Wednesday, September 05, 2012

September 5, 2012: No Other Name For It: Our National Disgrace

I saw an exchange on Facebook this morning about a much-publicized case from a year ago, about a homeless woman named Anna Brown. She died in jail immediately after refusing to leave a hospital emergency room near St. Louis, Missouri, where she had gone seeking treatment for a pain in her ankle. It turned out she had a case of deep-vein thrombosis. The blood clot in her lower leg  - which could have been identified by a  simple ultrasound test the hospital didn't give her - broke off, made its way to her lungs, and led to an agonizing, painful death on the floor of a jail cell. Then, she was taken back to that same emergency room, where she was pronounced dead.

The graphic video of her death was captured on a jail-cell security camera, and subsequently publicized by the St. Louis Post-Dispatch newspaper.

The video consists of four segments. First is from a hospital security camera, showing Ms. Brown on a gurney, awaiting transportation out of the hospital. Second is some footage from inside a police car, showing her complaining of pain and asking for a wheelchair that evidently isn't available, then the police officer and a jail employee carrying her from the car. Third is from a camera in her jail cell, showing her being carried into the cell, moaning in pain, then being left on the floor - right next to a bed the corrections officers didn't even lift her onto.  Fourth is a brief conversation, after her body had been removed, between the Richmond Heights, Missouri fire chief and a corrections officer, explaining that the reason the hospital staff had sent her to the jail was because they thought hers was a case of drug abuse.

No doubt, Anna Brown had a lot of problems. Her home was destroyed by a tornado, she lost her job in a fast-food restaurant and her two children were given over into their grandmother's care under the condition that Anna not live with them. It may well have been that she had some history of mental illness and/or drug abuse. Yet, the bottom line is that she was a human being, who presented herself at a hospital emergency room in pain, refused to leave after the hospital declined to treat her, and subsequently was physically carried to the floor of a jail cell where she died. Many have already commented on how her story is a case study of how our dysfunctional healthcare system fails the most vulnerable in our society.

Now, here's the greatest irony of all. The Richmond Heights, Missouri hospital that refused to treat Ms. Brown, St. Mary's Health Center, is a Roman Catholic institution, sponsored by the Franciscan Sisters of Mary. The mission statement on the hospital's web page reads as follows:

"Through our exceptional health care services,
we reveal the healing presence of God."

About the non-profit holding company that manages this and seven other hospitals, SSM Health Care - St. Louis, the website says:

"In accordance with the philosophy of the Franciscan Sisters of Mary,
we value the sacredness and dignity of each person.
Therefore, we find these five values consistent
with both our heritage and ministerial priorities:
Compassion, Respect, Excellence, Stewardship, Community."

This is not only a Roman Catholic hospital, but a Franciscan hospital. It's owned by one of the orders in the tradition of St. Francis and St. Clare, whose mission is specifically focused on sacrificial caring for what Jesus calls "the least of these."

Obviously, Ms. Brown's case is a massive failure of both the healthcare and the law-enforcement systems. Her death has touched off another round in the debate about single-payer national healthcare. It points out how the economics of our present system lead to sick people being neglected, even forcing religiously-based hospitals to join together in massive holding companies, like SSM Health Care, where they lose sight of their mission.

But, some will counter, a national health system would result in an even bigger conglomerate, where patients would be treated even less personally - wouldn't it?

Not true - at least not for the needy among us - as borne out by this testimony from a woman named Rebecca, who has personal experience living under Britain's National Health System. She shared it on Facebook, commenting on a posting by Jean, a minister friend of mine, about Ms. Brown's case:

There is very little overcrowding in the A&E (what the UK calls the ER) because people have regular access to a GP. From what I understand, a lot of the overcrowding in ERs is due to people going to the ER because by law they have to be seen, wheras a GP can turn you away if you do not have insurance. In the UK, everyone has insurance through the NHS - even an immigrant like me. The NHS, contrary to popular belief isn't solely funded through paycheque tax deductions. A Good portion is funded through sales tax (VAT in the UK), so everyone contributes something to it regardless of their employment status.

