Monday, October 11, 2010

In the Belly of the Beast

A funny thing happened when I was checking my mother into the hospital in the middle of the night for emergency surgery a fortnight ago. When she was settled into a room and I went home to rest, they had to come back and get me too. I was sure the pain in my side was from the stress of the occasion, but my gall bladder had exploded and Melody had to call back the bus. The same two paramedics who had looked after Mom hauled me out as well. When I got the 2am call from my mother, I could barely understand her and I entered her apartment to find her bug-eyed and howling in pain, making such theatrical faces that I thought no one could hurt so without tears. Mom later accepted my apologies for having ever doubted her. She had suffered a perforated ulcer which needed immediate attention. After our respective surgeries, we were even assigned to the same floor for recovery. We're both recuperating at home now and I don't think Mom would object if I said she is 89 and healing more rapidly than I. In the family tally, however, I have the larger scar. I've been told I'm lucky to have my mother's genes. I hope they start kicking in soon.

In my eight days in the belly of the beast, I learned that the hospital consists of two sections, like halves of the same heart, only working at cross purposes. The medical services side, the human side, offers care generously and with compassion. The administrative half - breathing icons of big insurance -gives care miserly and begrudgingly. There is the edifice, and then those that work within. The caregivers are the most wonderful people on earth, but the Hospital stands as a monument to the fraud and greed of the Health Insurance industry and their gangland, bureaucratic tentacles. American health care is run sort of like New York's five Mafia families. They muscled their way into a field they had never traversed before and forced people to buy their protection or face the consequences, only they call it, "You bet your life." Their loyal foot soldiers enforce "policy" in every major hospital in the nation, and are in the business of business, skimming profits from Medicare and deciding who gets preferential treatment according to who paid the extortion. After all, this is the world of the five dollar band-aid and the twenty dollar aspirin and a corporation's got to make a buck. The first line of the physicians' Hippocratic Oath is, "First, do no harm." The insurance industry's motto is, "Do harm first." Fortunately, my mother has, and deserves, the coverage by Blue Cross and Medicare known as the "Cadillac Plan." I, in turn, have the "barefoot pedestrian plan," which means I have been unable to purchase health insurance in over a decade because of the notorious "pre-existing condition," perhaps, the very condition that landed me in the hospital. Thus, when I checked into the same emergency room 12 hours after my mother, began a tale of two health cares.

Mom came in at an odd time and when her insurance was verified, the tests began. Within an hour a doctor was called, a CT scan performed, and immediate surgery recommended. Mom went directly from the emergency room, to surgery, and then the ICU where within three hours, thank God, she was resting comfortably after a successful procedure. My ambulance arrived during afternoon drive time and I was placed in a line of stretchers waiting to be registered. I was assigned an alcove, despite my "self-pay" status, and later found I was lucky enough to have hit the "early-bird special," and had only just preceded a rash of car crashes. I alternately hyperventilated into an oxygen mask or winced in agony for an hour before receiving an inoculation for pain, but the dosage wasn't sufficient and I swore they had given me a placebo. After several more hours, a sympathetic nurse who expressed her disdain for their allowing me to lie there in such a state, finally injected me with enough morphine to manage the pain in my stomach, but also give me a blinding narcotic headache. I was denied the two Tylenol I requested. In my delirium, a Physician's Assistant saw me and recommended a scan which produced the results requiring me to be admitted. When I was finally delivered to a private room close to 2am, I had already been in the ER for nine hours, during which time, I never saw a doctor.

Once delivered from the cash-register side to the human side, I received the same excellent care as did my mother. By sheer fortune, the doctor on rounds was ordinarily an oncological surgeon, and in one of those "only in Memphis" moments, I found  he was a fellow "Brothers' Boy," from CBHS. He informed me that nine out of ten people now have their gall bladders removed laparoscopically, through the navel, and the procedure is so non-intrusive, they go home and walk it off. I was to be that tenth person. But first, I was to receive a regimen of antibiotics, which allowed me to lie there for several days and observe health care in action. The main thing I learned was that the doctors get all the credit, while the nurses do all the work. They are the front line in the battle against infirmity, they do all the procedures, they offer comfort to the concerned, and personal attention to the afflicted. Doctors pass through on rounds, making pronouncements from on high while the staff strews rose petals in their path, but the nurses are the hands-on face of health care. At the same time, they are bound by hospital "policy" and are at the center of the crossfire between insurance companies, doctors, patients and administrators. They have so many regulations to follow and record, it's like going to work and wearing a wet, wool cloak during your daily labors.

