Vegas shooting victims finding tough road to recovery from mass tragedy

bullets-300x245When illness, accidents, and natural- or man-made calamities strike, victims discover in their long slog to recovery that our health insurance system only aggravates their pain and anxiety.  That’s a painful lesson that hundreds of Americans will keep struggling with in 2018, months after a madman rained gunfire from high-powered rifles down into a Las Vegas music festival crowd.

Modern Healthcare deserves credit for its follow-up of the October mayhem Nevada. It was part of what the industry publication calls an “epidemic of mass shootings,” tragedies stretching from San Bernardino, Calif., to Newton, Mass. They’re taxing hospitals’ capacities not only to provide large-scale emergency medicine but also to provide follow-up care — especially assisting survivors and their families and friends in dealing with their staggering medical expenses.

Victims in mass shootings, Modern Healthcare reported, confront a “proliferation of health plans with high deductibles and coinsurance requirements, leaving [them] exposed to many thousands of dollars in cost-sharing. Severely injured patients needing repeat surgeries may hit their out-of-pocket spending limits multiple years in a row, forcing them into bankruptcy. On top of that, even insured patients may face big balance bills if they are treated by out-of-network providers.”

Dania Palanker, an insurance expert at Georgetown University’s Health Policy Institute, told the trade publication, “There are enormous costs involved in living with a gun injury. For many people those costs, such as personal care support, are not considered medical care by our insurance system.”

Gunshot victims often need extensive rehabilitation, including physical and speech therapy, high-end wheelchairs, home modifications, and long-term mental health care, as well as constant transportation for medical services. They may need more help with their basic needs, including moving them from a bed, washing up, going to the bathroom, and getting meals and groceries.

To their credit, some hospitals such as Orlando Health have written off medical debts for mass shooting victims. Orlando Health treated 135 patients affected in the incident, which left 49 dead and 58 wounded. The health system dismissed $5 million in victims’ medical costs, saying they had been harmed by a “tragedy and crime against humanity.” Orlando Health also has tried to offer patients its expertise in handling their long-term care needs and costs.

In Vegas, at least two hospitals have said they will try to reduce or waive the costs of shooting victims’ medical services. But confusion also reigns about how those affected by the mass shooting might receive special compensation, including through public funds set up after the incident. Victims say they’re hitting dire circumstance because they have big medical bills, and many have been so traumatized that they’re struggling to get back to work as they heal from their wounds.

Modern Healthcare, in a second follow-up, found one hospital has set up a valued, needed, and free group therapy program for victims of the Vegas shooting. It’s at least one small effort to deal with the significant mental health needs created and long-persisting after gun-related tragedies.

In my practice, I see not only the major harms that patients suffer while seeking medical services but also how costly, demanding, and draining it can be for them to get on and to stay on any potential road to recovery.

Partisans put the nation through bruising political battles in 2017 over the Affordable Care Act, and especially Obamacare’s view that the government has role in helping Americans to get and keep health insurance. A key part of that unending fight focuses on whether risks, including those for calamitous health situations, should be borne individually or shared. Do we really want to tell mass shooting victims — innocent school kids or fans who just wanted to hear country music on a pleasant fall night — tough luck, you must make your way on your own after disaster strikes?

If Congress won’t even lift its funding ban to allow evidence-based research on guns and how to prevent the mayhem they can cause, it’s unlikely that the nation will take steps to get firearms better under control while still respecting owners’ Second Amendment rights. That means mass shootings, sadly, may persist. And that means that hospitals, insurers, victims — and we as a society — need to think hard if we find these mad crimes and their aftermath can keep going on as they have. They just can’t.

Bullets photo credit: The38superdude @ Creative Commons
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