Wednesday, July 22, 2009

What If? My thoughts on our health care crisis

When I think about the health care situation in this country, I always think of the people no one thinks about very much, the ones who fall through the cracks of consciousness. I think, first, of the mentally ill.

Mentally ill people are really despised in our society. They are not easy to live with and often their lives, and the lives of their families holds a level of stress and chaos that is simply unfathomable for those not affected. Mentally ill people often have trouble organizing their lives, trouble with personal hygiene and sometimes proplems with substance abuse. Chaos, stress and poverty are the offspring of mental illness. (I'm not saying that mental illness is the sole source of chaos, stress and poverty, but often when when mental illness is present, poverty follows).

The reason I think so much about the fate of the mentally ill is because my daughter is mentally ill. Will she get better? Is there a cure? Some enzymes, the right vitamins, a special diet? I ask myself these questions constantly, and much of my reading time is devoted to finding and answer.

As a mother, often my first reaction is to want to "fix it." And I'm not different when it comes to my daughter's mental illness. I want to fix it, and I often feel like it's my job to do so, my responsibility. Like, if I could find the right diet, and find the energy to help her implement it, then all would be OK.

But so far I"ve not done anything long enough or perfectly enough to really tell a difference. I do know that she was doing WAY better on the SCD diet than she currently is on the enzymes she's taking. Back to the SCD diet, or the very similar GAPS diet, soon.

But I digress. The health care system.

With a diagnosis of Schizophrenia, and an inability to do much school work we are fairly certain that in about three year's time, our daughter will be able, with our help, to apply for disability and get it. That will mean medicaid. And what kind of medical care will she get as a poor person, a mentally ill person, who is on medicaid because of her mental illness?

On the one hand, we want to be there forever to support her and provide a home for her. Is that what she wants? Too soon to know. But on the other hand, we are aware that she won't always qualify to be a dependant, and her status will have to change, in how we relate to her and what kind of health coverage she gets.

My brother-in-law's post about "poor man's insurance" is certainly chilling. Because the people in our society who probably need the BEST medical care, are consigned by our current system, to getting the very worst medical care.

There is a reason why many doctors don't take medicare patients and that is that the government does not provide enough reimbursement for the doctors to recoup their costs. At best they are breaking even on the medicare patients. Doctors, too, have to make a living, pay their malpractice insurance bills, staff, keep the lights on, etc.

So what is the solution? I don't know.

Another aspect of our current system that is not working is that we are effectively limited by our health insurance on what doctors can and cannot be seen. This means that often the best, or perhaps a doctor who might have developed an alternative approach to treating a particular disease, would be impossible for any but the very rich to see. I've run across, more than once, that the very best treatment facilities are often the ones who do not take insurance at all. As is the way of the world: The rich have access to the best medicine, and the poor have to suffer along with what is, in my view, basically the medical equivalent to fast food: cookie cutter, mass produced medicine that only asks a very limited number of questions, treats symptoms with the money-making products of big pharm, and which does not look at underlying causes or treat a person holistically (and by that, I'm not even touching non-physical issues, but rather does not even treat the human body in whole manner, but rather subdivides it into separate specialities).

Our medical system is as sick as our food-production system. I feel like we are so very very limited, and when I think of my daughter's future I see so few possibilities.

Meanwhile, we do the best we can.

4 comments:

elizabeth said...

This is really hard. You and your family and are in my prayers.

Mimi said...

I agree, there is no easy answer. I know what I want to see, but I honestly don't think that there is the political will in our country to do it.

So, the answer is to continue to float along with a patchwork that has huge holes in it, that people every day fall through. Sigh.

Prayers.

Philippa said...

My aunt, with whom I lived the first 20 years of my life, struggled with this same disease. Once she got past adolescence, she stabilized and lived a very productive life. She held down a full time job, had household responsibilities, traveled overseas, dated, socialized, and had several very close and loving friends. She graduated from high school successfully.

There is hope Alana. Hang on to that.

As for the health care crisis, I do not think our politicos have enough saavy to come up with a good solution. Nor do I think our doctors would be willing to adjust their attitudes to a national health care system.

I do not know an answer but I do know prayer helps in all things.

Hugs.

Anonymous said...

I'm a young adult now, but I had those things in common with your daughter. I had GREAT luck with medicaid, I found a lot of compassion for being that young, poor, mentally ill girl, and did not face at all the limitations in care that I had with private insurance. One thing to watch out for though with title xix mental health care for those under age 18 or 21, they are quick and fast and enthusiastic to violate parental rights and oversight. They almost consider that the state has become the guardian since it is paying, and unless the parent is right there and informed (I know you are) they are happy to go crazy with overmedicating or other harsh treatment that no decent parents would consent to.