Health Care Wins Another One

I came across an article on CNN.com which, on the surface, seemed more or less unremarkable.

Ohio Couple Pleads Guilty in Son’s Cancer Death

It is a terse quarter-page report on a couple who “denied” their son medical treatment for what turned out to be Hodgkin’s lymphoma. Apparently, the boy suffered from recurring swollen glands in his neck and on and off flu-like symptoms. The lymphoma went undiagnosed; the parents treated him with over-the-counter cold medicines. He died. He was eight years old. This was in 2008. This week, the parents pled guilty to plea-bargained manslaughter charges.

On the surface, you want to condemn these people as the sorriest excuses for parents. The news story paints them in a terrible light. You imagine this boy lying in bed, wasting away, in terrible pain (because to the average American, dying of cancer = excruciating pain), begging to be taken to the hospital, while the parents, crying “poor mouth,” callously turn their backs on him and let him die.

But something about this whole scenario just smelled like a three-days-dead herring. And the stink got into my brain and would not go away. Who were these people, really? Were they religious zealots? Were they cooking meth in their bath tub? Were they out buying flat screen TVs and ipads while their son languished in pain? If ever eleven lines published on a national news site cried out for back story, these did. Here was a situation that was doubtless composed of layer upon layer of deep emotion, wrenching loss, shock and shared culpability. There was no way the story could be done justice by a brief, and obviously biased, report of the final outcome. Almost four years later.

So I decided I would dig a little deeper.

On the website of the Cleveland PlainDealer, I found a few archived stories. All of them basically repeated the same damning piece of “evidence:” While the little boy was ill, supposedly in pain and “begging his parents to take him to a doctor,” the couple paid $87 to have a pet dog treated for fleas. On the surface, that sounds pretty bad. But, I wondered, where was the REAL damning evidence? Where was the list of frivolous luxuries for which they laid out cash, rather than take their sick boy to a doctor? Where was the evidence of involvement in drugs or domestic violence or welfare fraud? None of what I dug up—which wasn’t much, and yet was reported in such a way as to assure any reader would assume the worst about these folks—told me that evil or avarice caused this couple to act the way they did.

What—or who—convinced a county coroner to rule this death a homicide? And who or what then took the story to the media, so these folks would be convicted without a trial by a public provided with only the sketchiest and most sensational details of a family’s tragedy?

At the Huffington Post, the story was fleshed out some. HufPost included some quotes from the oldest daughter, now 18, and some rebuttal of prosecutors’ accusations by the defense lawyers. According to the sister, the boy’s episodes of swollen glands did not seem to bother him all that much. The thought that he might have cancer never entered anyone’s mind. The family had once gone to a “free” clinic for medical help, but left when they were informed they would have to pay. A family services caseworker told the parents that the lumps on the boy’s neck looked like swollen glands, but they should hold off until they received financial assistance before getting him checked out. Oh…and the mother’s lawyer asserts that the sensationalized flea treatment was actually paid for by the grandparents, to whom the dog belonged . Okay…so here is a conglomeration of “facts” designed to swing our opinion in the opposite direction. Obviously not the full story here, either.

Where are the answers to the real questions? Were the parents unemployed? Underemployed? Was there no health insurance available to them? The Cleveland PlainDealer alleges that the couple’s six children under 15 did not attend school. Is this true? If so, why not? We’re told the family moved to Cleveland three weeks before the boy died. Why? Was there employment available there? Did they lose their home and have to move in with relatives? Did they think moving to the city would put them closer to the services they needed for their family, including medical care and social assistance that was actually helpful?

In the end, I have no basis upon which to judge this couple. I have no idea what their circumstances really were. I only have conflicting pictures in my mind planted by incomplete and biased reporting. I suspect these parents were probably ignorant and overwhelmed (six kids under fifteen?!) and possibly even negligent. But I also have the deeply troubling suspicion that forces far beyond their control have exploited their family tragedy for purposes having nothing to do with truth, justice, or dedication to the protection of our society’s helpless children.

Because here is the reality that I have trouble reconciling: We live in a country where medical services are doled out or withheld based on ability to pay. We live in a country where medical insurance is routinely denied to people who might actually incur medical expenses, where insurance companies drop paying clients like a hot rock when they become ill, or deny coverage for certain conditions or procedures based on not much more than a whim.

