healthcare as a right: heresy or gospel?

[lawrocket 3]

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I'd would be thrilled to see the money going to help children, cancer and AIDS patients instead.

So would the children, cancer and AIDS patients, as well as the healthcare companies, drug companies, researchers, etc. Because, after all, people don't research for free.

My wife is hotter than your wife.

[pirana 0]

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True sign of a classist nation is one that promotes selective, exclusive care for the well-off while depriving those who don't,"deserve" it.

You can tell volumes about a nation by looking at its poor, and our poor don;t have healthcare. Hell, the Nazi administartion has failed to keep up with costs at the VA hospitals, cutting benefits for veterans. So if they do that for their soldiers, guess what if you're not a retired vet? I'm a non-wartime vet, non-lifer vet so I get zip.

Show me a nation with no classes; no social, cultural or financial divisions that result in some sort of ability to choose the manner in which people live. All people are not created equal, and there is nothing to be gained by trying to make everyone the same (as if that could be accomplished anyway).

What exactly is your point? That it is unfair that people are free to make choices, and that the myriad volume of choices and options ensure that we will end up living life differently - with some materially more well off than others?

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Show me a nation with no classes; no social, cultural or financial divisions that result in some sort of ability to choose the manner in which people live.

Of course tehy all have classes, not nearly as defined as here though. Choose teh manner in which we live / not to be confused with choosing which hospital to go to as in Socialized countries.

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All people are not created equal, and there is nothing to be gained by trying to make everyone the same (as if that could be accomplished anyway).

Gained? How about basic humanity? No one said anything about making anyone equal, just another EXTREME statement by a person avoiding the humanity issue (conservative pesticide).

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What exactly is your point? That it is unfair that people are free to make choices, and that the myriad volume of choices and options ensure that we will end up living life differently - with some materially more well off than others?

Are you for real? Look at the topic, look at my constant reiterations of, "It is unconscionable for the richest country in the world to not provide basic healthcare for its citizens." You can can all that rhetoric about cosmetic surgeries and forcing people to live equally, this is about having a cavity filled or an ulcer checked out.

Not a matter of deserve. As with most other services, it's a matter of can you afford. It is just too easy to jump to "Then I want it free" when it can't be afforded instead of addressing the root causes of not being able to afford it.

I don't see my example as extreme. The manner in which you live has a lot to do with how and where you seek health care. Just as it has a lot to do with where you shop for clothes, where (and if) you go to school, what you do for a livelihood, what you are likely to eat for dinner, and just about everything else in your life.

I see nothing wrong with people paying the price for their behaviors. I don't see healthcare as something sacred that must be exempted from the rules that apply to other material commodities and services. The only thing that bites is that in the long run we (taxpayers in general) end up picking up their tab anyway.

I understand you find the current system unconscionable. When enough people find it unconscionable enough, or as unconscionable as you do, it will change.

Personally, I find abuse of welfare and charity and the lackadaisical approach to cracking down on it unconscionable. If and when enough people feel the same way, it will change.

Until then, I refuse to support throwing good money after bad by advocating support for band-aid type fixes - especially when some of the money being thrown will be coming out of my pocket. (The government already taps me for 40 to 45% of my income. If they can't make ends meet on that, then we need to find new systems for delivery of the things they are handing out - - - and not just keep increasing the quantity of the handouts).

Just had another brain thingy about unconscionableness. How about the level of gun ownership and murder rate in the US compared to other developed countries. Now that's unconscionable. Apologies for the aside; couldn't resist.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[NCclimber 0]

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I'm sure Google's stockholders would be pleased if management gave away 2 Billion dollars.

It's about capitalism.

Uhm, they gave nearly 2 billion to two guys for a website that does basicly nothing.

Actually, they bought a company for 2 billion dollars. Considering the price tag, I'd guess some pretty smart people were involved in determining its worth.

Here's a classic quote that might put things in perspective:
"There is no reason anyone would want a computer in their home."

[rehmwa 2]

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I'd would be thrilled to see the money going to help children, cancer and AIDS patients instead.

