The New York Times has done a several part story on the diabetes epidemic. I know the snips are long, but I urge you to read them anyway, even if you do not click the whole article. The chances are good that if neither diabetes nor health care crime kills you, it will kill someone you love. And soon.
Begin on the sixth floor, third room from the end, swathed in
fluorescence: a 60-year-old woman was having two toes sawed off. One floor up,
corner room: a middle-aged man sprawled, recuperating from a kidney
transplant. Next door: nerve damage. Eighth floor, first room to the left:
stroke. Two doors down: more toes being removed. Next room: a flawed
heart.As always, the beds at Montefiore Medical Center in the Bronx were
filled with a universe of afflictions. In truth, these assorted burdens
were all the work of a single illness: diabetes. Room after room, floor
after floor, diabetes. On any given day, hospital officials say, nearly
half the patients are there for some trouble precipitated by the
disease.An estimated 800,000 adult New Yorkers – more than one in every eight –
now have diabetes, and city health officials describe the problem as a
bona fide epidemic. Diabetes is the only major disease in the city that
is growing, both in the number of new cases and the number of people it
kills. And it is growing quickly, even as other scourges like heart
disease and cancers are stable or in decline.Already, diabetes has swept through families, entire neighborhoods in
the Bronx and broad slices of Brooklyn, where it is such a fact of life
that people describe it casually, almost comfortably, as “getting the
sugar” or having “the sweet blood.”…There are two predominant types of diabetes. In Type 1, the immune
system destroys the cells in the pancreas that make insulin. In Type 2,
which accounts for an estimated 90 percent to 95 percent of all cases, the
body’s cells are not sufficiently receptive to insulin, or the pancreas
makes too little of it, or both.Type 1 used to be called “juvenile diabetes” and Type 2 “adult-onset
diabetes.” By 1997, so many children had developed Type 2 that the
Diabetes Association changed the names.What is especially disturbing about the rise of Type 2 is that it can
be delayed and perhaps prevented with changes in diet and exercise. For
although both types are believed to stem in part from genetic factors,
Type 2 is also spurred by obesity and inactivity. This is particularly
true in those prone to the illness. Plenty of fat, slothful people do
not get diabetes. And some thin, vigorous people do.The health care system is good at dispensing pills and opening up
bodies, and with diabetes it had better be, because it has proved
ineffectual at stopping the disease. People typically have it for 7 to 10 years
before it is even diagnosed, and by that time it will often have begun
to set off grievous consequences. …But as alarmed as health officials are about the present, they worry
more about what is to come.Within a generation or so, doctors fear, a huge wave of new cases could
overwhelm the public health system and engulf growing numbers of the
young, creating a city where hospitals are swamped by the disease’s
handiwork, schools scramble for resources as they accommodate diabetic
children, and the work force abounds with the blind and the halt.The prospect is frightening, but it has gone largely unnoticed outside
public health circles….One in three children born in the United States five years ago are
expected to become diabetic in their lifetimes, according to a projection
by the Centers for Disease Control and Prevention. The forecast is even
bleaker for Latinos: one in every two….Diabetes has no cure. It is progressive and often fatal, and while the
patient lives, the welter of medical complications it sets off can
attack every major organ. As many war veterans lost lower limbs last year
to the disease as American soldiers did to combat injuries in the entire
Vietnam War. Diabetes is the principal reason adults go blind…So-called Type 2 diabetes, the predominant form and the focus of this
series, is creeping into children, something almost unheard of two
decades ago. The American Diabetes Association says the disease could
actually lower the average life expectancy of Americans for the first time in
more than a century….“Either we fall apart or we stop this,” said Dr. Thomas R. Frieden,
commissioner of the New York City Department of Health and Mental Hygiene…Yet for years, public health authorities around the country have all
but ignored chronic illnesses like diabetes, focusing instead on
communicable diseases, which kill far fewer people. New York, with its
ambitious and highly praised public health system, has just three people and a
$950,000 budget to outwit diabetes, a disease soon expected to afflict
more than a million people in the city.Tuberculosis, which infected about 1,000 New Yorkers last year, gets
$27 million and a staff of almost 400.Diabetes is “the Rodney Dangerfield of diseases,” said Dr. James L.
