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poetry_writer
7-22-11, 11:32am
I know of two families going through it. One lady is paralyzed on one side and the hospital said "stress" and sent her home. Another was seriously ill for a long time. They did treat him , but they have informed his family "sorry there are no funds for rehab". they are on their own. he is totally bed bound and on a feeding tube. There is little they can do in either case. It is sickening.

Spartana
7-22-11, 12:56pm
An even worse scenario happened in Los Angeles a couple of years ago when several bed bound people who had been admitted to the hospital where taken by ambulance to Skid Row and litterally dumped onto the street - in full hospital gowns - and abandoned. They were people who often had family or even money but the hospital discharged them and dumped them. One woman layed there in the street for 2 days, unable to move, until someone did something about it. Just aweful!

catherine
7-22-11, 1:11pm
While I don't don't condone this, it's just symptomatic of how screwed up the entire healthcare system is. The foundation is crumbling, and it's unsustainable. We have the best healthcare in the world, but it's completely dysfunctional from a cost and accountability standpoint. Hospitals are absolutely strapped for cash and resources. Doctors order up whatever they can because they don't want to be sued. Patient lifestyle diseases are growing out of control. People are living longer but not better. Nothing is efficient in the way we access and utilize the best that medicine can provide.

Why are our per capita healthcare costs double Canada's?
Why did we get along ok without insurance in the 19th century?
Why wasn't plain old fee-for-service Blue Cross good enough?
Why isn't anyone accountable for their choices?--doctors or patients?
Why are people being dumped on the streets but illegals MUST be treated by law?
Why do we feel so entitled, but so unwilling to take personal responsibility?

loosechickens
7-22-11, 2:27pm
"Why are people being dumped on the streets but illegals MUST be treated by law?" (catherine)

I mostly agree with the things you said, catherine, but should point out that the illegals who go to the emergency room get the "emergency" care, just like the folks above, and then get dumped out in exactly the same way. Emergency care is mandated for all, but "care" itself, after the immediate emergency is not.

Our health care system should be a national embarassment, and we seem to have no ability at all to see that other western democracies have systems that provide care for everyone, at costs that are a fraction of our own. But, we are so blinded by our "exceptionalism" and fears of the bogeyman of socialism (although we don't mind socialism at all if it's Social Security, Medicare, roads, bridges, public schools, libraries, etc.......), and our leaders are so much in thrall to the profit making entities in health care, that nothing gets done.

Even the attempts of the health reform act had to work within the already existing system, and was watered down over and over to appease big campaign donors in the profit making health care industry, so while we're seeing some improvement, it's still pretty bad.

creaker
7-22-11, 2:44pm
http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

This was a healthcare mandate passed by Reagan in 1986 specifically targeting patient dumping. The problem was much more widespread back then. But it does not go beyond emergency care.

If the numbers of uninsured keep increasing, access to the ER regardless of ability to pay may have to be revisited just to prevent more hospitals from going out of business.

redfox
7-22-11, 2:54pm
While I don't don't condone this, it's just symptomatic of how screwed up the entire healthcare system is. The foundation is crumbling, and it's unsustainable. We have the best healthcare in the world, but it's completely dysfunctional from a cost and accountability standpoint. Hospitals are absolutely strapped for cash and resources. Doctors order up whatever they can because they don't want to be sued. Patient lifestyle diseases are growing out of control. People are living longer but not better. Nothing is efficient in the way we access and utilize the best that medicine can provide.

Why are our per capita healthcare costs double Canada's?
Why did we get along ok without insurance in the 19th century?
Why wasn't plain old fee-for-service Blue Cross good enough?
Why isn't anyone accountable for their choices?--doctors or patients?
Why are people being dumped on the streets but illegals MUST be treated by law?
Why do we feel so entitled, but so unwilling to take personal responsibility?

Some strong ideological perspectives in these statements... I would appreciate knowing how you formed your opinions about our healthcare system being the best? I sure agree that it's dysfunctional, sadly. I am genuinely interested in your perspectives about the value of our healthcare system. I am also interested in your opinion that "... we feel so entitled, but so unwilling to take personal responsibility". What have you seen that leads you to believe this?

I would also appreciate it if the word "illegals" wasn't used to describe human beings. This is very personal for me, as all of my family are immigrants, some as recent as 15 years ago, and from both the Americas and Egypt. If you're interested, I'll explain the mistreatment that many of them have had, and continue to receive, and perhaps that will give you some context for my hope that our society will drop the castigating language.

catherine
7-22-11, 5:00pm
redfox/loosechickens...

