Just Off Insular Senate Floor, Life of the Uninsured Intrudes

[HM2VikingRN]

WASHINGTON, Nov. 24-When senators debate health care, they usually speak in abstract terms about soaring health costs and the plight of the uninsured.

But just 20 feet from the Senate chamber is a young man who knows those problems all too well from personal experience. The man, Sergio A. Olaya, runs the Capitol elevators on which the senators ride. Whenever the Senate is in session, he is on duty.

Mr. Olaya, 21, is struggling with $255,000 of medical bills incurred by his mother before she died in April from an aggressive form of brain cancer.

His experience highlights the problems of the uninsured, from which members of Congress are usually insulated. The leading Democratic presidential candidates say all Americans should have coverage as good as what Congress has.

As a government employee, Mr. Olaya has health insurance. But his mother, like 47 million other Americans, was uninsured.

Source: http://www.nytimes.com/2007/11/25/washington/25health.html?ref=health accessed today.

[Simplepleasures]

One solution for situations similar to this would be to allow children to carry their non-medicare eligible parents as dependents for the purpose of health insurance. This is neither a conservative or liberal issue. It is an American issue.

This is exactly what my family and I are now discussing, as I dont get Medicaid in WI, and need specialized care by MDs that the free clinic I go to does not supply due to cost constraints.My daughter who is in the Navy is looking into this possibilty until the wait for SSDI approval comes through, and it has been almost two years already.I have no funds of my own anymore due to medical debt, which I paid.

[lamazeteacher]

It would chap me, too, except that this is what we've come down to in America. That is, since those who work are taxed so viciously, since you will lose the real estate and personal property you think you own if you do not pay the taxes for them, it seems only fair that people should weasel out of debts any way they legally can. And Senators are not in any position to talk - you and I pay not only their six figure salaries but also the cost of their insurance.

America wa sold down the river long ago by Godless, country-less non-patriots who were interested only in what good they could do themselves, at the public expense. None of them care for America or her peoples. They care only for themselves.

Dear Sasquatch and Trudy:

Please bear with me as I explain the things I know to be true about government subsidised (paid through our taxes in manageable amounts), because if that wasn't managable all the people who keep this country going, could go bankrupt).

I come to praise you for your interest in our country and God. This country was founded by "countryless" non citizens of other countries, who came here due to dissatisfaction with things in their homeland, and a need to strike out for themselves! They brought their religion with them, which alienated the natives here, to the extent that they rose up and were practically eradicated. Talk about "chapping" their unclothed butts! But enough history.

If you saw the amount of the bills that are run up on insuranceless, formerly hard working, tax paying individuals who, because they lack insurance, have much more serious conditions (by the time they have to go to the ER) than they otherwise would have, you'd run for the hills, too (unless you're independently wealthy). Those bills are well padded, which insurance companies know and refuse to pay the excess, which causes the hospital a tax deductable debt, which allows them to say they're nonprofit (like heck!).

The difference between rich people and poorer people, is lawyers. While we go paycheck to paycheck to support the banking industry, the politicians, etc., etc., etc. and think many times before engaging the services of a lawyer, rich people have "hot and cold running" lawyers whose job it is to save them piles of money to add to their piles of money (some of which they give away to acceptable charitable causes, to pay less tax, and). However, their mansions are taxed hugely (so they use a large portion of them to work at home, which you could do too, and deduct whatever % of your house).

I'm not dissing lawyers as a whole, because the laws of this land (that we approved when we elected the officials that made them)are so cumbersom to the average "Joe" and "daddywarbucks", that we need interpreters and expertise of knowledgeable, well trained people when we get into a legal fix. Rich people are always in legal fixes.

It is possible (to finally address the issue you raised), for rich parents to endow each of their children and grandchildren with $2,000 yearly, which many do, to reduce the inheritance tax that must be paid (none of which goes into healthcare) at their deaths. Their lawyers usually advise them to do that, but the kids can't get their hands on all of it, even after the rich person dies, as (again to avoid inheritance tax) trusts are set up to trickle money into the kids' bank accounts, or it's tied up in some stocks that don't give up the money for years.

However, the mansion can be sold to a kid (or all of them, according to the will for all of them to divide), for as low as a dollar. Except now, "capital" gain taxes are due on it, which are impossible for the kids to pay, much less afford the utilities for the huge echoing place. But don't cry, they'll live well probably for the rest of their lives, having inherited the business interests, on which they'll (again) pay tax.

That should create a picture showing that the rich do pay more taxes than the poor (duh!), simply becauise it's impossible to hide it all, unless illegal things are done, like sending the money to a tax exempt country offshore, or in Switzerland, our ally. Percentage wise, we probably pay more, but it's pennies compared to that of the (?honest)rich.

Now, about having to support healthcare for the poor, unemployed, sick masses. If they get "free" healthcare, they'll be provided earlier preventive care (ideally), and their hospital bills will be lower than otherwise (like now). They'll work in their jobs longer, and pay more taxes, as their lives will be longer and more comfortable. Does anyone have a gripe about that last sentence?

