Archive: Opinions

Some random, non-unified thoughts this week. Observations, comments and possibly unjustified frettings.

My interaction with the medical community and medical attention have been mercifully and gratefully few; I have been blessed with amazing health over the years (recent cholesterol readings not withstanding...). My partner, has had a few minor misfortunes over the years and last week went to surgery at University of Rochester Strong Memorial. It was a 'one-day' surgical procedure, but nonetheless it was serious and is still in the process of being clinically assessed; but it can be called a wonderful success. I was her accomplice and accompanist, driving so early to the hospital, standing by in the waiting room and post-op, then driving her home. I am reporting this so I can sing high and holy praises to everyone and everything at Strong Memorial.


From the moment of our arrival (only a yahoo like me could get lost in their parking garage, color coded, etc.) we were able to easily find our way to the correct desks in a less than intimidating, truly friendly atmosphere, met with smiles and caring concern, clear and concise directions and procedures. The staff in navy blue scrubs were amazingly proficient and precise, setting both the patient's and the nervous accomplice's unease and nervousness, telling us exactly what would happen and when/where. They treated me especially well, allowing me to stay with partner while she awaited the final pre-op and anesthesia, and during the next hours I received five (FIVE!!!) calls in the waiting room, from various medical staff informing me of progress, what would happen 'next' and when I could expect to see her, not to mention being called to inform me the operation was a success and the doctor would be in to see me shortly.

My levels of anxiety never rose above a dull roar and I was so amazed at how caring every person was, and every step along the way was laid out with compassionate and smiling care. By the time we left at seven PM, partner was on her feet (kind of) and I had survived (having worried enough for both of us leading up to the surgery). Then I got lost in the parking garage, couldn't find my car, and freaked out until Security was called by an understanding nurse and we were helped to find the car. I can't believe I'm admitting that in public.I began to understand about Moses being 'lost' for forty years....

The experience was just one amazing journey. I cannot sing the praises of Strong Memorial higher or louder: this is medical care that the world deserves. From the woman at the surgical check-in, to the pre-op nurses, to the anesthesiologist, OR attendants, the surgeon himself, post-op nurses, dietitian and the lady who helped called Security for us, God bless all of you!!!

Next thought: We continue to hear (though much less, it seems, as the weeks go by and the media runs to something else) about our opioid crisis. Let's call it an addiction crisis, as well, so we can really understand it. I want to throw in a few thoughts, with ten years experience in the addiction field.

We are watching and hearing about millions and tens of millions of dollars in state and federal money, almost lottery-like, being allocated and approved for what is being called 'treatment and prevention'. But what is being done, really? Most people are not aware that the primary office in New York tasked with alleviating this scourge is OASAS (Office of Alcohol and Substance Abuse Services) and they have recently authorized (after an unconscionable delay of years for unknown reasons) local hospitals to set up 'detox beds'; detox beds are usually used for intensive care for three or four days for the medically controlled detoxification of addicts and alcoholics (yes, detox is critical for alcoholic withdrawal, as well, even more critically so) but were severely limited to specific sites and are (reasonably) tightly controlled, even though the need for them has exploded.

This is why The Council and CARS have been trying to set up a detox unit in Tompkins County. Why has there not been detox available in Tompkins County, even with a critical need that anyone can see?? The nearest beds were in Chemung County (Elmira) and Broome County (Binghamton) and you can see why this fact was not serving the county's residents' needs, distance only being the first impediment.

Let's point something out, here: and I hope this shocks you as an intelligent and caring reader... Cayuga Medical Center has declined (I will refrain from saying refused, though there is a definite case for using that word) to set up or even allow any semblance of 'detox' in its facilities for years. You have an addiction problem? Take it somewhere else, we're not interested in even helping you, and will not admit you without co-occurring life threatening symptoms. Unless it is an overdose, Cayuga Medical Center has cast a blind eye and turned its back to the addiction problem in Tompkins County, forcing addicts and alcoholics to go out of county for detox. And there is no indication of any prospective change in a hospital setting, even with OASAS opening up the potential for additional care locally.

There is one word which I would also like to inject in your knowledge and caring about the addiction epidemic in our midst (no, it didn't go away without news coverage; au contraire, the media just seems to have become bored with the story). The word to contemplate is 'insurance'.

Have you noticed that in any media discussion the word is never, ever mentioned? It should be, and here's why. The health insurance companies (Aetna, Blue Cross, Anthem, Empire, to name a few in NY state) have practically abdicated their responsibility to their customers who need rehabilitation assistance in addiction. Even though 'parity' regulations (set up by law in 2009) require insurance companies to treat mental health and addiction issues (they go hand in hand, you may know) on the same basis as physical health issues, they often (more often than not) give lip service to this requirement. Ask any policy holder who has a family member ask for inpatient treatment.

The lack of available facilities is partly due to the insurance companies literally squeezing and starving treatment centers because of overwhelming refusals to allow admittance for inpatient treatment, using 'make them try outpatient treatment first' as their first defense. Recently Blue Cross was cited, fined and rebuked by the NY State Attorney General for tens of millions of dollars because of inappropriate turn downs of inpatient requests for addicts and alcoholics requesting treatment at inpatient facilities. (This is documented fact... check the NY AG Office for details concerning the lawsuit brought against Blue Cross) In many, many documented cases the insurance representatives (care representatives, they are called) will only approve detox services, then send the struggling addict back home, using the words 'medical necessity' to deny services that supposedly are covered by that policy you pay so dearly for. Many, many families have gone into serious debt, and bankruptcy paying out of pocket for what their insurers have refused to cover... second mortgages, credit cards maxed... all for the rehab services that their contract tells them is covered, then insurer refuses to approve, when these services can cost up to thirty thousand dollars for a twenty eight day stay.

"But, my policy says it is covered," you say. Yep, says the care representative on the phone, you're covered. But when the caregiver at the rehab center calls and gives the particulars of the case while the patient waits, the insurance company declines to pay for it saying 'take him/her to outpatient, first', or 'no medical necessity at this time'. Sorry, only those ordered to treatment by a court can stay for a length of time that can be beneficial (twenty one to twenty eight days is accepted efficacy)... that means Medicaid will pay for the court-ordered treatment, at taxpayers' expense.

You wonder why the country's addiction is deepening (and please don't doubt that it IS deepening). Say the word that media is afraid to say in its reporting. Insurance companies wrote all of the health care laws, including the so-called 'Affordable Care Act', and were required to actively treat the addiction crisis as a medical problem, but are complicit in the worsening problem. While they count their premiums dollars from denial of service for our addicted mothers, fathers, brothers and sisters, we hear about things like tightening the laws for drug dealing, lengthening sentences, as well as 'legal injection sites'... all chaff distracting us from some of the really basic issues of treatment. The saddest part of this is that so few people know of this ongoing crisis in the families that are affected emotionally, and financially, by this crisis. And there are many institutions and entities which are getting away scot-free from any responsibility or scrutiny.

And remember who donates a great deal of money into the electoral system and our beloved representatives in Albany and Washington: the medical and insurance industries. Investigations are overdue, but who can we turn to when they are running the show???

And families are dying.

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