Sunday, November 29, 2009
John Brodniak of Yamhill County, OR. - A Victim of Our Health Care System
Nicholas Kristof's column in NY Times 11-28-09:
Are We Going to Let John Die?
If Joe Lieberman or other senators came across John Brodniak writhing in pain on the sidewalk, they presumably would jump to help him and rush him to a hospital.
Unfortunately, an emergency room won’t help — indeed, the closest E.R. has told him not to come back, he says. So, for those members of Congress who are wavering on health reform, listen to John’s story.
John is a sawmill worker from Yamhill County, Ore., where I grew up. He was a foreman at a mill, he felt strong and healthy, and he had very basic insurance coverage through his job. On April 18, he was married, at age 23, and life was looking up.
Ten days after the wedding, he was walking in his backyard carrying a neighbor’s dog — and he suddenly blacked out. That led, after rounds of CAT scans, M.R.I.’s and other tests, to the discovery that the left parietal lobe of his brain has a cavernous hemangioma. That’s an abnormal growth of blood vessels, and in John’s case it is chronically leaking blood into his brain.
John began to have trouble walking and would sometimes collapse. He developed spasms and restless leg syndrome, he began to use a cane, and his mind suffered.
“He forgets stuff a lot, he bumps into things,” said his new wife, Esther Brodniak. “But he keeps things light. He jokes about it.”
Perhaps the worst is the pain — blinding, incapacitating headaches that have left him able to sleep only in short intervals. He vomits daily when the pain surges.
“The pain is constant,” John said. “It’s a 7 or 8 on a scale of 10, and then it hits the high peaks and makes me vomit.”
With John unable to work, he lost his job — and his insurance coverage. Esther had insurance for herself and for her two children (from a previous marriage) through her job building manufactured homes. But she couldn’t add John to her plan because of his pre-existing condition.
Without insurance, John has been unable to get surgery or even help managing the pain. When he collapses or suffers particularly excruciating headaches, Esther rushes him to the emergency room of one hospital or another, but an E.R. can’t do much for him. One hospital has told them not to come back unless he gets insurance, they say.
Esther used up her family leave time to look after her new husband. “Then I went back to work, and he fell several times,” she said. “I told my boss that I had to quit. Taking care of John was more important than building someone else’s house.”
That meant that the couple had no income — and no insurance for anyone in the family, including the children. Neighbors have helped, and a community program has paid the rent so that they are not homeless. But bills are piling up, and John and Esther don’t know how they will cope.
The doctors warn that pressure from the growth could lead a major blood vessel nearby to burst, killing him. “They tell me I’m a time bomb,” John said. With a touch of bitterness, he adds, “It sort of feels as if they’re playing for time to see if it bursts, to save them from doing anything.”
I’m not a physician, and I certainly can’t speak to the medical issues here. But I have examined John’s medical records, and they appear to confirm his story.
John says the principal obstacle to treatment appears to be simply his lack of insurance. In August, he qualified for an Oregon Medicaid program, but he hasn’t been able to find a doctor who will accept him as a patient for surgery, apparently because the reimbursements are so low. Doctors tell him that his condition is operable — but that they can’t accept him without conventional insurance. He is increasingly frustrated as he watches his family crushed by the burden of his illness.
“The mill won’t let me go back to work until a doctor gives me a note saying I can go back,” he said. “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.” John and Esther agreed to tell me their story in hopes that somehow it would lead to medical help.
John’s story is not so unusual. A Harvard study, to be published next month in the American Journal of Public Health, suggests that almost 45,000 Americans die prematurely each year as a consequence of not having insurance. John may become one of them.
If a senator strolled indifferently by as John retched in pain, we would think that person pitiless. But isn’t it just as monstrous for politicians to avert their eyes, make excuses and deny coverage to innumerable Americans just like John?
And Members of Congress
- Lawmakers' health insurance, which is the same available to all federal workers, is part of the equation. Members of Congress also receive care by a physician at the Capitol for a small fee and treatment at military hospitals — the same offered to presidents and visiting dignitaries, watchdog groups say.
- "They get what bureaucrats get — plus," said Steve Ellis with Taxpayers for Common Sense.