The pursuit of full American citizenship—life, liberty, and happiness begins and ends with our health and affordable quality health-care. In the language of Economics 101—the needs for health-care services are inelastic (meaning the needs for health-care services remain unchanged irrespective of price changes for services). On the other hand, demand for health-care services is elastic—in that, demand decreases when prices are increased. This is a stripped down version of how 50 million uninsured and 151 million under-insured Americans were generated.
Our health-care and financial markets have become socialistic cartels by and for rich and powerful Americans. They force poor and middle-class Americans to choose between food, housing, transportation, and health-care. As a direct result, the ranks of the homeless and bankrupt have swelled. The Banksters and Wall Street titans (college educated flimflam men, con-artists, and swindlers) get taxpayer funded welfare entitlement bailouts, and taxpayers get booted out of their foreclosed homes into homelessness. A neighbor of mine who lived across the street from me lost her home because she could not pay her health-care bills and mortgage too. As an American—this was very disheartening to witness. This is a reflection of the true republican brand of conservatism, patriotism, and hypocrisy in action. They have provided the unregulated health-care marketplaces and macro-economic foundation for extortion driven American patient-care and commerce. They have turned the American dream into a toxic medical and health-care nightmare.
Greed is not good, but true free market competition is very good for the democracy of fair pricing and distribution of health-care service resources. Considering our very costly stagnant monopoly public education system, and the fact that it provides substandard education—public government education has been, and is being helped by the introduction of real competition in the form of Charter and Private Schools. In the health-care industry’s case, which is heavy weighted with private sector unregulated monopolistically constrained markets, and is self-serving with regard to profiteering; providing quality health-care is not one of their consistent priorities. Our health-care system is a greed centric predatory system that preys on weak and elderly Americans who have health problems. Patients are never told upfront what medical procedures and tests will cost because they are so outrageous, and because of the collusions and conspiracies between Big Pharma, insurance companies, HMOs, and health-care corporations. Their pricing for medical services and pharmaceuticals are based on the dictates of monopoly power. A government option to compete with the non-competitive private USA health-care system is a critically needed fix to what is now a deadly and unsustainable money trap.
At the local level, health-care reformists are up against cartels of hospitals, alliances of doctors, and medical and pharmaceutical corporations. These cartels have been impacted very little by the recession. In Dayton, Ohio, two major hospital corporations have built 3 grand wings on 3 hospital campuses (Miami Valley Hospital, Good-Samaritan Hospital, and Sycamore Medical Center). Miami Valley Hospital built a whole new hospital campus in addition to the wing expansion at their older campus. To fund and recover their costs, they just raise their overhead costs and prices charged for medical services consumed by patients. Have you ever heard of or knew of any hospitals downsizing or closing? They are able to grow and expand irrespective of bad financial and economic times because of successful exploitation of needy sick Americans. This is capitalism and lack of democracy at their worst, and is the example the USA sets for the rest of the world and future generations. True democracy cannot exist in tandem with an unrestrained and unregulated market places because there are no safe guards or respect for health-care consumers. The marketplace is not free—when rich corporate power and rich powerful politicians control the means of production, control the Medias messages, and craft laws to align with their greedy ulterior motives.
They have a monopoly on an inelastic health-care need driven consumer base. Their captive consumer base is assured by population growth, baby boomers, and by the commercial marketplace—a marketplace that encourages excessive and irresponsible lifestyle habits. A government health-care competition option is a necessity to eliminate the current health-care monopoly that is hurting and killing Americans. Yes, some Americans are dying because of poor health-care choices concerning costs and service quality. It is obviously true to anyone who has personal experiences with USA private corporate style health-care—that doctors would choose the most costly medical procedures, most quantity of procedures, and most expensive technology based procedures. The exceptions to these rules are the doctors out there who are not motivated by greed and their own self-interest or ego. They are focused on providing the best possible health-care, and not on maximizing profits for themselves and shareholders.
Portrait of My Health-care History & Experience
I am 50, and my health has been a lifelong difficult challenge for me. When I was 2 1/2 years old; I almost die from Appendicitis because doctors could not figure out what was wrong with me until it was almost too late. Health-care diagnostics may not be any better today because of preoccupation with numbers of patients and profits. My vermiform appendix was surgically removed in just the nick of time.
