The issues of healthcare have always been a burning question in the US because of the inadequate system of insurance and medical care services provision. It has become evident that only those who have a stable income and a reliable health plan reassurance can be provided by medical services in full. Others are either uninsured or become underinsured because of the growing figures for health insurance billing or because of the growing prices for medications. Poor people are in general deprived of any right to medical care because they are unable to pay for the medical insurance on a stable basis, this is why they can use only the services of the emergency department. Children of the poor cannot get preventive care and vaccination, thus being exposed to early obtaining incurable or serious diseases.
Much has been discussed concerning the US healthcare system crisis, and the necessity of a substantial reform is obvious. The situation with all its implications and cruel street reality is very vividly shown in the book of Laurie Kaye Abraham titled Mama Might Be Better Off Dead – it perfectly shows the personal tragedy of one poor African-American family that has been struggling with inequality, racism, and multiple gaps in the healthcare providers in the USA and how strongly members of that family have been affected by the absence of adequate medical care. The book shows the dramatic discrepancy between the laws on healthcare in theory and their application in practice that is completely different from what it is intended to be and that fails to cater to the needs of the US population. The book contains a comprehensive account of the most developed problems that poor people encounter when they seek medical care and how they suffer from the inequality and indifference of the medical staff.
There are a great number of questions raised in the work of Abraham – the author ponders over the contradictory issues and tries to find the answer to such questions as who is responsible, what to do, and how to fight the range of problems that poor people who are eligible for medical care but unable to receive what they are entitled to face every day in their struggle for life. On a set of examples from the Banes family, Abraham shows how none of the family managed to avoid the inevitable problem with his or her health because of their inability to receive the help they needed. Looking for an answer she concerns many facts that may help understand the scope of the problem better, look deeper into it and try to invent a set of actions that will lead the nation to a better medical care future.
Starting with the story of Robert Banes whose kidneys failed and who need a transplant Abraham shows how hard it is to get a transplant for an uninsured person, especially if he is an African American. His story starts from the moment when he is in the hospital because he has previously been urinating with blood, which seemed not highly problematic for doctors but still required attention (Abraham 9). When a person has such troubles it is hard to imagine which doctor can consider such a state of health satisfactory. However, soon the reader finds out the reasons for such neglect – Robert is uninsured, hence nobody cares for him. Further on the author returns to the time when his kidneys could have been saved, as well as his health, but Robert could not afford insurance, which played the decisive role in the prevention treatment:
“None of Robert’s low-paying, short-term jobs, had provided health insurance, and he could not wriggle into any of the narrow categories of government-sponsored insurance, which are generally reserved for very poor mothers and children, the elderly, and the permanently disabled” (Abraham 10).
The problem that is described for Robert is not a rare one – despite the desperate attempts of the government to ensure as full coverage for the uninsured as possible, the laws still fail to take into consideration very vast groups seeking help, causing such problematic situations for them. Despite the loud claims that healthcare should be available for everyone in the US, it is extremely hard to get help on time, and people are often driven to the extreme state of health until they finally get a chance to get emergency treatment. However, emergency treatment, as it has been proven by medical statistics, causes incurable changes in the person’s health – emergency cases are called so because the body of the patient is driven to the final point of its resistance to the disease, so even eliminating the symptoms and relieving the patient’s sufferings it becomes impossible to eliminate the initial causes of the disease on the organism because it has already ruined it substantially.
The problem of emergency treatment is a grave one in the USA and the only way out that is commonly seen in the US medical care system for the uninsured nowadays is to shorten the period of eligibility checks – as soon as the sick person gets to the hospital with a health problem, why should the medical institution take overall expenses and cover the cost of medical treatment? It would be much more profitable both for the patient and for the hospital to place a request to numerous charity organizations and welfare medical programs to make the patient an enrollee. The time of processing of such bids should be reduced to a minimum, establishing more trust between the patient and the hospital and making their cooperation easier and more productive.
However, there are many more serious problems touched upon in the work of Abraham. The most serious issue to be changed is practically full absence of preventive care for the uninsured that causes aggravation of their diseases and worsens the overall state of health, as it can be seen from the Banes family. The central character is Jackie – her husband Robert needs a kidney transplant; her grandmother had both legs amputated because of complications caused by diabetes that was not cured due to doctors’ negligence and indifference.
