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Out, Patient

Heather Cave is well, but healthcare in Kansas City isn’t.


The good news: Heather Cave is cancer-free.

Readers might remember her story from election week last November. Cave, an artist and musician, is one of 45 million Americans who have no health insurance -- she's always had jobs, but she worked for mom-and-pop operations that couldn't afford to cover their employees. So when a trip to Planned Parenthood for free birth-control pills also yielded an abnormal pap smear and all the bad news that followed, Cave found herself, like countless musicians around the country, accepting charity at benefits where her friends played to raise money to pay her medical bills. Although Cave's story was sweet, it was just one example of how jacked up the U.S. health-care system is and how none of last fall's politicking offered hope of fixing it ("Now What," November 4, 2004).

After two surgeries and six months of chemo at Truman Medical Center, Cave went back to the doctor on February 7. "This surgeon and some wacky nurse walk in, and they're like, 'Well, you're good. It's all gone,'" Cave says. "They delivered the news so nonchalantly, I was like, shouldn't there be an organ playing in the background or an arched eyebrow? It was so non- dramatic."

This is the good news. The bad news is that the nation's health-care emergency is stressing everyone out. Just read the papers -- Republicans in the Missouri Legislature are scrambling to cover their asses after their coldblooded kid governor's budget-cutting schemes included slicing services for disabled toddlers and rural old folks; Republicans in Topeka are in a bitchfest with Gov. Kathleen Sebelius over health care in Kansas. And last week, menacing yard signs started showing up around Kansas City -- a black-and-white photo of a masked nurse behind a blood-red EKG line and the slogan "Save Lives! Vote Yes on Question 1."

That urgent ad campaign comes from City Hall. On April 5, Kansas City, Missouri, voters decide whether to approve a property-tax increase that would give an infusion to Truman Medical Center, the Metropolitan Ambulance Service Trust and neighborhood clinics such as Swope Health Services, the Kansas City Free Health Clinic and the Cabot Westside Health Center.

The cash-strapped city has cut millions in funding for Truman over the last few years, so there was something a little troubling in the air last Wednesday when Mayor Kay Barnes and other officials gathered to announce their push for the new tax at the Don Bosco Community Center. Barnes noted that, in the face of declining city revenues, taxpayers had been generous over the past few years: agreeing to higher sales taxes for the fire and police departments and approving bonds for streets and sewers. "Now it's time to invest in our human infrastructure," she said. "The health of our citizens is vitally important."

Who can blame people like Heather Cave for being cranky about one obvious omission in Barnes' recap of her successful shakedowns -- that big-ass arena campaign last summer, which was apparently much more important than the health of our citizens?

It was also creepy the way Tom Bowser, head of Blue Cross Blue Shield of Kansas City, blew hard about his company's "unique opportunity" to get behind the campaign, as if Blue Cross were the great savior of the uninsured. "We're fortunate to have 880,000 people as our customers," he said. "But we're losing more of them to the ranks of the uninsured than to our competitors." Couldn't Blue Cross just solve that problem by deciding to insure some of the relatively healthy people it routinely rejects for all sorts of ridiculous reasons?

Reporters at the press conference seemed hyperskeptical. KCTV Channel 5's Dave Helling wanted to know why Kansas City taxpayers should be asked to solve what is essentially a national problem. A radio reporter wondered whether the city would ask for another tax increase when this one expires in nine years. Councilman Chuck Eddy defensively noted that he was working with metro counties to make ambulance service more efficient and said they were certain to have a solution in the next few years. Bowser of Blue Cross coughed up a string of excuses about how the cost of health care had grown 10 percent to 11 percent over the past few years and said he hoped it would dip back into the single digits. He complained that technology and labor costs were high -- though he said nothing about insurance rates.

Who can blame Blue Cross for worrying about its own costs -- it is, after all, a not-for-profit itself. And no one wanted to ask voters to help bankroll the troubled MAST until a new board and director were in place. (Doug Hooten took over in January.)

Anyway, Kansas Citians have no choice but to pass the tax.

Because who but the most hardhearted bastard is going to vote against giving the public hospital more money? Nearly 55,000 people flowed through the emergency room at 23rd Street and Holmes last year. More than 7,700 patients had surgery on one of the floors upstairs. About 200,000 people sought help from the various clinics, and 2,242 mothers delivered children -- a handful of them still just squirmy slivers in incubators up in newborn intensive care.

The adult intensive-care unit is "99.9 percent full," says Truman head John Bluford, "which is indicative that the community is underbedded in ICUs. We were expanding by 12 beds but had to pull back because of revenue cuts."

Bluford says his staff delivered $53 million in uncompensated care last year. Most of Truman's patients have jobs -- they just can't afford insurance.

Heather Cave knows it's tricky asking property owners to pay fifty or a hundred more bucks a year to cover Truman's costs. "No one wants to shell out more dough for taxes in general," she says. "But which is worse: for that [health care] or for an arena that doesn't even have a fuckin' team?"

Before she got sick, Cave says, she could only imagine what people who have a serious illness must go through. Now she knows all about that, but there's something new. Her surgeon told her that if the cancer didn't come back for a year, she'd live. "I never imagined how, after they said you were OK, there's a new mindfuck of wondering if it's going to come back."

And even though she's cancer-free, there's more bad news. "I was looking into getting insurance now," she says. "But forget it. I'm done. Now I don't qualify for insurance, and no one's going to insure me."

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