Real People Denied Healthcare

[pickledpepperRN]

Real People Denied Healthcare

David Welch is an RN and a patient who was denied health insurance because of minor skin cancer on his nose. This story, of an upper middle class white male nurse, shows how virtually anyone can be denied healthcare, and further illustrates the need for a universal healthcare system such as AB 840 in California and HR 676 nationally.

This video was shot and produced by Colette Washington and edited by James Johnson at JJ Post.

http://youtube.com/results?search_query=David+Welch+is+an+RN+who+was+DENIED+health+Insurance&search=Search

[gauge14iv, MSN, APRN, NP]

Nathan's son Thomas Wilkes was born with severe hemophilia, which puts him at risk for major internal bleeding and for which he must receive nearly $1 million in healthcare costs each year to avoid death or serious disability.

Watch this important video to see how the private health insurance industry cares only about profits, NOT patients.

Video -

Industry = business = companies and people are usually IN business to MAKE money = we are surprised why?

Insurance is a BUSINESS like any other. If they didn't make money they wouldn't be in BUSINESS. Ya can't have it both ways.

Forcing everyone to go on a government health insurance plan is not the answer either, but there needs to be something available for the people who can't/won't get health insurance.

I will say this - I recently had a terminal patient who private insurance company (HMO with a nasty rep for leaving people in the lurch I might add) bent over BACKWARDS to get him far more than what he paid for. What did it take? A letter or two from his provider, and a family member who was willing to be strong in advocating for him. We asked, they provided and then went above their duty.

[burn out]

How can nurses not see the shape of healthcare in their own hospitals? This weekend we had a patient on dialysis and everyone knows that medicare pays for all dialysis patients 100%.. This patient was admitted with the most horrible bed sores I have ever seen and the most nasty personality. He as admitted to ICU for I don't know what reason, He treated all the nurses like crap, refused to have blood work drawn, refused to be turned and threatened to file a law suit if you did turn him . The odor was horrid. Essentially he laid in a $1400 us dollar bed and refused every medical order and his insurance paid for it.

In the room next to him was a 26 year old male that was a quad from a MVA 2 years ago. He is malnourished weighing only 96 lbs to the point that his bed sores were worsening and could not heal, he was loosing so much fluid from the wounds that he was unable to maintain his blood pressure. Yes the state paid for his care when he first had his accident but now they refuse to pay for any rehab facility to send him to. We found out yesterday that he would have to go to a rehab facility in another state and get on their Medicaid program then his own state would take him back with the other state footing the bill. Why isn't the state responsible for his care , why did they pay him become a quad and then let him just lay and "rot", why even pay for him at the time of the mva if this is how they are going t leave him, and nurses worry about being sued for abandonment is this not worse.

The frist patient coded and died yesterday and the second patient saw some of the action and he said"that is going to be me isn't it?" How do you offer any hope?

The flip side of the coin, I was talking to my doctor about the above situation and she said that she was going to have to close her practice because she didn't have enough patients with insurance to keep it open

much longer. She said she welcomed universal health care becasue at least then she could at least get $100 compared to nothing.

Patients are denied healthcare more and more everyday until now it is a big giant snowball hitting the medical practice forcing them out of business, while the insurance rates keep climbing and their profits and salaries keep soaring.

[madwife2002, BSN, RN]

How can nurses not see the shape of healthcare in their own hospitals? This weekend we had a patient on dialysis and everyone knows that medicare pays for all dialysis patients 100%.. This patient was admitted with the most horrible bed sores I have ever seen and the most nasty personality. He as admitted to ICU for I don't know what reason, He treated all the nurses like crap, refused to have blood work drawn, refused to be turned and threatened to file a law suit if you did turn him . The odor was horrid. Essentially he laid in a $1400 us dollar bed and refused every medical order and his insurance paid for it.

In the room next to him was a 26 year old male that was a quad from a MVA 2 years ago. He is malnourished weighing only 96 lbs to the point that his bed sores were worsening and could not heal, he was loosing so much fluid from the wounds that he was unable to maintain his blood pressure. Yes the state paid for his care when he first had his accident but now they refuse to pay for any rehab facility to send him to. We found out yesterday that he would have to go to a rehab facility in another state and get on their Medicaid program then his own state would take him back with the other state footing the bill. Why isn't the state responsible for his care , why did they pay him become a quad and then let him just lay and "rot", why even pay for him at the time of the mva if this is how they are going t leave him, and nurses worry about being sued for abandonment is this not worse.

