What's Bugging Me: Health Care

I wrote this one for a scaffolding assignment leading into my English 102 Proposal Research Paper.  It needs to start with a difficult problem that affects the writer's life or the life of someone they know.  They do not need to already know the solution.  I certainly don't know what the solution to this problem might be.  I don't know that the Affordable Healthcare Act is going to be any better.  I just know that the way things work right now is very far from perfect.  

 

What’s Bugging Me About Health Care

Something that really bugs me is how hard it is to get well after a major illness or injury.  One of the arguments I’ve heard against socialized healthcare is that it will take weeks or months for people to get appointments with the specialists they really need.  People are also nervous that medical decisions will be made by people other than doctors.  Apparently, people are of the opinion that when health care is capitalist in nature, healthcare is easy and quick.  Apparently these people do not have insurance companies that are already deciding what care they can have and are afraid of something not called an insurance company doing that very thing without the goal of saving themselves money.  Supposedly, under our current system, anyone can see whomever they need to see whenever they need to be seen.  This has not been my experience.

I know people who have to stop receiving the care they need because insurance companies have decided it is too expensive.  For example, my sister is a kidney transplant patient, so she depends on a number of drugs to keep her body functioning in a way that will not kill her borrowed kidney.  One of the drugs prescribed to her was a patented compound drug that included two drugs specially formulated to work together.  A few months ago, her insurance company decided that this drug is too expensive, so they dictated that instead of taking the two drugs in one pill, she would have to take two separate generic drugs not likely to work as well in combination.  She is now, by the way, forced to pay double co-pay, and the insurance company can pay less, which was a good solution for them, even though the drug was potentially going to be less effective for her.  This was a decision made by someone paid to cut costs rather than by someone with any sort of medical or pharmacological background.  To save money, the insurance company was willing to jeopardize my sister’s health. The same insurance company illegally looked up the insurance number of my sister’s kidney donor so that the donation surgery would not fall under my sister’s 100% coverage plan and would instead be classified an “elective” surgery by the donor and therefore not covered at all.  I also know people who have been denied healthcare insurance, and therefore access to much-needed healthcare because they had health conditions when they got their new job, or when they retired, or when their husband took a new job.  Seriously, we are proud of this situation? 

These issues I have described so far can be side-stepped by paying for health care out of pocket.  However, hospitals and healthcare systems charge individual patients at least three times as much for a service as they would charge an insurance company.  So while paying out-of-pocket seems like a reasonable solution in theory, it is only possible for the obscenely rich.  The people I know who claim that our system is the best are not obscenely rich, as far as I know.  One can only assume they have not tried to receive any sort of specialized care. 

Leaving aside matters of insurance, another thing that bugs me about trying to get healthy is how nearly impossible it can be to see the specialist one needs to see, even in our capitalist system.  My sister had another near-fatal health issue which her hospital refused to treat.  They referred her to Mayo Clinic, but Mayo Clinic said they did not have time to see her.  She managed to get a life-saving appointment only when her well-connected grandfather-in-law pulled some strings to work underneath the red tape of the system.  This had nothing to do with insurance or an inability to pay.  There simply was no above-board way to get an appointment with the specialist she needed in the time frame necessary.  People level such accusations at the health care system in Canada, but everyone I know who has lived in a country with socialized healthcare opted to stay there, some staying because of the ease of obtaining healthcare. 

I am infuriated by these events on behalf of my family members, but I am also bugged on my own behalf. 

In the spring of 2012, I did something to my back.  It went from feeling not good on a Thursday to feeling like I could not find a way to move it enough to get out of bed on Saturday.  I went to see the nurse practitioner on Monday, and she diagnosed me with a sprained back.  I mentioned to her that MRIs I had had taken a few years before had shown that I had some herniated disks.  “Is that perhaps the problem?” I asked her.  She claimed the disks were not the problem and the prescription for dealing with my back was physical therapy.  Unfortunately, the physical therapist could not see me for a month.  By the time I did see the physical therapist, I was feeling a little better, although clearly something was still wrong.  I was still in some pain.  I saw the physical therapist three times a week for twelve weeks, but even when she discharged me, my back was still sore.  She was just out of ideas for how to help me. 

