Basic Health Maintenance: Part I

The Situation: Desperate, as usual

Even as the many politicians line up on both sides of the party divide to try and convince the citizenry they’re the man or woman for ‘The Job’ of cleaning out the mess our current national leadership has made out of D.C. over the past 6 1/2 years, research studies, issue forums and public opinion polls are consistently tracking growing concerns about the state of health care in America. From many worsening indications, it looks like the patient is fading fast.

It’s not just the cost of health care, though at this point a significant majority of the solid middle class is just a single serious illness or accident away from bankruptcy. Rapidly increasing numbers of the insured are discovering that despite paying more for insurance every month than for the mortgage, their for-profit provider will not actually pay for health care. Most insurance companies these days pay whole departments full of people whose only job is to deny coverage. Other companies are requiring larger co-pays and deductibles, even while raising the premiums. And governments have capped the safety net systems (Medicare, Medicaid, SCHIP) so that they can’t accept the millions who have fallen through the cracks.

The public consistently reports health care as at the top of their concerns, right behind the war in Iraq. They’ve plenty to be concerned about. Those emergency rooms President Bush claims are there to take care of the citizens who have no insurance or money are now turning people away, or releasing them untreated. In my area there is a single hospital conglomerate the government allowed to merge a few years ago, that will not treat any state employees and no longer stitches cuts or sets broken bones in the ER. They’ll clean out your cut, put a band-aid on it, x-ray your broken arm and charge you $500 for the hour, but they won’t stitch or set. For that you have to make an appointment with a specialist. They’ll give you a name and phone number, perhaps get seen this week. Oh… and sometimes you can get pain pills, if that break is deformed enough or swollen enough to elicit the nurse’s sympathy. There are usually no doctors on duty.

Real analyses of the situation put the lie to the constant mantra of “best health care in the world!” from greedy politicians taking money from Big Pharma and the insurance companies. The US now ranks at the bottom of the list of industrialized nations in both life expectancy and infant mortality. The racial and class discrepancies are striking and growing worse as the working poor and middle classes put off medical care, doctor and dentist visits, and regular testing that was once routine. They’re sicker by the time they do get seen, and it’s often too late to help them. Insurance company accountants and pencil-pushers are practicing medicine without licences every day, all over the country. This is called “Murder By Spread Sheet.” []

So I think it will be helpful to talk about what regular people living through hard times (or choosing to live on less) can do about their health and basic health care on their own. This project will take up a series of topics, to include educating yourself and your family about being healthy, how to deal with emergencies they don’t treat at the ER anymore, how to avoid high-priced prescription drugs for common ailments, knowing something useful about alternative health care options, and how to tune your family’s diet toward something that enhances their lives every day while NOT killing them.

Provider Priorities

Until very recently on the historical scale – when a family needs at least 2 incomes just to cover food, clothing and shelter – the #1 health care provider was Mom. Fathers and grandparents have also helped to fill these roles, and very often there was a trained nurse (or otherwise titled medicine person) living somewhere within shouting distance and could be counted upon to analyze just about any situation quickly and efficiently as to how serious things might be.

When I was growing up it was also standard operating procedure for every teenager to take Red Cross first aid and life-saving training, with refreshers every June as soon as school let out. Worse, most of us had spent years in Boy Scouts or Girl Scouts, and had all our necessary badges. Moreover, everyone in my peer group was expected to volunteer for at least 2 out of the 3 summers of high school at the VA hospital or a nursing home, at least 2 days a week. That experience – part of a traditional social ethic our parents brought with them through the Great Depression and World War II – taught us a lot about sickness, injury, pain, depression, loneliness and hopelessness. Things kids seem to be shielded from quite thoroughly these days, when health care is shrouded in the foreign language of scientific sterility and people are so easily persuaded to believe health care is all about big, mysterious machines, Porche-driving specialists and expensive ‘designer’ drugs.

In that less dangerous (and far less obese) world when kids were outside most every day all day doing things that would likely give their parents heart attacks, we could count on the fact that 9 out of 10 of us at the swimming hole knew how to splint a badly broken bone, deal with a poisonous snakebite, stop serious bleeding, bandage cuts, assuage bruises, assess head injuries, remove fish hooks, halt choking, provide CPR to the drowned, even carry an unconscious friend to help without adding to the injury.

For anyone attempting to live on a shoestring budget at this point in history, I cannot emphasize enough how important it is to educate yourself on first aid and CPR, to take control of these aspects of caring for yourself and your family. I’ve linked some of the best sources below, but for little investment there are excellent teachers and very good courses available from your local Scout organizations, WMCA and WYCA, your local Red Cross, etc. If you live in a rural area, the volunteer fire department often has classes going at least twice a year that will cost YOU little or nothing if you’ll volunteer a Saturday watch a month.

And don’t be afraid to take it further. I have seen LPN [Licensed Practical Nurse] training offered at local community colleges for a mere $30 per semester (there will only be 2 before licensing) plus textbook, and you can often buy that used. We go to our tri-county “Textbook Fair” every summer, where textbooks that have been replaced by the State Board go on sale or are given away for free. We’ve an entire library shelf of basic nursing, biology, microbiology, first aid, health and other such books we’ve accumulated. We also keep handy a Merck Manual, which is the best printed resource for anyone who cares to identify conditions and know what the proper treatments are. Have a drug manual as well, which is a fat encyclopedia of prescriptions drugs that tells you everything you might want to know about what your doctor prescribed.

Last but not least, if you’ve got a friend or relative who IS a registered (preferably practicing) nurse, you’re three steps ahead of the average man-on-the-street. My sister is an RN case manager at a large private hospital in Florida. It’s her task to follow the diagnoses, testing and treatments to make sure patients are getting the best possible care for what ails them. That, and fighting with insurance companies over what they’ll pay for. Whenever we’ve got a condition we’d like to handle ourselves, I do the initial research and write it down, then give her a call. Sometimes I feel good about my choices, sometimes she tells me to go straight to a real doctor. I trust her judgment.

Nurses don’t get much respect these days, but they are in fact the primary health care providers in our society. A doctor may spend 10 years in medical school and grad school and internship for his/her specialty, and might be a great brain surgeon. But a nurse knows more about basic nutrition, health maintenance, wound management, immediate intervention, disinfecting a sickroom and assessing a patient’s overall state than the doctor does.

Most folks can learn a good deal of this sort of health care wisdom and practice, and can put it to good use in their home. People – including kids – really don’t have to be rushed to the hospital or taken to the clinic or sandwiched into the doctor’s schedule for most of the usual seasonal illnesses or accidents, or even some of the chronic illnesses that have become so prevalent these days.

I’ll talk about what more families can do for themselves in coming installments in this series. In the meantime, do check out the links below and start downloading – or buying (many books are available used for a fraction of list price) – information you can put on your handy health care shelf right next to the first aid kit and pharmaceutical desk reference.

Links:

KidsHealth: First Aid & Safety

HealthWorld Online: Emergency & First Aid

MayoClinic: First-Aid Guide

The Merck Manual of Medical Information (Home Edition)

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