The frist patient coded and died yesterday and the second patient saw some of the action and he said"that is going to be me isn't it?" How do you offer any hope?

The flip side of the coin, I was talking to my doctor about the above situation and she said that she was going to have to close her practice because she didn't have enough patients with insurance to keep it open

much longer. She said she welcomed universal health care becasue at least then she could at least get $100 compared to nothing.

Patients are denied healthcare more and more everyday until now it is a big giant snowball hitting the medical practice forcing them out of business, while the insurance rates keep climbing and their profits and salaries keep soaring.

What a sad situation, so what is the answer? How do we resolve issues like this?

There must be something we could do collectively

[madwife2002, BSN, RN]

Industry = business = companies and people are usually IN business to MAKE money = we are surprised why?

Insurance is a BUSINESS like any other. If they didn't make money they wouldn't be in BUSINESS. Ya can't have it both ways.

Forcing everyone to go on a government health insurance plan is not the answer either, but there needs to be something available for the people who can't/won't get health insurance.

I will say this - I recently had a terminal patient who private insurance company (HMO with a nasty rep for leaving people in the lurch I might add) bent over BACKWARDS to get him far more than what he paid for. What did it take? A letter or two from his provider, and a family member who was willing to be strong in advocating for him. We asked, they provided and then went above their duty.

A strong family member always seems to get more done for the patient in my opinion, I have been know in my career to encourage this on occassions in the past in the Uk when I felt it was needed, and it never failed.

[burn out]

To a large extent I think the patients need to be monitored if they are receiveing insurance from social programs. If they are not complient then they do not need to be receiving the funds. The first patient I mentioned earlier would go to dialysis and while it was going on be sitting there with a Big Mac and fires and a coke...this is abuse of the system as certainly as a doctor billing for a visit he didn't make. If he continues to refuse treatment for his bedsores then don't let this be an allowable diagnosis for admission to the hospital, everytime they refuse cut them off until they exhaust themselves not the insurance.

Eventually I think we will need a universal health care program, but for those opposed maybe more legislation like my state Governor Manchin is proposing. To allow parents to continue to carry their children on their health insurance until the age of 25. It has been statistically shown that most indiduals between 18-25 are uninsured or poorly insured. By allowing parents to continues health insurance for their children until25 whether or not they go to college or not may take a big strain off the social programs. It may be a small step but many small steps can lead to a difference.

Maybe by regulating the insurance industry to force them to extend insurance to allow those uninsured at lest the opportunity to have insurance and to expand programs to offer more choices for those employed instead of only taking what their employer is willing to offer.

[SuesquatchRN, BSN, RN]

The biggest strain on social programs are children and old people.

We have a lot of ethical dilemnas to face.

Who pays for that million dollar a year child? Do we build schools with that money or support one child? Who pays for Gramma's last 10 years of heavily-assisted life? And her meds?

I don't know the answers, nor do I have suggestions. But my, do I have questions.

[burn out]

The time for asking questions though are is running out. It is critical that we take some kind of action now whether it is a social program or expanding programs already in existence or a combination . We have to take a risk and make a decision too many people are being hurt by the current system. To do nothing just allows the status quo to continue. There is action in choosing to not do anything.

[HM2VikingRN, RN]

there is a limit to the amount of cost shifting that any individual will assume. the current system is broken and worsening by the day. malcolm gladwell wrote an excellent article about how the moral hazard argument in favor of cost shifting and reduced insurance actually contributes to a 2 tier society. over 50% of family bankruptcies in the us are attributed to medical costs.

the moral-hazard argument makes sense, however, only if we consume health care in the same way that we consume other consumer goods, and to economists like nyman this assumption is plainly absurd. we go to the doctor grudgingly, only because we’re sick. “moral hazard is overblown,” the princeton economist uwe reinhardt says. “you always hear that the demand for health care is unlimited. this is just not true. people who are very well insured, who are very rich, do you see them check into the hospital because it’s free? do people really like to go to the doctor? do they check into the hospital instead of playing golf?”

...

yet, when it comes to health care, many of the things we do only because we have insurance—like getting our moles checked, or getting our teeth cleaned regularly, or getting a mammogram or engaging in other routine preventive care—are anything but wasteful and inefficient. in fact, they are behaviors that could end up saving the health-care system a good deal of money.

