It was a beautiful weekend after a difficult week: the baby had been throw-uppy and diarrhea-y all week, and I was tired. Saturday dawned sunny and warm. The baby was wiped out, and hadn't shown much interest in eating - but that was understandable. We were pretty sure that once we got her outside with a little Vitamin D and freedom, she'd perk right back up, and we could have a grand and wonderful springlike weekend.
We were wrong. We spent the weekend at the hospital instead, and it was there that I had some epiphanies.
The poppyseedling had rallied earlier in the week after a high fever and gastrointestinal woes, but then she just kind of... slumped. Friday, she stopped drinking readily, though sometimes we could tempt her or trick her and get her to drink some water or Pedialyte. Saturday she woke up obviously not feeling good, but really, who feels good after a long bout of stomach flu? We took her outside, and she staggered down the sidewalk, sat down, began crying, and projectile vomited. Then she sat there in it whimpering until I could get to her and pick her up and love on her.
We decided right then that we needed to get her to a doctor.
It being a fine day, and a Saturday, our family doctors' office was closed, so it was the hospital for us. Off we went. The baby fell asleep on the way to the hospital, and all the way there, I worried about her being so quiet and still. Some friends of ours had taken their baby to the hospital for similar symptoms a couple of years ago, and he was diagnosed with HLH. So my motherly imagination ran away with me on the ride to the hospital, and I worried about my baby being diagnosed with a cancerlike illness, or dying on the way to the hospital, or any number of other things a mother who has never had a kid in the hospital worries about. I have a very vivid imagination, which is what led to my later epiphanies.
I castigated myself for not taking her to the doctor before. But honestly, her decline was rather precipitous - she went from smiling-through-not-feeling-good to pitiful heap of very sick baby really terrifyingly quickly. And if she were a more complainy sort, I'd have gotten her to the doctor sooner - but it didn't appear that something was very wrong with her until just before we made the decision to take her to the hospital.
Did you know they make hospital gowns for babies that are just like grownup hospital gowns? Snaps on the arms, ties in the (open) back. It's pitiful, but adorable. And who knew that diapers could be dignified? My baby was way more dignified with her diapered bum hanging out of her hospital gown than I ever was wearing a hospital gown with my bare ass shining for all the world to see.
The upshot is that the baby had picked up rotavirus, which, according to the CDC website, requires hospitalization for some 55,000 kids in the US each year, and annually kills 600,000 children around the world. We spent three-and-a-half days in the hospital getting the baby rehydrated with IV fluids. She's fine now, though a bit spoiled by the constant attention in the hospital.
I had a lot of time to think during the slow drip-drip-drip time at the hospital with the baby.
We're self-insured through Mega Health (and Life) Insurance, because Mr. Poppyseed does contract work, and we wanted to make sure we had insurance for our three kids even if he was between jobs. It's expensive - nearly a thousand bucks a month - but worth it, because, well, it just seems crazy to have kids and be uninsured.
Oh, wait. Some people can't get insurance coverage through their work or can't afford insurance (private or company-sponsored). That's not crazy. Or rather, it is crazy: thanks, Corporate America and Shitty Government! 45.8 million people (and this is a two year-old figure), don't have health insurance. 8.3 million of those uninsured people are children.
If I was a young parent, or I hadn't experienced hospitalizations before (my organs seem to crap out at pretty regular intervals, plus I've had three kids, so I'm well-acquainted with hospitals), and if I didn't have insurance, I might have hesitated to take my baby to the hospital. If I was working a crap job and didn't have any extra money banked, and thought I couldn't pay the exorbitant costs of an extended hospital stay, I might have hesitated to take my baby to the hospital. And if I hadn't taken my baby to the hospital, she almost certainly would have died.
How many Americans have to make that choice now? How many Americans must choose either letting their children die of nasty but deal-withable-in-a-hospital viruses, or doing a dine-and-dash at the hospital? When I was telling my mom about the figures I'd read on the CDC website and mentioned the horrible 600,000 who die annually from the disease, she lightly said, "Oh, well, most of those probably happen in third world countries." (The fact that she didn't seem to have a problem with third world kids dying of a disease that is pretty effectively remedied through a simple IV drip for a couple of days is another diary altogether.) I'd give my eyeteeth to know how many of those 600,000 children a year who die from rotavirus - who aren't able to get IV liquids that will patch them up in a couple of days - are American kids whose parents can't take the kids to the hospital because they do. not. have. adequate. health. insurance.
