A Physician’s Love Letter to ‘The Individuals’s Hospital’

Dan Weissmann

Might a charity hospital based by a crusading Dutch playwright, a bunch of Quakers, and a choose working undercover grow to be a mannequin for the U.S. well being care system? On this episode of the podcast “An Arm and a Leg,” host Dan Weissmann speaks with Dr. Ricardo Nuila to search out out.

Nuila’s new ebook, The Individuals’s Hospital: Hope and Peril in American Drugs, makes use of the modern mannequin of the Ben Taub Hospital in Houston, the place he practices, to argue for a publicly funded well being system within the U.S. that’s out there to all people, with or with out insurance coverage. 

Dan Weissmann

@danweissmann

Host and producer of “An Arm and a Leg.” Beforehand, Dan was a workers reporter for Market and Chicago’s WBEZ. His work additionally seems on All Issues Thought-about, Market, the BBC, 99 % Invisible, and Reveal, from the Heart for Investigative Reporting.

Credit

Emily Pisacreta
Producer

Adam Raymonda
Audio Wizard

Afi Yellow-Duke
Editor

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Transcript: A Physician’s Love Letter to ‘The Individuals’s Hospital’

Be aware: “An Arm and a Leg” makes use of speech-recognition software program to generate transcripts, which can include errors. Please use the transcript as a device however examine the corresponding audio earlier than quoting the podcast.

Dan: Ben Taub Hospital is a publicly funded security internet hospital in Houston, Texas. The vast majority of sufferers don’t have insurance coverage of any type. 

Dr. Ricardo Nuila has been working at Ben Taub since he was an intern, a medical scholar. He took me on a tour.

Ricardo Nuila: I began right here and, you recognize, actually I simply didn’t wish to go away right here cuz I simply, simply actually loved my job right here

Dan: He’s simply revealed a ebook referred to as “The Individuals’s Hospital” that’s not only a love letter to the place, it’s a pitch: 

Not solely is that this place method, method cheaper than what we’re used to, in some ways it’s higher. And it’s a mannequin, an actual various to what-we’re-used-to.

So, I ask him to choose ONE affected person’s story from the ebook to inform, he picks a affected person he calls Stephen. A restaurant supervisor, a Republican. A man who didn’t anticipate to finish up right here.

However he had a large lump on the facet of his throat, and his insurance coverage didn’t cowl a lot. He paid money, upfront, to get seen in a neighborhood ER. 

Ricardo Nuila: lastly there was a physician who had seen a CAT scan and stated, you might have tonsillar most cancers, most cancers, nonetheless, you don’t have, uh, insurance coverage 

Dan: Tonsillar most cancers. Most cancers of the tonsils. That landed arduous. So did the “nonetheless.” 

Ricardo Nuila: He felt shitty you recognize, that someone may let you know most cancers, however there’s nothing that we’re gonna do about it due to, of how a lot and…

Dan: It’s prefer it’s too painful — or too apparent — to complete the sentence: Due to your insurance coverage. Any person tells Steven to attempt the general public hospital, Ben Taub. He expects the worst. However that’s not what he finds.

Ricardo Nuila: He comes to like this place. He provides, that is like so Steven, however he, he provides reward playing cards to the individuals greeting on the door as a result of they’re good they usually do their job nicely cuz they make his day,

Dan: And it’s not simply that he likes the individuals on the door.

Ricardo Nuila: He seems like he obtained actually good healthcare and that he additionally, um, thought that the value was extraordinarily purpose.

Dan: Stephen misplaced his insurance coverage when he obtained too sick to work, and he doesn’t qualify for Medicaid. He owns a home, he’s obtained financial savings, Texas has actually stringent Medicaid restrictions– so he’s paying out of pocket.

Ricardo Nuila: However his ultimate invoice is pennies of what he thought he would pay.

Dan: Stephen’s dad had gotten radiation therapy for most cancers, and the sticker worth was 700 thousand {dollars}. Stephen had gotten radiation AND chemo AND surgical procedure — and had been hospitalized for a superb whereas. 

His invoice was 32 thousand, 300 and seventy-eight bucks. Actual cash for positive, however he pays it. And it’s lower than 5 % of his dad’s invoice for a lot much less in depth therapy. 

