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Edited on Mon Nov-16-09 11:06 PM by nadinbrzezinski
twenty years ago as a medic I was told by patients, that they did not want the care. WHY? They had no insurance/ their insurance would not cover it.
In a few cases we went for the EMS form and had them sign the Against Medical Advise and hoped they would not be worst for it and every time I felt like crap. Didn't care if they were Mexican or American I felt I failed them. More than once I fought the good fight and managed to get these patients into an ER... most were treated and released and never handed a bill. Some were American. So watching a woman with stage four cancer that has not seen a doctor hurts, but is not shocking, not to me. Been there done that.
Seeing another with hypertension that could lead to a lethal stroke within a month, again not shocking.
Diabetics... you kid me? Our daily bread almost.
I've posted the stories here. What we are seeing in our TVs has been there, right under the surface, for many years. It is a festering problem that gets worst and worst and worst every year.
My favorite of these cases was the 19 year old who was in a crash. When we arrived on scene he was rubbing his neck... usually NOT a good thing. By protocol he should have been on backboard and in the back of my rig within ten minutes, on the way to the hospital. We "wasted" most of the golden hour (the ideal time to get trauma patients to the hospital) arguing with him why he needed to see a doctor. Oh he had tingling in the tips of his fingers... and he was having a few issues with orientation by the time we got him to the rig. (One reason we transported) and swelling and tenderness on his neck. But you see he could not afford the damn ambulance, never mind I kept explaining to him that we did not charge. In the end we took him to the trauma bay, and yes his neck had a fracture... damn lucky that it never did move... his cord was swelling up (see that tingling) and he had a bad concussion. But he could not afford the ambulance, he did not have insurance.
We called parents, and they were more or less hysterical when they got to the Red Cross. It was not just the fact that their child, lets call him bob and not his real name either. was hurt. it was the... medical evacuation to come (and the cost) and the fact that they truly believed we were going to land them with a huge bill. It was that sense of desperation that you never forget... Well in the end he was evacuated. I called the damn county ahead of them, and told them that this was a county case... and they got some assistance. But that accident cost the family a LOT of money... and I could not imagine, and have been blessed over the years, to have to decide whether to pay for the rent this month or the ALS unit and other costs.
For the record we offered to do the transfer, but for many complex reasons there was a period when we were highly discouraged from doing that. At times I think it had more to do with squeezing blood from turnips. So we did the next best thing. We took him to the border and called 9.11 saving them the triple charge of an international evacuation. And that, among many other calls, made me a fighter for single payer. I saw way too many of those patients working in a border town. Oh and don't get me wrong, most of my patient load were Mexican Citizens who were in dire straits too. The working poor share much across borders... but at least I did not have to fight them to take them to the hospital because of the cost... and yes I will say it... most people expect that to happen in Mexico, but not in the United States. Oh and taking a public health elective I remember raising the issue back in the early 1990s. One of our class mates started going over how if they did not have the money they didn't deserve the care... right up there with right wing talking points. Lets just say I had to control my impulse to deck this guy.
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