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Fri October 25, 2013
The Waiting Room: A System Broken In So Many Places
Last night I watched the beautifully crafted documentary "The Waiting Room." It captures 24 hours in a single hospital's waiting room, following the stories of a diverse cast of patients and staff. There's no narration except how the characters tell their own stories and how those weave into the larger story this documentary tells. And that story is about a safety-net hospital bursting at the seams trying to care for people with no insurance and, often, the kinds of ailments that could be managed or treated with the kind of regular medical care none of them can afford.
The film is deceptively simple: 24 hours in the emergency department waiting room of Highland Hospital in Oakland, California. We follow a patient who ran out of diabetes medication, another whose strep throat has become so severe she can't open her mouth, the indigent, the unemployed, the working poor. Throughout the 24 hours the film depicts, we revisit the indefatigable triage nurse always ready with reassuring words, the ER doc who desperately tries to find someone to take the homeless addict he doesn't want to discharge but has to in order to free up a bed, countless negotiations for more space, more beds, more resources to cope with the deluge.
What emerges is a profound portrait of a system that's broken in so many places one hardly knows where to start fixing it.
Rhode Island doesn't have any public hospitals; every hospital in the state shares the burden - or duty, depending on how you look at it - of caring for people with no means to pay for that care. That means the bulk of so-called "charity care" patients aren't sent solely to one hospital's ER, though Rhode Island Hospital does see the bulk of them because it's a major trauma center. But Rhode Island is no different from anywhere else in that we have tens of thousands of people who are uninsured or under-insured. And people with no insurance might put off seeing a doctor until it's an emergency. At that point, it's going to be expensive no matter what kind of treatment they get. And then we all share in paying for that episode because it's got to come from somewhere: hospitals have to recoup those losses, governments have to provide more aid, social service agencies and nonprofits have to pick up the slack to care for people when they're discharged, and on and on. Is getting everyone insured the easy answer? Not necessarily, but it would certainly enable people to get the care they need earlier, before it's too late.
I saw The Waiting Room on HBO on demand, but you can find out more about the film and the very cool multimedia storytelling project connected with it here.