Health Care Failures in the USA (UPDATED)

UPDATE: So, the bill for part of the surgery finally came in: $171,900. No, it wasn't a transplant, it wasn't open heart surgery. It was pretty routine surgery, the kind many women undergo every year. Yes, $171,900 seems a bit overpriced. As would have $71,900, as would have $50,000. In fact, I'd be really interested in finding out how much hospitals and surgeons in other countries charge for the same type of surgery. I'll do my best to find out.

I wonder: Does God only unleash hurricanes and other national calamities on "gay-infested cities" like New Orleans, or does he get pissed when doctors, hospitals and insurance companies combine to swindle the American public? Because, if He doesn't, His priorities are out of whack. Honestly, if I hear one more American sing the praises of the American health care system and rail against socialized health care I am personally going to beat the crap out of him.

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So I finally have my own U.S. health care/health insurance horror story to tell.

I am among the lucky ones, I guess. Through my employer, I have a health care plan that covers most of my expenses. The only thing I have to worry about (until I find out otherwise) are my co-pays, which are fortunately manageable. Around 2 a.m. last Saturday, my wife (L.) started screaming for the pain in her lower abdomen. She was nauseous and could barely move. It was immediately clear that there was something seriously wrong with her, so I quickly got dressed and drove her to an E.R., which I will refer to as ER-1 from here on out.

We were at ER-1 from approximately 2:30 to 6 a.m. After ordering a complete blood count and a urinalysis, and after administering fluids, painkillers and anti-nausea meds to L., the doctor concluded that the best thing to do was to send her home and keep her on painkillers and anti-nausea for 12 hours, at which point if things hadn't improved we should return to the ER for a CT scan. (This visit was billed by ER-1 to our insurance company at $5,700 and change, and I had to write a check for $50 for the co-pay)

Come 6 p.m. things weren't better, they were the same. So, as instructed, we returned to ER-1, where L. was given CT contrast liquid in preparation for a CT scan, which she promptly threw up. Still in pain and as nauseous as she was in the morning, we asked for her to be admitted to the hospital. Armed with new negative blood and urine tests, as well as a CT scan), the doctor left us with a (botched) diagnosis of possible food poisoning, or viral gastroenteritis, or ielitis (an inflammation of the colon). The appendix was cleared as a culprit and we were advised to make an appointment with a GI for a colonoscopy on Monday. No antibiotics were administered, just the same painkillers and anti-nausea meds. We were sent home in spite of the fact that L. was evidently no better than when we first visited ER-1, some 15 hours earlier. (This second visit was billed at over $10,900 and I had to write another $50 check for a second co-pay).

Things did not get better on Sunday, and before we had a chance to make an appointment for a colonoscopy, L. woke up shivering and gnashing her teeth. She was running a fever of 103° F, and on the way back to ER-1 she threw up for the fifth time in 60 hours.

Back at ER-1, the admitting nurse told us to go and sit in the waiting room, which--contrary to the two Saturday visits--was quite crowded. I was quite shocked that they would tell us to wait, since they must have seen from their computerized records that L. had already been there twice on Saturday already even if they did not hear us say it when they taking information from L. 30-40 minutes after our arrival, we were still waiting to be called, so I decided I'd had enough of waiting, particularly since L.'s pain and nausea seemed to have abated, so I told the admitting nurse that we wished to sign a release and walk away, which we did to the nurse's seeming relief.

Since the situation was far from resolved, I immediately took L. to see her primary care doctor. While I parked the car they had already given her a urine test and measured her temperature and blood pressure. With that data in hand, they told me that in fact we needed to return to an E.R. and seemed to be wondering why we decided to leave ER-1. (I stand by my decision to leave because, while the emergency seemed obvious to me--a layman--it seemed equally obvious that the E.R. staff did not share my view.) We were advised to go to a different E.R. in the suburbs, which  I will call ER-2, which we did.

At ER-2, doctors were visibly concerned with her low blood pressure and oxygen levels and treated her with a sense of urgency I had not yet seen. After a 9-hour visit in ER-2, which included another CT scan, ultrasound, blood and urine analysis, the administering of fluids, antibiotics, painkillers and anti-nausea meds, L. was admitted to the hospital at around midnight. Just over 24 hours later, she was scheduled for emergency surgery since she had failed to respond to treatment with antibiotics and she had been diagnosed with acute infection of several organs, as well as sepsis.

I am glad to report that the surgery went well and that, barring any unforeseen complications, L. is on the mend, pending a 6-8 week convalescence and absence from work. But the experience has left her scarred, figuratively and literally, and has left me drained. Since sepsis and low vitals were involved, it was a closer call than I probably realize. We were lucky that I did the "wrong" thing, by refusing to let my wife wait for treatment in a busy ER. We were also lucky that at ER/Hospital 2 L. received very good treatment, the kind most Americans imagine when they speak of the U.S. health care system, which they dogmatically believe to be the #1 in the world. And we are also lucky that our financial exposure should be limited to a series of manageable co-pays, thanks to my employment. (I have yet to see all the bills, but my insurance plan should cover all the costs after the co-pays; we'll see.)

However, no matter how good the care L. received at ER/Hospital 2, the fact remains that the staff at ER-1 did not seem to perceive the gravity of the situation, that we live with a system that discourages hospitalization as a diagnostic step, and that their inaction could have cost L. her health, even her life. That our insurance company was billed approximately $18,000 for two visits which amounted to barely 7 hours of work only adds insult to the injury that L. sustained, and further shows that even outrageous amounts of money (unless you think that $18,000 is a fair price for 7 hours in an ER and a handful of routine exams) cannot buy us good health care.

I shudder to think what would have happened to a couple who makes barely enough to fall outside the net of Medicaid, but not enough to buy insurance that covers all medical costs.

I wrote this very personal post because a reader of this blog who describes himself as a centrist blamed my disappointment with President Obama on the fact that he (the president) is not the flaming liberal I would like him to be (John, that's you). I blame President Obama not for being too much of a centrist, but for failing to fix (or even show that he was committed to fix) a system that fails the people it is supposed to serve. When President Obama ran away from true health care reform and into the arms of the insurance companies, doctors, and hospitals he had claimed he'd reform, that's when he lost me. It was a betrayal of trust that explains why I, and many people like me, are disgusted with politics as usual. It should not take a flaming liberal to take on and fix powerful interests that disrupt people's lives; only a person with a basic sense of justice fairness.