One Long Monday Night in the Greatest Healthcare System on Earth

[McCamy Taylor]

“’(E)ven if Obamacare were a perfect piece of legislation, and it’s not , we can’t afford a trillion dollars of new federal spending,’ said Romney.”
http://www.politico.com/news/stories/0312/74404.html

Dear Mr. Romney. We cannot afford not to do something about the nation’s uninsured problem. Case in point:

My husband was making pork with garlic sauce when the knife slipped and he sliced open his index finger. The one he uses every day as a massage therapist. I took one look at the gaping, bleeding wound and said “That might need stitches.” Within minutes, my husband, my adult son and I were in the car heading for the closest hospital emergency room. Let’s call it Hospital X.

Just to set the stage, I should tell you that I am a family physician. I have group insurance through my employer. So, this is not going to be a sad story about how my family had to choose between health care and eating. This is a report from the trenches of our nation’s beleaguered urban emergency rooms.

Usually, I go to Hospital Y, which is a bit farther down the road. But the last two times I had been to Y’s (busting at the seams) emergency room, the physicians had treated my abdominal pain without actually touching my abdomen. Apparently, the Y ER doctors were too busy to perform the two minute exam, because both of them (on different nights) ordered blood work and CT scans in lieu of examining me.

Hospital X was closer. And, on the two occasions that my family had been there in the past, its ER was not nearly as crowded. Unfortunately, that was about ten years ago, before the uninsured crisis drove three area hospitals out of business, and the ER volume at those left standing went through the roof.

We were triaged right away. The RN on duty knew her job. She told my husband to apply pressure to the wound and have a seat in the waiting area. That was where the fun began. For, sometime in the last decade, Hospital X’s emergency room had become just another after work walk in clinic for those without health insurance.

The waiting area with packed with people. One woman, with abdominal pain and “bad nerves” had been there for three hours. Bad sign. Abdominal pain usually takes priority over a laceration. After waiting for hours to be seen, Bad Nerves was mad as hell and not going to take it anymore. Her friend suggested that they visit one of the city’s other emergency rooms, but Bad Nerves said she had outstanding bills at all of those.

I could tell that Hospital X’s ER was understaffed, when a woman came in shouting that her husband was in the car having chest pain. The only visible hospital employee, the RN doing triage, had to leave her post, get a wheelchair, go outside to their car and wheel the husband back to the patient care area, leaving triage unattended for about 20 minutes. Keep in mind that X is a huge urban hospital that does transplants, cardiac bypass and high risk obstetrics. Oddly, we did not miss the triage nurse, because no one in the ER waiting room that night, except for my husband with the sliced finger and the young man with a sport’s injury and the guy in the car having chest pain actually seemed to be having an emergency. They were all there to visit the after work walk in clinic that was required (by federal law) to treat anyone who showed up regardless of ability to pay.

We waited about three hours to be seen. Did I mention that slicing your index finger is very painful? But my husband was stoic. Eventually, we were seen. The care was fine. We went home and my husband’s finger is healing well. Happy ending? I don’t think so. Ninety percent of the people in that waiting room could have been treated more quickly, more cheaply and more effectively in an office. But doctors’ offices demand payment, either in the form of cash or insurance. So, they wait until after work and visit the “walk in clinics” also known as the nation’s hospital emergency rooms. There is only so much that emergency rooms can do for chronic conditions, so the care is half assed by necessity. Half assed and as expensive as hell—

Oh, I almost forgot to mention. About five years ago, we were out of town and my son had an asthma attack in the middle of the night. Since we did not have his inhaler, we took him to a local emergency room where he received one nebulizer treatment, got a prescription for an inhaler and was sent on his way. The bill for that visit? Over $5000. Half assed and as expensive as hell---

Which just about sums up the state of heath care in the U.S. right now. We spend over twice as much person per year (half of it coming from the government) as western European countries and Canada, and yet our health indicators, such as life expectancy and infant mortality are at third world levels.

The moral of my story? Spending a few pennies to insure more Americans will not break the bank, because the bank is already broken. Insuring more Americans is the only way we will put the bank—and our broken health care system---back together. If 30 million more Americans---many of them with chronic conditions like diabetes and high blood pressure---can get insurance, our hospitals will stop hemorrhaging money, everyone's health care bills will go down, and we will stop dropping like flies from preventable illness.