The health care circus is definitely three ring
It's been a long time since I was in the hospital for any kind of major, stay over, surgery. But my experience the last few weeks with a friend of mine who got sick has shown me what a circus all the aspects of health care can be.
About three weeks ago she developed a skin condition that seemed to get worse and worse. She made an appointment with a dermatologist. During the ensuing few days after she made the appointment she got very sick and weak. She got to the point she could hardly get out of bed. A single woman, living in Salt Lake, some of her friends helped out, but they all saw the deterioration. They finally took her to her appointment and it turned out she had a flesh eating disease and the sent her to emergency at Intermountain Medical Center in Murray. The looked at her and immediately admitted her to the hospital.
After a thorough examination, the doctors decided surgery was needed; extensive surgery. The disease had decimated part of her body and her kidneys had shut down. It really was touch and go for some time.
Up to that point things were done well. It was after that, the care and the rehab when we started to see that the entire systems is a mess.
She came out of surgery well and went to ICU. There she had a nurse that was very good for a couple of days and case workers who started to come in and talk to her about her future and what she would need to do. Finally she was removed from ICU and put on a care floor. While she was in ICU she had been told a lot of things from different people. Some of it contained mixed messages. One person would tell her one thing, while another would tell her another. I was there part of the time and other friends who stayed with her also heard these inconsistencies. And it wasn't just the nurses, social workers, respiratory therapists, etc. It was the myriad of doctors who came to see her. What was good was one nurse for each eight hour shift, the same every day, so they knew what she needed and what was going on.
That all changed on the care floor. The mixed messages became greater as resident doctors came in, some with great bed side manner, but one woman who wouldn't give anyone the time of day and basically treated her as if she were a child. Every shift brought on a new nurse; she never had the same nurse take care of her in the week she was on that floor. Each time it was like learning all over again. When friends weren't there, she would need things and no one would respond. The mixed messages about what she needed to do or what she would have to do, or even what was wrong with her continued at a greater pace.
Finally the case worker came in and wanted to talk to her about releasing her to a care center, mainly because the insurance wouldn't pay for any more days in the hospital. Her main doctor had requested she stay, but the insurance company overuled that. So he suggested she be sent to Promise, a special wound heal center at the old LDS Hospital. The insurance company said no and sent a list of places she could be released to. Her sister-in-law and I went out and examined some of these facilities before they were going to remove her. Of course what you can see and know on a visit is different than what you can see and know when one stays there. Most looked okay, but we had no idea.
So the insurance assigned her one and sent her there one afternoon before we knew it. By six o'clock that night we realized it was nothing that it seemed. It was a care center largely for Alzheimer's patients, not for a person with the kind of wound she had. Even the nurses at the center said they couldn't understand why she was sent there.
We finally got her admitted back into the hospital that night, because it was so bad. We basically had to threaten the insurance company to get her back where she should have never left. However, because we were requesting it after hours we had to use Gold Cross Ambulance to take her back through emergency, which the insurance, of course, is refusing to pay for. She left at 7 p.m. and it took until 1 a.m. to get her admitted again.
Again it was the same for the next three days. A parade of different people, all requiring the same information that 10 other people took time and time again because they were new and didn't know about the situation.
Again she was released to another care center. This one was better in terms of real care, but they treated her like a leper. In the hospital people were allowed to come and go and she was even taken for walks down the hall. In this place to visit you had to have a mask and a gown on when you went in her room and they sprayed your feet with a disinfectant when you left. She could not leave the room, period. She could not walk like she did in the hospital with the therapist. They were worried she would infect other patients. I thought that was a little odd since the actual hospital did not even seem worried about it. The food was terrible. Finally she said to all of us "I am checking myself out." She got ahold of her surgeon and told him she wanted home health care to come and take care of her. The surgeon was concerned but allowed her to go home.
Since then the care she has had at home has not been as good as we would have hoped (you know, the insurance, despite the fact they are saving bundles of money by not having her in a care center and instead having a nurse visit one hour a day) she is happier and is gaining on the disease. Her strength is coming back and she is able to even go out in her yard in her wheel chair and enjoy the air and her garden.
If this is the best health care in the world, as many claim it is throughout the medical conglomerate, then it must really be bad everywhere else. And I even left out many other gory details that I could have included but it would have made this piece much longer than it already is.
Governor Herbert can talk about how great IHC is all he wants, insurance companies can say they really take care of their insureds and hospitials can give us their credentials about the wonderful care they give patients.
But what I saw was largely an embarrassment. I know this was only one case, but how many more are there. Insurance companies control our health care, not doctors. The last report I saw said that our health care system is ranked 19th in the world. All the money we pay, all the money employers pay just goes into a system that is a mess.
I agree that Obamacare may not the answer, but neither is what we presently have.