I heard a horrible story when I was in Yemen last week. A couple visited a typical Yemeni hospital, filled with bacteria cultures and lack of basic hygiene. They told how, if you have an emergency and need surgery immediately, such as an artery spilling blood out, the hospital won't even treat you, until your family pays up, in cash, ahead of time. Then, as they're doing the surgery, the family waits next to the table, for very time you need something, like anesthesia, the family must run off to the hospital pharmacy to purchase it.
The callousness towards the human condition turns my stomach. How can people be treated that way? How can we see a fellow human suffering, and not respond? How can we not heal, especially if we are doctors, regardless of the cost to ourselves or the hospital?
And yet, I can see what they might argue. There are limited resources, in this, the poorest of the Arab countries. If they were to treat everyone without demanding payment first, they would quickly run out of the resources. And if they did not demand the payment up front, in this culture, most families would never pay, for things can be put off, and most families are frankly far too poor to pay.
No, I find none of these arguments convincing either. But I was then struck, as I listened to the story from this couple, how similar our situation in America is, and how similar my own situation is.
No, we wouldn't allow someone to bleed to death on the operating table for non-payment- not here in America. But we would allow, and do allow, someone to go without if they refuse to sign a statement to pay. If it is not immediately life-threatening, and the person is in great pain, we require them to sign a statement saying they will pay before we treat them. I experienced this myself when I had kidney stones, and I lay writhing on the floor in pain while they insisted I sign a document. Trust me, to get rid of that pain, you'll sign anything.
And if the emergency is immediate, we will work to heal the person- and then bill them for tens or hundreds of thousands of dollars (depending on how severe the treatment and how long the hospital stay). Many like myself know this, so we don't go into the doctor, for we don't want to go deeper into debt. We can't afford insurance, and we can't afford costly hospital bills, so we weigh out how much pain we can tolerate before absolutely going in.
And this is where it gets worse. Because we wait, it does get worse. And our country is like the Yemen in this respect too: we refuse to treat the uninsured for preventive care, unless they pay up in full. Yet I am not insured, and I can not pay up, and so I do not go in for treatment. And when you don't work on preventive care, not only does the cost for the nation increase, but the danger increases that one's illness will be irreversible.
And so these were my thoughts when I listened to the couple describe their horrible experience in the Yemeni hospital. I've been to the doctor a couple times, and gotten tests, in the last six months. This resulted in bills of about $900. Thankfully the hospital reduced it out of compassion to half, and my church assisted in covering a quarter, the last doctor's visit. But unfortunately, my pains still continue, and the doctor didn't discover how to fix them, or what completely is wrong. I suspect things might be very wrong, but can't afford to go to the doctor yet again. I can't afford more tests. I can't afford surgery to alleviate the pain. And things might get worse, or already be too far gone to fix.
Are we all that different from Yemen? We allow the poor to suffer and die because they can't afford preventive care, insurance, or costly hospitalizations and surgery. While I was in Yemen, evidently a huge national argument, more a riot, blew up in the States over universal health care. And I am convinced, from what I read in various comments online, that I have a number of conservative friends who would rather that I die, then for them to give up their resistance to universal health care, or give an inch to what they perceive as creeping socialism. Oh, I'm sure that each of them would be happy to pay my medical bills, could they afford them. But that's not possible for any one individual, unless they were fabulously wealthy. It's only something an insurance company or a central government could afford.
It's time to look at ourselves honestly, and to no longer perceive ourselves in some colonialist way as better than the teeming masses. Yemen and 2/3rds World countries like it is just more honest in their rejection of care for the ill. We can either decide that we are better than this, and change our ways radically, and begin caring for all of our ill, no matter their poverty and ability to pay and the cost it might have in higher taxes; or we can forgo for all time the claim that we are somehow better than other countries in our righteousness and compassion and care for the least of these. We can not have it both ways.