Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts

Saturday, April 26, 2008

Health Care (mine, this time)


Well, its been a rough week.

Last Saturday, I woke from an afternoon nap with pain in my left arm. Since I thought I had slept on that arm, I didn't think much of it, and went and preached Saturday evening, as usual. (See below.) The pain got stronger that evening, but receded after I took some Ibuprofen.

The next morning, as I dressed for church, the pain returned, but very faintly, this time in both arms. At church, it got stronger as the liturgy proceeded. As I started to drive home, it got even stronger and now also included my left shoulder and upper chest. Until this point, I hadn't connected this with my heart, because I expected that would include shortness of breath, a crushing tightness of the chest, none of which I had. But, this scared me, and I remember saying to myself, "I just want to get home." When I did, my wife immediately asked what was wrong. When I told her, she said, in a no-argument tone of voice, "We're going to the hospital." I didn't argue.

It took only a few minutes to get to the Perry Hospital's ER. It was nearly empty and when my wife told them my problem, they took me straight back. I was quickly hooked up to an EKG, blood was drawn and I got an aspirin, a nitroglycerin pill under the tongue (yes, they do cause headaches, but I didn't care!), and a nitroglycerin patch on my right shoulder. The ER doctor said my EKG was fine, but my enzyme levels were elevated, so they were going to transfer me to Macon where the specialists could look me over. I'd probably have a catheterization on Monday. I was apprehensive, but not that scared, in part because the ER personnel low-keyed the situation a little to calm me. I remember thinking that the lack of constant attention in a quiet ER had to be a good sign. My pain was diminished, but I knew I wasn't simply going home. We arranged for a friend of my wife's to bring her up to the hospital in Macon, since she hadn't been there before and her friend had.

After a 30-mile ambulance ride to the Medical Center of Central Georgia, I was taken directly into the catheterization lab ("Do not pass go, do not collect $200"). A team of 6 or 7 nurses (I didn't keep a close count) bustled around me and explained how catheterization worked. I would be given a tranquilizer (Versed (sp?)) to calm me, then, after a local anesthetic numbed my right inner thigh, an incision would allow the doctor to run a probe up my femoral artery and into my heart to see what was happening. I would remain conscious throughout and was to tell them if I felt any pain after the deadening shot. And off we went...

Meanwhile, as I found out later, my wife and her friend had made the trip up from Perry and were now discovering that no one seemed to have the slighthest idea where I was. Her friend was adequately aggressive and extracted the information they needed. (Remember they didn't know that I'd been taken straight in!)

I may or may not have dozed off during part of the procedure; I'm not sure. I remember listening to the team working on me, but not having the strongest interest in it. Versed is strong stuff! I opened my eyes and glanced around a couple of times, but after a moment or two, I lost interest and closed my eyes. There was never any pain, just a tugging sensation on my skin as he moved the probe back and forth and every once in a while, I'd feel an odd sensation that something was moving around in my chest. Finally, they started moving the equipment away and the doctor came up to explain that they had found a blockage and had inserted two stents in my right coronary artery. It had been 99% blocked! He said that he felt there was a hereditary predisposition, since my father had a heart attack at age 56 while I was in law school.

I was rolled down hallways to my room where my wife and her friend were waiting. The doctor explained the situation to them (they were much more interested at that point than I was). As the Versed wore off, I took more interest in the proceedings. I had to keep my right leg still for a couple of hours to make sure the incision sealed. My wife handed me my cell phone so I could make few calls. One to each of my children to assure them I was improving. Which I was, the arm pain was gone. One to my priest, who was shocked. After all, I had been in church that morning. He would come by the next day. Then to my boss, who was just about as shocked. I asked to notify the Federal court why I wouldn't show up for jury duty the next day. Since he lived in Macon, he planned to come by on the way to work the next morning.

