IF YOU WORK THE SYSTEM, THE SYSTEM WORKS

In the last post, I said I'd tell you about someone who found out the system isn't as broken as we might think. Here goes:

Several years ago, I had an acquaintance who had serious health problems, no education, no job, not much going for her. She was a severe diabetic and couldn't have held a steady job if she had found one. When she was feeling up to it, she cleaned motel rooms for minimum wage.

She would run out of her glucose monitoring strips, and out of insulin, and her blood sugar would rise to life-threatening levels. At that point, she would appear in the ED at the hospital where I work, and would usually go into ICU for a couple of days, then another week or so in general care. During the last phase, she would attend classes in our diabetic clinic and would be sent home with a supply of strips and insulin.

Since this hospital receives no government assistance, it does not provide ongoing free care. The care she was given during her admissions was not intended to be free, but she would be admitted nevertheless, because that's the law. She was ill, and could not be turned away. She was admitted, with the hospital knowing full well they would eat the bill. The end result of all this was a bill totaling over $200,000. She volunteered this information to me one day, so that's how I know.

I asked her if she had ever considered going to Parkland's free diabetic clinic. She replied that she called once, but they gave her an appointment about six months down the line, and she got sick and went to our hospital before that time arrived. She said she would like to get in the clinic, but just couldn't wait that long.

I suggested to her that she wait until she knew her sugar was rising, then pack a lunch and a good book and go to Parkland's ED. I told her she would have to wait, but it would be worth it, because that would put her on the fast track for their clinic. I could tell she wasn't buying it, so I dragged out some bigger guns. I told her that many hospitals were struggling financially because of unpaid bills like hers, and that if it continued, there might come a day when we would no longer be there for her! She said she'd think about it.

Well, just under a year later, I encountered her one day and she was just joyful, gave me a big hug and thanked me over and over. It seems she had followed my suggestion, and went to Parkland's ED one morning. She waited all day, but was finally seen in the late evening. They treated her rising sugar levels on the spot (not severe enough for hospitalization), gave her strips and insulin, and made an appointment for her for the next week with the diabetic clinic. Through the clinic, she was given strips and insulin as needed, she received laser surgery on her diabetes-damaged eyes which halted the advancing damage, her ulcerated feet were treated and healed, and she was put on medication to help her neuropathy. She had a hot-button number to call if she was in distress.

Naturally, she was just elated, and for the first time, had real hope. Because Parkland is tax-supported, they can offer these things. She just needed to position herself to receive them.

The point here is simple. Healthcare is available, if you do your part first. Someone just looking at her pre-Parkland situation might conclude that our health care system was letting this woman down, but that would not be true. It is true that she can't just waltz into a private endocrinologist's office at her convenience, and be given everything she needs, all the time, with no requirements on her. For that matter, neither can I. In order to do that, I have to do something first. I have to hold a job that provides insurance, or I must pay the premiums on private insurance. If I don't - or can't - do that, then I would need to go to Parkland. I am able to hold a job, so I have insurance. She was not able, so her responsibility was to play by the rules and make herself available to the Parkland system.

I'm sure there are people who, for whatever reason, don't fit in anywhere. Maybe their income is a little too high for one and a little too low for the other. I don't know, but I do know there are those who fall through the cracks. I believe it's in this area that some tweaking of the system is needed. Identify these folks, determine what the glitch is, and fix it.

Along with that, identify the wasteful spending and plug the leaks. These measures would, in my opinion, go a long way toward fixing our "broken" system. I really don't think it's broken nearly as badly as we're being told. Let's fix the obvious things first, and then we can see if it needs anything more.