The New Health Dialogue

 

“Are we going to let John die?” Nicholas Kristof asked in his Thanksgiving weekend New York Times column.

We certainly hope not. We’ve spent a lot of time writing and reading about the nooks and crannies of the health reform bills. Details matter. But as John’s story reminds us, so does the big picture.

A year ago, John Brodniak of Yamhill County, Oregon didn’t expect that he would spend this Thanksgiving unemployed and uninsured -- and very sick. Just this past April, John, at age 23, got married, had a stable job at a mill and was covered by a basic health insurance plan. Things were good.

A few short months later, John is living a different life. He suffers from cavernous hemangioma in the left parietal lobe of his brain. In other words, his blood vessels are continually leaking blood into the brain. It’s like having the worst headache of your life every day. “The pain is constant,” John explained to Kristof. “It’s a 7 or 8 on a scale of 10, and then it hits the high peaks and makes me vomit.”

Experiencing continuous discomfort, John is unable to work. He lost his job. This also meant that he lost his health insurance. His new wife, Esther, quit her job to stay home and care for her husband -- but this left her (and her children from a prior relationship) also without insurance. The family has no regular income and no insurance. The generosity of their community keeps them from being homeless.

Medically, his condition is not hopeless. It’s operable. But without insurance he can’t afford treatment. Now he has qualified for the Oregon Medicaid program, but the reimbursement rates are so low that he hasn’t found a doctor willing to perform the surgery. As John explains, “The mill won’t let me go back to work until a doctor gives me a note saying I can go back. I tried with several doctors. I said, ‘Just give me a note … I’ve got to do something for my family.’ But they won’t.” So what is he to do?

Kristof writes that this “story is not so unusual.” He notes that, “If a senator strolled indifferently by as John retched in pain, we would think that person pitiless.” But Kristof wonders if standing idly -- failing to enact legislation -- is any better. John Brodniak’s story is another example of how those without health insurance go without. Kristoff writes that if any senator -- or anyone for that matter -- saw a man “writhing in pain on the sidewalk, they would presumably jump to help him and rush him to a hospital.” But for many, like John Brodniak, the emergency room isn’t an answer. In fact, the emergency room closest to his home told him not to come back. So for him, the Senate needs to be his emergency room. They need to act. To get him decent health insurance. To stop him from writhing in pain. To save his life.