{"id":625200,"date":"2023-04-03T17:49:35","date_gmt":"2023-04-03T22:49:35","guid":{"rendered":"https:\/\/news.sellorbuyhomefast.com\/index.php\/2023\/04\/03\/a-doctors-love-letter-to-the-peoples-hospital\/"},"modified":"2023-04-03T17:49:35","modified_gmt":"2023-04-03T22:49:35","slug":"a-doctors-love-letter-to-the-peoples-hospital","status":"publish","type":"post","link":"https:\/\/newsycanuse.com\/index.php\/2023\/04\/03\/a-doctors-love-letter-to-the-peoples-hospital\/","title":{"rendered":"A Doctor\u2019s Love Letter to \u2018The People\u2019s Hospital\u2019"},"content":{"rendered":"
\n

Note: \u201cAn Arm and a Leg\u201d uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.<\/em><\/p>\n

Dan:<\/strong> Ben Taub Hospital is a publicly funded safety net hospital in Houston, Texas. The majority of patients don\u2019t have insurance of any kind.\u00a0<\/p>\n

Dr. Ricardo Nuila has been working at Ben Taub since he was an intern, a medical student. He took me on a tour.<\/p>\n

Ricardo Nuila:<\/strong> I started here and, you know, literally I just did not want to leave here cuz I just, just really enjoyed my job here<\/strong><\/p>\n

Dan:<\/strong> He\u2019s just published a book called \u201cThe People\u2019s Hospital\u201d that\u2019s not just a love letter to the place, it\u2019s a pitch:\u00a0<\/p>\n

Not only is this place way, way cheaper than what we\u2019re used to, in many ways it\u2019s better. And it\u2019s a model, a real alternative to what-we\u2019re-used-to.<\/p>\n

So, I ask him to pick ONE patient\u2019s story from the book to tell, he picks a patient he calls Stephen. A restaurant manager, a Republican. A guy who did not expect to end up here.<\/p>\n

But he had a giant lump on the side of his throat, and his insurance didn\u2019t cover much. He paid cash, upfront, to get seen in a local ER.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> finally there was a doctor who had seen a CAT scan and said, you have tonsillar cancer, cancer, however, you don\u2019t have, uh, insurance\u00a0<\/strong><\/p>\n

Dan:<\/strong> Tonsillar cancer. Cancer of the tonsils. That landed hard. So did the \u201chowever.\u201d\u00a0<\/p>\n

Ricardo Nuila:<\/strong> He felt shitty you know, that somebody could tell you cancer, but there\u2019s nothing that we are gonna do about it because of, of how much and\u2026<\/strong><\/p>\n

Dan:<\/strong> It\u2019s like it\u2019s too painful \u2014 or too obvious \u2014 to finish the sentence: Because of your insurance. Somebody tells Steven to try the public hospital, Ben Taub. He expects the worst. But that\u2019s not what he finds.<\/p>\n

Ricardo Nuila:<\/strong> He comes to love this place. He gives, this is like so Steven, but he, he gives gift cards to the people greeting at the door because they\u2019re nice and they do their job well cuz they make his day,<\/strong><\/p>\n

Dan:<\/strong> And it\u2019s not just that he likes the people at the door.<\/p>\n

Ricardo Nuila:<\/strong> He feels like he got really good healthcare and that he also, um, thought that the price was extremely reason.<\/strong><\/p>\n

Dan:<\/strong> Stephen lost his insurance when he got too sick to work, and he doesn\u2019t qualify for Medicaid. He owns a house, he\u2019s got savings, Texas has really stringent Medicaid restrictions\u2013 so he\u2019s paying out of pocket.<\/p>\n

Ricardo Nuila:<\/strong> But his final bill is pennies of what he thought he would pay.<\/strong><\/p>\n

Dan:<\/strong> Stephen\u2019s dad had gotten radiation treatment for cancer, and the sticker price was 700 thousand dollars. Stephen had gotten radiation AND chemo AND surgery \u2014 and had been hospitalized for a good while.\u00a0<\/p>\n

His bill was 32 thousand, three hundred and seventy-eight bucks. Real money for sure, but he can pay it. And it\u2019s less than five percent of his dad\u2019s bill for much less extensive treatment.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> And the healthcare is really good. And so he\u2019s almost proud that he\u2019s had this experience<\/strong><\/p>\n

Dan:<\/strong> Steven\u2019s become a convert. And as Ricardo Nuila walks me into a conference room, it\u2019s clear: He hopes his book will create more converts.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> you start to see this model and it makes you think, can things be different in healthcare? I think that that\u2019s an option. But we as a country haven\u2019t thought about that. Seriously. You know?<\/strong><\/p>\n

