Friday, August 28, 2009

Health Care Stories: Los Angeles, CA II

Glennis recounts the troubling tale of what happened to her son when he was a baby and wonders how it would've turned out if she'd had to worry about her insurance as well as her child's fate.

Mine is a story with a happy ending, but every time I hear about someone who is uninsured, or who has inadequate insurance, I think of how it could have ended up horribly wrong if I hadn't been so lucky. And it's not so much about having NO insurance. It's about the pressure of costs that forces you to make decisions based on so-called "free market" issues during times when you can easily make the wrong decision.

In the late '80s, my husband and I both were lucky, because we were public employees and had great health insurance. The kind of "gold-plated" plans you hear about.

When our son was 9 months old, he choked on a twig - actually a small bit of juniper, that had been tracked into our daycare provider's home on someone's shoe. Our daycare provider saved his life performing infant CPR and had him checked out by paramedics, who urged us to take him to our doctor.

In the next couple of weeks, our son developed a cough. Our daycare provider nagged us, but when we took him to our family practitioner, they said things like, "Oh, there's a cold going around," and it was winter, and yes, every kid had a cough, and that's how it went.

He kept having a cough. So we kept taking him in. Our daycare provider swore that the piece of twig that the paramedics got out of his lung was too small for him to pick up - so it must have been a bigger twig and part of it was still in him.

I took him to the doctor - maybe 5 - 6 times in two months, and finally our doctor scheduled us for a "forced exhalation" X-ray - she was reluctant to do this earlier because it is traumatic and painful and also exposes babies to X-rays. But between me being a pest and our daycare provider's nagging, she finally agreed. Also, to be fair, she was concerned. He had stopped gaining weight, he wasn't thriving, and at one point he was crawling on the floor and collapsed as if too weak to continue, frightening me.

They discovered that over half of one lung was completely blocked. They rushed him into surgery. They took a huge chunk of juniper out of his lung.

He is now a strapping 21-year-old, with no health problems.

But I had a "gold-plated" policy. I could afford to make an appointment once a week, even when the doctor thought I was being alarmist. My co-pay was only $10. I had a good doctor, who knew our son's history, who balanced between not over-treating and taking a frightened new mother's fears seriously.

I always think about this when I think about our healthcare dilemma. No matter how good a parent you are, you can't help but rationalize when you worry about cost. If I had had to worry about cost, I can't imagine what would have happened to my son.

Perhaps we would have discovered it later, when it was far more serious. Perhaps he would have been a sickly child with respiratory problems all his life. Perhaps he would have weakened and died. Instead, he lived for two months with one impaired lung, had two surgical procedures - all of which fill me with guilt, thinking of the two months of pain and suffering he must have gone through. But he is a healthy young man, now, thanks to a nagging daycare provider and a good health insurance policy.

I didn't have to nickel and dime. I didn't have to rationalize, "Oh, it's just a cough, it's winter, babies catch colds." I didn't have to worry about paying for each office visit when the doctor just advised "Wait and see". I didn't have to decide whether that $40, $60, $80, $100 should have been spent at the grocery store instead of at the doctor's office. I didn't have to argue with myself, my husband, my mother-in-law whether that office visit was money well-spent. I also didn't have to go to a random doctor at an acute care clinic or an emergency room, who didn't know his history and would have just advised me to "Wait and see."

Shitty insurance is just as bad as no insurance. You shouldn't have to decide whether you can afford to have your child go to the doctor. I was lucky. Another mother and child might have had a tragic ending to this story.

Los Angeles, CA

Check out Glennis' blog, Doves Today.


Sarah Alaoui said...

what a scary story :(

g said...

Thanks for posting this, William. I might also add - "thanks to a good health insurance policy won for me by my labor union."


phd in yogurtry said...

It's such a good feeling, when people who have "the best" of health insurance worry about those who have sub-optimum plans or none at all. Thanks for posting your story. And very glad for your son that he had such an attentive Mom.

kcinnova said...

I have felt the same way about my good health insurance. Those "what if" questions are scary indeed when I consider all those who are not as well-covered as my family.