Current events · Health Care · Honesty · Politics

A girl named Sue; U.S. Healthcare is failing people. Period.

I have not, and I will not share who I work with on Facebook, Twitter, here, or any other place online. I will let you know, however, that I work for the healthcare industry, and the company I work for is big. Like, one of the largest corporations in America big. Nationally recognized brand big. I work on the prescription side of things, assisting patients who need questions answered on their coverage, filling medications, helping troubleshoot our website (which is always down, grr), filling prescriptions, and just generally trying to bridge the gap between common knowledge and the labyrinthian hellhole that is the insurance industry.

Today was a rough day, at first because one system after another after another was crashing all while I was trying to assist patients on the phone.

But then it became a rough day for an entirely different reason. A patient called in and started talking to me. At first, I thought, “Okay, she’s kind of rambling on, but the situation is clear-cut enough. I’ll be able to get to the heart of this in a few minutes.”

I was on the phone with her for half an hour.

Sue (name changed, obviously), lives alone in California. She’s on Medicare. Two years ago, she found her husband dead in their bed. A few weeks later, her only daughter came home for five days and then died (she did not say how, though I suspect suicide or an accident). Sue saw the gardener who took care of the grounds in the trailer park where she lives get hit by a truck. He also died. She lost her dog, too, after thirteen years.

“I’m not doing well,” she told me. “I broke my back, and I broke my neck years ago. I can barely grip a pencil. Some days I can’t get out of bed. I can barely walk. The doctor thought I was going to be paralyzed. But most of all, I’m not doing well emotionally. I don’t know what to say, I don’t even have the words to say it. I don’t have anyone. I’m all alone.”

At this point, I was having trouble speaking clearly, because it was hard not to cry. Writing this now, I’m crying. Not knowing what else to say, I grasped for some bit of knowledge that might help her. I said, “There are programs available sometimes for people in your situation. You can see if you qualify for assistance.”

“I have,” she said, sounding deflated. “I’ve tried everywhere. They keep rejecting me because we bought the trailer I live in a few weeks before I found my husband dead in our bed. I just heard from a care group yesterday. I’ve been on their waiting list for two years, and they finally got back to me and said that they could afford to give me three hours of help a month. I’m taking it because it’s been months since I changed my sheets. I can’t even change my sheets. At least now I’ll have clean sheets.”

One of the measurements of success in my position is our talk time. We have to have an average talk time of around six minutes per call. It’s supposed to be a way for us to help the maximum number of people so that patients aren’t waiting on hold forever, but there’s an unintended side effect to it as well. With everyone paying attention and highlighting talk times so much, my colleagues and peers are bouncing patients around from department to department so they technically ‘end’ the call before that ~6-minute deadline. Even if they know or could find the answer to a patients questions, many of my peers care more about their stats (because that’s what the company cares about), and so they’ll bounce a patient around like they’re playing a game of Hot Potato.

“Every time I talk to someone I get a different answer,” Sue said. “Every person I talk to, I have to explain my situation all over again. It’s a complicated situation, and I’m just so tired of explaining it. I’m on opioid pain medications. I know they’re a problem, I see it on the news. I’m supposed to take five a day, but I stopped taking five a day, and I’m taking three a day. I don’t want to be addicted. The pain isn’t gone. Sometimes I can’t move around. But it helps.”

There are a lot of regulations that we and other pharmacies have to abide by to dispense opioids. We have to follow state and federal regulations and the guidelines of the insurance plan itself. It’s a hassle and a half.

“I hate that I have to tell people about my problems over and over again,” she said, “And I just wish I could get a straight answer. A consistent answer. I wish that I could keep talking to the same person and that we could work on this together because I’m all alone here. This system is so complicated. Sometimes I can’t write down all the steps because my hand cramps up writing and I can’t hold a pencil.”

I helped her. Because when it comes down to it, FUCK THE AVERAGE TALK TIME. When it comes down to it, I wanted to cry along with Sue and tell her, “You’re not alone. I’m here. I’ll help you as much as I’m able for as long as I’m able.”

But Sue is one of those who is going to keep having problems, because no one has been helping her, and because our system has let her down.

And I’m not just talking about the corporation I work for. I’m talking about THE system. The American healthcare system. There are too many laws, regulations, bills, and programs that are built around the greatest common denominator without taking into account the chaos that life can throw at you. Sue has been left in the cold. Sue is alone.

Sue is a human, just like you and me.

Hell, Sue could be you or me. Because you never know what life will throw at you.

I wrote to the director of my department this evening and proposed a program to assist people like Sue. I told her a little about the call, and that this was not the first person like this to come across my phone line. “We need to help these people,” I wrote, “They are falling through the cracks, and no one is helping them the way they need to be helped. I understand that this is a company, and it needs to be fiscally responsible and look out for their shareholders, but we can’t let people like this down.”

It was a long e-mail, just like this is a long blog post. It was difficult to write, but not as difficult as it was to say goodbye to Sue. I didn’t want to tell her goodbye. I wanted to give her a hug. I wanted to get her the help she needed years ago and get it for her now, but I couldn’t. I had to let her go.

“Thank you,” she said to me at the end, after I had gone over the steps she needs to take. Her voice cracked, and I could tell she was about to cry. “Honey, thank you. You have no idea how much it means to me that you listened.”

I’m showing you Sue’s story because more people need to listen to her. She’s been dismissed too much, and for too long.

She deserves better.


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