Rosenzweig, the director of disease management at the Joslin Diabetes
Center in Boston. As fresh cases and their medical complications pile up,
the health care system tinkers with new models of dispensing care and
then forsakes them, unable to wring out profits. Insurers shun diabetics
as too expensive. In Albany, bills aimed at the problem go nowhere.“I will go out on a limb,” said Dr. Frieden, the health commissioner,
“and say, 20 years from now people will look back and say: ‘What were
they thinking? They’re in the middle of an epidemic and kids are watching
20,000 hours of commercials for junk food.’….
link
Santos Alicea tottered haltingly over to the art shop in East Harlem,
his legs screaming. The regulars knew what he was going through. They
always did – the diabetes was speaking. He confirmed this with numerical
rigor: 228, his nasty blood-sugar reading this morning. Nods all
around. They had ugly numbers, too.James De La Vega owned the art shop on Lexington Avenue, near 104th
Street, and regarded the sidewalk out front as his living room. There,
with his friends and family, he shared a lot over the years: Latino art
and culture, the slow cadences of East Harlem life, runs of hard luck.
And diabetes.Indeed, in East Harlem, it is possible to take any simple nexus of
people – the line at an A.T.M., a portion of a postal route, the members of
a church choir – and trace an invisible web of diabetes that stretches
through the group and out into the neighborhood, touching nearly every
life with its menace.Mr. De La Vega, a 33-year-old self-styled “sidewalk philosopher” whose
murals and sidewalk chalk drawings are familiar neighborhood ornaments,
has a mother with diabetes. His stepfather’s case was confirmed in
March. And a number of Mr. De La Vega’s friends who occupied his chairs or
sat in the bordering garden, well, they had it. Mr. De La Vega said he
would probably get it, too.In East Harlem, in fact, it seems peculiar if you don’t have it.
Months spent in the easy company of the shop’s dozen or so regulars
reveal something more than just the insidiousness of Type 2 diabetes, the
disease’s most common form. Those months, and conversations, disclose
with relentless consistency the human behavior that makes dealing with
Type 2 often feel so futile – the force of habit, the failure of will,
the shrugging defeatism, the urge to salve a hard life by surrendering
to small comforts: a piece of cake, a couple of beers, a day off from
sticking oneself with needles….Elsie Matos, Mr. De La Vega’s mother,
sat out front, her dark hair in a ponytail. The two of them still lived
together. She was 56 and worked in the office at a local public school.She discovered her diabetes coincidentally, as many do, nine years ago.
A boil on her left thigh refused to heal. A blood test told her what
she didn’t want to know. Her fasting blood-sugar reading was nearly
triple the 126 milligrams per deciliter that defines the illness….When she got the diagnosis, the doctor told her to shed 100 pounds.
