Pre-Existing Conditions

About seven years ago my husband fell off a ladder. He was unconscious, broke his nose and chipped several teeth. He wound up spending two days in the hospital and got all sorts of tests. For the next two years a cardiologist was sure that there was something wrong with his heart; he just wasn’t sure what. During all this, our insurance company at the time, HMO Blue, started sending him material about living with congestive heart failure.¬† CHF was probably the only diagnosis the doctor hadn’t given him. However somewhere, someone coded the doctor’s as CHF. Insurance companies try to do a lot of education with people who have chronic diseases to help manage costs. That’s fine but not when you don’t have the disease. I was really worried that this would¬† wind up being a pre-existing condition that could prevent him from getting a different job in the future. It took me over a year to get HMO Blue to change the coding so he no longer appeared as having CHF. It is this kind of diagnosis by insurance companies that I hope President Obama’s health care reform will change for the better.

End of Life

While driving today I saw a car that had written on its side, “Obama Lies, Granny Dies.” Of course this refers to the mistaken belief that HR3200. one of the various versions of health care legislation, creates “death panels” that will deem a senior life not worth living. The bill does not really say this. It simply states that if a person receives end of life counseling from a doctor, Medicare will reimburse them for the cost of that consultation. In my experience as a nurse, end of life counseling, health care proxies, and living wills are very infrequent. Doctors are often woefully ill equipped to provide appropriate direction and support for family members needing to decide about whether their loved one should remain on life support. As a result, patients can suffer needlessly at the end of their life. Family members who have not discussed these issues prior to a crisis or final illness are often ill prepared and are more likely to panic and disregard the wishes of their family member. End of life counseling also covers hospice options and pain management choices. Finally, end of life counseling also can include a discussion of Do Not Resuscitate orders. Many people do not realize that if your aged mother goes into cardiac arrest and your father calls, the paramedics who respond are required to perform CPR, insert breathing tubes, and transport the person to the hospital. Having a signed DNR prevents this scene. Deciding against heroic measures at the end of life is a very personal choice. HR3200 would not dictate to anyone what choice he or she should make; rather it would strengthen the concept of informed consent.

%d bloggers like this: