Poverty Is Hazardous to Your Health

  1. The patient, mother of a month-old baby, was crying on the phone because for the past two days she had been tormented by head lice (Pediculosis capitis, if you really want to know). A simple problem, you might think--head lice is endemic among schoolchildren, as many a parent could tell you--and one that hardly needs a high-powered medical consultation. You just go to the drugstore, buy a bottle of Nix (permethrin) over the counter and spend a lot of time with that little plastic comb. But Nix costs $22.99, and this woman didn't have it. By then it was Saturday night, and the drugstores in her neighborhood were closed until Monday. Fortunately, there was an all-night pharmacy, so Michele prescribed her permethrin, which Medicaid would pay for. She does the same thing for women with yeast infections who can't afford $16 for the over-the-counter Monistat: She prescribes terazol (a much more expensive medication), which is covered by Medicaid.
    You can see this incident as a tiny illustration of the penny-wise, pound-foolish complexities of our bizarre healthcare system, in which routine problems are treated as full-blown emergencies, and the government will pay for prescriptions but not over-the-counter medications that may be cheaper and work just as well. The President asserted that there's no healthcare crisis, because anyone can just go to the emergency room if they need care. He's wrong--ERs don't give ongoing or preventive treatment; they just patch you up in a crisis. But to the extent that ERs and free services like Yale's have become the family doctor or the CVS for low-income people, that is the problem, because they're incredibly expensive. This is the system its defenders claim we must keep because single-payer health insurance would bankrupt the nation.
    ...
    Forget, too, the other things so necessary to good health that the rest of us take for granted. Fresh fruits and vegetables--try even finding these in an inner-city neighborhood. Clean air--poor neighborhoods are notoriously the most polluted. Safe streets. Housing in good repair. A life with no more than the ordinary amount of stress. Well, you'd be stressed out too if you couldn't afford to get rid of your head lice. What else can't Dr. Michele's patient afford if she can't afford that? Try school supplies and books for her child in a few years. Try vitamins and a good breakfast every morning.

    Source: http://www.thenation.com/doc/20071008/pollitt accessed 10/1/07.
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  2. 413 Comments

  3. by   EmmaG
    Excellent article. Thanks.

    The President asserted that there's no healthcare crisis, because anyone can just go to the emergency room if they need care.
    Typical, ignorant response.
  4. by   Charlottetack
    You have to be sure that you have insurance. Some of the folks we see drop their insurance for some reason and wind up in a pickle! They don't know that a few of the generic drugs have terrible side effects. They say you get what you pay for and in this case they are right!! So take the good stuff!
  5. by   Jolie
    Before you vilify politicians and taxpayers who are tired of funding entitlement after entitlement, how about demanding some personal responsibility? People shouldn't have children they can't reasonably afford to raise.
  6. by   leslie :-D
    Quote from Jolie
    People shouldn't have children they can't reasonably afford to raise.
    up until recently, i felt the same way for the longest time.
    but now, i'm feeling more convinced that apathy tends to pervade the dictates of sound judgment and clear thought processes.
    working for yrs with the truly impoverished, it seems to go hand in hand with a unique mindset/mentality, that only hopelessness brings.

    i'm not talking about those who want to milk the system.
    yet, even if i were, aspirations to remain on public assistance, elicits a pity response, acknowledging how lamentable these people's lives really are.

    leslie
  7. by   VivaLasViejas
    Which is exactly why you have to reach down deep inside for the inner strength that has enabled you to survive in poverty for so long, and pull yourself OUT.

    I hate to be one of those people who say "If I can do it, anyone can do it", but it's the honest truth. My family and I were poor for years, but living that way finally became so unpleasant that I would have done ANYTHING to change it. Climbing out of that morass of indignity, shame, depression, and hopelessness was probably the toughest thing I've ever done, but it can be done, and if truth be told, I don't have a lot of sympathy for anyone who finds it perfectly acceptable to live off the labors of others for any longer than absolutely necessary. There's no excuse for not trying. And if that makes me hard-hearted, well, I guess I'm guilty.........but unlike the politicians and the John Q. Citizens who were born in better circumstances, I do know whereof I speak.
  8. by   HM2VikingRN
    No vilification was directed at anyone. The point of posting this link and excerpt was to make people think about some of the ways that we can improve health care access for the poor.