By fall of 2012 I was in ever-increasing pain.  My back was too stiff and sore for me to exercise.  Then it was too stiff and sore for me to load and unload the dishwasher.  It was too sore for me to sit down for more than a few minutes.  By early December it was too sore for me to walk a mile even though I had been running sixty miles a week a year before.  I made an appointment with an orthopedic doctor who, when I finally saw her three weeks later, said she did not treat backs.  She was pretty sure, though, that the problem was not with my discs.  She sent me to a physical therapist and a doctor of osteopathy.  By the time I saw either one, I was unable to do anything other than lie on the couch until it was time to lie in bed.  I was trying to still take care of my family, so I would stand up for ten minutes at a time cooking, after which the pain would make me feel nauseated and faint, so I would rest.  Thus, it took me all day to make dinner, and by the time it was cooked, I couldn’t stand up to eat it.  I could never sit.  The only silver lining in the fog created by the combination of kill-me-now pain and the peace artificially induced by strong narcotics was that I finally read Pillars of the Earth along with about six other books I’d been meaning to get to eventually. Even so, the wait was excruciating. The doctor of osteopathy said he thought the problem was the discs in my spinal column.  An MRI was ordered.  When the results of that became available, I was told to stop therapy and make an appointment with a neurosurgeon as soon as possible. 

I called a neurosurgeon recommended by a friend.  His office was in Glen Ellyn, a half hour from my house. I could not sit for half an hour, but I needed the help.  It turned out that whether or not I was willing to sit through the half hour ride, alternating between nausea and fainting from the pain, the doctor could not see me for over six weeks.  So I called another doctor who was able to see me in four weeks, but only if I could, in that intervening time, acquire large prints of every MRI I had ever had of my back.  My dad, bless his heart, agreed to drive all over the Chicago area picking up large packets of prints in case I could get an earlier appointment.  I could not.

When I finally saw the neurosurgeon in February of 2013, he was impressed by the severity of my injury. I have always been something of an over-achiever. More than half of the space in my spinal column at the L5-S1 vertebra level was taken up with extruded disc material.  It was the worse herniation the doctor had ever seen.   “I think we should operate on this as soon as possible,” he said.  “The longer we wait, the more likely there will be permanent nerve damage.”  Too bad I had been struggling with this back problem for almost a year at that point. He arranged to operate on me the following Tuesday. For this I am thankful.  Even so, the nerve to the outside of my right leg and foot had been severely damaged. I still cannot feel the outside of my right foot.

After the surgery, I went back to physical therapy.  I did not progress as quickly as one would expect, given that I am generally a very fit and healthy person, but I was devoted to getting well.  I was finally discharged from that round of physical therapy in August of 2013 with some residual numbness and tingling in my foot and some nerve pain and muscle knots in my leg.  My back was not perfect either, but I was again told it would work itself out.  It didn’t.

I gave it time.  I really did.  But around Christmas of 2013, my back went bad again for about a week.  Again in February I was getting to the point where I could once again not bend enough to tie my own shoes.  My leg was a ball of nervy knots.  So in mid-February, I called the neurosurgeon’s office for a prescription to go back to physical therapy again.  His nurse said he would want to see me first and said the first available appointment would be April 10^th.  “Is that really the first appointment?” I asked.  It was.  “The first appointment is more than seven weeks away?” I asked again, incredulous.  I was told it was.  I asked to be put on a waiting list in case there was a cancelation, and I went to get another MRI, as ordered. 

After several weeks of reduced activity, my back was feeling better, although still stiff and sore, particularly in the mornings.  I was eager to get back to exercising, but, “I can make it to April,” I told myself.  In mid-March, however, I received a phone call that the doctor was going to have to change around his appointments.  My new appointment was on April 24^th.  I consoled myself that this was not a big deal, since I was feeling much better.  Not well, exactly, but not in the kind of terrible pain I was in before my surgery.  Then I realized that when the doctor’s office called and moved my appointment, they did not ask me if I was feeling better.  For all they knew, my pain could have been progressing, as it did in 2012, as I was worried in February that it might.  It is likely that waiting for so long to see the appropriate doctor in 2012 is the reason the nerve to my foot is still damaged, the reason I am missing the reflex in my ankle and cannot feel the outside of my foot.  Am I traveling down that same road again? I was still stewing about this issue when, last week, the neurosurgeon’s office called yet again to tell me my new appointment date is May 5^th.  A few days later, the same woman called to tell my new appointment is May 12. Yes, I called mid-February, and without asking me how I am feeling, the neurosurgery practice has now moved my appointment to mid-May.  That is a twelve week wait to see a doctor for a possible spinal injury.  Something about that doesn’t seem like the sort of high-quality care that I’ve heard lauded as the best system in the world.  That bugs me.