I Watched My Patients Die of Treatable Diseases Because They Were Poor | Alternet

An sad narrative on the state of the sick and dying in America. This is not just a Texas problem but one that plagues the whole country, the poor are basically given a death sentence because of their poverty. The powers that be, whether left right or middle need to understand how their actions and policies are killing the poor. One cannot pursue "life, liberty or happiness" if they are dead (or dying); the right to life extends beyond the womb.

The first patient who called me “doctor” died a few winters ago. I met him at the St. Vincent’s Student-Run Free Clinic on Galveston Island. I was a first-year medical student then, and the disease in his body baffled me. His belly was swollen, his eyes were yellow and his blood tests were all awry. It hurt when he swallowed and his urine stank.

I saw him every Thursday afternoon. I would do a physical exam, talk to him, and consult with the doctor. We ran blood counts and wrote a prescription for an antacid—not the best medication, but one you can get for $4 a month. His disease seemed serious, but we couldn’t diagnose him at the free clinic because the tests needed to do so—a CT scan, a biopsy of the liver, a test to look for cancer cells in the fluid in his belly—are beyond our financial reach.

He started calling me “Dr. Rachel.” When his pain got so bad that he couldn’t eat, we decided to send him to the emergency room. It was not an easy decision.

There’s a popular myth that the uninsured—in Texas, that’s 25 percent of us—can always get medical care through emergency rooms. Ted Cruz has argued that it is “much cheaper to provide emergency care than it is to expand Medicaid,” and Rick Perry has claimed that Texans prefer the ER system. The myth is based on a 1986 federal law called the Emergency Medical Treatment and Labor Act (EMTALA), which states that hospitals with emergency rooms have to accept and stabilize patients who are in labor or who have an acute medical condition that threatens life or limb. That word “stabilize” is key: Hospital ERs don’t have to treat you. They just have to patch you up to the point where you’re not actively dying. Also, hospitals charge for ER care, and usually send patients to collections when they cannot pay.

My patient went to the ER, but didn’t get treatment. Although he was obviously sick, it wasn’t an emergency that threatened life or limb. He came back to St. Vincent’s, where I went through my routine: conversation, vital signs, physical exam. We laughed a lot, even though we both knew it was a bad situation.

[,,,]
The shame has stuck with me through my medical training—not only from my first patient, but from many more. I am now a director of the free clinic. It’s a volunteer position. I love my patients, and I love being able to help many who need primary care: blood pressure control, pap smears, diabetes management. We even do some specialty care. But the free clinic is also where some people learn that there is no hope for the chemotherapy or surgery that they need but can’t afford. When UTMB refuses to treat them, it falls to us to tell them that they will die of diseases that are, in fact, treatable.

[,,,]
Perry’s refusal is catastrophic health policy. For patients, it means that seeking medical care will still require risking bankruptcy, and may lead nowhere. For doctors, the message was not only that our patients’ lives don’t matter, but also that medicine—our old profession, so full of people who genuinely want to help others—will continue to be part of the economic machine that entrenches poverty. When the poor seek our help, they often wind up with crippling debt.

[,,,]
Among those consequences are the deaths of the poor. As Howard Brody, director of the Institute for the Medical Humanities, has shown, 9,000 Texans per year will die needlessly as a result of our failure to expand Medicaid. However, because dying patients are often too sick, exhausted and wracked with pain to protest, UTMB and states like Texas aren’t forced to reckon with the consequences of their policy decisions.

Because the very sick and the dying may not be able to speak about these issues, health-care providers—particularly the providers of the so-called “safety net”—must do so. It is in our clinics, in the bodies of our patients, where the consequences get played out.

I Watched My Patients Die of Treatable Diseases Because They Were Poor | Alternet

So everyone is bitching about Obamacare but when asked for an alternative all I hear is

• Nothing 
• Leave healthcare alone it's fine the way it is 
• Get a job/better job so you can get your own, or 
• Anything is better than what HE is proposing, damn ______ (commie, Marxist, socialist, fascist, Nazi, Muslim or any other "derogatory" word you can think of but I won't print) 

 Lets look at these in order.

The "I hear Nothing,,," 
People in this category either are clueless or just don't care, they vote straight party line and are one issue voters. It's either anti-equality (specifically LGBT), anti-immigration or anti-abortion. No other issue(s) matter and how a candidate votes in regards to infrastructure, jobs, veteran issues, domestic and foreign policy is moot as long as the candidate vows to eliminate protections for one (or all of) the aforementioned issues. They will ignore their economic well-being to prove a point. This group tends to be in the a pro-Israel camp which can mis-align their views. They may vote for a pro-Israel candidate who is considered weak in support for other concerns.

