The Economy and Healthcare

Much is said about the economy these days-is it rebounding?  Is unemployment down? Who is responsible for the massive debt? How can we save Medicare?  Into this setting, a little reality slips in to my office on a frequent basis.  Today I saw a middle aged man who has a significant lumbar (lower) spine problem.  He has a ruptured (herniated) disc with nerve compression causing severe pain, numbness and weakness.  Together we have tried many treatments to heal this problem which have given him temporary relief but the symptoms soon return, usually worse than before.  The time has come when he should seriously consider surgical intervention BUT he can't.  Here is his story.
This hard working man has spent the last 18 months out of work, made redundant in the heat of the recession.  Just two months ago he finally landed a great, competitive job which he loves (and his evaluations have been outstanding to date) and is finally beginning to right his personal economic boat.  Taking the necessary time off of work, he feels, would jeopardize his job-there are 30 or more talented individuals who would gladly snap his position up.  Bad timing all around.
I find it really difficult at times like these to remain a dispassionate neurosurgeon.  This man is suffering great pain and disability.  He has taken no time off of work and even refuses most medicines because he wants to perform well every minute at work.  Firing him because of having surgery would be wrong and probably illegal but as a large company, I suspect they could find some way to handle that.  Being ill is hard enough, having those issues compounded by fear and financial insecurity has to aggravate the problem considerably.  Of course, I understand that the company needs him at work-that is why they hired him-and what good alternative do they have?
No one plans to have a medical problem and this many has done all the right "health" things (not overweight, exercises, goes to the doctor regularly, etc.) but nature can get in the way.  I am glad that I help many patients in my practice because when faced with this patient, I felt largely helpless.  I just hope the time I took to talk with him, reassure him, adjust his medications to try and get some relief will help in some small way.