much more likely to die en route to the hospital than, say, the resident of Collingswood, which is on the edge of Camden."

He said yes.

I said, "So essentially, it's not survival of the fittest so much as survival of the proximity-to-the-right-hospital."

My doctor said he was doing and saying all he could to save emergency care in all of the local hospitals. But New Jersey has a budget crisis, and one way of saving big money is to cut back on the number of critical care emergency rooms and charity hospitals.

Would someone please explain to me how this is not a Death Panel? Better yet, explain it to Tony of Mount Ephraim, who died of a treatable heart attack in the ambulance on his way to distant Cooper Hospital in Camden.

(By the way, the governor got his wish. A few months after my hip appointment, I saw a small article, buried in the back of the newspaper, noting the closure of five coronary care units in suburban New Jersey hospitals, due to reductions in state funding.)

My final note on this morbid topic has to do with location-related Death Panels.

One day I found myself in midtown Manhattan, standing on the sidewalk bearing witness to one of the city's infamous gridlock traffic jams. In the midst of this gridlock stood an ambulance, sirens blaring -- I mean blaring -- as it sat there, unable to progress an inch.

That ambulance was still sitting there, still blaring its horns, a half hour later. It had not budged.

If my uncle out on Polish Mountain, middle of nowhere, needed an ambulance and emergency care, he would have to wait about a half an hour, maybe slightly more, for the ambulance to arrive. Then it would take a half hour, maybe a little more, to transport him to the nearest hospital. Are his chances of survival better or worse than those of the patient in midtown Manhattan whose ambulance got stuck in gridlock?

The Panel will see you now. Don't fear the Reaper.

10 comments:

A Wild Celtic Rose said...

When I was a paramedic, I'd see children sit in emergency rooms not equipped or staffed to deal with pediatic isssues for hours on end (I'd go back to the same ER several times in a shift)

These were the uninsured children.

The insured children were transferred to the children's hospital up North.

The incident that finally did me in emotionally (I will never work in the health care field again) was a burn victim.

I had literally pulled this guy out from under a burning truck on Interstate 5 near Buttonwillow California (Central Valley)

He had 1st, 2nd and 3rd degree burns over 90% of his body (maybe more)

I watched him (once again, repeat trips to the same emergency room and we had 4 in Bakersfield) in agony, shivering from hypothermia (not having any skin left will do that to a person) crying out in pain in a facility that was not equipped to treat him or ease his suffering.

He suffered there for at least 6 hours (I don't remember the exact times, this was in the late 80s) while the insurance companies aruged over if they would pay for a helicopter or ground ambulance to transfer him to the burn unit at the University in San Francisco.

I felt like a monster for "saving" him, only to have him suffer like that for so long.

Stories like these happen every day.

I can take blood, guts, danger, etc...

But I could not take watching things like that happen to people.

YELLOWDOG GRANNY said...

did you see my second to last post?

Celestite said...

It's not only the uninsured...once they suck all the charges they can out of you, they don't want to see you. My mother is dying of cancer, she has excellent insurance and has paid probably well over a quarter of a million dollars into the system in the last few years. Now that there are no more tests to be run...although three different doctors would each like her to get a new PETSCAN every week, she won't go (the insurance will still pay, she is just too exhausted to run all over town)...they are playing hot potatoe with her, having trouble find an appointment and suggesting that "if she needs a doctor she should go to the emergency room."
Don't believe that crap about emergencies rooms full of uninsured....the insured are there too and not for emergencies...they are there because their primary care doctors are not practicing medicine.

THE Michael said...

Now now,you people, don't you know that this country has the most advanced health care in the world for those who can afford it? That's right, since this is a capitalist country, that's all that matters! The FREE MARKET solves ALL our problems, which apparently, is that we have too many people with not enough people bothering us, thus our FREE MARKET rids us of them by denying them care. However, since we are a God-fearing capitalist democracy, we don't have to worry about some socialist system taking over our lives and taking care of ALL our citizens. THAT would be un-American, according to our God-fearing Christian conservative brothers and sisters who apparently all have plenty of money, most of which they keep by utilizing illegal immigrants, avoiding taxes, and ripping off poor people with predatory credit and legal fine print commerce.

I love this country, I really do.

THE Michael said...

Please replace the second "people" in line five with "money". Thank you.

Buzzardbilly said...

Damn! I was hoping the Death Panels were here taking suggestions for names to add to their list. I could keep them busy for quite a while. Damn! I thought it was going to be almost as good as having Darth Vader take up for you in all of your fights.

*oh well*

Curmy is self-employed so we're self-insured. What that really means is: Every month we bend over and let them drive matching trucks up our asses, and we have the right to tell doctors truthfully that we are insured, though we know if anything catestrophic came up and it looked like we were going to seek treatment for it, then we'd be dropped.

I've been dropped twice before by group plans. First time, I had my thyroid tested I got a letter in the mail saying "you've been dropped." The other time, the sinus dude said I needed surgery. Well, not only was I dropped, but they backdated the fucking letter TWO months so that we had to buy the up-butt-truck-driving insurance as "uninsured" people.

I'd take a real live death squad over continuing with the current system. And, I did have that year of living under National Health in the UK. Really, I miss it.

Debra She Who Seeks said...

You're absolutely right, Anne, and you show exactly how ignorant and hypocritical the right wing's over-the-top rhetoric on "death panels" really is.

Pom said...

"If we can find money to kill people, we can find money to help people" - Tony Benn

The thought he had about NHS in the UK just before it was implemented immediately after WWII!! This was just after their country had been devastated in the war! They helped people in desperate times for the country, not when there was so much excess that everyone could justify the slight pinch. Tony Benn was an elected SOCIALIST for 50 years in the UK running on a platform of higher taxes and universal health care. If only America had a man like that to offer!

Pitch313 said...

I wonder where all that "saved" money from the closed down care units REALLY went?

And I wonder how helping sick, ailing, and injured folks feel better turned into the urgent overburdening question of WHO PAYS FOR IT?

Obviously, if we provided no public services, more money could be saved...

seithman said...

I hate to break it to you, Pitch, but I think that's exactly what some people are angling for.

Well, unless you're wealthy. The government will always be more than happy to help the wealthy. And the wealthy will be more than happy to let them.

-- Jarred.