'Sicko' - Sleep Apnea patient is filmed

Wow. You need to tweak your machine tonight. Maybe your dad too.

Newsgrouper wrote:Jeff,
Although some in America do not have health insurance, EVERYONE has health care. American hospitals cannot refuse medical care to anyone. It's the law of the land. A doctor firend tells me that the only diference for him is he writes generic prescriptions for insured patients (to keep their co-pays low) but writes non-generic prescriptions for uninsured patients (they have no co-pay).

Oh you can get it alright, but you will get a hell of a bill with it that is higher than what is billed to people with insurance. When you can't pay it, your credit will be ruined. Then you have the mental anguish that goes along with being dunned for money you don't have.

You call this getting health care????

Not me.

Babette,

You said:
"Take it from me - American medical personnel donating two weeks' vacation to "play" in third world countries is not changing anyone's life. My father is an MD and he's just SICKENED by these so-called "do gooders" who make damn sure they get their faces on TV while they brag about their idiot vacations in Guatemala."

Let's see if I have this correct.
1. Fidel and Raul's motives = Good
2. U.S. Volunteer Doctor's motives = Bad

You seem to discount American generousity. Why the affinity for the people's paradise of Cuba. Do you really believe any nation does more for the poor people of our world than the U.S.A.?

Newsgrouper wrote:Babette,

You said:
"Take it from me - American medical personnel donating two weeks' vacation to "play" in third world countries is not changing anyone's life. My father is an MD and he's just SICKENED by these so-called "do gooders" who make damn sure they get their faces on TV while they brag about their idiot vacations in Guatemala."

Let's see if I have this correct.
1. Fidel and Raul's motives = Good
2. U.S. Volunteer Doctor's motives = Bad

You seem to discount American generousity. Why the affinity for the people's paradise of Cuba. Do you really believe any nation does more for the poor people of our world than the U.S.A.?

Lots of countries now do more for the poor than the US of A. Hell, we can't even save New Orleans.

Newsgrouper wrote: Although some in America do not have health insurance, EVERYONE has health care. American hospitals cannot refuse medical care to anyone. It's the law of the land. A doctor firend tells me that the only diference for him is he writes generic prescriptions for insured patients (to keep their co-pays low) but writes non-generic prescriptions for uninsured patients (they have no co-pay).

Newsgrouper,

Throughout my career in public health and the nonprofit health and human services world, I have seen tons of people (Americans) who do not have health care.

Being forced to go to an emergency room to wait for hours and then be turned away with little or no care unless you are so incredibly sick you have to be hospitalized is NOT health care.

Having to decide whether you will go to the emergency room with a condition that should be treated in a primary care setting, but you don't have a primary care setting and you know what the emergency room experience is like is NOT health care.

For people over 50 years old to have to make choices about which one of the highly recommended screenings (e.g., mammogram, pap smear colonoscopy, bone density) they will get this year and put all the others off because they cannot afford it (or putting all of them off another year) is NOT health care.

For a substance abuser who has decided to break away from drugs to learn that he or she cannot get treatment unless they are in the criminal justice system is NOT health care.

For a mentally ill person to be homeless and a danger to him or herself or to others because there is so little community mental health care is NOT health care.

For a low-income minority to learn they are HIV infected only at the point that they have full-blown AIDS and a very damaged immune system because of lack of access to health education and care is NOT health care.

For nontraditional families to not be able to purchase coverage for their family members on their work insurance is NOT health care.

For the millions of people who only have a crappy major medical insurance policy and have to pay $3,000 in deductible before their insurance pays anything AND they have pre-existing exclusions for any condition they had before they got the policy is NOT health care.

For old folks and disabled folks with Medicare Part D who hit the infamous "donut hole" in that system and have to pay several thousand out of pocket when they are at 150 percent of the miserable federal poverty level is NOT health care.

I could go on and on, but won't. I am not praising Cuba's health care system because I don't know much about it. I am saying that this rich, wonderful, diverse, country we live in could and should do so very much better in its health care systems. I don't think it is too strong to say our systems are disgraceful in the context of our country's wealth and technology.

Janna

You go, Girl! Well said.

Janna,
Thank you for your thoughtful and sincere post. I ask about one statement.
You said:
"For the millions of people who only have a crappy major medical insurance policy and have to pay $3,000 in deductible before their insurance pays anything AND they have pre-existing exclusions for any condition they had before they got the policy is NOT health care."

Should there be no deductibles? Should health care be free? Food and shelter are also necessities of life. Should the government provide free food and shelter? I guess we have different ideas about individual responsibilities.

JeffH,
Try for a moment to put aside your disdain for American generosity. America and Americans are the most generous people on Earth.