I think that my post did come off sounding really harsh and ideological as you said. I am going to think about it and formulate a response, but don't have time at the moment.. however, I do want to apologize for any offense taken by the "illegals" part... believe it or not, I'm very much a social liberal, and I highly value ALL immigrants--I believe they're the lifeblood of our country because the old guard tends to represent the status quot. So please know that I meant no offense, although I totally can see how I might have come off offensively.

I'll try to revisit the post with a little bit more intelligence later on.

IshbelRobertson
7-22-11, 5:57pm
When I read instances such as in the OP's post, I thank the gods that I live in a country with an NHS. Whilst it is a long way from perfect, those who need treatment urgently get it, without being asked whether or not they have insurance.

YAAAY for the NHS! I just wish my American friends had the peace of mind that a national health service gives.

iris lily
7-22-11, 6:30pm
redfox/loosechickens...

I think that my post did come off sounding really harsh and ideological as you said. I am going to think about it and formulate a response, but don't have time at the moment.. however, I do want to apologize for any offense taken by the "illegals" part... believe it or not, I'm very much a social liberal, and I highly value ALL immigrants--I believe they're the lifeblood of our country because the old guard tends to represent the status quot. So please know that I meant no offense, although I totally can see how I might have come off offensively.

I'll try to revisit the post with a little bit more intelligence later on.

Oh sweet Jesus do NOT apologize! I though your post made a lot of sense. Well, there we are. The SLN boards.

reader99
7-22-11, 8:10pm
I'm not sure we got along ok without insurance in the 19th century. Of course, back then the more expensive treatments had not yet been invented. Still, I suspect that the very poor did without what medical treatment then existed, for lack of money to pay for it.

razz
7-22-11, 9:45pm
I'm not sure we got along ok without insurance in the 19th century. Of course, back then the more expensive treatments had not yet been invented. Still, I suspect that the very poor did without what medical treatment then existed, for lack of money to pay for it.

If you check the history of Canadian medicare and its startup at http://en.wikipedia.org/wiki/Tommy_Douglas, you will find a lot of factors made Canadian medicare possible - tough personal experience, joint efforts by diverse political interests and political will despite the self-interest of the doctors and the system at the time. All these are needed now as well.

I remember reading the stories of the cancer sufferers, for example, who died in acute pain with no medical help since there was no money for healthcare and the family felt anguished in their helplessness. It is the same story that seems to be repeated today in the US.

"In 1910, his family immigrated to Canada, where they settled in Winnipeg. Shortly before he left Scotland, Douglas fell and injured his right knee. Osteomyelitis set in and he underwent a number of operations in Scotland in an attempt to cure the condition. Later however, in Winnipeg, the osteomyelitis flared up again and Douglas was sent to hospital. Doctors there told his parents his leg would have to be amputated. Fortunately, a well-known orthopedic surgeon took an interest in his case and agreed to treat the boy for free if his parents would allow medical students to observe. After several operations, Douglas's leg was saved. This experience convinced him that health care should be free to all. "I felt that no boy should have to depend either for his leg or his life upon the ability of his parents to raise enough money to bring a first-class surgeon to his bedside", Douglas told an interviewer many years later.[2]


"Douglas's number one concern was the creation of Medicare. In the summer of 1962, Saskatchewan became the centre of a hard-fought struggle between the provincial government, the North American medical establishment, and the province's physicians, who brought things to a halt with the 1962 Saskatchewan Doctors' Strike. The doctors believed their best interests were not being met and feared a significant loss of income as well as government interference in medical care decisions even though Douglas agreed that his government would pay the going rate for service that doctors charged. The medical establishment claimed that Douglas would import foreign doctors to make his plan work and used racist images to try to scare the public.[example needed][citation needed] Their defenders have also argued that private or government medical insurance plans covered 60 to 63 percent of the Saskatchewan population before Medicare legislation was introduced.[citation needed...

The Saskatchewan program was finally launched by his successor, Woodrow Lloyd, in 1962. The success of the province's public health care program was not lost on the federal government. Another Saskatchewan politician, newly elected Prime Minister John Diefenbaker, decreed in 1958 that any province seeking to introduce a hospital plan would receive 50 cents on the dollar from the federal government. In 1962, Diefenbaker appointed Justice Emmett Hall—also of Saskatchewan, a noted jurist and Supreme Court Justice—to Chair a Royal Commission on the national health system—the Royal Commission on Health Services. In 1964, Justice Hall recommended the nationwide adoption of Saskatchewan's model of public health insurance. In 1966, the Liberal minority government of Lester B. Pearson created such a program, with the federal government paying 50% of the costs and the provinces the other half. So, the adoption of healthcare across Canada ended up being the work of three men with diverse political ideals - Tommy Douglas, John Diefenbaker and Lester Pearson."

catherine
7-23-11, 7:12am
OK, to explain my earlier rant...

