August 6, 2011

The Individual Cost of the Lack of Affordable Healthcare

I started dating Johnny around 1995 when we both worked for a small cab company, as dispatchers. The company was small enough that they were not required to offer insurance to their employees. (Cab drivers here in AZ are all sub-contractors that are not considered employees) I knew that he had diabetes and thought he was controlling it. We eventually moved in together to pool our meager resources to make ends meet. At the time he was making $10.50/hr and I was making $6.75/hr. (He had been dispatching there for nearly 10 years by this time). He was also delivering newspapers on a route for extra money.

After a couple years of scraping by, he decided that he would go back to cab driving, where he wouldn’t have a limit of hours or money that he could make. After dispatching for that long, he knew the ebb and flow of the calls & locations of the better calls. At the same time, he continued delivering newspapers to keep the money from that job coming in as well. I used to wonder what people thought to see a cab driving down their street to deliver the daily newspaper.

I eventually found a better job that provided a higher wage and some medical insurance. Since we were not married yet, I couldn’t put him on my insurance, but at least my son and I were covered. One day we were visiting Johnny’s sister, and I asked if I could check Johnny’s blood sugar, since we couldn’t even afford testing strips. Normal levels are between 80-100. Johnny’s blood sugar level was 588. Yes, almost 6x the normal levels. He said “That’s not right, I feel fine.” I knew better and knew that it was going to mean rough consequences down the road. I also knew that he wasn’t “fine.” We got married on /17/1998 and I was able to add him to my insurance, but the damage was done.

As he started finally having access to doctors, we started learning about what the high blood sugar was doing to every single organ in his body. The worst part was having to tell a cab driver, who loved to drive that he had become a danger to everyone around him because he couldn’t see well enough to tell if a street light was red or green in time if he was going 40 MPH. He’d been a very active person, always driving, but ended up nearly a shut-in, other than to go to the doctors or the hospital. 

With the other health issues, he was seeing a lot of different specialists:

  • Ophthalmologist
  • Cardiovascular Specialist
  • Neurologist
  • Dermatologist
  • Pulmonary Specialist
  • Nephrologist
  • Podiatrist 
  • Gastroenterologist
  • Endocrinologist
  • Psychologist (being sick for years is depressing)
  • His Primary Care Doctor who could ONLY keep up with what all of the other doctors were doing because of my notes during the doctor appointments (which I let all of the doctors review each visit.) There was a point in time where he was seeing a different doctor nearly every single day of the week, visiting each one every one – two weeks, as his condition was steadily declining. 

The list of “Co-morbidities” was growing faster than we could keep track of them. I’ve probably forgotten a couple of them, as it’s been a decade.

  • Diabetic Neuropathy
  • Diabetic Retinopathy
  • Partial Paralysis of the Upper GI system
  • Hepatitis B  
  • Thinning of the Epidermis layer of skin.
  • Cataracts
  • Valley Fever
  • End Stage Renal Disease (Kidney failure / Dialysis
  • Stroke
  • Stage 4 Colon Cancer (discovered 2/5/2002)
  • Tumor removed (2/7/2002)
  • Released from hospital (2/14/2002) on Hospice

He Died 2/24/2002 at Age 46

End Stage Renal Disease alone costs $9,760 per person per month, according to Medicare (CMS) data. ($117,120/year or $234,240 for the last two years of Johnny’s life.) That’s after the $60,000 fistula surgery that connected a vein to an artery in

his lower arm, to make it easier to hook up to the dialysis machine. (Think Julia Roberts in Fried Green Tomatoes, when her character needed to start dialysis.)

Other people who have End-Stage Renal Disease live many years longer, and this cost is only one portion of the costs of being a Diabetic without insurance.

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