Denial of Care

Ray is a 50-year-old truck driver who has been unable to get insurance due to the high cost based on his profession and past medical history. His wife previously held insurance until she lost her job after her health issues interfered with her ability to perform her job. Those health issues never were fully resolved before her insurance ended after she was let go due to not being able to fully perform her job “requirements”. This left both of them uninsured and struggling to make ends meet on one income and a difficult job market has not helped them recover since his wife has been unemployed for several months now, despite several interviews and hundreds of job applications being sent out.

Ray experienced some vision issues when he woke up on the Saturday before Labor Day. He reached out to his eye doctor on Tuesday, when they opened after the holiday, and they promptly fit him into their schedule for an appointment a couple of days later. This was at an out-of-pocket cost of $100.00 since he no longer had insurance coverage, which left them broke for the week but as a truck driver, his vision is extremely important. By the time Ray got to his eye appointment, he was barely able to see out of his left eye. What had started as some floaters in the vision and dark spots quickly turned into a black curtain across most of his vision area in the left eye.

An Emergency Situation

The eye exam revealed that Ray had a detached retina in his left eye and the eye doctor was frantic over this discovery. They could not treat this at their office and they tried to locate a retina-specialized doctor that could treat it in the local area, however, most were not accepting new patients, even emergency ones, and others refused to take a patient without insurance. The eye doctor advised Ray to head to the local ER for treatment since it was an emergency situation to try to save his vision in his left eye.

Ray’s wife quickly drove him to the ER where after several hours of waiting, they were told that there was no retina specialist at their hospital and the ER doctor assigned to his case was having difficulty locating one in the area that would see him. The only thing that happened was they confirmed it was indeed a retinal detachment and it did need to be cared for urgently to avoid a complete and permanent loss of vision in his left eye. Ray and his wife returned home waiting to hear back from the ER doctor to see if they had any luck finding anyone to care for the detached retina emergency.

A couple hours after they left the ER, they received a call back from the doctor and she advised them that she was able to get an appointment with a retina specialist for the next morning but it was in the next state, which meant a couple of hours drive for them. They agreed since they knew that getting urgent treatment was vital for saving the vision in Ray’s left eye and they assumed from what they were told, that this would likely be an inpatient surgery done there to correct the detachment. They headed a couple of hours away in the morning for his appointment and once they arrived, they were taken back as several tests and images were done on Ray’s eyes.

Capitalism Over Healthcare

After the exams and images were taken, they waited for about three and a half hours for the retina specialist to be finished with surgery to come meet with them. While they waited, one of the other doctors came in to discuss the price of the surgery with them. The doctor explained how expensive the surgery was and how that should be a factor to consider when weighing options on what to do. Essentially, the doctor was making the loss of vision in one eye sound comparable to choosing to have a tooth pulled instead of paying the high price of saving it at the dentist.

When the retina specialist arrived and did their exam on Ray, they advised him that the retina was almost completely detached at this point due to the time that had passed since the detachment started. There were also other factors involved and his surgery would be a more complicated one and could not be done outpatient like most. This was something that could not be done at their facility since they only handled outpatient surgeries. After a 2-hour drive there, 5 hours spent at the appointment, and a 2-hour drive home, all Ray ended up with was a recommendation to reach out to his state county hospital for care since they would be able to do the surgery without him having insurance, and hopefully it could save some of the vision in his left eye.

Even the retina specialist seemed to imply to Ray that he should seriously consider whether or not saving his vision in his left eye was worth the financial burden of the surgery, especially surgery without insurance coverage to help pay for it. The county hospital in his state is a 4-hour drive one-way for Ray and his wife, and they would have to go there for another “initial consultation” before a determination could be made regarding surgery. A family already struggling on one income to make ends meet was now looking at possibly several trips 4 hours away, likely overnight stays which means hotel costs. All of this out of pocket because the American medical system does not have anything in place ensuring patients like Ray can receive the care they need if they lack insurance coverage.

The first eye doctor and the ER doctor telling Ray and his wife that surgery would be needed immediately to save the vision in his left eye. However, the retina specialist seemed less concerned about this and more concerned over Ray’s ability to pay for the surgery, almost to the point where the tone they used seemed to hint at just letting the eye go. Ray and his wife were disillusioned by this total failure of the healthcare system in a country like the United States, where there is so much bragging done about how “top of the line” the healthcare is. What is apparently left out of this is how impossible it is for people who make “too much” to qualify for state-assisted healthcare programs, but who can’t afford the private insurance premium costs, especially for older persons with pre-existing health issues.

Faced With Impossible Decisions

Now, Ray and his wife are facing an extremely difficult decision — do they pursue the expensive eye surgery that may or may not save the vision in his left eye (the doctor could not say how well he would be able to see out of the eye even with the surgery), or do they just let it go and let Ray go blind completely in his left eye, possibly risking his career as a truck driver? Considering, that even if Ray has the surgery, at this point too much time may have passed since the detachment started, and with these continued delays, the doctor did not seem confident that Ray’s vision would ever fully return. They could not say how well he would be able to see out of the left eye with the surgery, or if he would be able to see at all even after the surgery in that eye.

Ray could not wonder if they were giving this more “grim” outlook to try to discourage him from pursuing the surgery due to the cost since it was brought up immediately after the mention of irreparable damage to his vision already likely being present. Ray and his wife were having flashbacks to 2016 when they had to file for bankruptcy because they were left with over $100,000.00 in medical bills after Ray had a massive heart attack that nearly cost him his life. This was the out-of-pocket cost after insurance paid their part. Ray was unable to work for 2 years after his heart attack, and they were left with just the income of his wife, which while it was a livable income, it was not enough to pay for over $100,000.00 in co-pay costs. That was even higher than the price of their house!

Despite months of trying to make payments to all the hospitals and specialists demanding payment, Ray and his wife could not pay enough and they were being threatened with garnishment of wages by their mounting bills. Bankruptcy became their only option. Now, Ray and his wife are feeling that same familiar sense of the walls closing in around them over the price of needed emergency medical care and their inability to pay. When Ray had his heart attack, they had what was considered “good insurance”, yet it still left them with an astronomical bill that is unreasonable to expect any middle-class family to be able to pay.

Nearly every other country in the world has a system in place providing government provided healthcare for their citizens to ensure that health needs and emergencies are handled despite an inability to pay. Yet, here in the United States, where we brag about our healthcare being the “best”, citizens are being forced into bankruptcy due to healthcare co-pay costs even with insurance. They are being forced to decide if trying to save one’s vision is worth the risk of a second bankruptcy. Citizens are being faced with a long delay in getting emergency care needed to ensure a more full recovery because they are turned away automatically without insurance, or encouraged to “not” get the care because of the cost.

This reality is faced by many people here in the United States every single day because the struggle to afford healthcare is becoming a privilege given to those who are lucky enough to afford it. Those who cannot afford it are being neglected and being refused access to needed emergency medical care because they lack a means to pay for that care. This is what happens when the healthcare system becomes fully a “for-profit” service, rather than a basic human right. Healthcare is no longer about the health of the patient, or the care of the patient, it is now ruled by corporations with a goal of making millions of dollars from those with the means to pay for it, and punishing those who cannot.

Welcome to healthcare in the United States, circa 2024.

Note: Names have been omitted and changed in this article to protect the privacy of the subjects interviewed.

Article originally published on Hubpages https://hubpages.com/health/denial-of-care © 2024 Luna Verity