I spent most of today with my best friend trying to find a place to bury her mother. She wanted to do it with Inglewood Cemetery but they are so booked they could not do it for a week and a half. Their attitude was she should have faced the truth and done it sooner. People are dying so fast in the hood that funerals are a booming business.
Her 60 year old mother died a long slow painful death from January of last year til Thursday night because she had excellent insurance and no basic medical knowledge.
We will call her Belle because she was beautiful with equisite eyes. She was witty and she had a life. She is the mother of five children and her oldest son was killed in a drive by shooting and her hair turned white overnight. Her youngest daughter is my best friend and I tutor her 13 year old son. Her daughter works for the Department of Water and Power in
Los Angeles in a good union making good money, a homeowner, and a responsible community member. Her daughter has kept her mother in good insurance policies ie: supplemental medical etc. She was recently disability retired from the US post office service.
The whole family is on some form of PPO which they all understand is more expensive but gives them choices they are willing to pay for. Belle had a heart condition for over ten years but was stable and responsive to medication. The family sees doctors in a medical group. Bells's cardiologist is in the group and she saw him on a regular basis.
In January, Belle sees the ENT specialist of the group for acid reflux. She is in good and stable health at the time. Because more and more people in LA are loosing their jobs and thus their health insurance and cannot afford expensive cobra and/or expensive co pays in their regular insurance, these groups are seeing substantial reduction in their incomes.
Their defense is to seek to do more and more procedures that are more and more invasive because they pay more money. So instead of just giving Belle some more efficient acid reflux prescription pills which is their intention, they tell her we want to do an endoscopy and look down and see what is actually going on. At this time, there are no breathing problems and no bleeding problems nothing really that serious to not try the pills first.
The doctors do so many of these endoscopies that they consider them rather routine and no big deal. They do it locally in a semisurgical room with a
nurse anthestist who uses minimal respiratory assistance machines and with not the most sophisticated of response levels. They feel the twilight sleep is easier on the patient and easier on them and it adds to the billing.
Make no mistake this is in fact a form of elective surgery which the patient has no real idea of the inherent risks. But both her daughters called and asked should they drive her and should they be with her and both were told it was not necessary and no big deal. Belle's ingroup cardiologist was never consulted or even advice the procedure was being scheduled. He has admitted it would have never advised the procedure and with her heart conditiion she required a defibulator to be present which was not the case.
Sometime during the procedure, Belle stopped breathing and no one is really sure for how long because the machine stopped working and the anesthetist did not notice because when the machine stopped working there was no automatic warning bells whistles or lights. You would have to be paying attention to your patient which is soooo 1980s in today's billing madness.
So Belle has been in a coma ever since. She has been moved to three different facilities so far. She went into the hospital Wednesday because she had a severe lung infection. Both her daughters visit regularly and they keep informed of her care like she bit her lip or bedsores etc. But no one told them she had a lung infection until she is majorly hospitalized again. No one told the daughter Belle had a lung infection because they were not treating it.
I spent 4 hours with Belle and her daughter Thursday. I listen to the five doctors on their rounds. She now needs dialysis, a blood transfusion, etc. She is still breathing on her own but needs intensive respiratory therapy with medication to reduce the swelling in her lungs.
I listen to the social worker go through her litany. And everybody wants the daughter to sign the DNR which up to now she has refused to do.
I am here for an outside medical analysis for the daughter because she wisely now trusts no one. I am also very spiritual about the process of death at this time. The daughter and I have lunch and dinner together.
I tell Belle that I love her daughter and she can be very proud of the job she has done raising her and she has a grandson she can be proud of. I tell her daughter her mother is very tired and is sick of all the poking and proding and she is staying because her daughter wants her to. I tell the daughter she can tell Belle she loves her dearly, will miss her much but she is okay and will be all right if Belle wants to go. When the daughter says this to Belle her heart instantly stops and the daughter is okay with it.
This is now a law suit but with caps etc. there is no real money in it. But this was a long slow agonizing death for no reason but a billing.
When medicare came in the AMA opposed it but at the same time they were working on how to use it. My first husband began medical school in 1966 and medicare began in 1968, and he did his first practice management seminar in 1969 prior to even graduating in 1970. My first husband got into medical school with Cs and Ds because his father was roommates with the president of the medical school he attended. He flunked biochem five times and was allowed to take it til he passed. He was in the bottom of his class. Lucky for patients he died of renal failure from being alcoholic before he did too much practice. Everyone should be aware that all medical care is labeled PRACTICE.
What medicare did is introduce dipstick medicine. The doctors found they could bill for every action and so more and more actions were developed. The mantra being they had to protect themselves from mal practice. It has been my personal experience that that is plain and simple bullshit.
In 1968, a routine urine analysis was sent to a lab and cost $28 which was fully paid by medicare. Almost over night there was the invention of dip stick testing of urine which allowed all doctors offices to bill for urine analysis for dipping their sticks.
A lot of medical "progress" was waiting in the wings because there were no patients to try it on. High quality surgical heart care was available but it was not perfected. One of my nursing instructors was on the surgical team of a major hollywood star who died at 43 on the table because the heart surgeon accidentally servered his aorta. Heart surgery was known to be both dangerous and expensive. The same with eye surgery for cataracts etc. that led to all the lazer retinal repairs today. But notice all these doctors wear their glasses because they do not know what long term results of some of these surgeries are. Where to get the patients to practice on?
Well medicare provided them. Most were too old and not educated enough and not cynical enough to realize that doctors would proscribe something at the drop of a hat to make money. Not all of them but by far too many of them.
One hospital in LA got in so much trouble that USC servered their relations with them. The hospital took a huge hit until they came up with the idea of a definitive observation unit. How to fill it. They went out to convalescent hospitals and rounded up those without family or funds and put them on respirators, etc. the whole works until they died. Presto, in six weeks after the DOU opened the hospital was in the black.
All of the really horrible and major medical practice I have seen never went to court and for the most part never saw the light of day. That is because everyone with responsibility covered it up and those who might potentially tell the truth were threatened with their licesnses and black balling etc. For instance the heparin dosage delivery labeling has been a problem for some time and was known and had cost some infant lives before the Dennis Quaid twins. The Quaids said they sued because they found out it was known and nothing was done until they high profiled it. This is typical of US medical practice.
So doctors got tons of experience from medicare they never would have had to serve the very, very wealthy much more safely. Recently in LA, three doctors were arrested for medicare fraud to the tune of 150 million dollars. They were recruiting the poor for unnecessary surgies like carpal tunnel syndrome etc to bill medicare for. The moral hazard everyone talks about is not patient abuse---all the US together of patient abuse would not equal just those three doctors alone.
Patients are caught between the insurance companies who know how many doctors practice medicine and the patients who need care. We pay twice as much for everything as the rest of the world and we can no longer afford it. We need doctors and medical care people who want to be healers. We can no longer afford a medical system based on wealth, power, and prestige.
That is what we are really fighting about. The same thing as the banksters. Accountablility as to how these professions are practiced.
It is the simple: when do the needes of the many out weigh the needs of the few? The few will always always answer never but they will do it in beautiful patriotic terms.
Meanwhile your death is expected and it will be planned well to make it as profitable as possible and when it is not--the plug will be pulled or maybe never even placed in the socket. And the corps will collect their dead peasant insurance that they are swaping around the world.
I have done the best I can on this diary. I remain closed head blunt brain injury and I am not in the mood for the grammar police.