Constancio Asumen, Jr.
ObamaCare: How Lucky Can You Get?
November 5, 2009

"All politics is local," is a truism attributed to the late Tip O’Niell. He was Speaker of the House when Ronald Reagan was President. I believe Chris Matthews of "tingling legs" fame may have worked for him, in some important capacity.

I hasten to add, however, that in a land like America, where individualism is supposed to flourish and reign supreme, "all politics is personal." (It sounds so delicious I should get this trademarked.)

The essence of what the Obama Administration is doing with respect to healthcare is an assault on individual liberty. All the machinations and lawyerly schemes buried in thousands of pages and a mesh of cross references impact every citizen in the most personal way.

I Got Lucky Once

On August 30, 2007, less than one year after I started collecting Social Security, I underwent an open heart surgery with aortic valve implant and a quadruple coronary bypass. This was the byproduct of an attempt to get an inguinal hernia fixed surgically.

The cruel dollars-and-cents scorecard was rather staggering. Upwards of $149k paid for by my insurance provider and our co-pay in the neighborhood of $15k, an obligation we are still struggling to meet.  All this cost for another lease on life, now as a card-carrying member of that exclusive club of people with artificial implants bearing the manufacturer’s serial number.

Beyond the cost, even more staggering was the realization that this was the result of discrete individual decisions made by professionals practicing their professions under the free market system. Mainly the patient’s best interest and the highest integrity of their respective professions were the deciding factors.

As the debate on ObamaCare unfolds or heats up, what haunts the inner chambers of my reverie is this: The outcome could have been drastically different had the decision been made by a Health Care Czar or any low-level bureaucrat concerned only with cutting costs from wherever it can be done in the domain.

With triage driven strictly by a cost-benefit analysis, denying me the heart surgery would have represented multiple savings: the cost of the surgery itself and the monthly social security check due me if I continued living. 

It would have been a sort of accomplishment to eliminate what can be construed as a potential useless eater. It’s a gruesome thought that betimes besets me even while playing an occasional round of golf with my nine-year old granddaughter (which she seems to immensely enjoy).

The Tedious Narrative

It all started with the need to have my hernia fixed, before the health insurance coverage lapses as a result of my wife, Krystyna changing jobs. Not that she had another job to go to but she was very unhappy with the working conditions at the job she held for the time being. She was seriously thinking of going for a change.

I had scheduled a surgery for Tuesday, 21-Aug-07. I reported for the pre-op procedure on Friday, 17-Aug-07. The anesthesiologist said he did not like the looks of my EKG., and wanted a cardiology clearance for the surgery. So, instead of going for the hernia surgery on Tuesday, 21-Aug-07, I went for a cardiac stress test. At which point, the cardiologist said he did not like the looks of the frontal area of my heart and wanted a closer look.

There really was not much of a choice but to abide by the cardiologist’s prescriptions. After all, I consulted him for his professional expertise. The cardiologist secured a 28-Aug-07 appointment for a Cardiac Catheterization for the coveted ‘closer look.’

Meanwhile, while taking a shower in the early evening/late afternoon of Saturday, 25-Aug-07, I experienced all the telltale symptoms of a stroke reminiscent of the one I suffered on 1-Feb-93 which had me out of commission for a month. (Then I was paralyzed for two weeks, I spent the third week doing in-patient rehab at Beekman Downtown Hospital, the fourth week outpatient rehab at home.) I was admitted to the Emergency Room at SBUH (Stony Brook University Hospital). I underwent a battery of tests which turned out negative for stroke but was kept in the hospital for observation in light of my appointment for cardiac catheterization.

Whether inadvertently or by design, during cardiac catheterization I was only half-way sedated. I could hear the conversation of the people conducting the procedure as if it was taking place in the adjacent room. But my recollection of what I heard is as vivid as my mother’s words when I bid her my final goodbye back in April 1974. I can see it engraved in marble in the inner chambers of my mind:

Voice A: “I cannot do this anymore. It’s too far gone. I want the surgery team to take a closer look at this. Can you do this?”

Voice B: “We are looking. Yes, that’s doable.”

Voice of My Mind’s I: “Hey, guys, are you talking about me? I’m still here. Can somebody please fill me in on what it’s all about?”

I got my wish. I was wheeled into the waiting/staging room to wake up from my sedation. Some thirty minutes later the surgeon (Voice B above) informed me that I need an aortic valve replacement and a triple, possibly, quadruple coronary artery bypass. If I had any questions, this was the time to ask:

Me: “So doc, what are my options?”

Surgeon: “Not too many. You can take either a metal or a tissue implant.”

Without losing a breath, I picked tissue. Somehow the idea of inorganic object implanted in my body, other than dental, did not sound too appealing.

Surgeon: “Good choice. That way you don’t have to be on blood thinner all your life.”

He proceeded to inform me that he can do the procedure the following Thursday as his second patient for the day. Under the inertia of hospitalization, I accepted the schedule but deep down in my soul I was struggling for a moral justification for the attempt to extend my physical life with an artificial implant.

Although I am no longer a church-going Christian, somehow, I had apprehension that the impending procedure violated my perception of Divine Providence. I have to come up with a reason to justify what I then considered as making a mortgage of my soul with the Devil. Then came the epiphany. I need to sing at Nikki’s wedding. Nikki is my granddaughter who was seven years old (and four months) at the time.

The aortic valve (affectionately referred to as a “pig’s heart”) has a statistical longevity of fifteen years, give or take a couple. Fifteen plus seven makes twenty-two, and that is about a marriageable age, depending on circumstances. Nikki does not know this but she has been the main reason for my still being around. As far as she is concerned she is just happy that Pa (as she calls me) is here as opposed to being a distant memory.

It was under these circumstances that I submitted myself under the knife which in its essential components consisted of: nine hours of surgery, seventeen hours sustained by the respirator machine, eighteen units of blood transfusion, and my daughter getting hysterical that I might have been dead when the hospital staff finally allowed her to look at my seemingly lifeless carcass.