My opinions are formed in large part by my 17 years in market research in the healthcare industry. Over the course of doing research for all different kinds of clients--big pharma, small biotech, insurance companies, etc, I've spoken to literally thousands and thousands of doctors, patients and payers.

I've also seen trends along those 15 years--when I first started interviewing PCPs, maybe 10% of their patient population was being treated for diabetes. Now I ask the exact same question and it's 30%!!! We don't know all the answers for the diabetes epidemic, but believe me, it's not ALL genetics.

Anyway, I've learned a lot from asking doctors how they feel about treating their patients, and that's trended negatively, too. They are very unhappy campers, with very little autonomy to make prescribing decisions that they feel is best for their patients, constrained by outside forces. Just yesterday a verbatim quote I got from a doctor is "Business of medicine is an oxymoron... they never work together. What's good for business isn't good for health." Doctors spend a good chunk of their day on the phone with insurance companies and pharmacies who pressure them into switching to generics. Doctors can't prescribe what they want, unless patients are willing to pay out of pocket, and of course, with the price of branded drugs, that's not going to happen.

So, to explain the rhetorical questions I raised:

First of all, I misspoke on the best healthcare "system." What I meant was, we have the ability to provide the best doctors and the most highly advanced technology. Our R&D is very healthy. It's the system itself that is not healthy--even the dollars and cents point that out--we are getting VERY LOW bang for the buck in terms of health in return for the paying the highest % of GDP on healthcare.

One of the reasons I get frustrated and come off sounding like I'm blaming the victim, as in the "personal responsibility" statement, is because while I know for a fact that diseases incurred by lifestyle choices are spinning out of control (some sources say 75% of diseases are lifestyle/environment related), there are other forces at play. I'm not going to completely blame the guy whose doctor tells him at every visit that he needs to diet and exercise and who just glazes over and drives through the drive-thru for a Big Mac on the way home from the doctor. I truly believe that our culture has put probably the biggest nail in the coffin. When I speak with doctors about the obesity epidemic, they blame the "grab-and-go" lifestyle as being a major factor.

Over the past few decades we have simply chosen the wrong stars to follow--in our American work-work-work-spend-spend-spend way we have chosen to work more and eat less healthy food, have time for sitting in front of the computer, but not for walks around the neighborhood. We have not adjusted our domestic division of labor in a way that allows the family to slow down and eat a well-preapared meal together.

Not to mention the influence of advertising on eating habits--packaged foods seduce us at every moment of the day. Not to mention the influence of farm subsidies on the production of corn. Not to mention the influence of corporate agriculture. Not to mention the fact that we are so far beyond a natural, normal way of life that kids think spaghetti grows on trees. We don't have any relationship with the food that we eat. We don't even have much of a relationship with the people who provide it--we get our meals from the guy with the headset on the other side of the Wendy's window.

When I say that no one is accountable I mean that we have this cost spiral because the actual payment is intangible and unreal. Tests aren't coming out of the doctors' pocket so he/she orders them to prevent liability down the road. Patients don't feel any responsibility towards changing lifestyles that are making them sick, but if their copay goes up $10 they scream and holler. Insurance companies are simply there to make money, so they hamstring the doctor and deny the patient.
We are ALL at cross-purposes!

When I made the comment about the illegals, it is true that cities in which people who are here in this country without proper documentation (is that better?) are taxing the hospital services. That's also true for all uninsureds, by the way. But the economic burden of this population is real. I'm not saying that anyone who can't pay should not be treated, but we have to realize that money has to come in from somewhere in order to be able to be shared in services. However, I really don't know enough about the actual impact overall of undocumented immigration on the US healthcare system.

Then there's the impact of poverty, but I'm not even going to go there. Inequality in the country is another whole problem with a huge economic impact on healthcare. Why else are the poorer Southern states the ones who consistently, decade after decade, lead the growing statistics in obesity?

I think that because our current system has been cobbled together to become what it wound up... from a small Blue Cross company in the late 19th century, to being a "perk" employers provided their factory workers, to a widespread employer-based offering, to Medicare, to PPOs and HMOs to a situation where we have the best on the table to help us conquer disease, but it's as if the table is at the finish line of a long marathon, and when you get there, the table is too high for many of us to even reach. Those people are just licking the crumbs off the street.

So I propose that we strip it ALL down, start with a basic national healthcare system, but continue to reward capitalism and entrepreneurship in terms of R&D. Keep the option open for private insurance. Invest in prevention. Cap malpractice lawsuits. Find ways to incentivize health.

