Personal Responsibility In Health Care and Conservatism

Appearances can certainly be deceiving, as the saying goes. I have been accused of being able bodied, as if that were a crime. But seriously, I have a handicap placard for use in vehicles, and both of my cars and my wife's car have a red handicapped sticker in the upper left corner of the license plate. Granted, I do not use a walking aid, and one of my vehicles is a panel van with ladders on a rack on top of it. But on more than one occasion I have been derided by of all people, the elderly! One lady sneered at me as I was coming back to my car, "you certainly look handicapped". I asked her if she would like to see the scar from my defibrillator? She just got into her car continuing to jeer at me.

I do get about rather well because I responded well to the regimen of medications that I take. However, without those medications, I would be in a world of hurt. Without those medications I could not walk more than 75 feet without having to take a 5-minute break to catch my breath.

I have severe dilated cardiomyopathy. That means that I have an enlarged heart that is severely weakened. My heart has been damaged. Perhaps it was genetic, as my grandfather also had this condition. It could have also been years of hard living in my youth that contributed to this condition; I make no claim on sainthood. But regardless of the reason for the condition of my heart, the fact remains that I am handicapped.

This condition of my heart was found out as a result of going through another health crisis back in January of 2004. I had what is called ARDS, which stands for Acute Respiratory Distress Syndrome. ARDS is respiratory failure that is often accompanied by other complications like congestive heart failure or sepsis, or multi-organ system failure. I had it all in spades. I had double pneumonia and I very nearly died because of it. I spent 42 days in the hospital from January 21, through March 2. I spent 15 of those days on advanced life support in the respiratory ICU. The reason that I had gotten so ill in the first place was that at some point in my past I had contracted HIV. This lengthy hospital stay was when I first found out that I had been carrying around this deadly virus for possibly the past decade.

It was a harrowing experience, a very narrow escape. Not only was I bedridden, but I was paralyzed as well. I was totally reliant upon others for everything. They fed me, washed me, changed my bed sheets, medicated me and helped plan for my rehabilitation. I went through intensive physical therapy to regain my strength and the full use of my limbs. It was an arduous task fraught with tears and doubts. I also received extensive speech therapy that was designed as much to assess my capabilities as well as to regain them. During my time on life support, my brain had swelled dangerously and they were not sure if it had been irreparably damaged or not. It was exhausting work, but well worth it. By the time that I checked out of the hospital, I was able to walk with a walker for about 100 feet before requiring an extended break.

I had received a crash course in medicine and the health care system. I was attended by several teams of doctors and nurses of various specialties. I learned about endocrinology, cardiology, virology, gastronomy, immunology and infectious diseases, and internal medicine.


To this day, after leaving the hospital, I continue to see the infectious disease doctors on a regular basis. I did not start HAART therapy, until a few weeks after going home. HAART stands for Highly Active Anti-Retroviral Therapy. Retroviruses are different from viruses in that viruses normally contain DNA that allows them to reproduce its RNA by taking over a host cell's resources, whereas a retrovirus contains only RNA and enzymes that it uses to insert it's RNA into the DNA of a host cell which then becomes a virus factory. The host cell becomes totally responsible for replication of the virus.

The infectious disease doctors along with the Visiting Nurses Association of Michigan provided me with information about all the available medications for combating HIV. the VNA also provided case management for me. But the decision as to what particular medications to use was ultimately left up to me. I researched possible side effects, efficacy and ease of compliance. I had to pick three medications for my HAART therapy. The doctors told me which classes of drugs that would work best for my specific HIV genotype but the specific drugs to use was my choice.

It has been six years since then and I continue to do well. But after what I went through then, I can not possibly support what Obama's administration is proposing to do to our health care system. I have too much at stake. I have too much to lose if I can no longer access all the teams of my doctors, or no longer have access to all of my medications. I have been through step therapy with medications already, and the regimen that I am on works well for me. It is not time to reinvent the wheel here. I have one cardiologist who takes care of my implanted defibrillator/pacemaker and another one for my heart itself. I have a primary doctor who specializes in internal medicine. I have a wonderful dentist. I have a great podiatrist. I also have a great ophthalmologist. I even have a wonderful otolaryngologist. I have a fantastic dermatologist.

I have established relationships with all of these doctors. They all accept my insurance. They all know my medical history, and me! Now is not the time to have some bureaucrat insist that I start the process of assembling my medical team all over again. Or that government officials insert themselves into my business at all. I know best what works well for me!

Good health care begins and ends with the patient. If you aren't ill, you don't need a doctor. And when you are ill, you must actively participate in your own recovery. You can't show up at a doctor's office and expect them to just wave a magic wand and make you all better by prescribing a medicine for you. Personal responsibility is a huge factor in getting well again. Personal responsibility is also a huge factor in maintaining your good health.

William Beaumont hospital in Royal Oak Michigan is a very large hospital system. There are three hospitals in it and the Royal Oak campus is the largest and the original one. They are one of the top 10 hospitals in the country for number of beds, admissions, and for positive outcomes. I could not have been in a better place or in more capable doctors' hands while there. They certainly did all that they could do for me but even they would tell you that it was nothing short of a miracle that I am still here today. But as with most large corporations, they tend to move slowly from an administrative point. Beaumont is no exception to that rule. They did not get around to billing my insurance until six months after my discharge. That was unfortunate indeed because the over the road trucking company that I was working for at the time was self insured and had switched administrators for the plans that they offered right in the middle of my stay! I checked into the hospital on January 21, and on February 1 we had a new plan administrator. Now my COBRA payments were all up to date, but because my company chose only a 90 day run out on the previous plan provider, when the bills finally came to the new provider their records showed that I did not have coverage for those last 10 days of January when in fact I did. So it took several phone calls and one 80 page fax of denied EOB's (Explanation of Benefits) and hospital bills to my former employer's human resources department to get it paid. 


Because the hospital had begun billing me for the unpaid balance, I was amazed to see just how much my stay had cost. The total bill was $742,636.59! Over 54 thousand dollars of that was for medications alone! Now I did have an obligation to pay my co-pays, and my out of pocket maximum. Thankfully, it only came to a few thousand dollars. My wife and I immediately organized a debt management plan through our credit union and we were able to pare it down in short order.

I pay my part. I pay my co-pays. I pay my premiums. I shopped for low cost generic medications. I get most of my prescriptions from Walmart. I take responsibility for my own health care. I will not foist this responsibility upon others. As far as the poor or indigent goes, there are free clinics and charities that willingly take up the cause of those who fall through the cracks. Our current system works well. I know this from experience. That is why when I say that this administration's efforts to take over health care in our country has nothing to do with health care but instead has everything to do with power and control over you, I am indeed speaking from experience! This is not some slogan or bumper sticker or talking points that I am parroting. I speak from experience!

I know what works best for me. When this hospitalization happened, I had lost my job, was on COBRA and disability for 18 months before I could return to work. My wife and I were deep in debt, had all of our stuff in storage and were living in a room at my grandmother's house. Now we own our own home, I am back working my day job, and running my business, and advocating for responsible solutions to the minor problems that our health care system does have. Believe me when I say that Obamacare or Pelosicare is not one of them!