My wife fed me dinner, surprisingly good for hospital fare--salisbury steak, mashed (real) potatoes with gravy, corn (I think) a roll and even Jello with whipped topping. (I think this was because I hadn't been set up for the cardio yet; this would be fixed by breakfast.) I definitely lucked out 26+ years ago when she married me. After a while, I sent her home with her friend. As the evening went on, things got removed--the IV system, the continuous monitors--which allowed me to get out of bed and go to the bathroom. Don't underestimate that until you've had to use a plastic bottle while lying down.

From this point on, I felt fine, with an underlying edginess as I wanted to be out of there. Sleeping was challenging as hospital beds don't bear a whole lot of resemblance to real ones; there's an underlying noise level that I'm not used to, a vital signs check and to top it off, I was awakened at 3 to have blood drawn and EKG taken and at 5 for the nurse to check to make sure my incision was healing well. Also, I had to make several trips across the hall to the bathroom. Apparently some of the stuff I was being given was a diuretic.

Monday was boring. I felt pretty good and was getting tired of the place. My boss came by early for a brief visit. My wife spent most of the day (clearly boring for her) and two co-workers came by, one with flowers from the office. I also got a few phone calls, and I appreciated them. Father Anderson came by mid-morning. He told me that the parish rumor mill had me having a "massive" attack as I drove home from church. (I would learn after I got home on Tuesday that I had also "driven myself to the ER in Macon"!) He reminded me that the prayerful thoughts, not the factual details, were what counted. He prayed with us and said he'd see me Tuesday afternoon if I were still there.

The food quality took a serious dive. Breakfast was artificial eggs, toast with Promise substitute and OJ. Coffee was provided, but I don't drink coffee and I never found out how to request hot tea. Lunch was pork, a roll with Promise, an unremembered vegetable, and chocolate pudding (!). Dinner was grilled chicken, another roll, anonymous vegetable and Jello. (At least I like Jello--on occasion.)

The internal medicine doctor, Dr. Sultan, came by in the afternoon and said that, as far as he was concerned, I was good to go home that afternoon, but the cardiologist had to approve and he never came by. My GQ (Grumpiness Quotient) increased as I realized I wasn't going home that day. I agreed that my wife should go home rather than wait any longer that evening. She had our animals (dogs, cats, and chickens) to attend to. Just before 10, Dr. Teherani came by. He said I was doing well and could go home the next morning. I would need to see him in about 2 weeks to start rehab. I thanked him for his work and he told me to thank my wife, presumably for getting me to the ER. I told him that I do, very much.

Another uncomfortable, interrupted night gave way to Tuesday. Breakfast same as on Monday.

My wife showed up and the morning dragged, waiting for clearance to leave. We waited long enough that the lady from Food Services showed up with lunch. I politely (probably because my wife was present) told her, no thanks, I was getting ready to leave. Finally, about 1 pm, I was rolled out and on my way home.

Our little house, not the best, looked wonderful! The dogs and cats were happy to see me. After a light, low-fat lunch, I took a nap (first getting a face wash by Herbie, our cairn terrier) with Herbie and Max and Jewel, two of our cats watching over me. I was home!

But it's not quite the same. We had 7 prescriptions to fill: blood thinners, a beta blocker, chloresterol controllers. (The co-pays were $113, which meant the full price was $452. Except, I'm sure Blue Cross has negotiated good deals with CVS and an insurance-less person would have paid more. I'm still troubled by that.) I'm awaiting the real bills, but not with the anxiety an insurance-less person would have.

My diet is changing. General ejection of fried foods. More fish, turkey bacon and sausage, less sugar. As I get stronger, more exercise. When I return to work in 2 or 3 weeks, my boss has said he will help me get to use the fitness center. My wife and I have both undertaken to lose weight and get fitter together.

I've been amazed by the expressions of concern from people at work and at church. I knew that my relatively gentle disposition kept people from disliking me, but as a co-worker said to my wife today when she brought a huge fruit basket, "Everyone loves Paul..." Wow... I sent an e-mail through my colonel asking everyone to use this as a free wake-up call for themselves and fix their own health issues. I've already received an e-mail from one of them saying he's already changing his diet and exercise regime. Neat!