After my blood pressure scaled higher than a Sherpa's yak, my doctor decided it could no longer wait and informed me that only after waking up in recovery would I know if I had surgery or laparoscopy. While I was greeting the same anaesthetist that knocked out Mom the day before, my pressure was putting up numbers like Barry Bonds. I woke up with the pain of a gored matador, but thanks to the wonderful people on post-op floor 5-N, from Bessie the singing housekeeper, to dedicated professionals like Kayola Brown, who is bright and passionate and listened to several "mini-rants" that didn't make the paper, my healing has begun. I am indebted to these people, especially the nurses who should be making some of that doctor money instead of being unable to afford health insurance from the very place they work. Mom's bill is covered; mine would make Warren Buffett gag, reminding me of something wise my father once told me; "It's better to be rich and healthy than poor and sick." We're working it out. They're used to it now. The human side of health care is the best in the world, but the commerce side, the health-for-profit racket, is worse than wasteful and corrupt; it's immoral. We live with a medical system locked within some nightmarish Dr. Jekyll and Mr. Hyde duality which severely limits the greatest good. If we could only do something to rid ourselves of that evil Mr. Hyde. Oh yeah, I voted for Barack Obama. Sock 'em, Rocky.

24 comments:

Willard Morgan said...

Consider this a cyber bouquet of flowers for you along with my best wishes for a speedy recovery for you and your mom. I was recently back at Beth Israel Hospital where I was birthed some 61 years ago on a cold February morn. I was in the ER where I had taken my girlfriend who had suffered an extreme allergic reaction to a cashew nut in her Indian curry. St. Vincents, our ER of usual choice has closed along with the rest of that venerable health institution due to mismanagement. It's a great loss to the Greenwich Village community. It was a four to five hour wait until she was finally seen, being a Tuesday night this was relatively swift. By that time, she was ready to walk out there. After a Benedryl IV drip did it's work, we were on our way home. What you went through sounds horrific and our system seems a long way from being fixed, kind of like waiting to see the doctor.... on the way to the coroner! best to you and your mom! Will

Anonymous said...

I was afraid something was wrong not seeing a post for a while. I wish you a speedy recovery. If you think it's bad now wait until government's tentacles reach furhter into the health care system. I have to say from my experience with my wife United Health Care paid hundreds of thousands while I paid a pittance. But even with that great coverage most people experience the kind of delays in service you described.

Anonymous said...

Those CBHS friendships last a lifetime, don't they? Hope you and your mom are up and around, raising heck soon.
Can't believe it took you so long to learn the real value of nurses.
My brother, who lives outside of Austin and had/has no health insurance, was stricken with the same little belly ache as you and Lyndon. He participated in a pain med study and had the surgery for free. He loved the sandwich options, liked the surgeons, and felt no pain, though he was assured that he would be given the sho' nuff drugs if he felt pain.

Anonymous said...

PS, Larry. my friend, another CBHS and UT-Knox grad who lost his textile related job several years ago, works at Home Depot, just for the Health Insurance. At 61, he's treated terribly; but he has insurance. I'm just sayin'....
--the one with the estranged Overton/UT-Knox bro in TX who posted to you and Alex on the nola.com forum. peace.

Anonymous said...

Ooops, I mean RANDY. Better double the Lipitor dose today....

Mary Lindsay Dickinson said...

Randy,

I'm glad you and your mom are on the mend. It sounds like your lack of "Cadillac insurance" caused you to have to wait a few extra hours, which I'm sure was tough, but I'm so glad you got "Cadillac" care. That says something good for the system. Hopefully, Obamacare (if it ever gets funded) will improve the scary pre-existing means no insurance gap.

