I work in a large urgent care group in the western suburbs. During each shift I take care of at least 1-2 patients without health insurance. Below are some vignettes that clearly illustrate the seriousness of our health care crisis:

I saw a patient about 18 months ago for bronchitis. I checked his digital snapshot on the computer as I do with each patent. As I looked over the page, it stated “abdominal aortic aneurysm” or triple A. I reviewed his CT scan results from three years ago and found that the lesion was about 3 inches in width. He has not had a CT scan since but he should have had a follow-up scan every year. A triple A this size requires surgery.

The aorta is the high pressure pipeline, the lifeline from the heart that brings oxygenated blood to the rest of the body. Weakening of a blood vessel wall from hardening of the arteries and/or hypertension can cause an abnormal out-pouching or aneurysm. A triple A is a potentially life-threatening condition after it gets to a certain size because it will rupture and a person will bleed to death. If it gets to a size of 2.2 inches in men it should be surgically repaired.

I asked him, “Why didn’t you get a follow-up visit and scan?” He uttered two words that said it all, “No insurance.” He had little money and was just going from paycheck to paycheck every month. When he didn’t work, he dipped into his savings, which were dwindling even before our present financial crisis. He had little money for gas for his older truck.

He said, “Doc, If I am lucky to get a job and if I can’t afford a CT scan every year, then how am I going to pay to get this thing fixed and be out of work for 2-3 months?” His question cut to the core of it all. I treated his bronchitis and asked him to do his best for follow-up, discussed the need for further testing. I reminded him of the ultimate danger weighing on his future. His death sentence.

Here are some other sad stories:

A good friend of mine buys health insurance for herself and family. For four healthy people they pay $12,000 with a 5,000 deductible.

Elderly patients come in with severe congestive heart failure. They stop taking their meds because they can’t afford them and are hospitalized for two days at a cost of about $8,000. They have to make a choice between eating, paying their bills and buying their medications.

My friend buys health insurance for his daughter for $250 a month. Her back is excluded as a pre-exisiting condition, and if she needs obstetrical care, then he will have to pay $350 a month. Then there are the other a la carte items such as vision, medications, dental care. How about the optional oil and lube for $19.95?

I saw a mother of three yesterday with uncontrolled asthma. She can’t afford a maintenance med that costs $205 a month because her health insurance won’t pay for it. She is thinking of going back to work for the health insurance but would have to work full time and will have to then pay for child care.

Our ability to provide health coverage to our citizens is the disgrace of the industrialized world. I am sick and tired of hearing these stories every day and watching while people try to figure out what tests and treatments they wish to “buy.” I cringe when patients ask for prices in order to make an informed decision about the financial aspects of their care. I feel like a waiter giving the day’s specials.

We need a mandated affordable health care system that will cover every American.

This is a desperate plea for change by a person who sees injustice with health care coverage every day. Providers in the public sector see even more glaring examples. If the congress and the president can provide a financial bailout, then they should be also provide a health care bailout.

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