When I was 12, my thyroid gland went bad, and it was partially removed surgically. There were problems with this surgery and surgeon, and I had to spend days in an Intensive Care Unit to be kept alive. After I had miraculously recovered, my parents and I decided to end our medical business relationship with Dr. Jerome Meyers. This was after he had me back in Good Samaritan Hospital to have another thyroid surgery at age 13. He had not informed my parents or me regarding his intention to operate on my thyroid gland a 2nd time. We were given the impression I was admitted to the hospital for evaluation and testing. This doctor also put radioactive chemicals into my body to illuminate my thyroid gland through my body tissue. Furthermore, he never communicated to me or my parents concerning the mutagenic and carcinogenic risks associated with these chemicals. We were not given the opportunity to provide informed consent. It is common practice today not to communicate the risks involved in radioactive medical diagnostics. My parents chose not to sue this surgeon, when they could have sued him and won.
The 1st thyroid surgery did not solve my health problem, so during my 13th year, I had to have another thyroid surgery. This time my thyroid and 2 ½ parathyroid glands were totally removed. The parathyroid glands are 4 pill size nodular glands that are embedded in the backside of the thyroid gland. Dr. Charles Fortson performed the 2nd surgery, and prior to surgery, he never communicated to my parents or me concerning totally removing my thyroid gland. After this surgery, he did not counsel me or recommend that I seek counseling regarding going through the rest of life without a thyroid gland. Nor did he express to us the possibility that my remaining parathyroid gland tissue may fail, and could be life threatening without replacement therapy. Total parathyroid glands failure did eventually occur, and the challenge to keep myself alive has grown. The thyroid is a 2 lobed gland that is located on the front of the trachea, and the parathyroid glands are 4 pill-sized glands embedded on the backside of the thyroid gland lobes.
Since that last surgery at age 13, I have had to take replacement therapy pharmaceuticals to replace natural thyroid hormone to keep myself alive. Also, it is necessary for me to flood my body with calcium and magnesium because I do not have the parathyroid hormone that regulates these elemental biological chemicals throughout the body. They both are essential to life support, and have presented me with a monumental joggling act since age 13 because my natural thyroid biochemical intelligence no longer exist. Also, oral intake of extra vitamin D is important to aid the proper metabolizing and adsorption of calcium. Replacement therapy is not a precise science, and the manmade pharmaceutical chemicals made for human consumption may cause biological damage in the long-run. This is true because the chemicals and binding agents and other chemicals are not naturally biochemical.
Earlier this year I almost died because my Blood Serum Calcium dropped down to 6 mg/100 mL, and my Endocrinologist Doctor informed me that we stop breathing and die when it drops down to 5 mg/100 mL (the normal range values are 8.5 to 11.5 mg/100 mL). This has been the most difficult year for keeping some of my elemental biological chemicals and minerals in the healthy life support ranges—because there is an interrelationship between them. When one is out of the normal range, it can have an adverse affect on others.
Within the past 2 years, I had a critical Vitamin D blood serum level problem. This Vitamin D problem was given rise by 2 doctors whose care I was under, and whose medical services were purchased and rendered. The involved doctors are Dr. Unkind and Dr. Busted. Dr. Unkind is an Endocrinology Specialist, and I was under his medical care because of thyroid and parathyroid gland problems. He also taught at a local medical arts college. I was under his medical care supervision from 2001 to 2005; and he started me on a prescription of Vitamin D 50,000 International Units by mouth daily. The prescription was increased to Vitamin D 50,000 I.U. 3 times per day (150,000 I.U. daily). He stated that I could take all 150,000 I.U. of Vitamin D at the same time because I would get the same result as I would by taking 50,000 I.U. 3 times a day.
Since Dr. Unkind is a Specialist, he recommended that I become a patient of Dr. Busted as my family doctor because he specializes in Internal Medicine. I was a patient of his in the 2005-2006 timeframe, and he kept me on the same prescription daily dosage of Vitamin D.
My Vitamin D blood level problem has developed because Vitamin D is fat-soluble (i.e., it stores or builds up in body tissue), and neither doctor monitored my Vitamin D blood level close enough. The USDA recommends a daily amount of Vitamin D for human consumption of 400 I.U., and at the high prescription doses they have had me on—it has accumulated in my body tissues.
January 12, 2009 was when my blood was tested last, and the Vitamin D level measured 116.0 ng/mL (the normal range is between 32.0 – 100.0 ng/mL). The highest out of range Vitamin D blood serum level measured value I have record of (report dated 6/11/2007) was 391.0 ng/mL. Both these tests were ordered by Dr. Busted, and the only blood lab test results I have from Dr. Unkind has a report date of 9/9/2005. This report shows no indication that Dr. Unkind requested that my Vitamin D blood level be tested – which was a peculiar oversight. The question I still have is whether they are generally this negligent with all their patients, or just with me because I’m African American?