As for alternatives they offer none as they have no opinion since it doesn't affect them. Either they have insurance or are a strong supporter of the Bush Jr. mindset from 2007:

"The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America," he said. "After all, you just go to an emergency room."

If one remembers this is also "the plan" that Romney called being a form of socialism in 2007:


"Leave healthcare alone it's fine the way it is,,,"
This group is similar to the first group but realizes that there is a problem in regards to healthcare. Though not clueless per se they just don't have a full understanding of the issues as it has never affected them. In their mind universal healthcare was passed in 1986 with the Emergency Medical Treatment and Active Labor Act (EMTALA) which requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.

This mindset is superbly echoed by Rick Perry in 2011:

,,,everyone in the state of Texas has access to health care, everyone in America has access to health care,,, from the stand point of all people in this country, our government requires that everyone is covered.

What is at issue with this line of thinking, the ER does not provide preventive medicine, individuals (have to) wait until their illness, injury or sickness puts them in a life threatening situation. Instead of a $25 co-pay doctor's visit and a $10 prescription becomes a $5000+ emergency room bill and bankruptcy. Author and novelist Upton Sinclair sums this group up best, "It is difficult to get a politician to understand something, when his salary depends upon his not understanding it."

"Get a job/better job so you can get your own,,,"
I have a job, one that I like (for the most part). Actually I have two jobs and neither pays a "liveable" wage, hence why I also receive SNAP; I work 45-55 hours per week sometimes more. So even with the offer of health insurance from my primary employer, I can't afford it and the deductible is too high. I also qualify for Medical Assistance for Workers with Disabilities (MAWD), a health insurance program for working individuals with a disability. But again due to my low wages, paying my premium is difficult, why I had to return to my second job as I can no longer go without insurance. (This getting old shit is for the birds!)

Now some would say, "get a better job that pays more." Well considering that the "better paying jobs" where I live are manufacturing jobs, I run into the issue of my disability. I can no longer physically handle working in a factory. Also please define "better paying," as most of the peon line jobs pay $10-$12 per hour with starting pay at around $8.50. Losing 3 years seniority, schedule flexibility, and $30 a week in wages to start would be foolhardy. Also these "better paying jobs" are victim to lay-off; on average 3-4 months out of the year.

"Well move!" Uhm, need money to move, and given our economy jobs are not easy to come by despite the 3.9 million openings Republican Representative Dave Joyce asserts are available. I also live in a decent area in regards to cost of living. The $400 a month rent I pay for my apartment would not even rent me a room in Boston.
Why should I have to move away from "family" and friends to a place lacking in a proper support system., not only on a personal level but also in regards to my health. Changing medical providers is not an easy task. I do not drive, can't afford to, so would have to "hire" someone. So this "well move" solution is not a solution at all.

"Anything is better than what HE is proposing,,,"
This group IMHO is the funniest of them all and is currently being led by Heritage president and former South Carolina senator Jim DeMint:

DeMint said opponents don't have much time to try to make changes to the law before a March 2014 deadline for people to enroll. Benefits will kick in Jan. 1 for those who enroll earlier.
"This might be that last off-ramp to stop Obamacare before it becomes more enmeshed in our culture," he said.
"This is not about getting better health care." DeMint said uninsured Americans "will get better health care just going to the emergency room."

Yet again the alternative to the Affordable Care Act is the emergency room of your local hospital, the so-called “free” care provided by (EMTALA). So if you have a chronic condition (diabetes, asthma, dialysis, cancer) with a need for medication or treatment, guess what your shit out of luck. Also, if your lacking in private insurance, good luck if you suffer a traumatic injury, a 2009 study shows that not all emergency room patients have equal outcomes. That's reassuring, NOT!!

What makes this such an oxymoron, the Heritage Foundation is now lambasting a plan they once advocated for and supported.

I believe that we have a responsibility to our fellow man and that we should help when and where we can: "We are all one. When one is harmed, all are harmed. When one is helped, all are healed." Healthcare is not a privilege for a wealthy few, but a basic right for all citizens. But according to the Reich only the top 1% deserve a chance at "life, liberty and the pursuit of happiness," for the rest of us it's a crap shoot at the ER . I know I would be willing to pay and extra fourteen cents for a pizza or sixty-eight cents for a BigMac, what about you?