Mama Might Be Better off Dead, Reaction Paper Example

In Chapter Three the issue of how insurance and other programs do not always meet the needs of patients. The biggest problem described in this chapter is that Mrs. Jackson, the elderly patient, receives most of her health care from her granddaughter. There are visits from home health care workers, but they are typically not very long. When Rose, the nurse, stops by the house, it is for the purpose of doing a brief examination of Mrs. Jackson’s wounds resulting from her amputations. When Jackie asks about resources she needs for her grandmother’s care (specifically adult diapers), Rose tells her that neither Medicaid nor Medicare will cover their costs. Later, when a social worker visits the home, Jackie is told that Medicaid will cover the costs. This highlights some of the practical limitations of the situation, when simply getting the right information is difficult, let alone navigating through all the different rules and regulations involved in government insurance programs.

Despite Mrs. Jackson eligibility for adult diapers under Medicaid, the social worker is unable to find a supplier, which exposes yet another weakness of the system. Mrs. Jackson’s spend-down had not been correctly entered into the computer, so it appeared that she was ineligible. For people with more financial resources, this would not be as much of a problem. But in Mrs. Jackson’s case, she lives barely above the official poverty level, and her granddaughter only has so many hours in the day to help her. Even with the provisions of home health care workers and the help of social workers, those at the bottom of the socioeconomic ladder face enormous challenges when trying to access health care.

When Mrs. Jackson needs to see a primary care physician, simply getting her to the appointment is a significant challenge, because of the costs of paying for transportation. Mrs. Jackson had, in fact, missed an appointment with another doctor for the same spend-down issues that caused a problem with her adult diapers. She could not get her visits arranged for the same day because of doctor schedules.

The root causes of Mrs. Jackson’s problems are found in the ways that Medicare failed to meet her needs in treating her diabetes. The resulting complications led to the eventual amputation of her foot and then her entire leg. This led to subsequent mobility problems, so Mrs. Jackson now has bedsores and other complications. As the book describes it, Mrs. Jackson received “episodic, uncoordinated care” which “conspired against her health.”  Rather than effectively coordinating her treatment and medical care to avoid major complications, much of her care has been driven by one crisis or another which could possibly have been avoided. Her granddaughter, who is now her primary caregiver, has to learn how to navigate the complex system in order to even get Mrs. Jackson to her doctors or to a hospital. This transportation issue is part of the reason Mrs. Jackson had her amputations, as her condition had gotten worse while her daughter tried to find a way to transport her and to find a hospital that would treat her.

At every step, Mrs. Jackson faces problems in the health care system. Inadequate services, ineffective communication between doctor’s offices, and limitations in insurance coverage all make it difficult for Mrs. Jackson to receive the care she needs.