Dan:<\/strong> And if it seems politically unimaginable that we could have anything like this around the country\u2013 an effective, efficient, CHEAP, publicly-funded health system\u2013\u00a0<\/p>\n

Well, the idea that Houston could have one, that was pretty unlikely too.<\/p>\n

In fact, the story of how Ben Taub got here may be the most surprising story in Ricardo Nuila\u2019s whole book.\u00a0<\/p>\n

This is An Arm and a Leg, a show about why health care costs so freaking much, and what we can maybe do about it. I\u2019m Dan Weissmann. I\u2019m a reporter, and I like a challenge. So our job on this show is to take one of the most enraging, terrifying, depressing parts of American life and to bring you a show that\u2019s entertaining, empowering and useful.<\/p>\n

Ben Taub Hospital sits at the edge of the Texas Medical Center\u2013 that\u2019s a giant neighborhood full of hospitals and medical schools, including some of the best in the country, like the M.D. Anderson cancer center.\u00a0<\/p>\n

In his book, Ricardo Nuila writes about how some patients at Ben Taub can see from their rooms the gleaming buildings of Ben Taub\u2019s neighbors.\u00a0<\/p>\n

So when I visit, I make him show me the view. We look out from a stairwell at a glass tower, M.D. Anderson\u2019s Sheikh Zayed building.<\/p>\n

Ricardo Nuila:<\/strong> that\u2019s glamorous. Right? you get a glimpse into the rest of the medical center here. Ben Taub sticks out, I feel like, because it\u2019s, it\u2019s brick versus glass.\u00a0<\/strong><\/p>\n

Dan:<\/strong> But as Ricardo Nuila makes clear in his book: This unglamorous brick building gets the job done.\u00a0<\/p>\n

In addition to Steven, there\u2019s Ebonie, whose complicated pregnancy \u2014 there\u2019s a lot of vaginal bleeding\u2013 gets tracked more precisely than it would elsewhere:\u00a0<\/p>\n

At other hospitals, nurses eyeball the pads that absorb that blood and note heavy, medium or light bleeding. At Ben Taub, they\u2019ve adopted an innovative approach: weighing each pad to get an exact measurement.\u00a0<\/p>\n

Another patient, Christian, has bounced around other systems without anybody accurately diagnosing the dire kidney problems that have kept him in pain for years. Because he didn\u2019t have good insurance, it wasn\u2019t worth anybody\u2019s time.\u00a0<\/p>\n

At Ben Taub, insurance isn\u2019t an obstacle,\u00a0<\/p>\n

Ricardo Nuila:<\/strong> We organize things, which is basically, okay, we need to focus on your kidneys right now and we need to get you to see a geneticist. And both of those things happened.<\/strong><\/p>\n

Dan:<\/strong> they not only diagnose him, they get him on a form of dialysis that he can manage himself at home.<\/p>\n

It\u2019s cheaper, and delivers better quality of life for him.<\/p>\n

Everything at Ben Taub is cheaper. The system spends about a third as much per patient as the national average. In part, that may be because nobody earns million-dollar salaries here.\u00a0<\/p>\n

But Ricardo Nuila makes the case over and over again that they take the time\u2013 because they have it\u2013 to make wise use of resources.\u00a0<\/p>\n

They don\u2019t have as many MRI machines as other hospitals. But guess what? A lot of patients don\u2019t need MRIs.\u00a0<\/p>\n

But Ben Taub can\u2019t meet every need: One patient, Geronimo, needs a liver transplant, and that requires resources the hospital just doesn\u2019t have.\u00a0<\/p>\n

But Ricardo Nuila and his colleagues put a lot of time into wrenching him back onto Medicaid, so he can get the transplant somewhere else. They rope in a Congressman to get it done.\u00a0<\/p>\n

Geronimo tells his mom:\u201dI feel so important. Everyone treats me like I\u2019m rich.\u201d\u00a0<\/p>\n

Ricardo Nuila:<\/strong> That\u2019s what I think a lot of people really want is just the sense that the person who\u2019s responsible for your care is thinking through the problem with you and aware that you are not having a great day and wants to deal with that situation with you. And I just felt like this environment allowed me to like, have those moments.<\/strong><\/p>\n

Dan:<\/strong> So who pays for this environment? It may be cheaper, but it isn\u2019t free.\u00a0<\/p>\n

Some patients are on Medicaid. Some are on Medicare. Some have private insurance. But the majority don\u2019t have any insurance at all.\u00a0<\/p>\n

Some, like Stephen, pay cash. And a lot of the rest \u2014 about a third of Ben Taub\u2019s patients \u2014 are treated for free.<\/p>\n

