Sunday, July 08, 2007

Leg Bones and Tri-Care, Broken and in Pieces

My best friend, my barhopping buddy, called me last night. He was in great pain and the sound of it was in his voice. Through clenched teeth he told me that as he left his last bar of the night at 2 a.m. another guy on a motorbike had struck him. His lower right leg was swollen up twice normal and the puny pain meds they’d given him weren’t working. The x-ray showed both lower bones broken with half his tibia in shards all the way up into his knee.

He was worried because he thought he was in the wrong hospital for payment purposes. He was in the old PIH now called Good Shepherd or Divine Heart or something like that. He knew that if he was in a medical facility not certified by Tri-Care that he’d be stuck with the bill. I wasn’t sure about the Tri-Care situation so I called another retired military buddy, who happens to be my psychologist and a medical doctor. Turns out he had just arrived home from Mount Caramel Hospital located over in San Fernando after surviving a seizure induced heart stoppage. If not for the quick action of his medically qualified wife, he would not be alive to talk about my other friend with the shattered leg.

Sheesh. Two phone calls--two hospitalized friends! Maybe I should turn off my phone before someone gets killed!

So, my heart-attack buddy gives me the scoop on my broken-leg buddy, telling me no morphine for a patient who will probably be in need of surgery; AND, the surgery must wait until the swelling goes down. In the meantime only low-level pain meds are allowed. Okay, I tell him, how about you call my broken legged buddy and give him all this good info so I don't miss anything? He agreed and called me back a few minutes later.

He calls me back with more info that I'm not so thrilled to learn. It seems that the old PIH has long since been blacklisted by Tri-Care, so U.S. retirees should NOT go there for care unless they got all the bucks needed to pay for it themselves. Alas, a further problem for us is that Tri-Care has stopped paying ALL Philippine medical facility applicants, and because of that bit of stinginess, now, AUF (Angeles University Foundation Hospital) has stopped accepting all Tri-Care patients unless they have the money. It seems that we will have to pay up front and hope that Tri-Care will refund our 75% after the yearly deductible has been reached.

I’m not sure if the Mercedes clinic in downtown Angeles is still on the Tri-Care "good list;” as far as I'm aware it was the last known local Tri-Care facility that was still working with American military retirees under the "old" financially friendly system. Somehow I doubt if they have been spared. I'll try to find out this week...

So, it seems that we are just about on our own out here for medical care. My psychologist suggests that if you are married to a Filipina eligible for PhilHealth to go ahead and sign up for it. His heart attack treatment this week cost him about a grand and PhilHealth paid about a quarter of it. Now he’ll have to submit his claim to Tri-Care and fight it out with them when the inevitable bullshit denials come down from the bastards in Wisconsin.

For any military retirees thinking about moving to the Philippines here's something to think about. If you have medical conditions greater than moderately serious consider long and hard before coming. Aside from the Tri-Care difficulties, healthcare in the Philippines is spotty when it comes to quality. For instance, my heart attack pal was in the ICU and they made his wife stay by his side to monitor him for them for two straight days; and that was in one of the better facilities. Can you imagine such a thing? In most ICUs in places like the USA, Europe, Australia, etc., there is supposed to be one nurse per patient. In this case, they didn't even have a cot for his wife to lay on while she did THEIR work, so she took naps with her head on his mattress.

One has to reorder how things are "supposed to be" when living here. Hospital care is an iffy proposition in the Philippines. Consider this, in most hospitals many of the nurses basically work for free to get the experience required so that they can go work abroad. Scary thought isn't it? All the best nurses and many of the best health care providers such as technicians and therapists LEAVE the first chance they get. So, try to pick your hospital and medical team carefully and hope for the best.

For example, one of my friends died late last year in a large local Angeles City hospital, perhaps unnecessarily. He had a bad liver from an old hepatitis infection and when it flared up suddenly he ended up in the hospital trying to recover enough to get back to the States for more extensive treatment. Well, he didn’t recover. We might never know exactly why he died, but it couldn’t have helped that his IV had come out of his arm sending all the IV fluids into his mattress instead of into his body. His wife was the one who discovered the problem, not any of the oblivious nurses. By the time she found it, it was too late. He was gone and his mattress was a sodden mess. I wouldn't be surprised if they charged the family for the ruined mattress.

A couple hours ago my friend with the splintered leg bones called me with an update. After my psychologist buddy had called him he decided to transfer to another hospital. Sometime in the next few days he’ll need an extensive operation to try to rejoin all the disparate tiny pieces of bone in his lower right leg. The doctor told him the bits are too small to use plates and screws, so some other complicated method will be entailed. In our quest to help veterans with their claims we found a good orthopedic surgeon, and we hope he’ll be able to get this leg back into one usable piece. My fingers are crossed and I will walk around in continuous prayer that it all turns out well.

