One family’s experience with the U.S. healthcare system: An argument for a single-payer

I sometimes think that if I had never answered the phone that morning, none of this would have happened. If only I hadn’t been able to get my key out and get the door to my office opened fast enough to grab the phone on what was probably its last ring, maybe the accident in Italy that claimed my father’s life and left my mother in a coma for several months would never have been a reality. But I did answer the phone and I did get the news that the rented car my father was driving had skidded into a guard rail on a highway outside Turin and both my parents were in hospitals in that industrial city in the north of Italy. And so the nightmare began.

I have often written about this accident, but my focus was always on what happened in Italy, how my father died of a heart attack after weeks in a cardiac hospital, how we brought my mother home in a coma, on a stretcher, on an Alitalia 747, accompanied by an Italian neurosurgeon. But I have never specifically written about how we were treated by their medical insurer. I feel compelled to do so now because of the debate that is going on about the President’s proposed national health care system. My experiences dealing with my mother’s insurance company have convinced me that a single-payer system is the only way to go.

At the time of the accident, my parents were living in Hollywood, Fla. So when I brought Mom home my sisters had arranged to have an ambulance meet us at Miami International Airport and take her to a hospital in Hollywood. Shortly before leaving Italy, she had shown signs of coming out of the coma that had been induced by her doctors to spare her the pain of multiple fractures over her head and body. It wasn’t long after she was admitted to the hospital in Florida, that she started to come out of it completely.

We were faced with a terrible dilemma – how to tell my mother that my father was dead. She had no recollection of the accident. The last thing she remembered was leaving the wedding of a cousin the day before. Fortunately, she wasn’t asking questions. But we knew it would only be a matter of time. The hospital provided her with a psychologist, who advised us that it would be some time before my mother would be able to handle the news. The best thing for the time being, she told us, was to wait for her to ask. The problem was that she wasn’t asking. She was hallucinating visits from my father in the evenings when we weren’t there. This went on for a couple weeks. The psychologist told us that, even if she had completed her physical therapy, my mother should not be released from the hospital until she had come to the realization that when she went home my father would not be there.

At the time, one of my sisters and I were living in New York. My other sister lived in Chicago. We had taken turns attending to my parents for more than a month while they were in the hospital in Italy, now we were doing the same in Florida. We all had families and jobs. The situation was taking its toll on us emotionally and financially. We enlisted other family members to help out. At one point my daughter flew in from Seattle and my ex-wife flew down from New York to relieve us. I was in New York when they called to tell us that the insurance company had informed the hospital that they wanted my mother discharged the next day, that they would no longer pay to keep her in the hospital. My mother still did not know about my father.

I telephoned the psychologist. She was appalled, but there was nothing she could do to intervene. Her advice was to tell my mother about my father before she left the hospital. I told her that I could not ask my ex-wife or my daughter to do that. She agreed that, as her son, it would be best coming from me, even if I had to do it over the phone. What ensued was the hardest thing I have ever had to do in my life. And I have no doubt that it permanently scarred me as well as my mother. To this day, ten years later, and three years after my mother’s death from cancer, I am still second guessing myself on how I handled it.

That having been done, my ex and my daughter took my mother back to her home in Hollywood in a wheelchair and tended to her there. She was still unable to walk when a few days later someone from the insurance company called and said they were sending someone to pick up the wheelchair. My ex told them they better come with the police, because she wasn’t opening the door. That settled that until another wheelchair could be obtained.

For weeks, we took turns staying with Mom. Other family members and friends graciously lent a hand. She had a home health aide, provided by the insurance company, who we had to fire because she was taking advantage of my mother when we weren’t around. When she would drive my mother to the store, she would stop by the racetrack. She convinced my mother to give her many of my father’s belongings that she had been planning to give to me. Eventually, my sister moved from Chicago to the west coast of Florida and arranged for my mother to move to her own place nearby. She lived there for several years until she died of cancer.

Thinking back on this as the healthcare debate heats up, I have concluded that the last thing one needs to go through at a time like that is dealing with a for-profit health insurance company. The alarmists are warning us about government bureaucracy. There was a time that I might have agreed. But after my family’s experience, I am convinced no system could be worse than what we have now.

Whole cottage industries have grown up around the medical insurance business. Hundreds of software companies are in business solely to write medical billing software to facilitate communications between doctors and insurers. There are companies that do nothing else that can be contracted to do that for doctors. A medical practice consisting of one or two doctors, who choose to handle it in house, will have a half-dozen employees whose sole task is to deal with the insurance company bureaucracy. All of this is terribly inefficient and an added expense. And, in most cases, you have to see a doctor that is on the insurance companies list.

A single-payer system, where the patient could choose their own doctor, would eliminate a tremendous amount of waste and might even free up doctors to go to bat for their patients in a situation like we had with my mother. We need to get the insurance companies out of the healthcare business completely. It is in their best interest to raise premiums and deny claims. Time-after-time, as they did in the case of my mother, they have shown heartlessness in the pursuit of profit.