The Devastating Process of Dying in America Without Insurance
By Mark Betancourt
oris Portillo keeps the door to her father’s old room closed to avoid remembering the last few months of his life. It’s a small room, barely large enough for a bed, a small bureau, and a television, all of which are long gone. This is where she, her siblings, and her nephew cared for her father, Aquilino Portillo—feeding him, lifting him out of bed to take him to the bathroom, doing their best to clean the sores that festered beneath his weight.
A naturalized citizen from El Salvador, Portillo brought her parents to the United States in 2001 and sponsored their green cards so that she could take care of them as they aged. In late 2013, when Aquilino was diagnosed with end-stage metastatic prostate cancer, she discovered how difficult taking care of him would be.
Portillo’s insurance through her employer—she works nights cleaning offices for the City of Houston—didn’t cover her father, and the family couldn’t afford to buy insurance for him. They tried to determine if he could qualify for Medicare, the federal health benefit for the aging, or Medicaid, the state-run health insurance for the poor, but were given conflicting responses depending on whom they talked to. Confused by the requirements and limited by her poor English, Portillo applied for Medicaid for her father, but never got a response. So, for the better part of a year, the Portillos carted Aquilino back and forth to the emergency room in a wheelchair, where they would wait for hours, sometimes all night, simply to have his pain medications refilled.
As Aquilino’s condition worsened, he could no longer be moved from his bed to see a doctor. His body was riddled with tumors. His legs became too heavy for him to move, and his pain became unbearable. “It was ugly, ugly and scary, to see a loved one dying,” Portillo says in Spanish. “And if that person is your father, it’s something indescribable.”
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had a close friend who began not feeling well in 2013. She worked but didn't make enough for the subsidy, so she called the county hospital's community clinic to make an appointment. The wait was 8 months. When she got to see a doctor, they did a cursory exam and blood work. Diagnosis: diabetes. She struggled to get her blood sugar down. Did everything she was suppose to. Yet her blood sugar remained elevated, hovering between 300 and 400. All the while in pain. In April 2015 she went to seek cause for the pain at the clinic, and was told it was a pulled muscle, was prescribed flexaril, and a sonogram was scheduled for mid June. A few days after this appointment, the pain became unbearable, so she finally went to the er. Within 20 minutes, she had a CAT scan a was diagnosed with Pancreatic cancer. She died within 2 months. She had no insurance. There is no medicaid in Texas for adults. She was finally put on disabilty, but only received one check. I know pancreatic cancer is most often terminal, but no one should suffer as she did. And suffer she did. I watched her wither away. It was heartbreaking.