At least the system worked well enough that you and your mother will both be okay. I praise the Lord for that.

Anonymous said...

Mrs. D, belated condolences to you. I regret that my family moved from Mphs before so much happened. I had to learn about your spouse and sons from a friend in England. Too, I read somewhere that y'all lived on White Station for a time. We were on Walton. I didn't know who Alex was when I posted to him on that nola forum. He was just a nice guy who stayed during the storm. Didn't know who Big Star were, even though I was home when Chris died. Thank you all for the wonderful music--your own and those on which you shown light. Thanks, too, to Randy for creating this blog.

Anonymous said...

LBJ'S navel certainly isn't very Presidential looking.

Anonymous said...

If you think that it is bad now, just wait until Obamcare kicks into high gear in 2014. Then, health care will be as efficient as our public schools, the post office, Freddie Mac, etc., etc. About 40 million more people will be dumped into the system, Medicare will be slashed half a trillion, and countless older doctors will abandon their practices, because they will refuse to be jacked around by the government. If you think that the waiting time to see a doctor is bad now, just wait. Medical services may not be socialistic enough to satify you now, but it will be soon enough. Be careful what you wish for, because it just might come true. It is already being said that medical services for the elderly will be severely rationed. I have heard that no one over the age of 55 will be allowed to have expensive procedures like heart by-pass operations. The next time that you need expensive treatments may be your last thanks to our 'benevolent' government. I prefer to swallow the negative effects of a capitalist society than a socialistic one. I think that any honest person who has worked for the government would say the same. Government employees tend to be slack-jawed drones who couldn't make a living if they actually had to produce. The government doesn't give a shit because it spends other people's money, doesn't have to be accountable, and its employees are practically impossible to fire. All of this will apply to government health care. Costs will go up exponentially while efficiency and quality will decline. What you said about the nurses and aides is correct, though. They do tend to be angels of mercy. The bottom line does need to be managed, though and this can produce some 'hardball' situations. Once government takes over, they won't give a shit about the bottom line. The gov. will just keep increasing taxes to cover costs, the bottom line be damned. That is how they are in regard to public education and look what kind of shape it is in. Health care is a tough situation, because no one wants anyone to suffer. It is a question of which system will produce the least negative consequences. I know that it is heresy to say this here, but I trust capitalistic solutions over socialistic ones.

Rocky said...

Old and dear----That your experience could touch the personal lives of all those who sit in the seats of our Congress.

Unfortunately, it will only occur when they themselves recognize that your apt description of the private health insurance industry in this country as the Mafia as a correct depiction.

We don't need nor want for-profit corportations making a few extra cents/share (billions of dollars in toto) in this or that quarter on the backs of the sick and injured for whom they deny care. Nor do we want our physicians' back offices stacked with people who have been hired solely in order to make sure that a bill that goes to an insurance company to be paid is not "lost" somewhere.....with the payment due to the physician or hospital left sitting in the bank accounts of the insurance company while they float with your premiums for as long as they possibly can.

Their crimes are documented every year as they take their turns paying $20 million or $50 million in settlements for denial of care or of withholding appropriate payments to providers in which these companies are made to pay but are allowed to forego a "guilty" verdict in a court hearing via settlement.

Administrative overhead for Medicare is about 1.5%. Medicare receives bills and pays them. That's their job. The private health insurors have an overhead of about 35%. They receive bills and pay only most of them and in many instances only when they must.

What is wrong with the IQ of this country that the usual demagogues can stir otherwise good people to cut off their own limbs (metaphorically and literally) in the name of principles that have been so twisted that reality is long gone from the dialogue.

Simply put: Private health insurance companies, or more appropriately, the private companies that do billing for the medical care system who must make a profit for their stockholders at the same time, are criminals who have hurt you or someone you love, or will in the future...directly or indirectly.

These are crimes against our society directly in their cost in unnecessary human suffering and indirectly as the back breaker it is to our economy costing jobs, self esteem, and self respect.

And at this stage in the evolution of the USA, we need to find as much honest self esteem as we can. Paying billions of dollars to people for something we can do much more cheaply ourselvles (Medicare) just because they can outwit us is sickstupid.