The bulk of Ben Taub\u2019s funding comes from a special property tax in Harris County, where Houston is located. It funds a whole system called Harris Health\u2013 Ben Taub, a second hospital, and a bunch of clinics.\u00a0<\/p>\n

And of course, none of this has always existed.\u00a0<\/p>\n

In fact, it\u2019s only here, like this, because of a really wild story, with two big characters. One of whom wasn\u2019t even from Houston. He was a writer I\u2019d never heard of, a Dutch guy named Jan de Hartog.<\/p>\n

Ricardo Nuila:<\/strong> de Hartog was one of the most amazing people that you could read about. He was a Nazi resistance fighter, Dutch ship captain.\u00a0<\/strong><\/p>\n

Dan:<\/strong> And while he was hiding out in Denmark during the war\u2013 in between saving a few Jewish babies and running war missions in his tugboat\u2013\u00a0\u00a0<\/p>\n

he wrote a romantic dramedy that \u2014 later became a broadway hit. And then got adapted into a Broadway musical called I Do, I Do\u2013 which, Broadway-musical nerds in the house\u2013 starred Mary Martin and Robert Preston\u2013 you know, The Music Man\u2013 and had a song that your mom might still remember.\u00a0<\/p>\n

\u00a0(musical sounds)\u00a0<\/p>\n

Dan:<\/strong> Yeah. So, interesting guy. And in the early 1960s he came to Houston to teach playwriting at a local University.\u00a0 It was a big time for him. He\u2019d just gotten married \u2014 for the third time, but this one was for keeps- and become a Quaker.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> And when he and his wife Marjorie come to Houston, they find that there\u2019s all these whisperings about this charity hospital in town in Houston about how, how awful the conditions are. That the children in the maternity ward would cry all night for the, for a lack of milk, and so as part of his faith, he decides that he needs to volunteer there<\/strong><\/p>\n

Dan:<\/strong> When de Hartog writes about the hospital later, he describes the experience of walking in for the first time as literally mind-boggling.\u00a0<\/p>\n

He\u2019s like: I know what a hospital smells like. Disinfectant, maybe some fresh laundry. And I know what a slaughterhouse smells like: Blood, and shit. And the smell here is slaughterhouse.\u00a0<\/p>\n

As he looks around, the sights are something else.<\/p>\n

Ricardo Nuila:<\/strong> He sees a cockroach crawling into the tracheostomy of like a patient. He sees like people sitting in their own filth.\u00a0<\/strong><\/p>\n

Dan:<\/strong> He and Marjorie do not up and quit. They stick around. And then they recruit a dozen Quakers and a few society ladies to come volunteer with them, and get the Red Cross to train them.<\/p>\n

And it\u2019s nuts. This is a rich city. The ZOO is air conditioned. But not this hospital.\u00a0<\/p>\n

And he starts to catch on: Why it\u2019s so horrible.<\/p>\n

Number one is racism.\u00a0<\/p>\n

The hospital serves mostly Black and Brown patients. When Jan and Marjorie start volunteering, the other volunteers are all society ladies, and the whole program is set up so they don\u2019t touch patients. DeHartog later says he asked why, and the volunteer coordinator says, Southern ladies can\u2019t have physical contact with black people.<\/p>\n

But she doesn\u2019t say black people. She uses the n-word.\u00a0<\/p>\n

\u00a0When he asks staff why public officials don\u2019t do something about the rotten conditions, they say: What politician is going to stick up for black people? The n-word comes up again.\u00a0<\/p>\n

And\u2013 de Hartog doesn\u2019t make this connection, but it seems pretty on the nose: The hospital itself is named after Jefferson Davis, who led the Confederacy in the Civil War.\u00a0<\/p>\n

But there\u2019s also a political mechanism for institutionalizing this neglect, without ever having to acknowledge the role of racism:\u00a0<\/p>\n

No one particular political entity \u2014 no one particular political leader\u2013 is responsible for the public hospital, financially. The city of Houston and Harris County are each supposed to kick in HALF. So it doesn\u2019t belong to either of them. Here\u2019s de Hartog describing the city-county dynamic in a lecture he gave many years later.\u00a0<\/p>\n

Jan de Hartog:<\/strong> And they were continuously at each other\u2019s throats. The one said, you don\u2019t pay enough. The other said, but you don\u2019t. And they went back and forth<\/strong><\/p>\n

Dan:<\/strong> The top official for Harris County actually has the title County Judge. At that time, this was a guy named Bill Elliott.\u00a0<\/p>\n

And you\u2019ll hear in this clip from a local newscast, he wasn\u2019t exactly reaching for the bill. Here he is, explaining why the some problem with the hospital is actually the CITY\u2019s fault.\u00a0<\/p>\n

