Strap in folks, this is a fun one.

Yesterday at around midday my almost 75 yr old Pa started feeling extremely fatigued, weak all over, hot and, in his words, very odd.

He rang my sister who lives 5 minutes away, she got there and immediately called an ambulance. They were there in sub 10 minutes and checked him over. He couldn't even walk in a straight line. They took his blood pressure and it benched 199/98. They said he had a possible stroke and needed to go to A&E (ER for my US friends). Not living more than 10 minutes from the local Medway Hospital (major hospital) they went there. It took 3 hours to get to being triaged. The time was 4:30pm when they're told that the closest Stroke clinic is Maidstone hospital, 40 minutes away at rush hour.

On the way out, they saw the paramedics that had been out to respond and they called ahead to Maidstone Hospital so he was on record. That did nothing. When he got there, it took another 2 hours for them to do another triage, then another 2 to do blood work. Then the stroke unit refused to take him stating that they didn't think it was a stroke. After politely arguing the case my sister had to remind them to do his blood pressure again. At this point it had come down a little. He is still really weak and couldn't hold a cuppa without spilling it.

Eventually they relented and did a CT scan. When they checked the results they said it wasn't a major stroke but could have been a posterial stroke which wouldn't show. They couldn't do anything else there and should go back to Medway. At this point it's midnight. At 1am, my sister is checking my dad back into Medway A&E. 1.5hrs later they're through reception and sitting in waiting room 3 with 29 other people. I headed down at 5am to relieve my sister. Between 5am and 11am they took his blood pressure twice and we waited in the waiting area with everyone, my usually fit and healthy dad in a wheelchair. He's exhausted, had no sleep and was genuinely scared, which he never is.

It took until 2pm to see a doctor and we had to put in an official complaint to the nurses liaison team about the handling to even get that far. An hour later and then he saw a consultant who gave him a thorough check.

Concerned, the doctor said he wants an MRI scan performed, but to do this he was being made an outpatient and sent home. He would get an appointment and come back in the next few days. Why? Because if they admitted him he would join the inpatient side and they have 1 MRI scanner. He may not have been seen for up to 2 weeks and would simply be taking up a bed. As an outpatient the team has 3 MRI scanners and he will be seen quicker, plus less likely to pick up an infection from the hospital. It took another hour and a half after this, plus chasing the team to get them to take bloods and remove his cannula so he could go home.

Sorry for the long read, but how backward and broken is this system?

They still don't know if it was a stroke or a brain degenerative issue, all we know is he is home, cannot look after himself or my disabled mother and the whole situation sucks.

I very much would not be. My son had a rough birth, but it probably wouldn't have killed him or my wife.

Both my brothers had children in the last six months. Neither of the kids would have survived, and one of the mothers would definitely have died.

The better question might be: how many of you can say for sure you'd be alive without modern medicine?

Up until recently my girlfriend’s grandmother had a relatively good life. She’s taken care of, had some interesting allucinations, slept most of the day and had funny interactions with her grandaughter, some of which ended up on Instagram.

In recent weeks, she started refusing food and spent days at the hospital. The sudden lost in autonomy made her hostile. It’s a struggle to change her diapers. The situation was made worse by the feeding tube up her nose, which she attempts to remove non-stop, and can only be replaced at the hospital. We had to restrain her arm. That is no way to live.

She's made it very clear she does not want to be in this world any longer. Today I heard a hundred year old lady scream, multiple times: "just let me die!".

I don't know what to make of it.

Edit: I'd like to thank everyone's answers. I wasn't really looking for a solution since the legal situation in my country does not allow for any wiggle room. But it is always nice to read the smart people of Tildes passionately explore their ideas, sharing knowledge with compassion. Sometimes it is enough to feel less alone. Thank you and good night.

I'm in line at a free covid testing site. It is a CVS minuteclinic. I have to use the normal drivethrough, and self administer the nasal swab.

What the hell is that bullshit? My wife went to a 'real' test site where a professional swabbed and she described it as a pap smear on the back of her eye.

So I'm going to a CVS so they can print a barcode, give me, an unqualified layperson a long qtip and a test tube to do my own test and drop in a collection box. Which they will likely ship to an actual lab.

And for all of this 'work', they get to bill my insurance for hundreds or more, which will likely mean rate hikes later.

Our healthcare system is a sham, and this is just further proof. Given I have to do it myself anyway, the government should just mail me a kit which I then drop off.

It would not shock me in the slightest if they actually just drop the tests in a dumpster and just send a 'negative' a few days later.

Edit: 40 min later, through line and swabbed. Yes, they just have Quest diagnostics empty the dropbox. 0 reason CVS should be involved.