That's just a start--until we live more like our counterparts in Japan and many European countries who have low health expenditures and higher life expectancy, and we realign our values, we're probably going to be just treating the wrong disease.

JaneV2.0
7-23-11, 9:42am
[QUOTE=catherine;34790]OK, to explain my earlier rant...
...

One of the reasons I get frustrated and come off sounding like I'm blaming the victim, as in the "personal responsibility" statement, is because while I know for a fact that diseases incurred by lifestyle choices are spinning out of control (some sources say 75% of diseases are lifestyle/environment related), there are other forces at play. I'm not going to completely blame the guy whose doctor tells him at every visit that he needs to diet and exercise and who just glazes over and drives through the drive-thru for a Big Mac on the way home from the doctor. I truly believe that our culture has put probably the biggest nail in the coffin. When I speak with doctors about the obesity epidemic, they blame the "grab-and-go" lifestyle as being a major factor.
...

**************************
While others, perhaps better informed than the average physician, cite the government-sponsored Food Pyramid/"feedlot diet" as contributing to rising diabetes rates--in other words, people doing what they're told is good for them. But "let's beat up Fattie" has been a popular game since schoolyard days, so carry on.

As long as we're blaming people for getting sick, let's not forget people who take part in sports, give birth, handle stress poorly, take prescription drugs, drink and/or smoke, drive carelessly, handle household or garden chemicals,
exercise to the point of exhaustion, suffer from depression, work long hours, work too hard, exercise too little, exercise too much, and--most egregious of all--have the audacity to grow old. (Did I cover everyone? I doubt it.)

Most people want to be well and make attempts to "do the right thing," which is a moving target--my mother was advised by a doctor that smoking would be just the ticket to treat her asthma--and as I mentioned above the low-fat fad has done more harm than anyone has had time to quantify. People drop dead on a regular basis running oh-so-healthy marathons.

But it's standard operating procedure for our profit-driven medical/insurance complex to blame its patients for everything and anything--including being born in the wrong country--and direct their attention away from the evil greedy men (see Stephen Hemsley) behind the curtain. People--perfect or imperfect-- will get sick and injured, and in civilized countries they can get care without paupering themselves.

catherine
7-23-11, 10:06am
Jane, I hope you're not suggesting that my entire post can be reduced to "let's beat up Fatty." This is a very complex issue, as I've tried to point out. If we have an epidemic, that's a problem, right? And if the greedy gnomes, and our very culture are setting us up for failure, that's a problem, right? And yes, personal responsibility does come into play when it comes to our health.

pinkytoe
7-23-11, 10:30am
I know it's none of my business what people eat but when I go to the grocery store and note what is in people's carts, I can't help but wonder if that is why there is so much obesity and illness. I am not talking cheese and butter, but things like soda, chips, processed foods - absolutely no nutritive value. That has to take a toll on one's health. On hospitals...I spent one horrible 24 hour period there for a medical emergency - the whole experience is not something I ever want to repeat. A bill for almost $2000 followed even with my supposedly "excellent" healthcare. The hospitals here are full of immigrants from Latin America and poor people who will never pay for their services, ie childbirth, ER etc. It's all a mess for sure...

JaneV2.0
7-23-11, 11:31am
Jane, I hope you're not suggesting that my entire post can be reduced to "let's beat up Fatty." This is a very complex issue, as I've tried to point out. If we have an epidemic, that's a problem, right? And if the greedy gnomes, and our very culture are setting us up for failure, that's a problem, right? And yes, personal responsibility does come into play when it comes to our health.

As I pointed out, most people try to follow the moving target of health principles as set out by the nexus of industry and government--eat piles of fruit and grains, shun fat, jump up and down in place until you drop* Diabetics are told to eat lots of carbohydrates by clueless dieticians who advise they can just up their medication to compensate. People who store energy easily as fat may spend their entire adult lives dieting with no success--recent research into the interplay between insulin and leptin is beginning to indicate why.

Suggesting people are irresponsible because they've failed in numerous attempts to outsmart their genes is plain scapegoating, in my opinion. And again--why is no one railing against an epidemic of overwork, poor stress management, or in fact an epidemic of greed?

*Recent research suggests the ever-popular cardio exercise is counter-productive and only unduly stresses cardiovascular and joint systems. As I said, moving target.

ApatheticNoMore
7-23-11, 1:20pm
Nah catherine it is a fair assessment. As for why people don't take care of themselves. I think it is because they are ignorant and unhappy. If they knew that their food contained GMO (genetically modified organisms) would they put it in their bodies? Less likely. If they knew what a chemical soup packaged foods really are, would they eat them? But they often don't know. Ignorance.