In the June 11, 2007 timeframe, I asked Dr. Busted what the health consequence would be from having such a high level of Vitamin D stored in my body tissue. He stated that he was unsure, and would get that information for me. Well, he never did provide me with the information I requested. So, I did my own research, and found the following information:
1. Vitamin D and vitamin A are the most toxic of the fat-soluble vitamins. The symptoms of vitamin D toxicity are nausea, vomiting, pain in the joints, and loss of appetite. The patient may experience constipation alternating with diarrhea, or have tingling sensations in the mouth. A single dose of about 50 mg or greater is toxic for adults. The immediate effect of an overdose of vitamin D is abdominal cramps. Toxic doses of vitamin D taken over a prolonged period of time result in irreversible deposits of calcium crystals in the soft tissues of the body that may damage the heart, lungs, and kidneys. Vitamin D is stored in the body, and taking too much over a period of time can cause poisoning and even death. (http://www.drugs.com/cons/rocaltrol.html) Deposition of calcium and phosphate in the kidneys and other soft tissues can also be caused by excessive vitamin D levels. [Medical Encyclopedia: Vitamin Toxicity: Causes and symptoms] (http://www.answers.com/topic/vitamin-toxicity-causes-and-symptoms) [Dietary Supplement Fact Sheet: Vitamin D {Office of Dietary Supplements; National Institutes of Health}] (http://ods.od.nih.gov/factsheets/vitamind.asp#h8)
As a result of over prescribed and under monitored Vitamin D, I was placed at grave (walking time bomb) risk as excessive amounts of it accumulated in my body tissue. Currently I am under the medical care and supervision of another Internal Medicine Specialist, and I have been working with him to get my Vitamin D blood level down to within the normal range. To date, I have not had a catastrophic failure or damage to my liver, kidneys, heart, or lungs diagnosis. However, I have had some of the Vitamin D toxicity symptoms such as poor appetite, weight loss, headaches, fatigue, itching, higher blood pressure, arrhythmia, diarrhea, constipation, bone pains, nausea, and frequent urination.
Most of my experiences with doctors have not provided me with the best possible confidence in their commitment to providing health-care service excellence. In most cases, doctors don’t even remember they have a particular patient until they show-up for their next appointment. I have had doctors to have me to have tests done, and when I returned for the follow-up office visit, they did not remember requesting the tests. I have changed doctors a lot over the years trying to find doctors who have their patients’ best health-care interests at heart.
At the beginning of 2009, I consulted with a cardiologist, and he scheduled me for 3 tests. After pricing these tests through their billing department, I decided not to have them done. Their prices were ridiculously high. In the past month (near the end of 2009), I received 2 voice messages on my answering machine asking me to reschedule these tests. The female voice in this message stated that the prices for these tests have come down. Also, I received a notice through the US postal service requesting me to reschedule these tests. Their interest in me taking those tests has more to do with a recessionary slumping in their cardiac care business than with their concern for my health-care. If I had had serious cardiac problems, I would have been long dead when they decided to pursue me about taking those tests. As a side note, some of these diagnostic tests use radioactive scanners that shot into body tissue, and in other tests, patients are asked to ingest radioactive chemicals that radiate out through body tissue. These tests can be hazardous to healthy body tissue in the short or long run.
Earlier this year I researched the associated costs for a colonoscopy, and depending on the doctor I spoke with, and whether it was going to be done at a hospital or outpatient surgery clinic – the price ranged from $707 to $7,000. Other examples of ridiculous medical service costs I incurred in the past few years are as follows:
1. Office Consultation with a Cardiologist for 15 to 20 minutes – $266 (priced arbitrarily at their highest Level 5),
2. Office Consultation with a Digestive System Specialist 40 minutes – $253,
3. Office Consultation with an Internal Medicine Specialist 30 minutes – $306,
4. Office EKG by Cardiac Technician 10 minutes – $66.
5. Blood Libratory Work – $786.34 (for 8 separate tests)
6. Blood Libratory Work – $629.90 (for 5 separate tests)
7. Blood Libratory Work – $541.75 (for 5 separate tests)
8. 2 Biopsies – $1,306
9. Pathologist Services – $404.00 (for 2 minute tissue samples)
The average cost for a Blood Libratory Test (Direct Laboratory Services, Inc.) is $109, and the average AARP Health-care Options insurance reimbursement coverage is $15. This leaves me to pay an average of $94 out of pocket each time I have blood lab work done. I regularly have to have my blood tested, and blood tests are probably the most commonly prescribed medical procedure. Since AARP provides such a low insurance coverage amount—they obviously do not have the best interest of senior citizen’s as their prominent core customer service value.