Ricardo Nuila: And the healthcare is absolutely good. And so he’s virtually proud that he’s had this expertise

Dan: Steven’s grow to be a convert. And as Ricardo Nuila walks me right into a convention room, it’s clear: He hopes his ebook will create extra converts. 

Ricardo Nuila: you begin to see this mannequin and it makes you assume, can issues be completely different in healthcare? I believe that that’s an choice. However we as a rustic haven’t thought of that. Severely. You understand?

Dan: And if it appears politically unimaginable that we may have something like this across the nation– an efficient, environment friendly, CHEAP, publicly-funded well being system– 

Effectively, the concept Houston may have one, that was fairly unlikely too.

Actually, the story of how Ben Taub obtained right here will be the most stunning story in Ricardo Nuila’s entire ebook. 

That is An Arm and a Leg, a present about why well being care prices so freaking a lot, and what we will possibly do about it. I’m Dan Weissmann. I’m a reporter, and I like a problem. So our job on this present is to take probably the most enraging, terrifying, miserable elements of American life and to deliver you a present that’s entertaining, empowering and helpful.

Ben Taub Hospital sits on the fringe of the Texas Medical Heart– that’s a large neighborhood stuffed with hospitals and medical faculties, together with among the finest within the nation, just like the M.D. Anderson most cancers heart. 

In his ebook, Ricardo Nuila writes about how some sufferers at Ben Taub can see from their rooms the gleaming buildings of Ben Taub’s neighbors. 

So after I go to, I make him present me the view. We glance out from a stairwell at a glass tower, M.D. Anderson’s Sheikh Zayed constructing.

Ricardo Nuila: that’s glamorous. Proper? you get a glimpse into the remainder of the medical heart right here. Ben Taub stands proud, I really feel like, as a result of it’s, it’s brick versus glass. 

Dan: However as Ricardo Nuila makes clear in his ebook: This unglamorous brick constructing will get the job accomplished. 

Along with Steven, there’s Ebonie, whose sophisticated being pregnant — there’s lots of vaginal bleeding– will get tracked extra exactly than it might elsewhere: 

At different hospitals, nurses eyeball the pads that soak up that blood and notice heavy, medium or gentle bleeding. At Ben Taub, they’ve adopted an modern strategy: weighing every pad to get an actual measurement. 

One other affected person, Christian, has bounced round different methods with out anyone precisely diagnosing the dire kidney issues which have stored him in ache for years. As a result of he didn’t have good insurance coverage, it wasn’t price anyone’s time. 

At Ben Taub, insurance coverage isn’t an impediment, 

Ricardo Nuila: We arrange issues, which is principally, okay, we have to focus in your kidneys proper now and we have to get you to see a geneticist. And each of these issues occurred.

Dan: they not solely diagnose him, they get him on a type of dialysis that he can handle himself at house.

It’s cheaper, and delivers higher high quality of life for him.

Every thing at Ben Taub is cheaper. The system spends a few third as a lot per affected person because the nationwide common. Partially, that could be as a result of no person earns million-dollar salaries right here. 

However Ricardo Nuila makes the case again and again that they take the time– as a result of they’ve it– to make sensible use of sources. 

They don’t have as many MRI machines as different hospitals. However guess what? A variety of sufferers don’t want MRIs. 

However Ben Taub can’t meet each want: One affected person, Geronimo, wants a liver transplant, and that requires sources the hospital simply doesn’t have. 

However Ricardo Nuila and his colleagues put lots of time into wrenching him again onto Medicaid, so he can get the transplant someplace else. They rope in a Congressman to get it accomplished. 

Geronimo tells his mother:”I really feel so essential. Everybody treats me like I’m wealthy.” 

Ricardo Nuila: That’s what I believe lots of people really need is simply the sense that the one who’s liable for your care is pondering via the issue with you and conscious that you’re not having an incredible day and needs to cope with that scenario with you. And I simply felt like this surroundings allowed me to love, have these moments.

Dan: So who pays for this surroundings? It might be cheaper, nevertheless it isn’t free. 

Some sufferers are on Medicaid. Some are on Medicare. Some have non-public insurance coverage. However the majority don’t have any insurance coverage in any respect. 

Some, like Stephen, pay money. And lots of the remainder — a few third of Ben Taub’s sufferers — are handled without spending a dime.

