COMMENTARY The health care crisis becomes personal

I had the recent misfortune to fracture my right ankle, having a little too much fun on it. It has impacted my mobility, reduced my hours at work, and not least of all, cast me into the purgatory that is the contemporary health care system. I am additionally burdened by being one of the tens of millions of Americans without health insurance, a fact that has immediately and radically colored my hospital experience.

My initial intake wasn’t so bad, though the comrade who took me to the hospital was thoroughly appalled at the open-coughing, hurry-up-and-wait atmosphere at the nearest hospital to where I live. Actually, I’ve done a lot worse. I’ve spent much longer wait times in much greater pain, on a weekend night at the local federally-funded hospital while the shooting and stabbing victims kept jumping the triage line. Waiting two or three hours to see whether I’d get taken care of was a minimal expectation under the health care system as it’s existed for the entirety of my adult life.

The news, however, was bad: it was fractured, and I’d need a cast. However, the surprising part was that they weren’t going to cast it that day. They splinted it, with plaster strips and an ace bandage, and told me to come back Tuesday. I’d had the misfortune of damaging myself at the start of a holiday weekend, and there was only one orthopedist on premises.

So I returned the next Tuesday, and stood in line with my broken ankle. When I got to the desk, the first question was what insurance I have. Well, um, I don’t have health care insurance. As an alternative, I could pay $250, up front, for the appointment. I just shrugged-- I bring home $8 an hour from my job as a retail clerk. I never have that kind of extra money. Well, in that case, I was informed, it would take permission from an unnamed, unspecified ‘supervisor’ before the hospital could actually put a cast on my broken ankle. I sat and waited.

I waited 90 minutes, in the course of which I observed barely-controlled pandemonium at the nurses’ station in orthopedics. Twenty-two patients were waiting to be seen, and the co-receptionist had called in sick, so that one nurse with a splitting headache was left to sort through everyone’s insurance situations. Furthermore, the printer was taking 15-20 minutes to print the paperwork from each ‘print’ command. At some point, a “suit” showed up and demanded to know what the hold-up was. He left the lone receptionist muttering that she wished she’s get suspended from her job, because she couldn’t take much more of this.

I followed up with expressions of empathy for the fact that she was overwhelmed and in pain-- in fact, my situation didn’t differ that much. She in turn got back on the phone and got me my authorization, warning me that if I didn’t successfully get on ‘Emergency Medicaid,’ I would have to pay before any more appointments. Well, I reckoned, at least they’re not ‘rationing’ care around here!

My cast went on without incident, except I couldn’t have any pain medication stronger than ibuprofen, because I’m not insured. When I asked for one of those little cast-bootie things, I was told to use a sock. I’m not supposed to get my cast wet, but I have to wash the street grime off my toes every night. My ankle is healing apace, not least because I sprang the nearly $20 for these wonderful calcium-vitamin D supplements. As for the prescription, Advil was cheaper. Also, since I lost a whole shift at work, I’m getting enough sleep, though I’m not sure what I’m going to eat after I pay rent next month. It could have been worse-- I could have lost two shifts, but they worked with me. Unfortunately, working with me did not include offering me health care for my labor. Retail sales are radically down, you know, and in a very real sense, I'm lucky to be working at all... particularly with a disability.

Wiser folks than I have written that it is the duty of Communists to locate themselves at the heart of the struggles of the people, as they’re experienced in real time. Well, that’s unwittingly what I’ve done, as I’ve in effect thrown myself on the tender mercies of the contemporary American healthcare system, with a real need and no insurance. I suppose I should, according to some ‘reasoning’ in the current health care debate, rest assured that some ‘Washington bureaucrat’ isn’t ‘rationing’ my access to health care. After all, an overworked and harassed nursing-station receptionist and her threatening boss got me a cast, if not painkillers or a cast slipper, right? And that represents the 'best' health care system in the world, buddy! Indeed, I rest assured.

Specifically, I reassure myself that if I can’t get on ‘Emergency Medicaid’ (as if there’s any other kind), and so can’t pay for my next appointment, I can at least wait the six weeks and remove the cast myself. Actually, I’ll ask my boss, the nursing student, to do it with one of the power tools at work. Because that is the reality of American health care in 2009-- you might as well do it yourself, because the hospital administration may well deny you the care you need, unaccountably and without excuse or apology, if the insurance company doesn’t say ‘no’ first.

Frankly, I don’t see that theoretical 'government bureaucrat’ as much of a threat, from my admittedly subjective point of view. After all, they at least have a boss somewhere, whose job depends on the next election.