A Fib: This is personal, almost.
May 31, 2009: Five-thirty in the 95-degree heat of a Palm Springs late afternoon. I’d just gotten out of my air-conditioned car, crossed the supermarket parking lot and entered the cool of the store when I began to feel a slight fluttering between my breastbone and the bottom of my neck. I began to sweat, even though my skin was cold. I knew this couldn’t be a good thing.
But then, raspberries were my favorite fruit of all, and they were on sale. So, regardless that I began feeling slight notions of unwell, inklings toward mild nausea, discomfort at the back of the jaw and some lightheadedness, regardless that I felt hot while also cold, I continued on, concluding my purchase. I then got back in my car, took the groceries home, put them in the refrigerator, then called the VA medical center to confirm that in a life or death emergency I could repair to any nearby hospital, or call 911 and have EMTs transport me to the nearest medical facility, and the VA would pay the tab.
After I had parked my car in a “visitors/patients” space, while maintaining my characteristic smart-ass smirk and wisecracking banter, I sauntered up to the ER desk in the sprawling Eisenhower Medical Center in Rancho Mirage.* I presented my VA identification card, explained my symptoms, and before I knew it I was wheeled into an exam room for an ECG (electrocardiogram).
Upon review of the scroll, the physician in attendance asked whether I had a history of irregular heart-rate problems. “Nope.”
“Well, you do now.”
I was having an atria fibrillation episode; otherwise known as “A-Fib.” It’s a case where, as opposed to the typical lub-dub heart beat, the upper chambers of the heart palpate rapidly out of control, as many as 400-600 per minute. Episodes can last anywhere from a few moments to a couple days. The heart’s normal rhythm can “convert” back on its own, or it can require pharmacological intervention. Extreme cases can result in the shock paddles; “Ready everyone? Clear.” Ka-BWAM!! The danger with A-Fib is that the heart will throw a clot . . . Stroke; and not one of good luck.
I was lucky. On so many counts. Following three hours of a Cardezem I-V drip, my heart rate converted, and, with the admonition that I consult with a VA cardiologist within the next few days, I was discharged. Feeling well and free. And lucky as hell.
Lucky because I was in the vicinity of one of the country’s truly great medical centers. The cardiologist who treated this walk-in was Dr. Euthym Kontaxis, one of the most highly respected in the region, if not the US. Next, I was lucky because I had the VA to fully pick up the tab. Not a dime from my pocket. And I was lucky because I was able to live, to continue breathing the cool night air, to go on living my life, because I had access to all the other elements of good fortune.
And ya know — THESE are the points I want to stress.
Point One. Nowhere in any part of my soul resides a notion that my life is more important than anyone else’s, or that anyone’s life is more important than anyone else’s. Through the VA I enjoy pretty good healthcare benefits. Within the next day or so, I’ll consult with a cardiologist, for follow-up of my heart condition. And I’ll receive whatever pharmacological products seem efficacious. But what if I had been, say, a non-Medicare subscribing grandparent in a lower economic strata, who had accepted the burden of raising grandchildren, and who had suffered the very same A-Fib, or some other distress? But rather than knowing the VA would back up whatever costs might be incurred, what if I suspected or knew there would be no backup, only dunning, perhaps wage garnishment, if I was unable to pay? And what if, given such suspicions or knowledge, I had decided to defer seeking the immediate emergency treatment, and risked a stroke? A stroke, or something equally as serious . . . all because of the absence of affordable healthcare! Who will dare suggest there inheres anything the least morally defendable in that scenario? Who?
Point Two. The most current estimates state that some number slightly shy of 50,000,000 Americans — one out of six — have zero healthcare coverage. (In Texas, it’s one in four! http://www.washingtonpost.com/wp-dyn/content/article/2009/05/29/AR2009052901548.html?wpisrc=newsletter&wpisrc=newsletter&wpisrc=newsletter)
My guess is that, with the recent collapse of GM and Chrysler (more about them in a moment), the number of uninsured is, or soon will be, considerably higher. The drain that places on everyone else is astronomical. Only the fools among us can pretend they are not paying the tab in dollars and in loss of production.
Point Three. GM collapsed yesterday; June 1. When it fell, the staid American fixture in the Dow-Jones 30 Industrials was unceremoniously booted out. However, while the sad suggestion that the United States doesn’t actually make anything anymore is tragedy sufficient unto itself, that’s not a primary component of this epistle. Among the many reasons GM fell, and among those that led to Chrysler’s demise, and among those that plague every American employer who provides part or all its employees’ healthcare coverage, is the truth of the employer’s burden that makes it noncompetitive with its foreign counterparts. NO EMPLOYER can carry that added $3,000 to $15,000 (for a family) annual load and hope to remain in business.
The down and dirty: Under the current paradigm you’re either at risk of losing your healthcare protection, or your job! It won’t matter what wizardry President Obama can work. If the healthcare scheme in the US is not dramatically amended, the economic spiral will continue its downward trajectory. Continued recession is not the concern with which we ought to be primarily concerned. Depression is.
But the answer to the problem is not some tweaking of what we have now - the employer paid, for-profit private insurance system, even if it is expanded to include all Americans, without regard for the demographic factors of age, gender, or present or prior health. Private for-profit insurance bogs the issue down, which should be the delivery of healthcare, with an average administrative cost of 30 percent. Add to that whatever profit margin the carrier can earn, and that means somewhere around 40 cents or more of every premium dollar buys not one cent of care.