The desperate plight of people trying to deal with cancer without health insurance. - page 3

the american cancer society has been campaigning to raise awareness of the desperate plight of people trying to deal with cancer without health insurance. i offer dan and sharon brodrick as exhibit... Read More

  1. by   EmmaG
    Quote from CRNA2007
    We just want you liberals to start forking over your cash before you demand that everyone else pays for it. Show me your cancelled checks for everyone elses health care and then we can find some common ground to work with.
    I see the cost of providing healthcare to everyone is important issue for you. Ok, fine. That's understandable. Not grounded in fact, however.

    Single-payer healthcare, with a heavy emphasis on preventative care (including prenatal care) will pay for itself in a very short time. And actually end up saving this country billions of dollars in the long run.

    Our healthcare model is built upon crisis management, not preventative care. We spend our time and resources putting out fires.

    Take my favorite example, diabetes. Care to make a guestimate on how much this one condition alone costs US taxpayers?

    Take ANY system of the body, and there are complications--- serious complications--- that arise from poorly managed diabetes. Yet a well-managed diabetic can lead a normal life with little or no complications with just some basic preventative care, teaching and monitoring. VERY cheaply done.

    Consider what poorly controlled diabetes can lead to. Heart disease, renal failure (dialysis ain't cheap--- and guess who pays for THAT? hint: not private insurance), infections, infections, infections (think that doesn't affect you? think MDRO), amputations, blindness, stroke, gastroparesis, extended hospital stays with repeated admissions and so on.

    I had a friend who was diabetic; poorly managed and went completely blind in his late 20's and had his first heart attack in his 30's. Not only was his medical care costly, but now you have all the costs associated with his blindness and cardiac condition in addition to those associated with his diabetes.

    The cost to all of us is staggering. Add to that the impact of lost work productivity, the amount spent in government entitlement programs to cover the cost of chronic treatments such as dialysis, or 30 and 40 year olds collecting disability, or other benefits because of related complications (blindness, for example) and it's easy to see how cost effective universal preventative care would be.

    And that is just an example of ONE chronic condition.

    Crisis management healthcare has a snowball effect.

    And yeah, we all pay for it.
  2. by   EmmaG
    That doesn't answer my question to CR, btw.

    But it does prove him wrong.
  3. by   pickledpepperRN
  4. by   EmmaG
    Quote from spacenurse
    Are you saying that backs up his assertion that "It is a law here in the US that someone visiting an emergency room must be treated" ? As pointed out by Elkpark, that isn't the case. ERs are only required to provide screening to determine if a medical emergency exists and then provide treatment necessary only to stabilize or transfer. Think about the reasons people go to ERs--- how many are true "medical emergencies"?
  5. by   jjjoy
    What exactly is your question to CR then? I thought it was asking what law stipulated that someone visiting an emergency room must be treated. EMTALA requires that any hospital with certain contracts, such as with CMS (Medicare) which is almost every hospital out there and addressed in the FAQ, must assess anyone who shows up at the ER and must treat them if they are assessed to have a qualifying emergency condition. Beyond that, the ER doesn't have to treat. There's no requirement that the treatment be free to the patient or that it go any further than immediate stabilization - not continuing treatment. The main point is that if you show up to an ER on the verge of death with a treatable condition, they can't refuse to treat you because you ultimately may not be able to pay for that treatment. They can refuse to treat if you don't have a qualifying emergency condition, though fear of lawsuits makes people & organizations reluctant to not treat someone they have assessed.

    That still doesn't change the desparate situation cancer patients without insurance may face.

    The fact that some insurance companies won't cover some costs simply means that we can't assume that a national health plan wouldn't also refuse to pay for some of the newer, costlier treatments out there. Having insurance one way or another doesn't solve ALL problems, but it can help.

    I think the best we can aim for is some kind of plan that minimizes the chances of a major illness leading to complete financial ruin, leaving even more people dependent upon public assistance and charity.
  6. by   pickledpepperRN
    Quote from Emmanuel Goldstein
    Are you saying that backs up his assertion that "It is a law here in the US that someone visiting an emergency room must be treated" ? As pointed out by Elkpark, that isn't the case. ERs are only required to provide screening to determine if a medical emergency exists and then provide treatment necessary only to stabilize or transfer. Think about the reasons people go to ERs--- how many are true "medical emergencies"?

    NO, to claim that anyone visiting an emergency room must be treated I would not be truthful.
    The link just gave the wording of the law referred to in the FAQ.
    A person must be screened. If an emergency medical condition exists they must be either stabilized or transferred to a facility that can stabilize them.

    Clearly if I show up in an ER stating that I have cancer and need treatment there is no obligation to treat me. Or anyone not determined to have an emergency medical condition.
    There is no way to back up that assertion because it is false.
  7. by   Djuna
    Quote from Pixi_Lixi
    I'm in Australia and we have public health care. Our economy hasn't collapsed.
    If you are sick you will be treated, sometimes patients have to wait (say for a hip replacement) but you are cared for. Here people also have the option of private cover if they want it, so they can choose to have surgery etc. straight away. But if you are poor or disadvantaged public hospitals will treat you regardless.

    The idea that you could just leave a sick or dying child without health care because they have no insurance is horrifying. Many Australians fear going down the route of the American service delivery model.
    Pixi_Lixi, I think you are simplifying the Australian healthcare system slightly. People without health insurance have died waiting for their chemotherapy, especially in rural areas where access to specialist services are limited. With full cover insurance you get to see the Specialist of your choice as soon as possible. Free healthcare for all is a nice sentiment but it is also wasteful.

