Health Care & Poverty

[Ann]

HEALTH CARE

I noticed that the topic of health care reform hasn't been touched in this thread. Here's a site that compares the health care proposals of the candidates (not sure how accurate or unbiased it is): http://www.health08.org/sidebyside.cfm

I have a lot to read before I can give a more educated opinion on how to fix health care. My experience is this: health care as it now stands is on its way toward disaster. I am so sick of dealing with the entitled poor (and I mean specifically those) who demand the million-dollar work-up and then can't or won't even pay for their prescriptions. They return time after time to the ER, often costing the hospitals, Medicaid, and Medicare thousands of dollars per visit, instead of paying a fraction of that cost to go to a primary care physician. The government siphons off billions of health care dollars to pay for a select few, many of whom don't even contribute much in the way of taxes anyway. In a similar light, insurance companies are often stuck with reimbursement requests from a similar group of paying "frequent flyers," causing premiums to skyrocket. And then there's the insurance companies making their fortunes and the pharmaceutical tycoons earning their billions by sticking their fingers in everywhere and sliming the FDA. So much of health care decision making is done by those who are not health care providers (physicians and mid-level providers) - the correct diagnostic tests and treatments are often not reimbursed or allowed on formulary, which leads to more unnecessary paperwork, time lost in patient care, and useless tests and treatments (in the end, often costing more money). And don't forget the often ridiculous lawsuits (of course I agree that some - few - are necessary) that lead to a climate of incredibly defensive medicine, driving up costs even further. The losers in all this: the patients, the health care providers, and the taxpaying and insurance paying American public. I'll stop there. Sorry for venting. Thoughts on healthcare reform and the candidates...?

[Edward]

I think we forget, however, what it means to be poor. Not poor as in eating broccoli every night, but poor as in spending weeks bouncing from shelter to shelter. In NYC I worked with the poor, I was friends with the poor, many men and mothers and children that had nothing, literally nothing. What can they do when a child gets ill, or heaven forbid, if the mother becomes ill? Or if there is a father, and he's hurt at work? They can't pay anything--they literally have nothing to give. It seems foreign to us, but it's so devastatingly real to them that it's beyond our comprehension. Even 5 dollars to them is a fortune beyond their reckoning. In that case, I think that yes, they are entitled--entitled to help and charity, entitled to receiving medical attention when they need it, entitled to the very best treatments available. How utterly awful it is to consider that in America, being rich means the best medical care, while being poor condemns you to second-rate attention at best. The hideous undertone becomes the thought that those with jobs and education deserve to be well, while those who don't deserve to be ill. It's bad enough that we pay so much just to see a doctor; does that really mean we deserve to be ill if we are also poor? The overwhelming majority of these people don't want to be sick--it makes their financial crises increase tenfold.

I am immensely grateful for governmental medical assistance. Time and time again I saw people in the City saved because there was help for them. These people can't pay for it themselves! Primary care physicians? Out of the question, the cost to them is unthinkable. Prescriptions? They can't even buy milk for their children, let alone the insane costs of medicine. How can we let costs deny people help? The question should be 'how can we help people who are sick and suffering?' not how much is this going to cost us. Anything else is merely impeding charity when it should be our primary concern. That's what taxes should be for. Would we really dare to deny medical attention to somebody if they can't afford insurance? Would you leave a refugee to die in the street because he isn't paying taxes? If that's where my tax money goes, I'm glad. Helping those who can't help themselves is, in my eyes, an excellent way to spend my tax money, and I am pleased to pay them if I know it'll go to helping people who don't have anything.

Maybe I'm being a bit idealistic, but I am so in the face of bitter realities, and I'm perfectly happy with that. We can't look down on the poor because of their poverty. Maybe one of the most valuable things I learned during my mission was that there is real, insufferable poverty right here in America, often totally overlooked by those who have a home to go to and a meal every day. We can't condemn them for it. They are trapped, and only the help of others can get them out of it. And if nobody helps them, what then?

[Bryn]

Let's not forget that many of us have witnessed bare-level poverty. Ann has seen a lot in both Guatemala and in Honduras, the later of which is one of the poorest countries in the Americas.

I'm not an expert on Health Care, but from what I understand, there's a lot that needs to be improved upon. If I'm not mistaken, it's a pretty heavy domestic issue. I agree with Edward that health care should be provided to those in need; however, many people are in a situation where they as individuals need to take care of themselves more attentively. Lots of money is being spent inefficiently. I think what Ann was talking about was spending less money (like with preventative medicine which is way cheaper and tons more effective) and getting better results. Yes, unfortunately it's true that the rich get richer and they get better health care, but lots of less affluent people can take certain inexpensive steps towards better health.

