Saturday, March 7, 2009

Looking Back...Haitians Highlight Limits

See my comments written today, March 9, 2009, at end of this Peoria Journal Star editorial.

Peoria Journal Star
January 12, 2003

Haitians highlight limits on care for Peorians

On Wednesday a man called the Heartland Community Clinic for help. An out-ofwork diabetic, he was about to become an out-of-insulin diabetic. His supply was dwindling, and he had no money to replace it.

The clinic, godsend to many of this area's uninsured, told the man to phone back Monday morning, the only time in the week it takes calls from people hoping to become patients. This is because its small volunteer staff is overwhelmed.
But it accepts only one new diabetic patient every month. This is because diabetics require intensive, costly care the clinic cannot afford.

And, generally speaking, it confines its practice to the working-poor uninsured. This is because that is its unique mission, and it's a fine one.

Last year the Heartland had to turn away two out of three people who got their phone calls in on Monday mornings. Those who succeeded had to wait for screening. Those who were sick had to wait again as long as 15 working days to be seen. ''We're doing the best we can,'' says Joan Krupa, the executive director. ''But that's pretty awful when you're sick and trying to get well.''

So the odds of getting seen at Heartland are against this man, who said he'd sought help from government sources and been denied. He was encouraged to try other charitable clinics, but they also are overwhelmed by too many patients, too few doctors and too little money.

Adults who seek appointments at the clinics Methodist Medical Center runs at Carver Center and Friendship House typically have to wait four weeks, unless it's an emergency, in which case they'll be referred to a hospital walk-in clinic. Mother Frances Krasse Center has temporarily suspended taking new patients until it can hire another doctor. OSF Community Health Care Center is closed to new adult patients, except for those who meet stringent poverty guidelines, so it can catch up with the backlog.

Even godsends have their limits, as Sister Judith Ann Duvall, president of OSF Health Care System, was acknowledging just about the same time the unemployed diabetic was calling the Heartland.

She was acknowledging it in the course of a conversation about efforts to keep alive a popular program that provides free care and surgery for Haitian children with life-threatening heart problems. The program counts on volunteer doctors, some of whom say they also are overwhelmed; deep hospital discounts; and community fund-raising.

The founder, Dr. John Carroll, picketed OSF St. Francis last week when the hospital suspended the program, which it says owes $400,000 to its Children's Hospital affiliate.

Children's Hospital subsequently agreed to forgive the debt and to work with Bishop Daniel Jenky, who wants to make Haitian Hearts a Diocesan mission. It seems a good compromise, intended to keep the number of Haitian children coming here to a level local doctors and volunteers can support while recognizing Peorians' passion for the effort and the doctor who began it.

Children's Hospital officials say the number of Haitian Hearts patients quadrupled over the last four years, and they can't afford for that to continue. The hospital bill alone can run from several thousand to several hundred thousand dollars. Rooms and specialized nursing staff are limited, too. The more resources devoted to Haitian children, the less there may be for Peoria-area kids.

''We've never had to turn a central Illinois patient away'' because a Haitian child is filling a bed,'' says Paul Kramer, executive director of Children's Hospital. ''But it's been close,'' adds Dr. Richard Pearl, director of pediatric trauma.

OSF expects to spend an impressive $40 million this year on charitable care but still does not claim to fill all local needs. Last year it quit supporting in-school health clinics and church-based nurses. More sobering decisions likely lie ahead in a state approaching a $5 billion budget gap. Half of the Children's Hospital patients are enrolled in Medicaid, the government-funded health-care program for the poor. State Medicaid spending is second only to state school spending, and substantial cuts are feared.

When Haitian Hearts were threatened, anguished central Illinoisans mourned on TV and complained to the newspaper that OSF had abandoned its mission. Forty million dollars say it has not.

But when a Peoria diabetic can't get his insulin, when a Pekinite with a Medicaid card can't find a doctor to see her, when somebody who is sick has to wait a month for an appointment, when dental care for poor adults nearly vanishes from the community, as it has here, nobody calls, nobody writes, nobody pickets.

If the problems Peoria-area people have in getting health care evoked as much sympathy as do the needs of strangers, then the solutions would come quickly. The community needs them.

My comments today, March 9, 2009:

1. The Journal Star and OSF are pitting the poor against the poor in this editorial. That is not ethical and they should not do that.

2. Paul Kramer, Executive Director of Children's Hospital of Illinois, and Rick Pearl, M.D., Medical Director of Childen's Hospital of Illinois, were trying to scare readers in central Illinois in to thinking that Haitian kids could possibly be taking intensive care beds from our kids. I made rounds on my Haitian patients in intensive care for years and years and never saw a dilemma like this occur. Mr. Kramer and Dr. Pearl were simply playing the "fear card", and don't forget that Dr. Pearl had asked me repeatedly over the years to bring him Haitian kids to operate at OSF-Children's Hospital of Illinois.

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