Drawn to despair by the unwillingness of doctors to handle Jackie’s grandmother after her leg has been amputated, Jackie even tried to invent her techniques for home treatment. First of all, she needed it because of the inability to pay for the stationary health care in a hospital’ secondly, she could not afford that care because of Mrs. Jackson, even being an elderly poor woman with disabilities, still being ineligible for Medicaid due to certain gaps in the US legislation. The tragedy of that discrepancy was that many elderly and disabled people received help of the government according to the Medicaid program even if they had family members who were able to take care of them and had enough money to enroll to health plans with more advanced options. But a poor, African American woman was not eligible for free medical help even having diabetes and both legs amputated for some reasons, which in itself was a shocking observation (Abraham).
It is hard to underestimate Abraham’s observations as for the absurdity and inequality of the medical care system that was based only on the ability of patients to pay money for the services (Abraham 43). The author describes the region where the Banes live, North Lawndale, as one of the most medically equipped regions in Chicago, but still shows that all glimmering buildings with perfectly designed medical services, with the neat and educated, intelligent and courteous medical staff are open only for those who pay money, but not for those who need medical care services. Abraham (43) speaks much about the inequality of the workload offered for social workers who do not get adequate treatment in the hospitals with the workload of the usual staff who need much money for the services they can render. The author also dedicates much attention in her observations to the comparison of different coverage plans that give their clients full reassurance in the fact that they will get any possible aid when needed, while others cannot be sure in anything even if they are eligible for health care and even badly need it (Abraham).
The tragedy of untimely health care assistance is also raised in the story relating to Tommy Markham, Robert’s brother-in-law. He suffered a devastating broke because of the inability of local hospitals to cater for his needs before the crisis. However, after the tragedy happened and the urgent need for medical help was recognized, the hospital allocated some resources to help the patient (Abraham 98-99). The worst to understand in such a case is that the help Tommy received was already useless because of the unchangeable aggravations of his state of blood system that took place during the stroke and that could have been prevented is medical help were provided BEFORE but not AFTER the irreversible consequences in the organism of the patient take place.
The book is not fiction – it is based on documented facts, on the author’s investigation of one family in Chicago and thorough records of all health-related facts concerning the Banes family. Abraham herself states that the job was complicated to do because she needed to watch all that inconsistency, inequality and cruelty of the system that simply ignored to aching health issues of those left beyond the scope of all kinds of federal or charity Medicaid programs but who still badly needed the state’s assistance. The author investigated how blind and deaf the medical care system may be failing to understand who needs help and what consequences their inaction will bring. The most frightening and threatening fact is that all this happened to an average African American lower-class family, which makes a possibility of such a tragedy’s coming to any family that will one day fail to pay for the insurance. Thus, all questions raised in the book need an urgent solution – it is not surprising that they have been used as leverage by many politicians within several past decades.
There is much inconsistency in the US medical care, and the worst and the most frightening inconsistency is that the US healthcare system fails to provide the citizens even with the most basic healthcare services. People are drawn to a desperate situation in which they are not entitled for anything in case they do not have money to pay for medical help; this causes the devastating reduction of statistics of preventive care for the uninsured. Judging from the point of medical sociology, it is hard to decline the fact of the direct interconnection between the class of the Banes family, their being African American and in addition poor and their inability to get at least rudimentary eligibility for at least basic health care needs.
Proper understanding of the fact that in case situation remains similar and the inadequacy of healthcare provision in the US remains on the same level, many more families may pursue the destiny of the Banes, will help healthcare executives take action and make constructive decisions. Heath standards statistics has always been the main indicator of the country’s stage of development, so the US being one of the superpowers of the world may spoil its reputation and get lower on the international scale with its worsening position with healthcare. As soon as the boundaries of federal eligibility programs for the poor are extended to a necessary extent so that not to drive people to extremes, the emergency departments will not be overloaded with patients standing next to death – they will get more opportunities for basic preventive care, this way substantially reducing the risk of aggravations and complications. As a result, the healthcare system will manage to become healthier, more adequate and equal, as well as more realistic both on paper and in daily lives of the US citizens of all categories.
Works Cited
Abraham, Laurie Kaye. Mama Might Be Better Off Dead: The Failure of Heath Care in Urban America. University of Chicago Press, 1994.