Judge Bill Elliott:<\/strong> it\u2019s absolutely ridiculous, uh, to say that, uh, this is a responsibility and this is the fault of Harris County.<\/strong><\/p>\n

Dan:<\/strong> And the city? At least one.council member is calling for a budget cut.\u00a0<\/p>\n

Which really pisses de Hartog off.\u00a0<\/p>\n

And de Hartog actually loves the city. It\u2019s an exciting place. It\u2019s booming\u2013 growing super-fast. And it\u2019s not just an oil town.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> Houston at that time was the home of NASA.<\/strong><\/p>\n

NASA narrator:<\/strong> Future manned space flight missions to the moon and perhaps the planets will be commanded from this control room of the Mission Control Center at NASA\u2019s Manned Spacecraft Center,<\/strong><\/p>\n

Ricardo Nuila:<\/strong> It had built this Astrodome, it was the city of the future.\u00a0<\/strong><\/p>\n

Dan:<\/strong> The Astrodome\u2013 you know, a sports stadium WITH AIR CONDITIONING. .\u00a0<\/p>\n

Astrodome Narrator:<\/strong> A fully enclosed building, large enough for any sport convention show or conclave with constant temperature and humidity independent of outside weather,<\/strong><\/p>\n

Dan:<\/strong> CBS News does a report about the booming city: NASA, the oil wealth, the Astrodome. And de Hartog is a main character\u2013 talking about how much he loves the town.<\/p>\n

Jan de Hartog:<\/strong>\u00a0 it is a city of, a city of unlimited opportunities. It\u2019s an immensely exciting town, and you feel that anything is possible,\u00a0<\/strong><\/p>\n

Dan:<\/strong> It wraps up with Walter Cronkite talking about how everybody in town is absolutely nuts about football.<\/p>\n

Walter Cronkite:<\/strong> Their brand of football is like their brand of city and brand of life. Play wide open. Take a chance, try anything. Above all, do it with zest and do it big.\u00a0<\/strong><\/p>\n

Dan:<\/strong> Oh, and there\u2019s this OTHER thing Houston is really becoming known for.\u00a0<\/p>\n

Cutting edge medicine. For twenty years, the city\u2019s been building the Texas Medical Center \u2014 that giant campus where more than a dozen hospitals and med schools now operate right on top of each other. Baylor College of Medicine actually moved from Dallas to Houston to be part of it.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> Houston is a really deeply medical city. And at that time they\u2019re all working on extraordinary things<\/strong><\/p>\n

Dan<\/strong>:<\/strong> Yeah, in 1964, while Jan de Hartog is witnessing the suffering at the charity hospital, Dr. Michael deBakey is performing the world\u2019s first coronary artery bypass at a private hospital in town.\u00a0<\/p>\n

But the medical establishment were not allies. Jefferson Davis hospital, on the outskirts of town, was about to be replaced by a new building in the Texas Medical Center.\u00a0<\/p>\n

But the Medical Society\u2013 the local doctors\u2019 association \u2014 hadn\u2019t wanted the charity hospital as a neighbor. They\u2019d actually put up a ballot initiative to keep the new building at the old site.\u00a0<\/p>\n

Medical Society Voice-Over:<\/strong> you the taxpayer, will pay the extra cost That\u2019s why your doctor recommends you vote for the new hospital to remain at its present site.\u00a0<\/strong><\/p>\n

Dan:<\/strong> It hadn\u2019t worked, but along with the budget cuts, officials were now talking about DELAYING the charity hospital\u2019s move to the new building, which had just been completed. De Hartog and his friends, smell a rat.\u00a0<\/p>\n

They think the powers that be are actually going to sell the new building in the Medical Center to some other hospital that wants in. This has been a public conversation.<\/p>\n

Jan de Hartog:<\/strong> There had been offers to buy it and they wanted to wait for the highest bidder<\/strong><\/p>\n

Ricardo Nuila:<\/strong> He writes a series of op-eds for the Houston Chronicle that start to get press, not just in Houston, but around the country and in fact around the world.\u00a0<\/strong><\/p>\n

Dan:<\/strong> He describes the awful things he\u2019s seen. And he appeals to Houstonians\u2019 sense of pride in their bustling, futuristic city. A city he loves, too. Here\u2019s how his first op-ed ends\u2026<\/p>\n

Jan de Hartog:<\/strong> I cannot believe that it is the will of the citizens of Houston, that our growing medical center rightly becoming famous all over the. Shall be allowed to harbor the cancerous sore of man\u2019s inhumanity to man. It would turn the entire center planned as Houston\u2019s glory into Houston\u2019s shame.\u00a0<\/strong><\/p>\n