I can't say it too many times.
SickStupid.

Amanda Reckonwith said...

I'm glad both of you are on the mend!

I do remember, Randy, my mother (born in 1911) telling me many pre-insurance-days stories of families losing everything when one of their loved ones grew ill.

Even when health insurance arrived, mother always tried to put away as much as possible into savings. With seven children, she knew the odds were that something would happen to one of us (or one of our parents), and she did not want to be caught short.

Insurance has not been a perfect system; no doubt about that. But, compared to the old days, it has kept many people living longer and their families out of the poor house.

One dark side of insurance, as I see it, has been that many people have abdicated their health to the insurance company and plan-provided care. It has encouraged the American tendency to not see consequences until they are dire.

Joe Spake said...

I was was lucky enough to have the laproscopic (suck it out with a straw) gall bladder removal when the deed needed to be done 15 years ago. I was amazed that my gall bladder went before my liver, but that's another story.
Having recently had some routine tests, I was amazed at the 2 faces of modern medicine you described. The "show me the money" posture of the administrative offices was appalling. The real medical folks were stellar.
My biggest fear is a lengthy hospital stay.

Martin D. Cohen said...

Randy,

Sorry to hear of your surgery and more sorry to hear that you have discovered the truth about hospitals. All in all, you have had a pretty good experience. Trust me, it could have been much worse.

After five major surgeries and over 25 lithotripses for kidny stones, I am living proof that it can be far worse, including malpractice and incompetence.

I am glad that your mother and you are recovering and hope that you do not have to return to the hospital any time soon.

I used to think that when you are in a hospital, you are in a safe place. You are in more danger in the hospital than almost anywhere else, and the food isn't that good either.

Lucky for me, I am engaged to one of those loving nurses you speak so highly of, and you are right.

Heal and take care my friend.

MDC

The Watcher said...

Rocky, you seem to imply that Medicare is a model of cost effectiveness and efficiency, because it operates with a 1.5% overhead. Aren't you being a little disingenuous? You didn't mention the trillions of dollars in unfunded liabilities generated by Medicare. If medicare had to be run like a real business, its overhead would be considerably higher. Remember, the government feels that it doesn't need to be concerned about the bottom line as long as it can tax the citizenry into oblivion. Care to rethink the issue? Or, do you also see the citizenry as an endless source of revenue through uber-taxation? Socialism ultimately fails because it eventually runs out of other people's money. Of course, at that point labor could be conscripted and wealth generated through forced slavery. This is what some fear if the socialist track is followed to its logical conclusion. It is a real threat if the socialists manage to consolidate their power on a global level. Who will be able to stop them from any atrocity at that point?

Alan said...

Rocky
I doubt the 1.5% figure, but that would explain the huge amount of fraud involved in the medicare system. I would bet if the fraud were added the % overhead would be more than private insurance. 500 Billion of the supposed saving of Obamacare is by stopping fraud.

Anonymous said...

Sputnik, the health-care issue was item #1 on my Obama for Pres list. Then, out of Iraq, Afghanistan, hand-gun and assault weapon control, education overhaul, womens' right to choose, and reining in run-away finacial thiefs, of which I admit participation in, so that the "average joe" would be on a fair playing field, when borrowing for a home, car, credit-cards, etc. Stopping the huge pay disparities, and un-regulated markets which gave us AIG, Madoff, et al. I have to admit, that I've been sorely disspointed in the Pres, as I don't see him fighting for these things which I hold dear. Some, he even campaigned on, and has let fall by the wayside in a foolish attempt at bi-partisanship.. HA HA.. Your pic of LBJ is fitting, because there was a guy who like him or hate him, knew how to get things done, and fought hard and dirty to make them happen. You can't just be an arbiter, or wish for the best from your party.

No, I'm afraid that things have gotten so out of hand, what with mis-information, private interests, the money, no term limits, and lack of focus, that our best days are truly behind us. I wince when I say this! But, it happens with all great civilizations, and I think it's the path we're on now.

