Category: Access to Treatment

HEALTH REFORM: Poll Shows Hopes, Not Just Fears for Reform | New America Blogs

HEALTH REFORM: Poll Shows Hopes, Not Just Fears for Reform New America Blogs:

The poll doesn’t indicate that Americans would prefer not to have health reform. In fact, the data shows just the opposite. When asked what they though would happen if ‘the government did NOT create a system of providing health care for all Americans,’ a solid majority of people were ‘very’ or ‘somewhat’ concerned that the number of uninsured people in the U.S. would keep increasing, that they themselves might be uninsured at some point and that the cost of their own health care would go up.

To us, the poll doesn’t indicate support is falling apart for health reform — it does mean that uncertainty is on the rise. This is understandable, as a lot of details are still being hashed out and even members of Congress have difficulty quickly grasping all the complexities of the policy options being discussed right now. That’s why it will be important for advocates of reform, including the President, to explain it clearly (and repeatedly) in the coming weeks. Shift the focus from the scary unknown to the known — that the current system is broken, and it’s time to fix it. Because there’s a lot in it for all of us.

Foregoing care due to cost | New America Blogs

HEALTH CARE: If This Is An Emergency, Please Press “Can’t Afford It” New America Blogs:

From the New America Healthcare Blog …

“Imagine being sick enough or hurt enough to rush to an emergency room—and then leaving without getting the recommended tests or treatment because you can’t afford it.

“Doctors have a name for those discharges—’Against Medical Advice.’ It seems to be happening more often, both in the ER and in the rest of the hospital as health costs rise and insurance coverage falls.

“MSNBC interviewed several doctors and patients about how the economy is affecting emergency care. A patient with acute appendicitis needing emergency surgery who waited for his mother to drive him to the hospital so he wouldn’t have to pay for an ambulance. A patient with an infected kidney stone. People with chest pains who were not in the throes of a life-threatening heart attack that very minute but who couldn’t or wouldn’t follow up to find out what the pains signaled. A 31 year old knocked unconscious in a bike crash, who asked about the cost of the recommended follow up, only to be told by the ER doctor, that she was ‘a physician, not an accountant.’ Declining treatment, he still got a $600 bill.”

There’s more at New America and at MSNBC…

I would only add this, from a wise NY Times reader:

Mr. Krugman rightly notes that emergency room care cannot substitute for health insurance since the cost will be billed directly to the patient.

There is another reason emergency rooms cannot provide adequate health care. Emergency rooms are for emergencies. They can treat a patient in a diabetic coma, but they cannot provide continuing help in managing diabetes. They can treat a full-blown asthma attack, but they cannot provide the medications needed to manage asthma daily.

They can treat a woman who has gone into early labor, but they cannot provide prenatal care.Emergency rooms cannot offer any help for managing Parkinson’s, Alzheimer’s or cancer. On a more basic level, they cannot provide eyeglasses, hearing aids or dentures.

Republican claims that no American is without access to health care because “you can just go to an emergency room” are openly false as well as appallingly callous.

With Son in Remission, a Family Struggles to Find Coverage – NYTimes.com

With Son in Remission, a Family Struggles to Find Coverage – NYTimes.com:

“Now the Walkers face the possibility that Jake will no longer be seen at Houston’s renowned M.D. Anderson Cancer Center, which they credit for his remission.

“You realize how vulnerable you really are,” said Ms. Walker, who exhibits the maternal ferocity of a black bear. “You just — not give up — but you just feel that you’re at a loss, that you’re at your wits’ end. I ask myself, ‘Do I really have to lose my home to save my son’s life?’ ”

Neither of the Walkers has been able to land a job with the kind of large group coverage that would disregard Jake’s health status. His cancer history effectively makes him uninsurable on the individual market. He is too old to qualify for Medicaid as a child, and it is virtually impossible in Texas to qualify as an able-bodied adult.

Because the Walkers own their modest house, they have been told they do not merit other government assistance. With little predictable income beyond Ms. Walker’s $688 unemployment check every two weeks, the family cannot afford the state’s high-risk insurance pool or continuation coverage through the federal Cobra law.

To date, Jake’s treatment has cost nearly $2 million. Almost all of it has been paid by Cigna under a preferred-provider family policy that Ms. Walker paid $426.28 a month for through DHL, the troubled shipping company where she worked as a billing agent.

Until last fall, Mr. Walker was the co-owner of a business that supplied DHL with trucks and drivers, but it too fell victim to downsizing. The feed store, the last in an area where suburbs are swallowing ranchland, has been losing money.

What has made the Walkers feel most helpless, though, is that their son has been left so exposed, after all he has endured.

“Your job as a parent is to protect your children at any cost,” Ms. Walker said. “I really felt like I had let him down.””

At the beginning of the article, Mrs. Walker’s salary was noted to be $37,000. She paid, out of that, $426 a month for her health insurance (admittedly, pretty darn good insurance given the expense of Jake’s treatment). $426 x 12 = $5112 per year bringing her salary down almost 14%, not counting the subsidy on the employer side, probably close to another $5K.

The economic costs are brutal enough, but the fear, uncertainty, and skimping on care (prescriptions, skipping office visits, etc.) are just not acceptable in the richest country in the world.

Dodd Hears Anger, Frustration At Meeting On Health Care — Courant.com

Dodd Hears Anger, Frustration At Meeting On Health Care — Courant.com:

“On the first day of a listening tour on health care, an issue pivotal to the new Congress and his own re-election, U.S. Sen. Christopher J. Dodd got an earful Friday.

The first comment came from a furious homeless shelter manager: He and his clients have no coverage, yet insurance giant American International Group got an $85 billion federal loan.