Dan:<\/strong> Even just that first op ed made a lot of noise.<\/p>\n

Jan de Hartog:<\/strong> the bomb exploded and the national magazines and newspapers and TV zeroed in on the hospital to find out what was going on,\u00a0<\/strong><\/p>\n

Dan:<\/strong> \u2026 and immediately, the hospital DOES move into its new home in the Medical Center. But the funding issue isn\u2019t solved.\u00a0<\/p>\n

So de Hartog keeps pushing.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> He writes a book called \u201cThe Hospital\u201d\u00a0<\/strong><\/p>\n

Dan:<\/strong> He goes to churches around town, synagogues, everywhere he can, recruiting hundreds of volunteers.\u00a0<\/p>\n

But there\u2019s no political progress \u2014 and conditions at the hospital actually get worse. Key nurses get burned out and quit. Things go to hell.<\/p>\n

In a harrowing diary entry, he writes about full bedpans left on tables next to trays of food. About a patient crying out for help, and hearing back \u201cShut up!\u201d\u00a0<\/p>\n

Jan de Hartog:<\/strong> Never before had I realized to this extent, the depth of our damnation, and at that deepest moment of desperation, when we knew nothing could be done, nothing would change for the simple reason that<\/strong><\/p>\n

Jan de Hartog:<\/strong> those who had the fate of the hospital in their hands were not there. Mayor Welsh didn\u2019t work there. Uh, commissioner Bill Elliot Judge, the county judge did not work there.\u00a0<\/strong><\/p>\n

Dan:<\/strong> But THEN, there\u2019s a turn. Somebody shows up. That\u2019s right after this.<\/p>\n

This episode of An Arm and a Leg is produced in partnership with Kaiser Health News. That\u2019s a non-profit newsroom about health care in America. KHN is not affiliated with the giant health care player Kaiser Permanente. We\u2019ll have more information about KHN at the end of this episode.<\/p>\n

So, Jan de Hartog keeps slogging away.\u00a0<\/p>\n

He gives a talk at a Baptist church\u2013 he reads that diary entry, the one with the bedpans, and the absence of Judge Elliott and other leaders.<\/p>\n

And at first he thinks he didn\u2019t go over so big. Nobody even raises their hand to volunteer.\u00a0<\/p>\n

But then it happens.\u00a0<\/p>\n

Jan de Hartog:<\/strong> When, uh, we were about to leave, a man turned up with a baby on his hip who said, uh, do you train people at night?<\/strong><\/p>\n

Dan:<\/strong> And the guy seems to be looking around, trying to make sure nobody\u2019s listening. De Hartog tells the guy, yeah, we could do that\u2026<\/p>\n

Jan de Hartog:<\/strong> He said, I mean, a dead of night without anybody seeing.\u00a0<\/strong><\/p>\n

Dan:<\/strong> De Hartog\u2019s like, \u201cum, sure, I guess. Why, though?\u201d\u00a0<\/p>\n

Jan de Hartog:<\/strong> He said, well, I am Judge Elliot,\u00a0<\/strong><\/p>\n

Dan:<\/strong> Judge Elliott. The county judge. Probably the most powerful politician in town. That\u2019s who wants to volunteer. In secret. Without anybody seeing. He says to de Hartog<\/p>\n

Jan de Hartog:<\/strong> I cannot do it as a judge, but I must do it as a man. And that was the moment that the whole damn thing changed..\u00a0<\/strong><\/p>\n

Dan:<\/strong> Because Judge Bill Elliott followed through.<\/p>\n

Ricardo Nuila:<\/strong> He trains himself in a clandestine manner to be an orderly, at night, and he verifies everything that de Hartog has said.\u00a0<\/strong><\/p>\n

Dan:<\/strong> de Hartog actually oversees the judge\u2019s final practical exam, where Bill Elliott tends to an African-American man named Willie Small.\u00a0<\/p>\n

Jan de Hartog:<\/strong> the judge with his thermometer went and put his hand on Willie\u2019s shoulder and said, Mr. Small, sir, I\u2019d like to take your temperature to hear that, to hear a southern judge, , say \u201cMr. Small, sir\u201d\u00a0<\/strong><\/p>\n

Dan:<\/strong> It was a symbolic moment. The judge had to touch, had to defer to, a Black man. So not only had the judge now seen everything, he took responsibility for what he had seen.\u00a0<\/p>\n

There\u2019s a proposal for a county-wide property tax, to fund what\u2019s called a Hospital District. Now there\u2019s a referendum, and Elliott backs it all the way.<\/p>\n