The costs of procedures, tests, and doctors office appointments and consultations are never voluntarily disclosed. Also, hospitals and doctors out-source blood lab work, ultrasonic tests and evaluations, anesthesiologist services, and pathology tissue analyses. These are all costs incurred by unknowing patients—because they have not been itemized and priced out to each patient up front before services are rendered. If a patient is lucky, she or he will get all the detailed elements of costs they will incur for medical services rendered after their inquiry. The non-costs disclosure practice should be illegal, and is un-American. Most doctors and hospitals are on par with the corruption of bankers and Wall Street brokers. Republicans and others want to maintain this system of monumental chaos and mega bucks of inefficiencies. This is the status-quo—the repugnance party of no wants to maintain.
Of the 6 Digestive System doctors consulted concerning a colonoscopy and EGD procedure—only one of them was concerned about my blood serum calcium level being too low. This doctor informed me that I would need to get my blood serum calcium level up before she would perform a colonoscopy on me. Another of these doctors had scheduled me for this procedure, and for an exploratory EGD/biopsy to determine if there are any tissue calcium absorption issues or lesions problems. After I thought this over, I contacted this doctor’s office, and informed his team nurse that I did not want an exploratory EGD biopsy. She then got an attitude, and stated, “There is no reason to go into doing the EGD”. She said she would inform the doctor of my decision and get back to me. She called back and left a voice message stating, “The doctor would discuss this decision with me the day of the procedures”. I ended doing business with this doctor.
I had my 1st colonoscopy and EGD October 13, 2009 with another doctor. These procedures took about an hour, and near the end of the colonoscopy, I was asked to look at a monitor. The colonoscope was still in my colon, and I could see the inside of it and blood being flushed out after a polyp had been clipped off. This was a strange twilight Disney fusion effect.
Since I had been significantly sedated, I had given permission for the doctor and nurses to share details of the procedures’ outcomes with the person who accompanied me. The only thing the doctor and nurses communicated to this person was that everything went well, and I looked ok inside. They had put a post-op instruction sheet and prescription (for 1 Carafate 1 gm Tablet per day) in a folder I brought with me. It was disappointing that this prescription was not emphasized to the person who accompanied me. It would have been helpful to know about this prescription sooner, and to have been informed pertaining to its remedial use. This hospital could have provided this medicine from their own pharmacy, or they could have recommended that I stop by their pharmacy before leaving the hospital to get it. Also, it would have been nice for this doctor to emphasize making an appointment for a free follow-up office visit.
I had to contact the involved doctor’s office December 11, 2009 to request a copy of the post procedures’ report. This was over a month after the procedures, and this report had significant information, which should have been communicated sooner. There was the EGD biopsy sample that was taken, a gastritis condition noted, a stomach reflux condition noted, and internal hemorrhoids spotted. The medicine was primarily needed to help heal the internal sore spots caused by taking biopsy samples, and to help cure the reflux problem. Also, the morning of having these procedures, during prep, I was asked to read over and sign a multi-page legal document. It would have been much better patient customer service to send such documents to a patient days ahead of time. This would give patients a fair chance to concentrate on them with a clear head. Asking a patient to sign legal documents after a day and night of procedure prep induced diarrhea is not in a patient’s best interest.
Unfortunately, this lack of focus on quality patient-care with regard to closing the communication and feedback loop, fair legal document presentation, and individual patient follow-up and closure—is state of the art health-care in America. Doctors don’t remember we exist until our next appointment, and forget us as soon as we leave their offices. This approach to customer service patient-care cannot possibly be in the best interest of patients and national health-care.
Additional Health-care Experiences and Observations
The day my mother gave birth to my brother, her doctor was called in from a party, and he was not happy about it. Miami Valley Hospital was where mother was about to give brother birth. I was 1.5 years of age at the time, and in a quarantine unit at Miami Valley Hospital. My doctor had diagnosed my appendicitis as being tuberculosis until it was almost too late for me.
Mother’s obstetrician rushed my brother’s delivery, and broke brother’s arm because of his aggressive delivery approach. This doctor also injured my mother’s pelvis with his ruff method of delivering my brother. I believe mother and brother experienced disrespect, gross indignation, and physical injuries because of racism. My parents did not sue this obstetrician or hospital, when they could have sued them.
My mother had rotator cup surgery a few years ago at an Outpatient Surgery facility in Kettering, Ohio. She had had this surgery that morning, and they released her that evening to fend for herself. The next day she discovered she had a sore hot feeling in one of her legs. She tried to contact her doctor by telephone, and he was not available. So, she had to settle for explaining the situation and symptoms to his physician assistant. This assistant was not very concerned about mother’s condition, and instructed her just to take something for pain.
