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Part 133: Ethics in Healthcare:
December 13, 2004:
This is another very personal case. When I first began this essay series, I thought I could write it without being personal. Now I find that impossible. Too many of these failures of our culture have involved me personally. In addition, I have concluded it is necessary to point out bad behavior when and where it occurs. Be it our government or a citizen it is necessary to name names. People who default on their duty, whether through criminal intent or indolence must be held accountable. It is a serious failure of our culture that their breaches are often ignored.
In a previous essay, Part 131: License To Kill, I discussed one facet of healthcare and government regressiveness in a particularly personal case. That is not the only negative experience I have had with bad behavior in this industry. A major case had to do with the HMO I used while employed by Ford Motor company. That was the Detroit based Health Alliance Plan. I now think of it as the Health Abuse Plan. Again I discovered our government has betrayed us. They have given a license to commit murder to the HMO industry. We are not allowed to sue these people in Michigan. I don't know how it is in other states.
In this HMO situation I was almost killed by an incompetent HMO doctor. I still suffer from the effects of her bungling and arrogant assumptions. She was a young snot who had me down as a whiney old man after drugs. If I had continued to depend on her as my physician I would certainly be dead now. Her name is Julie Elgas, I'll never forget her. I'll never forgive her.
It is possible I should have known when she was still there the second time I came that she was trouble. Up until then, I had had several appointments for yearly exams. This was at the Fairlane Branch of Henry Ford Hospital in Dearborn Michigan. Every time I went to this clinic I saw a different doctor. It seems the good doctors, by one means or another, got out of the place. The very good ones ended up at the main hospital in Detroit. In retrospect, I finally realized why she was still at Fairlane.
I don't know if she meant to kill me. I doubt it. I think she just did not care if I died. I would guess she has killed some people by now if she is still in practice. It would be an inevitable outcome of her methods. Like too many others in that HMO trap she was just turning the subscriber crank. For her, I believe it was a nine to five job. She processed her HMO assigned quota of subscribers per shift and got her pay. That was all.
I did not understand the problems I had at that time, but my health began to degenerate while I was in her care. I just knew I was experiencing increasing pain every day. I explained this to her, but she continued to sluff it off. Like so many young people, her attitude seemed to be, "so what. Your old. What do you expect?" One time she sent me to another doctor in the same building who specialized in joint problems. He brushed me off too. Again, I now understand why he was there instead of at the main hospital.
Another time, when I complained of severe neck and shoulder pain, Elgas sent me to a medical therapist. With no x-rays or any other diagnostic tool, she had decided I had a pinched nerve in my neck. The therapist did what the doctor ordered. She did the worst possible thing considering what the real problem turned out to be. She put me on what amounted to a medieval rack and stretched my neck. I went to that treatment twice and the experience was so painful I never went back. It was well I did not or I might have died right there on the therapist's rack.
Later Elgas refused even to give me pain medication. By this time I was sometimes falling down with no warning for no known reason. It just happened. Suddenly I would be on the ground without knowing what had happened. I did not black out or anything. My body simply collapsed. That was when I began to believe she expected me to die and quite bugging her. I also expected to die. I began psyching myself up for the inevitable. That was the only time in my life I have ever given up. I explained this conclusion to my wife. I knew I was going to die. I knew there was something terribly wrong with me. I knew the doctor did not know what was wrong and did not care. I expected to just go on doing the best I could until the end.
Well, my wife would not accept that. She took me to a local doctor who she knew personally. So, I finally got around this incompetent bungler by paying doctors outside the HMO to help me. I told this doctor, Doctor Katkuti Dutt, everything I had told Elgas. The difference is, he believed me and he acted on what I told him. He sent me through a whole series of test, most of which I had to pay for out of my own pocket. My wife's Blues helped some, but HAP paid almost nothing. That was about 15 years ago. To this day, they have not reimbursed me.
It turned out, the main problem was arthritis in my spine. I had calcium deposits in my spine that were compressing my spinal column. The only possible cure was high risk neurosurgery. After I had proven Elgas was incompetent HAP did allow the surgeons at Ford Hospital to treat me and save my life. However, as I said, they never reimbursed me for the diagnostics procedures that Elgas should have ordered under the insurance agreement.
When the neurosurgeon who saved my life, Dr. James Ausman, sent her a courtesy memo outlining what he was doing for me, she did not even have the decency to come to the hospital to see me. That is how my HMO assigned, primary care physician behaved. I hope you will not read this as an indictment of the medical profession. Rather, read it as an indictment of the money grubbing HMO industry. It was the heroic efforts of many excellent, real doctors which restored me to some degree of health and functionality. There was a time for about two years when I was certain I was going to die. I have had two heart attacks, four major surgeries, an angioplasty, a bleeding ulcer, and night terrors.
Now this would just be a "pity me" sad story except for other facts. The other facts are my HMO story is not unique. We see news accounts and expositions regularly on television, in magazines, and in the newspapers. From these the picture emerges of a total immorality within the entire health maintenance industry. There are executives all through the HMO industry with no morality whatsoever. My case with HAP is just one very good example of this. There may have been no overt intent by Elgas, but I honestly believe the HMO would rather have killed me that to pay the cost of my treatment. It was only when I spent my own funds and forced the issue that they allowed the Ford Hospital doctors to treat me.
Call it negligence if you wish. I will make the case wherein deliberate intent and calculated negligence are equivalent crimes. From the standpoint of the victim, the result is the same. People die because of the criminal dishonesty of the HMO industry. If I live long enough, I intend to write a fictionalized account of my own experience. I will call it License to Commit Murder. In that, I will lay most of the blame at the doorstep of our state and federal governments. It is they who grant the licences.
For now, I will insist, we definitely need reform in the Healthcare
industry, not just in the insurance part, but across the board.
There are crooks and murderers in hospitals and in the medical
ranks. Some of these people should be imprisoned. There are also
great doctors who cannot be effective because of this. There are
others who write off their bills rather than waste time fighting
the machine. And our government encourages and supports the crooks
and the murderers. I my next essay, I will outline one partial
solution.
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