So would the children, cancer and AIDS patients, as well as the healthcare companies, drug companies, researchers, etc. Because, after all, people don't research for free.

NO - only Children, cancer, and AIDs patients. That's it, no other disease or cause or anything else. Just those 3. That's the list. Too bad, thanks for playing.

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Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[pirana 0]

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I see, so fuck your fellow man, fellow families,etc? I understand.

So I'm responsible for their consequences, their station in life? I've fucked them? Because I don't want to pay their bills? That's absurd. I think they've fucked themselves.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[kallend 1,678]

www.sciam.com/article.cfm?chanID=sa006&articleID=000AF3D5-6DC9-152E-A9F183414B7F0000

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The only sure way to survive a canopy collision is not to have one.

[freethefly 6]

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NO - only Children, cancer, and AIDs patients. That's it, no other disease or cause or anything else. Just those 3. That's the list. Too bad, thanks for playing.

Oh, I could had added more but then I would be here all day keying. I know that I am not the only one when I say that what some Americans consider important is just plain fucking stupid. How in hell can some idiotic website of idiotic people doing idiotic shit be more important than the health and well being of their fellow humans? Nearly 2 billion dollars for something that does not produce any type of product, does not employe anybody, does nothing at all. I have never been to the youtube website. I have only heard of it on the news and was amazed at the discription and what it does. I am sure that here are plenty of people who feel as I do when they see so much money being spent in such a wasteful fashion in a time when the number of ill people are rising, the number of people who are sure to die without care are rising. There is no such thing as compassion. Just a word that some use to make themselves look good. Has nothing to do with helping others. On your death bed expect to hear the doctor say, "Out of chips? Too bad, thanks for playing".

"...And once you're gone, you can't come back
When you're out of the blue and into the black."
Neil Young

[freethefly 6]

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The results for the households at the bottom of the income distribution are astoundingly good, especially in contrast to the mean-spirited neglect that now passes for American social policy. The U.S. spends less than almost all rich countries on social services for the poor and disabled, and it gets what it pays for: the highest poverty rate among the rich countries and an exploding prison population. Actually, by shunning public spending on health, the U.S. gets much less than it pays for, because its dependence on private health care has led to a ramshackle system that yields mediocre results at very high costs.

And in the long run, as well as the short, it has cost this country more than money it has cost this country its reputation of being a moral and just country.

"...And once you're gone, you can't come back
When you're out of the blue and into the black."
Neil Young

[skydiver30960 0]

Wow, great thread so far.


TO A DEGREE, I agree with Jen: technology has found incredibly expensive ways to keep the heart beating and the lungs breathing longer than any other organ in the body, including the brain. We are spending huge amounts of money keeping alive seniors (and others of all ages) who have lost all mental faculties. I don't think we should absolutely blame the hospitals and doctors as moneygrubbers however; remember that keeping people alive is what is what is expected of them. Remember we are bound by implied consent: if a person cannot express consent, we are forced to act as if they would tell us they would want help if they could rationally ask for it. Yeah, it's a CYA measure, but imagine the lawsuits that would happen the first time they let somebody die "because they thought that's what the person would want."

I also don't see Medicare/Medicaid as the cash cow you do. Cuts are coming often and deep, more and more doctors are able to do less and less. There was a time when it was porkbarrel, that time is fading fast.

I think the reason we hold on to our dying loved ones for so long is that it happens one small step at a time. If one day we just woke up on a ventilator, with IV fluids running, feeding tube down our nose, unable to move or communicate, shitting our diapers every hour on the hour, and covered in bedsores then we'd all agree it was shit and "opt out." But it happens so slowly, and each step down the road is such a small one that nobody notices the direction were moving in until it's too late...