Mother’s 36 years of nursing assistant experience helped her realize she most likely had a blood clot problem that could be fatal. So, she then called her family doctor, and she instructed my mother to go to the nearest emergency-room. Following this instruction, she went to a local medical center emergency-room. There was a delay getting her examined, and getting her admitted and in a suitable room. These problems were resolved by the assertiveness of her 90-year-old friend Bones, and by other family members. She had blood clots, and was very lucky they had not killed her. Blood clots on the outside save you, and blood clots on the inside can cause damage and kill.
I once went to a doctor for an exam because I had concern pertaining to a feeling I had in my chest. My naiveté was high back then, and again I assumed this doctor would have my best interests at heart. After my appointment with him was over, I realized he was just another doctor practicing transaction volume medicine. He was too eager to give me a chest X-ray when the symptoms indicated an EKG or a recommendation to see a Cardiologist would have been more appropriate. This doctor also wanted to give me an experimental steroid shot, which I refused. It was my 1st and last appointment with this doctor.
Mother’s Care Giving
My mother was the primary caregiver, advocate, and medical power of attorney for Bones (a friend) and Bob (her brother). They are both deceased now; Bones died in his nineties and Bob in his eighties. This care giving lasted for about 10 years for both of them. I was in regular communication with her during this period, and sometimes I drove her to visit them. This involvement provided me with eye-opening and profound learning experiences. I learned that state Medicaid can come after your estate and other assets after you die to recover what they paid for your medical expenses.
I learned that senior citizens are more likely to be marginalized—particularly when interfacing with health-care service providers. They are likely to be overly tested diagnostically, and over medicated. Also, they are more likely to be abused psychologically, emotionally, and physically. Sometimes they are taken advantage of financially. Mother had to back off health-care providers from over medicating Bones and Bob on occasions. On one occasion, she showed up to visit Bones unexpectedly at a Kettering, Ohio Nursing Home, and caught a big bruiser male nurse being overly physical with Bones. He was trying to give him an injection of something. After being caught in the wrong, he hurried away. Not only was this individual unethical and immoral, he was also an ignorant coward.
Based on health-care providers I observed and information shared with me by mother, relative to Bones and Bob; these health-care providers seemed to be obsessed with giving them something for pain—even when they had none. Senior citizens are more likely depressed, and antidepressants would be more appropriate for their near end of life care. On rare occasions, Bones and Bob had been so heavily medicate, they were not lucid enough to communicate with mother or me. She was, for the most part, successful at preventing them from being over medicated. In the end, Hospice won out.
End of Life Involvement
Mother and I observed that we already have euthanasia health-care options, which are unofficial, covert, and probably illegal. Over medicating seniors like Bones and Bob is deleterious, and speeds up their health decline and deterioration. Hospice was brought up prematurely by nursing home and hospital staff as the best option for Bones and Bob as their health deteriorated from medication and laying around so much. The hospitals and nursing homes apparently have a collaborative relationship with hospice because hospice comes to hospitals and nursing homes. They are needlessly obsessed with pain relief too. Central to their public persona (as generated by public relations and promotions) is the notion of end of life comfort care. Seamlessly bundled with their end of life comfort care is medicating with hard and heavy narcotics. This is what Bones and Bob experienced without their informed consent; consequently, their hospice deaths were not with respect and dignity. As their medical power of attorney, mother was not given the opportunity to provide informed consent or opposition. Also, Advance health care directives, living wills, or advance end of life decisions did not come into play.
Hospice is brought into the discussion and patients’ care (based mainly on mother’s shared observations) after nursing staff at hospitals and nursing homes no longer want to care for a particular patient. In the cases of Bones and Bob, nursing staff emphasized to mother that they were not going to get any better. Nursing staff had Hospice personnel calling her at home, and meeting with her at the nursing homes. Essentially, they were doing sells pitches for Hospice-care. The sells songs they sung were how Hospice would take-care of all her love ones needs, and would even come to the nursing homes to give them baths. Mother agreed to bring Hospice-care on board with the hard-line stipulation that they not over medicate Bones and Bob. They placated her, and in reality ignored the stipulation. When called out on this transgression a charge nurse angrily stated, “Medicating is what we do”. In other words, adult end of life death services are what they do best with drugs.
Another example of this is when mother was requested to assist with the care giving of Madam X (her daughter’s mother-in-law). She was being taken care of at her home, and near the end of her life hospice was allowed to participate. On her last day of life, mother was there when the hospice nurse showed up. She observed this nurse put the narcotics in the refrigerator, and later on she observed her prep them for administering to Madam X.
