Monday, September 15, 2008

a mild health care rant

Health care seems appropriate to rant about while I'm waiting for this season's first episode of House MD to download, alas, my guilty pleasures, medical dramas.

Anyway, I have this client, well, a lot of client's actually who have issues in our health care system, sort of like how, well, they have issues in our social and societal systems. A typical story might be something like this. It's time for a story, so imagine for me now, the following.

You are a person in your early sixties, life has been hard, and you have been broken in many ways. Your addictions are very encompassing, and you have very little social or family support. You get sick, but just keep trying to drink away the sick feeling, you're old, you're tired, who cares. Eventually, you're found passed out drunk somewhere and wind up in the emergency room where they tell you, you have - insert infection/condition here- and give you a prescription, and tell you to get some rest.

See but here's the thing. You never wind up filling your prescription, or you do, but you lose it. Or you go to the pharmacy, but find out your welfare benefits have been cut off, or you drop it off, but forget to pick it up, and then forget which pharmacy you brought it to in the first place. Oops. And so you stay sick. And it gets worse, and worse. You wind up at the hospital three times in two days, clogging up the emergency room and frustrating the medical staff. You're not sick enough to be admitted, if you would take your pills and get some rest, but the thing is, you're not going to do that. It's hard to find rest when you're kicked out of the shelter, so you wind up drinking, and spending the night in the drunk tank.

The people in the drunk tank are quite worried about you, and you tell them that you just want to die, that living like this isn't worth it. You've had it. Everything hurts, and you can't breath. And so, seeing as you're in obvious -pain, trouble, unable to breath - they call an ambulance to take you BACK to the hospital.

See where the problem is? The problem is not with the health care system itself necessarily, but on the after care and followup. How much money could be saved if there was a way to get people to take their medications. How much money could be saved if there was a safe, clean place for them to sleep. How much more still, if we invested money in the prevention of homelessness/addiction in the first place!


Anonymous said...

I would really love to meet you... I've been lurking for a while now because I too want to save the world... but am burning out... or should say am burnt out. I'm trying to re-kindle my flame so to say... Who are you...???

Caroline said...

Lordy - the merry go round goes on and you run round it trying to hand out sticking plasters. It's demoralising, frustrating and disheartening. We can all see the problems but it's like trying to change direction in an Ocean going liner, not simple or instantaneous.All we can do is do what we can with a system that is fatally flawed - because if we stop trying...then what?

Hilary said...

I TOTALLY agree with this post...I get soo frustrated when dealing with clients who legitimately want to maintain stability, but have no transportation to the pharmacy, or don't have the benefits to pay for very expensive meds....I believe that if we could boost follow-up/insurance/etc., then we would have less people who have to repeatedly use hospitals, psych hospitals and jails as their only treatment...