The following essay was written about what seems like the directions of the health care system.
What about when other people cost too much?
Much of what you do with other people depends on one simple question: “Do they cost too much?”
Much of our health care system is based on the central idea that people can cost too much. For all of the arguing and debate most of the plans we hear politicians talk about are attempts to solve that basic issue. How do you make people who cost too much cost less?
In Tennessee the state insurance is called TennCare. Depending on whose numbers you believe, in the next year somewhere between 140,000 and 180,000 people will lose their benefits. The kinds of medical problems these people have are for the most part our worst dreams: cancer, heart disease, chronic mental illness, kidney failure, and an array of other genetic or chronic conditions that seem to make the idea of a happy life little more than a cruel delusion.
Most of us like to see ourselves as giving people. We expect to do for others. We look down on those whose lives are defined solely by what they acquire or what they have. We look at the message of Jesus which seems to be that others don’t cost too much. After all we didn’t cost too much is what He might tell us.
The question of what happens when people cost too much is really a question that you can’t get around. As long as our health care system is based on that basic assumption, times being what they are, people will always cost too much. And we will talk ourselves into believing that the only responsible course is to refuse to pay.
What has happened in Tennessee is that the local communities have found that although the state can indeed refuse to pay they cannot escape the cost. In 2005 in our first attempt to solve the problem we also took away benefits from over 100000 citizens. The mental health system, for example, now has huge holes and gaps. Jails have become our biggest mental health treatment centers. Experience is clear about one thing. People who come to jail because of mental health issues come back over and over again.
For a new patient to get an appointment at the local mental health center in the county where I live is an 8-12 week wait. What does someone with a mental illness do who has to wait? They do what any other sick person does. They get worse and worse. In the end they give up on a system that further adds to the injury of their illness. The message is clear even to the mentally ill—“You cost too much.”
In the next round of cuts somewhere between 15,000 and 20,000 with primary mental health diagnosis will be cut off from benefits. I don’t know how many of these people are from my county but it looks like we are going to solve disaster by covering it with chaos.
I have a personal stake in all this. My wife is one of those people who is going to lose her TennCare. She is one of those people who cost too much.
She has bipolar disorder. She also has had epilepsy since birth. Our story is I think indicative of the stories of many.
7 years ago a good day for Linda was 10-15 grand mal seizures. There were not many good days. She finally got hurt real bad in a seizure. She fell down a flight of stairs, hit her head on the banister and broke her face in a seizure. She literally broke her face. She looked like I had beaten her half to death with a baseball bat.
The doctors told us what our experience already told us. No medications were going to stop the seizures. They did a lot of tests and finally recommended that Linda have brain surgery. After a lot of prayer we finally agreed. They took out her amygdala and hippocampus. The next 18 months were a nightmare. She came out of the surgery with a whole host of disabilities that she never had before. Most of these she deals with to this day. Her short term memory was shot. She has never seen a rerun. She many times can’t concentrate and it is hard for her to learn many things. She loves to read but sometimes her comprehension just disappears. Many times she can’t get the words out that she wants to say. She could get lost going from one room to the next and that is just the tip of the iceberg.
After a year the seizures came back and they came back with a vengeance. 4 years ago she was in Vanderbilt Hospital having a hundred seizures a day. In the last 7 years I have had to quit work 3 times because it was too dangerous for me to be away from home. The last time I was out of work for about 9 months and we survived purely through God’s grace.
Last year after going through a major emotional crisis Linda was finally diagnosed as bipolar in addition to everything else. We had all known for a while other things were going on but there was so much that we couldn’t even see what now looks like it was right in front of us all along. Linda thinks she has always been bipolar. Maybe it was at least partially a gift of the surgery. Whatever it was lost in a thousand other battles.
We have now started a support group we call “Hopeworks” part of the DBSA. What is so strange is that maybe for the first time hope has begun to work for us. It appears more than wishful thinking.
TennCare has been a lifeline for us. In the last 7 years Linda has been in the hospital 16 times and went through 5 surgeries. Right now though Linda is in the best health of her life. In the last 4 months she has had 1 grand mal seizure. The bipolar with the right meds, therapy and lots of support is being managed successfully. Life for her finally has some opportunity, after years of each day simply being a process of waiting for the next thing to go wrong. But……………….
Without TennCare it wouldn’t have been possible. What is most important is that the miracle of Linda’s health is not a done deal. It must be done and redone each and everyday. We were in hell and managed to find a way out. The path back is always there.
We have one sword hanging over our head. Several years ago a neurosurgeon told Linda that she had another spot on the other side of her brain that was caused by seizure damage. He told her with time if seizures continued unabated that she would be unable to do anything for herself. He recommended more brain surgery. Her neurologist said so much tissue had been taken out already that she might come out of surgery a vegetable.
She takes 5 medications a day related to either bipolar or seizures. We checked the other day. One of them—not the most expensive one—costs $869 a month. Without TennCare this sword gets closer and closer to our head.
Linda is the kindest and best person I know. She has a faith in God that takes my breath away. According to our health care system she costs too much. Soon she will not cost them anything, but the damage done to her life will be incalculable.
Many other democracies believe that health care is a human right. As long as we accept without question the idea that people can cost too much then it will never be a human right here. People who have the bad luck to be sick or disabled will find in the end they have committed a crime from which they have no appeal.
Larry Drain
865 951 4252
hopeworkscommunity@gmail.com
website- hopeworkscommunity.com