If a patient’s condition deteriorates to the point of untreatability while the doctors, HMO’s and hospitals iron out the details of who is going to pay, no one goes to jail. If a senior citizen suffers a stroke because she has to make a choice between eating and filling five expensive prescriptions, no one is led away in handcuffs. If a man dies because he couldn’t afford health insurance, and by the time he was sick enough to go to an emergency room it was too late to help him, no one calls the cops. But two average citizens whose child died because, for whatever reason, they did not buy into the mess that is American health care today, are going to jail.

Let us understand the world in which these Ohio parents live. The times when it was a no-brainer to trundle your sick kid over to the family doctor are long gone. These days, there’s a maze of forms and co-pays and procedures and protocols and months-out appointments with two or three different providers before you eventually are seen by some specialist you don’t know and probably doesn’t care enough about you to piss on you if you were on fire. And it’s entirely likely that you’ll receive inferior care—or no care at all—if you can’t cough up big bucks. In advance.

Over the past three decades, our society has actively encouraged a deadly metamorphosis in the practice of healing the sick. Medical treatment has gone from a right to which a thriving society entitles every member, to nothing more than a consumer commodity. A commodity to which a premium price tag has been attached. In 21st century America, nothing less than cold-hearted greed dominates the allotment of the procedures and medicines which heal our bodies or help keep them healthy. American Health Care has deteriorated into a complicated maze of high costs, insurance rules and legal wrangling that has nothing to do with either “health” or “care.” It’s all about the money.

So is it any wonder that these parents in question might have been so cowed by the process and the likelihood of rejection that they chose to self-diagnose and treat their son’s symptoms as best they could at home? Especially since those symptoms seemed to come and go, and the thought of cancer never entered their minds? Who thinks their eight-year-old has cancer? Really? And say these parents had taken their son to the emergency room which a county official insisted (after the fact) would have taken the boy and treated him regardless of their financial situation. Can we say for certain, given today’s medical protocols, that the boy would have been properly diagnosed? Or would he have been given a prescription and the admonition to see his family doctor for a follow-up and sent on his way? If this had happened and the boy died anyway, who would be going to jail?

Anyone who wants to sit in judgment of these folks needs to walk a couple of miles in their shoes. Those of us who grew up in the 50’s and 60’s did not face those roadblocks when it came to obtaining medical help, neither when we were kids nor when we were raising our own children thirty years ago. Medical care may not have been as “advanced” as it is today, but at least it was accessible. And medical insurance was provided by your employer. For free.

We don’t have medical care in this country any more. We have Health Care. And it is big business. Make no mistake: Health Care will contrive to make examples of folks who either can’t or won’t buy into it. Health Care might hide in dark corners armed with fistfuls of cash or promises or threats, to perhaps nudge a county coroner to create a crime where none exists; or pressure a district attorney to pursue prosecution against people who have the audacity to believe they have a choice when it comes to purchasing medical treatment. Health Care would think nothing of taking a family’s personal tragedy and mercilessly exploiting it for its own purposes.

Possibly this is not what happened in this case. We’ll never know, will we? But we must not be naïve enough to believe it can’t or doesn’t happen. It’s all too possible. All too conceivable.

In any case, a society which allows medical treatment to be dispensed on the basis of who can pay (and how much), which allows power over life and death to rest in the hands of third parties who handle the cash flow with obvious disdain for the needy, has no business punishing any private citizen whose personal choice has produced a tragic outcome. Either a society values life, or it doesn’t. Either it charges all persons and entities with the responsibility of caring for the most helpless among us, or it cannot legitimately charge anyone.

A boy died. A boy who could have been healed with proper medical treatment, received in a timely manner. That is an abomination. It is not my purpose here to absolve the parents and chalk this one up to the vagaries of free choice. My point is that they never should have had to make the choice. Parents should never, ever be put in a position where they are too afraid, intimidated, confused or ignorant of Health Care to receive healing for a child. Health Care failed this boy. Health Care failed these parents.

But Health Care is not going to jail. The parents are.

Justice has not been served. It has been used. To serve Health Care.