This past weekend, I came face to face with Ron Paul’s world of ‘let him die’. As a sociologist, I already ‘knew’ that world as a statistical and theoretical phenomenon…in which people without resources, and living on the fickle grace of the state…obtain inadequate and late healthcare that shortens their lives. This time, it was a part of my personal circle that it touched…and in a manner that illuminates the moral vacuousness of the worldview of ‘me, myself, and I’ all justified in ‘just work hard(er)’.
A close friend and business associate (aka ‘Ismael’ – not his real name) last week was called to the home of his cousin (aka ‘Kahlil’ – not his real name), who was reporting a high fever, near paralysis, diarrhea and vomiting blood. Ismael reached Kahlil’s home, and on assessing the situation, called 911 and asked for an ambulance.
Kahlil is an immigrant. Ismael had helped convince and make possible for Kahlil to immigrate to the States some time ago, where he has struggled to find enduring employment. Kahlil, now a college student, went back to school, when his previous degree was not generating employment. He is, in his sixth decade of life, in college again, to help him find work. Kahlil’s situation leaves him covered by Iowa Care, the state health program meant to cover people not eligible for Medicaid.
Like many immigrants, Kahlil left his unstable country to come to the US to have an opportunity to build a better life. His immigrant community has a higher educational level than the US in general, but in their migration, for many, their degrees have languished as they struggle with immigrant issues of language, customs and the residue of the Great Recession. Kahlil is not one of the ‘illegal immigrants’ which gives broad moral license to some to ignore their plight. Legal immigrant…but now without resources…and rebuilding.
The vomiting of blood was very concerning to Ismael, and Kahlil’s lack of being able to walk was also scary. Upon arrival of the ambulance, Ismael is approached by a woman who begins asking him questions on insurance.
This is healthcare in the United States…where emergency healthcare must first ask…”who’s paying”? Don’t ever confuse your ‘emergency’…with someone else’s pre-eminent need to know…who’s paying. Let’s talk money…then we can talk about yer right to life and well-being.
When Ismael explains that Kahlil’s covered by Iowa Care, the woman’s irritated response is that Iowa Care does not cover the ambulance. “Can he walk”? asks the paramedic.
“No…he cannot.” She insisted that Ismael make Kahlil get up and walk, rather than place Kahlil on the gurney (no clarity on the money yet). So Ismael and a friend of Kahlil’s, lift Kahlil, and start dragging him to the door, feet and legs dragging behind him, draped as he is over the shoulders of Ismael and Kahlil’s friend.
Remember…this is the best healthcare system in the world! Not a temperature taken, blood pressure, pulse…anything. No assistance offered or given. BUT…an attempt was made to ‘diagnose’…where’s the money?
Ismael is not the healthiest guy. He is on disability from brain trauma suffered from a car accident in which he was a passenger of a car that was T-boned in an intersection by someone running a light. He is still slowly improving…4 years later. He lost three small businesses due to his injuries and the incapacitation of his ability to work. Also in his sixth decade, an immigrant citizen, he too is struggling to rebuild, and he has a number of health issues. He can’t carry people easily.
In leaving the apartment building … with Kahlil…Ismael notices that the ambulance is parked at the far end of the building. He informed the woman that he cannot carry Kahlil that distance…and she said she would pull the ambulance to the other, much nearer end of the building.
After doing so, as Kahlil is being pulled towards the ambulance, she comes and asks again for insurance information. Ismael responds again that Kahlil is covered by Iowa Care. In a sharp response, “I told you guys before Iowa Care does not cover the ambulance! Do you guys have money because this is going to cost a lot of money!” My friend tried to get her to focus on his cousin, and suggested now is not the best time to try to figure out the money…Kahlil needed help immediately.
“This is going to cost at least $700!”
The weight of his cousin had reached Ismael’s limit for trying to carry him, so he and the other friend dragged Kahlil to Ismael’s car sitting very nearby, where they opened the back door, and laid Kahlil down in the back seat. The paramedic instructed Ismael to drive to the emergency room and they will follow (towards what end?). Confused, panicking, deeply uncertain of what to do…Ismael and friend help get Kahlil to fit, lying down, scrunched up in the small back seat, and Ismael jumps in and starts the car and starts to back out.
