Dying for dollars

MIAMI – There is almost no end to the adjectives that could be used to describe the January 13 death in Miami of thirty-eight-year old Maria Huaman. Untimely. Tragic. Unnecessary. Heartbreaking. Unjust.

The cold, hard facts, as laid out in last Saturday’s edition of the Miami Herald, are these:

“A Miami woman in need of a lung transplant died this week after her family said they tried repeatedly to have her transferred from a West Kendall medical center to Miami-Dade’s taxpayer-owned Jackson Memorial Hospital, the only facility in South Florida capable of transplanting lungs and a designated safety net for uninsured county residents.

“The woman’s family says Jackson Memorial officials denied her transfer first because they believed she was an undocumented immigrant, then because she was uninsured — and ultimately, after a week of denials, because she was too critically ill to move.”

There are so many factors that can blamed for the passing of this relatively young mother of three—and so many things that might prevented her death—that one scarcely knows where to begin to unravel the tale.

Things began to take their tragic course on December 17, 2015, when, according to her husband, Maria accidentally drank from a cup containing weed killer before spitting it out. Sometime later she became ill with stomach pain and vomiting. Her husband took her to Jackson South Community Hospital where she was kept for a while and set home with a prescription for an acid stomach.

Put this down to the random aspect of human life. Doctors can miss signs of big trouble, especially in early stages. Accidents happen. Or, as the more vulgar expression goes, shit happens. You can’t always prevent it. Then there are those who don’t believe in coincidences.

Who puts herbicide in a cup? Who drinks from a cup when they don’t know what it contains?

But this is not an existentialist meditation or an episode of “Forensic Files.” More than from bad luck or anything contained in that herbicide, Huaman died from a perfect storm in which nearly every form of injustice and prejudice in our society came into play, every form of stigma and disadvantage had a role.

Money may or may not be the root of all evil—bureaucratic indifference and political dogma shouldn’t be discounted—but it certainly was seminal here. The Marquez family, two adults and three children, lived on less than $28,000 in 2015, even though the married couple owned a cleaning business and worked for their money. That’s a meager sum anywhere in the country, especially in Miami with its soaring rents. No wonder they couldn’t afford health insurance.

Count the factors: the shocking levels of inequality in the country as a whole, more acute in Miami, which make the life and death chances of those whose properties are cleaned and those who clean them for them strikingly different; living in the only developed nation in the world that doesn’t provide public health insurance to all its people; living in a state ruled by Republican politicians so blinded by their hatred of government that they turned down free Obamacare money, which would have provided health insurance coverage to people just like the Marquez’s.

Then there is the idea that a public hospital would deny a person a potentially life-saving procedure because she is undocumented. The United States is going through one of its recurring bouts of xenophobia, which is a social pathology that can be lethal. The irony is that Maria was in fact a legal resident. But the very thought that a hospital that receives $400 million annually in taxpayer money, in part to care for people who are actually undocumented, would turn its back in this case is mind blowing. And here is another thought. In 1973, the United States Supreme Court ruled that the state of Texas could not deny undocumented children a free public education. Is education more valuable than life itself?

Then there is there the Kafkaesque and Orwellian element. Huaman was admitted at West Kendall Baptist Hospital on December 18. By January 5 her condition had deteriorated enough that she needed a lung transplant, and hospital staff asked Jackson for a transfer. Jackson denied it giving no reason. That’s the same wall Kafka’s characters often ran into: bureaucratic silence.

Huaman’s father-in-law wouldn’t accept that, and he says Jackson officials gave him a reason: the hospital demanded a $350,000 deposit in order to accept his daughter-in-law’s case. That’s twelve times the family’s annual income.

After Huaman died, never having gained admission at Jackson, a spokesperson for the hospital issued this statement that reeks of Orwellian doublespeak: “All American transplant centers adhere to complex criteria that prioritize the patients who are most likely to survive and thrive through the transplant journey. Even after surgery, patients need a lifetime of medication, doctor visits and follow-up care. Many, many people on transplant waiting lists across the country have heartbreaking stories of need — part of our job at the Miami Transplant Institute is to create the best outcomes for as many of these people as possible.”

But if Huaman’s father-in-law is telling the truth, those “complex criteria” are nothing $350,000 wouldn’t have been able to take care of.

There is a lot about this tragedy that is not yet known. An autopsy has been performed but no cause of death has yet been announced, for instance. And a single example can’t be used to prove a general thesis. Yet this case seems to mirror many of the things we can prove about the worst aspects of American society in general and health care in particular.

The poor and the uninsured get less care, have lower life expectancy, and suffer from more and worse illnesses. Being an immigrant, especially an undocumented one, but even a legal one, can subject you to discrimination. Dying for dollars, or rather for the lack of them, is still a reality in this country, even after Obamacare. That’s an ugly moral scar for any society to bear.