Line in the Sand, Part Two: the line is being crossed

Follow-up today from the patient with an abdominal mass, unable to afford care, despite the possibility of an untreated cancer (mentioned previously in Line in the Sand).

First of all, I find it interesting that, when I bring up the fact that I am writing a blog about our broken American health care system and the need for health care reform, patients like this express their willingness to allow me to write about them on the internet. I worry about confidentiality issues, but every patient I have mentioned it to has expressed gratitude that a doctor would take an interest in this way. It should be noted that I will continue to omit, and even modify, some information, to protect identities, and I won't mention the age or gender of any patient.

Anyway, this patient came back for a follow-up appointment. My nurse had inquired with a specialist in our organization about the possibility of offering a low-cost option for surgery. We were told that the patient would have to put down $10,000 before the procedure would be considered.

The patient, luckily bright and resourceful, made other plans. They called a previous physician, in another country (South America), and have arranged a medical vacation. Cost of the surgery plus a two-week hospital stay: $2,000. Cost of the rest of the trip (two months), all costs included: $1,200. So, a patient is forced to leave the country to get reasonably priced medical care! We hope for a positive outcome.

We can no longer tolerate this situation. People are suffering, not due to disease, but because of a health care structure that systematically denies care, rather than giving care. This is a humanitarian crisis playing out insidiously in front of our faces. How we address this is a test of our humanity, a test of our nation just as dire as any terror threat. We die inside, as a nation, when we allow people to suffer in this way, unnecessarily.