Reducing the real cost of illness

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In the recurring debate over health care reform, you seldom hear one thing mentioned, even though it’s plain fact: Being ill sucks.

True, lots of things in life suck, but illness has a special suckiness to it. Yeah, we could all eat better and exercise more, but a lot of illnesses — probably most – come unbidden. They happen, whether due to accident or little critters that can’t be seen with the naked eye. There are unbidden and basically unavoidable.

This has come home to me in the last week while I’ve felt worse than I have in years.

A couple of years ago, I fell and landed on my right kneecap, breaking it in two. At the time, I was a member of the great uninsured class, so I never got it looked at. I lived with the pain, which was, at times, considerable.

Once I started school in January, I could get student health insurance, so I finally began having it treated. That in itself was an interesting experience. There are two things you never want to hear your doctor say. One of those is “oops.” The other, which I heard, always accompanied by a rueful chuckle, is, “boy, I’ve never seen this before.”

Needless to say, my knee hadn’t gotten any better in the time since I injured it. By the time I had my operation Monday, the two halves were 9 centimeters apart. That’s 3½ inches. And it looked like hell, not that my knees were ever going to remind anybody of Betty Grable.

And yeah, it hurt, and it was weak. I’d learned to live with the pain and fell on my butt only occasionally. Still, as one doctor pointed out to me, I didn’t have long before those rare falls could have put me in danger of breaking a hip. And that can be fatal, if only indirectly.

So the operation was a week ago Monday. They cut open the knee, pulled the two halves together and grafted them. That was no mean feat; the length of time it had been broken allowed tendons to shrink and the surgeons nearly gave up getting the two halves together before finally getting it done.

Now I’m in a knee brace. Fortunately, I have a big, honkin’ bottle of oxycontin (known on the streets as “hillbilly heroin”). It does a fine job of killing the pain, although it tends to make me a bit sleepy. I’m using a walker to get around, which doesn’t exactly look dashing but works well enough. Fortunately, Karon, my girlfriend, is staying with me and taking extremely good care of me. In fact, without her, I probably couldn’t have had the operation done.

But it hurts. I’ve been in more or less constant pain for a week. I’ve managed to keep my mood up, but every so often I get sick enough of it that it makes me a little cranky. And even at its best, my mood is tenuous.

The worst part about constant pain, though, isn’t the pain itself. The real problem is that pain is exhausting. It was about all I could do Monday to attend four hours of class. By the time it was over, I wasn’t in much shape to do anything other than watch TV.

It pointed out to me something I hadn’t thought of. There are legions of unemployed people in this country. Many are sick, some seriously. We not only expect them to fight through the pain and exhaustion to find work; we also expect them to meet the nearly superhuman demands of making a living when you’re feeling like hell and tired because of that.

You never really hear about that in the debate over health care reform. It’s always all about the money. The debate has become totally disconnected from its human aspects. People worry about how much it will cost the nation to provide health care for everybody, but nobody ever worries about how much it will cost the nation, financially and morally, to simply allow people to suffer.

Gee, is that socialism? I don’t think so, but I could be wrong. But this much I know: It’s decency.

I can tough out the recovery from my knee operation and, in the end, I’ll feel better than I did before (even if they have to fuse the joint, which will happen if the graft doesn’t take). But it makes me wonder about people who are still uninsured, whose pain will be with them for the foreseeable future, if not the rest of their lives. There are people whose pain, at best – at best – will doom them to a miserable existence. And if we’re going to make the kind of moral calculus that allows that, we’d better have a much better reason than, “Hey, it’s their own fault and besides, why should I help somebody else?”

Well, guess what? It’s not always their fault. And as far as why we should help such people, in a supposedly “Christian” nation, no explanation should be necessary. As I recall, Jesus was pretty big on the Golden Rule.

Like many issues in this country, the morality of the health care system takes a back seat to debates over the mathematics of money. Maybe it’s time that debate gets reframed.

Here’s a suggestion, just to give you a new perspective: Get rid of your health insurance, break your kneecap and leave it untreated for two years. If you find that a less than unpleasant experience, then you can tell me there’s no need to reform the way we provide health care in this country.

It didn’t change my perspective, personally, since I’ve always felt the same way about the issue.

But if you disagree with me, the experience might just change your mind. Maybe even your heart.

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