My biggest beef (being an ER care provider) is that we have made one of the most expensive places to get care (the ER) the ONLY place somebody without insurance can go to get care. Uninsured/underinsured individuals flood my ER (and ER's all over) for the most benign of needs, such as a common cold or drug-seeking. They don't give a damn because they aren't paying for it anyhow: either they're on Medicare/Medicaid or they have no money anyhow so they look at it as a "blood from a turnip" kind of thing and roundfile the bill when it comes. The system (i.e. YOU) foots the bill. As more people become uninsured, this is a situation that will get worse. Example: it will get QUITE a bit worse this Jan 1, when all the pediatricians in the area won't be obligated to accept Medicaid anymore. Guess where all those kids with stuffy noses and overanxious mothers will end up? You got it. And, BY LAW, we cannot turn them away.

Probably my longest SC post ever. Yep, must be a good thread.

Elvisio "disregard this notice" Rodriguez

[Lindsey 0]

And, BY LAW, we cannot turn them away.

You're right, you cannot turn them away at the door. But physicians can, and some of us do, refuse to treat non-emergent conditions in the ER. I often tell people that the problem they've come for is an inappropriate use of the Emergency Room, and that they need to go to their primary care doc in the morning for treatment.

Sometimes they just have me too beat down, though, and I'm not strong enough to stand up for my convictions....lol.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[nathaniel 0]

Hah, that poor fellow conveniently omits demographics from his assessment. He may as well blame the English language in his conclusion.

There's a reason you see crap like that published in scientific american, and not an economic journal. It would be as if you snuck a paper on nuclear fusion into the NEJM.

He gets a C-

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?

[freethefly 6]

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I also don't see Medicare/Medicaid as the cash cow you do. Cuts are coming often and deep, more and more doctors are able to do less and less. There was a time when it was porkbarrel, that time is fading fast.

Many have never abused the system but will pay the price because of those who have. But it is not just certain people on the streets who are responsible for the waste it is the administrators who start projects that are of no use and the doctors themselves who line their pockets with little to no concern for their patients.
Here is one such waste of our money
http://www.msnbc.msn.com/id/14575285/

"...And once you're gone, you can't come back
When you're out of the blue and into the black."
Neil Young

[jenfly00 0]

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Since 1986, EMTALA has banned patient dumping (for any hospitals receiving Medicare). That means that anybody who shows up in an emergency must be stabilized before transfer, or must be treated. The poor usually go to a county medical center for treatment.

Actually, they are almost never transferred because of the following requirement "the receiving hospital has been contacted and agrees to accept the transfer, and has the facilities to provide the necessary treatment to him"

About the only time transfer occurs is if the public hospital offers a level of care (e.g. neurosurgery) or equipment (e.g. MRI) not available at the original hospital. You can contact the public hospital and when they have a bed not required by patients already admitted there (or in the ER pending admission) they'll get back to you. The county hospital in Miami has admitted patients in the ER waiting days for a bed, so guess how long the original hospital will keep the patient. If the patient is a costly ICU patient, by definition, they are in critical condition and cannot be transferred. Most hospitals don't even make the effort.

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So, the system can work as follows - let's say you're a college student with no property renting an apartment. You are uninsured, because you want beer money instead. One morning, it burns when you go pee. So you go down to the county medical center, bringing your books and laptop so you can study - you'll have lots of time to do that while you wait. 18 hours later, you are seen and given some antibiotics. You leave without paying.

Medi-Cal will try to put a lien on you, but you don't own anything. So they'll have a hard time collecting.

The system is such that for many, it's socialized by choice. Abuses such as what I gave can and DO occur regularly. Maybe it'll come back to haunt the kid in a few years with a credit check, but maybe not. Why pay for insurance when you can go someplace and get treated for free?

Better than coming back to haunt the kid as an untreated UTI that progressed to kidney failure and life time dialysis (paid for by medicare, BTW)

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"O brave new world that has such people in it".

[jenfly00 0]

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And, BY LAW, we cannot turn them away.

You're right, you cannot turn them away at the door. But physicians can, and some of us do, refuse to treat non-emergent conditions in the ER. I often tell people that the problem they've come for is an inappropriate use of the Emergency Room, and that they need to go to their primary care doc in the morning for treatment.

Sometimes they just have me too beat down, though, and I'm not strong enough to stand up for my convictions....lol.

linz

Indeed, the law requires only a screening by a physician. I asked my mom about this (ER nurse for a couple of decades) and she has never seen or heard of this happening in practice. You are an ER physician???

