I work in the bedroom next to my father’s so I heard him get up last Thursday morning, the clunk of his shoes as he got dressed, then the whir of the stair lift as he rode downstairs. Then I heard him open the door and go out for the newspaper and to sample the blueberries from bushes lining one side of the walkway. I knew he was coming back inside when I heard a little clatter of the lawn chair on the porch, which is only one step up, but it did not seem out of the ordinary. I didn’t hear him call for me, so I went back to my writing. It seemed a long while between the clatter of the chair and the sound of the front door opening and closing, but he could have been sitting on the porch admiring the lovely, clear day and watching the cardinals perched on the cages of the heirloom tomatoes in the front yard. (Shut up, it’s where the sun is.)
But Dad had fallen down trying to step onto the porch. I came down about 10 minutes later and he was sitting in his lift-recliner chair watching the Sotomayor hearing on CNN. He told me about the fall, in the interest of keeping me up-to-date since I am his care provider and make all his doctor’s appointments. I asked about his ankles, knees and hips. He said they were fine. Then I examined his wrists, which can easily break in a fall, and the left one was swollen.
I learned from taking care of my late life partner, Margaret Ardussi, who had multiple sclerosis and was quadriplegic the last 10 years of her life, that if you are going to have a health emergency, have it as early in the day as possible. If you do, you can get people on the phone for information and follow-up appointments, you can fill prescriptions, and a LOT more people are doing jobs that you need done during the day than in the middle of the night.
Rookies hope the problem will go away. But usually it gets progressively worse, and when they are in agony at midnight, THAT’S when the emergency they could have dealt with easily at noon has to be a red hot crisis.
No, no, no, no!
So, knowing that if there was swelling that quickly that Dad ought to get his wrist X-rayed, I called his gerontologist. He was on vacation, but one of his nurse practitioners agreed about the X-ray and suggested it would be better to go to an urgent care facility instead of the local hospital’s emergency department.
Urgent care facilities are a big gap in my caregiving expertise because if Margaret had a problem that we couldn’t get handled with a home nursing visit or a doctor’s appointment, then she was sick enough to go by ambulance to the emergency room. However, I took good care of her and she was rarely that ill — but these ER visits loom rather large in my memory because most of them were in the last year of her life — which is common for people who are dying of a chronic, progressive illness.
But Dad is ambulatory and urgent care facilities diagnose and treat broken bones, so that’s where we went. At first the doctor didn’t see the hairline fracture, but as he looked a second time to show me there was nothing, he saw it. So, he put Dad in a splint and referred us to an orthopedic surgeon, who saw Dad the next morning and said it was not a big deal although he doesn’t want Dad swimming until he’s better. He made Dad a more comfortable splint and had us make an appointment to check back with him in a week.
It felt wonderful to get my father prompt, expert care, which we were able to do because his health insurance is excellent. Obamacare would not be as good a deal for him, since at 93, Obamacare would rate him as “life unworthy of life.”*
But I have to admit that the current system isn’t working out as well for me. Under the current system, I feel like “life unworthy of life.”
I don’t have health insurance, so I asked for a price list at the urgent care place to see what problems I could afford to get treated. No deal. The administrative assistant said they do everything they think is needed, THEN I would find out what it cost. I have to say that doesn’t really work for me.
I probably qualify for Medicaid, but it is a means-tested program. I can’t stand the thought of having the loss of my health care be a disincentive for earning enough money to be able to afford private health insurance, which, if I could afford it, I could obtain through Maryland’s private insurance programs for companies of 1 to 50 employees. I know this means I’m saying I’d rather die than commit to being poor. Really, I would rather live. Health care would really help. So would health insurance. But that health insurance program is a pricey one — over $7,000 a year for someone my age, the last time I looked. Obtaining actual health care would be additional, of course, due to the co-pays.
One wasteful aspect of our current system is that people in my situation who do get sick and go on Medicaid can run up hundreds of thousands of dollars in care that may prolong life, but not save it, when the problem could have been cured cheaply if caught early. We don’t just lose the money — we lose a productive human being, too.
And I believe a news story I read recently of a woman who had to choose between buying food for her children and buying her blood pressure medication, who had a stroke due to her high blood pressure and died. Ironically, the money that will pay for her ER care — wherever it comes from — would have kept her in blood pressure medication for years. And her children are left without a provider — there are costs associated with that, too.
I do not support Obama’s healthcare reform, mostly because I think its purpose is to destroy our economy and repose power in a totalitarian bureaucracy. But I disagree with conservatives and Republicans defending the status quo. We have to figure out how more people can obtain health insurance and health care. And I do not see why health insurance should be provided through employers — when you get sick, and need your health insurance, you are most likely to lose your job and your health insurance. That is a crazy system.
I hope Obama’s healthcare reform fails so hard he never talks about it again. But for those of us who are Republicans and fiscal conservatives to oppose Obamacare by saying the current system is fine and does not need to change is just nuts. Not coming up with a better system to propose as our alterntive is the same as saying we are too stupid and selfish to figure out how we can preserve liberty and expand the number of people who can have access to affordable healthcare. It is an abdication of duty. It is an abdication of leadership. And because we have abdicated our duty and our leadership, people seem ready to follow a sociopathic pied piper perfectly prepared to tell them whatever they want to hear that will induce them to give up the system that gives them their freedom to make the most of themselves. That’s because, when people have to choose between the death of capitalism and their own death, I’m pretty sure the majority will choose to save themselves and let capitalism die.
*”Life unworthy of life” is the expression the Nazis used to justify their eugenics program of killing the disabled.