The health-care reform debate has stirred strong emotions, but all the attention has been paid to the fury and fear on the right. Take it from me: There's plenty of both on the other side.
The fear and rage come with the thought that desperately needed reform may once again be subverted by the giant drug and insurance companies, working tirelessly through paid-for congressmen and senators, through ranting sock puppets in the media and sophisticated advertising. It comes from watching millions of people fall, once again, for the same old crapola.
Choice, we're told. It's all about choice. You want to be able to choose your doctor, choose your hospital, choose never, ever to die.
As if. I have told this story before, but it only seems to become more urgent.
On a late-February day in 2004, my sister-in-law and I waited for four hours with my 46-year-old brother, Charlie, for him to be seen in the emergency room at Tucson Medical Center. (The wait would probably be longer today: A recent national survey showed that in 2008, Arizona—surprise!—had the third-longest ER waits in the nation, with an average of more than 5 1/2 hours.)
Charlie had been diagnosed with hepatitis C more than 10 years before; hep C leads to liver cancer if untreated. Even when it is treated, it usually does. My brother had been feeling increasingly unwell for six months; he'd had a biopsy at Thanksgiving that was clear, but his blood work had been ominous. After Christmas, he started feeling so bad that he'd missed work, and in the previous week, he'd developed severe pain in his back and legs. The pain had become unbearable that morning. His fierce stoicism finally collapsed, and he'd called his internist, who told him to go to the hospital and get admitted.
Beth and I waited helplessly with him as he sat, gray-faced and sweaty with pain. The minutes crawled by as we watched while every last toddler with an earache and drunk with a cut on his hand was taken back to be treated. We complained to the ladies behind the desk, who blew us off; we called Charlie's doctor and were told there was nothing he could do. We talked seriously about leaving. We despaired.
Understand that my brother was middle-class, employed, fully insured and married to a woman who worked in administration at another hospital. He had no choices that day. His only choice was to wait.
When he finally got an MRI, it turned out that he had stage IV liver cancer, and that his pain was caused by a secondary bone tumor pressing on his spinal cord. Pressing on his spinal cord. It was dinnertime before he was given morphine, and the pain was only fully relieved by a course of palliative radiation therapy that shrank the tumor. There was no effective treatment, though, for the fast-growing primary cancer in his liver. He died on March 25.
Nothing along the way was harder to take than those hours in the waiting room. There really are no words to convey Charlie's suffering, or our rage and sick disbelief that this pitiless trap was the only entrance to the glorious U.S. health-care system.
Several things were wrong, are wrong, with what happened that day, things that would not be hard to fix. But the essential problem is one that only sweeping reform can address: The ER was flooded, as it always is, by poor people with urgent but relatively minor ailments and injuries who could be treated in five minutes by a nurse practitioner at a doctor's office or urgent-care clinic—or these days, at Walgreens—if they had insurance. Instead, they were jamming a fantastically expensive critical-care facility, because that's the only place they could get free treatment. They're still going there.
So here's my advice to everyone who hates the idea of paying for universal coverage: Support it for your own protection. Demand that your representative vote for it because, in your hour of pain and need, you want the hapless, the homeless and the children of immigrants out of your way.
Because sooner or later, you will have to go to the ER. You don't want it to be the one my brother went to.