During this latest call of a few minutes ago the description about the accident itself changed drastically since he first described them to me yesterday, mostly because he had been knocked out during the crash and all the events were a jumbled blur. Recall that at first he had told me it was a drunken local man on a motorbike that had plowed into him. Actually, it was a speeding jeepney with no lights on that had pulled out from the wrong side of the street heading back towards the Checkpoint area that had hit my friend head on. Witnesses say that instead of waiting when he saw my friend pull out, the jeepney driver had endeavored to quickly cut in front of him in a vain attempt to get back over to his own side of the street. All he managed to do was to go faster when he struck my friend.

With this new information I remarked to my buddy, still racked with almost unbearable pain, that he was lucky to have survived a head on with a speeding jeepney. It reminded me of an accident that my wife had observed on the same deadly nighttime street where he had almost bought the farm. A Swiss man, a local expatriate, had sped away from a bar, also on a motorbike and was surprised by another lightless jeepney stopped in the middle of the street to drop off a passenger. He veered around it right into the path of another oncoming jeepney. A terrible coincidence is that the driver of the jeepney that killed him was his best friend. He slid under his best friend's jeepney and was horribly disemboweled by the weight of the wheels as it rolled over his body. My wife was sickened by the memory of it for weeks. He died after a few minutes, his head cradled by his weeping best friend and inadvertent killer. Of course the real killer was his unnecessary speed combined with the very common event of a local vehicle operating without lights.

"So," I told my own best friend, "You are lucky that you LIVED through YOUR jeepney collision."

He acknowledged his "good luck" and told me more of what had happened.

The impact had knocked him out for almost 15 minutes. Luckily a fellow American retiree, a drinking buddy of his, had just said so long and was standing on the curb when the whole thing happened right in front of him. Without this man's presence, my hurt pal would probably would have lain in the street for much longer and might well have lost whatever he had in his pockets to "helpers."

In the interest of expediency they loaded the semiconscious body of my broken legged pal into the back of the VERY jeepney that had just struck him down. At the end of the short 5-minute ride to the hospital, the driver, who in my opinion should be in jail for attempted manslaughter or at the very least for reckless endangerment, proceeded to charge 500 pesos! Let the sheering begin!

If you’re a Filipino driving a jeepney in Angeles City the moral of this story is this: strike down as many Americans as you can. Then, drive them to the hospital and charge an exorbitant price to do so. Then, sue for damages. Excuse my bitterness...

For those of you out there like me that count on their two-wheeled vehicles to get around, here’s another small tip. Go slow! Take nothing for granted. In this case, the idiot guy driving the jeepney took off from the wrong side of the street from an unlit dark spot with no lights on and instead of waiting for a break in traffic opted to try “to make it” across to his side of the street hoping he could make it in time. Chances are he was drunk, but drivers here make compulsively bad decisions all the time. If you are one of the good Filipino drivers then you know exactly what I'm talking about... Right Wat?!

The final word is: BE READY for the idiots to do something idiotic, AND, slow DOWN so you'll have enough time to save yourself from them!

As this bit of ugliness proceeds I’ll continue to provide updates. (Go here for part 2)


Anonymous said...

Living in the Philippines is not as attractive as it was five years ago when I moved here. Since then I've lost about 20% of my income just from the different exchange rate, and perhaps another 10% from inflation. And now we've lost access to our military health care benefits. Wowser!

And as for those idiotic drivers . . they ARE scary! They can come up really fast in the wrong lane and without lights.

Sorry to hear about your friend, man. Sure hope he can deal with this.

PhilippinesPhil said...

As it stands now, I would counsel anyone over the age of 50 NOT to come here to live, at least not UNTIL the medical situation is figured out. Most people cannot afford to pay up front completely a medical bill, but that is EXACTLY what facilities here require. Otherwise, until paid up, you stay in your bed continuing to accrue more debt. And Tri-care is just digging in its heals and giving everyone a hard time. There are more and more reasons for US military retirees NOT to live here: the plummeting dollar for one, and the aforementioned medical care situation for the other. All the other reasons preexisted these important ones, such as the nutty drivers, bad roads, under-engineered infrastructure, con-artists, and crime. Those have always been a part of life here.

KA said...

not to sound like an obtuse liberal... but when i first came to the US I still had many complaints about the country (none of which have really faded...) and was often met with those same, idiotic words "if you dont like it, go home".

I've also heard the question "so how do you like our freedoms" and I stand there mute, contemplating how their public school system went so wrong as to breed that type of ignorance. I know... switzerland is the home of many oppressed, rich, privacy-oriented ppl... a very oppressive state indeed. Then again, people who say "go home" and ask that question can't even place Switzerland on a map, so I had it coming....

voila. Stepping off the soap box.

PhilippinesPhil said...

Excellent observations K.

The freedom thing that Americans are so proud of, the real freedom available there is the freedom of having options. I never really realized that until living in poor countries like this where most people have almost no options on just about every level. This is supposed to be a free nation, yet the poverty and lack of government assistance (that we take for granted in America) reduces the average person's liberty to whatever little they can eke out, which for most is not much. If the average American is going to be proud of anything it should be of the freedom to succeed without really having to try to do so. That alone makes the USA a very unique place in the world.

