Ever since Thomas Eric Duncan made his way into the news I have been asking whether or not the fact that he was uninsured had anything to do with why he was sent home from the emergency room that first time.

Was it because he was a foreign national? Was it because he had no insurance, and Texas hasn't expanded Medicaid, causing hospitals to lose millions in federal reimbursements? Because this is a somewhat emotional story with lots of fear to accompany it, I hesitated to ask those questions.

Whether I asked or not, we now have some answers, thanks to Duncan's nephew Josephus Weeks' opinion piece for the Dallas Morning News.

Here's some background on Duncan:

Thomas Eric Duncan was cautious. Among the most offensive errors in the media during my uncle’s illness are the accusations that he knew he was exposed to Ebola — that is just not true. Eric lived in a careful manner, as he understood the dangers of living in Liberia amid this outbreak. He limited guests in his home, he did not share drinking cups or eating utensils.

Weeks points straight at Texas' broken health care system:

Thomas Eric Duncan was a victim of a broken system. The biggest unanswered question about my uncle’s death is why the hospital would send home a patient with a 103-degree fever and stomach pains who had recently been in Liberia — and he told them he had just returned from Liberia explicitly due to the Ebola threat.

Some speculate that this was a failure of the internal communications systems. Others have speculated that antibiotics and Tylenol are the standard protocol for a patient without insurance.

The hospital is not talking. Until then, we are all left to wonder. What we do know is that their error affects all of society. Their bad judgment or misjudgment sent my uncle back into the community for days with a highly contagious case of Ebola. And now, officials suspect that a breach of protocol by the hospital is responsible for a new Ebola case, and that all health care workers who care for my uncle could potentially be exposed.

Even after his admission, Duncan's treatment was unequal:

Thomas Eric Duncan could have been saved. Finally, what is most difficult for us — Thomas Eric’s mother, children and those closest to him — to accept is the fact that our loved one could have been saved. From his botched release from the emergency room to his delayed testing and delayed treatment and the denial of experimental drugs that have been available to every other case of Ebola treated in the U.S., the hospital invited death every step of the way.

When my uncle was first admitted, the hospital told us that an Ebola test would take three to seven days. Miraculously, the deputy who was feared to have Ebola just last week was tested and had results within 24 hours.

The fact is, nine days passed between my uncle’s first ER visit and the day the hospital asked our consent to give him an experimental drug — but despite the hospital’s request they were never able to access these drugs for my uncle. (Editor’s note: Hospital officials have said they started giving Duncan the drug Brincidofovir on October 4.) He died alone. His only medication was a saline drip.

Meanwhile, Rick Perry is traveling Europe while the health care system in Texas disintegrates. According to the Nurses' Union, the situation at Dallas Health Presbyterian Hospital is pathetic:

Deborah Burger, co-director of the nurses union, read an account of hospital conditions she said had been given from nurses at Texas Health Presbyterian. The statement painted a portrait of carelessness, with nurses who interacted with Duncan wearing flimsy gowns and protective gear that left parts of their bodies exposed.

"Nurses had to interact with Mr. Duncan with whatever protective equipment was available at the time when he had copious amounts of diarrhea and vomiting, which produces a lot of contagious fluid," Burger said.
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"When the director from the CDC in March said hospitals should prepare for possible pandemic of Ebola, and what's happened in the country is the hospitals essentially ignored that," DeMoro said.

More to the point, hospitals in Texas are bleeding millions because of Rick Perry and the Texas legislature's refusal to expand Medicaid, which would have covered their losses from the cost of treating uninsured patients. When the budget is the bottom line, preparing for pandemics might seem like a luxury they decided they simply could not afford.

This is, first and foremost, a tragedy. But that doesn't mean we should ignore the policy implications when a state refuses to accept federal funds to provide accessible health care to all. Every time you hear a Fox News wanker say that Ebola in the United States is Obama's fault, remind them of the costs associated with an ideological decision to deny health care to all but those who can pay for it.