Healthcare in America
12-27-2010 16:25:00

     One reason why President Obama is driven to reforming the health care system in the United States is because of what happened to his grandmother. An insurer denied her coverage as she was dying from cancer.
     It was a little different with me, but it was at bottom the same thing.
     While Kaiser pretends to be a health care organization, it is in fact an insurer. And it behaves like one. Avoiding what the insurance industry calls "medical losses" -- i.e. medical bills for care to the sick and dying -- is what Kaiser is about.
     In my father's case, Kaiser doctors consistently under-diagnosed his condition and then put off tests that would have shown them wrong. So when he had a blood clot that threatened his life, the Kaiser folks said he had sprained his ankle.
     They advised rest.
     When the clot broke apart and went into his lung - when it could just as easily have gone into his heart and killed him - Kaiser kept him overnight and then sent him home. Most importantly, they did not install a simple and cheap precaution called a Greenfield Filter, a filter placed into the artery running up the leg, that would stop any more clots from coming up to his heart and lungs.
     So it happened again.
     While we were on a camping trip in Baja. We got him back safely, and this time, they put in the filter.
     And then after many warning signs, he contracted cancer. The Kaiser docs -- and this is no lie -- said he had pulled a groin muscle. They advised physical therapy.
     Crucially, the Kaiser system delays tests. So when, after he lost a huge amount of weight and my sister and I changed his doctor and insisted on a thorough check out, the tests were scheduled for months down the line.
     When at last he was taken to an emergency room at a non-Kaiser hospital, a simple x-ray, returned in less than an hour, showed a large and fatal cancer. Kaiser then had him transferred to a Kaiser hospital, gave him physical therapy, and then sent him off to a sour, confined and depressing nursing home.
     From which I took him so he could go home to die as he wanted, at his little farm in Ramona.
     A really nice nurse came to attend to him. Kaiser promptly pulled her. They replaced his pain-killer with a cheaper drug that was not as effective, so he suffered.
     It was like fighting a multi-headed borg, everywhere and nowhere. There was no one person to go to, no one doctor, they moved you around on the phone, and at the hospital, and left you with no answer and inadequate care.
     My dad was cheaper to them if he got sick at home until he was beyond saving, and then went back there as fast as possible, to die.
     So that's how I know America's health care system must be changed. But I don't know that the Obama administration has laid out the elements of reform in a simple way:
     That the insurance companies will screw you if left to their own devices. So they must be regulated.
     That there needs to be a public coverage option to keep the bastards honest.
     That the young and healthy need to be included in the system and pay into the system.
     That coverage of the poor, the addled, the amputated, the blind, those with additional limbs from toxic poisoning, the incurably diseased, those adults with the minds of infants or animals, the hopelessly messed up - those who suffer from all the tragic and terrible things than can befall someone -- those folks need to be subsidized.
     And lastly that the cost will be offset by savings in some places and additional taxes, so the deficit does not increase.
     But what reawakens an old and deep anger, like blowing on gray coals to turn them incandescent-red, is to see the increasing public groundswell against reform, pushed by the now-old, once-new, right-wing Republicans and the fools at Fox.
     And in that anger, and an equal and balancing sense of fatalism and, as the French say, "mepris," for which there is no English equivalent but roughly means despising something, in that mix of reactions, I wonder what it will take for someone to think that there needs to be fundamental change in the way Americans get treated for illness. What will convince them.
     They have to die first.