Over 90 minutes, the Democratic senator heard from a string of constituents, who waved their hands, hoping for a chance to describe a struggle to hang onto middle-class lives after losing jobs and affordable health care. A few were angry, others just scared.

On the way out, Dodd embraced one woman who burst into tears as she described losing health coverage for her disabled 2-year-old. Dodd held her until she stopped sobbing.”
…
“Dodd said during his introduction that he was seeking reforms that provided universal coverage, cut costs and prevented disease. In an interview later, he made clear another condition:

“Not putting the insurance industry out of business.

” ‘I hear people talking about a single-payer plan and the like,” Dodd said. “That isn’t going to happen. It’s going to be a combination of public, private.’ “

Unless, as MLK did for LBJ, we make it impossible for them NOT to do it!

Panorama (BBC) Documentary on US Healthcare

The episode is entitled “What Now, Mr. President?” Sadly, there is probably nothing you didn’t already know in here, but it is a good program to share with your friends who still beleive in the Best Healthcare in the World(TM) myth.

Part 1

Part 2

Part 3

Has a section on RAM Medical, which “60 Minutes” covered last year, as well as a section on wealth disparity, health care lobbying, drug pricing, and a few striking anecdotes, if you like that sort of thing. (Getting chemo in a tent, begging for Tennessee Medicaid toive a liver transplant, and thousands seeking help at RAM.)

More Americans Skipping Necessary Prescriptions, Survey Finds – NYTimes.com

More Americans Skipping Necessary Prescriptions, Survey Finds – NYTimes.com:

“One in seven Americans under age 65 went without prescribed medicines in 2007 as drug costs spiraled upward in the United States, a nonprofit research group said on Thursday.”

Medical Debt Is a Growing Worry, for Those With Insurance and Without – washingtonpost.com

Medical Debt Is a Growing Worry, for Those With Insurance and Without – washingtonpost.com:

“‘People who are underinsured end up facing almost identical problems as the uninsured,’ said Karen L. Pollitz, director of the Health Policy Institute at Georgetown University. ‘The difference is, they paid for the privilege.’

“Medical debt is likely to figure prominently in the looming national debate over reforming health care.

“Jim Eyler, 57, of Westminster, Md., says he needs help. The cement company manager said he spends about 33 percent of his take-home pay on unreimbursed medical bills, many connected with the advanced breast cancer his wife has been battling since 2005. ‘I keep wondering, where’s the money going to come from?’ he asked.”

More anecdotes here, of course, but the larger point is that our current cost structure is unsustainable.

Thomson Reuters Survey Finds Cancer Patients Forgoing Treatment

Thomson Reuters Survey Finds Cancer Patients Forgoing Treatment: “cancer treatment decisions of individuals.

Entitled “The Cost of Cancer,” the report aggregates survey responses from 1,767 adults currently being treated for cancer. It finds a clear link between patients’ annual income and their decisions to curb cancer treatments due to cost — even among patients with late-stage cancers.

The report notes that among the 569 survey respondents with late-stage cancer, 12.3 percent said they have passed up recommended treatment because it was too expensive. This figure varies dramatically by patient income level. Twenty-five percent of late-stage cancer patients who earn less than $40,000 a year said they have chosen not to undergo a recommended treatment due to cost — compared with 11.2 percent of those earning between $40,000 and $80,000 per year and 4.8 percent of those earning more than $80,000 annually.

Similarly, 65 percent of all respondents with late-stage cancer said the out-of-pocket cost of treating their cancer has caused them distress. Among all cancer patients earning under $40,000 per year, that number jumps to 77 percent.

“The physical and emotional burden of illness is not the only challenge cancer patients face,” said Bill Marder, PhD, senior vice president and general manager for the Healthcare business of Thomson Reuters. “Many also struggle to cope with medical costs. This survey shows that the cost of cancer treatment is affecting patients’ ability to get the care they need.””

I think this research speaks volumes about the American healthcare system. This is why I have it categorized under so many topics (see links below and to right). It speaks to the de facto rationing by income in the US, it speaks to how consumers “drive” healthcare (i.e., decision making is not rational), how our waiting times are trimmed by not including those who don’t seek care due to financial concerns, and how those who love to try to compare anecdote horror stories just don’t geet how bad our system is for so many people.

Letter – Health Care Fiction – Letter – NYTimes.com

Letter – Health Care Fiction – Letter – NYTimes.com:

Too well said not to cite in its entirety…

“Re “Feeling No Pain,” by Paul Krugman (column, Aug. 29):

Mr. Krugman rightly notes that emergency room care cannot substitute for health insurance since the cost will be billed directly to the patient.

There is another reason emergency rooms cannot provide adequate health care. Emergency rooms are for emergencies. They can treat a patient in a diabetic coma, but they cannot provide continuing help in managing diabetes. They can treat a full-blown asthma attack, but they cannot provide the medications needed to manage asthma daily.

They can treat a woman who has gone into early labor, but they cannot provide prenatal care.
Emergency rooms cannot offer any help for managing Parkinson’s, Alzheimer’s or cancer. On a more basic level, they cannot provide eyeglasses, hearing aids or dentures.

Republican claims that no American is without access to health care because “you can just go to an emergency room” are openly false as well as appallingly callous.

Elizabeth Vandiver
Walla Walla, Wash., Aug. 29, 2008″

Texas still leads nation in rate of uninsured residents | Dallas Morning News | News for Dallas, Texas | Dallas Business News

Texas still leads nation in rate of uninsured residents Dallas Morning News News for Dallas, Texas Dallas Business News:

“But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain’s health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

‘So I have a solution. And it will cost not one thin dime,’ Mr. Goodman said. ‘The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

‘So, there you have it. Voila! Problem solved.'”

Wow. Breathtaking, isn’t it?