Tuesday, August 12, 2008

What's Wrong With US Health Care: Jane's Story

Karen Hover is a doctor in Maine. As such, she is in a prime position to note the shortfalls, mistakes, and outright failures of the American health care system. On Monday, she wrote a guest OpEd column for The Bangor Daily News in which she puts a face on these wide and dangerous gaps in the way we take care of our sick.

In it, she relays the story of "Jane" (not her real name), an administrative assistant who suffered an accident that broke both her elbows after falling off a roof. As you might imagine, the splints used to immobilize the fractures stretched from fingers to armpits. She rapidly discovered that the splints kept her from being able to do, well, anything.

"I couldn’t scratch my nose, or feed myself, or get a glass of water, or pull my pants down." She needed around the clock care. Jane called her insurance company, which told her that her plan included 100 days of skilled care.

Arrangements were made to go to a rehabilitation facility on Friday, which was good because Jane’s friend had to go back to work. When Jane arrived, around noon, administrators told her that the insurance company had denied her claim and that she could not be admitted because she had no need for skilled medical care. After a couple of hours on the telephone, no one had a better idea, so she was sent back to the emergency room. By this time, she needed to go to the toilet, but staff refused to take her because of fear of liability. Her ex-husband helped her.

Can you imagine? Not the runaround -- that is something we have all come to expect (at least those of us who have had to deal with the health care system directly) -- but the treatment. Imagine yourself with both arms in splints, bladder bursting, lots of people around whose job is to help you, and yet no one does. This points up an aspect of the current system I do not often get to touch upon: the fact that often there seems to be no attempt made to help a patient preserve basic dignity.

The emergency room was packed. She was seen by a doctor who asked her if she had cash to pay for a hospital room. He talked to her about going to a local shelter. Jane was hungry, dirty and in pain. "I just need someone to take care of me," she said. A stranger who had been following the story brought Jane supper at 10 p.m. and fed it to her. She was admitted at midnight.

Jane's adventures are far from over though. It took another eight days of refusing her claim before the insurance agency came around and had her transferred to a rehab facility. Sounds like things should have been fine from there on out, doesn't it? Unfortunately not.
She was sent to the same facility that had treated her so badly before and spent three weeks there, enjoying inappropriate food, an accidental injury, an often unclean toilet, miscommunications between staff and her orthopedist, and a banging door that prevented sleep. The splints were removed. Jane went home with a new case of athlete’s foot. She learned to use her arms again and is now back at work. She feels her family and friends were very supportive.
No, this is not a scene from Stephen King's The Kingdom. It is yet another homegrown horror story cultivated right here in the United States. This is why we need to keep health care at the forefront of the Presidential debate, to stop this from happening.

For Jane's sake.

SOURCE: "Karen Hover: How our health care system failed Jane" 08/11/08
photo courtesy of hypertypos, used under its Creative Commons license

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