Healthcare and Chaos

Toronto Found a New York Times down the street in Cabbagetown on Parliament near where Judy Duncan, ACORN Canada’s head organizer, lives. That was the good news. On the other hand the shop charged $9 Canadian (which is almost the same as US Dollars) for the paper, and that was the bad news!

At the meeting of the ACORN Canada national board we had all spent some time talking about wages and benefits for the staff and various proposals. There was discussion of putting aside a small sum per organizer in a discretionary fund for supplemental benefits for health care where there are any small gaps in the Canadian system, but clearly neither the board or even the staff thought this was a desperate need, even though it would be a nice thing to do. The basic assumptions about health care availability and equity are worlds apart between the US and Canada.

The Times ran a front page story that was depressing and infuriating about the impact of cancer. A young, plucky woman of 35 with a preciously young baby was fighting for her life in this story against colon cancer that had metasized to her liver even as they discovered the problem after her baby’s birth a year ago. Treatments to date had cost over $400,000 and had been paid by her husband’s employer (Starbucks) insurance. Obviously, you wanted the story to end with her making it, but….

Disturbingly, almost buried behind this narrative was the more tragic story of people lost and the systems failures. The inability of the system to communicate meant that tens of thousands of lives were lost because lost because somehow the doctors and patients failed to connect and make sure that surgeries happened when warranted and prescribed. In other situations like prostrate cancers the opposite happened with tens of thousands of needless, expensive, and evasive surgeries happening when they were not needed. In one procedure where surgery is almost always effective, the inability to get it done was killing thousands. Add in the mismatches of income, gender, race, and education, and these are stories of killing fields, not health care.

How could any of this be possible? How can any medical system, whose watchword is “do no harm,” be allowed to operate so dysfunctionally and at such a basic and fundamental level?

The story’s end was a quote by the young Seattle woman about money. She said that she was not worried about paying whatever it cost to keep alive, essentially because she knew there were people who would not let her die for $200,000. I could spend lifetimes thinking about that quote and what it says about people and society and the injustices and inequities involved. People are dying because doctors and medical professionals can’t finish a sentence and make sure the patient fully comprehends in the shock of their condition their own chances for life or death. Health systems cannot assure the follow-up that makes sure health care needed is in fact health care provided.

I hope she makes it regardless of the cost, but the other part of the story seemed to say that for most people their lives are not worth 50 cents. How terrible is that?

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