“We Americans live in a nation where the medical-care system is second to none in the world, unless you count maybe 25 or 30 little scuzzball countries like Scotland that we could vaporize in seconds if we felt like it.” –Dave Barry
Health care in America. It’s an enormous, sprawling industry, much of it wildly profitable, but with spiralling cost increases that could well wreck our economy. And make medical care so expensive that most people just won’t have any: we’ll just get sick and die. Our most recent effort to manage it, and to provide decent care for all our citizens is, as you might have noticed, a thorny political issue in itself. The Affordable Care Act will bring access to health care to more of our people, but it’s not all that we really need. And there are still determined efforts to stop it. There are certainly many considerations. How can we afford it? Can we afford not to have it? And do we want to be a nation that refuses to take care of its people?
Big questions, with few easy answers. And with unimaginable amounts of money at stake. It’s a problem we are bound to encounter in painfully personal ways as well. I’m not exactly comfortable writing about private stuff, but I can’t help thinking about health care these days, in both profoundly personal and fiercely political terms.
My mother is almost eighty-six, with end-stage kidney disease, so she’s been taking dialysis 3 times a week for over a year. It’s a grueling procedure, one I’m not sure I would go through myself. She dreads it, and complains of the cold and the misery of sitting almost without moving for four hours, but Mom is very tough and keeps going, despite losing forty pounds during the process. Now she’s developed some additional health problems, nothing dramatic, but disheartening and exhausting on top of the big things. Most worrying is her loss of appetite, a common experience for dialysis patients. To me, this seems like one hell of a thing to go through, if you merely gain enough time to starve to death.
I’ve spent several weeks with her, just giving that bit of extra care and encouragement she seems to need now. It’s quite a roller coaster ride, as Mom has days when she has a good deal of energy and enthusiasm, followed by bouts of lethargy and discouragement. And vagueness. She may not have dementia, but her memory and concentration are getting pretty unreliable. I live ninety miles from her, and need to be home at times, but I’m most uneasy about leaving her on her own.
We are extremely fortunate to have family nearby who are willing to help, grocery shopping for Mom, keeping her prescriptions and pillboxes filled, and doing her laundry. She gets some home delivered meals, has help with housekeeping, and has wonderful neighbors who tend her lawn and check on her often. But soon even this won’t be enough assistance. She owns a modest home, and has a little in savings. But do you have any idea how soon assisted living facilities and nursing homes can burn through that? Ironically, Mom has swallowed all the Tea Party nonsense, and often rants about government death panels, and the appalling spector of … socialized medicine. We should be so lucky. I keep thinking that if we had civilized health care in this country, she would have better odds of staying in her home, as she badly wants to do for the time she has.
I notice that (thanks to that horrible, big-government Medicare program) our medical industry is fine with the high-tech, high profit things my mother has needed — knee replacement, cataract surgery, the dialysis, numerous meds for high blood pressure and so on. But something simple, that no one can make a zillion dollars on? I had to introduce this woman of great personal dignity and vanity to baby wipes, magnesium citrate and enemas. In the past, nurses were all trained to administer such things, but even if that’s still the case, it’s not easy to find or afford in-home nursing care, especially not at short notice. And it required trips to three different drugstores even to find a traditional hot-water bottle kit. They have lots of tiny disposable pre-filled enemas on the shelf, of course. More cynical, profit-driven bottled water bullshit. Literally. These over-priced items hold very little, and the container must be squeezed with some force, at an awkward angle. Not so easy with Mom’s diminished upper body strength.
I’ve also wondered why her kidneys failed in the first place. They tell us it’s all damage from years of high blood pressure. Maybe so. But Mom worked for over thirty years with solvents, solder, epoxies, other polymers and military components. At least once, everyone in her work group had bladder infections at the same time. Coincidence? And as a teenager during World War II, Mom worked in a paper mill, where for a time they were using carbon tatrachloride rather than glue to fasten bundles of paper. With no extra ventilation. She says she was the last of her crew to get ill, and went to a doctor — who turned the plant in to the NLRB, as this was decades before OSHA. Between that act of “disloyalty”, and her open support for a union, Mom wasn’t too surprised not to be rehired after she had me.
And I often think of Mom’s youngest brother, who spent years working for the John Birch Society, spouting whatever their current line was — including righteous indignation over all that big-government intrusion like silly industrial regulations and safety standards. For extra income, he spent at least one summer cleaning gunk out of old industrial smokestacks in eastern Ohio, and at a guess with little protective clothing, masks, gloves or anything. What could happen? How about prostate cancer? I now think of him as a laissez-faire or free market martyr, dying for what he believed in, I guess. Or at least for the greater good of the Chamber of Commerce and Consolidated Coal.
I don’t mention these musings to my mother, of course, that would be pointless and cruel. But I can’t stop thinking of all the needless suffering in this country because we have a few people — who already have vastly more than they will ever need — who are nonetheless so damned greedy and selfish that they’ve spent decades demanding total deregulation, along the way shredding our workplace health and safety provisions, and making sure we have super-expensive, sub-standard health care. Just to keep profit margins high, and their god-damned tax rates low, so they can grab still more millions. Is it hyperbole to regard that as blood money?