It's shameful, that Americans - not just babies, either - are dying from relatively simple diseases that could be relatively easily treated if only the American healthcare and American health insurance systems were not completely fucked. I mean, come on, the death rate (for all ages) from pneumonia and flu actually rose between the years of 1979 and 1996 (the last year for which I can find data). In 1979, 20.1 people out of every 100,000 died of flu or pneumonia; in 1996, 31.6 out of every 100,000 people died of one of those diseases. In 1979, the population was 225,055,487 (PDF file). In 1996, the population was about 265,229,000. The population of the US has come nowhere close to doubling in that time period, so why has the fatality rate for pneumonia and flu increased so much? I don't know the answer to that; I can't prove that broken healthcare and insurance systems have anything to do with the disproportionate rise in deaths of relatively common diseases. But then, I couldn't find any evidence to refute my theory that our crappy healthcare and insurance options contributes to the rising death toll, either. (Update: A couple of people noted in the comments that there are perfectly cromulent reasons that may explain what happened with the stats. AIDS/HIV health matters came into play during those years, and we have more older people than ever now [who are susceptible to these maladies]. Not to undercut my tinfoily theories about the evils of government and people dying, but facts is facts.)
This isn't, of course, just about sick babies, or people with common diseases relatively easily quelled with proper care. It's about millions of Americans of all ages who can't afford health insurance to take care of ailments from broken bones to car accident injuries to cancer. It's about a healthcare system that racks up fees (think $25 Band Aids) and about rich white men deciding that the uninsured who don't qualify for Medicaid should be assessed for their hospital charges (and any costs unpaid should be taken by state tax levies or payroll deductions). OK, look. Again, I don't have stats to back this up, but I'm speaking from experience as a financially irresponsible person - if insurance is available and affordable, most people are going to take it. Which means that those who are not insured not only can't afford health insurance - they can't afford to have enormous hospital bills taken out of their meager paychecks. From this site comes a quote from this site that sums it up nicely:
I have an even bigger problem with the tired rhetoric that gosh, these lazy poor people just don't want health care, and we will have to beat them with a stick to get it....I don't know of any folks who would prefer to forgo health insurance and hit the ER, and the rhetoric that would suggest otherwise is breathtakingly ignorant.
In a NewsHour with Jim Leherer segment from November 2005, the plight of the uninsured is discussed. Anthony Wright, executive director of a consumer advocacy group, Health Access California, says:
An uninsured person is half as likely to go to the emergency room as an insured person and it's not because uninsured people have half as many emergencies. It's simply because they know that if they go to the emergency room, they will get a bill and that bill will be very major and have an impact on their financial future.
The fact that the uninsured in America are not "lazy poor people" was backed up by Dr. Ana Valdes in the NewsHour segment, who said:
I definitely think it speaks loudly about our society and what our priorities are when we have so many uninsured people; they're not just homeless and addicted, but they're working, oftentimes they're educated, with Ph.D.'s, looking for jobs, or have a job, and they just don't have insurance.
Dr. Martin Brotman, also interviewed for the segment, said:
Unless there is a national resolution, a national commitment to address the problems of the uninsured, it will never be addressed. Anyone who needs health care who is turned away from access to health care, that is unacceptable to me as a physician, to me as a member of the community.
It is illegal to turn people away from the hospital, regardless of their ability to pay, if they require emergency care. But ERs are increasingly crowded, and if your situation is determined to be a non-emergency (and you can't pay a percentage of the cost of treatment up front), you can be screened, or "triaged out" and sent elsewhere without care. So let's say you go to the ER and you don't have insurance and you don't have a wad of cash in your pocket: what happens? You get to play Emergency Room Roulette, and you're sent from one place to another to another until you can find someone to treat your problem. Or else you go home and stay sick.
I'm semi-Buddhist and somewhat (grudgingly) Christian, and this problem with uninsured people and a rotten-to-the-core healthcare system doesn't jive one little bit with either of those belief systems (though a shocking number of so-called Christians are more than happy to throw the unfortunate and poor of our society under the healthcare bus). (And again, note that the "poor" I'm speaking about here isn't just a mass of unwashed hoboes [not that unwashed and itinerant people don't deserve the same health care that everyone else does; they do, which is kind of my point here] - a lot of these people are regular middle-class folks who just can't fucking afford the exorbitant costs of insurance, or the exorbitant costs of hospital care without insurance. A lot of the people this problem affects are just like us. They are us.) The problem of adequate healthcare for all Americans is not just an issue for people with sick babies, or people who can't pay for insurance and can't afford healthcare - it's a problem for all of us, from the perspective that you judge a society by how it treats the most vulnerable members of that society. Our society is sucking, and sucking hard, in that respect. It's yet another thing that makes me ashamed to be an American. (Thanks, George W. Bush, greedy corporate overlords, and bought-and-paid-for politicians!)
