Crime Scene

OBAMA'S proposal of nationalized health care in America is like yellow police tape swathing a crime scene. While preserving the crisis area, it excludes people gathering at the perimeter.

In the context of medical needs, the crowd pressing up against the issue is much more committed than simple curiosity; they are waiting for services which are unavailable because the state says so.

The idealism of creating equality in health care access is inherently opposed to the happy result proponents claim. An overwhelming success-buster really does come down to numbers:

"...Not even a carbon tax would pay for Obama's vast expanded welfare state. Nor will Midwest Democrats stand for a tax that would devastate their already crumbling region.

What is obviously required is entitlement reform, meaning Social Security and Medicare/Medicaid. That's where the real money is -- trillions saved that could not only fund hugely expensive health and education programs but also restore budgetary balance. Except that Obama has offered no real entitlement reform. His universal health care proposal would increase costs by perhaps $1 trillion. Medicare/Medicaid reform is supposed to decrease costs." (1)

Talk of 'community supported medicine' (2) likewise appears unsustainable. Americans don't like red tape. They really don't like being told what they can and can't do. And they will not tolerate waiting - for anything. However, on an issue as monumental as a radical transformation in American health care, the public response so far is hardly a hiccup.

Learning by example evidently is no longer reasonable and prudent. The European and Canadian standard of care stinks. They are loud about their frustration with interminably long waiting lists for unremarkable diagnostics like MRI's and elective procedures like hip replacements. There is no negotiation. The state has been allowed to dictate 'cost-effective' protocol for assessing what treatment options will be tolerated and which will be denied. You might be too young, or too old or too sick to warrant treatment. A green light for care is hardly timely; thousands of patients wait years for procedures which could certainly alter quality of life. Many have actually lost their lives in the process. The lucky and the privileged come to America and get it done right.

Closer to home, examples of government-run health systems gone bust are common place. Sadly, the indigent patient base they were intended to serve is also the most exploited by the bureaucratic failure which loses their files, hires miserably unqualified staff, treats patients with contaminated instruments and sub-standard equipment - or worse, doesn't treat them at all. One public hospital ironically was established in Watts after the race riots in 1965 to show good faith serving this vulnerable community's needs. Four decades and hundreds of millions of dollars later, the hospital had earned the gruesome nick-name of "Killer-King" for tragically accurate reasons. (3)

Ours is not a perfect system. The insurance and pharmaceutical giants are too powerful, and a disgustingly litigious society values lawyers for their ability to secure lavish settlements for spilled McDonald's coffee. Affordable health benefits are almost non-existent. Hospital emergency rooms have been choked into disease-spreading bottle-necks as they become primary care for illegals and the uninsured. Surgeons and OB-GYN's are retiring early or abandoning medicine because of prohibitive malpractice insurance. More patients who finally make an appointment with their doctor see a nurse practitioner instead. Skyrocketing costs are impossible to justify. I used to dream of becoming the Joan of Arc for health care change.

I remember an insulting new posting inside each exam room at our family doctor's clinic about 10 years ago (one of the rare times we had insurance!) that read: "Due to rising costs, please limit your concerns to one issue only during today's 15 minute appointment. For additional health issues, please schedule another appointment." This ~ after waiting for over 2 hours in his Disneyland-crowded reception room.

Or another incident, where I arrived with all 5 children for my appointment. They were violently sick with the same thing. I had been up literally all night. The receptionist crisply said, "You'll have to make additional appointments for each of the other children. I have one opening tomorrow..." Miss Organization was informed I was not leaving, and the doctor would see all of my sick children today. The doctor and his defensive staff were shocked by my appeal for collective diagnosis of all five kids, and corresponding antibiotic prescriptions for the same. Acknowledging current failures evident in the status-quo, I am nevertheless a witness for what our health care system does right.

