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April 23, 2006
Doctors to Terminate Texas Woman
Her family says 'no' but her doctors say 'yes':
A life or death struggle is taking place at St. Luke's Hospital, where doctors are planning to remove a woman from life support.
The patient is not brain dead, and according to her family, she wants to live.
Andrea Clark has been at St. Luke's since November.
They may be small in number, but the protesters said the bigger picture is the gravity of their message.
"They just say, 'well she's miserable.' Well, to me that's a quality of life decision that is up to her and her family," Lanore Dixon said. "That is not a medical decision."
Dixon is protesting on behalf of her sister Andrea Clark, a patient at St. Luke's Hospital since November.
In January, the 54-year-old underwent open-heart surgery. The next month she developed bleeding on the brain.
Now an ethics committee has recommended removing her ventilator and taking her off life support.
But her family is fighting to stop that despite not having the law on their side.
"If their ethics committee makes a decision, it doesn't matter what the patient wants," Dixon said. "It doesn't even apparently matter what the patient's condition is, because our sister is not in a coma, she's not brain dead," Dixon said.
In fact, family members said even though their sister cannot speak, they know she wants to live. They said she communicates by moving her lips and blinking her eyes
Clark will be killed on April 30th unless the family can find a facility to move her to.
How did this happen? According to Andrea Clark's sister, insurance companies pressure hospitals to get critical patients "off the books" - those in their care become worth more "dead than alive":
When the hospital notified us about the ethics committee meeting, we knew what the outcome would be. We had tried to put off that meeting so that we could have more time to find a hospital that would admit Andrea as a patient, but we were not successful in that regard. We are still trying to find a hospital to take Andrea as a patient. However, none of this would have come about if it were up to the hospital alone.
Andrea's attorney explained it to us this way:
An insurance company negotiates with the hospital how much they will pay for certain services. Say, for instance, someone in the ICU costs $10,000 for treatment per day. The insurance company says to the hospital, "Okay, we will pay you $7500 for you to provide that service to our insured patient."
There's a catch, though. The insurance company will pay the negotiated amount to the hospital, but if a patient goes on and on, needing that service, the insurance company begins making noise. This insured patient is costing them too much; they are losing profit. They begin to put pressure on the hospital to get that patient off of their books. The hospital either does this by getting aggressive with the patient's treatment, getting them well, and discharging them, OR by "pulling the plug" on that patient.
In other words, that patient has now become, in terms of profit, both for the hospital and the insurance company "worth more dead." If that patient continues to receive that intensive care, it costs the hospital in terms of where they stand the next time they negotiate prices with the insurance company. The next time negotiations come up, the insurance company will say, "Hey, we would give you the going rate on an intensive care patient this year, but you gouged us for 90 days on Andrea Clark last year, so we are lowering our starting point for payment to $7000, to make up for it."
St. Luke's Episcopal Hospital, in my opinion, is heartless and cold, and only concerned about the bottom line. But the insurance company, Blue Cross Blue Shield, is also a party to this kind of thing. That's where the pressure needs to be applied. I am sure Blue Cross Blue Shield is suffering no negative publicity in this battle. But they should.
Most people don't know how this system works. And I wouldn't have known, either, had I not been faced with this horrible situation. Poor Andrea, knowing that her health was delicate, bought supplemental insurance policies right and left--most of which do not cover this type of situation at all (she didn't know--she was just doing her best, to protect herself). The sad thing is that Andrea spent large pieces of her limited income in order to avoid just such a situation, and here she is faced with it anyway.
More to follow ...
Posted by tim at April 23, 2006 5:32 PM
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