...

in their eyes, insurance is meant to help equalize financial risk between the healthy and the sick. in the insurance business, this model of coverage is known as “social insurance,” and historically it was the way health coverage was conceived. if you were sixty and had heart disease and diabetes, you didn’t pay substantially more for coverage than a perfectly healthy twenty-five-year-old. under social insurance, the twenty-five-year-old agrees to pay thousands of dollars in premiums even though he didn’t go to the doctor at all in the previous year, because he wants to make sure that someone else will subsidize his health care if he ever comes down with heart disease or diabetes. canada and germany and japan and all the other industrialized nations with universal health care follow the social-insurance model. medicare, too, is based on the social-insurance model, and, when americans with medicare report themselves to be happier with virtually every aspect of their insurance coverage than people with private insurance (as they do, repeatedly and overwhelmingly), they are referring to the social aspect of their insurance. they aren’t getting better care. but they are getting something just as valuable: the security of being insulated against the financial shock of serious illness.

http://www.newyorker.com/archive/2005/08/29/050829fa_fact?currentpage=2

[pickledpepperRN]

Bonnie Drew was a successful attorney working for the federal government authorizing benefits for people with disabilities and social security. After developing a rare disease and being denied adequate health insurance coverage, she now finds herself in the same boat as many of her former clients, and is advocating for a SinglePayer healthcare system in the U.S. Please post and share this story widely.

[TCRNCOB61]

My son was in a MVA Jan. 22, 2007 and fx. both hips. MVA was NOT his fault, he WAS wearing his seatbelt (only reason he is still alive), spent 3 weeks in the hospital to the tune of $200,000 so far. His insurance ran out at the $100,000 mark. In Fla. we are a no-fault state and are having to sue the other guy that caused the MVA (will take years and the guy has nothing).

He can not walk and will not be able to walk for at least 4 to 6 more months, will not be back to work untill who knows when. We can't even get him rehab. because he has NO insurance. He doesn't quailfy for anything because he is a 26 yr. old single male with no children. Everywhere we have tried to get help for him keeps asking if he has kids, if he had a minor child he would get state help. YES, I HAVE TRIED MOST EVERYTHING. He is living with me and I am paying all his bills (not the hospital ones) as best I can. I am paying his house payment because I don't want him to lose his house. I am paying for his rental hospital bed and wheelchair and all his meds. We are doing the best we can but it's a daily struggle. I am fast learning to be a rehab nurse!

I don't know what the answer is either but there has to be one somewhere.........

Theresa

[HM2VikingRN, RN]

My son was in a MVA Jan. 22, 2007 and fx. both hips. MVA was NOT his fault, he WAS wearing his seatbelt (only reason he is still alive), spent 3 weeks in the hospital to the tune of $200,000 so far. His insurance ran out at the $100,000 mark. In Fla. we are a no-fault state and are having to sue the other guy that caused the MVA (will take years and the guy has nothing).

He can not walk and will not be able to walk for at least 4 to 6 more months, will not be back to work untill who knows when. We can't even get him rehab. because he has NO insurance. He doesn't quailfy for anything because he is a 26 yr. old single male with no children. Everywhere we have tried to get help for him keeps asking if he has kids, if he had a minor child he would get state help. YES, I HAVE TRIED MOST EVERYTHING. He is living with me and I am paying all his bills (not the hospital ones) as best I can. I am paying his house payment because I don't want him to lose his house. I am paying for his rental hospital bed and wheelchair and all his meds. We are doing the best we can but it's a daily struggle. I am fast learning to be a rehab nurse!

I don't know what the answer is either but there has to be one somewhere.........

Theresa

I am so sorry about your son's injury. I hope you find a solution.

[TrudyRN]

i just read about the father in colorado whose son has hemophilia and whose medical insurance, as a result, is going to expire (reach its lifetime cap of a million dollars) in a month. that will be a problem of severe magnitude for this family and a virtual death sentence for his son. he is nathan j. wilkes, colorado

article: capital sources: a father's call for health-care reform - to your ...

commentary: newsweek - a call for 'radical change' - newsweek comments and ...

the article on the cna (california nurses association) website is called ,

"a call for 'radical change' - a colorado father journeyed to washington to pead for health-care reform on behalf of his chronically ill son.

what was so scary is that he reminded me that our own coverage has a lifetime cap of $1,000,000, which is nothing these days. what does your own health insurance have as a cap? probably not much better. what if you or your loved one develops a severe, devastating condition and you lose your insurance? the us is truly barbaric in this regard (not having universal coverage for everyone).:uhoh21:

to the moderators: please consider leaving this post in general discussion for a while so that more people see it. thank you.