My mother asked the nurse what the medicine was she was about to give Madam X, and the nurse gave her a euphemistical name. She then pressed this nurse, and the nurse admitted it was the narcotic opiate morphine. She administered it to Madam X by mouth or sublingually. At this point, mother knew Madam X was about to take her last breaths, and informed family members in the other room. They came into the room where Madam X was laying in bed—and while they were saying their goodbyes, she took her last breath and died. Afterwards, the nurse gathered up her things and the narcotics from the refrigerator, and hurried away. Mother’s 36 years of experience is the basis of her knowledge pertaining to the use of morphine just before patients would take their last breath and died.
End of Life Medication
Morphine an opiate is a main stay for pain therapy. It also eliminates the autonomic biological oxygen hunger response, therefore is commonly used in end of life medical-care. In other words, morphine relieves or suppresses a sense of air (oxygen) hunger—that leads to less breathing, oxygen deprivation, and to cardiac arrest and brain death. In the end, the involved patients lose their lives by drug induction, or a morphine overdose death.
Hospice-care organizations certainly provide end of life comfort-care in their lavish facilities, and no pain deaths with narcotics. Their approach is obviously much more comfortable than what death-row inmates’ experience. However, I question their right to decide when people take their last breath—absent an advance directive. Our 1st and last breathes are suppose to be God’s call not Hospice or Palliative care’s call. God’s pertinent statute in his 10 commandments states: “Thou shell not kill or take innocent life.” It is similar to when people take their dogs and cats to a veterinary to be put down or to death when they become old, infirmed, and are too much work and no fun anymore. There are certainly arguments from those people who want to be putdown or to death when they become terminally ill. This is where legal informed consent comes into play in the form of advance directives. Hospice and Palliative care businesses need to be held accountable to the law by providing informed consent—to their clients and their clients’ families. The public needs to be better informed concerning their end of life-care legal rights, legal remedies, and options.
The business model dilemma for hospitals and hospice is understood, in that, they have limited facility space, time, and staff; and terminally ill patients can linger on-and-on-and-on. The sooner a patient’s health-care transactions can be brought to a close; the better it is for business profits. So that room can be made for new patients. This is obviously connected with racking up charges for medications, nursing services, and general end of life care numbers and total dollars. I believe these end of life care business practices and model apply to palliative-care as well.
End-of-life-care (death-care, human-put-down-care, or euthanasia) has become more than a cottage industry, and came into being because it is bad for hospital business to have patients lingering in their inventory, and dieing on their property. Such patients are considered deadbeat inventory, and are transferred to euthanasia organizations who promise no pain death with dignity and heavy narcotics. The patients and their love ones never know what hit them until it’s forever too late because of their emotional states and exhaustion. The business model gravity is to encourage old and terminally ill patients to die as soon as possible. American end-of-life-care is not straightforward as is the Netherlands’ euthanasia public policies. Obfuscation, covert activities, and looking the other way while crimes against humanity are being committed—have become the American way of life and governance. Honesty has become an ugly foreign public and private refuge to be disposed of as soon as possible.
‘As Dr. Martensen alluded, most lay people have no idea that this is the consequence to their loved one in allowing a doctor or nurse to put them under euphemized and euthanasia end of life care. And he says it is much, much easier to hand over a family-member to an end of life care organization, than it is to take unconditional care of him or her for an extended period. He recommends that doctors have a discussion with their patients and their families about what is important for their last days. Furthermore, when people have a conversation with their doctor about what they want for themselves when they get close to death, the costs become lower as well. Dr. Robert Martensen has held positions teaching bioethics and medical history at Harvard Medical School and Tulane University in New Orleans. Over the course of his career, author, doctor, and bioethicist, Robert Martensen has treated an estimated 75,000 patients in the emergency room and the ICU. He is the author of the newly published A Life Worth Living: a Doctor's Reflections on Illness in a High-Tech Era.’
Real Death Panel Activity
A friend of mine was a surgery scrub nurse at a local hospital in Dayton, Ohio a few years ago, and she share with me details of an unsuccessful surgery. She was also a student studying to be a physician’s assistant at this hospital. She expressed that she participated in a surgery that involved an African American who was about 55 years of age, and the surgery was Tracheotomy related. Somehow, the doctor cut through a major artery in this mans neck, and this man bled-out and died.
She also state that after this mistake had been made, the doctor did not behave responsively or professionally to try to save this mans life. She said he froze up, and after this man died, this doctor had trouble looking her in the eyes. Behind the scenes, she became aware that this doctor oversaw his dead patient's body through the autopsy process. This patient’s death is not a reflection of the USA elderly citizen disposal industry, but, rather, is a reflection of the overt and covert public and private USA genocide against African American males.