Your comment on American public schools is more a comment on the failure of our society to instill respect among students and for authority--the prevalence of "ghetto culture" seems to be instilling this 21st Century antisocial behavior among young people. Its the resultant "acting up" of some unruly students that makes our failed schools the failures many of them are. On the other hand, I know of many kids here who cannot even attend so-called free public schools because they don't have the little money required for a uniform or supplies. I find that to be outrageous, especially considering the millions of pesos pocketed by politicians through corruption and fraud.

My Filipino-American wife was once told to "go back to China bitch" by an obviously ignorant African-American woman in Arkansas. People say mean stupid things to each other all the time. As for the resentment I get from some Filipinos here I usually tell them that there are about 3 million Filipinos in the USA. I'll go home when they do. In this global family we SHOULD be living in, we should NEVER be saying such things as GO BACK HOME to anyone. Its an obsolete notion.

Isn't a Blog just another name for electronic soap box? So hop on back up there girl!

Anonymous said...

The root of our Tricare problem is because of what Thomas Arthur Lutz, DOB 04/24/1967, of Olongapo City, Republic of the Philippines did.,%202006%20-%20Thomas%20Lutz%20Pleads%20Guilty.pdf
After all the smoke cleared he got three years in prison and fined $250,000. He gets to keep more then 8 million that he made in the scam.
I think Tricare needs an official office here in the Philippines. Do three years and make 8 million. This is not a very good deterrent.

Another scary fact...I was told by a Dr I trust, that there is no law in the Philippines that prevents a Dr. from making false claims.

Lutz was a dual Citizen so the US deported him for trial.

If a Dr who is a Filipino citizen makes a false claim here Tricare can't do anything. They can't deport the person and he has not broken any laws here.

Angeles City is the worse for Jeepneys and has the worse driver in the Philippines. I hope the new mayor who took office the first of this month does something. But the Jeepneys are to powerful so he probably will not be able to do much. If he cracks down they will just go on strike.

Have you driven in Olongapo City? The Jeepneys stay in the right lane and Trics are not allowed on the main road. No passing on the right. Not only are the head lights on but the tail lights work. We have the same rules here in Angeles, but they are never enforced. The have random checkpoints everywhere 24/7. And drivers stop at sidewalks

Four years ago you never saw a Tric on the main road, now they are every where.

Four years of driving a four wheeled vehicle here has been an experience. I use many of my motorcycle safety training skills.

I honestly believe most of the drivers have no idea what the rules of the road are and could not pass a driver exam if given one. The last time I renewed my license I watched an official erase answers and change them to correct answers so that the person could pass. All you need is rubber money and you can get your license even if you answered all A's on your test. And forget about taking a road test. A little rubber money gets you through everything.

There is no concept of integrity in this country. I'm reminded of a quote Warren Buffet made.

Somebody once said that in looking for people to hire, you look for 3 qualities:
1. Integrity
2. Intelligence
3. Energy
And if they don't have integrity, the other two will kill a company. Think about it, it's true. If you have somebody without integrity, you really want them to be dumb and lazy.

I'm off the soap box.

PhilippinesPhil said...

Yup, I agree, some of the worst governance, or lack of it, exists right here in AC. None of us can vote so nothing will ever change. We are the epitome of 3rd class citizens, except we aren't even citizens. Still, its nice to get it off your chest, right?

James, if the site is more than a few characters long please don't post it. There's a way to imbed it easily. I use the new post page, then I change the format and paste it into the comment. Easy, peasey, nice and easy.

Nick Ballesteros said...

I read and re-read the last couple of lines there. Were you actually talking to me? I was surprised. hahaha! Well... I haven't had a ticket violation yet, nor have I bribed anyone not to give me a ticket....

Motorcycles and scooters are indeed dangerous things if you get careless. Or others get careless. Just this afternoon, a friend called to say he just saw a dead man lying on a flyover in EDSA with his head ... well, I don't want to go into the gory details.

That was really a bad turn of events for your friend. I'll continue reading on your story. And I sympathize with your bitterness.

PhilippinesPhil said...

Oh yah, I'd forgotten I'd said that. I was just trying to get a tongue in cheek "Amen!" out of you Wat that some drivers out there can be a bit dangerous because of their unpredictability.

It doesn't surprise me that your pal had to see the fellow with the mashed head. The use of scooters and motorbikes in this country has exploded in the past 5 years. Used to be when you saw a guy on a motorbike, 9 out of 10 times it was an Indian. And with that explosion, NO ONE has a clue how to ride their bikes safely. Its NUTS out there!

Just today, I'm riding just behind a line of traffic and some fellow on a motorbike comes flying up to my right and starts to force his way in front of me. I gave him a "Hey! What the hell are you doing? Get behind me dude. I'm already here!" I don't think he even realized what an idiot he was being. Like I said its nuts out there!

On that note, its no wonder that 1.3 million young Asians died last year riding motorcycles and scooters. I'll bet you it will be even more next year...