Jan de Hartog:<\/strong> and we all waited with baited breaths for the outcome. And it was no<\/strong><\/p>\n

Dan:<\/strong> Yeah. The referendum fails. And as de Hartog tells it, once it does, a real backlash starts to build. It gets personal.<\/p>\n

Jan de Hartog:<\/strong> those who had resented our presence from the very beginning became vocal. Margie and I, were called communists<\/strong><\/p>\n

Ricardo Nuila:<\/strong> De Hartog just would not flinch. I mean, he and his wife\u2019s lives were threatened.\u00a0<\/strong><\/p>\n

Dan:<\/strong> Also, somebody threw a bag of excrement at their door.\u00a0<\/p>\n

Eventually, de Hartog says the Red Cross, which was training and supervising volunteers at the hospital, came to him and Marjorie and said, \u201cIt might be better for us if you left town for a while.\u201d\u00a0<\/p>\n

They did \u2014 went on to all kinds of adventures.\u00a0<\/p>\n

Meanwhile, Bill Elliott kept pushing, and keeps pulling in allies\u2013 including, eventually, the Medical Society.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> he rallies them to get behind it.<\/strong><\/p>\n

Dan:<\/strong> He gets the question on the ballot AGAIN later that same year. And it passes in November 1965.\u00a0<\/p>\n

It\u2019s a big moment.\u00a0<\/p>\n

Ricardo Nuila:<\/strong>\u00a0 What\u2019s also interesting is that it\u2019s forgotten. Something that I\u2019ve gleaned from all this is that you know, people will forget and you have to remind them.\u00a0<\/p>\n

Dan:<\/strong>\u00a0 And while we\u2019re remembering: In 1965, the whole country is making some big commitments to health care for a lot of people. President Lyndon Johnson signs Medicare and Medicaid into law in July of that year.<\/p>\n

It\u2019s probably also worth noting that Medicare and Medicaid help make Ben Taub possible: About a third of the hospital\u2019s patients are on one or the other. It\u2019s a minority of patients, but it\u2019s many millions of dollars of funding.\u00a0<\/p>\n

The 1960s were a notoriously divisive time. And so is this.\u00a0<\/p>\n

Ricardo Nuila doesn\u2019t ignore today\u2019s political polarization \u2014 or how that polarization makes it hard to imagine a national conversation about creating a different health care system.\u00a0<\/p>\n

Or the role that doctors have historically played in resisting that conversation.<\/p>\n

It\u2019s part of his story. His family story. And in a book about a place where a lot of sad things do happen, this may be the toughest one.<\/p>\n

Ricardo Nuila:<\/strong> I was born into a family of doctors and my dad in many ways was a hero to me. I saw how much pride he took in his work of being a doctor\u00a0<\/strong><\/p>\n

Dan:<\/strong> But over time\u2013 as insurance companies got tougher to deal with\u2013 the business side of running a medical practice looked a lot less apealing.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> . He had to hire more and more staff. He hired his mother, my grandmother, who is, uh, the type of person not to back down from Chicago, you know, . And so, her job was to be on the insurance companies to make sure that they wouldn\u2019t, screw him out of money.<\/strong><\/p>\n

Dan:<\/strong> His dad turned away patients who didn\u2019t have insurance. His dad growled and grumbled\u2013 about insurance companies, and about patients who didn\u2019t have money to pay.\u00a0<\/p>\n

When Ricardo finished college and got into medical school, he put off starting for two years. What he sees as his dad\u2019s life in the business of health care is not appealing.<\/p>\n

Ricardo Nuila:<\/strong> the grind wears on him, you know? The fighting with the insurance companies<\/strong><\/p>\n

Dan:<\/strong> I mean in the book, your dad is a bit of a stand-in for . For doctors as a doctoring, as profession and the, and the way in which doctors get alienated from medicine.\u00a0<\/strong><\/p>\n

Ricardo Nuila:<\/strong> yeah, he is a stand in a bit for doctors. And it\u2019s gonna be, I think the doctors have a lot to say about how healthcare goes in America,<\/strong><\/p>\n

Ricardo Nuila:<\/strong> And unfortunately, the history shows that they haven\u2019t been a great piece of that, at least as far as universal healthcare is concerned.\u00a0<\/strong><\/p>\n

Dan:<\/strong> This becomes part of Ricardo\u2019s story with his dad. Dad invites him to form a family practice. Ricardo chooses Ben Taub. And over the years, it becomes clear: They\u2019re on opposite sides of a political divide. There are painful conversations, and then they go months without speaking.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> that\u2019s how deep politics run, you know, it\u2019s really, it\u2019s really difficult when you overlay like politics onto like a family dynamic,<\/strong><\/p>\n

