I am a psychiatrist practicing for a decade in a Catholic hospital in Pittsburgh. Our hospital has a mission to treat the poor, and in this country, that means treating the uninsured. Last year, I spent the entire year practicing in a public hospital in Newcastle, Australia. In Australia, every citizen has Medicare, from birth to death. Being able to treat patients without worrying about insurance completely transformed my practice and brought the joy back to my job. I believe that no one should have to go without health care or suffer the guilt of bringing financial ruin to their family just because they are sick.
It hasn’t been easy since I have returned to Pittsburgh. Every psychiatrist is continually involved with patients who are in deep emotional pain, but here, patients’ problems are made worse by lack of health insurance. I recently counseled a woman who was unable to overcome her alcoholism until residential alcohol treatment. When she relapsed a year later, almost dying in a drunken driving accident, she told me she knew she should go back, but she still owed five thousand dollars from the original treatment and could never afford to go back. It still haunts me that she is out there somewhere, in danger of killing someone on the road.
I have another patient, a young man who suffered a head injury, which left him crippled and in a wheel chair. Because he had no insurance, he was denied care at an expensive rehabilitation facility. Instead, he spent 6 years in a nursing home for the indigent watching TV all day. He says he is not angry anymore, even though he believes that if he had had insurance, he would be walking today. I have spent hours in meetings to decide what to do with patients like him – uninsured, brain damaged patients who are stuck in the hospital with no where to go.
I have listened to the heartbreak of a depressed, suicidal housewife who had exceeded her 30 days of hospital coverage for depression. She knew that each day she stayed in the hospital was going to add over $1000 to a hospital bill which would ultimately bankrupt her husband. She tried to pretend to be well enough to leave, but when she was honest with me she said “I am worthless. I should have killed myself a long time ago. I’ve ruined our lives. I won’t ever come back.” I knew she meant to kill herself if she was allowed to go.
Every day I look for ways to tell people of the misery of medical and psychiatric patients in a country where they suffer guilt and shame knowing that they are bringing financial ruin upon their family just by being sick. This kind of suffering weakens families, communities, and ultimately the nation. This is what I believe.
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