The American Health Care System

I've been on vacation and haven't had time to blog, but before I forget, and while it is topical, I want to write a post about my family's experiences with the American health care system.

I'll begin with my mother's experiences. When we first moved to Colorado in 1975, my parents were impressed with American hospitals - they are far superior to anything in the Middle East. Our health insurance was paid for by the Iraqi government, since my dad was on a government-sponsored scholarship. Our family was cared for by the excellent doctors at Lutheran Medical Center in Wheat Ridge, where my mother was warned early on that her diet would result in adult onset (Type II) diabetes. Her doctor referred her to a staff dietitian, who put her on a diet that saved her from diabetes. She is still grateful to that doctor at Lutheran.

In 1980 we returned to Iraq, where health care is a joke. In 1982 we fled the tyranny of Saddam's regime and returned to Colorado. This time we were not insured and my parents were jobless. Unfortunately my mother was not in good health. She had been suffering from dysfunctional uterine bleeding. She visited Denver General Hospital, but was refused treatment because she was not insured. As her condition worsened and the bleeding became more severe, my father's friend, a doctor in Texas, offered to perform a hysterectomy without charge. We moved to Texas, the hysterectomy was performed, and my mother became healthy again. We were very lucky to have such a friend. We moved back to Colorado in 1984, when my father found a job and again we had health insurance.

During her last years living in Colorado in the late 1990s, my mother often felt she had no energy and she had difficulty swallowing food. By that time we were covered by Kaiser Permanente. She visited her doctor, who examined her mouth and throat and concluded nothing was wrong with her. In 2000 she moved to the UK and joined my father, who began working in London the previous year. By this time her condition worsened to the point where dark spots began appearing inside her mouth, and swallowing food became nearly impossible. Within days of moving to London she visited an NHS GP (General Practitioner), who immediately referred her to St. Mary's Hospital. It took weeks, but the doctors at St. Mary's were determined to diagnose the cause of my mother's illness, and they also used her case to teach medical students - St. Mary's is also a teaching hospital. After several blood tests, St. Mary's doctors determined that my mother was suffering from a severe deficiency of vitamin B12. They immediately placed her on a regiment of two B12 injections per week. After the second injection, the dark spots in her mouth disappeared. She began feeling energy she hadn't felt in years. She was so happy she felt compelled to visit St. Mary's Hospital to thank the doctors for their hard work and determination. She told them what they had done was magic. They told her that she had been B12-deficient for years. She continues to receive an injection of B12 every three months, and she says she loves the NHS. She still lambastes Kaiser Colorado for failing to diagnose her B12 deficiency.

It sucks to be unemployed and diabetic in Los Angeles

Second, I'll summarize my brother's experiences with Kaiser and the American "health care" system. My brother was diagnosed with Type 1 diabetes at the age of 11. During his first years of diabetes my brother was cared for at the Barbara Davis Diabetes Center, which provides excellent (and free) care for diabetic children. At age 14 my brother was covered by my mother's health insurance through Kaiser Permanente. Unlike my sister, who also has Type 1 diabetes and controls her blood sugar quite well, my little brother is not very good at controlling his blood sugar. His blood sugar often rises to 200 and higher, which may lead to a variety of diseases. Before his Kaiser coverage expired at the age of 21, I suggested that my brother go to Kaiser and ask for an insulin pump, which responds directly to his blood sugar, making it much easier for him to regulate his blood sugar. My brother was seen by a Vietnamese American doctor named Dr. Pham at Kaiser in Long Beach, CA, in 1999. For some reason I cannot forget his name and his appearance - I noticed his shoes were quite old and worn out. I wondered if he could not afford some nicer newer shoes, and thought maybe he was not well paid. Dr. Pham told us that my brother was not eligible for an insulin pump, because basically he wasn't near death yet. His condition has to be really bad - kidney failure or blindness - in order for Kaiser to pay for an insulin pump. I was surprised to hear this from a doctor at an American hospital. After that meeting my brother and I nicknamed him "Dr. Scam" but we knew that he was just doing his job as a cost-saving employee of Kaiser Permanente and not a real doctor.

After getting married, my brother found a job in the real estate business in 2002. Even with his job's health care plan, he had to pay around $400 per month out of pocket to cover himself and his wife and daughter, and that did not include dental coverage. In 2007 my brother became unemployed. He goes through a bottle of NPH and a bottle of regular insulin every month. Each costs $40 at Rite Aid. I have paid for many bottles of insulin since he became unemployed. One month last year he ran out of insulin, had no cash, and was unable to reach me, as I was traveling for work. He walked into Silverlake Medical Center (a private hospital in LA) and told the receptionist and nurse he was unemployed, diabetic, and was completely out of insulin. They asked him if he has health insurance. He said no. They said sorry. The next day I had to scold him for waiting until he was out of insulin before telling me. He said he was too embarrassed to tell me.

MRI is too expensive for a profitable "health care" provider

The last case I'll write about here is an example of the worst of America's health care system. In 1995 a good friend of ours named Sa3ad, an educated (PhD) Iraqi American, one of the kindest people I've met, married a beautiful woman in Iraq and brought her to Colorado. She resembled Uma Thurman. About a year after their marriage, she began experiencing severe migraines. She visited her doctor (I believe they were covered by Kaiser, but I'm not certain), who prescribed some kind of pain killer. The migraines continued, and after a few weeks she returned to the hospital, where she was told that her migraines were a result of psychiatric problems! A few weeks after that, Sa3ad noticed she was slurring her speech and immediately took her to the doctor, who finally ordered an MRI and discovered two large tumors in her brain. Surgery was performed, and a large portion of her brain was removed. I was amazed to see her walking and talking normally a few weeks after surgery. The tumors, however, had spread to other parts of her brain. More surgery was performed, but it was too late. Sa3ad's wife died.

After Kaiser California denied my brother an insulin pump in Long Beach, I realized that there is a conflict of interest in what Kaiser does. Companies should not be allowed to provide health insurance and "health care" at the same time. It's in the financial interest of an insurance company to minimize its expenses, and evidently Kaiser is more an insurance company than a health care provider.

The American health care system is wonderful for the rich, but for the middle class it is in general mediocre, for those insured by Kaiser and other for-profit companies it is risky, and for the poor it does not exist.