Ricardo Nuila:<\/strong> It just felt like he was like totally on board with this idea that, you know, healthcare is something that is earned and healthcare is something that people, if you can\u2019t afford it, you don\u2019t deserve it. Is what I heard from what he was saying.\u00a0<\/strong><\/p>\n

Dan:<\/strong> is your dad an ideal reader of the book? Is your dad kind of who the person you wanna make that case to?\u00a0<\/strong><\/p>\n

Ricardo Nuila:<\/strong> That\u2019s really interesting.<\/strong><\/p>\n

Ricardo Nuila:<\/strong> I would say this, that, I did not write this to preach to the choir for sure.<\/strong><\/p>\n

Dan:<\/strong> But he\u2019s not sure his dad would actually pick up a book like this.<\/p>\n

Ricardo Nuila:<\/strong> It\u2019s just because I know my dad, he, my dad\u2019s the type of person who reads John Grisham on a beach, you know? So I\u2019m not a hundred percent sure if he would pick up this book, you know?<\/strong><\/p>\n

Dan:<\/strong> Unless, say, his son wrote it. Ricardo does expect his dad to read The People\u2019s Hospital. And even if he doesn\u2019t agree with everything his son has written, Ricardo thinks his dad will be proud.<\/p>\n

Ricardo Nuila:<\/strong> I can tell you now as a, as a father, , it\u2019s not clear that your kids are gonna come out Okay. . You know what I mean? I\u2019m just saying that like he has reason to be proud just because I\u2019m a, a living and breathing person right now, you know?<\/strong><\/p>\n

Ricardo Nuila:<\/strong> And I\u2019m, I\u2019m working in as a doctor. So I, I feel, I feel good for him.\u00a0<\/strong><\/p>\n

Ricardo Nuila:<\/strong> And I think that he\u2019s probably very happy that I wrote about medicine cuz he loves medicine.<\/strong><\/p>\n

Dan:<\/strong> The last chapter of \u201cThe People\u2019s Hospital\u201d is called \u201cfaith\u201d And in it, Ricardo Nuila describes a daily ritual that he says keeps him grounded. It starts with passing a plaque on his way in. Of course I have him show it to me.\u00a0<\/p>\n

Ricardo Nuila:<\/strong> I park like right over there, .<\/strong><\/p>\n

Ricardo Nuila:<\/strong> I come in here and I just look at, look at this every time.\u00a0<\/strong><\/p>\n

Dan:<\/strong> So, and describe what we\u2019re seeing here.<\/strong><\/p>\n

Ricardo Nuila:<\/strong> Well, we\u2019re seeing, a plaque that, talks about when this hospital was founded, and the people who constructed the building. And there\u2019s also the, I forgot this is, this is bad of me, but I forgot the name.<\/strong><\/p>\n

Dan:<\/strong> the snake around the stick?\u00a0\u00a0<\/strong><\/p>\n

Ricardo Nuila: <\/strong>I\u2019m in big trouble now because I\u2019m on the Caduceus Caduceus. I, it\u2019s the Cadus. Yeah.\u00a0<\/strong><\/p>\n

Ricardo Nuila:<\/strong> And it\u2019s just a reminder, you know, that we have this structure in place to help care for people who don\u2019t have, uh, the means and that, and\u00a0<\/strong><\/p>\n

Dan:<\/strong> that people decided to put this building here. Yeah.\u00a0<\/strong><\/p>\n

Ricardo Nuila:<\/strong> Exactly. It\u2019s a community effort.<\/strong><\/p>\n

Dan:<\/strong> Ricardo Nuila writes that he sees that community as he walks from that plaque to his desk\u2013 all the co-workers, in every kind of job, doing their best.\u00a0<\/p>\n

And this is the faith that he says gets affirmed\u2014 reading from the book here:\u00a0<\/p>\n

If someone is suffering and there is the capacity within the community to help, in a way that doesn\u2019t harm anyone else, then we not only owe it to that person, we owe it to ourselves to help.\u00a0<\/p>\n

Whatever your politics are, I think that\u2019s pretty great.\u00a0<\/p>\n

Dr. Ricardo Nuila practices at Ben Taub Hospital. He\u2019s associate professor of Medicine, Medical Ethics and Health Policy at Baylor College of Medicine. His book is called \u201cThe People\u2019s Hospital.\u201d<\/p>\n

Honestly there\u2019s a lot in this book, \u2014 more patient stories, more family stories, a very deft summary of a hundred years of health care economics and politics.<\/p>\n