With a crash diet she did just that, slimming down to 150. She stayed
thinner for a year.“Then I started cheating,” she said. “Sandwiches. Frankfurters. I
didn’t care. I didn’t think it would matter.”She was put on pills. Those who have diabetes usually suffer from
related conditions, especially high blood pressure and high cholesterol, and
often swallow 8 to 10 pills a day. Ms. Matos had high cholesterol and
asthma.She was warned that she had to control her lust for calorie-rich food,
that taking pills was not enough. Doctors like to say that patients can
eat their way through the pills. And a cruel truth of diabetes care is
that many oral medications prompt weight gain. Oral diabetes drugs also
tend to lose effectiveness. They sometimes work for a few years, then
have to be teamed with other drugs. Anyone who has diabetes long enough
is likely to find herself on insulin.Ms. Matos frowned at her stomach. She said she was 165 or 170 pounds,
still too much. “The doctor said if I didn’t diet, I’d have to take the
insulin,” she said. “I don’t want the needle.”…For many Type 2 diabetics, doctors say, a half-hour of daily exercise
and the loss of as little as 10 to 15 pounds can make a big difference
in their health. Still, that can be a formidable challenge.Understandably, people talk about wanting to take a vacation from
diabetes, but it grants no time off.Ms. Matos often found herself succumbing to a lifestyle guaranteed to
make her sicker. Until it has been in the system for a long time,
diabetes doesn’t hurt. In East Harlem, what doesn’t hurt is often ignored.She pointed out that many people in her world were stressed out and
depressed. There are other serious health issues, like asthma and H.I.V.,
the signposts of many poor neighborhoods. Their cobbled-together lives
drain residents of their resolve. And so they cede diabetes the upper
hand and eat what tastes good to them to counteract the gravity of
unhappiness….“Listen, if I want to eat a piece of cake, I’m going to eat it,” she
said. “No doctor can tell me what to eat. I’m going to eat it, because
I’m hungry. We got too much to worry about. We got to worry about
tomorrow. We got to worry about the rent. We got to worry about our jobs. I’m
not going to worry about a piece of cake.”Ms. Matos gave a feeble glance at a shopper mulling the mugs and
T-shirts. She carried her glucose meter around, but didn’t like to use it
regularly, especially when she was with friends, a vanity of hers. “It’s
embarrassing to check your blood in front of people,” she said. It irked
her, this machine laying a claim on her.Diabetes, then, had worn her out. She was quite direct about that. “I
hate it,” she said. “I hate diabetes. I’m tired of checking my blood
three times a day.”…He was 50 and lived with his mother. She was 66, and after more than a
dozen years with diabetes had been hit by its full-court press. Kidney
dialysis three times a week. Open-heart surgery. Dependent on a
wheelchair. Legally blind. It was Mr. Rivera who had to inject her with
insulin twice a day. “She’s black and blue from all the needles,” he said.
Lately, she had been in the hospital more than out.Mr. Rivera, after a back injury, quit his job as a parking attendant 15
years ago. He had no income or insurance. He had not been to a doctor
in several years. Last time he saw one, he was told he had high
cholesterol and given medication. He didn’t take it. He didn’t like pills.
“That’s me,” he said.Juan Concepcion, 57, Mr. De La Vega’s stepfather, materialized. He had
been a truck mechanic, until he became disabled by rheumatoid
arthritis. In March, he spent 12 days in the hospital after nearly passing out,
and his diabetes became bleakly clear. Ten years ago, his father died
of diabetes. “He kept taking sugar,” Mr. Concepcion said. “He kept
drinking beer. He was a stubborn guy. They cut one leg at the ankle. Then
they took the other above the knee.”He stared unblinkingly into the distance. “I felt I was too strong for
it,” he said.He drew on a cigarette, ashes fluttering in the air. He knew he should
quit. Smoking is especially bad for diabetics. “I check my blood every
morning and every night,” he said. “I’m supposed to do it four times,
but sometimes my fingers hurt and I don’t do it as often.” He was trying
to lose weight. “I loved my coffee with three sugars. My Pepsi, Coke,
beer.” He was given a book about diabetes by a doctor. “But I didn’t go
deep into the book, because it makes me lose my mind,” he said. “I’m
going to do it slowly. But I know, this is a killing machine.”He shook his head. “Everywhere you go here, someone tells me they have
diabetes. I’ll go into a store and ask for coffee, no sugar. They say,
‘Oh, you have diabetes?’ “…Doctors say the will to fight the
disease is often eroded by its psychological toll.Sitting with these men and women whose lives were pervaded by diabetes,
one couldn’t escape feeling that they shared a dark cosmic joke – that
diabetes was too much to master at the individual level in a world that
had become so hospitable to it.Mr. Concepcion said: “Everything about this neighborhood, the pollution
in the air, it all makes you sick. Don’t get me wrong, we love this
place, we love Spanish Harlem. But it does stuff to us. Now it’s giving us
all diabetes.”Mr. De La Vega nodded. “We love eating trash,” he said. “We grew up
eating McDonald’s, and I still find myself eating candy and chocolate
cake.”People got huffy about their doctors. “Mine tells me, ‘Lose weight,
exercise more,’ ” Ms. Matos said. “Let him live my life and see.”Mr. Rivera said: “You know what I think? I think there’s a cure. We’re
the poor, so they don’t want to give it to us.”…Mr. Rivera bathed Mr. De La Vega with an odd look: “Did Mike have
diabetes? The guy who passed away?”Mr. De La Vega said, “Yeah, he had it.”