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"O brave new world that has such people in it".

[Squeak 17]

Come live in OZ we have free health care

You are not now, nor will you ever be, good enough to not die in this sport (Sparky)
My Life ROCKS!
How's yours doing?

[Lindsey 0]

Indeed, the law requires only a screening by a physician. I asked my mom about this (ER nurse for a couple of decades) and she has never seen or heard of this happening in practice. You are an ER physician???

Doctors who are solely ER physicians probably don't turn people away who use the ER inappropriately. If they were to do that, they wouldn't have a job. But there are many emergency rooms who are covered by physicians whose livelihoods aren't dependent on maintaining a high volume in the ER. It's these doctors who will screen people and direct them back to their primary care docs.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[Andy9o8 0]

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there are many emergency rooms who are covered by physicians whose livelihoods aren't dependent on maintaining a high volume in the ER. It's these doctors who will screen people and direct them back to their primary care docs.

...whereupon these people will probably just go home, sick, and do nothing more because they are uninsured and thus can't afford to go their primary care docs (assuming they have one) -- and thus, they fall thru the cracks.

Or, they can move to Oz. Or the UK. Or France, or Germany, or Spain, or Portugal, or Italy, or Switzerland, or Belgium, or Norway, or Greece, or Canada, or .... well, you get the point - just about anywhere but the US.

[Lindsey 0]

...whereupon these people will probably just go home, sick, and do nothing more because they are uninsured and thus can't afford to go their primary care docs (assuming they have one) -- and thus, they fall thru the cracks.

Yes. They'll go home sick with their viral upper respiratory infection or their headache or their gastroenteritis....and they'll get over it in a few days with or without treatment. The problem is that people come to the ER with every bug bite (and I'm not exaggerating....I saw 2 people in the ER with bug bites last time I covered). And the same people come in over and over with the same ridiculous complaints. They are the biggest part of ER volume, and they contribute greatly to the inflated cost of ER care. I believe everyone should refuse to treat these folks in the ER.

linz

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A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[skydiver30960 0]

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Indeed, the law requires only a screening by a physician. I asked my mom about this (ER nurse for a couple of decades) and she has never seen or heard of this happening in practice. You are an ER physician???

Heh, no. At the moment I'm just a tech, about 1.5 semesters away from being an RN.

I've heard that in larger hospitals (with situations MUCH more dire than my little hospital's) they are starting to put doctors out at the triage desk rather than a nurse. That way they can get an "evaluation" before they get put in a room, and sent packing if they are not an emergent case.

But at my ER (60,000 patients/yr.) we just don't have the Docs available for that. So, EVERYBODY gets triaged, waits for a room, gets a room, gets assessed my the nurse, and finally gets seen by a doc. For our size I think we do pretty good: if you're really having an emergent problem, we probably have a bed available for you (might be in the hall, but it'll be someplace a doc will see you). If you have the sniffles or are in for your fourth "migraine headache" of the week, count on waiting about 2-3 hours for a bed.

Only the most frequent of flyers (i.e. drug-seekers or obvious hacks) get sent out the door without anything. Benign cases might get what they need (i.e. antibiotics) or just a "let your body fight it on its own" speech. But how much time has been invested by this point?

Anyone coming to the ER for just about any complaint can expect to get care above and beyond an assessment by nurse and doctor. For example, a chest pain patient will always get an EKG and bloodwork, a cough/cold patient will probably get a chest xray, and will probably get an EKG as well if the words "chest" and "pain" are used in the same sentence in any way. I don't see this as the ER docs driving up the bill; fact of the matter is so many of our patients are not planning on paying anyhow (and they know it, and we know it) that these tests just cost the hospital money, not the patient. Instead I think the docs do it simply to cover their ass: they need to do the minimum necessary to make sure that chest pain IS just a pulled muscle and not a heart attack... because the first time they send an AMI out the door with an rx for a muscle relaxer, well, you know.