Kahlil, moaning, groaning, pleading for something to stop his pain…taps Ismael on the shoulder, and indicates, with mouth filling with fluid, that he needs to vomit. Ismael jumps out of the car and opens the back door to allow Kahlil to vomit once again, more bloody fluids. Panicking worse, Ismael ran to flag down the ambulance turning to leave the parking lot. Informing the ambulance crew of Kahlil’s sharp pain and continued vomiting…the woman, undaunted, offers “Ok…I’ll give you a vomiting bag” and proceeds to hand Ismael a bag with which to catch the vomit. Window back up.
Ismael jumps back in his car and giving the bag to Kahlil, assures him to go ahead and vomit and don’t worry about the car. Quickly, Ismael drives off to the Emergency Room. He runs inside and gets a wheelchair and struggles to place Kahlil in the chair…finally succeeding…and then proceeds to roll him inside and get registered.
Late at night, quiet…no one in the waiting room. No one being treated that Ismael can hear in ER. Nurse comes and puts a blood pressure monitor on Kahlil’s finger, takes his temp, and leaves. In lots of pain, Kahlil keeps pleading for a pain-killer of some kind. Pleads for water. Feverish. No one will address his pain, or his thirst. A group of medical personnel sit nearby, laughing, working on computer. No one giving any attention to Kahlil.
It takes more than a half hour, to get attention from a doctor. Quiet ER…and it takes more than half an hour.
Different deliberations occur. And then finally…one suggests…he thinks Kahlil is having a heart attack. Something that could have been diagnosed by the ambulance crew…resulting in a cardiac-arrest team waiting and ready when they arrived. Instead…nothing…no intervening action…for more than an hour since the ambulance first showed up at Kahlil’s apartment.
Now, shortly after they begin treatment…Kahlil has a second heart attack. CPR is given for almost two hours.
And now…Kahlil is a cousin in memory only.
Ismael thought of suicide a couple of times over the weekend…as he feels he failed his cousin, his family, himself. His confrontations with the institutions of healthcare, disability and poverty have been deeply wearing. A proud and resourceful man…he finds his adopted society…doing everything it can…to do as little as it can. Healthcare is wearing on people with good insurance…who find out the limits and the fine-print conditionals that meet one at so many turns. Ismael is seeing more and more a face of this country that he finds incomprehensible…and brutally ugly.
Time for someone to remind him…best healthcare money can buy! That face should also remind Ismael that ANYONE (which is not synonymous with ‘everyone) can make it in the US…which is how you fool yourself into thinking you’re guaranteed good healthcare…and all the while, that patronizing, reminding being offered from behind that smug, anxious smile of ‘I got mine…try to get yours’.
And for all the Coliseum crowd cheering on Ron Paul and the ideology lions…not to worry.
They let him die.
Tags: class, classism, conservative, conservatives, emergency, ethnicity, health, health insurance, healthcare, hospitals, immigrant, libertarian, libertarians, medical care, medicine, moral, one-payer, race, racism, right to life, Ron Paul
February 12, 2013 at 8:07 pm |
The profound reality of this harsh depiction of real life health care for many of us causes me to want to do something more than just read this article. This is utterly sickening. Thanks for bringing more light to the darkness of our American society Mark.
February 13, 2013 at 12:07 am |
Thanks for your response, Joan. Too often…social issues are buried in data, rhetoric and smoke. This was the most brazen example I’ve encountered of the ‘your-money-or-your-life’ structure of US healthcare. I’ve known of it…but it’s been too much at a distance to lift. Feel free to share the link with friends!
February 12, 2013 at 11:18 pm |
I would like to know exactly where this happened in Iowa.
Jerry
February 13, 2013 at 12:04 am |
Thanks for responding, Jerry. I have held off being too specific because all the follow-through is not complete. When it is appropriate…I will be more than thoroughly happy to let folks know.