However, should some of this even be the individual's responsibility to be informed about? Europe just doesn't ALLOW many of the things that we allow in food. It doesn't allow many of the artificial ingredients we do, it doesn't allow chickens to be bathed in chlorine, etc. etc. (a long list could be made and someday maybe I will). So you just don't have to keep as informed about what the latest poison being put into food is, because it just never makes it to the market.

As for unhappy I think a lot of people try to eat healthy food and might even be somewhat informed but are so overworked, so stressed out, and yes are so unhappy that they end up eating junk. It is the same reason I think over-consumption happens to the degree it does, yes there are a lot of structural factors driving much of it (why we have to use cars to commute etc. etc.) but I also think people are also just unhappy so they shop more than they need to, unhappy so they eat junk and too much, etc.. I think a lot of modern behavior is compensatory (to compensate for all that is lacking, including a less stressful lifestyle.)

I also think the load of environmental toxins we are exposed to is huge and is probably contributing to a lot of sickness.

sweetana3
7-23-11, 1:55pm
Personal points:
1. I found out that a "routine" colonoscopy costs around $4000 for the uninsured. I think after insurance negotiation, ours was down to $500. For a basic test no less, not a diagnostic to rule out issues. Dont get me started on the costs for a mammogram if a "stupid" doctor suspects something and asks for a diagnostic mammogram.

2. We have gone to the emergency room 3X and was so thankful they were there. Husband cracked his head on a door frame and bled all over the place. Needed stitches. I thought I had broken my leg while on vacation and finally had an asthma attack at night. Each time, there was no alternative and the bills were around $1,500 or less before insurance. Granted we were never admitted and did not need or request any specialists. My gripe is the paperwork even with insurance and I consider myself a good consumer.

Even the stitches were done right there by the doctor on call (he did a great job on husband's forehead). Bet if we had asked for a specialist, the bill would have skyrocketed.

3. So many of my friends have medical conditions they are trying to control with medicine instead of making the basic lifestyle changes to try the simple things first. One is a diabetic and does not control his diet. He eats out at least once per day and it is not a healthy meal. For my asthma, we removed all triggers from the house first and try to keep the air as clean as possible. This was step one. I learned exactly what steps to take at what time to reduce an attack without involving a medical professional. This is step two. The object is to only escalate into the medical system if I cannnot control myself.

4. No running to the doctor for me. A cold requires liquid, rest, ibruprofen, etc. I monitor my symptoms and only treat the ones I am having. No antibiotics for a virus. A cold lasts 7 days with or without advanced treatment. I cannot believe the number of people running to the doctor for every ache and pain and demanding medicine.

Alan
7-23-11, 2:13pm
Suggesting people are irresponsible because they've failed in numerous attempts to outsmart their genes is plain scapegoating, in my opinion. And again--why is no one railing against an epidemic of overwork, poor stress management, or in fact an epidemic of greed?


Sure, let's not scapegoat those personal traits that may apply to certain people, let's scapegoat those personal traits that may apply to someone else.

Jemima
7-23-11, 10:43pm
OK, to explain my earlier rant...

Over the past few decades we have simply chosen the wrong stars to follow--in our American work-work-work-spend-spend-spend way we have chosen to work more and eat less healthy food, have time for sitting in front of the computer, but not for walks around the neighborhood. We have not adjusted our domestic division of labor in a way that allows the family to slow down and eat a well-preapared meal together.



Amen. So much of what is wrong with our nation boils down to an obsession with money. Many doctors, hospitals, and drug companies are motivated primarily by money. Many patients are too harried by overly demanding jobs (or having to hold down several of them to make ends meet) to eat well or exercise, which IMO are the very foundations of good health.

I'd add the "happy motoring"* culture to the mix. In many areas of the country, it's impossible to walk or bike to a grocery store because having a car and the means to maintain one are just assumed by town planners. When I was a kid, back in the Leave-It-to-Beaver fifties, the small town where I lived had two grocery stores, a pharmacy with an old-fashioned soda fountain, a soda fountain-hamburger-newstand place where kids could hang out, an adult seafood restaurant, a department store, a gift shop, a library, a big plastic molding die company, a cannery, a lumber yard, an insurance agency, a post office and a hardware store, all within walking distance of most parts of town. Dairy products and bread were delivered to the door. There was bus and train service to larger towns. Most people walked to their jobs.

By the time I got to junior high school, it was expected that all adults in a family would have their own cars, and the big box stores started popping up like roaches. I went back there about twenty years ago to take care of my father after my mother died, and there was nothing left but the post office and the library, which eventually was closed and consolidated with another one about eight miles away. The town is now a bedroom community of Baltimore with no stores at all.