My first memory after leaving the house to cycle was being taken by the ambulance to the hospital. I was evaluated by several medical professionals. One of them spent two hours stitching my mouth and forehead back into something that resembles a human being.

Brazilian SUS is not perfect by any means. It's unorganized and some procedures and operations can take a long time to happen. There's lots of corruption with doctors that work in multiple places at the same time.

But, a lot of the time, it freaking works. The paramedics were gentle, affectionate, and competent. Some in the street knew my mother so they when to my house and called her--she accompanied me in the ambulance.

The hospital was not pretty by any standard. There were burn victims screaming bloody hell and I'm pretty sure I saw a woman die--but hey, that's a hospital, people die there!

An actual orthopedist made sure I did not have any fracture. An actual neurologist made sure I have no neural damage. A surgeon stitched my mouth and forehead back together into something that doesn't look like a character out of Frankenstein. It still looks bad, but it'll improve with time. A very nice nurse cleaned up all my bruises and have me aftercare orientations.

On several occasions, we had to manually seek people and procedures that were supposed to happen automatically. The operation itself was a mess, but the doctors and nurses were extremely caring, competent, and dedicated.

This all cost me exactly zero dollars. I didn't even had to fulfill any absurd form or provide an excess of documentation: just my national registry (RG), something almost every citizen has unless they're a very specific kind of homeless.

This is in a very poor unstable country. It is absolutely not perfect, but on many occasions, it kinda works!

So I don't know about all of you, but I'm pretty sick of terrible healthcare in the USA.

So I'm starting this thread for all of us to rant about our personal issues with healthcare. I'll be writing my rant into it's own reply later (it's a bit of a long one), but I wanted to start the thread now to give others a chance to start venting.

Rules of Rant Thread:

1. Don't argue a rant
2. Thread is likely going to be incredibly USA-centric. USA healthcare is assumed unless stated otherwise.
3. Rants should involve people no more than 2 degrees of separation from yourself. This thread is to vent about your personal experiences, not hearsay from total strangers.

In order to foster further discussion, and include those without a rant: Here are some things I personally would appreciate and expect for replies, but others might not.

• Explanation of how things would work out for you if you were in a similar situation
• Advice for dealing with any ongoing or future problems

This comes from an article in Current Affairs, which to be upfront is an openly leftist publication. I thought it was an interesting anecdote, especially with the news from a few weeks ago about the woman in Boston begging for people not to call an ambulance for her because she wouldn't be able to afford it (which is also mentioned in the article).

I was in a New York City diner two nights ago and something disturbing happened. It was about 2am, and a woman was sitting alone in the next booth. She was disheveled and possibly homeless, and looked unwell. She had been eating a plate of food, but then sprawled herself along the seat and fell asleep. Someone in the restaurant must have called 911, because an ambulance showed up. They parked directly in front of the entrance and left the flashing lights on, and through the large windows the lights filled the restaurant and were overwhelmingly dazzling. The two paramedics approached the woman and told her to sit up. She mumbled a refusal. They insisted. As she finally sat up, bleary, they told her she would need to leave with them and that she should pay her bill. She replied that she had no money. The paramedics became upset, one of them asking her why she would order food if she couldn’t pay for it, and telling her she’d need to pay before they left. While the paramedics stood issuing her instructions as she muttered and fumbled, a young man at the front of the restaurant quietly approached a server and paid her bill. He then told the paramedics he had paid for her. They looked vaguely annoyed, and told her she should be grateful that a stranger just paid for her. The woman did not seem to comprehend, and just made a noise. Then the paramedics took her out to the ambulance. In the hour or so I stayed in the restaurant, the ambulance didn’t leave, and kept its lights on.

Here’s why I was disturbed: the paramedics did not act like health professionals. They acted like cops. At first, I thought they were cops. Their uniform was similar, and the dazzling flashing lights were like police lights, and had the same bewildering effect. They were more concerned with whether the woman had paid her debts than whether she was okay. They had very clear contempt for her, treating her as a nuisance who was bothering restaurant patrons and needed to be removed. She wasn’t actually bothering anyone, of course; I was sitting in the next booth and had barely noticed her, and there were plenty of spare booths in the diner. But the paramedics were aggressive and unsympathetic in the way that many cops are. Incidents like the one I saw must happen constantly all across the country: homeless people and drug addicts (I don’t know whether the woman was intoxicated or on drugs, though it seemed somewhat likely) not being cared for with compassion, but being “policed” even by those who are supposed to be selflessly devoted to the improvement of health. The flashing lights were totally unnecessary, and made the whole diner feel like a police raid. And, of course, how typical of America that the issue of whether you can pay the bill is more important than whether you will live or die.

What do you think of this? If you've had an experience with emergency medical services, how did it compare?