The official pathologist’s autopsy designated that this man had an irregularly configured artery. Even if this could have been true, I do not understand why this doctor had not diagnosed this problem artery before surgery. Especially considering all the noninvasive and invasive diagnostic technologies and science that was available at the time. Essentially, this doctor operated blindly without having comprehensive information pertaining to his patient's anatomy, and the surgery ended tragically for his patient. This patient and my surgery scrub nurse friend are both African Americans. This doctor is Caucasian, probably suffered no consequences for his negligence and irresponsible behavior, and undoubtedly is still practicing medicine today.
When did you last hear about a hospital, a health insurance company, a pharmaceutical corporation, or a doctor being sued for malpractice or wrongdoing? It just does not happen very often because they are too big, rich, powerful, and privileged to be held accountable. The criminal executives and doctors are shielded and passed on to other hospitals, cities, and states (like catholic priests, bank executives, and Wall Street brokers). They are above the law, and rarely lose there professional licenses, are rarely prosecuted, and are rarely incarcerated.
Summary of Additional Health-care Experiences and Observations
Unfortunately, for our national health ranking in the world, what my mother and I experienced and observed over our lifetimes is state of the art USA health-care customer services. Health-care begins and ends with delivery or consumption of health-care services, and Americans (for the most part) are receiving substandard services per health-care dollar spent. This bleak reality is in stark contrast to the health-care systems in Japan, Netherlands, Germany, Sweden, and Singapore. You can research this for yourself. Sure, the republican corporate Medias and lobbyist have cherry picked the worst case scenarios in the world to frighten Americans away from reform. Theirs is a greed and politics as usual agenda—while Americans suffer and die from lack of quality affordable health-care. Wouldn’t it be great if someday we as Americans could factually express that the USA health-care system is among the most successful in the world in terms of cost-effectiveness and community and national health results. This would be health-care to cherish, and would inspire real patriotism.
In this most critical area of public national health-care, the unregulated free market enterprise health-care system has failed America. Obviously, America is a free market democracy, and there will away be a private health-care industry. The key element of reform President Obama needs to stand strong to deliver is an affordable public health-care option to compete with private predatory corporate health-care capitalism. He needs to be a man of his words, and keep the promises he made to Americans. This would not be a total government takeover of health-care, as big money republican fear-mongering pundits would have us to believe. Words for this political fear mongering are preposterousness, and gross disregard and disrespect for what is best for America and Americans. It is certainly not best for some Americans to be priced out of the health-care marketplaces. These Americans are unable to maintain their lifestyle and health, because health-care corporations, doctors, and HMOs are more concerned with maximizing their profits—than with delivering quality affordable patient health-care. They have perfected cherry picking and dumping lemons patient health-care. This is the savage reality of unchecked and unregulated capitalism in marketplaces constrained by the greedy and powerful narrow selfish interests.
The last example of American style health-care gone wrong occurred most recently—where I received a voicemail message, 2 weeks before my next appointment, stating that my outstanding endocrinologist has quit practicing medicine because of undisclosed medical reasons. He worked for a large area health-care corporation, and I was told by this medical practice to find another endocrinologist. They made no recommendations or referrals. Keep in mind that I was under their physician’s care and supervision for life-support thyroid hormone replacement therapy.
Conclusions
Some of the names of people, locations, businesses, and organizations have been left out of this essay and retrospective for personal legal and safety reasons. In other cases, the names of people, locations, businesses, and organizations have been changed for personal legal and safety reasons. This was necessary to protect the innocent and myself, and those whose permission was impossible to obtained.
Other Contributors to our national health-care crisis are insurance and pharmaceutical corporations. They are integral components of the cartel that drives health-care service prices ever higher because of excessive administrative costs and savage predatory capitalism. Another element of our current quagmire jigsaw puzzle health-care system is its links to Wall Street by way of shareholders and bondholders. Unregulated markets and capitalism, most often will error on the side of savage predatory capitalism. Currently, our financial markets, our capital markets, credit markets, and our health-care system and marketplaces are a reflection of unsustainable unregulated predatory capitalism. The last thing patients are informed about is the costs associated with medical services and procedures. It is worse than pulling wisdom-teeth to get hospitals and doctor’s offices to fully disclose the total costs patients will rack-up for their services. If you are a rich American, you can purchase some of the best health-care in the world, and if you are a poor to middleclass American, your health-care options are the emergency-room or morgue.