Some facts:

Actual dollar contributions reveal that the U.S. is the world’s largest donor. The OECD calculates U.S. development assistance (based on bilateral assistance, humanitarian assistance, and contributions to multilateral institutions like the International Development Association of the World Bank) in 2003 at $16.2 billion—more than double the amount given by France, Germany, or any other European nation. Japan is second at $8.9 billion.

These numbers do not include private assistance. This is not a major factor for most other nations because private charity is not large in most countries. It is a gigantic oversight when calculating America’s aid ratio, however, because the U.S. Agency for International Development estimated that private assistance was $33.6 billion in 2000.

America’s central role in humanitarian efforts is ignored. Criticism becomes patently ridiculous after an examination of U.S. assistance for disaster and humanitarian relief—the type of aid needed in the Indian Ocean. Data from the OECD reveal that the U.S. gave nearly $2.5 billion in emergency and distress relief in 2003. All other countries combined gave $3.4 billion, including $475 million from France and $350 million from Norway. Moreover, the U.S. contributed nearly 70 percent of all food assistance.

America is a key donor to U.N. relief organizations. The United States is a major donor to international relief organizations, including the U.N. Office for the Coordination of Humanitarian Affairs, to which the U.S. is second largest donor (nearly 14 percent in 2003). America is the largest contributor to the U.N. budget at 22 percent, or $317 million, in 2004. It gives over 56 percent of the World Food Program budget and $72 million and $94 million to the Food and Agriculture Organization and the World Health Organization, respectively.

Conclusion
The United States is the world’s largest source of humanitarian aid. By nature, humanitarian aid must be tailored to individual crises: Every single famine, earthquake, flood, or other disaster is unique and requires different types of aid and different strategies. As death tolls climbed in the wake of the disaster in Southeast Asia and the needs of the survivors became clearer, the United States upped its humanitarian aid commitments to the region to $35 million, and expectations are that total U.S. contributions will continue to increase.

Newsgrouper wrote:Janna,
Thank you for your thoughtful and sincere post. I ask about one statement.
You said:
"For the millions of people who only have a crappy major medical insurance policy and have to pay $3,000 in deductible before their insurance pays anything AND they have pre-existing exclusions for any condition they had before they got the policy is NOT health care."

Should there be no deductibles? Should health care be free? Food and shelter are also necessities of life. Should the government provide free food and shelter? I guess we have different ideas about individual responsibilities.

Newsgrouper,

I don't have a problem with deductibles. I have good insurance and I pay deductibles gladly for the value and peace of mind I get from my insurance. I can afford all my co-pays and deductibles and feel very fortunate that that is my situation.

However, the example I use with the crappy major medical relates to people who have policies that really provide them very little value. For example, I know one person who just got a major medical policy because her work policy is so limited it does not pay for much of anything. She will be paying about $250 a month and her policy will not kick in until she reaches her $3,000 deductible, which is based on a calendar year. So, hmmm, she would have to spend $4,500 out of pocket (premiums and deductible) before December 31st for her policy to kick in. Then in January it all starts over again (oh, except her premium will increase a hefty amount on her policy anniversary).

The only two things she has had medical issues with are excluded from coverage. So, probably the policy will only benefit her if she has a catastrophic illness not related to the pre-existing conditions or a major injury. That is some peace of mind as those situations would no doubt bankrupt her. She probably earns less than $20,000 a year, so $4,500 in out of pocket is no small thing.

So, let's see --- I have had unusually large medical expenses this past year and have probably shelled out about 4% of my annual gross income on medical care. The person in the example above may have to shell out about 22.4% of her gross annual on medical care. So what is the deal? Am I smarter? More productive? More deserving? More responsible? Hmmm. Not really. What I am is extremely fortunate to have had the opportunities I have.

I am all for individual responsibility, but I don't think it is the be all and end all to everything. Individual responsibility does not even come into play when we are talking about a child in poverty who did not choose to be there or an elderly person or a disabled person who needs a little help to get by.

There are many ways to measure the greatness of the US. One way for me would be the extent that we provide a safety net for those who need it.

Another way to look at this is what makes economic sense. Having people get their medical care through emergency rooms costs all of us money. Focusing 95% of our medical research and care dollars on diagnosis and treatment, but only 5% on prevention is a huge financial mistake. Inadequate insurance coverage that pays for heart bypass surgery, but not for a colonoscopy to detect early colon cancer is short sighted. Not providing low income kids with medical care will produce low income adults that will have expensive medical conditions. Not spending money to teach self management care to people with diabetes, asthma, etc. will cost much more in the long run. Not focusing on preventing obesity in children is going to cost us a untold fortune when those kids develop complications of diabetes in their 20s, 30s, and 40s.

However you want to slice it -- compassionate conservatism, wild-eyed liberalism, fiscal prudence, whatever -- it makes sense for a country that has the resources to do so to provide a reasonable level of quality health care for its residents.