I'm writing about my two trips to ER over the last two days, mostly as a way of processing for myself, but also because some things came up that were interesting to me. This story is very detailed medically, which may be gross to some people.

Many years ago when I lived in Chicago, I had a few weeks of life that were utter hell. I would be in constant lower right flank and abdominal pain. I would feel hot and cold flashes. I began drinking water constantly, but would throw up everything until I could vomit was bile. The pain would be so intense that I would have to take scalding hot showers to distract from it for a little relief.

After several weeks, I was convinced that I was dying somehow. Maybe something had ruptured? I didn't know. As a student, I had some insurance. But I had no friends or family at all in Chicago. Finally, one day I walked the three miles to the ER and was seen. They did a sonograph of my groin and said nothing was wrong. They asked me, "Have you been under a lot of stress lately?"

I had been, and they attributed it to that. This event forced me to move back in with mom (I was 19 at the time), back in a rural part of the state. I began the long and tiresome process of working on stress management as a religion, and strong boundaries as a lifestyle. Since then, my patience has grown, and I am able to stay calm even when being physically assaulted or threatened with death (something that happens often in the acute psychiatric setting in which I work).

I never really bought this diagnosis, though. It seemed like a diagnosis of exclusion.

Years later in the current day, I began having some similar symptoms. At work one night, I started having trouble focusing because of pain in my lower flank. I attributed this to stress and went through my steps to see what might be bothering me, but I couldn't find anything. I then thought about what I'd been drinking and realized that I had drunk nothing but coffee, tea, and Mello Yello for the last two days. I went out to my car where I keep 24 packs of water and started drinking some more. Pain went away, no big deal.

On Sunday morning, about 8:30 AM, I awoke in tremendous pain. The same place, I recognized it. I drank more water, the pain wouldn't go away. I took two Naproxen, no relief. I went to the shower to douse my back in scalding hot water - relief. Temporary, until the water stopped.

Then I tried urinating, and it didn't go very well. I couldn't get out more than a few drops, and they were brown. Having worked in medical settings for most of my adult life, I knew this was no bueno.

I hate going to ER, but I hate it more when I have to give a vague complaint like "Lower Back Pain." When I worked in the ER, this phrase was often coding for, "I'm here for my Norco." But I went anyway.

The ER was huge, and I was seen by a doctor very quickly. They did a CT which showed a <5mm kidney stone still in my kidney. They told me it would pass in a few days. They took a urine sample, which I was able to provide, and it was the darkest sample I've ever seen. They came back and told me that there was so much blood in it that they had to "swab it manually," because their machine wouldn't work fast enough (I assume this is common, but have no idea).

They gave me Norco 5 and a medicine to help dilate the ureters to encourage the stone to pass. I had never had Norco, and was intent on going to work that afternoon. The ER Nurse strongly discouraged this, so I called my boss (who is also a nurse) to see what her suggestion was. Per her, I took the evening off - and I am so glad that I did.

I got home and the first dose of Norco was hitting in. I really dislike pain medicine, and I usually don't take it even if prescribed because of a family hx of addictive behavior, not to mention my experience working on the front lines of treatment in the opioid epidemic. The stuff demands respect. I slept for a few hours, then woke up in minor pain. I waited for the 6 hours to have passed, took my next dose.

Except, nothing change. The pain got worse. I would not take more Norco outside of the prescription guidelines, so I went to Walgreens and got a heating pad, icy-hot, and Ibuprofen that the MD told me I could stack on top. Nothing helped. Around 10, I started vomiting. I hadn't eaten much, so I was vomiting up my medicine and all the water I'd been drinking. The pain was so bad that I ran a scalding bath and just laid in it. I had to do this over and over again all night, vomit, shower, bath. That hot water is what let me get a few 10-15 minutes of sleep here and there.

Finally, after suffering through to 6:30 when my next dose of Norco was up, I took that and the Flomax. I waited another hour, nothing. I vomited again and realized it'd be a big waste of time to keep taking the meds if all I was going to do was vomit them up. I called the ER to get their advice, and they told me to come in.

When I got there, about 24 hours after I'd been the first time, they put me in a different room and did their assessments. The pain was much worse, and I was holding back tears. They told me they were going to give me an IV painkiller and some other medicines. The MD came in within me having been in the room for about 10 minutes and told me about my CT again. He explained that a lot of "kidney stoners" are able to pass <5mm without a problem, but a small percentage become very symptomatic and experience a lot of pain. He said they were going to consult with Urology and try to get me into surgery today to have it removed if possible or at least put a stent in.

The nurse came back with a syringe, "This is fentanyl, it's going to help with your pain." I was astounded that they were giving me fentynal for this. Yes, I think it was appropriate, but I have never had a painkiller like that. Working in the field that I do, I hear many stories about accidental overdose often involving fentynal. We talked about dosage, half-life, and expectations before she gave it to me.