I\u2019ll tell you: reading this book, I was reminded of an idea I\u2019ve had before.\u00a0 That it might be cool someday to convene a kind of \u201cArm and a Leg\u201d book club. Because I\u2019d like to have someone to talk with about a book like this\u2013 like maybe you.\u00a0<\/p>\n

Right now, that\u2019s just an idea. The how would take a LOT of figuring out.\u00a0\u00a0<\/p>\n

But I\u2019m curious how that idea sounds to you. You can let me know at Arm and a Leg show dot com, slash contact.<\/p>\n

I mean, that\u2019s always a good place to send ideas and stories and questions\u2014 so many of our best episodes come from you.<\/p>\n

And I\u2019m curious what you think about this virtual book club idea. If you\u2019ve taken part in something like this, or helped to organize it, I\u2019d love to hear how it went.<\/p>\n

That\u2019s arm and a leg show dot com, slash contact.<\/p>\n

Next time on An Arm and a Leg: A woman named Lisa French asked her hospital what her surgery would cost her. They said, with your insurance, about thirteen hundred bucks.<\/p>\n

They expected about 55 thousand more from insurance.\u00a0<\/p>\n

They got 75 thousand. But then they wanted more. 229 thousand more. They wanted it from Lisa French, and they sued her for it.<\/p>\n

After eight years, the case finally got resolved last June. Lisa French won!<\/p>\n

The case has a LOT to teach us about our legal rights.\u00a0<\/p>\n

That\u2019s next time on An Arm and a Leg.<\/p>\n

Till then, take care of yourself.<\/p>\n

This episode of An Arm and a Leg was produced by me, Dan Weissmann, with help from Emily Pisacreta, and edited by Afi Yellow-Duke.<\/p>\n

The recording of Jan de Hartog\u2019s lecture is courtesy of the Baylor College of Medicine Archives.\u00a0<\/p>\n

The audio of Bill Elliott is from a KHOU-TV newscast, thanks to the Texas Archive of the Moving Image.<\/p>\n

Big thanks to the archivists who helped us find some of the tape for this episode!\u00a0<\/p>\n

That includes Emily Vinson at the University of Houston library\u00a0<\/p>\n

Matt Richardson and Sandra Yates at the Texas Medical Center Archives<\/p>\n

And David Olmos at the Baylor College of Medicine archives.\u00a0<\/p>\n

Daisy Rosario is our consulting managing producer. Adam Raymonda is our audio wizard.\u00a0 Our music is by Dave Winer and Blue Dot Sessions.\u00a0<\/p>\n

Gabrielle Healy is our managing editor for audience. She edits the First Aid Kit Newsletter.\u00a0<\/p>\n

Bea Bosco is our consulting director of operations. Sarah Ballema is our operations manager.\u00a0<\/p>\n

This season of an arm and a leg is a co production with Kaiser health news. That\u2019s a nonprofit news service about healthcare in America, an editorially-independent program of the Kaiser family foundation.\u00a0<\/p>\n

KHN is not affiliated with Kaiser Permanente, the big healthcare outfit. They share an ancestor: The 20th century industrialist Henry J Kaiser. When he died, he left half his money to the foundation that later created Kaiser health news.<\/p>\n

You can learn more about him and Kaiser health news at arm and a leg show dot com slash Kaiser.\u00a0<\/p>\n

Zach Dyer is senior audio producer at KHN. He is editorial liaison to this show.\u00a0<\/p>\n

Thanks to Public Narrative \u2014 That\u2019s a Chicago-based group that helps journalists and non-profits tell better stories\u2013 for serving as our fiscal sponsor, allowing us to accept tax-exempt donations. You can learn more about Public Narrative at www dot public narrative dot org.\u00a0<\/p>\n

And thanks to everybody who supports this show financially.\u00a0<\/p>\n

If you haven\u2019t yet, we\u2019d love for you to join us. The place for that is arm and a leg show dot com, slash support.<\/p>\n

Thank you!<\/p>\n<\/p><\/div>\n

Read More<\/a>
\n Dan Weissmann<\/p>\n","protected":false},"excerpt":{"rendered":"

Note: \u201cAn Arm and a Leg\u201d uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast. Dan: Ben Taub Hospital is a publicly funded safety net hospital in Houston, Texas. The majority of patients don\u2019t have insurance of any<\/p>\n","protected":false},"author":1,"featured_media":625201,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[22241,1150],"tags":[],"class_list":{"0":"post-625200","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-doctors","8":"category-letter"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/625200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/comments?post=625200"}],"version-history":[{"count":0,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/posts\/625200\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media\/625201"}],"wp:attachment":[{"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/media?parent=625200"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/categories?post=625200"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/newsycanuse.com\/index.php\/wp-json\/wp\/v2\/tags?post=625200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}