My first wish for a universal health care for all seemed like a possibility. No family should go broke, because they can't afford health care, or can't find, or pay for insurance. Maybe in the East block countries, South America, or some repressive regime, but not here, not in the richest, most powerful country in the world! I'm sorry that while my friend said he was for the public option, or whatever you wish to call it, he let it slip away and just passed some private corporation funded health "scheme" which really won't ease citizen's health woes. Such is life. I understand that strong forces are at work, and that the guys with the gold make the rules. It's unfortunate, because I think the "chickens are coming home to roost now" As they say in Mexico, AMF.... Adios.... my friend......

zephyrman

Avenger said...

Obama is an empty suit and the biggest farce ever to be perpetrated on America. A tsunami is going to wash away a lot of Washington trash this Nov. There will be another one in 2012 to wash away Obama's worthless ass along with the rest of the traitors that pass themselves off as our statesmen.

Anonymous said...

There is no such thing as Obama Care, and whether you know that or not, the Republican leadership knows it but their constituency is not you,
it is the insurance corporations, and yes they will loose their monopolistic power through the new Health Care changes... they will have
to be satisfied with a reasonable profit as opposed to whatever they can squeeze out of our economy. The Republican leadership knows you will still have your own private insurance and doctors, they know that it will reduce the deficit by more that a billion dollars, they know that it does not cover illegal immigrants, They know that it will increase
free market competition (the insurance corps. do not want this). But they have to lie and spin the truth because their opposition isn't based on a different perspective. And they cannot just tell the truth, because even if you are conservative you would not support their truth... which is that the current health care reform is "great" for you personally, and that it does not create a socialized healthcare system, but does take away a monopoly by the healthcare insurance corporations that is bad for all Americans. That doesn't make for a great campaign slogan... So they put out propaganda that it's socialism, that it will destroy insurance companies, that you will loose your choice, that God forbid immigrant children might get medical attention, that the sky is falling. They know that isn't the truth. The Republicans are talking about jobs while voting against tax breaks for small business to create jobs... and then spinning their
obstruction as the current administration not doing all they can for jobs. Republican legislators have lock step opposed each and every step of progress, and denied the progress made (even bills they came up with) and then turn around and say we are not moving fast enough. The Republican leadership knows
that Obama is a citizen, that he is a Christian, that he is not in any way a socialist; yet they have fostered these, and have looked the other way to spin where just an honest different perspective isn't there. The biggest spin is that they want you to forget that their policies directly brought us to the brink of depression, lost jobs at a rate of 650,000 to 700,000 jobs a month, that their lack of regulation and green lighting big business/financial interests created our distress, their lack of holding any financial institutions accountable... which is their belief doesn't work....
The truth doesn't make a great campaign... so the strategy, lie/ spin/ propaganda/ the big lie theory/ and a steady diet of uproar to awaken the racism, hate, ignorance, fears, etc.... and then we have the teahadists holding up signs about
taxes, while under Obama we have the lowest tax rates since Truman and 95% of wage earners have had their taxes lowerd....

Anonymous said...

You must have graduated cum laude from the Democrat Spin School. Say all of that many times over and you might get a few suckers to go along with you, especially on this blog.

Zarathustra said...

Alan, are you going to let the deceived Anonymous who last posted get away with his litany of bullshit?

The Watcher said...

Isn't it interesting that progressives never tell anyone what it is they are progressing toward. Isn't it interesting that so much of what they do is done in the cover of darkness? Why do they fear the sunshine? Could it be that if they were to tell the truth about their endgame their cabal would be stopped? I think so.

Maitreya said...

