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Monday, December 5, 2016

This weekend, The Weekend Reader brings you The Body Economic: Why Austerity Kills by David Stuckler and Sanjay Basu. The Body Economic explains how the Republican approach to economics has and will continue to hit Americans’ wallets and cost lives. Stuckler and Basu analyze austerity and its effects on the health care system, and include moving personal stories of average people who have been affected by these harmful policies.

You can purchase the book here.

Diane was forty-seven years old when a splinter ruined her life.

She had been a teacher at a charter school in California. Because of $8.1 billion in education budget cuts the state enacted in 2009, she lost her job. Without her job, Diane lost her health insurance, so she had to purchase an individual coverage plan and pay the monthly premiums out of pocket. Diane signed up to the best plan she could afford, but that came with a high deductible: typically she would have to pay $5,000 before her insurance company covered any significant medical bills, making her think twice about whether she really had the money to seek medical help.

One afternoon, about a year after she lost her job and signed up for this high-deductible health insurance plan, Diane was walking on the floorboards of her old apartment and got a large splinter in her foot. Because Diane has diabetes, her minor wound became a large gash, then an ulcer that wouldn’t heal.

Diane felt that she couldn’t afford to pay the fee for a doctor’s office visit, nor for prescription antibiotics. So she tried to treat her leg herself—hoping that the redness creeping up her leg would go away if she strictly followed instructions she had found online: hot baths, soap, scrubbing, and over-the-counter antibiotic creams.

After a few weeks, Diana started to feel feverish and sweaty. Then she passed out. Luckily, a neighbor heard the shatter of glass when Diane’s head broke the coffee table. The neighbor called 911, and the police broke down Diane’s door and called an ambulance.

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That’s when Sanjay met Diane—in the intensive care unit of the local hospital. Her leg was so badly infected it had to be amputated—something that could have been avoided if the infection had been treated earlier. Worse still, the infection had spread to her bloodstream. It was so overwhelming that it was causing her to become septic—causing her blood pressure to drop below 80 over 40. To stop it from dipping any lower and leading to a potentially fatal cardiac arrest, Sanjay inserted a catheter through her jugular vein and into the right side of her heart, so he could pump intravenous fluids into her system and give her medicines that increase her blood pressure. Her kidneys were failing because of the infection, so a dialysis port had to be sewn into her groin. But the dialysis machine created its own problems. Diane suffered a stroke when the dialysis caused a second precipitous drop in her blood pressure.

Diane now lives in a nursing home. At the age of forty-seven, she is unable to speak or walk or move the right side of her body. Like hundreds of uninsured or underinsured patients, she delayed medical care because of fear of the cost. But ironically, her one hospitalization cost over $300,000. Her stroke left her disabled, and she will cost the state of California tens of thousands of dollars a year for the rest of her life. She requires twenty-four-hour nursing care to turn her in bed, clean her when she soils herself, and spoon her food into the left side of her mouth so she won’t choke on it.

Diane’s story is an extreme, tragic example of an everyday occurrence in the United States: the deferral of essential medical care among Americans who simply can’t afford it.

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