“He was, like, 300 pounds.”
“He would brag about eating a pint of ice cream every night.”
“He used to eat six pork chops in one sitting. Then he would drown them
down with a quart of Budweiser. What was he when he died?”“Fifty-four.”…
Bigwig pulled up a chair beneath a thicket of light. The streets were
puddled from morning rain. His real name was Luis Hernandez. His job was
route supervisor for a produce company. He was a veteran member of the
art-shop crowd, and now a new admission to its diabetic subset.His vision had been getting a little blurred – he’d look at a paper and
it was like 3-D vision; one morning he woke up and one eye wouldn’t
focus – and a physical found the source. “When they told me, it was like
somebody punched me in the gut,” he said.His diabetic mother died in 2004, at 59. She had done little to address
her condition. She continued to smoke and eat generously.He was confused. He said his doctor put him on pills and suggested
avoiding juice or sweets, but didn’t tell him much more.He weighed 252 when he got the news. He had cut it to 245. He knew it
should be lower. But he found it excruciatingly hard to adopt a new
rhythm of life, particularly since it was less appealing than the one he
had.Bigwig had to go. Maria Calderon stopped by to visit Elsie Matos. Give
her a moment. Ms. Matos was waiting on a young woman torn between two
T-shirts.Yes, Ms. Calderon had it, too. Seven years since the diagnosis. She was
69. She was 210 pounds, and had been told to lose weight. “I didn’t
think it was important,” she said….“How can you worry about your health when you don’t know where you’re
going to live next week?” …She said to Ms. Matos: “I have a friend, she’s diabetic and everything
else. She takes 52 pills a day. She has everything in the book. When
she calls, she wants to talk for 99 hours. I say: ‘My sister’s calling.
I’ve got to get off.’ “Ms. Matos said: “What, 52 pills? She’s nuts.”
On Third Avenue, around the corner from the art
shop, a banner outside McDonald’s proclaimed, “$1 Menu.” Down the way,
plastered on Burger King, “New Enormous Omelet Sandwich. It’s Huge.” At
KFC, a sign boasted, “Feed Your Family for Under $4 each.”…In East Harlem, people sometimes have to choose between getting their
diabetes medication and eating. They sometimes share their pills, cut
them in half and take half-dosages. They improvise. Everywhere blare the
signals that the best meal is the biggest meal.Nutritious food exists, but it isn’t easy to find. Dr. Carol R.
Horowitz, an assistant professor at Mount Sinai School of Medicine, heads an
East Harlem coalition trying to improve diabetes care. She oversaw a
study several years ago that tracked the availability of diet soda,
low-fat or fat-free milk, high-fiber bread, fresh fruit and fresh vegetables
in food stores in East Harlem and the Upper East Side.Stores on the Upper East Side were more than three times more likely
than those in East Harlem to stock all five items. It did not seem to
matter that East Harlem has more than twice as many food stores per capita
as its wealthier neighbor to the south….James De La Vega laughed. “We’ve got cultural differences,” he said.
“Here, for a guy to eat a salad, he’s a wimp. He’ll eat a big portion of
rice and beans and chicken. The women can’t be chumps, either. A woman
can eat a salad but has to eat it on the low. She has to do it quiet.