    Is it a wise use of tax dollars to have a system where medicaid patients are prescribed more expensive drugs to treat yeast infections because the OTC remedies aren't covered by medicaid? Wouldn't it be a better program if the Medicaid formulary rules were changed to cover OTC meds? Of course that would cut into Big PHRMA profits.

    As to the comment about having children only when affordable that is an offensive statement. Life circumstances do change. People fall from the middle class into working poor or poverty. There needs to be a protective mechanism for children to mitigate the very real harm that poverty causes. Children are our greatest resource as a society. At some level that means that there is a mutual responsibility for ensuring an environment that promotes healthy growth and development.

    And that does mean helping their parents find/develop the resources to improve the living situation of the family.
  9. by   leslie :-D
    Quote from mjlrn97

    I hate to be one of those people who say "If I can do it, anyone can do it", but it's the honest truth.
    i admire your will, marla.
    but don't you think it may be easier for a white person to claw their way out, than a person of color?
    i'm just trying to be realistic.

    and back on topic, yes, i do feel there should be a societal contribution to helping those less fortunate.
    and yes, viking, it would make perfect sense for medicaid to cover otc meds.
    but as you've implied, greed is the driving force that quells common sense and sound judgment.

    leslie
  10. by   Jolie
    Quote from hm2viking

    as to the comment about having children only when affordable that is an offensive statement.

    why is it offensive to expect people to live within their means? if one is not capable of raising a child, s/he should not have a child. personal desire should not be the sole factor in making life's important decisions, especially when the consequences of those decisions will impact others (such as the child who will potentially be raised in poverty, and the fellow citizens who will be taxed to pay to pay for the child's living expenses). i am not talking about people who need temporary assistance due to job loss, or those who are permanently disabled due to injury, illness or advanced age. i am talking about able-bodied young men and women who have no job, no schooling, who rely on public and private assistance for their daily room and board, and yet choose to bring children into the world anyway.

    children are our greatest resource as a society. at some level that means that there is a mutual responsibility for ensuring an environment that promotes healthy growth and development.
    that "mutual responsibility" rests with the mother and father. children of two-parent, married families are far less likely than those in single mother households to live in poverty. so, let's place the responsibility on both of the parents, where it belongs, and stop expecting society at large to fill the father role that so many young men abdicate and so few young women hold them to.

    we don't need newly-designed entitlements. we need programs that reward parental responsibility and foster independence.
  11. by   HM2VikingRN
    I don't think that I have ever argued otherwise about fostering independence. If anything I have always argued for interventions designed to give families the job skills to earn a living wage. Families with real financial stability tend to have the resources to weather the storms of life. As I wrote earlier this posting was excerpted to show the fiscal impact of bad health care policy decisions and not to target any political viewpoint.

    My own kids are soon to be out of our public school system. That doesn't mean I will vote against future school bonding proposals to improve instruction because my kids won't benefit. I will always advocate and vote to improve health care and education for kids because I believe that I have a responsibility to my community to help improve the chances for a more prosperous future.
  12. by   banditrn
    Quote from earle58
    i admire your will, marla.
    but don't you think it may be easier for a white person to claw their way out, than a person of color?
    i'm just trying to be realistic.

    and back on topic, yes, i do feel there should be a societal contribution to helping those less fortunate.
    and yes, viking, it would make perfect sense for medicaid to cover otc meds.
    but as you've implied, greed is the driving force that quells common sense and sound judgment.

    leslie
    Leslie - I see no reason why 'persons of color' need to remain in poverty, other than societal expectations. Which is total BS.

    Black people have the intelligence and capabilities to do anything they want - I should know. But instead, too many of them listen to the two 'Reverends' and fall into the 'victim' mentality.

    This is also what our run-away social programs have done - encouraged people to develope the 'entitlement' mentality.

    When I grew up, and again when we raised our kids, we didn't ask for 'government' handouts - we did it ourselves, and it wasn't always easy - but now I'm being asked to approve greater and greater give-aways!!

