This is Compassion?
As a follow-up to yesterday’s post found here, I had promised to continue my discussion concerning the chronic inebriate and the cost they impose upon society. Today I’ll give a second example and wrap up with some editorial comments that tend to make a lot of people uncomfortable.
We were called to a “Wet House” (which I will describe below) and found an intoxicated individual lying in his bed. There were stool and urine all over the floor and his bed clothes were soaked with the same. He was awake, spoke in a monotone and had just awful color. He gave us a history of pancreatitis and GI bleeds that were associated with his chronic alcoholism. His main complaint today was black stools (indicating the presence of blood) and abdominal pain probably caused by the pancreatitis.
He had been having pain, diarrhea stools and vomiting for several days. He admitted to a 2 week binge of drinking a liter of vodka a day, though it is likely the time frame was closer to 2 months.
We got him on the stretcher without getting “dirty” ourselves – which was quite the trick considering that he been rolling around in soiled bedding, fully clothed for quite some time.
We then asked him about any medicines and he pointed to a couple of bottles on a bed side table. On reentering the room, I found that it was going to be impossible to reach the bottles without stepping in stuff I’d rather leave behind. It was then that I noticed a few boxes, plastic garbage bags and paper sacks at my feet. Inside were found at least 200 prescription bottles, every one of which appeared to be full.
Now we frequently see folks that are non-compliant with their meds, but never have I seen so many medicines left untouched.
My immediate thought was: “I don’t care what the Department policy is, I’m not going to write all these down.”
We were left with three options:
1. Declare a hazardous materials emergency and call in the Fire Department.
2. Pretend we didn’t see the bottles and just leave them behind.
3. Bag everything up and take them with us.
I asked the staffer if she had a garbage bag – a Big garbage bag. She soon returned with a bag the size you would use to rake leaves into in the Fall. We filled it up beyond half-way. As my partner slung it over his shoulder, I swore he could’ve passed for Santa Clause, except Santa has more hair on his head.
To make a long story short, we got him to the hospital.
”Wet Houses” are facilities for the destitute chronic inebriates who have failed time and again to dry out. The purpose is to give them a safe place to drink. In fact, this place has a sign posted by the elevator that reads, “Drink if you want to. Stay sober if you have to.”
They are assigned to a space about the size of a college dorm room. There is no meals provided. There is a staff that oversees the operation. If memory serves, the cost to state government is about $1300/mon. They are also provided a type of bank card in which the state deposits about $150 a month for food. In addition, they are provided a little over $200 in a monthly payment.
But the $20,000 a year described above does not yet cover their expenses. Folks like this are huge consumers of health care services. The program that this patient and the one described in the last posting has over 30,000 enrollees that have incomes of less than $7500 a year. They incur health care costs to the state of over $1000 per month per person. But that still isn’t the whole story. The reimbursements the state pays to the providers of this care is significantly less than the total cost of the service.
So how does the provider make up the difference? They charge everybody else more. That’s you and me folks. Our insurance premiums are higher and our out of pocket expenses are higher due to care given to those who cannot pay and depend on government.
I’m not claiming that every one of those 30,000 people are drunks and beyond help. But I will assert that a significant percentage of them are and it is costing a fortune. In this instance there were several thousands of dollars of medicines in that bag which will be simply thrown away – paid for with taxpayer money.
The cost of this particular program is rising at a rate of 18% a year. Simple math tells us that the cost will double every 4 years with that level of yearly increases – and it already is a $1 billion item in the state budget.
What we are doing here is not working. The sad part is that society has tried every reasonable (and unreasonable) way to try to help people like this and none of it works. We simply end up enabling behavior and calling it compassion.