Wednesday, January 29, 2014

On Flu Shots and Health "Care"

For anyone who believes there’s nothing amiss in the American health care system:

A five-year-old in Eugene receives a flu shot in September.  Three months later, his parents, who did not get flu shots, both come down with the flu.  When the boy becomes ill, nobody—not his parents, not his pediatrician, not a hospital Emergency Room—entertain the notion that he might have the flu. Because he got a flu shot.  Right?

I have never been on board with the whole “flu shot” song and dance.  Call me a die-hard skeptic, but it has always seemed suspicious to me that the media whip up an annual frenzy of influenza-phobia, which then give rise to those cute little TV commercials where sincere adults look meaningfully at the camera and pontificate about how being a good parent means you have to protect your family—everybody gets a flu shot! 

It seems to me that five or six years ago, flu shots were only recommended for “high risk” patients—the elderly, the chronically ill—and health care workers to whom these patients would be exposed.  Fast forward half a decade, and suddenly they’re doling out flu shots at Walmart and Target like Halloween candy.  The entire population is cajoled, frightened or guilted into lining up and sticking out their arms.  To get injected with a vial full of this miracle fluid…that may or may not prevent  them from getting the flu.  After all, any one vaccine can only cover three strains of flu.  Vaccine recipients are just as susceptible to any other strain as someone who never got a flu shot.  Add this to the fact that one is warned when one receives the vaccine that one might actually GET the flu from it, and I have to wonder exactly how stupid the American public can be. 

And who is making money off all this…

The drug companies, of course.       

But my opinion of the efficacy of flu shots is not really the point I wanted to communicate here.

The story of this little boy who dies of the flu has the parents, after being assured by their pediatrician that the boy has “the croup” (is that even a legitimate medical term in the 21st century?) rushing him to the ER because he’s having serious trouble breathing.  The hospital does a “soft-tissue x-ray” and “noticed that his airway is a little collapsed.”  They then proceed to tell the mother that this is “nothing too disconcerting” and send them home.  A few hours later, the boy collapses and basically dies on the floor of his home—or he would have died had CPR not eventually got his heart beating so they could take him to a hospital and put him on machines to support his now brain-dead little body.   

Am I the only person in the world who looks at this story and screams “Why in God’s name was a boy with a partially collapsed airway not admitted to the hospital?!?”  They sent this dangerously ill child home…why?

H1N1 didn’t kill this boy.  The hellish quagmire that is the American “health care” system did.

Over the last half of the 20th century, the health insurance industry began its ascendency into the ranks of international financial “players.”  The enormous sums of money that passed through its systems—client payments in, claim payments out—became too much of a temptation.  There was all that money coming in.  Why should they not restrict the ways in which it could go out again?  Why not keep more for the executives, the rich investors and the stock holders? 

So the insurance companies began to call the tune for medical treatment.  They began to actually form medical practice based upon the treatments that would or would not be covered by medical insurance.  It started out with the exclusion of “pre-existing conditions.”  Then they expanded to the exclusion of expensive treatments like brand name drugs and “experimental” procedures.  Treatment was no longer based upon what would produce the best outcome for the patient.    If it was expensive, the patient was not going to get it.

Since the insurance companies managed to get away with this with relatively little public outcry, they escalated to canceling benefits for clients diagnosed with cancer or other life-threatening illnesses, and refusing outright to insure people with medical histories that indicated they would be likely to need medical insurance sooner rather than...never.  Finally, a discontented rumbling could be heard in the ranks of the health-care-consuming public.   

Twenty years ago, the American people very nearly figured out what was going on.  Investigative reports were done, TV dramas were written, about the shame of an industry that literally let people die so the insurance companies could hold on to a buck.  Not so very long ago, there was outrage about this.  We were shocked.  We were incensed.  But somehow, in the interim, we simply…forgot.  Or were snookered into forgetfulness by an industry so rich, it had the financial chops to invest in the most monumental cover-up/misinformation campaign in the history of democracy.

This shameful perversion of “health care” has been going on for a generation, now.   There are doctors in the field who have practiced in this system all their professional lives.  They know no other way.  They don’t know that things used to be different.  And what was shocking and unacceptable fifteen or twenty years ago, has become…policy.

Policy.  Always push the least expensive treatment option.  Cost of treatment is the number one factor, given the greatest weight by any doctor, hospital or clinic.  Treat ‘em and street ‘em.  Give them a bottle of pills and send them home.  Most likely, they’ll recover.

More often than is in any way acceptable in the richest country on earth--they don’t.

I’m not sure what you have to do to be admitted to a hospital these days, besides DIE.  Or nearly die.  My brother-in-law was sent home from his local ER; two hours later, he nearly died of a heart attack in his living room recliner.  My husband was diagnosed with dangerous blood clots in his legs, and he was sent home with syringes full of heparin (powerful blood thinners) and told to shoot himself up twice a day and come back to the lab every other day for blood tests.  Thank god, he didn’t nearly die, but no thanks to Kaiser Permanente.  This little boy goes to the ER unable to breathe and they send him home…he dies.  He doesn't get a second chance. 

And everyone cries, “Oh, no!  He died of the flu!”

I’m willing to bet serious money that he would still be alive if he’d been in the hospital when he stopped breathing. 

Medical care in America took a serious wrong turn when we began to allow insurance companies to dictate treatment options.  This has been going on for so long, evidently, that we don’t even recognize it for what it is anymore.  How can anyone possibly pronounce our health “care” system vital, state of the art, or anything even approaching “the best in the world,” as right-wing opponents of the ACA continuously insist upon doing?  We don’t have health care in America.  We have a huge money-making, compassionless juggernaut that has little to do with "health," nothing to do with “care” and everything to do with profit.

The ACA is a start…not the best start, to be sure, but it is the first wobbly step in the right direction.  But things are not going to change significantly if we continue to refuse to recognize the problem.  Sure, it will probably take years of activism and concentrated efforts to control the insurance industry and take obscene profits out of medical treatment in order to get our health care system healthy again.

But how many more little boys have to die in their mothers’ arms before we resolve to engage this battle in earnest?