February 13, 2013 at 6:05 pm |
Mark, I’ve lost some respect for you over this writing. Ron Paul’s world is not “Let him die.” During an interview, Wolf Blizter asked “Should we just let them die?” and a few nut-bags in the crowed cheered. Ron Paul answered, that no, you don’t let people die. So seconds after the nut-bags cheered, it was clear what Dr. Pauls’ stance was, but that didn’t matter to the Liberal bloggers that made up a story that “Letting him die” was Ron Paul’s world, and ran with it, and everyone else ate it up, and repeated it, and soon the echo chamber’s consensus was that Ron Paul wants uninsured to die. Fiction was repeated enough to turn in to fact. And you ate it up too. And now you’re repeating it and trying to add to it! Shame on you!
And you finish your piece giving hint that you might know what actually went on there with Ron Paul, but again make no attempt to clarify. Indeed the Colosseum crowd was cheering, but Ron Paul wasn’t. You know that human nature dictates that there will always be a few of the very worst in that Colosseum crowd. That doesn’t make it the opinion of the whole crowd, and certainly not the opinion of someone that blatantly stated their disagreement with it!
From Wikipedia:
——–
When one of the moderators posed a hypothetical scenario of a healthy 30 year old man requiring intensive care but neglected to be insured pressing Paul with “Are you saying that society should just let him die?”, several audience members cheered “yeah!” Paul disagreed with the audience reaction stating that while he practiced as a doctor in a Catholic hospital before the Medicaid era, “We never turned anybody away from the hospital.”[35] Paul elaborated further a few days later that he believed the audience was cheering self-reliance and that “the media took it and twisted it”.[36]
——–
Now, you decide that this story fits this same fictional model of “Let him die”. But it just doesn’t fit, for several reasons. Here’s how it played out in my head: Ismael is 60 years old, and has 4 businesses fail in 6 years. He’s wise. *FOUR* failed businesses wise! As a matter of fact, Ismael is expert at dealing with lack of money, and or debt, and or overwhelming bills (4 business failures!). Here’s someone that knows how to deal with a bill that can’t be paid….and knows full well that people will take payment over time, and take something, anything, over time, any amount of time, rather than get paid nothing. Here’s someone that knows and understands that when you need something, you need it, and you figure out the money later. Ismael shows up and assesses the situation as bad, really bad, and calls an ambulance. Ismael learns it will cost $700+ (Let’s round up to $1000) out of pocket for the Ambulance to transport his cousin. Ismael chooses to take his cousin by car instead. That was the choice that *he* made. It wasn’t made for him. At the hospital, where they’re GUARANTEED TO GET PAID BY THE STATE, due to the STATE HEALTH PLAN, cousin Kahlil dies. (So did the hospital let him die or did the state?) Ismael is overcome with guilt and is suicidal for not saying “I’ll pay for the Ambulance ride.” Ismael thinks his choice of transporting in his car is responsible for sousin Kahil’s death. Then Mark decides this story might fit the twisted vision (created by left wing bloggers) of how the left’s political opponents want the world to be. And we have this blog post.
In reality, it’s about as far from that as it could be. What played out in the story is clearly a failure of public insurance! It’s an erie preview of what’s to come when Obammacare ramps up to taking over the whole of the health care system!
Now, I may be very wrong in my assessment of the above story. There seems to be a lot more to this story! I was a big fan of Paul Harvey, and I will be happy when I know…. the rest of the story!
So I come along and read this story, and my humbug detector immediately starts to go off, and I start actually engaging my brain, and asking myself questions while while I read it, and start to realize that maybe this is spun entirely the wrong way. And that’s where this comment came from. To me, this looks like a way to further a political idea by spinning an unfortunate, and probably preventable death as a problem with insufficient state provided public insurance. I see it as an example of how the government will always fail, when it’s asked to provide for the people.
February 14, 2013 at 12:43 am |
Ahhh…ideology. What a tool!