Now I'm only a few weeks away from retirement. I work at a job where I have to commute three hours a day from a "suburb" of Philadelphia that's thirty-two miles from the city and I'm too blasted tired to do much of anything in the evenings but read. I manage to eat healthfully in spite of the time demands, but taking a walk after work requires more energy than I've got. There's a grocery store four miles from my house, but I drive because the roads are too congested and dangerous for biking. Et cetera, et cetera.

I greatly look forward to living in jeans, driving seldom, and getting plenty of exercise by raising my own food. Oh, wait, wasn't that how my ancestors lived most of their lives?



*James Howard Kunstler, author of The Long Emergency, coined this term

poetry_writer
7-23-11, 10:59pm
This particular man has a rare autoimmune disorder. Not caused by lifestyle or smoking or anything he has done. As of Monday, he is outta there. No home health, no rehab, not even a chance at being transfered to a nursing home, which would be a poor choice for him. He is only 50 something. Their only hope is getting him accepted by Medicaid. That can take months and may be tricky due to his age and the nature of his illness (the prognosis is uncertain). I dont know they will even afford his meds or nutritional supplement for the tube feedings. I dont know the answer.

early morning
7-24-11, 3:45pm
4. No running to the doctor for me. A cold requires liquid, rest, ibruprofen, etc. I monitor my symptoms and only treat the ones I am having. No antibiotics for a virus. A cold lasts 7 days with or without advanced treatment. I cannot believe the number of people running to the doctor for every ache and pain and demanding medicine.
sweetana3, many many employers require a note to return to work. If I miss work, in almost all cases I must have a doctor's note. So, the options are: go to work sick and risk infecting others, OR, take a day or so and visit the doctor.

poetry writer, I'm sorry to hear about your friend.

sweetana3
7-24-11, 5:06pm
Early morning, I understand the employer/employee issue . We had to have a note if the manager was "crazy". Some knew their employees and knew why we were out. They knew who milked the system.

Mostly left to the manager's discretion in our office. Seems to me it makes the sickness worse to have to get to a doctor for a note rather than staying in, sleeping, and getting well.

I chose to go in usually in the middle of the flu and show the manager just how bad the symptoms really were in person rather than an unnecessary visit to the doctor. They almost always sent me home usually for the rest of the week. A real problem in our workforce and the cause of some unnecessary doctor visits. I mean a nurse can sign the statement and the office would never know.

poetry_writer
7-25-11, 11:08am
I have a friend who was working a minimum wage job for about 8 hrs a week. If they were ill, a docs note was required. Right. Can you get more absurd?

flowerseverywhere
7-25-11, 11:34am
*Recent research suggests the ever-popular cardio exercise is counter-productive and only unduly stresses cardiovascular and joint systems. As I said, moving target.

do you have any links to peer reviewed published literature to support this? I did a google search and found nothing.

I bike everywhere and spend a good amount of time at the Yoga studio and YMCA. My unscientific observations are that people who exercise seem to be happier, more positive, healthier, more fit (although not all are thin) and way more interesting than those who don't.

catherine
7-25-11, 1:21pm
Suggesting people are irresponsible because they've failed in numerous attempts to outsmart their genes is plain scapegoating, in my opinion. And again--why is no one railing against an epidemic of overwork, poor stress management, or in fact an epidemic of greed?



Jane, I'm sorry you feel that people are powerless to control their health. I realize that things happen, people get sick, people get into an accident, people just grow old and have degenerative diseases along the way.

But, just a question. Let's say a magic genie touched us with a magic wand and all of us all of a sudden were only eating a variety of unprocessed foods, not in excess, and were were all spending 30 minutes a day exercising, doing activities of our choice. Do you think healthcare costs would go up, down, or stay the same? If up/down, by how much? 5%? 10% 50%?

Then take it one step further, and let's say the genie touches us with the wand again, and there are NO marketers of food. All the tobacco companies are wiped from the earth. No advertising, no cultural influence on our diet at all. Do you think healthcare costs would go up, down, or stay the same? If up/down, by how much? 5%? 10% 50%?

Then, what if we all were able to work at a living wage (poverty abolished) but with no commute and no more than 40 hours a week. Families would be able to get by one one salary. The extra time would be spent getting to know neighbors, regularly socializing with family and friends, and preparing most of the every day meals at home. Do you think healthcare costs would go up, down, or stay the same? If up/down, by how much? 5%? 10% 50%?

Then, if we were able to remove the ubiquitous toxins from our environment, including the plastics that seemingly now are leeching hormones--all of them, so you think healthcare costs would go up, down, or stay the same? If up/down, by how much? 5%? 10%? 50%?

