For the past seven months, Jim Kuhn, 53, has been in intensive care in a West Palm Beach hospital with a failing heart, watched over daily by his mom and dad in a case that raises fundamental questions about the value of life and the national push to drive down healthcare costs.
His family, his doctors and the staffs of three U.S. senators have battled without success to get him the operation he needs, pressing four hospitals, including Jackson Memorial, to install an expensive heart pump that could keep him alive.
But a combination of little-known Medicare limitations, hospital requirements and, most recently, uncertainty over Kuhn’s ability to endure the surgery have amounted to a life-or-death situation for the former truck driver. As Kuhn waits in a hospital bed, his family hopes his condition will stabilize while they and senators, including Miami’s Marco Rubio, search for a way to get him the help he needs.
His cardiologist, Steven Borzak from Atlantis, says the surgeons he contacted at other hospitals where Kuhn might undergo the operation have all been positive, but the problems begin when finances are considered. “They say the procedure is medically pretty straightforward. ‘Sure we’ll take him,’ they said. And then the clipboard people” — hospital administrators — “get involved and then it falls apart.”
Last week, the situation became even more complex. Borzak said that after inquiries by the senators’ staffs and a reporter, doctors from two hospitals, including Jackson, notified him they were reconsidering their rejections. Medicare also reevaluated Kuhn’s status. But then Kuhn’s condition worsened, making him a less likely candidate for a heart pump, at least temporarily, his cardiologist said.
Ultimately, that pump may be Kuhn’s only chance. His heart is so bad that he’s been disabled for a decade, meaning he qualifies for both Medicare and Medicaid, the state-federal program for the poor. “If we don’t get the doors to the hospital open, there’s no chance he will live,” said Fred Kuhn, Jim’s brother, who speaks for the family. “If we get the doors open, there’s a slim chance.”
The case has been pushed vigorously by the staff of Rubio, a conservative Republican who endorses major changes in Medicare to keep the program for seniors and the disabled from going bankrupt.
“What is upsetting to me is that all of the parties involved seemed to have gotten to ‘no’ pretty quickly,” Rubio said in a statement released last week. “No one was working on how to get to ’yes’ for Mr. Kuhn. Not Jackson Memorial, not [the Agency for Healthcare Administration] and not the Palm Beach County health care district representatives. No one was working together to try and figure out how this man’s life might be saved.”
Two other senators also tried to help: Sens. Bill Nelson of Florida, a Democrat, and Orrin Hatch of Utah, the ranking Republican on the Finance Committee, which has huge clout with government agencies.
“It took two weeks, the involvement of three U.S. senators, and the assistance of the staff at the Florida Hospital Association to even get Mr. Kuhn an evaluation for the operation that he was ultimately denied because of his deteriorating health status. It is a sad day when patients are treated like numbers instead of human beings,” Rubio wrote.