This is for the illumination of the Watcher. What I am about to say covers an immense topic about which there are many variations in regard to the particulars. That being said, here goes. The central organizing principle of progressivism is evolution. Briefly stated their goal is to evolve toward a planetary governance that is more evolution-friendly and which establishes a more sustainable and equitable economy. Socialism is an important facet of this, but it is a relatively small issue in regard to the whole. The New World Order which is the governmental wing of the movement has a concomitant religious aspect called the New World Religion which is a syncretic amalgam of esoteric teachings (aka, New Age) purportedly drawn from ancient mystery schools which have always been with us and which purport to hold the keys of true wisdom. The NWR is the engine which drives the NWO. The great world religions are said to be spin-offs of the teachings of these mystery schools, but are now believed to be out-dated. At this point I must digress. It is taught that after God created the material universe, the Spirit or Consciousness of God involved itself into matter. Therefore, all of creation has some degree of consciousness, hence the religious aspect of 'deep' ecology. This Consciousness has been evolving throughout the ages to produce all of the Earth's life forms. Physical evolution has now ceased as man is the 'crown of creation'. Evolution is now primarily in terms of the evolution of man's conciousness. New Age meditations and other exercises are designed to aid man in his conscious evolution to godhood. It is believed that some have evolved to the point where they have ascended to a higher plane that goes by different names and from there these beings assist in the evolution of those remaining in the physical so that they too can become divine. Drilling down from here to more immediate issues, it is believed that mankind is now approaching a quantum leap in consciousness to produce a new spiritual species that some call Homo Noeticus that will be selfless and capable of transcending war and poverty. Here is where danger enters the picture. It is believed that those who won't go along with the program, largely the adherents to the old, divisive religions (Judaism, Christianity, etc.) are preventing this leap in consciousness, so they must be eliminated. This is not seen as a bad thing, because these people are evolutionarily dysfunctional and it will be a blessing for them to be dismissed as they will be re-tooled on the other side and made able to reincarnate and join the rest of humanity in their march to divinity. This is a rough outline of the big picture of the progressive agenda but much more can be said. New Agers refer to this as The Plan and they collectively pray a prayer called The Great Invocation to hasten all of this along. Those progressives who don't know all of this are just temporarily behind the curve.

Anonymous said...

I can add something to all of this because I was once a New Ager. An explanation for the manifestation of all of the telepathic and other bizarre mental powers that people are increasingly imbued with is that they are forerunners of Homo Noeticus. After the planetary initiation or Omega Point has been reached everyone will possess these powers and they will be used for the common good, hopefully. Homo Noeticus signals the advent of the god man who will then quickly evolve out of the physical plane to join the ascended masters of the Great White Brotherhood in Shamballah. I just never tied all of this in with progressivism, but I can see how it all can fit together now. Thanks for the heads up Maitreya. By the way, Maitreya is supposed to be one of the really higher ups in the Brotherhood. I also wasn't aware of the issue of eliminating those people who are seen as preventing mankind from reaching the Omega Point. That is rather unnerving. But if a one world government is established who can stop the powers that be from doing anything that they want? Look at the other dictators through history and their murderous regimes. Who is to say that it couldn't happen again and on a bigger scale when all governmental power is consolidated on a global basis? I don't have that much faith in man. He has a bad record when it comes to administering unbrideled power. The progressives must not be hip to the reality of evil.

Zarathustra said...

Anon 12:04pm, progressives don't believe in evil. They believe in the infinite perfectibility of man through the evolutionary process. They see 'evil' as potential good awaiting the evolutionary process. It just takes time...unless you institute genocide against all of those deeemed to be evil (unevolved) in order to expedite evolution. It really does get dangerous at some point. Also, you can understand why progressives consider themselves to be the more evolved elites who must endure the troglodytes who still believe in the vision of the Founding Fathers and in Constitutionally based government. They believe that the Creator mentioned in the Declaration of Independence who gave mankind inalienable rights not to be infringed upon to be a fiction. They believe that as the vanguard of human evolution they are the giver of rights. The Creator gave us the right to life, liberty, and the pursuit of happiness, but they believe these to be incomplete and inadequate. Because they are more evolved than the Creator of the Declaration, they want to include housing, food, clothing, healthcare, etc., etc. as rights which if implemented would destroy free market capitalism and hence, freedom itself. But, the common man is too stupid and unevolved to manage his own affairs so the progressives must come to the rescue. All it will cost is freedom, but the stupid, unevolved common man only gets himself into trouble if you allow him to have freedom. So,everything must be regulated by the more highly evolved and enlightened progressive elites. They are too arrogant to even consider that they may be wrong. Maybe humility is for the less evolved.