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» A tale of two patients

Commentary 13 Dec 2012 11:03 pm

A tale of two patients

I knew it was coming.

I woke up Saturday with a scratchy throat, sinus drainage and a pounding headache. For most of the day, I ignored my symptoms and soldiered through, pretending I wasn’t getting sick. By sundown, however, I was looking for the license number of the truck that hit me. I crawled in bed early and slept fitfully.

On Sunday morning, I felt no better and started weighing options. In the coming week, I had zero time to see my doctor, nor did I have the luxury at semester’s end to take off a day to recuperate from anything less than full-bore cardiac arrest. *

My best option, I decided, was an immediate care center in Louisville, where I waited for almost two hours before having my throat swabbed (no strep, thankfully), coughing a few times for the doctor, and leaving with a prescription to fill.

The line at the pharmacy was long both to drop off and, an hour later, to pick up. Lots of sick people, apparently. By Sunday night, I was feeling better, maybe because the medicine worked that quickly, maybe because of the much-underrated placebo effect, maybe both.

Seeing a doctor and filling a prescription are no-brainers because I am one of the fortunate Americans with health insurance. For the working poor without such benefits, the scenario would play out differently.

Without insurance, I would wait out symptoms instead of going to the doctor, ransacking the medicine cabinet for over-the-counter remedies or some half-finished prescription from years past. The latter is less effective and dangerous, but when money’s tight, you do what you must.

I wouldn’t want to take a day off work because if my job were part time or low-paying or both, I likely wouldn’t have the luxury of sick time. Instead, I would muddle through as best I could, hoping co-workers would cover for me as I had for them when they were sick.

Without timely medical care, it would almost certainly take me longer to recuperate, during which time I could infect friends, co-workers and family. Getting my kids sick is a double-whammy, because then I’d have to take time off to care for them, which would further hurt my finances, or find somebody reliable to watch them, which is sometimes problematic.

If the infection settled in my lungs, I could end up with pneumonia, which could send me to the emergency room. Without insurance, I could rack up a considerable bill there, much more than the cost of a routine office visit back when my symptoms were limited to coughing and a tightness in the chest. Maybe the hospital would write me off as a charity case, or maybe it wouldn’t.

My debt could climb, leading me to a second, third or even fourth part-time job to stay solvent. Likely, I would put off routine checkups, meaning conditions that could be caught earlier wouldn’t be, leading to longer illnesses and a further erosion of my finances and my quality (and length) of life.

It’s a vicious, rotten cycle, and it comes from our curious belief that health care is a benefit and an entitlement, but not a right.

Analysts like to throw around numbers to demonstrate how the Patient Protection and Affordable Care Act will destroy health care as we know it and how it’s impossible for the system to remain solvent if we suddenly provide insurance for 94 percent of Americans. Doctor shortages, higher prices and the ascendency of hospitals and bureaucracies over physicians have all been threatened. Scare tactics, all.

Yet if the people in charge of implementation at the state and federal levels drag their feet, obfuscate, and throw up roadblocks at every turn, instead of working proactively to make changes work and fix a flawed piece of legislation which was, after all, the best that could be passed given the political climate of the time, then failure is virtually assured.

We are the United States of America, which found a way to spend $695 billion on the military in fiscal year 2011 alone, so we can surely find a way to implement a law that will provide medical care to the vast majority of the nation. If that means taxes must go up, mine included, then so be it.

Because — bottom line — health care for all is the responsible, moral, right thing to do.

Being sick is no fun. Being sick without insurance is worse.

*Update: Pride goeth before a fall. I ended up back at the doctor’s later in the week, diagnosed with flu, and flat on my back for several days. It turns out my body didn’t care about my work schedule at all.

@cschillig on Twitter

Originally published on Dec. 13, 2012, in The Alliance Review.

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