Head Strong: Uninsured who can't afford medical care lose a lot more

 

By Michael Smerconish - Inquirer

Inquirer Currents Columnist

I have a renewed appreciation of my access to health care after witnessing the passing of a loved one last month. She outlasted most survival curves because of the financial resources available for her care, the competency of her medical providers, and the corresponding availability of her medication.

The laminated card in my wallet tells me those things are available to me, too. But they remain out of reach for more than 45 million Americans. There is something seriously out of whack where she got what many Americans cannot.

My memories are more raw than reflective. We did so many things together over so many years, but the fact that she enjoyed a full life is still of little consolation. All that seems to matter now is that she's gone. I know in time that I'll reflect on the pictures, videos, and jpegs with fond memory, but not yet. Instead, I'm paralyzed by decisions like whether to remove the bed in which she steadily declined for months. For now, it remains untouched.

In the end, she just ran out of steam. A combination of old age, kidney dysfunction, and the residual harm from an environmental disease took their toll. She couldn't keep food down, dropped lots of weight, and ultimately lost large clumps of her hair. Then came the end.

She was never provided health insurance early in life, and by the time she was an adult, her medical course made it cost prohibitive. Still, money was not a factor because of my availability to directly provide for her. I would sooner have mortgaged the house than let money stand in the way of obtaining her care. Which made her unique in the current climate.

Those resources afforded her tremendous medical attention. Dr. Matthias Genser, her primary caregiver, is old school - hands on, unhurried, and legitimately concerned. (Even his name is straight out of Mayberry.) She underwent emergency treatment after a fall close to Christmas. During a 10-day hospitalization, she received a full workup from both an orthopedist and a neurologist. All of which improved her quality of life and extended her time to the equivalent of 98 years.

Only now do I realize how lucky I was to have her around for that long. There are too many people in this country who wouldn't have the resources to take the measures I did. Forget caring for a best friend. They wouldn't be able to afford the right medical treatment for themselves. I can't imagine having that kind of uncertainty and helplessness always hovering just around the corner.

My experience reminded me of an exchange between Barack Obama and John McCain during the second presidential debate last fall. Tom Brokaw asked each whether health care in America is a privilege, a right, or a responsibility. McCain deemed it a responsibility - one assumed by employers and small businesses. He then explained his aversion to government-mandated health care.

Obama differed: "Well, I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can't pay their medical bills - for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they're saying that this may be a preexisting condition and they don't have to pay for her treatment - there's something fundamentally wrong about that."

Right or responsibility? I'm still not sure where I fall in that regard. But I can better appreciate why health-care reform will play such a significant role in President Obama's budget plan.

During Tuesday's address to the joint session of Congress, the president made several references to the "crushing cost of health care." His words dealt mostly with the financial. Left to run rampant, he said, the rising cost of health care now causes a bankruptcy every 30 seconds. Millions could lose their homes. Millions have already been priced out of their coverage.

And now I know this: All that doesn't even begin to explain what else the uninsured stand to lose when they can't afford medical care.

In the end, no sum could provide my friend what she required. Saturday night was our last together. We snuggled on the sofa and watched TV in front of a simmering fire. Last Sunday, she took a turn for the worse, and by Monday I was sure she let me know she'd lost her fight. She wasn't speaking, but her eyes told me it was time. She wanted rest of the permanent kind.

Yes, she's gone. And like Hall and Oates once sang, I'd pay the devil to replace her. Even though they weren't referring to a Labrador.