The majority of Ben Taub’s funding comes from a particular property tax in Harris County, the place Houston is situated. It funds an entire system referred to as Harris Well being– Ben Taub, a second hospital, and a bunch of clinics. 

And naturally, none of this has all the time existed. 

Actually, it’s solely right here, like this, due to a extremely wild story, with two large characters. One in all whom wasn’t even from Houston. He was a author I’d by no means heard of, a Dutch man named Jan de Hartog.

Ricardo Nuila: de Hartog was probably the most superb those who you would examine. He was a Nazi resistance fighter, Dutch ship captain. 

Dan: And whereas he was hiding out in Denmark throughout the conflict– in between saving a couple of Jewish infants and working conflict missions in his tugboat–  

he wrote a romantic dramedy that — later turned a broadway hit. After which obtained tailored right into a Broadway musical referred to as I Do, I Do– which, Broadway-musical nerds in the home– starred Mary Martin and Robert Preston– you recognize, The Music Man– and had a tune that your mother may nonetheless bear in mind. 

 (musical sounds) 

Dan: Yeah. So, attention-grabbing man. And within the early Sixties he got here to Houston to show playwriting at a neighborhood College.  It was a giant time for him. He’d simply gotten married — for the third time, however this one was for keeps- and grow to be a Quaker. 

Ricardo Nuila: And when he and his spouse Marjorie come to Houston, they discover that there’s all these whisperings about this charity hospital on the town in Houston about how, how terrible the circumstances are. That the kids within the maternity ward would cry all night time for the, for a scarcity of milk, and in order a part of his religion, he decides that he must volunteer there

Dan: When de Hartog writes concerning the hospital later, he describes the expertise of strolling in for the primary time as actually mind-boggling. 

He’s like: I do know what a hospital smells like. Disinfectant, possibly some recent laundry. And I do know what a slaughterhouse smells like: Blood, and shit. And the scent right here is slaughterhouse. 

As he appears to be like round, the sights are one thing else.

Ricardo Nuila: He sees a cockroach crawling into the tracheostomy of like a affected person. He sees like individuals sitting in their very own filth. 

Dan: He and Marjorie don’t up and stop. They stick round. After which they recruit a dozen Quakers and some society women to come back volunteer with them, and get the Pink Cross to coach them.

And it’s nuts. It is a wealthy metropolis. The ZOO is air conditioned. However not this hospital. 

And he begins to catch on: Why it’s so horrible.

Primary is racism. 

The hospital serves principally Black and Brown sufferers. When Jan and Marjorie begin volunteering, the opposite volunteers are all society women, and the entire program is about up so that they don’t contact sufferers. DeHartog later says he requested why, and the volunteer coordinator says, Southern women can’t have bodily contact with black individuals.

However she doesn’t say black individuals. She makes use of the n-word. 

 When he asks workers why public officers don’t do one thing concerning the rotten circumstances, they are saying: What politician goes to stay up for black individuals? The n-word comes up once more. 

And– de Hartog doesn’t make this connection, nevertheless it appears fairly on the nostril: The hospital itself is known as after Jefferson Davis, who led the Confederacy within the Civil Battle. 

However there’s additionally a political mechanism for institutionalizing this neglect, with out ever having to acknowledge the function of racism: 

Nobody specific political entity — nobody specific political chief– is liable for the general public hospital, financially. Town of Houston and Harris County are every alleged to kick in HALF. So it doesn’t belong to both of them. Right here’s de Hartog describing the city-county dynamic in a lecture he gave a few years later. 

Jan de Hartog: They usually have been repeatedly at one another’s throats. The one stated, you don’t pay sufficient. The opposite stated, however you don’t. They usually went backwards and forwards

Dan: The highest official for Harris County really has the title County Choose. At the moment, this was a man named Invoice Elliott. 

And also you’ll hear on this clip from a neighborhood newscast, he wasn’t precisely reaching for the invoice. Right here he’s, explaining why the some downside with the hospital is definitely the CITY’s fault. 

Choose Invoice Elliott: it’s completely ridiculous, uh, to say that, uh, this can be a accountability and that is the fault of Harris County.

Dan: And town? Not less than one.council member is asking for a funds lower. 

Which actually pisses de Hartog off. 

And de Hartog really loves town. It’s an thrilling place. It’s booming– rising super-fast. And it’s not simply an oil city. 