The current health-care system is unsustainable due to the lack of cost control regulations, rampant greed, and the exploitation of sick Americans for profit. Mega pharmaceutical corporations, hospital corporations, and insurance corporations collude to overcharge health challenged Americans. The collusion and conspiracy between insurance companies, HMOs, and health-care corporations create extra layers of unnecessary costs for American patients. Americans are force (because of unreasonable costs) to forgo health-care altogether, skip or stop taking prescribed medicines, and in some cases—to accept death as their only alternative. This is an epic tragedy for America’s present and future global moral and ethical success and world standing. Also, this tragedy is on par with the historical state and nationally sanctioned exploitation and murder of Native Americans, Africans, and African Americans. It is also on par with the Civil War.
ProPublica compiled thousands of records to track the financial ties between doctors and drug companies. See these ProPublica.org articles: “Docs on Pharma Payroll Have Blemished Records, Limited Credentials” [(www.propublica.org/article/dollars-to-doctors-physician-disciplinary-records) and “Dollars for Docs: What Drug Companies are Paying Your Doctor” (www.propublica.org/topic/dollars-for-doctors)]. Doctor’s are on the payrolls of pharmaceutical corporations as they travel and lecture to help them market and promote their over priced brand named products. These doctors are being paid 100’s of thousands of dollars on top of their private practice salaries by Big Pharma. Big Pharma pushing of their drugs at extreme prices for the most critical need patients—is immoral and unethical. This is so because patients can’t afford these drugs, and are force to make life and death decisions to go without their medicines. Some of them are dying. In reality, MD’s and Big Pharma are worst criminals than drug pushers because there are suppose to be about saving and preserving lives. Another pejorative issue is unaffordable health insurance.
What we have is not really a national health-care system; it is really a corporate profit-care system. An overall health-care delivery quality control system is urgently needed because just like public education, the quality of health-care delivery varies from state-to-state, county-to-county, city-to-city, and township-to-township. This health-care delivery quality control system will need to be composed of real marketplace competition starting with a government option, price control regulations, best practice procedure regulations, and overall health-care system oversight.
The problem with our health-care system is in essence a crisis of leadership similar to the corrupt leadership that gave us the current global economy recession. The victims are the same, and their qualities of American life, again, are negatively impacted. With the recession, these Americans have lost their homes, cars, jobs, pensions and retirements; future security; and with health-care deprivation—they have lost insurance coverage, peace of mind, their homes, their sound health, and in some cases their lives. Thanks to republicans, people who have been harmed by medical malpractices have been severely constrained by limited access to legal remedies. Caps have been place on legally claimable damages, statutes of limitation have been shortened, and court benches have been stacked (George Bush Texas style) with anti-consumer crony capitalistic free-marketers.
This essay, presented real life examples that illustrate the problems and complexities of America’s health care system, and argue that safeguarding the quality of a patient's end of life care hinges on inform consent and medical or advance directive decisions that also determine whether Hospice or Palliative services will be used. Too often, profit motivation and greed are given priority over the Hippocratic Oath, integrity, and bioethics. Just considering mine and my mother’s personal health-care histories, and those of her friends Bones, Madam X, and her brother Bob, it is distinctly clear that our health-care system is a national and international embarrassment. It is greed run-a-muck, and is a tragic mockery of democracy. How can we be proud patriotic Americans while our health-care system is not the best and fairest to all American citizens?
Health-care is where the best of American style humanity should be exhibited instead of inhumanity. Patients are considered to be numbers (profit goals, patient load quotas, a conglomeration of clinical lab cells), and in most patient/doctor relationships—consideration for total engagement and compassion are tertiary at best. We may have the best technology in the world, and some of the best-trained doctors in the world, but these advantages are being misappropriated by doctors who are too self-important to consider patients as equal human-beings. The best interest of patients and America’s health-care system are not being served. Patients deserve to be treated with the utmost dignity and respect at their difficult times of health crises and need. Besides the healthiness of Americans being at stake, the very character, heart, and soul of who we are as a nation on the world stage is also at stake.
Furthermore, technologies should not be employed for technologies sake, and for exploiting and extorting excessive profits out of each and every patient. Most of the Doctors, hospital administrators, pharmaceutical industry executives, health insurers, and their lobbyist love money more than they love humanity and providing the best quality health-care in the world. This approach to health-care is inhumane, unethical, immoral, and has no place in the world’s riches economy and most powerful nation. Perhaps artists are needed in our national health-care equation in order to incorporate caring hearted creative people. Above all else, American people with illnesses and senior citizens are not refugees, debris, or marks to be exploited for excessive profits. To all those health-care, health insurance, and pharmaceutical industry professionals who deliver customer services with the utmost integrity and commitment to excellence in caring for patients—as an American, you have my profound apology that you have to work in the current corrupt health-care marketplace and industries.
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