I'm only relaying what thousands of doctors have told me, as well as relaying my insights into how doctors' responses have changed over the years. They have explicitly said that they give up trying to empower their patients, because the patients just want a pill to fix it. A miniscule percentage of patients will be motivated to eat better and exercise. The doctors have explicitly said that preventable disease is more prevalent, and they are getting younger and younger patients who are diabetic and obese. Some of these doctors I interviewed are unhealthy, too. Some were overweight, but found the motivation to lose weight and they feel better and can encourage their patients through example.

We can't wipe out disease, and there's a lot we can't control. But we can open our eyes and do what we can. If you think today's cardio is tomorrow's heart attack, so don't bother and just be a victim, that's OK. But, IMHO, the answer to those three waves of the magic wand is that for every one of those situations, healthcare costs would be diminished significantly, and we might be more on par with the healthier nations of the world.

pinkytoe
7-25-11, 2:40pm
patients just want a pill to fix i
This is the one thing that upsets me the most on those rare occasions when I lose my common sense and go to a doctor. It does not matter the ailment or complaint - a prescription for a drug or test always follows. I no longer have any faith in doctors as that is all they do now.

Spartana
7-25-11, 7:40pm
. But it does not go beyond emergency care.



Many of the patients that have been dumped were originally admitted into the hospital, stayed several days - even weeks - and then were discharged while still ill or injured - sometime severly - and taken by ambulance or taxi and dumped on the street barefoot and in hospital gowns. So it does go beyond er care.

From the LA Times:

"Carol Ann Reyes, a 63-year-old homeless woman, was found wandering in the street near Los Angeles' Skid Row. Reyes had just been discharged from Kaiser Permanente Bellflower hospital where, after taking a fall, she had been treated for three days. Wearing little more than a hospital gown and a diaper—the hospital lost her clothes and even left her without pants or shoes—Reyes was put in a taxi and dumped on Skid Row, a 50 square-block area that is the last stop for approximately 11,000 "

"Since 2006, the city attorney's office and Los Angeles Police Department have uncovered hundreds of cases in which patients were dumped by hospitals across the region at facilities in skid row and other homeless shelters. In one case, College Hospital of Costa Mesa dumped more than 150 patients."

flowerseverywhere
7-25-11, 9:11pm
Many of the patients that have been dumped were originally admitted into the hospital, stayed several days - even weeks - and then were discharged while still ill or injured - sometime severly - and taken by ambulance or taxi and dumped on the street barefoot and in hospital gowns. So it does go beyond er care.

From the LA Times:

"Carol Ann Reyes, a 63-year-old homeless woman, was found wandering in the street near Los Angeles' Skid Row. Reyes had just been discharged from Kaiser Permanente Bellflower hospital where, after taking a fall, she had been treated for three days. Wearing little more than a hospital gown and a diaper—the hospital lost her clothes and even left her without pants or shoes—Reyes was put in a taxi and dumped on Skid Row, a 50 square-block area that is the last stop for approximately 11,000 "

"Since 2006, the city attorney's office and Los Angeles Police Department have uncovered hundreds of cases in which patients were dumped by hospitals across the region at facilities in skid row and other homeless shelters. In one case, College Hospital of Costa Mesa dumped more than 150 patients."

who can do such a thing? It boggles the mind that someone can make the decision to do things like that to the 63YO.

rodeosweetheart
7-25-11, 9:28pm
Thank you so much, Spartana, for posting these stories.

I have revised my post after a meditation session that has left me trying to detach from negativity, in this case, the situation, and my own immensely negative response to the injustice.
The injustice makes me really sad.
I wish only peace and healing for all mankind.

iris lily
7-25-11, 9:32pm
I don't understand why ya'll think expensive, highly trained health care professionals in a hospital need to provide what may be babysitting service for Carol Ann. The newspaper article, intended to incite, does not detail the residual injuries (?) from her fall. What were they? How does anyone here know? Persons without assets, those who truly are medical cases, can go to a nursing home and Uncle Sammy picks up the tab. Probably Carol Ann was dropped off at Skid Row because Carol Ann asked to be taken there.

I don't want public resources to be paying hospitals to provide, essentially, homes for the homeless. What a waste of those $80,000 highly trained professionals and the rooms with million dollar equipment. But I think that it's perfectly fine for those of you who think differently to organize efforts to get private funding to carry out your objectives of providing Carol Ann, who is likely to be mentally ill and/or drug dependent, into a care facility and pick up her tab.