Ricardo Nuila: Houston at the moment was the house of NASA.

NASA narrator: Future manned area flight missions to the moon and maybe the planets will probably be commanded from this management room of the Mission Management Heart at NASA’s Manned Spacecraft Heart,

Ricardo Nuila: It had constructed this Astrodome, it was town of the longer term. 

Dan: The Astrodome– you recognize, a sports activities stadium WITH AIR CONDITIONING. . 

Astrodome Narrator: A completely enclosed constructing, massive sufficient for any sport conference present or conclave with fixed temperature and humidity unbiased of out of doors climate,

Dan: CBS Information does a report concerning the booming metropolis: NASA, the oil wealth, the Astrodome. And de Hartog is a predominant character– speaking about how a lot he loves the city.

Jan de Hartog:  it’s a metropolis of, a metropolis of limitless alternatives. It’s an immensely thrilling city, and you are feeling that something is feasible, 

Dan: It wraps up with Walter Cronkite speaking about how all people on the town is completely nuts about soccer.

Walter Cronkite: Their model of soccer is like their model of metropolis and model of life. Play broad open. Take an opportunity, attempt something. Above all, do it with zest and do it large. 

Dan: Oh, and there’s this OTHER factor Houston is absolutely changing into recognized for. 

Leading edge medication. For twenty years, town’s been constructing the Texas Medical Heart — that big campus the place greater than a dozen hospitals and med faculties now function proper on high of one another. Baylor School of Drugs really moved from Dallas to Houston to be a part of it. 

Ricardo Nuila: Houston is a extremely deeply medical metropolis. And at the moment they’re all engaged on extraordinary issues

Dan: Yeah, in 1964, whereas Jan de Hartog is witnessing the struggling on the charity hospital, Dr. Michael deBakey is performing the world’s first coronary artery bypass at a non-public hospital on the town. 

However the medical institution weren’t allies. Jefferson Davis hospital, on the outskirts of city, was about to get replaced by a brand new constructing within the Texas Medical Heart. 

However the Medical Society– the native docs’ affiliation — hadn’t wished the charity hospital as a neighbor. They’d really put up a poll initiative to maintain the brand new constructing on the previous web site. 

Medical Society Voice-Over: you the taxpayer, pays the additional value That’s why your physician recommends you vote for the brand new hospital to stay at its current web site. 

Dan: It hadn’t labored, however together with the funds cuts, officers have been now speaking about DELAYING the charity hospital’s transfer to the brand new constructing, which had simply been accomplished. De Hartog and his mates, scent a rat. 

They assume the powers that be are literally going to promote the brand new constructing within the Medical Heart to another hospital that desires in. This has been a public dialog.

Jan de Hartog: There had been gives to purchase it they usually wished to attend for the best bidder

Ricardo Nuila: He writes a sequence of op-eds for the Houston Chronicle that begin to get press, not simply in Houston, however across the nation and actually all over the world. 

Dan: He describes the terrible issues he’s seen. And he appeals to Houstonians’ sense of pleasure of their bustling, futuristic metropolis. A metropolis he loves, too. Right here’s how his first op-ed ends…

Jan de Hartog: I can’t consider that it’s the will of the residents of Houston, that our rising medical heart rightly changing into well-known all around the. Shall be allowed to harbor the cancerous sore of man’s inhumanity to man. It will flip your complete heart deliberate as Houston’s glory into Houston’s disgrace. 

Dan: Even simply that first op ed made lots of noise.

Jan de Hartog: the bomb exploded and the nationwide magazines and newspapers and TV zeroed in on the hospital to search out out what was happening, 

Dan: … and instantly, the hospital DOES transfer into its new house within the Medical Heart. However the funding situation isn’t solved. 

So de Hartog retains pushing. 

Ricardo Nuila: He writes a ebook referred to as “The Hospital” 

Dan: He goes to church buildings round city, synagogues, all over the place he can, recruiting a whole bunch of volunteers. 

However there’s no political progress — and circumstances on the hospital really worsen. Key nurses get burned out and stop. Issues go to hell.

In a harrowing diary entry, he writes about full bedpans left on tables subsequent to trays of meals. A couple of affected person crying out for assist, and listening to again “Shut up!” 