    There is no perfect system of fair and equitable distribution of healthcare, even in the so-called 'almost perfect' utopia of France (for those who have seen the movie Sicko). Healthcare is expensive any which political view you take.
  8. by   EmmaG
    Quote from spacenurse
    NO, to claim that anyone visiting an emergency room must be treated I would not be truthful.
    The link just gave the wording of the law referred to in the FAQ.
    A person must be screened. If an emergency medical condition exists they must be either stabilized or transferred to a facility that can stabilize them.

    Clearly if I show up in an ER stating that I have cancer and need treatment there is no obligation to treat me. Or anyone not determined to have an emergency medical condition.
    There is no way to back up that assertion because it is false.
    Thanks.
  9. by   EmmaG
    The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 47 million without health coverage and millions more inadequately covered.


    This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment though a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.



    http://www.pnhp.org/
  10. by   pickledpepperRN
    Quote from Djuna
    Pixi_Lixi, I think you are simplifying the Australian healthcare system slightly. People without health insurance have died waiting for their chemotherapy, especially in rural areas where access to specialist services are limited. With full cover insurance you get to see the Specialist of your choice as soon as possible. Free healthcare for all is a nice sentiment but it is also wasteful.

    There is no perfect system of fair and equitable distribution of healthcare, even in the so-called 'almost perfect' utopia of France (for those who have seen the movie Sicko). Healthcare is expensive any which political view you take.
    I agree that there will not be a perfect system of anything.

    I don't understand how providing healthcare is wasteful because some in rural areas don't get treated in time.

    What am I missing. It seems the waste is because some don't get needed treatments. Wouldn't it be more wastful if even people in cities died waiting for treatment?

    Would you choose to eliminate of the Australian healthcare system in favor of privately purchased insurance for everyone?
  11. by   EmmaG
    to answer my own question above:
    Quote from emmanuel goldstein
    care to make a guestimate on how much this one condition alone costs us taxpayers?
    http://www.fda.gov/diabetes/related.html

    direct medical and indirect expenditures attributable to diabetes in 2002 were estimated at $132 billion. direct medical expenditures alone totaled $91.8 billion and comprised $23.2 billion for diabetes care, $24.6 billion for chronic complications attributable to diabetes, and $44.1 billion for excess prevalence of general medical conditions. inpatient days (43.9%), nursing home care (15.1%), and office visits (10.9%) constituted the major expenditure groups by service settings. in addition, 51.8% of direct medical expenditures were incurred by people >65 years old. attributable indirect expenditures resulting from lost workdays, restricted activity days, mortality, and permanent disability due to diabetes totaled $39.8 billion. u.s. health expenditures for the health care components included in the study totaled $865 billion, of which $160 billion was incurred by people with diabetes. per capita medical expenditures totaled $13,243 for people with diabetes and $2,560 for people without diabetes. when adjusting for differences in age, sex, and race/ethnicity between the population with and without diabetes, people with diabetes had medical expenditures that were ~2.4 times higher than expenditures that would be incurred by the same group in the absence of diabetes.

    the estimated $132 billion cost likely underestimates the true burden of diabetes because it omits intangibles, such as pain and suffering, care provided by nonpaid caregivers, and several areas of health care spending where people with diabetes probably use services at higher rates than people without diabetes (e.g., dental care, optometry care, and the use of licensed dietitians). in addition, the cost estimate excludes undiagnosed cases of diabetes. health care spending in 2002 for people with diabetes is more than double what spending would be without diabetes.

    diabetes imposes a substantial cost burden to society and, in particular, to those individuals with diabetes and their families. eliminating or reducing the health problems caused by diabetes through factors such as better access to preventive care, more widespread diagnosis, more intensive disease management, and the advent of new medical technologies could significantly improve the quality of life for people with diabetes and their families while at the same time potentially reducing national expenditures for health care services and increasing productivity in the u.s. economy.


    http://care.diabetesjournals.org/cgi.../full/26/3/917

    (sorry this is five years old; however, i seriously doubt that the cost is less now)
    Last edit by EmmaG on Oct 27, '07 : Reason: fixed link
  12. by   Djuna
    Sorry spacenurse, I went off on a slight tangent with the waste of resources statement.

    I'll give you an example of wasting resources that I see regularly. I work in a rural hospital, in the ER. We see probably 2/3 of all presentations that could be treated at a GP clinic. Instead they come to ER because they don't have to pay for it, get free medication and very expensive x-rays, CT scans, USS.

    Now I know for a fact there are a number of people who have been ordered further tests such as USS and CTPAs, by their GP but cannot afford to pay for it, so they will front up to ER and have these tests performed FREE of charge.

    There are some inherent flaws in the free healthcare model. Taxpayers should not have to pay taxes for people to freeload in my opinion.
    Last edit by Djuna on Oct 27, '07
  13. by   HM2VikingRN
    I think we would all be better off if the COBRA law was amended to allow private individuals to buy into state health programs such as Minnesota Care if they are in between jobs and/or without coverage.

    (That doesn't erase my belief that the only real long term solution is single payer.)
    Last edit by HM2VikingRN on Oct 28, '07 : Reason: spelling

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