Yes…you’re correct…the gladiatorial audience cheered for blood. Blitzer “… should society just let him die?” Members of the Republican audience across the auditorium…”YEAH!” Not all blood-thirsty. Just the vocalists. If you watch the video…their cheering is not about self-reliance. That is Paul’s disingenuousness…knowing full well, that cheering erupted around ‘let him die’…as reported not just in some ‘echo-chamber’ of the left…but in the world press.
So…if you didn’t like Ron Paul…and thereby want his answer to somehow look effective and at minimum…not cold and unfeeling…what did Ron Paul actually answer in substance…not form? An answer to the question…not to his own ideological pose?
He did the classic conservative dance of calling on the ‘good old days’…when white picket fences, lined with beautiful geraniums, with the air wafting apple pie…meant that ‘the hospital he worked at (in the early 60s), before Medicaid and Medicare…no one was turned away’. “I practiced in Santa Rosa Hospital in San Antonio…and the churches took care of them.” and “We’ve given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves, our neighbours, our friends, our churches would do it,’ he said.
Huh? A society born on the backs of Native Americans and slavery…has an ideology that believes ‘we might take care of ourselves and assume responsibility for ourselves, our neighbours, our friends’? What fricking species is he thinking would do this? Is he waiting for aliens? We had to use the National Guard to get kids of color into good ol’ boys schools…and we are going to be compassionate and provide adequate healthcare…charitably?
Did you see the ‘duck-and-weave’? One moment…he’s asserting that lack of coverage is a ‘freedom’…because of how Blitzer posed the question…and then he imposes the solution on neighbors, friends…and churches? Freedom…and don’t worry…some vague someone, somewhere, will take care of the sick and dying. Still socialized medicine…but by choice!
i.e., he offers a solution that didn’t work before (thus…why Medicare and Medicaid were created)…but yet somehow…now…with far fewer ‘charity hospitals’…and far fewer people going to church as a percentage of the population…and income inequality magnified…the good church folks would take care of things. Wonderful nostalgic images…grounded in ideology…not fact. Didn’t successfully and comprehensively take care of them before…and can’t keep up with the demands of poverty now as evidenced in just their food banks. No facts…just nostalgia and good, warm feelings. “..we might take care of ourselves and assume responsibility’. Ahhh…I hear the ‘Music Man’ in the background…
Somehow…it’s alright to assume the good church folks will pick things up…or our neighbors…but we can’t assume those same church folks and neighbors can pick it up when done by the state? Isn’t that fascinating? It’s ‘freedom’ to assume (i.e., impose responsibility) that someone, somewhere, will do it from the goodness of their heart (i.e, think Jim Crow and Southern Baptists?) but somehow it’s tyranny to assume those same folks can come together as a society and make the decision ‘we’ will take care of one another…democratically?? This from a guy from a state still under federal control for voting because it still has racial issues?
Isn’t that a wonderfully rich ruse? Imagine a southern doctor…with a personally fascinating racial history…posing nostalgic answers for serious medical issues…relying on charity…having lived that rich personal and state history? And people wanna follow this guy.
So then, substantively…though he knew better to come out and lick his teeth as some of his audience were doing…his substantive answer was…’yes…let them fend for themselves…and die’. Protect his followers from the camera’s glaring view…’…was cheering self-reliance and that “the media took it and twisted it” It’s real clear…the only twister was Paul.
Take away the fancy dance. No glamorous geraniums. Just the ‘reality’ that savages gussied-up, inane ideologies. A nation of many cultures…should rely on older white folks for charity? Mmm…that’s a good one. I suppose that explains the dogs and hoses in Birmingham and Montgomery? Charity? Probably explains CEOs making several hundred times what their line employees are paid. Very charitable species.
Then you decide ideology is useful to understand Ismael? Did you really read the part of Ismael’s failure, Jerry? Businesses failed…because he had brain trauma…and couldn’t operate his business. Went from 60-0 in a second…literally in the accident…figuratively in his businesses. Still wrestling with sight problems, hearing problems, memory problems, processing problems. Crushing defeat…because of someone driving through a stop light.
