Disparity in healthcare for the sickest among us.

We live in a nation that is intolerant of intolerance toward any person, gender, or race that is different from the standard white American. Unless you are poor, addicted, and mentally ill. Then it is assumed that intolerance, stereotypes, and disregard are justified.

Recently my girl has needed some significant dental work done. Let me tell you what that process has been like. My girl who has medi-cal insurance, no income of any sort, who is brilliant, but compromised in some significant ways as far as emotional stamina and executive functioning skills go... needed an oral surgeon who was prepared to sedate her for the work she needs done. Because of her methadone dose and because of the amount of work she needs done that is tricky and needs to be done in a hospital, we found out after calling 8 oral surgeons through out Northern California who accept medi-cal but being told all of the various reasons why they couldn't serve her. Finally, one kind phone answering girl suggested going to Highland Hospital in Oakland. She even provided me with all of the information and told me how the process works and what to ask for. A bright light in a dark world, an act of kindness for a tired out old woman.

Highland Hospital is 3 hours away from our house. This is the process....start calling at 5:30am on the dot, to hopefully be one of the 50 patients they will see that day. One day we made the cut and we were on our way by 7am with referral in hand, to grab a coffee and listen to podcasts and get to downtown Oakland by our appointment time of 11:00. Two other attempts have been met within minutes by the recording saying they are full for that day and to try again tomorrow. Any day that we decide to this, has to be a day I don't work, has to be cleared of all commitments in case we do make the cut....its quite the process.

Once there you go through several check in stations, walk through a maze as the hospital is being renovated...take the elevator up to the 4th floor, walk down the left corridor and then take the elevator to the 3rd floor, go to the right, take that elevator down to the second floor, go through the double doors, let them know you are there, then leave that room and go down the hall into a huge (filthy) waiting area and they will call you from there in a couple hours.

She was treated eventually but they would not sedate her due to her methadone dose, and they only take care of one tooth per visit....she has 5 that are an issue.

In contrast, I have a friend whose husband needed some dental work done by an oral surgeon....this person has good dental insurance, a good job, is a professional person. He made his appointment locally, had someone go with him the day of the appointment to give him a ride home after being sedated.....and went home to rest and recuperate.

I understand all of the dynamics and factors here...one person works hard, is a rule follower, has lived within the parameters of societal good behavior.....and one hasn't. One became sick at a young age and it changed the course of her life. Because of the type of sickness, because of the time period 17 years ago, because of the lack of understanding at that point, because of the complexities and lack within the giant HMO health facility that was available to her (which is still being picketed by the mental health care workers as recently as 2 weeks ago to improve care) .....she fell through the cracks of a gigantic system of care. Despite her families best efforts.

Today, the very healthcare system that initially failed her, continues to chant, "you don't matter." Not in words of course, but in deed. Navigating the system to receive the most minimal care she requires to survive is impossible for her. She can't do it without help. Getting help is so hard, so complicated, so far away, nearly impossible, that without a helper, one would quickly give up. She said on the drive home, “Thank you mom for doing all of this. I wouldn’t have known where to even start. I don’t know what someone does who doesn’t have someone to help them. Its all too much.”

Kindness matters. Preserving some sense of dignity matters. Treating people like human beings matters.

Some years ago in a meeting I heard a woman share. She looked rough, had poor grammar, her hair was overgrown and unkempt, her makeup was garish and bright...and then she began to speak about being sexually abused by someone she trusted and how that held her captive for so many years of her life, how it led to her substance use, and eventually to her ruin, until she found her way to forgiveness. She was able to go to this person on his death-bed and forgive him and let him go in freedom. What this gave to her was priceless. Her hurt spots were healing and not holding her prisoner any longer. As I sat and listened I thought of the gift I had just been given by the most unexpected source. It made me cry, her story was so filled with her beautiful spirit, and hope and redemption and grace. This beautiful testimony from this rough woman who had lived through hell on many levels, who was broken and hurting inside just like I was, whose path probably would never have crossed mine except in an AA meeting. I thought of how recovery is the great leveler. How we can all learn so much about connecting with people we wouldn’t be drawn to in any other realm of our lives. I thought of all of the people I have missed out on because they didn’t naturally fit into my circle, because I judged them based on appearance or life choices and decided to not let them in.

On a larger scale that is what our medical care system is doing. Judging who is worthy of straight forward, accessible, medical care and who isn’t. Its an ugly truth. Its of course about money…..who can bring in the most money. Money isn’t the core issue though…. Greed is. If we could charge appropriately and in a straight forward manner for a procedure received, if the system wasn’t top heavy and we could keep things simple (this is all in my utopian unrealistic world of course LOL) if care was available to every human being based on the fact that they are a living being, and where there is breath hope still exists for change and renewal, if we could only stop assigning worth based on performance. If only…



Lolly said…
It is an ugly system, our healthcare. I'm glad your girl has you to help her navigate the way through. Blessings being sent to you both for this new year ahead.
Mark Goodson said…
So sorry this was your experience, Annette. Thank God your daughter has you. What would someone in her position possibly due without a parent or love one to care for them they way you do her. Talk about a light in the darkness.
beachteacher said…
Soo true....thank God she has you, and it's tragic for all of the people that don't have someone to help them navigate this daunting maze of American healthcare. What strikes me so dramatically is how unusual our country's system is....in the worst way. ALL of the other developed countries in the world provide health care for their citizens...whether they're poor or wealthy and all in between. It's just that we Americans are so accustomed to our horrible system that most of us can't imagine how amazingly better it can be......that it CAN work ! God bless your daughter.

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