Jan de Hartog: By no means earlier than had I spotted to this extent, the depth of our damnation, and at that deepest second of desperation, after we knew nothing may very well be accomplished, nothing would change for the straightforward purpose that

Jan de Hartog: those that had the destiny of the hospital of their arms weren’t there. Mayor Welsh didn’t work there. Uh, commissioner Invoice Elliot Choose, the county choose didn’t work there. 

Dan: However THEN, there’s a flip. Any person exhibits up. That’s proper after this.

This episode of An Arm and a Leg is produced in partnership with Kaiser Well being Information. That’s a non-profit newsroom about well being care in America. KHN shouldn’t be affiliated with the large well being care participant Kaiser Permanente. We’ll have extra details about KHN on the finish of this episode.

So, Jan de Hartog retains footslogging away. 

He provides a chat at a Baptist church– he reads that diary entry, the one with the bedpans, and the absence of Choose Elliott and different leaders.

And at first he thinks he didn’t go over so large. No person even raises their hand to volunteer. 

However then it occurs. 

Jan de Hartog: When, uh, we have been about to go away, a person turned up with a child on his hip who stated, uh, do you practice individuals at night time?

Dan: And the man appears to be trying round, attempting to ensure no person’s listening. De Hartog tells the man, yeah, we may try this…

Jan de Hartog: He stated, I imply, a useless of night time with out anyone seeing. 

Dan: De Hartog’s like, “um, positive, I suppose. Why, although?” 

Jan de Hartog: He stated, nicely, I’m Choose Elliot, 

Dan: Choose Elliott. The county choose. In all probability probably the most highly effective politician on the town. That’s who desires to volunteer. In secret. With out anyone seeing. He says to de Hartog

Jan de Hartog: I can’t do it as a choose, however I have to do it as a person. And that was the second that the entire rattling factor modified.. 

Dan: As a result of Choose Invoice Elliott adopted via.

Ricardo Nuila: He trains himself in a clandestine method to be an orderly, at night time, and he verifies every part that de Hartog has stated. 

Dan: de Hartog really oversees the choose’s ultimate sensible examination, the place Invoice Elliott tends to an African-American man named Willie Small. 

Jan de Hartog: the choose along with his thermometer went and put his hand on Willie’s shoulder and stated, Mr. Small, sir, I’d wish to take your temperature to listen to that, to listen to a southern choose, , say “Mr. Small, sir” 

Dan: It was a symbolic second. The choose needed to contact, needed to defer to, a Black man. So not solely had the choose now seen every part, he took accountability for what he had seen. 

There’s a proposal for a county-wide property tax, to fund what’s referred to as a Hospital District. Now there’s a referendum, and Elliott backs all of it the way in which.

Jan de Hartog: and all of us waited with baited breaths for the end result. And it was no

Dan: Yeah. The referendum fails. And as de Hartog tells it, as soon as it does, an actual backlash begins to construct. It will get private.

Jan de Hartog: those that had resented our presence from the very starting turned vocal. Margie and I, have been referred to as communists

Ricardo Nuila: De Hartog simply wouldn’t flinch. I imply, he and his spouse’s lives have been threatened. 

Dan: Additionally, someone threw a bag of excrement at their door. 

Finally, de Hartog says the Pink Cross, which was coaching and supervising volunteers on the hospital, got here to him and Marjorie and stated, “It is likely to be higher for us if you happen to left city for some time.” 

They did — went on to every kind of adventures. 

In the meantime, Invoice Elliott stored pushing, and retains pulling in allies– together with, finally, the Medical Society. 

Ricardo Nuila: he rallies them to get behind it.

Dan: He will get the query on the poll AGAIN later that very same yr. And it passes in November 1965. 

It’s a giant second. 

Ricardo Nuila:  What’s additionally attention-grabbing is that it’s forgotten. One thing that I’ve gleaned from all that is that you recognize, individuals will overlook and it’s important to remind them. 

Dan:  And whereas we’re remembering: In 1965, the entire nation is making some large commitments to well being look after lots of people. President Lyndon Johnson indicators Medicare and Medicaid into legislation in July of that yr.

It’s in all probability additionally price noting that Medicare and Medicaid assist make Ben Taub potential: A couple of third of the hospital’s sufferers are on one or the opposite. It’s a minority of sufferers, nevertheless it’s many tens of millions of {dollars} of funding. 