There was a lady who's son had a sore throat, so she called an ambulance for a 30 mile trip to the ER. After verbally abusing the doctors who were trying to help her, she insisted on a free ride back to her home. This whole process was free to her. 1500 dollars was spent on a problem that could have been resolved more effectively for much less. To me, this does not seem fair to those who really need the help. We're spending money in health care for someone's free ride to the hospital (by the way, she wanted to go to a hospital further away than the nearest ER).

I just think health care needs some fixing. There's got to be a better way to do things. Does anyone else know about some current proposed solutions?

[Ann]

Well, I didn't intend for my previous post to end up in a new thread, but it seems like it has taken somewhat of a new direction. Perhaps we have to discuss more of the current problems of health care before we can begin to talk about solutions and what the presidential candidates have proposed?

I wasn't talking about all poor people - I was talking about those who unnecessarily use and abuse the system by racking up big health care bills and then do not pay them. These people feel entitled because they know they can get all the services they desire and have really nothing to lose. (I was using the word "entitled" sarcastically - I wasn't discussing my feelings on whether or not health care is a right or a privilege) Sorry, I realize I was pretty unclear as to exactly whom I was talking about.

Edward seems to be making a lot of judgment calls on how I feel about the poor. You say that helping those who can't help themselves is a great way to spend your tax money. So, why can't these people help themselves? And if they could, how would they help themselves?

[Edward]

They weren't judgment calls on your feelings towards the poor; if it came off as such I'm sorry. Still, while we've all seen poverty, I don't think any of us has really, truly lived it, except for maybe Mom. Our eyes are always veiled by our own affluence. We can't look at the poor as just being a job away from better health care--it's almost never so simple. As far as running things more efficiently and impeding those who abuse the system, I'm all for that. Of course that's wrong, but being too strict runs the risk of affecting those who need the system. It seems the Democrats want to change it to make it more inclusive and effective, but don't know how--which at times is more than I can say for the Republicans. Again, the politics seem to cloud the really important issues themselves.

As for why they can't help themselves, there are thousands of reasons. Read Amazing Grace by Jonathan Kozol. It's one of the best books I've read in years. It talks about life in the Bronx, in one of the poorest areas in the nation. There were places in my mission just like it. Anyway, so many people are literally trapped--by society, by the lack of education (both formal and practical), etc. etc. etc. You can't say that if you're poor it's your own fault. You just cannot say that--there's so much more at play.

[Ian]

edward, you have an uncanny ability to relate your mission to any topic, or vice versa.

i was quite shocked by ann's comments. please forgive me for saying this but i believe your initial comments were rude and offensive. discrimination against the poor is no worse than discrimination based on race or gender, but for whatever reason, discrimination against poor people seems much more palatable in our society. just replace the word "poor" in your comments with "mexicans" or "blacks" or "women" and you'll see what i mean.

think about this from the perspective of the patient. what if you have no money to go to a primary care physician? what if you are sick, and you have no money for the prescriptions? what if the ER is your only choice? the alternative would be to go without treatment. do you think people go to the ER for the fun of it, because it's "free?" should we use income to determine the amount of health care people are entitled to receive? people with low incomes don't pay taxes, because they can barely afford to survive. they are also given the opportunity to receive health care (mediocre health care, by american standards) for certain types of illness or injury. even most of the most cold-hearted republicans agree with these policies. we should use tax money for these things. i'm not advocating socialism, but i certainly don't believe the poorest people should pay for health care. they can't pay for health care! they have no money!

and you say those people feel "entitled" because they can get tons of free health care? how do you know how they feel? i find it hard to believe that someone would get overly excited about a free surgical procedure or free insulin or whatever. i think it's safe to say that people generally go to the hospital because they have to, not because they want to.

then bryn said that "less affluent people" can take inexpensive steps toward better health. so the affluent people don't have to take such steps? why are you drawing this distinction between poor people and affluent people? and are you going to draw a line between who deserves treatment and who doesn't, based on what "preventative" steps they could have taken?

ok, so you have some outrageous story about someone with a sore throat called for an ambulance and yelled at some doctors. are we supposed to feel sorry for the doctors? shall we use that story to justify blatant discrimination against other "poor" people?

poor people are not to blame for america's health care problems. they just don't have the money to pay for doctor's visits and medications. it's as simple as that. they don't have the money. why is that? is it because they are unlucky? is it because they are lazy? is it because they're stupid? it doesn't matter. if you had no money, and you needed medical care, the last thing you would want to hear is someone telling you "why don't you just help yourself?" or "why don't you just get some money then?" where's the compassion, people?

i'm not making a judgment on how ann or bryn or anyone else feels about the poor. it's irrelevant how many poor people you have witnessed in your life. i'm simply telling you my opinion about the comments that were made. i'll assume that they do not reflect your actual beliefs.