They make fun of you: What are you, a rabbit?”What’s wrong with an orange?
Mr. De La Vega said: “Oranges are messy. You dirty your teeth.”
Uncontrolled diabetes is a forced death march. Literature handed out in
the community underscores this.Knowledge alone, though, is never enough to change behavior,
particularly in an overwhelmed neighborhood. Chocolate cake may be a risk, but it
tastes so good on a bleak day. What stops that?Mr. De La Vega said: “People ultimately feel powerless about a lot of
things. People think about bigger things. They think about survival.
Kids grow up fighting in the streets, so you want to raise big, strong
kids. So you give them three pork chops, a nice tall glass of soda to make
them strong. You realize, some of these people go to prison, and they
have to be strong. They eat and they eat. Nobody teaches them about
diabetes.”“I have two nieces,” Ms. Matos said. “They’re 24. I call them the sumo
wrestlers. They eat everything.”…His mother said, “If you drink a diet soda and a man is watching, he’ll
say, ‘Why you drinking that?’ “Mr. De La Vega said: “Nobody here goes out and gets an apple. They get
cake. People here associate diet as unhealthy. If you’re dieting, then
you’re sick. You look at the people on the streets, they’re heavy.
That’s the way we grow up here.”Mr. De La Vega was silent, listening to the boom box. He said: “Around
here, if you make it to 40, you think, hey, I’m lucky, I made it to 40.
You have to understand, the philosophy out here is we’re going to die
from something.”…Xiomariz didn’t mind her weight. “I feel my weight makes me look like
me,” she said. “So I don’t have to look like those skinny people.”Not long after starting, in fact, she quit the gym – too much time and
too much money.She didn’t comprehend the terror of the disease. “I know you can’t pass
it like kissing someone or something,” she said.Some mornings, rushing, she neglected to take her pills. She had
stopped checking her sugar. She said she had lost the meter.Was she worried about her diabetes?
She moved her head from side to side. “Sometimes I forget I have it,”
she said. “It’s not that big a deal.”What other disease would she compare diabetes to? She thought a moment,
and found the answer. She said, “A cold.” …He was talking to Jose Castro, 52, a squat man with a grizzled face,
worlds of feeling in his eyes. “I got it, too,” he said. “Yeah, I got the
diabetes.”The diagnosis came six years ago. Was he monitoring his sugar?
“I check once a day or every two days.”
How was it?
He laughed. “Been a little high,” he said. “I started eating Frosted
Flakes. What can I say? I like them. You can’t always be eating things
without sugar. Sometimes, you have to take a chance.”…“The other day, I took my blood count and it was 40,” he added. “My son
took me to the hospital. They said I may have forgotten to take my
insulin. I don’t know. I don’t remember.”He used to keep a log of his readings, but quit. Why?
“I don’t know,” he said. “So many things you have to do. It gets
boring.”…Mr. Alicea tired, his
eyelids sailing down, and he returned to his two-room apartment across
the street. His furniture was plain. Bare bulbs protruded from the
ceiling. Mr. Alicea shared the place with his older brother, Pedro.He, too, had diabetes. His vision was poor, his circulation was not
good, he had asthma, he had a weak heart. A while ago, he had fallen and
broken his arm and hit his head, and had not been himself since. “He’s
like a baby,” Mr. Alicea said. “He’s supposed to use insulin, but he
doesn’t like the needle.”He didn’t like to prick his finger to check his sugar level, so he had
no idea what it was….When he had the amputations, Mr. Salicrup was in the hospital a month
and a half, amassing medical bills he put at more than $300,000. It was
an amount in some ways laughable to him, because he expected never to
pay it off in this lifetime, but at the same time he knew it was a
serious matter. He gave something each month, and it constricted his life,
hanging over him like a sentence. He had since acquired insurance, for
which he paid stiff premiums.“You make choices,” he said. “Instead of buying sneakers, you stay with
what you’re wearing. I’ve got to stay ahead of the blade.”…Five toes gone, Mr. Salicrup didn’t want to lose more. He did his best,
he said, to tame his illness. He never cut the toenails on his left
foot. He paid a podiatrist. He still had a hard time wrapping his mind
around that: Here he was, a grown man, paying somebody else to clip his
nails….link
Many affluent Americans will read this part of the series and aghast, raise horror-stricken palms. “How stupid!” They will say, as they go off to the pharmacy to purchase their medications with their well-stocked bank cards, on their way to the endocrinologist, no wait, it’s the dietician this week.
