In Response

Christine-Megan had a great comment on my last post, so great that I had to dedicate an entire post to respond to it.

I agree that healthcare isn't nearly what it should be here and a lot of people get screwed, but I'm not sure what the solution is.
Healthcare as it is in the UK or Canada scares the crap out of me.
It's HARD to get a pump in the UK, and I like my pump.
I know people in Canada that bought their's out of pocket.

Why does it scare the crap out of you? Maybe it is news, but it can be fairly hard to get a pump in the United States as well. First of all, you must meet at least one of the following criteria in order to get a pump in the US: Be well-to-do or have pretty damn good insurance. If you are well-to-do then you can afford the co-pays & deductibles of your insurance to not only initiate pump therapy but also continue it. You also have the option of paying for a pump out of your own pocket if you are well-to-do and your insurance doesn’t feel that it is a medical necessity. If you aren’t well to do, then you can pay your percentages, co-pays and deductibles, and hope it doesn’t bankrupt you with your current insurance policy to continue pump therapy.

So who in the US doesn’t get the option at all? The un-insured and the under-insured. They can’t get a pump at all. The un-insured can’t afford to buy a pump out-of-pocket nor can they afford the supplies needed to maintain therapy. The under-insured, even if their insurance approves the purchase of a pump and covers part of the cost, still can’t afford their portion.

So I guess that it is easy to get a pump in the US if you meet certain class criteria (see above). If you don’t, sorry man, you are out of luck.

When I needed a neurology consult, I got one in 2 days here. I can often get into the doctor's office the next day if I need to. When I needed a CT scan, I got one that day.
My family in the UK has connections and they wait a LONG time to see a specialist.
When I was observing in the ICU there was a patient there who's family was paying out of pocket for him to be in the ICU here, because the one in Canada was full.
That scares me.

I find this interesting because the US of A has fewer doctors, fewer nurses, and fewer hospital beds per capita than the average country in the Organization for Economic Co-operation and Development.

(I stole the above reference from “Your Pharmacist May Hate You”. Hop on over and take a look at his blog.)

As they say- access, quality, affordability- pick any 2.

And the uninsured and underinsured of America have which of these? That’s right, none.

I’d love to share with you a personal story about a man I know, a man I know and love, who just so happens to be uninsured.

This man is a small business owner (we’re talking one man crew), and at the tender age of 35 he discovered (quite painfully) that he has a congenital defect of his urethra which over the course of his life caused his urethra to completely close.

In significant (excruciating) amounts of pain, this man went to visit the Emergency Room. Upon finding out that he had no insurance, they performed a uroscopy on this man under local anesthesia to widen and open his urethra. So basically, what they did (in laymen’s terms) is they put a long camera up his urethra (penis) while he was fully awake and somewhat anesthesized (thanks to fentanyl) and used rods to widen his urethra so it was no longer closed. Typically this type of procedure is done in an OR under general anesthesia, but why waste the time and money on someone who probably can’t pay for the expense in the first place?

This man wore a catheter for two weeks, and after this period followed up with a clinic in the hospital, where they informed him that if he had insurance (or once he had insurance) they would schedule surgery to correct the problem with his urethra. In the mean time, he would have to self-catheterize himself daily (with the same catheter no less) for at least two weeks to help assure that his urethra would stay open longer. They prescribed him some empiric antibiotics (levaquin) to help fight off certain infection for a period of two months and sent him off on his way.

Oh, and his bill? Over $10,000. He was billed over $10,000 for sub-par care that did not take into account his pain level (in the hospital nor at home) nor his capabilities to perform the tasks requested of him, tasks that are typically reserved for a home-health nurses. The care also did not correct his problem, and this problem is likely to (will) happen again when their temporary solution runs its course. And then? Another $10,000 bill this man cannot pay.

To this day approximately one year later, this man still has not had the surgery to repair his urethra, and fortunately, has not yet had another problem.

Is this the type of care we want for our loved ones (or ourselves?) should they not have health insurance? This is just one story, I’d love to hear more.