The bat and the bills

AS A medical social worker, I followed the story of Natasha McShane with horror and hope.

On the night of April 23, the 23-year-old exchange student from Belfast in Northern Ireland was beaten with a bat and suffered a traumatic brain injury (TBI). She was rushed to Illinois Masonic Medical Center in critical condition, and doctors weren't sure she would live.

Natasha did live--and so began her odyssey through the for-profit American health care system.

Natasha was a student at the University of Illinois at Chicago (UIC) when she was attacked. Students at UIC are required to have health insurance, and many have CampusCare--a bare-bones HMO. The coverage is expensive: $471 a semester.

If Natasha had been covered by CampusCare, she would have been out of luck the second the bat crashed into her cranium. That's because CampusCare has a lifetime maximum benefit of $500,000 and a $2,500 maximum drug benefit per year.

The injuries that Natasha sustained were catastrophic. She was in a medically induced coma for the first month and required a vast array of medical resources--surgeries, anesthesia, X-rays, IV medications and round-the-clock monitoring by a coterie of highly trained specialists.

In less than four weeks in the intensive care unit, she would have reached the cap on the lifetime benefit. The drug benefit limit would have been reached in one hour.

Natasha was transferred to Northwestern Memorial Hospital and finally to the Rehabilitation Institute of Chicago (RIC). At RIC, Natasha began rehab with a team of physical and occupational therapists, speech language pathologists, social workers, nurses, neurologists and physiatrists.

The health care professionals who treated Natasha saw one thing only: a patient in need of care. The three hospital billing departments, on the other hand, saw the need to send bills that reached astronomical levels.

If Natasha had been a resident of the U.S., she probably would have had to declare bankruptcy. Instead, her parents Liam and Sheila McShane did what thousands of uninsured and underinsured Americans do when they can't pay medical bills--start fundraising.

All over the country, medically indigent Americans plan pancake breakfasts, backyard barbecues, bake sales, bar nights, raffles and walk-a-thons. They set up Web sites that reveal their diagnosis and their cost of treatment in order to solicit donations. In the richest country in the world, people have to plead for charity to pay for health care. It is humiliating.

With the help of the Irish American community in Chicago, the McShanes organized a fundraiser at Cans Bar and Canteen, with 15 percent of the bar sales going to Natasha. There was a silent auction and a "Natasha McShane Day." A Web site titled the Natasha McShane Fund was launched. An astonishing $400,000 was raised--an example of the enormous amount of sympathy and solidarity that ordinary people have for someone in need.

The McShanes must have wondered why the American health care system doesn't confer health care as a right for all--because they're from Ireland, which does. In Northern Ireland, there is a government-run, national health care system funded by taxes that covers everyone. Fundraisers at pubs to save people from medical bankruptcy are unheard of. Not even in a bad Irish joke.

In the second week of July, Natasha was Medevaced back home to Ireland. The staff at the Royal Victoria Hospital in Belfast was waiting to admit her. Her family must have sighed with collective relief when the plane touched down at Belfast International Airport.

From that point on, the McShanes wouldn't get one single bill for the medical care their daughter would receive. They could focus exclusively on Natasha's rehabilitation, and planning for her future.

Natasha McShane endured a double assault in this country--an assault with a baseball bat that changed her life forever, and an assault by health care bills that her parents are still trying to pay.

First appeared at Firedoglake.