Saturday, January 2, 2010

What Makes For A Good Health Care System, Anyway?

After burdening the health care system of Hawaii with a number of unnecessary tests that he could afford, an exuberant Rush Limbaugh proclaimed himself pain free. The violently objectionable scourge of free thought, measured and intelligent discourse, and the slightest bit of human empathy extolled the quality of care he received and then declared that "I don't think there's one thing wrong with the United States health system." He got the first three words right, anyway.

As for the rest, Limbaugh seems to believe that a fair measure of the system is how well it addresses the needs of a multimillionaire blowhard who can afford every test and procedure in the book and then some. Me, I'm taken back to the days of my cancer treatment in the spring of 2000. Like Limbaugh, I was struck by the high quality of care I received and the attention given me in radiation oncology by everyone from the receptionist to the oncologist. But then, I was insured and I was well off. I didn't have to go hat in hand to the oncological social worker -- who I am certain was a fierce patient advocate -- looking for ways to ease my payments and pay my bills. I was treated in a comfortable, relatively new suburban hospital committed to acquiring the latest technology and installing it in an atmosphere of comfort and tranquility.

Unlike Limbaugh, I wondered what people less well off or less well-insured did. I discovered a part of this story when, about ten days into my treatment, nausea set in. My doctor initially prescribed Compazine, a common anti-nausea drug that might as well have been a placebo for all of the good it did. Several times a day without warning, a sudden wave of nausea jolted me and I scurried desperately for the bathroom, hoping (at times fruitlessly) to get there before vomiting on myself or the floor.

I told one of the radiation therapists about the problem. There was, she said, a new generation anti-nausea pill that worked. The problem was that the pills were expensive -- about $40 each -- and rarely insured. I didn't care. I could afford a prescription and fending off this several-times-a-day humiliation would be worth it.

Here's where I found out how the other half lives. There was one patient, the therapist told me, who could afford the new med every other day. So, one day she threw up, the next day she was fine. For some reason, this registered with me as especially perverse, a disease and a system combining to force a sick and possibly dying individual to decide which days her dignity would remain relatively intact.

Others, of course, were not even this lucky: They vomited. So when Rush Limbaugh bloviates that "there's nothing wrong" and that the American health care system is "the best in the world," I think of these people. Yes, they got excellent medical care. But the system let them down when it denied care that would allow them to work, to hold their heads up, to believe that it was in their corner instead of their adversary...

Don't miss Nihil Obstat's acerbic take here...

8 comments:

T. Clear said...

And what Citizen K. fails to mention here, in his genuine and gentlemanly modesty, is that he set up a fund for cancer patients who couldn't afford this medication, so that they were able to afford themselves that modicum of dignity in the midst of their debilitating treatment.

K. said...

Blush.

I should add that the effective medication eventually went generic and became affordable. As I understand, it has been surpassed by other meds and is rarely used now.

It may not seem like it from the outside, but there have been major advances in cancer treatment since my experience. Tumors can be mapped within a pixel and more and more radiation treatments can concentrate on the precise boundaries of the tumor, if appropriate.

Something I learned is that while the push to find a "cure" for cancer may make for good marketing PR, the payoff is actually in tumor management and in reducing cancer to a chronic condition that people can live with. We're still a ways from that -- if we weren't, remission wouldn't typically be a death sentence (I know that this isn't 100% the case) -- but we're getting there!

Roy said...

Rushbo saying all is well with the American health care system because he was treated well is like Nero saying all is well with Rome because his fiddle is in tune.

Foxessa said...

It's rare these days to find people who have and are able to afford decent to good to terrific health care who also care about those of us who can't.

Thank you. Most don't even notice, or else like the bigcheetos of the country, believe that is how it is SUPPOSED to be.

Love, c.

K. said...

Roy, that's a good -- make that great -- one!

F, you know the people in my experience who are among the most sympathetic are the docs. This surprised me in some ways, and not because of any stereotyping of doctors on my part. It's that the system is geared toward pushing the docs to concentrate on their billable time with the patients and to remain ignorant of financial issues. The onco who took care of me -- and his partner -- are great guys, compassionate and committed to their work and their patients in spite of a system that creates a medical assembly line.

mouse (aka kimy) said...

bravo to your post and to your generosity in setting up the fund for those who are in need.

my blood pressure shoots up when I hear idiots like rushbo extolling the virtues of the us health care system. you said it right about the only thing rush got correct is his preface "I don't think" - he could stop there and that would pretty much summarize his view on 98% of the social issues that challenge us....

K. said...

Well, try not to let them affect your health. They're hardly worth it.

What used to get me down was the thought that these clowns had actual influence. Nihil Obstat pointed me to an article by David Brooks -- no liberal himself -- that argued the contrary. It's here.

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