Part II: Access to what?

Since Joe Lieberman killed the public option, I've decided there's no hope for this country. In fact, the day the public option died, I drove my Chevy to the levy and almost decided to throw myself into the raging river. Fortunately for my cats,  I instead decided to die a slow death and throw myself into art.

So I've given up on politics and just do art in my spare time, which I don't have much of, being a working person in America. Never-the-less, while toiling on a project one day I thought about how strange it was that in an indirect sort of way, Joe Lieberman was my inspiration. It was then that I started to think about health care again. What occurred to me was that back when I would run around with my forehead furrowed and my hands on my hips shouting about access, I forgot to examine the thing that I was insisting on access to.

"Access to what?" I thought.

You see, people, it became apparent to me that if we opened the proverbial door to the wild place called “health care in America” we would find a tangled web that is virtually impossible to navigate and even dangerous. In this world communication sucks, wasteful, unnecessary spending is rife, the big picture is often ignored, paperwork trumps people, patients are generally treated like shit, have most of their time wasted and are lucky if they leave the system better rather than more impaired, stressed out or addicted to pain medication. Sometimes they get well in spite of the system, not because of it.

Notice that I'm blaming the system, not the people in it. There are all sorts of competent, knowledgeable, compassionate, hard working health care professionals . However, I have seen the innumerable examples of the inefficiencies, callousness and frustrating serendipity of the health care system in America first hand because A. I'm a nurse working in a hospital and B. for most of my adult life I have been sick.

What I suffer from is a mysterious roaming back/hip pain that is usually absent but can be so crippling that I am unable to get out of bed. Over the years these “flare-ups”, as I call them, have become more frequent, more intense, and last for longer periods. Most of the time, I just plow through it, taking good care of my body with exercise and a balanced diet, but occasionally it gets so bad that I have no choice but to go to the doctor. Usually, by a "doctor" I mean Dr. Jack Daniels, which works pretty well and only costs 16.99 for a 750 ml bottle,  but sometimes, this means an actual doctor in an emergency room or clinic, the only two options I had as an uninsured person, which is what I was for most of my adult life.

 

In any event, over the course of twenty years, and hundreds of tests I was finally diagnosed with “ankylosing spondylitis” and, more recently by a rheumatologist with "some kind of spondylitis but not the ankylosing kind” since my spine apparently slides around like it’s greased with butter. This rheumatologist who I was finally able to see now that I do have health insurance, listened to me for five minutes, examined me for three minutes and then handed me a prescription for what I now refer to as the “miracle drug”: meloxicam.

 

I swear I'm not getting any kick backs, but I’ve never felt better in my life. Meloxicam is just a measly old NSAID, not one of those expensive designer drugs that you hear about on TV. You know, the ones that come courtesy of our clever neuroadvertisers who know that the only thing more attractive to the human brain than a person dancing is a content, smiling person arranging flowers. 

 

So, this may sound like a success story, but it was a bumpy twenty year road to my little yellow pill. For example, a few times I waited around the emergency room in excruciating pain until being sent home half a day later with an information sheet on exercises and instructions to take Tylenol. One time a doctor told me “I think it’s some kind of rheumatoid thing, but you wouldn’t be able to afford the medication so there isn’t much I can do.” One trip brought on a four day stay in a hospital on a heparin drip with somebody telling me I had a pulmonary embolism and another person, four days later, telling me that whoever read the CT scan was “hallucinating”. Most of the time I was barely listened to and then treated like a liar or a drug seeker. Once, a doctor practically shoved me out of her office telling me that, according to my blood tests I was in perfect health and suggested an over-the-counter anti-inflammatory and warm compresses. This despite the fact that I had told her several times that I slept on a mattress made of Aleve and snacked regularly on warm compresses. I was still in crippling pain. 

 

One day, I was hopping around an empty waiting room after drinking copious quantities of water for an ultrasound (this during the era of the “ovarian cyst” hypothesis of my mysterious roaming back pain) and contemplating the closed opaque sliding window that the secretary who I'd spoken to briefly forty five minutes before presumably still sat behind. I thought either everybody had forgotten about me and gone home for the day or there had been a nuclear war and the opaque window was made of some special radiation proof plastic that protected me. This window, I thought, was the perfect metaphor for the system as I saw it. Then, though maybe it was the azotemia since I’m pretty sure that my urine was backing up into my blood stream, I started to fantasize about my perfect health care system.

 

There was no doubt, first, that my perfect health care system would be patient centered, holistic, and completely tax-payer financed. There would be no insurance companies at all. The system would contain health care entities that would operate pretty much the same way they do now but with the stated cultural changes.  What would be really different, and this is the part that would have me hammered and sickled if I ever decided to bring it up at the next Tea Party Rally, would be the annual  weekend “health retreat”.

 

This is how it would work in a nutshell. All citizens, from the time they were born until the time they died would be strongly encouraged/incentivized to go. During this retreat, the person would get a full check-up that would include quality time with physicians and a plethora of routine and customized tests. The record that resulted from the health retreat would be in a protected data base that could be provided to the other health care entities as needed, so that the patient’s history/baseline would be laid out, in an organized, linear fashion. In addition, and as an incentive, the retreats would be pleasant, with plenty of down time for people to attend cooking and or exercise classes, get a massage, take a dip in the pool, or hang out in the sauna. It would be a weekend getaway for the whole family, just with some needle sticks and x-rays and maybe a few mandatory classes. For instance, all diabetics might have to attend a refresher course on diabetes, updating them on the latest information. The possibilities for education on prevention and healthy living are endless.

 

I think the benefits of this system are quite obvious. It would save time and money, emphasize prevention, catch serious problems early, improve communication and remove waste generated by redundant testing and scattered health histories.

 

So, this is what I imagined as I hobbled around in the empty waiting room, leaking urine into my panties and having no idea when or if somebody was ever going to come through the door to get me. After an hour and a half I ended up rushing to the restroom and just letting it all out. When I knocked timidly on the opaque sliding door to inform the secretary she shook her head scathingly, clicked her tongue and told me I had to reschedule for another day. 

 

 At least there hadn't been a nuclear war.