The latest chapter of "there's something awfully wrong with our health care system." I have a patient who's been ready for discharge for a couple of weeks... but is still in the hospital because there's nowhere for him to go. He can't be discharged home -- he needs a nursing home. His wife refuses to have him sent to a nursing home, because she doesn't want to pay for it. They have too much money for Medicaid, but not enough to afford nursing home care. The nursing homes don't want to take him without guarantee of payment, since he's not on Medicaid. So we're stuck holding onto him -- we can't discharge without a safe place to discharge him to.
The usual reaction in cases like this (and this isn't the only time it's come up) is to say that the wife is the problem and she's preventing someone who actually needs the hospital bed from getting care... and that's completely true, except I also understand where she's coming from. Her husband isn't really her husband anymore. He has no quality of life, he's non-verbal, may or may not know who he is, or where he is, or what's going on. But he may linger for months or years, and it'll bankrupt her, and destroy whatever they might have been saving with the hope of a decent retirement. And then if she ends up with medical costs down the line... perhaps in a situation where she could have some quality of life remaining... the money isn't there.
Of course there are all sorts of problems and inefficiencies with government-run health care. But there are all sorts of problems and inefficiencies with a hospital ending up in a standoff with an elderly woman, losing her husband, who doesn't also want to lose her financial footing in the process, for no good ends-- her husband will never regain function, he will never be himself again.