The Sixties have been a notoriously divisive time. And so is that this. 

Ricardo Nuila doesn’t ignore at this time’s political polarization — or how that polarization makes it arduous to think about a nationwide dialog about creating a unique well being care system. 

Or the function that docs have traditionally performed in resisting that dialog.

It’s a part of his story. His household story. And in a ebook about a spot the place lots of unhappy issues do occur, this can be the hardest one.

Ricardo Nuila: I used to be born right into a household of docs and my dad in some ways was a hero to me. I noticed how a lot pleasure he took in his work of being a physician 

Dan: However over time– as insurance coverage firms obtained harder to cope with– the enterprise facet of working a medical apply regarded lots much less apealing. 

Ricardo Nuila: . He needed to rent increasingly workers. He employed his mom, my grandmother, who’s, uh, the kind of particular person to not again down from Chicago, you recognize, . And so, her job was to be on the insurance coverage firms to guarantee that they wouldn’t, screw him out of cash.

Dan: His dad turned away sufferers who didn’t have insurance coverage. His dad growled and grumbled– about insurance coverage firms, and about sufferers who didn’t have cash to pay. 

When Ricardo completed faculty and obtained into medical faculty, he postpone beginning for 2 years. What he sees as his dad’s life within the enterprise of well being care shouldn’t be interesting.

Ricardo Nuila: the grind wears on him, you recognize? The preventing with the insurance coverage firms

Dan: I imply within the ebook, your dad is a little bit of a stand-in for . For docs as a doctoring, as occupation and the, and the way in which by which docs get alienated from medication. 

Ricardo Nuila: yeah, he’s a stand in a bit for docs. And it’s gonna be, I believe the docs have lots to say about how healthcare goes in America,

Ricardo Nuila: And sadly, the historical past exhibits that they haven’t been an incredible piece of that, a minimum of so far as common healthcare is anxious. 

Dan: This turns into a part of Ricardo’s story along with his dad. Dad invitations him to type a household apply. Ricardo chooses Ben Taub. And over time, it turns into clear: They’re on reverse sides of a political divide. There are painful conversations, after which they go months with out talking. 

Ricardo Nuila: that’s how deep politics run, you recognize, it’s actually, it’s actually troublesome whenever you overlay like politics onto like a household dynamic,

Ricardo Nuila: It simply felt like he was like completely on board with this concept that, you recognize, healthcare is one thing that’s earned and healthcare is one thing that individuals, if you happen to can’t afford it, you don’t deserve it. Is what I heard from what he was saying. 

Dan: is your dad a really perfect reader of the ebook? Is your dad form of who the particular person you wanna make that case to? 

Ricardo Nuila: That’s actually attention-grabbing.

Ricardo Nuila: I’d say this, that, I didn’t write this to evangelise to the choir for positive.

Dan: However he’s undecided his dad would really choose up a ebook like this.

Ricardo Nuila: It’s simply because I do know my dad, he, my dad’s the kind of one who reads John Grisham on a seaside, you recognize? So I’m not one hundred percent positive if he would choose up this ebook, you recognize?

Dan: Except, say, his son wrote it. Ricardo does anticipate his dad to learn The Individuals’s Hospital. And even when he doesn’t agree with every part his son has written, Ricardo thinks his dad will probably be proud.

Ricardo Nuila: I can let you know now as a, as a father, , it’s not clear that your youngsters are gonna come out Okay. . You understand what I imply? I’m simply saying that like he has purpose to be proud simply because I’m a, a dwelling and respiration particular person proper now, you recognize?

Ricardo Nuila: And I’m, I’m working in as a physician. So I, I really feel, I really feel good for him. 

Ricardo Nuila: And I believe that he’s in all probability very blissful that I wrote about medication cuz he loves medication.

Dan: The final chapter of “The Individuals’s Hospital” is known as “religion” And in it, Ricardo Nuila describes a day by day ritual that he says retains him grounded. It begins with passing a plaque on his method in. After all I’ve him present it to me. 

Ricardo Nuila: I park like proper over there, .

Ricardo Nuila: I are available in right here and I simply take a look at, take a look at this each time. 

Dan: So, and describe what we’re seeing right here.

