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Medicaid Expansion could have saved my dad’s life

Today marks eight years since we said our final goodbyes to my dad. A man that meant the absolute world to me, who carried my family and worked every single day of his life to provide for me and my sisters and the community he loved. A man that we had to wait and watch die because despite working two jobs, he didn’t have health insurance.

I want to put a face to what someone who falls in that healthcare coverage gap in North Carolina looks like. 

It isn’t the deadbeat laying on his couch at home too lazy to work or the girl who keeps losing jobs because she can’t seem to ever make it in on time — The type of North Carolinians that closing the healthcare coverage gap through legislation such as the NC Health Care for working families introduced in the House last year are North Carolinians like my dad, Jim Burns. 

My dad worked his entire life to provide for our family — and I know that I might be a little biased, but I think he did a pretty good job raising me and my two sisters. He was a small business owner — owning a half a dozen businesses with countless employees during my lifetime. When I was 10 or 11 he owned the full-service gas station in downtown Sylva that is now innovation — before that a carpet store with a dozen employees that did a ton of commercial work — one job particularly I remember was when he and his staff recarpeted the entirety of the Fontana Village Resort. He always worked. He always had a job— right up until about two weeks before he died from liver cancer — a job he was fired from for missing work because he was in the hospital. 

My dad isn’t just the face of the type of person that closing the healthcare gap would help — it is so much more than that. I wholeheartedly believe that had North Carolina expanded Medicaid when the opportunity first arose in 2010 — my dad might have had a fighting chance at life. 

At the beginning of 2013, my dad started having knee pains. Working two jobs, he couldn’t afford to take off to rest, and with no health insurance, he had no other option but to work through the pain. He took a couple of ibuprofen and kept working. In a few days, dad’s knee pain turned to stomach pain, so he took a few more ibuprofen. He started to get sick. He couldn’t eat anything, and would throw up everything. But he kept working because he had no other choice. One night, after a family dinner, to celebrate my parent’s 30th wedding anniversary, the pain became too much so he went to the emergency room. After waiting several grueling hours, he was finally seen and was told that he was fine. He was given medicine to help with his nausea and was sent home. He went back to work, but over the next few days, the pain got worse. He could eat less and less and had started to lose weight rapidly. The next Friday he went back to the emergency room doubled over in pain. They gave him an IV because he was dehydrated, gave him some more nausea medicine, and sent him home. Why would they send home a man who was obviously sick? He had no health insurance. His suffering wasn’t visible, so there was no urgency to treat him. 

This isn’t the hospital’s fault. This is the result of a broken system. 

By Sunday he was in so much pain that he drove himself to Mission Hospital in Asheville, where he was immediately admitted to St. Joseph’s. After a series of tests, they diagnosed my dad with severe pancreatitis and discovered that his stomach was full of ulcers. Not only did he have ulcers, which doctors think were caused by taking the ibuprofen, but the ulcers were also rupturing and bleeding out into his stomach, a far different diagnosis than the “just fine” he has received a day earlier in Sylva.

Doctors started treatment and tried to manage his pain. After a few days in St. Joseph’s when he was able to start eating solid foods without throwing it up, he was discharged and sent home — because he was stable. And without insurance — it would cost the hospital too much for him to stay there.

When he got home, he slept a lot, but the pain quickly came back, and so did the nausea and vomiting. While he laid in bed sick, his boss called and told him that since he had missed a week of work while at the hospital, he had lost his job. Just another blow that my family had to deal with.

By the following Friday, he was doubled over in pain again and found himself back in the Sylva Emergency Room. This time, even though Sylva knew of the diagnosis he got while in Asheville, they still told him there was nothing they could do for him and that he would have to follow up with his family doctor that Monday. The same happened again Saturday night. On Sunday night, my mom drove him to the Franklin hospital hoping that some doctor would see that he was sick and offer to help. Franklin began to treat him and were able to come to their own diagnosis of pancreatitis, but before they could treat him, they found out he had been in Sylva the night before, and sent him home with the same recommendation, to follow up with his family’s doctor on Monday.

When Monday rolled around, my dad’s family doctor was booked and couldn’t make time to see him — did you know doctor’s offices have a set number of “available appointments” for people without insurance? He could not handle the pain any longer, and was nearing 60 pounds of weight loss in just six weeks. My mom drove him to Asheville, where he was once again admitted. My dad’s new doctors were apologetic and said that he should had never been discharged in the first place. The doctors started to look for a cause of the pancreatitis.

On Thursday, nearly a month after his first doctor’s visit, a simple MRI found that my dad’s liver was completely consumed with cancer. I imagine by now you can guess why no one else had done an MRI — without insurance, it cost a fortune.  The right quadrant was covered in masses, as was the left. The tracts connecting his liver to other organs in his body were also covered, showing signs of the cancer spreading. Doctors gave him four to six months to live.

I was at work when I got the call. I was 24 years old and was expecting my first child, due in May — which meant I was about eight months pregnant for my first child — my dad’s first grandson. I answered the phone and was told to come to the hospital because they finally found out what was wrong, and he didn’t have much more time. The only thing I could think about was that my son will never get to know his grandpa. Devastation does not even begin to describe what I felt. Complete heartbreak. 

Just a week after we got word of his diagnosis, doctors changed his 4-6 month outlook to just a few more days. They took him off of all his IVs, he stopped eating, and then we are just had to wait. Eight months pregnant and all, I slept on that hospital room floor every single night. Praying that God let my dad hang on long enough so he could meet my son. Now eight years later I know how selfish that prayer was — to want him to stay in pain just for my sake. But it would have meant the world to me. April 2 marked eight years since his death, and today is eight years since his funeral.

If my dad — a 55-year-old mountain of a man had gotten healthcare when North Carolina was first able to expand Medicaid — he wouldn’t have put off going to the doctor when his knee started to ache. He wouldn’t have worried about how he was going to pay for his yearly physical or checkups.

Closing that healthcare gap would have simply given my dad — and families across North Carolina — the dignity of having access to literal life saving healthcare. Not only would healthcare have likely caught my dad’s cancer before it was too late — but then it would have allowed my family to seek treatment — instead of spending two weeks waiting for him to die because at that point it was simply too late. 

So if you take anything away from the things you hear here today — I ask you to at least do this one very small thing for me. As you have conversations with others about closing the healthcare coverage gap — about expanding Medicaid in North Carolina —while I know there are disagreements and stigmas attached to it —  please help people to understand that it’s the working families in North Carolina it would help — would be people like my dad. Hardworking, loving, kind — grandpas — that deserve to still here today. 

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