Elvisio "master of emesis basins and bedside commodes, not too bad with a vacutainer or 12-lead either" Rodriguez

[lawrocket 3]

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Better than coming back to haunt the kid as an untreated UTI that progressed to kidney failure and life time dialysis (paid for by medicare, BTW)

Thank you for pointing that out. It is presumed that the government is gonna pay for it, right? And yet, this thread is loaded with accusations that we are not a socialist system.

The problem with our system IS socialism, not the lack of it. If health care is expensive now, wait till you see how expensive it is when it's free.

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Since human compassion doesn't sway you

I resent that comment. Perhaps it is easy for you to draw lines as being between those who care and those who cannot show compassion. Well, if the world really was that simple, it would be nice.

But don't go suggesting that I lack human compassion. I put my money where my mouth is, sister. I quit working at a hospital because of the fucking nightmares I was having. Compassion? How about the remarkable lack of human compassion and understanding it took for you to accuse me of such things?

The comment was absolutely uncalled for.

My wife is hotter than your wife.

[mnealtx 0]

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Come live in OZ we have free health care

At some point before I die, I want to go visit Australia...

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[kallend 1,678]

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...whereupon these people will probably just go home, sick, and do nothing more because they are uninsured and thus can't afford to go their primary care docs (assuming they have one) -- and thus, they fall thru the cracks.

Yes. They'll go home sick with their viral upper respiratory infection or their headache or their gastroenteritis....and they'll get over it in a few days with or without treatment. The problem is that people come to the ER with every bug bite (and I'm not exaggerating....I saw 2 people in the ER with bug bites last time I covered). And the same people come in over and over with the same ridiculous complaints. They are the biggest part of ER volume, and they contribute greatly to the inflated cost of ER care. I believe everyone should refuse to treat these folks in the ER.

linz

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My GF (along with many other people) has a serious allergic reaction to wasp stings. I hope you are not suggesting that when she goes to an ER that they turn her away to possibly die.

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The only sure way to survive a canopy collision is not to have one.

[Lindsey 0]

My GF (along with many other people) has a serious allergic reaction to wasp stings. I hope you are not suggesting that when she goes to an ER that they turn her away to possibly die.

Of course not. Anaphylaxis is a medical emergency.

I would also treat the UTI (it was prob'ly an STD, which I'd treat too) because those can become serious infections.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[freethefly 6]

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My GF (along with many other people) has a serious allergic reaction to wasp stings. I hope you are not suggesting that when she goes to an ER that they turn her away to possibly die.

Over the summer I was stung on the back of my right hand by a wasp. Within 3 days my hand swelled to the point that it looked like a water balloon. By the end of the week my arm swelled up past my elbow and onto my shoulder. It was extremely painful. I had severe headaches, a fever above 100, severe nausea and diahrea. For the most I stayed in bed. Would I had been seen by an emergency room doctor or just told to go home? Mind you, I also have AIDS. Would that had placed me ahead of the line? I have been stung a good number of times over the years by bees and wasp and never had any reaction. I always pasted meat tenderizer on the sting and it quickly took care of the problem, this time it had no effect. I did research on this reaction and found that this is considered to be an extreme reaction requiring medical attention and that the next sting can be fatal. So, would I had been viewed as someone merely abusing the E.R.?

"...And once you're gone, you can't come back
When you're out of the blue and into the black."
Neil Young

[Lindsey 0]

Within 3 days my hand swelled to the point that it looked like a water balloon. By the end of the week my arm swelled up past my elbow and onto my shoulder. It was extremely painful. I had severe headaches, a fever above 100, severe nausea and diahrea. For the most I stayed in bed. Would I had been seen by an emergency room doctor or just told to go home?

That's something that I'd treat....but I'd have to suggest that next time you decide to sit and let something fester for 3 days that you go see your primary care doctor in that time period. Unless it's a long weekend and the office is closed on a Monday or Friday, you should be able to get in to see your doctor....and the care you receive would be much less expensive.

edited to add: sorry....I realize that you said a WEEK. There would be little excuse for you to use the ER for something you let go for that long without seeing your primary care doc. I'd still treat you though.

linz

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A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail