STRAY THOUGHTS

A teacher has a lesson from the ER for all of us

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evans randy 16-01-14s

Schools across Iowa have been dark for more than a week because of winter vacation. But a Des Moines teacher still managed to teach a very important lesson during that time — but this lesson wasn’t aimed at the kids she normally works with. It was intended for adults.

Laura’s lesson is one more people should learn from, because the discussions in Washington, D.C., and at the Capitol in Des Moines would benefit from a wider appreciation and understanding of what she was telling us.

Try to remember her lesson in the New Year when the talk from our political leaders gets around to such topics as food stamps, Medicaid, the Affordable Care Act, the minimum wage, the cost of prescription drugs, the costs of higher education and many other issues that affect the haves differently from the have nots.

Laura’s lesson began on Christmas when her 3-year-old daughter began experiencing intense abdominal pain whenever she moved. The concerned mom finally called UnityPoint Health’s 24-hour nurse hotline to get expert advice.

The nurse told Laura to have the child jump up and down. The result was a sharp reaction to intense pain. The nurse expressed concern that this could be a sign of appendicitis and should be checked immediately.

So about 7 p.m., Mom, Dad and daughter headed to the hospital emergency room — with thoughts of Christmas, Santa Claus and holiday gifts pushed to the back of their minds.

There in the hospital ER, the doctor examined the child, who bravely answered his questions. There were blood tests and urine tests.

The parents were already wondering how expensive this emergency room trip was going to be. That’s when the doctor put the issue into clearer focus:

He asked whether the couple wanted to have a CT scan done. That would be the only way to know definitively whether the intense pain was being caused by appendicitis or a virus.

Laura told friends later, “It didn’t occur to me until after why he was asking instead of just saying, ‘This is what we need to do next.’ ” But it was obvious to Laura and her husband that a CT scan would be expensive. Very expensive.

Left unsaid was the possibility that if they decided against the CT scan because of the cost, their daughter’s pain could turn out to be appendicitis. And left untreated, appendicitis could lead to a burst appendix that unleashed potentially deadly infection in their little girl’s abdomen.

Hundreds of thousands of families in the United States go bankrupt each year because of huge medical bills. Some supposed leaders preach that the way to control health care costs is to simply require doctors and hospitals to post their fee schedules and then allow families to go shopping for the lowest-cost provider.

There’s a fundamental flaw with this “solution.”

People don’t search for health care the way they buy cars or shoes. Time often does not allow such cost comparisons.

On Christmas when Laura’s family knew they needed to get their daughter to the ER, there was no time to carefully research the costs of ER visits at various hospitals or to investigate the costs of treating abdominal pain. It was irrelevant on Christmas evening that the most cost-effective place for treatment might have been in Iowa City or Omaha or Rochester, Minn.

Here was where Laura got to the heart of her Christmas Day lesson:

“What do people do that don’t have the money? How could anyone choose between helping their child and having money for food on the table?”

This family’s story had a happy ending. The late-night CT scan showed no inflammation of the girl’s appendix. It was a virus, and the ER doctor advised the couple how to treat the symptoms while the girl’s body fought off the virus.

Mom, Dad and daughter arrived back home about 4:30 a.m. But this teacher mom’s mind was not finished.

“I can’t help but think about what I have to be thankful for,” Laura told her friends later.

“Thank God it ended up to be a virus and she didn’t need to have surgery. Thank God that even though we will probably have an expensive medical bill, we can afford to pay it.”

And then came the most important point in her lesson:

“I couldn’t help but wonder how many people would be potentially crushed by their visit to the ER last night. I only wish that everyone could be as fortunate as we are.”

And I only wish that our government leaders in Washington and Des Moines remember that the decisions they make in Congress and in the Legislature, in the White House and in the governor’s office, have real-life consequences for real people who are not as fortunate as my friend and her family.

These officials’ decisions affect countless families who want nothing more than a roof over their heads, food on their table, and healthy and safe lives for their children.

Randy Evans is executive director of the Iowa Freedom of Information Council. He can be reached at IowaFOICouncil@gmail.com.

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