A couple weekends ago I got to go see Michael Moore's new movie Sicko. Having seen how well it works for German relatives and Canadian friends, the sections about socialized medicine were no big news to me. I have been a big proponent of universal healthcare for a long time now. Watching the movie just strengthened my resolve about it. It also dredged up some of my own family's own decade old HMO woes.
Rather than see him when my father called his doctor to report dizziness, headaches, and numbness on one side, he was told to "call back if it happens again". Any doctor should have been able to two and two together to come up with the idea that he might have been experiencing TIA's (transient ischemic attacks - basically "mini-strokes" that do no lasting damage, but warn of a more serious episode to come). The American Stroke Association advises calling 911, but apparently Giant HMO Corp doesn't feel they're serious enough to merit even an appointment. In the end, it did happen again a week or two later, but that time instead of TIA's it was a massive stroke that left him partially paralysed.
Once he was in the system, I will admit that the care did improve somewhat. There was one careless therapist who chose the day after my dad's stroke to have a "you don't want to become a burden to your family, do you?" talk with him. He was quickly set straight when we asked to see his boss for our own talk about tact and the notion that no human being is a burden. One may become ill, but that does not make the person a "burden". That individual notwithstanding, the treatment (I hesitate to use the word care) at his HMO hospital was okay. Thing did turn around for a bit after he was moved from his HMO system to Good Samaritan's RIO (Rehabilitation Institute of Oregon) program and the nurses at the hospital where he died (also not part of his HMO system) were really lovely. Everyone we encountered there was not only professional, but caring. Unfortunately, once he was released from the hospital, it was back to long waits for appointments.
Even worse, about year after his stroke, my father suffered a heart attack. Following HMO Corp's instructions to call the number they had provided in case of emergency, my mother dialed it only to connect with a line that rang and rang, finally ending with a recording suggesting she call 911 if it was urgent. Precious time was lost. By the time the paramedics arrived, my father had been unconscious for too long to revive. He was put on life support. At 27 I was left as half of the team that got to make the decision of whether to sustain it. A young woman dreams of many things. The torture of grappling with whether doctors could have been wrong about the lack of hope as she listens to the life rattle and wheeze out of her father's body is generally not among them. For years afterwards, I had recurring nightmares of a blackened room, filled with the sounds of the gasping breaths. Thanks for the memories, corporate medicine.
After my father's death, we went to an administration office to register a complaint with the HMO regarding the phone information. We were quickly relieved of the documentation we had with the bad phone number, but their literature now does refer people to 911 in an emergency. At the time I was too numb from just having gone through it all to see what they were doing. In retrospect, it is pretty obvious that they were relieving me of any paperwork that could be used in the law suit we never filed against them.
Now, ten years later, I don't know if my father would have survived the heart attack anyway after such a massive stroke. It is very likely that the damage was already too great. It is very likely that life support decisions may have had to have been made, even if he had received more responsive care. People do get sick. People do die. What I do know is that thanks to the crappy administration of his health management program, he was never really given much of a chance. Certainly, there were some dedicated nurses and doctors who meant well and took their positions as caregivers seriously, but I can't see where the system itself helped them too much. Those who want to protect the big business of healthcare always say that socialized medicine will result in poorer care, long waits. Yet when I compare the treatment my father got to what my grandfather in Germany received for his multiple heart attacks (his doctor made regular house calls and scolded him when he tried to come to the office when he was too ill), it's not our corporate run healthcare that comes out smelling like the rose. Even worse, my father had insurance. There are a lot of people who don't even have that and are far worse off than he ever was. It baffles me to think that he was one of the "lucky" ones.