A hard look at ailing American healthcare
By Joanne Weintraub
Knight Ridder News Service
Many years ago, an Italian immigrant to New York City's Staten Island fell ill. A man of modest means, Aniello Esposito was admitted to a local hospital's charity ward — where, his descendants say, the war veteran and city employee was left to die.
7 tonight NBC An examination of the health of the American healthcare system
This year, Aniello's great-grandson, Paul, also a man of modest means, needed and received hundreds of thousands of dollars' worth of care at the same hospital. How this extraordinary situation became ordinary and what it means for the American economy are the subjects of "Critical Condition," a special edition of "Dateline" reported by Tom Brokaw.
'Dateline: Critical Condition'
This one-hour report won't tell you much you don't already know about the exorbitant cost and erratic functioning of the American health-care system. But by focusing on the way that system has worked — or not worked — for Esposito and a few others, it humanizes the facts and figures.
Every politician has a solution to the problem of spiraling medical bills, which by one estimate rose 70 percent from 1990 to 2000.
Yet in the midst of 2004's presidential campaign rhetoric, Brokaw observes, healthcare lies "like a patient in a hospital bed surrounded by specialists, all arguing about what's the best treatment, while slowly (the patient's) life-support system breaks down."
Esposito, a 24-year-old waiter, survived the October 2003 Staten Island ferry crash that killed 11 others. But his injuries were grievous, including a fractured pelvis and such severe damage to both legs that they had to be amputated above the knee.
A remarkably upbeat guy with dark hair and a smooth, open face, Esposito talks freely and without self-pity about what it felt like to lose his legs. He doesn't flinch when a therapist, discussing the fitting of prosthetic limbs, asks him, "How tall were you?"
But Esposito's lack of health insurance — "It's not something a 24-year-old thinks about," he admits — casts a fearful shadow. Over the long months of surgery and physical therapy, his bill at Staten Island University Hospital pushes past the $200,000 mark, and that doesn't include the $85,000 each custom-made artificial leg will cost.
Another ferry passenger, 62-year-old Audrey Biase, was luckier than Esposito: Her injuries, though serious, were less-disabling than his, and she has health insurance to cover her $79,000 hospital stay.
Biase, however, is distressed to learn this insurance won't cover the equipment she needs for rehabilitation. Having paid $5,000 a year in premiums, she can hardly believe the news.
Those numbers with all the zeros after them — for hospitals stays, operations, medications, insurance premiums and all the rest — no longer seem shocking. But for all their familiarity, it's still hard to understand how they soared out of control.
One of many reasons is hospital-subsidized care granted to uninsured patients like Esposito.
Near the end of "Critical Condition," experts, liberal and conservative, make the case for and against the remedy of a national healthcare system. It's an argument that will continue, no matter who wins in November.