[CRNA2007]

Yep, as a former ER nurse a lot of my patients were medicaid ( I would say the majority) some had legitimate reasons to be in the ER, but many did not. They had free health care and the ER visit was free, but most did not have a primary care physician. Giving someone anything thats free will only get abused. The ER will be clogged more than ever with people who don't have to pay for their health care and have no disincentive to go to the ER and be seen right away. Heck even the ambulance ride will be free.

Does anyone have a gripe about that last sentence?

[lamazeteacher]

Yep, as a former ER nurse a lot of my patients were medicaid ( I would say the majority) some had legitimate reasons to be in the ER, but many did not. They had free health care and the ER visit was free, but most did not have a primary care physician. Giving someone anything thats free will only get abused. The ER will be clogged more than ever with people who don't have to pay for their health care and have no disincentive to go to the ER and be seen right away. Heck even the ambulance ride will be free.

Is there a list of "legitimate" reasons for ER visits? Were the patients you've cared for in the ER "for free" not ill? Did anyone explain the function of a PCP, in terms and language they understood?

When I had to go to the ER for severe gastric bleeding due to prescribed ibuprophen EC, with SOB, it was a dismal experience, which I noticed others there weren't enjoying, either.

I wasn't hospitalized, with a Hgb of 9, but when I got home (where I live alone, with no relatives or friends in the immediate vicinity, which the ER doctor knew), I received a telephone call from someone saying that I had been "put on the critical list", and needed to go to an outpatient unit at the hospital the next day, for transfusions.

Now as some of you know, I've been a Registered Nurse for 47 years, and remember times that were different, in terms of care that was provided without immediate concern about payment.

I haven't actually researched whether insurance other than Medicare would have made hospitalization an option in my situation, but I strongly suspect that the medical regime would have been different, had my coverage not been Medicare. It was not my wish to be admitted, but then it wasn't an option, either.

Believe me, Canadians don't have the rate of ER visits that we do. My niece is a physician in Toronto, and she says the majority of patients are seen regularly by a PCP, with emphasis on preventive care.

By the way, I heard on ABC talk radio today, that Hospice coverage under Medicare is being radically diminished.......... Do any of you know anything certain about that?

The host of the "show" said the biggest problem was that hospice agencies would file for bankruptcy, and patients wouldn't die at home, which would raise the cost of their health care.........is any human need not measured in dollars and cents?

My experience in the short time I worked at hospice, was that patients are sedated so profoundly, they (mercifully) die sooner than they would have without hospice - which, to be crass, does save a considerable amount of money!

[calliesue]

I know this thread is old but I still have something to say.

Ok to all you people griping about "free health Care", and non emergency er visits.

Do you think people should be denied care because they are poor?

PCP? If you don't have insurance you probably don't have a pcp.

If your choice is pay the electric bill or feed the kids or go to a doctor for a chronic problem that you don't understand is a sign of a serious health problem, what decision would you make ?

I guess you would be between a rock and a hard place. Can't tell you how many people I know who make their bills, barely, but can't afford the crap insurance provided to non-nurses in the health care industry. Ironically they make too much for government asst,

Since there is such a gap shouldn't those of us who can help do so?

I mean isn't caring for the sick and indigent a moral imperative for a "Christian nation" ?

[Zookeeper3]

i know this thread is old but i still have something to say.

ok to all you people griping about "free health care", and non emergency er visits.

do you think people should be denied care because they are poor?

pcp? if you don't have insurance you probably don't have a pcp.

if your choice is pay the electric bill or feed the kids or go to a doctor for a chronic problem that you don't understand is a sign of a serious health problem, what decision would you make ?

i guess you would be between a rock and a hard place. can't tell you how many people i know who make their bills, barely, but can't afford the crap insurance provided to non-nurses in the health care industry. ironically they make too much for government asst,

since there is such a gap shouldn't those of us who can help do so?

i mean isn't caring for the sick and indigent a moral imperative for a "christian nation" ?

this is not what er nurses are complaining about. to be truly educated about er abuse and the waste of valuable resourses- spend 4 hours at your local er between 8pm and midnight. this is something i want every tax paying american to do. for a real treat, make it a friday night. the medicaid system would be overhaulded that next election year.

people show up 10 minutes after their doctors office closed, or instead of seeing a free clinic for sniffles... a $2000 er cost incurs. ambulances are called for nausea (no emisis).... on and on. these are not rare occurrences.

there is a limited pool of government finances. rather than tax me more, let's work on fixing the system, eliminate the abuse and funds will quickly free up to help a vast majority.

my nurse insurance, demands all my health care is done at my hospital or i pay an additional 20%, on top of my 20% copay. after an illness i had to set up payment plans... was sent to a collection agency and when i returned to work, my wages garnished. almost bankrupted me. this is how those who do not have medicaid and have co-pays navigate the insurance world.

for those who lack insurance, the hospital writes off debt, some to all of your debt and hikes up fees to charge insurance companys. if you can prove an inability to pay, there are programs to help. there are free clinics and health departments as well as doctors that have free samples of meds and med. funded programs.

so by working, not utilizing the government systems and paying 30% tax as well as all of my meds and health care costs.... i feel i already do my part in this "christian nation".

i say fix this medicaid mess before putting more people on this inefficient system, the abuse is rampant:banghead:. and if you're a non abuser, this obviously is not meant to offend you in any way. if you need the medicaid, this is not meant to offend you either... this is not about denying the poor, it about stopping the poor who qualify from wasting tax dollars and wasting money that could have beeen spent helping others in this "christian nation".

