Saturday, September 15, 2012

Best Healthcare In The World, or Just The Most Expensive?

Hubby is improving in leaps and bounds, however, the bills for his care have started rolling in. This week we've had to throw ourselves on the mercy of our hospital administrators and seek relief from some of the bill. We haven't received all of the bills yet and given the amount we do know we owe, the total will run somewhere in the $35,000 range. For those readers who are thinking we should have been paying for health insurance,  our income has dropped so significantly in the past 3 years that we are only $1700 a year over the amount that would have qualified us for full payment of our bill through the charity established by the hospital.

On Tuesday we submitted the paperwork which is based on Hub's projected income and my current income, which is some $200 a month less than it was in June. The county agencies haven't been taking new cases so there has been nothing to replace cases I lost to nursing homes. Once the paperwork has been submitted, our income can't change until after the determination on the amount they're willing to forgive. It's usually half, and then they set up monthly payments. Of course, the way our luck has been going, on Friday I finally got offered new cases and I can't take them. The number of hours offered aren't enough to make much difference in the determination, however, they'd be enough to stop the process so we would have to resubmit the application. I'm not going to say I make this much, increase my income and not report it.

I'm also not going to obsess over what we owe. There are people out there in worse shape than we are. Even people with insurance are on the verge of bankruptcy due to their medical bills.

I was talking to my brother-in-law yesterday. His wife had fallen, shattered her shoulder and needed to have it replaced. The mechanical shoulder parts alone cost $16,000. The surgeon's bill was another $16,000. Assorted other charges, hospital, rehab, etc. came to $53,000+. Total of her bill was over $85,000. They have great insurance which costs them a pretty penny monthly so most of the bill, minus co-pays and deductables got paid.

While they may be in decent shape with their medical bills, there are people out there experiencing the same problems without their great insurance. Even Medicare doesn't pay what people think it pays. Which Hubby will have in 8 more months. I think the "if it weren't for bad luck we'd have no luck at all" idea applies here.

Hubby's stay was at an award winning hospital here in Central NY. They've made significant changes since both my parents acquired MRSA back in the 2005-2006 care years. However, I still saw mistakes which could have had the potential to interfere with the recovery of my husband.

From his time in the ER, there were nurses ignoring the alarms from the IV pump. Every time Hubby moved and he did a lot of that because he was vomiting, the alarm would indicate air in the system. I'd have to open the door to the main room and ask for assistance because it was scaring me. They'd bleed it out and reattach it and then ignore it again. These alarms communicate with the main desks, yet you have to go find someone to care for it.

The day after surgery, Hubby's IV infiltrated. No one noticed it, despite the fact that the patients are supposed to be checked every hour by someone. Usually an infiltrated IV causes a localized swelling and if left untreated will then spread as far as it can. Hubby's spread to his elbow. His hand and arm were swollen to 3 times it's normal size and he was hallucinating from it. I had gone home for a couple of hours and he had to ask his roommate's wife to ring for the nurse because his remote had been placed out of his reach when they took his blood pressure. Seeing a clock and TV on the ceiling scared him. They aren't supposed to move like that, you know?

They brought him towels, wash cloths and clean gowns so he could wash up. Then they didn't disconnect anything so he could get up and use them. He had an IV on his left side, inflatable booties on his legs which were connected at the foot of the bed and an NG tube connected to the wall behind his head on his right side. A nurse came in later in the day and discovered that he hadn't changed and was in the process of speaking to him about his not cooperating with the cleanliness keeps the germs down agenda. I very calmly pointed out that he was hooked to the vacuum on the wall and nobody seemed to grasp that it should be disconnected long enough for him to get up and do so. DUH!

The surgeon ordered the NG tube disconnected around 10 am on Thursday. The order went to the dietician to discuss the low residue diet he needed to be on and she did so at 11 that morning. However, the tube was still in when they sent his lunch up at 12:30. It seems that the floor staff felt that an order for continuing the NG tube post surgically, written on Wednesday and an order to discontinue it written on Thursday were "conflicting orders requiring clarification". The tube came out around 3 that day. First thing he did was head to the patients bathroom to wash up thoroughly and shave. Then he took a walk in the hallway with me. The booties weren't as successful in keeping the edema in his lower legs and feet down simply because he couldn't walk as much as he should have.

Fortunately none of these mistakes interfered with the process of recovery, but every one of them had the potential to do so. Local doctors do everything in their power to either avoid sending patients to the hospital or to get them released as soon as possible. Hubby was released a day early with the advice to go home and shower immediately and wash all clothing that remained in the hospital during his stay. That advice tells me that despite claims to the contrary, superbugs like MRSA or C. dificile are not things of the past. So far, we seem to be clear of both. I'm still keeping my fingers crossed.