"But in America if you don't have money, you can't get on a ventilator."
I feel my shoulders stiffen, the hairs stand up on my spine, and I'm ready to fight. Not debate. I'm quite tired of this constant bullshit view of American healthcare, which includes among other things: Money=care. No money=no care.
The neonatologist who is giving us a tutorial on Ethics, is apparently, quite respected around here for her ethical views. We'd be discussing the Shiavo case (painful, didn't we hash this out at the time) and I must say I'm quite aghast at some of the views being expressed in the room. We move past Shiavo and she is talking about different access to health care goods in different countries, when she makes the gross statement above; which almost made me fall off my seat.
I raise my hand. In protest. And I voice my protest at this statement. And I'm quite pissed actually. I've seen so many babies and children denied the right to be ventilated here in SA because there are no vents available, that to make such a statement pisses me off. I've never seen somebody denied being placed on a ventilator for reasons of no vent available in the US, or because the person couldn't pay. And mind you, I've been in health care for a while now.
And so I say that, this simply isn't true. Somebody wouldn't be denied the right to be placed on a vent because they couldn't pay. To which, she replies, "I've been to America, and I've seen this happen."
Yes, I'm sure. That's what we like to show foreigners when they come to America. Walking down 5th Avenue on a bright sunny day there is some homeless person gasping outside what ever hospital is on 5th avenue with a sign that reads "I can't breathe, and they won't vent me because I don't have money."
And now I kind of look like an ass. Because my tone isn't chill and calm, and I state my authority on the issue (being an American, having WORKED in AMERICA in healthcare for years, and knowing lots of doctors in other hospitals who have never mentioned this happening). I try to bring it back to an adult conversation, and explain that the way hospitals are reimbursed by medicare/medicaid means they can't really refuse care like this. But I get no where.
"Let's move on, I will recognize your objection." Oh yeah, I bet you wish you could have seen the look on my face then... As if I should just bow down, kiss her ass, and leave it at that. I'm not making an objection. I'm making a point.
A poor child who has AIDS will not get vented, here.
An poor adult who is a sub-optimal ICU candidate will not get vented, here.
I refuse to back down. Health care in America is far from perfect. I readily acknowledge this. But heaven forbid I am every really sick, please, please, please let me be in America. Where there are resources to help make me well. And if I don't have money... sure, I'll go bankrupt and be even more poor, but let me be somewhere where there are resources which I can get access to.
I'm thinking to the care we give back home. And I think, that in the hospital where I train back in the US, that we give excellent medical care to every patient, regardless of their socio-economic status. I won't bow down in this argument, and won't take a pacifying bullshit statement and let her continue her lecture.
"Excuse me," I say as she moved on to the next slide, "instead, let us agree to disagree." (A saying my college advisor taught us).
I keep quiet the rest of the lecture/debate, and observe the thoughts of my colleagues. I observe in slight horror.