[RN4MERCY]

I know this thread is old but I still have something to say.

Ok to all you people griping about "free health Care", and non emergency er visits.

Do you think people should be denied care because they are poor?

PCP? If you don't have insurance you probably don't have a pcp.

If your choice is pay the electric bill or feed the kids or go to a doctor for a chronic problem that you don't understand is a sign of a serious health problem, what decision would you make ?

I guess you would be between a rock and a hard place. Can't tell you how many people I know who make their bills, barely, but can't afford the crap insurance provided to non-nurses in the health care industry. Ironically they make too much for government asst,

Since there is such a gap shouldn't those of us who can help do so?

I mean isn't caring for the sick and indigent a moral imperative for a "Christian nation" ?

As progressives, we realize we're all in this together. Do unto others, and first do no harm. All the other civilized, industrialized nations provide medically necessary healthcare on a single-payer model for their residents as a right!

"To each, according to his needs irrespective of his ability

to pay, a system of health care from the cradle to the grave,

free at the point of delivery. Paid for by social insurance

where care is based upon clinical need." Ernest Bevin, 1946

[HM2VikingRN, RN]

You Marxist. How on earth can we ever afford that? Why people will go to the doctor willy nilly....The market can save us all.....

(I am most assuredly being facetious!)

Great quote that says it all.............

[lamazeteacher]

I mean isn't caring for the sick and indigent a moral imperative for a "Christian nation" ?

It certainly is for a Jewish one - Israel. Anyone, including those rabidly opposed to that country receive free care there: Muslim Arabs, Jews, Christians, Buddhists, Hindis, atheists........ and it's appreciated. Some of it is funded by American Zionists, who support Haddassah hospitals and clinics as well as American charitable causes. The funds are raised by mostly Jewish women who are wealthy and those of more modest means, by having luncheons, fund raising events, and the usual bake sales and rummage sales. Their purpose is to portray the necessity and possibility of providing health care for all, no matter their affiliation. History has shown enough inequity in the name of Christianity, for all time.

Now it is time to be caring of others, for our own sakes, as well as theirs, as circumstances reverse all too quickly (e.g. people newly homeless due to banks forclosing loans, the terms of which should be illegal).

Insurance comopanies are now providing education for their "members", so they will get preventive care that will be less expensive in the long run, and monitoring people with chronic illnesses to encourage compliance with their medical regime. If/ when those people retire (and as is expected Medicare becomes bankrupt), or lose their employment and insurance, it is doubtful that their illness(es) will be kept in abeyance. So they'll be bonafide patients in crowded ER waiting rooms anyway. There is much wrong with that picture!!

If education for children is important enough to be provided by civic/government funded programs, so should the education to prevent illness/worsening of illness. The former education provides a foundation for gainful employment and inclusion in life. The latter education keeps people working longer and includes them in healthy endeavors and in the mainstream of life.

Is that pie in the sky? Will some refuse to do what is necessary to accomplish their goal? Sure they will......... and they'll be provided with more education to assist them in making decisions for themselves, to make better decisions. I like that picture.

The picture provided by the ER staff members who think people "take advantage" of what is given "free" is negative thinking that reflects self fulfiling prophesies that patients where they work, perceive and obediently bring to fruition. Negativity breeds negativity. When thoughts are positive, ("You can do this"), it usually happens.

DM is a "case in point". Those who are overweight or obese are told that they are going to have diabetes. So they don't realize that it's a choice they have. They can lose weight and stay well, or they can gain more weight and get sick, with all that implies. Education makes the difference.

So learn to effectively teach all patients in a manner they can understand (not the same for all), the pathway to health, whether they can afford it, appreciate it, utilize it, or not. Eventually it will reward society by costing us all less.

[RN4MERCY]

Some people seem to believe that hospitals are a "vacation destination." Overuse and frequent fliers? I say no, just real people with unmet needs and nowhere else to go for help. They forget that most people aren't qualified to diagnose and treat their own illness or injury. Patients go to hospitals because they need care. As a nation, we've got to stop allowing "the market" to control access. It's unjust and morally wrong to commodify health care and allow corporations to profit by exclusion of pre-existing conditions to outright denial of claims.

No nurse or physician should ever be compelled to deny care to those who need it. Blaming the victim and making assumptions about people is dangerous. Co-pays and deductibles ration many people out of the system. They are among the many barriers to people who seek the health care they need.

:cry:How can we ever forget the sad story about the poor lady who writhed in the ER and died on the floor of the waiting room of a perforated intestine--nurses and doctors and orderlies stepped over her, assuming that she was a malingerer with drug seeking behaviors. Her boyfriend called 911 in order to get some help, after hours of waiting for hospital personnel to take her pain and suffering seriously. Shameful and embarrassing.