[Ian]

and no, the irony did not escape me that i called someone else's comments "rude and offensive." haha, beat you all to the punch!

[Steve]

Actually, for me the irony was in the "where's the compassion, people?"

[Edward]

edward, you have an uncanny ability to relate your mission to any topic, or vice versa.

It is a gift . . . a gift to the foes of Mordor!

Oh, and I agree, totally. When money becomes a factor in determining the help a person receives there is something wrong.

[Tuly]

I appreciated the website on Health Ann, I looked up the Republican Parties response to health. So far the candidates I was grateful for some of their answers was McCain and Romney. McCain is the only one that mentions preventive medicine and Romney is the only that has an idea of how the health issue would be financed. I guess it is still a hard question for them to fully know how to answer.

[Bryn]

Well, I guess there's little or no way not to offend somebody in politics. I don't think anyone was saying health care should be more exclusive. If someone thought that, then I think there was some misunderstanding. I wonder if Ian misunderstood the tone of Ann's post in the same way that many people misunderstand his.

This offensive material wasn't deliberate; however, are you saying the health care here is perfect? I somehow think it's naive to say they (the poor, or whatever term you prefer) just don't have the money to pay for doctor's visits and medication and so on. Is personal accountability not a factor in this? Did we somehow give the impression that we're in favor of throwing people out of the hospital if they don't have enough money?

I still think it is worthwhile to consider ways of having more effective health care that doesn't drain funds. This kind of health care should be for the rich and the poor (we're all human. "If you prick us, do we not bleed," or whatever) . That money could actually be used to help more people! And not just the rich, either.

Yes, we should help the poor, sheesh. Health care is a good use of tax money. I still think things could be better!

[Ian]

it is unfair to blame "poor people" for the problems in the health care system. no one is disagreeing that the health care system is imperfect. but why are you blaming poor people for that? what does it matter to you that they "don't even contribute much in the way of taxes?" what does it matter to you that they "can't or won't even pay for their prescriptions" or that they are "costing the hospitals, Medicaid, and Medicare thousands of dollars per visit?"

you say that you're not talking about all poor people, but "certain" poor people. that does not make the comments any less offensive. you're still referring to "poor people."

bryn brought up "personal accountability." accountability for what? for being poor? for being sick? accountability has become a political catch phrase used by those who would cast blame on the poor for our problems.

when you talk about preventative measures with reference to poor people, you imply that poor people are engaged in more "risky" behaviors than non-poor people. you cast blame on a group of people, based on their socioeconomic status.

[Steve]

I'm a bystander for the time being, watching to see how this discussion plays out, but I did want to throw in one bit of info.

Ian: you imply that poor people are engaged in more "risky" behaviors than non-poor people.

Based on information from my sociology class earlier this year at BYU, this isn't just a mild implication; they actually are engaged in more risky behaviors. Individuals with lower incomes typically eat more fast food and are more likely to engage in other harmful practices than those who have sufficient funds to be able to afford a well-balanced diet and get the exercise they need. Just a sidenote.

[Edward]

bryn brought up "personal accountability." accountability for what? for being poor? for being sick? accountability has become a political catch phrase used by those who would cast blame on the poor for our problems.

Part of the problem is that we sometimes feel this tremendous fear of creating a dependent society, and we think that 'the poor' should be responsible for their own problems. But with health care, there's nothing they can do--they're sick. What are they supposed to do? Are they accountable for not being well? Does their responsibility require them to become well? What if they don't? Is that a flaw on their part? No! They have no money. It doesn't matter why not, if they can't pay for they help, they still deserve it--everybody does. Accountability doesn't make a difference when one is sick.

[Ian]

you have to be kidding me steve. "information from sociology class?" ok, so there are "statistics" that men are better than women at math. anyone want to come out and say that women stink at math? it's just as ridiculous to make such generalizations about the poor.