    Do you realize in some states that it's forbidden for the social workers to ask about a person's immigration status when they apply for welfare?
  13. by   leslie :-D
    Quote from banditrn

    Black people have the intelligence and capabilities to do anything they want - I should know. But instead, too many of them listen to the two 'Reverends' and fall into the 'victim' mentality.
    bandit, i understand that with a fierce determination, anyone is capable of digging themselves out of a hole.
    i was wondering aloud, if perhaps poor white people would get more breaks, than poor black people.

    there was recently a thread about being a nurse of color in the workplace.
    it was through that thread that i came to understand that prejudice remains a fulminant force in this country.
    so while marla was saying that if she can do it, then anyone can.
    i'm not so sure.
    and if anyone can, i still think it's going to be a heck of a lot more difficult for some.

    i appreciate your concept of victim mentality.
    i've always been in awe of people who have defined themselves and have touched the stars.
    that any obstacle is only another challenge and one that can and will be conquered.

    feeling apathetic is not the same as a victim mentality.
    this social class needs their props.
    they need programs, classes, funding, to support them in learning a trade.
    this will provide them with the hope, vision and motivation that so many lack.

    there are certainly enough loopholes and incentives in our system, that enables the rich to only attain more money.
    why not do something productive for our society as a whole, and provide a foundation for those truly in need?
    personally, i tire quickly of this "every man for himself" attitude.
    it's time to come together.
    dang, even many churches, who are known for their philanthropy, ultimately rake in the dough.
    it would be nice to see us truly extend ourselves, as the brothers and sisters we are, w/o having ulterior motives or perceived gains.

    my rose-tinted glasses, i think, are blinding me.

    leslie
  14. by   banditrn
    Quote from earle58
    bandit, i understand that with a fierce determination, anyone is capable of digging themselves out of a hole.
    i was wondering aloud, if perhaps poor white people would get more breaks, than poor black people.

    there was recently a thread about being a nurse of color in the workplace.
    it was through that thread that i came to understand that prejudice remains a fulminant force in this country.
    so while marla was saying that if she can do it, then anyone can.
    i'm not so sure.
    and if anyone can, i still think it's going to be a heck of a lot more difficult for some.

    i appreciate your concept of victim mentality.
    i've always been in awe of people who have defined themselves and have touched the stars.
    that any obstacle is only another challenge and one that can and will be conquered.

    feeling apathetic is not the same as a victim mentality.
    this social class needs their props.
    they need programs, classes, funding, to support them in learning a trade.
    this will provide them with the hope, vision and motivation that so many lack.

    there are certainly enough loopholes and incentives in our system, that enables the rich to only attain more money.
    why not do something productive for our society as a whole, and provide a foundation for those truly in need?
    personally, i tire quickly of this "every man for himself" attitude.
    it's time to come together.
    dang, even many churches, who are known for their philanthropy, ultimately rake in the dough.
    it would be nice to see us truly extend ourselves, as the brothers and sisters we are, w/o having ulterior motives or perceived gains.

    my rose-tinted glasses, i think, are blinding me.

    leslie

    Leslie - I understand what you are saying, but again, I have to stress that a person's destiny, whether black, white, or green is within their grasp - if they want to see it.

    I have no problem with churches, philanthropic groups, etc. 'sharing their wealth'. I believe that many do. What I object to is the expectation that it's no longer voluntary - but required.

    I know this is an old fable, but did you ever hear the one about the grasshopper and the ant? The ant works all summer to gather food and supplies, while the grasshopper plays? When the winter comes, the ant is cozy and warm, while the grasshopper, who has done nothing for himself, dies.

    It's now changing - the ant still works, the grasshopper still plays - but when winter comes, the government wants to tell the ant that he must share with the grasshopper because the poor grasshopper has nothing. That is called socialism - and it's what our society is rapidly sliding into!!

    Why DON'T these poor people have opportunities? Is it because they make the wrong decisions sometimes? Aside from the very affluent class - we all start out basically equal - with the chance to make our own opportunities, or to sink into a pit of self pity.

    What I taught my children was this - "You can do anything YOU set your mind to. No one owes you anything. If you want it, find a way to achieve it." I don't consider that an 'every man for himself' attitude. I call it personal responsibility.

    I can also tell you that my sons volunteer their time and money for various causes - because they feel that it's the 'right' thing to do, not because they are being made to do it.

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