Wisdom? Is that what you want to call his depression? His sense of lostness? His humiliation and sense of failure to his community and family? His confusion? His years of recovery? Are you thinking he was supposed to step up in his state-assisted disability, with three children and wife, life in constant financial turmoil…and commit to the $700…or to go with your offer…$1000? Cuz that’s what makes a whole lot of sense to me. Someone on state-support…offer time payments!
Is that the ‘brain engaging’ part of this analysis? And you’ve lost respect for me in this writing?
Hear the ideological filters buzzing in your head? I don’t know why…but so many people have so many ‘solutions’ to impose on people, always assuming that the weak and vulnerable should just be able to rise?? From where does the training for that come? A ‘system’ of social relationships is failing big time…and the answer is…time payments? He took his cousin in the car…because he had no way to pay the $700. Is that somehow incomprehensible? His panic, frustration and loss…is my ‘left-wing’ spin? Notice the lack of questions? That’s the clue to ideologies. No questions to understand the finer details. Just assertions…to write the story that makes sense…to you…so the boogieman doesn’t live in your house. Journalists ask questions. Scientists ask questions. Ideologues…take minimal information…and make up stories.
Can you hear the ideological filtering…blocking you from actually ‘engaging your brain’…as you choose instead to look for ideological apologetics? Bring doubt and skepticism to ask questions. Not to spin to fit your comfort.
What the story suggests…before your ideology overwhelms it…is that the healthcare system is insane…with this idiotic mishmash of trying to force those less fortunate to rely on the inadequate coverage of the state…while those more fortunate get siphoned for money from private health networks, be it private insurance, private hospitals, etc.. Before ideological blinders are applied…the story points to how state insurance, which is demanded to be as low as possible by…ideologues…in a system designed to maximize profit (ambulance)…will always fail to provide for the well-being of all because there is nothing to maximize in profit when first…you try to maximize a people’s well being…all people’s well being.
The first steps towards the loss of life…is about profit before people…implicit in the paramedic’s orders to not pick up people without evidence of capacity to pay. Failing to be attended to…Kahlil’s heart attack is not detected…nor addressed…nor alerted to the ER. The problem begins…with that profit dictum..worshipped by the same people who want state-supplied health insurance to be as minimal as possible…to be as cheap as possible..and ineffective as possible…forcing people back to the private markets.
Ideology replaces thinking…not enhance it…nor permit it. It is a cancer in perception…and another dead man…waiting.
February 18, 2013 at 9:04 pm |
Somehow the story seems a little far fetched to me…especially to have happened in Iowa. It makes good left wing spin I’m sure but I’m like Mr. Pasker..I’ll wait for “the rest of the story”. The writer obviously hates Republicans along with profit, rich people, capitalism, church, individualism, private property, second amendment and the Constitution. Probably me as well because I am a “licensed to carry” citizen.
February 18, 2013 at 9:49 pm
Hear the blinding smugness here, Jerry? Somehow…the death of a poor person…is about spin…not about…a highly tilted, ineffective healthcare system that sells itself as the ‘best money can buy’…which implicitly means…’no money…no buy.’
I have never quite understood how in pointing out the failure of systems…protected by all of its ideology’s apologetics…how that leads to ‘hating’ things other than the inequality, the abuse, the injustice such systems engender? Do I hate “Republicans along with profit, rich people, capitalism, church, individualism, private property, second amendment and the Constitution.” It’s a trivializing, meaningless and non-illuminting charge…the invalidating illogic of gross generalizations and change of topic…that attempts to take the eyes off the issues at hand…horrendously ineffective healthcare system hamstrung by ideological foolishness…and make broad sweeps across the ideological plain to take on the ‘woe is me’ mentality of ideological identities lacking grounded, rooted, evidentiary argument.
Might as well wrap yourself in apple pie, a flag, and hold pretty kittens…to offer crocodile tears for the golden calves of an ideology that results in the original story. The rest of the story? What exactly would satisfy for the rest of the story? That it’s poor people’s fault that the health system promotes profits before people??
What I hate…is our desire to believe…anything…that keeps us from taking our foot off the necks of others. I’m sorry I don’t hate you for ‘license to carry’…but…I’m not an image sold to you by ideological media.