THE TREATMENT AUGUST 27, 2009
Harold Pollack is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment.
If you have not seen this CNN clip, watch it now. Here is the transcript, which hardly does justice to the 2-minute clip of what was happening in that room.
Unidentified participant: "My husband has traumatic brain injury. His health insurance will not cover him to eat and drink. And what I need to know is: Are you going to help him?
We left the nursing home, and they told us we are on our own. He left with a feeding tube. I have been working with him, but I'm not a speech pathologist, a professional that takes six years for a masters', and I'm trying to get him to eat and drink again. [inaudible due to weeping].
Senator Coburn: "First of all, yeah. We'll help. The first thing we will do is to see what we can do, individually, to help you, through our office. But the other thing that is missing in this debate is us as neighbors, helping people that need our help. You know we tend to... [applause] The idea that the government is a solution to our problems is an inaccurate, a very inaccurate statement. [applause].
My wife and I watched this episode. She is a clinical nurse specialist who has cared for patients with delicate issues involving feeding tubes. We could not believe what we were watching.
We were not the only ones. I've heard from many physician-researchers and health policy experts who have seen the clip. They react with virtually uniform dismay to Senator Coburn's comments. Among physicians, this dismay was tinged with embarrassment, since Senator Coburn is one of their own.
Here, for example, is the reaction of Dr. Philip Pizzo, dean of the Stanford University School of Medicine. Dr. Pizzo practices in areas of pediatric oncology and HIV that have brought him intimate exposure to the profound traumas families face when a loved one is stricken with a life-threatening, costly, and prolonged illness. (I should mention that we cross paths since we are both advisors to Doctors for America.) In a phone call and a follow-up email, he noted:
I thought this was a very sad display. Here is a member of the United States Senate, a physician, who is essentially brushing off the experiences of a woman bringing forth a very tragic situation involving her spouse.
Dr. Pizzo went on to discuss romanticized notions of neighborhood and community help for people in medical crisis outside the realm of government.
In my career in pediatric cancer and AIDS, I remember when parents needed to take up collections from the community for serious medical conditions that - including at one time, bone marrow transplants. This was an untenable situation. We all recognize that when there is an immediate illness, neighbors, friends, and family will respond. And while that is appreciated and helpful, it will rarely if ever be able to cover the cost of medical care - especially for the millions of individuals who are uninsured or underinsured That is not a sustainable response.. to a serious and chronic condition. Only serious health insurance and healthcare reform will address such crises and human tragedies.
I'm sure that Senator Coburn is a compassionate man who will, "individually," do his best to help. He and much of his audience miss the larger point. This Oklahoma couple deserves better than to be treated as the pitiable objects of charity. They are entitled to effective help and support as fellow Americans whose lives have taken a tragic turn.
They indeed need the love and support of their neighbors, friends, and family. They need more, too. They need skilled home health care to guard against infection. They need visiting nurses and home health workers to help him regain whatever function he is capable of regaining in eating, drinking, and speaking.
Government, while not the solution to all problems, is the instrument through which a nation of 300 million people ensures that everyone receives proper care, even when some insurer or nursing home leaves him wounded by the road without adequate help. We owe each other that, in recognition of our common citizenship and our common humanity.
Americans face a stark choice in health reform. On one side, we have the President and Democrats who produce the Senate HELP and House Dingell bills, which (among other things) would remove lifetime expenditure caps on coverage for people with traumatic brain injury and would provide specific benefits for disabled people and their caregivers through the Community Living Assistance Services and Supports (CLASS) Act. We have the late Edward Kennedy, who declared last year that the cause of his life was to guarantee every American "decent, quality health care as a fundamental right."
Opposing them, we have almost the entire Republican Party, which continues its fight against universal coverage. Even within this group, Coburn's inflammatory statements stand out. His claim that "the stimulus is a step towards a Soviet America" exemplifies a spirit which animates many Tea Party protesters, such as the man I recently met carrying a blunt sign that read: "Drop dead, I'm not paying for your health care."
When you think of that desperate Oklahoma woman, which of these two sides is the more loving neighbor? That's a question that answers itself.