Five years ago I ran into the paramedics who signed-off my little girl to the hospital. The handwritten report recorded their estimation her right leg would be amputated. "She'll be fine," they said smiling, "there was very little blood loss." None of us knew at that very moment she was suddenly losing half her blood volume in a matter of minutes. 14 year old Asia had sustained a catastrophic degloving injury,

(Behind knee; skin on shin still present, but dying - almost total loss a few days later. All muscle structure intact; a major surprise to the surgeons.)

a broken ankle (tendons bowed and laid-out), and multiple 3rd degree burns after a stolen truck in a police chase hit the bus stop where she was sitting. The 75 +mph impact did not rip-off skin and fat, but had evaporated it. The head of the trauma unit shut-down the emergency room after receiving Asia. He told us later he did not want to compromise the team of specialists he was summoning to emergency surgery.

Before I could see her, I had to sign an array of papers for state insurance since we were uninsured. For three days we did not know if her leg could be salvaged. She was so critical they could not do a CAT-scan until the 3rd day. She had 5 major surgeries in a little less than 2 weeks. Over the next 3 1/2 years she would have 9 more surgeries and a continually open wound. She lost 750 square centimeters of skin and fat. This, and the donor site on her thigh for numerous skin-grafts meant a ghastly wound from the top of her foot to her panty-line for the first year at least. Her leg was so involved, that the home-care nurse who came to teach me how to dress the wound looked at it and said, "I've been an RN for 15 years, and a home-care nurse for 16. I have never seen anything like this. I need to call my supervisor."

If this had happened in my mother's day, it would have been fatal. If it had happened to me, I would have lost my leg. But something miraculous was developed and ready for the public and Asia around 1995. It is called "Integra". It is the most ideal substance for substitution as human fat. It is made out of shark or bovine collagen and synthetic material. This matrix product encourages blood vessels to quickly integrate into it until it essentially becomes part of the body.

It is the reason Asia's leg has been spared from immobilizing scar tissue behind her knee, and why a more natural contour has been achieved. Integra is the miracle darling of burn units and reconstruction medicine. It has an unbelievable 90% success rate. If it doesn't 'take' the first time, a second application usually succeeds. Integra is also obscenely expensive.

Once we were given 2 little portions of it about 3 x 2" each in a specimen jar to take home and keep in the fridge until Asia's next surgery (thanks to the gross ineptitude of state insurance which automatically assumes a patient should be healed after 18 months and kicked Asia out of the wound specialist's clinic and into a generalized children's rehabilitation program which failed to stock anything a plastic surgeon would need). The doctor joked with us that our little jar was now worth about $3,500.

Had we been in the U.K., the use of Integra likely would have been denied. Had we been in a nationalized health care system, a bone-deep staph infection she suffered might have progressed to the point of no return since treatments are rationed. Fentanyl is an expensive, heavy-hitting pain-killer enormously more powerful than morphine. It was in Asia's I.V. and also in a lollipop form with warnings on the wrapper that contact with just the wrapper might be fatal to pets and small children. This was the drug of choice preparing Asia for her first dressing change in the hospital. It didn't seem to touch the pain. Two of the 5 nurses struggling to dress her leg were in tears. Too many times to count, Asia needed critical care that could not wait. She needed materials on the cutting-edge, and specialists who literally were premium in their field. Under nationalized standards, amputation likely would have been deemed "cost-effective". A million dollar little girl is hardly fair to the needs of the larger community.

I am ever thankful ~ despite the onerous dysfunction of Arizona's AHCCCS (public health care) "Mercy Care" and all its accompanying over-paid moronic case-workers who were positively stunning in their stupidity, a ridiculous re-qualifying schedule, an insulting exclusive contract with a corrupt medical supply company which made ordering bulk gauze a WWF event, (to name only a few) ~ I am deeply thankful we had the benefit and miracle of American medical technology and standard of care. I am grateful we had surgeons and nurses who were motivated

and competitive.

I believe there is a better way to reform American health care, reduce costs and preserve the sacred trust between doctor and patient, and to keep research in medical advancements - including generic pharmaceuticals - alive and well. Anything that interferes with this is a crime.

By the way; the U.K. allots a degloving the same compensation as for an amputation.

* See CPR for alternative health care proposals, and for testimony from those who suffer in nationalized environments.

1. Charles Krauthammer, "The Road to Health Care Rationing" 25 April 2009

2. Jennifer Hathaway, "Single Payer or CSM?" OpEdNews
3. John R. Graham, "Martin Luther King Jr. - Harbor Hospital Shows the Cost of Government Monopoly Health Care" 18 March 2009