So yeah, having my baby in the hospital made me realize how very lucky I am that I could take her there and get good care for her (instead of having to trundle her from clinic to clinic while she got sicker, or being completely overwhelmed by health care costs that I couldn't afford to pay for): the very personal brought into my line of sight the very huge problem of health care and insurance in the United States. Honestly, it wasn't something that really meant a lot to me until I contrasted my experience with the kind of experience millions of Americans would have had if they'd been in my place.
I had another epiphany, too, and it's tangentially related. If avian flu is going to be the hiding-powdered-milk-and-tuna-under-your-bed emergency that they're thinking it could be, what the hell is going to happen to millions of uninsured Americans once the disease gets here? OK, for now, it's killing more birds than people, thank god. But what if it mutates, or starts killing people like the 1918 flu pandemic did? You'll have a lot of dehydrated babies out there - how many of them will die because their parents can't afford to take them to the hospital for an IV drip? How many adults will try to tough it out because they don't want to be crippled with hospital bills for the rest of their lives because they don't have insurance - how many of them will die?
After taking my baby to the hospital because of a stupid little virus, I'm half-inclined to barricade my family in the house (and live off our under-bed stocks of canned tuna and powdered milk) once avian flu makes its way to the United States, even if it doesn't turn out as dire as predictions have said it could be. Of course, I can afford to do this: my husband (who is our sole household income provider) makes enough money for us to afford not only insurance, but private insurance, and I can stay home without worrying about missing work and not being able to pay the bills. And should the awful become reality, and one of us should be stricken with bird flu (or anything else) and should require hospitalization, we can go to the hospital.* But millions of uninsured Americans can't - or at least, won't. They can't stay home from work because they're afraid they'll get sick (or their bills won't get paid), and they can't go to the hospital if they get extremely ill (or they'll be in debt for the rest of their lives).
This isn't an action diary; I don't know what the answer is here, unless it's universal health care, which I doubt will ever happen because the pearl-clutchers on the Right will cry "communism!" with a scandalized gasp at the first mention of universal health care, right before shooting down any legislation that might seek to provide a socially responsible answer to the health care and insurance problems gripping our society. I don't have a lot of hard-core statistics here, nor any personal anecdotes illustrating how shitty the systems are now. All I have here is a visceral reaction to a problem I knew existed, but that I hadn't really given a lot of thought to before, and that I, as one of the lucky ones, feel compelled to try to do something about. Those of us who are fortunate are responsible to help those less fortunate than we are, because that is what good people and good societies do. The very first step, before fixing the problem, is realizing the problem exists - feeling the problem - even if it isn't something that directly affects you in your personal life. I did, I do. Do you?
Now to learn more. And then, to act.
*Update: From the comments (thanks, Kossack Overseas! And this "thanks" is not sarcastic), a very good point about just trotting off to the hospital, insured or not, if avian flu becomes a big huge deal:
If there ever was to develop a real Avian flu pandemic, the hospitals would be over-run with cases. The hospitals estimate they would need 700,000 respirators and they have only 100,000; so maybe 1 in 7 gets one and the other six do not. How long before the doctors and nurses also come down with the virus destroying the usefulness of any hospital? It will take up to 6 months to develop a vaccine. What happens during that six months? The only drugs we have are to hopefully mitigate the symptoms. Your statement "we can go to the hospital" is possibly naive and having insurance or not may not be a factor.
Update 2: Please visit the excellent
Flu Wiki, an effort of Kossack
DemFromCT, among others, for more info. Thanks to
lesliet in the comments for the tip!
Update 3:
Monkeybiz included in the comments a link to
Alphageek's diary about flu preparedness, for anyone interested in tuna-under-the-bed alternatives. (I haven't read the diary yet, but it is highly recommended; I'm putting the link here as much for my own reference later as for you guys.)
Update 4: Like I said, I'm one of the lucky ones. My story is a happy one. If you have an unhappy story, please tell it not just here (personal anecdotes are effective!), but
also to Michael Moore. Many thanks to
dnamj for the reminder that Michael Moore is collecting health care horror stories. God knows, there are plenty to tell.