Janna

For the millions of people who only have a crappy major medical insurance policy and have to pay $3,000 in deductible before their insurance pays anything AND they have pre-existing exclusions for any condition they had before they got the policy is NOT health care."

Should there be no deductibles? Should health care be free? Food and shelter are also necessities of life. Should the government provide free food and shelter? I guess we have different ideas about individual responsibilities.

Umm. If you have three thousand dollars laying around just waiting to pay a medical bill, this is not exactly your problem. Most people already have a chunk taken out of their paycheck or pay a hefty premium each month. I'm all for REASONABLE deductables. Healthcare doesn't need to be free, but it does need to work for everyone.

Peoples lives shouldn't be RUINED because they have got some kind of health condition and don't have the money to pay for it.

I'm no communist, but something needs to change.

Jen[/quote]

[quote="JZ"]........

Throughout my career in public health and the nonprofit health and human services world, I have seen tons of people (Americans) who do not have health care!

...........

Janna

Rooster,

I sort of agree with you -- scary!! I probably do get more than my share of resources. However, some of the "small army" of healthcare providers are not covered by my insurance so I am paying 100% for those out of pocket. I really do feel fortunate that if I need to spend $750 on chiropractic that my insurance won't cover, I can afford it. Lots of folks would just have to forego the care.

And, hey, what was did that first crack you made about my career? LOL. You, sir, are a stand up guy whether or not we see eye to eye on some things. I always enjoy your posts.

Janna

rooster wrote:

tillymarigold wrote:................
Cuba is also the country that does the most humanitarian medical work, ............

Preposterous. There was a PBS program dealing with voluntary medical work about two years ago. Regarding doctors and other health professionals traveling out of their country to do voluntary work, U.S. doctors do more of this than all other countries combined. Maybe Cuba does more than their share, but they were not mentioned on the program.

*shrugs* It was an article in the Washington Post on medical aid after the tsunami in Indonesia. I may be mis-remembering; it might be that Cuba has a higher percentage of doctors who do aid work than any country, or they stay longer, or something. I can't find the article and I don't think it's likely I could.

Newsgrouper wrote:JeffH,
Try for a moment to put aside your disdain for American generosity. America and Americans are the most generous people on Earth.

Some facts:

Actual dollar contributions reveal that the U.S. is the world’s largest donor. The OECD calculates U.S. development assistance (based on bilateral assistance, humanitarian assistance, and contributions to multilateral institutions like the International Development Association of the World Bank) in 2003 at $16.2 billion—more than double the amount given by France, Germany, or any other European nation. Japan is second at $8.9 billion.

These numbers do not include private assistance. This is not a major factor for most other nations because private charity is not large in most countries. It is a gigantic oversight when calculating America’s aid ratio, however, because the U.S. Agency for International Development estimated that private assistance was $33.6 billion in 2000.

America’s central role in humanitarian efforts is ignored. Criticism becomes patently ridiculous after an examination of U.S. assistance for disaster and humanitarian relief—the type of aid needed in the Indian Ocean. Data from the OECD reveal that the U.S. gave nearly $2.5 billion in emergency and distress relief in 2003. All other countries combined gave $3.4 billion, including $475 million from France and $350 million from Norway. Moreover, the U.S. contributed nearly 70 percent of all food assistance.

America is a key donor to U.N. relief organizations. The United States is a major donor to international relief organizations, including the U.N. Office for the Coordination of Humanitarian Affairs, to which the U.S. is second largest donor (nearly 14 percent in 2003). America is the largest contributor to the U.N. budget at 22 percent, or $317 million, in 2004. It gives over 56 percent of the World Food Program budget and $72 million and $94 million to the Food and Agriculture Organization and the World Health Organization, respectively.

Conclusion
The United States is the world’s largest source of humanitarian aid. By nature, humanitarian aid must be tailored to individual crises: Every single famine, earthquake, flood, or other disaster is unique and requires different types of aid and different strategies. As death tolls climbed in the wake of the disaster in Southeast Asia and the needs of the survivors became clearer, the United States upped its humanitarian aid commitments to the region to $35 million, and expectations are that total U.S. contributions will continue to increase.

So what does this have to do with sorry health care coverage in America? Nothing that I can see. And quoting World Bank numbers doesn't hold much weight with me, sorry. The Wolfie crowd had already shown their true colors and I wasn't too impressed.

JeffH wrote:

Lots of countries now do more for the poor than the US of A. Hell, we can't even save New Orleans.

Jeff,
You asked what my last reply has to do with health care in he U.S.

My last reply was in answer to your incorrect remark that, "Lots of countries now do more for the poor than the US of A." Try to follow along here.