One of the most difficult aspects of life under the American healthcare system is the expectation that one be able to be their own self-advocate. Unfortunately, this expectation makes somebody whom is suffering from mental illness or any other serious illness/disease have to suffer twice. In addition to suffering from the symptoms of the illness, said person also must suffer through the difficulties of being their own advocate when everything related to healthcare has a dollar sign affixed to it. Since hospital systems expect doctors, therapists, and other allied health professionals to account for every minute of their day, time not spent directly on patient care is not billable and thus seen as lost revenue. Therefore, the unfortunate onus is placed on the sufferer to have to advocate for themselves.
Somebody suffering from mental illness in its active stages is unable to effectively advocate for themselves because often they’re having difficulty thinking clearly and organizing their thoughts to begin with. This past week, it took me a long time to muddle through the labyrinth of seeing how I can get coverage for Spravato, a ketamine drug specially formulated to help with drug-treatment resistant depression. Getting the drug approved through pre-authorization is a piece of cake, instead the challenge becomes affordability. When I am already in a depressed state, it’s difficult to find assistance with medication co-pays. Most of the non-profit organizations out there that help with medication co-pays only have funds for auto-immune diseases, cancer, and neurological diseases. Out of 10 organizations that I found, only one has a fund for mental illness and it is closed with a long waiting list.
The current state of affairs has me motivated to go back to school for a masters degree in clinical social work because people like myself need a fighter in their corner. They need somebody able to research and effectively come up with plans and strategies for assistance. It should not be this way and in many other countries it is not, but in America, the predominant belief is that one should pull themselves up by their bootstraps. If you think about it, it is physically impossible to pull oneself up by their own bootstraps; every law of physics would have to be violated for that to happen. I am really writing this to draw attention to the pervasive problem with healthcare in America.
The only way to improve healthcare in America is to take capitalism out of the equation. We have to stop assigning a monetary value to every aspect of care. We have to allow our doctors and healthcare professionals the latitude to advocate for their patients’ well-being. Ideally, our professionals should not have to advocate for their patients beyond the basic medical justification. As a society, we must learn to stop seeing healthcare (and calculating it) as a profit/loss scenario. We begin this process by advocating Medicare For All. We end the disparate systems of Tricare and Medicaid and fold them into one single-payer, government-funded Medicare For All system.
As it stands now, the sick must not only fight their own illness, but a fight a system that is stacked against them. The sick must go ten rounds with a system dedicated to deny them care at every corner. In addition to denying them care, the same system is trying to deny them housing and food assistance. Once you get sick and become disabled, the system becomes a jackhammer dedicated to making you and your family suffer mightily. I wish I had the answer and I wish I had a guide to helping one become their own advocate but the reality of forcing one to become their own advocate is unrealistic.