Monday, January 16, 2012

Interesting case of discrimination

Not racial.  Financial...though, I don't blame the hospital at all.

A few years ago, a good friend of mine had a baby at the same hospital I had my two in.  She was on Medicaid, and did not get the same level of care that I, a self-pay patient, did.  Her nurses didn't change the way they treated her--they brought her water, juice, snacks, and anything else she asked for, as well as helping her with her personal care, and with caring for her baby.

No, the telling difference was this: as a Medicaid patient, she was never notified that the hospital had a lactation consultant, and that she could request a consultation appointment.  She never learned that no mother starts out with adequate milk, that we all start out with a very little colostrum (which is all baby needs right at first), and that milk comes in as the baby keeps nursing.  So, without a meeting with a lactation consultant, she didn't know that, and nobody that did know told her.  She wanted to breastfeed her baby, but thought she couldn't, so wound up feeding the baby with formula. 

This didn't happen just once.  It happened both times with both children she had at that hospital. 

I suspect that, if she'd known about the lactation consultant going in, and had asked, she never would have been turned down, but that's not the point.  I was told by the hospital administration when I filled out the insurance claim after having my son eight weeks early, and when I filled out the self-pay paperwork before I had my daughter.  She was not told at any point during her check-in or stay.

I suspect that, once Mandatory Medicaid (otherwise known as Obamacare) comes into play, the lactation consultant will only be made available by the hospital to those individuals who self-pay, or who pay through the nose for what will swiftly become inadequate private insurance.  Once those are made against the rules to accept (like Canada did), the lactation consultant will more than likely be forced out of the hospital altogether, to cut costs.  Never mind that a good start in breastfeeding will cut costs just by itself, with the boost to the baby's immune system, and a lower cost to the WIC voucher system (formula costs something over $400/month!).  That's long run savings.  They won't have the ability or the authority to go with long term thinking--they'll be government workers: well paid on the part of admin, and indentured servants on the part of the actual medical staff.

I also suspect that, once Mandatory Medicaid comes into play and the triage and rationing starts, cases like my mother's won't be treated at all any longer.  After all, my mother is on the older side, in poor health, and is a net drain on the system.  It won't matter if she's a taxpayer or not, they'll just send her home to die because she won't be worth it in their numbers game.

Because numbers don't have grandchildren that adore them.


  1. I have battled getting medical with the state of Florida for 4 years, then they cut me off after 6 months and I finally got the meds I needed. Now in 2 months I will not have any refills on my B.BP.Pills or Anti depression pills. Since Dec. I have gone from 4 meds down to just two. Also I have had to pay for theses two myself. Couldn't pay for all four.

  2. Ah...see? You know exactly what I mean, don't you Rob?

    For the record, I really hate admin types, that don't look at the impact of their "save a buck, here," policies on their patients, and I'm sorry you're going through that, too. I wish things were different.

  3. We don't know troubles we will have once the government has total control of our health.

  4. Sure we do, Duke. All we have to do is look at Canada. Or Britain.

    Did you know that Britain is trying to push women giving birth out of the hospitals and back into their homes? Yeah, now that's a good idea. Way to reverse the whole death in childbirth declining statistic. I just had a good friend who had a baby. Her husband had wanted her to have the baby at home, but I'd talked her into going to the hospital if it were at all possible. Good thing, too--she had to have a C-section to save both of them.

    But yeah: it failed there, but we just know it will succeed here!

  5. Rob, I suggest you contact each drug company that fills your RX's
    and ask for the PATIENT ASSISTANCE program-if you are truly unable to pay, the drug company will give you your prescription FREE.

    LACTATION INSTRUCTION: Why blame the hospital?

    I assume she had pre natal care with her doctor, which means she had a few months of any needed post partum instructions.

    ......and I bet she thought the food was bad too.

  6. I wouldn't be surprised if a lot of things that could improve people's lives medically go away or change under Obamacare.

    That said, I have a relative who received two totally different pieces of advice from two different doctors (one: "Surgery is necessary. Go home and wait and I'll have someone call you" (and no one called for three weeks) Second doctor: "We can probably correct this with a brace and some physical therapy." and kept my relative in the loop, told them what to do while waiting for the brace to be made...)

    So I really wonder: Is our healthcare here starting to decline already? I know there are bad doctors out there but the first one came highly recommended.

    I suspect also we will see tremendously long wait-times for things, to the point where you will be well again (or dead) by the time you can get in to the doc.

  7. OCM: by the time the six week post partum visit happened, it was too late to start breast feeding. There's no post partum care between getting out of the hospital after a two day (max) stay and that six week visit with the OB or midwife. It was the hospital admin that mentions the lactation consultant, and they're the ones that put the new mommas on her list of rounds. The hospital I had my two and she had two of her three in did not do that with Medicaid moms.

    Ricki: I'd bet so. And yes, rationing and wait times will be so bad that our average life expectancy will plummet. Not to mention the whole attitude of "Well, why don't more women start having their babies at home? They did that for eons before hospitals came into being," popping up.

    (Yeah, and deaths in childbirth just didn't happen, either. Sorry, that's kind of a sensitive topic for me.)

  8. It's always the hospital's fault....?????

    Your doctor runs your "show" not the hospital.

    The lactation issue should have been resolved PRE-NATAL.

  9. PS

    Rob, did you check with the makers of your prescriptions?

  10. OCM: No, it's not always the hospital's fault--especially not the actual patient contact medical personnel--it just was in this case. It just happened to be in this case, and will be more often as Obamacare comes into play.