It reminds me of all of the moaning some years ago about "drive through" baby deliveries. Why should those specialty health personnel wait on perfectly healthy women? I hear again and again that childbirth isn't an illness, and etc.

These human situations are complex and newspaper articles intended to incite aren't going to give facts that are useful.

Spartana
7-26-11, 12:59pm
I don't understand why ya'll think expensive, highly trained health care professionals in a hospital need to provide what may be babysitting service for Carol Ann. The newspaper article, intended to incite, does not detail the residual injuries (?) from her fall. What were they? How does anyone here know? Persons without assets, those who truly are medical cases, can go to a nursing home and Uncle Sammy picks up the tab. Probably Carol Ann was dropped off at Skid Row because Carol Ann asked to be taken there.

I don't want public resources to be paying hospitals to provide, essentially, homes for the homeless. What a waste of those $80,000 highly trained professionals and the rooms with million dollar equipment. But I think that it's perfectly fine for those of you who think differently to organize efforts to get private funding to carry out your objectives of providing Carol Ann, who is likely to be mentally ill and/or drug dependent, into a care facility and pick up her tab.

It reminds me of all of the moaning some years ago about "drive through" baby deliveries. Why should those specialty health personnel wait on perfectly healthy women? I hear again and again that childbirth isn't an illness, and etc.

These human situations are complex and newspaper articles intended to incite aren't going to give facts that are useful.

Well, first off it's illegal (with both criminal as well as civil charges applicable) and many of the cases like Carole Anns (who also had dementia) have resulted in the hospital being found negligent and fined and sued and even slapped with criminalk charges. Second off it's inhumane... and well I can think of a few more too. This has happened at hundreds of hospitals around the country, and those are just the ones who have been caught. How often does it really happen? There are tons of stories out there. And yes, maybe the papers print them to "incite" and "inflame" but THAT'S a good thing IMHO! People should be incited and inflamed to the point of anger at these kind of injustices. What happened to the Hippocratic Oath? What happened to human decency? Guess those things fall to the wayside when the All-Powerful and Mighty dollar is at stake. And now to incite some more :-)!

"Gabino Olvera is a 42-year-old man who is mentally ill, paraplegic, and homeless. He was dropped off by Hollywood Presbyterian Medical Center in a soiled hospital gown with a catheter bag and no wheelchair in a neighborhood populated by many other homeless people"

pinkytoe
7-26-11, 1:18pm
It might just be my Catholic upbringing, but I would hate to say a certain person is not worthy of receiving care because the doctor is a highly paid professional and might be wasting his time on them. Is one human more "valid" than another? I don't know the details of Carol Anne or others like her but more than likely there are mental health as well as physical issues. Once upon a time, we used to take care of those less fortunate but more and more it seems like those days are just a memory. Or maybe I was just dreaming...

flowerseverywhere
7-26-11, 3:42pm
It might just be my Catholic upbringing,

could be, but I am an atheist and treating all humans like they have worth seems to be the right things to do regardless of religious beliefs.

At one time the mentally ill were houses in big institutions (which had their share of problems), now they are on the city streets, living under bridges and coming to a street corner to beg near you. Shameful.

Should they be kept in the hospital? probably in most cases no but at least making sure people are clothed and are released to a homeless shelter seems far better than what these stories tell.

IshbelRobertson
7-26-11, 5:11pm
We have closed our large mental health hospitals and now rejoice in a cheaper option called 'care in the community'. It means putting vulnerable people into small units, usually terraced houses, with insufficient checks that they are taking their meds etc (it's a way of saving money). It won't DO.

razz
7-26-11, 10:10pm
I have been following this thread with interest.
What is the responsibility of the hospital? Where does it end? Who makes the decision? What are the options that provide healthcare alternatives?

I agree with IrisLily that hospitals are not babysitting services and until someone or something is designated as a provider, it strikes me that only by dumping these poor unfortunates is the issue going to get the media, social and political attention that is required. As long as they keep on picking up the tab, the hospitals will be left holding the bag and the increasing number of mentally ill and drug dependent. Is that what you as a taxpayer want? How will this be funded? What would one suggest be done to relieve the hospitals of the dilemma that they are facing?

pinkytoe
7-27-11, 10:33am
A recent article I read is that our local hospitals "fund" the care of "unfortunates" with the profits made from those with insurance or who pay their bills outright. Along with federal and state funds of course when applicable. When they charge your insurance or you $20 for something worth $1 on a continual basis, they must be making some money. Another thing I have noted in our area is that new hospitals are popping up all over the place. The bill from my hospital stay charged me twice for supplies and services because I checked in at 11:30p and thus they figured all charges as two days even though I was only there for one hour the first day. I fought it but they won.