Ricardo Nuila: Effectively, we’re seeing, a plaque that, talks about when this hospital was based, and the individuals who constructed the constructing. And there’s additionally the, I forgot that is, that is dangerous of me, however I forgot the title.

Dan: the snake across the stick?  

Ricardo Nuila: I’m in large hassle now as a result of I’m on the Caduceus Caduceus. I, it’s the Cadus. Yeah. 

Ricardo Nuila: And it’s only a reminder, you recognize, that we have now this construction in place to assist look after individuals who don’t have, uh, the means and that, and 

Dan: that individuals determined to place this constructing right here. Yeah. 

Ricardo Nuila: Precisely. It’s a group effort.

Dan: Ricardo Nuila writes that he sees that group as he walks from that plaque to his desk– all of the co-workers, in each form of job, doing their finest. 

And that is the religion that he says will get affirmed— studying from the ebook right here: 

If somebody is struggling and there may be the capability throughout the group to assist, in a method that doesn’t hurt anybody else, then we not solely owe it to that particular person, we owe it to ourselves to assist. 

No matter your politics are, I believe that’s fairly nice. 

Dr. Ricardo Nuila practices at Ben Taub Hospital. He’s affiliate professor of Drugs, Medical Ethics and Well being Coverage at Baylor School of Drugs. His ebook is known as “The Individuals’s Hospital.”

Actually there’s lots on this ebook, — extra affected person tales, extra household tales, a really deft abstract of 100 years of well being care economics and politics.

I’ll let you know: studying this ebook, I used to be reminded of an concept I’ve had earlier than.  That it is likely to be cool sometime to convene a form of “Arm and a Leg” ebook membership. As a result of I’d wish to have somebody to speak with a few ebook like this– like possibly you. 

Proper now, that’s simply an concept. The how would take a LOT of determining.  

However I’m curious how that concept sounds to you. You may let me know at Arm and a Leg present dot com, slash contact.

I imply, that’s all the time a superb place to ship concepts and tales and questions— so a lot of our greatest episodes come from you.

And I’m curious what you consider this digital ebook membership concept. For those who’ve taken half in one thing like this, or helped to arrange it, I’d love to listen to the way it went.

That’s arm and a leg present dot com, slash contact.

Subsequent time on An Arm and a Leg: A girl named Lisa French requested her hospital what her surgical procedure would value her. They stated, along with your insurance coverage, about 13 hundred bucks.

They anticipated about 55 thousand extra from insurance coverage. 

They obtained 75 thousand. However then they wished extra. 229 thousand extra. They wished it from Lisa French, they usually sued her for it.

After eight years, the case lastly obtained resolved final June. Lisa French gained!

The case has a LOT to show us about our authorized rights. 

That’s subsequent time on An Arm and a Leg.

Until then, handle your self.

This episode of An Arm and a Leg was produced by me, Dan Weissmann, with assist from Emily Pisacreta, and edited by Afi Yellow-Duke.

The recording of Jan de Hartog’s lecture is courtesy of the Baylor School of Drugs Archives. 

The audio of Invoice Elliott is from a KHOU-TV newscast, because of the Texas Archive of the Transferring Picture.

Massive because of the archivists who helped us discover among the tape for this episode! 

That features Emily Vinson on the College of Houston library 

Matt Richardson and Sandra Yates on the Texas Medical Heart Archives

And David Olmos on the Baylor School of Drugs archives. 

Daisy Rosario is our consulting managing producer. Adam Raymonda is our audio wizard.  Our music is by Dave Winer and Blue Dot Classes. 

Gabrielle Healy is our managing editor for viewers. She edits the First Help Equipment Publication. 

Bea Bosco is our consulting director of operations. Sarah Ballema is our operations supervisor. 

This season of an arm and a leg is a co manufacturing with Kaiser well being information. That’s a nonprofit information service about healthcare in America, an editorially-independent program of the Kaiser household basis. 

KHN shouldn’t be affiliated with Kaiser Permanente, the massive healthcare outfit. They share an ancestor: The twentieth century industrialist Henry J Kaiser. When he died, he left half his cash to the muse that later created Kaiser well being information.

You may be taught extra about him and Kaiser well being information at arm and a leg present dot com slash Kaiser. 

Zach Dyer is senior audio producer at KHN. He’s editorial liaison to this present. 

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