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My brother-in-law's father is dying. He has a particularly aggressive cancer, and we found out last night that it has spread to his brain. He has about six weeks left to live.  Despite all of the incredible care, despite the heroic efforts of doctors, nurses, and everyone else in the medical system, he's going to die.

I'm going to call him my father-in-law because I'm not sure of the proper terminology.

My father-in-law is a farmer. He's a rugged man, tanned and strong from years working on the farm. He's a powerful man, an individualist, not given to flights of victimhood or self-pity.  Iconic, despite his small stature.  He's not a perfect man, but he's a devoted husband, a loving father, and one of the strongest people I know.

We found out about the cancer a few months ago. It was a blow to this powerful man.  But he fought hard right from the start.  He fought to beat the cancer, to remain strong in the face of this horrible news.

The doctors and nurses fought too.  He received the best care, cutting edge treatment, aggressive attempts by top notch medical professionals to save his life.  In the end, as too often happens, it's not going to be enough.  He's going to die.  But the care he received was nothing short of miraculous.

Yesterday he visited his doctor to discuss the next round of treatment.  Instead the doctor told him that there was nothing more to do, because the cancer was in his brain and was now untreatable, even with the best medical technology.  They advised him to stop taking his meds, to focus on living the end of his life well, and to put his affairs in order. They discussed options about what to do as the end approaches.  They weren't giving up.  They just knew that they'd reached the limits of reasonable care, and that now was the time to focus on making the most of the time he has left.  Tragic, unwelcome news, but not unexpected.  

As he spends his last weeks and days, he'll still be taken care of. He will have hospice care available to him.  He'll be able to receive pain medications.  When he reaches the end, he'll be given all the support he wants to relieve his pain, though by that point he probably won't be able to express his wishes any more.

And all of this isn't costing us a penny.  Well, maybe a penny.

This isn't a story about haggling with insurers, because there wasn't any of that.  This isn't a story about bankrupting the family to pay for expensive treatments, because there's no chance that'll happen.  This isn't a story about the anguish of wondering who will pay, and how we'll pay if the insurers don't come through.  Why?  Because my father-in-law lives in New Zealand, and his care is paid for by the government.  More accurately, his care is paid for by his fellow citizens, a penny or so per person to fight to save this great man's life.  That the effort will ultimately be unsuccessful is irrelevant.  His prospects were poor the minute he was diagnosed, but he received the best care on the planet to try to give him more time.

What are we doing with our time? How are we handling this tragedy, when we don't have to spend our waking hours defending his care to an insurance company?  We're making travel plans for my brother-in-law. We're spending time with each other remembering his life.  We're beginning our mourning.  

My brother-in-law can't get coverage in the United States because of pre-existing conditions.  Or, rather, he can pay hundreds of dollars a month for insurance that doesn't cover anything.  If my nephew has to go to the hospital, my sister invariably receives a "coverage denied" letter from the insurer, and then spends precious time disputing the decision.  Sometimes they agree to cover.  Often they don't.  And when they do, the copay is exorbitant.

I told my sister that she needs to go. Go now. Move back to New Zealand. Who knows what might happen in the future?  I hope she and the family will be healthy.  But if the worst happens, it will be cheaper and easier to buy a last-minute plane ticket to New Zealand than it will be to deal with America's barbaric insurance nightmare.

Unless something changes now.  This is a great country.  We are a generous country.  But on this issue, we are wrong.  Dead wrong.  And it's time to change our broken system.

So go. Go now. Fight.  Because everyone deserves heroic care, no matter their ability to pay. And nobody, nobody should have to spend their remaining days with a beloved family member fighting an insurance company.

Update: First, thank you for all the recs. Second, remember that my story is unusual in this country. The stories in the comments are awful and heartbreaking.  Read them and remember what we're fighting for.  For far too many Americans, this sad story would be much sadder.  Keep them in your thoughts and in your prayers.  Third, keep fighting. Do not give up.  Keep the pressure on the President and on Congress, but don't give in to dismay and fear.  Support our elected officials who are with us, even the ones who aren't with us 100%.  Urge them to reconsider if they're off base.  And do not listen to the noise.  There are interests in this country that oppose change for financial or ideological reasons, but America wants change.  It's up to the President, the Congress, and us to make that change happen.

Originally posted to socratic on Wed Sep 02, 2009 at 08:05 PM PDT.

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