The NHS also has a service called the NHS Direct which can put you in touch with a nurse 24 hours a day to answer any questions you have. This nurse will then help you determine if you need to go to A&E, if it's safe to wait until morning to call your regular GP, or if you should make an appointment with the after hours/on call GP. All of this is done free of charge, inluding seeing a GP at 2 in the morning or speaking to a nurse at 5. When I was recently on holiday (vacation) in Wales, I needed to use the NHS direct service when I fell ill (got sick, sorry. My vocabulary has shifted largely to UK English!) and they were able to get me an appointment at a local GP.

I was diagnosed with Type 2 Diabetes this past March after having blood work done for something unrelated. Since then, I have had three further blood glucose tests, seen a diabetic specialist nurse, a dietician, a diabetic eye specialist, a podiatrist, and I have an appointment with a diabetic ob/gyn speciaist at the end of this month. Would any of this have happened if I were still in the US? Probably not, unless I had loads of money to pay for all the specialists. 

The NHS saved my father-in-law's life when he needed a kidney transplant 6 years ago and his kidney was donated by my mother-in-law. My husband's little brother had Leukaemia in the late 70s/early 80s. My in-laws would have been unable to pay for the level of care that he needed, but the NHS was there and his little brother beat cancer, but sadly died after contracting pnemonia due to his weakened immune system. My husband's grandmother was in hospital for 6 months before her death, and instead of being worried over who was going to pay the hospital bills, our family was able to celebrate her life. Grandad is still going strong at 95 thanks to his NHS care, which includes a carer who comes to his house daily to assist with dressing, bathing, and other daily functions he is unable to do for himself. By coming to his house it enables him to remain at home instead of a care home and has undoubtedly contributed to his longevity.

Oh, and if you're worried about not being seen right away because of the "long waits", you don't have to. The NHS operates on a priority system based on needs, not when you get put in the queue. You also can purchase US-style private insurance and see private doctors and specialists sooner if you really don't want to wait.

In the US, young women pay out anywhere from $20 to $60 per month for birth control. In the UK, birth control is free for all, including visitors. And if you do get pregnant, all your needs will get taken care of by the NHS and you will be assigned a midwife, who will visit you in your home after the baby is born for the first 6 months of its life to prevent the baby from picking up germs at the GP office.

Suffice it to say, I love the NHS.

Now, here's what my friend Jean writes, in response:

Thanks, Rebecca, for setting the record straight. I think most Americans have an irrational fear of socialized medicine based on hearsay and propaganda by our pharma/medical industrial complex. The truth is socialized medicine provides better care at lower cost. When people say we have the best health care system in the world they are really talking about the most advanced procedures that the vast majority of people in this country don't have access to or can't afford. There is absolutely no excuse for a woman with a blood clot to be forcibly removed from the ER because they will not do the medical test that would confirm her suspicion that she was seriously ill. That would never happen in a state with socialized medicine. I also believe we need to have a serious conversation about how we unnaturally prolong death long past the time tests have shown that treatment is futile. It is crazy how those who want to get medical care can't and those who have money can do whatever they want regardless of the cost/benefit. Now I'll be accused of promoting "death panels." I've told my children I don't want their inheritance wasted on prolonging my death if I have a terminal disease. I've held hands too many times with those who have gone down that road and it is not for me!

In all the frenzied political debate about so-called "socialized medicine," there are many falsehoods promulgated about the alleged poor quality of care in all the other advanced democracies - like the U.K., Canada, France, Germany and Japan - that offer government-funded universal healthcare to their citizens. Most are based on either unsubstantiated rumors or outright lies. Yet, only our system creates the abysmal constellation of unfavorable conditions that can lead a Franciscan hospital to turn away a poor woman of the very sort Francis of Assisi devoted his life to caring for, allowing her to die on the cold, concrete floor of a jail cell.