And yet, I'm different than the guy who went to Red Lobster 7 days ago and got the fried seafood platter. (That's the end of that!) I have had one of the ultimate scares. But, I'm looking forward to changing things and going for 52 more years!

Tuesday, April 15, 2008

Health Insurance--Part 2

Last month, I talked about my unhappiness that so many people are excluded from potentially life-saving diagnostic procedures, like colonoscopies, because of cost.

I had brought to my attention an article in the New York Times yesterday, "Co-Payments Soar for Drugs With High Prices." The articles talk about how insurance companies are creating fantastically high co-payments for some of the new, very expensive drugs which can save lives or slow the progress of diseases. One example was of a woman who was prescribed Copaxone for multiple sclerosis. Her husband's insurance company, Kaiser Permanente, had been charging a $20 co-pay for several years. But, when she went to refill the prescription in January, her co-pay jumped to $325 for one month.

Another case was of a man who was presribed Sprycel to control his chronic leukemia--a condition my father had. (I have no idea what he was prescribed.) Sprycel blocks the growth of the cancer cells. He had what he thought was good insurance through AARP, but his 90-day co-payment is over $4,000!

(I checked through my plan's website to see what it would charge. The news on Copaxion was better, if not good: $451.61 for 90 days. For Sprycel, the co-payment for 90 days is $3,255.53, not much better than the AARP insurance in the story. My company has a mail order pharmacy at a flat rate of $35 for 90 days and listed it as an option for Sprycel. But not every plan has mail order.)

This practice, called "Tier 4" and "Tier 5" (for even more expensive stuff) is designed to shift the cost of the most expensive drugs to the patients that use them, sparing the rest of us any need to support them. Isn't the idea of insurance to pool costs so that we share the costs among us? I'm convinced that something about universal medical care coverage needs to be done. One of my co-workers is opposed because that will erode our current fairly privileged position. I can live with that to a degree if that will help situations like these.

Don't assume that your insurance, when you do have it, won't slide "Tier 4" pricing in on you. If you have any choices, look carefully at drug coverage. And, if you have choices, be thankful that you do... and stop to think of those who don't.

Thursday, March 6, 2008

Health Insurance

Last December, I did something many men of my age do--I had a colonoscopy at our local hospital. An easy procedure, back home by noon, with excellent results.

Why do I bring this up now? A couple of days ago, I got a statement from my insurance company that the hospital had billed them $2,900! Add to that the doctor's bill and we're up to $3,800. (I still expect an anesthesiologist's bill.) Because of my insurance, I only had to pay $15. But here's what bothers me. The medical community says that colonoscopies are essential for early detection of colon cancer; without them, you can die of it. But, even with a salary well above the national average, I would be struggling mightily to pay a $3,800 bill for a diagnostic procedure. People farther down the economic ladder can't even dream of it. I have trouble with a healthcare system that says this is acceptable.

According to the Robert Wood Johnson Foundation, 47 million Americans (and 9 million children) lack health insurance coverage. Here in Georgia, over 17% lack coverage, above the national average. My former home state of Texas is #1 (or perhaps #50) at 23.9%!

The Roman Catholic Church has stated "Health care is fundamental to a healthy, flourishing society–it is not a product or commodity. When people have unmet health needs, it is difficult for them to fully function as members of their families, their workplaces or their schools, which then affects the broader community and economy." They believe that a moral health care system should be
  • Available and accessible to everyone, paying special attention to the poor and vulnerable;
  • Health and prevention oriented, with the goal of enhancing the heath status of communities;
  • Sufficiently and fairly financed;
  • Transparent and consensus-driven in allocation of resources and organized for cost-effective care and administration

Even though it could be said that I benefit from this system, I'm not comfortable with it. Where's the morality in this? If we call ourselves Christians, where's our concern for God's justice on behalf of those in need?