The feeling was... Strange. My whole body became a little numb. The pain went away about three minutes after the shot. My head felt warm, then the rest of my body did. I felt like I was floating. I now understand why the stuff is addictive. I was very tired, so I nodded in and out of sleep while watching CNN on the hospital TV.

A Urology PA came in to consult with me and explain the surgery, she was super nice and clear. I got moved up to Same Day Surgery and nurses there explained everything to me. They asked, "Who is picking you up today?"

"What do you mean?" I asked.

"You're going to be under general anesthesia, so we can't let you sign yourself out. Someone has to come up to provide care for you."

"I don't have anyone that fits that description within 100 miles." (I moved here about 6 months ago, and while I have friends from work, I wouldn't really put them in this category[1]).

The nurse got a facial expression that I've seen many nurses put on, I call it, "Well, that sucks, but too bad." She said that if no one could come, I'd have to stay in Observation overnight. Too rich for my blood. I put in a call to mom who started on the way up.

The surgeon came in and spoke to me, saying that the stone was probably too high up to try and get without damaging the kidney, so they would put a stent in if they couldn't get it out safely. I was okay with that. Went into surgery, it lasted less than an hour and woke up 20 minutes afterward in the recovery section.

I have a lot of experience coming out of anesthesia because of a birth defect that required a lot of surgery when young. Sometimes I came out combative, sometimes over emotional with a sense of the world ending. I came out of this anesthesia fully functional, running some of my own assessments and talking to the nurses about the surgery. My perception of time was wonky, as far as how long these were taking, but nothing too serious.

They had to put a stent in. Has anyone ever had a stent running from their kidney to their urethra? It's not fun. I constantly feel like I need to urinate a little, and there is a severe burning sensation when doing so. My first urine sample was straight blood, which didn't surprise me.

My mom got there around this time. I spoke to the nurse and discharged a bit later. We went to get some lunch, then the grocery store, and she dropped me off at my house before going home. I was very appreciative that she came up, but I don't feel like I need someone with me for the 24 hours they suggested.

I took a nap, and just now woke up.

I write this mostly to process in my head and help facilitate memory storage. But some themes came up:

1. I have insurance, and yet still waited as long as possible, because I have a $2000 deductible (this is lower than my old one, which was $4k.

2. I made a statement, "Not friends that I'm going to involve in this."
   This one, for me, highlights some old behavior. I used to have a very rigid social classification. Work friends, school friends, and that's it. I disliked when the boundaries crossed. This got me into serious trouble in Chicago, because I had gone out of my way not to make friends, and found myself in a bad way medically without help. Do other people do this? I find it to be a little unhealthy and will be trying to work on it as time goes on.

3. I think that I got better treatment once I started talking about working in ERs in the past and doing psych care now. I'm not sure, but medical culture loves the Patient Story or scary tales of practice. I exchanged some with the nurses and doctors and a sense of camaraderie develops quickly.

I'm also just writing for myself because I think it's super helpful to debrief. If you made it this far, hope you enjoyed!

In case you don't live in the US and don't know, it is very common for health insurance to be tied to employment.

I've held four jobs over the last twelve months. Health insurance has been the most frustrating part of it. I'm married, I have kids. I don't want to go months without health insurance. My wife is self-employed so no employer subsidized insurance for her. We live comfortably so no option for government subsidized insurance.

The cheapest plan with insanely high annual "deductible" of something like $10,000 (the money you have to pay before insurance will pay) I can get independently is around $1000 / month. For comparison, with my current employer, my part of the insurance is around $440 month with a $3000 / year deductible.

During the past year I've four different insurance companies, one of them paid entirely out of my own pocket, no coverage for dental care for a while, no coverage for eye care for a while. Really WTF? Why are teeth and eyes so different from other medical care?

I'm now three weeks into my current position, insurance coverage with this employer began on the first of the month (so after about one week of working) — another gripe, the waiting periods to start coverage; my position before this had me working six weeks before coverage began; this time I had no idea when it would begin until I spoke to HR on my first day. I finally got my new insurance cards yesterday.

So today I decided to try to cancel my out-of-pocket coverage. I have until the sixteenth to cancel for this month. Haha, no. I can't. Not only are the human operators not working today (which granted is a Saturday), but the website is shut down for the weekend. I can't make any changes until Monday.

If the cost to me was the same, or close, I'd just buy my own insurance all the time instead of dealing with the hassles of constant change. But the costs are no-where near close. And I've got college tuition costs coming up very soon, so it's not like I'll have money to spare.

I feel like health insurance in the US is the worst of all possible worlds.