Tuesday, October 6, 2009

Noah's Story

Just then a man from the crowd shouted, “Teacher, I beg you to look at my son; he is my only child.”
Luke 9:38

The names are fictitious, but this is a true story about real people. And it unfolded over the past few days.

On Friday I got an email from my friend Jack, telling me that his son, Noah, was in the hospital. Noah is a young man in his mid-twenties. He has a form of autism and related disabilities, but he lives on his own with sporadic help from a social service agency. Noah receives Social Security Disability Insurance, but he does not have health insurance.

For several weeks Noah had been coughing, but he thought it was a seasonal allergy. Last Thursday he had swelling and pain in his left leg, just below the knee. He put ice on it and took Tylenol, but the pain got worse. On Friday morning, when he came back from the laundry room, he collapsed outside the door of his apartment. The building supervisor found him and called 911. The EMT’s came with an ambulance and brought him to Kent Hospital, in Warwick, Rhode Island.

Noah has blood clots in his lungs and legs. He could easily have died from the clots. But after two days in the Intensive Care Unit, he is recovering in a regular hospital room. After visiting with Noah on Monday afternoon, I met his dad in the hallway.

“I have to tell you,” said Jack, “this experience has taught me there is nothing wrong with our healthcare system. You can’t believe the care he has gotten. The people here have been incredible. And they knew from the beginning that Noah had no health insurance. There was no hesitation. They just took care of him. CAT scans and MRI’s. Blood test after blood test. And they sent some of his blood to the Mayo Clinic to test for a rare genetic disorder. They’ve been amazing.”

Noah still has a long way to go, but his story over the past few days has some lessons about the health care debate.

1. It begins with specific institutions and specific people. Kent is an excellent hospital, and within that excellent institution Noah encountered a series of dedicated and gifted professionals, who treated him with both caring and competence. That personal aspect cannot be overlooked.

2. Our health care system as a whole does well with emergencies. People with acute problems get the care they need, whether they have insurance or not.

3. At least in emergency situations, we already pay for universal health care. Kent may recover some of the costs from state and federal programs, or they may simply absorb them. In either case, those costs are ultimately paid by our society.

4. It’s quite possible that if Noah had been insured the costs would have been much less. If he had seen a physician for the persistent cough, the blood clots might have been discovered without two days in Intensive Care. But the lack of insurance made the cost of a doctor’s visit prohibitive. This is a case where universal health care might have saved money.

5. If Noah were a full time student, in college or graduate school, he would be covered by his father’s health insurance. Because of his disability, he did not go to college and was not eligible for that benefit. We need to provide health insurance for kids in college and we want kids to go to college, but this means that families like Jack and Noah’s subsidize families like mine.

Finally, I want to go back to Kent Hospital. I know that Kent (like many hospitals) has a major operating deficit, and since I know that, I am reasonably certain that the physicians who cared for Noah also know that. And they knew that when they ordered the scans and the tests, they were adding to that deficit. They did it anyway. And (apparently) they did it without hesitation.

Our health care system is in crisis. The costs are rising at an alarming rate. And those costs jeopardize our whole economy. But the problems are with the system and not with the people. At the center of the storm there are good people doing good work, for the good of everyone.

1 comment:

  1. I am "Noah's" mother.

    We, as a country, have highly skilled physicians most of whom have the intent of doing their level best for each patient, regardless of the financial circumstances ---at least on the emergency level. However, greed does taint the system and greed discriminates against almost everyone. Someone is accumulating wealth in this scenario. Follow the money.

    Noah used his savings from years of work to pay into COBRA after his job (for an insurance company) was eliminated. The money ran out and his work history prevented social assistance. He sent out resumes for two years trying to get a job with health benefits. He went from independent living with a good job and great benefits to subsidized housing with a disablility stipend and no health care coverage at all. He doesn't run to the ER with things like a cough or a sore leg and so he was brought there in an ambulance in a life threatening situation. The costs are enormous in every way.

    When I attended a health care forum in August it was to stand for health care security for all Americans and a strong public option. --And that was before my own son got sick; before his life depended on the willingness of good doctors to put aside thoughts of cost at whatever hospital he was taken to.

    Good Samaritans are most needed when we have first allowed theives free reign. Surely, we've got this backwards.