Without leaving the U.S., I now understand how much better hospital care can be when it’s made available as a human right, rather than administered as a corporate business transaction.
When my daughter suffered serious burns as a result of an accident, she was referred to the Boston Shriners Hospital for Children, a 12-bed pediatric burn hospital that is a registered charity.
Arriving in Boston late at night after a long ambulance ride from Vermont, we were met by nurses who advised we would never get a bill from Shriners Hospital, no matter how long or acute the hospital stay might be. Furthermore, my daughter would be eligible, free of charge, for any burn-related outpatient care up until her 21st birthday.
The registration process, done right in my daughter’s room, and without the use of a computer, was completed in less than a minute. Insurance was never mentioned. In fact, I never produced my insurance card until our first outpatient visit, some weeks later. I was told Shriners Hospitals (there are 22 of them in the U.S. and Canada) only reluctantly began billing insurance in 2012. The Shriners network despised the administrative requirements imposed by insurance companies, but financial pressures forced them to acquiesce.
With so little paperwork necessary, the treatment of my daughter’s injuries proceeded without concern over what was covered or what I could afford, without suspicion that a care plan was influenced by what insurance would pay for, and without fear of a “utilization review” officer who might kick us out on the street before my daughter was ready to go home.
All that aside, it was the quality of care, and the dedication and high morale of the staff, that most impressed me at Boston Shriners Hospital.
One nurse told me she had an hour-and-50-minute commute before beginning her 12-hour shift at the hospital at 7 a.m., and another hour-and-50 minutes before joining her husband and two teenage sons at home late in the evening. I asked how she could possibly manage such a grueling schedule. She replied that the driving took its toll but she did not regard being a nurse at Shriners Hospital as work. It was what she loved to do.
Burn care is highly specialized, and while skin grafts and other surgeries are often indicated, most of the care at Shriners is administered bedside by nurses trained in this field. At the Boston facility, some of the nurses have been employed there for decades. The longest serving nurse at Boston Shriners started work in 1980. As a child, he had received care as a burn patient at Boston Shriners Hospital, and the experience instilled in him a passion for nursing.
The coordination of care, something I have found to be lacking at hospitals in Vermont and New Hampshire, was exemplary at Boston Shriners. Every day during the time when the two nursing shifts overlapped, the entire acute care team — doctors, nurses, physical therapists, nurse practitioners, social workers and others — met to go over the plan for each patient, adjusting as necessary based on input from all involved.
Each patient at Boston Shriners is also assigned a Child Life Specialist, trained in child psychology, who is beside the child to lessen anxiety whenever a procedure is scheduled. As the patient recovers, the Child Life Specialist encourages the child to play games, create art work and re-enter the imaginative world that all healthy children inhabit.
I thought I would have to be hospitalized in Europe in order to experience health care as it should be provided, that is, without the profit motive and the intermediaries of insurance companies, accountable care organizations and the like, asserting themselves at a time when all attention should be focused on healing.
I also did not realize how much better the quality of care could be when the hospital staff loves their work, loves the hospital and loves their patients. Despite the ordeal of seeing my child in pain and fearing for her future, the experience at Boston Shriners was an affirmation of a shared humanity, of a shared responsibility to our fellow human beings.
If only the U.S. could implement such a philosophy across all of health care, by public funding, as in Medicare. The Shriners hospitals are financed by foundations, private fundraising and corporate sponsorships, for which I am immensely grateful, but I firmly believe public financing (through taxes I would willingly pay) based on the principle of health care as a human right, could achieve the same results.
Ethan Parke lives in Montpelier.