Intellectually, most of us know that we are all mortal, but to suggest that the immediacy, the emotional proximity of mortality is no different for rich and poor in America is to ignore reality.
Within the context of the ghetto, the barrio, the projects, death is not a thing of hushed tones and carnations, gold-edged sympathy cards and phone calls to Tele-Florist for something really nice, or when it hits closer to home, not a thing of catered wakes and readings of the will and long discussions round the big oak table in the stainless steel professional kitchen over expresso on the weighty subject of whether to sell or keep the lake house, that land down south.
Death is the special quality after the scream that follows the pop of a cap, gunfire itself is elevator music. Death is blood and brains all over the stoop, your clothes, right there. Wet and warm and nasty. Death from disease is one day you come home and there they are. And the first thing that comes to mind is not oh no granny’s gone, but how the hell are we going to pay to bury her because she cashed in that little policy she had, remember, when the rent went up the last time, isn’t there some thing at the city, some program, yeah I think so, when Sophia’s daddy died they called somewhere and they sent a truck. There are not many people in the projects who have not seen at least one somebody die before they get to high school. If they get to high school.
Death is not only something that is going to happen to you, death is something that is pretty certain to happen to you sooner rather than later. There are more aspects of life that are going to kill you than ones that are not, and within that context, diabetes care must take its place. And it’s not a very high one.
This fatalism, this meekness, is at once both infuriating and understandable. Infuriating for those who naturally, looking at history, and to an extent, even toward more contemporary events, cherish some sort of expectation that the Revolution is going to spring up from this teeming, burgeoning underclass, that at some point, somebody is going to stand up and say, “Oh no you DON’T!! I am every bit as valuable as the rich lady up on Park Avenue who gets all the test strips she needs, and who doesn’t have to split her tablets in half and share them with her sister!”
And understandable for those reality-based enough to know that anyone who did such a thing would be hauled off by “security” and most likely imprisoned, where her chances of receiving adequate care for her diabetes would hardly improve, or the chances that her cause of death would involve a bullet from the gun of the popo today would outweigh the chances that her diabetes will kill her in a year.
For those with even an inkling of awareness or familiarity with the real world effects of the feudalism, racism, the whole slimy tangle of nasty little isms that make up life in the US for the bottom 75 or so percent of its inhabitants, most of the revelations in this part of the series may cause sadness, but little surprise.
But some of what we hear from the East Harlem residents could just as easily come from the minds, if not the mouths, of people anywhere. Who among us does not know smokers, for example, whose denial and magical thinking, avoidance and resignation are every bit as evident in their behavior, if not their words, as anything told to the NYT reporter?
And is there a diabetic, or person suffering from any chronic illness, anywhere on earth, in any economic situation, who cannot relate to the desire to “have a vacation” from the disease? Even the wealthy, who can afford the best of medicine and medical treatment, cannot buy their way out of diabetes, or lupus, or heart disease, or cancer, even for a single day.
How many times have you heard someone say, “I don’t want to go to the doctor because they might tell me something is wrong?” And this is not something heard only in ghettos and barrios, but in the suburbs and the McMansions and the penthouses.
Thus while some of the East Harlemites’ attitudes and behaviors regarding their illness may have roots in the culture of poverty and despair, we also see many emotions that are quite universal, even among people with access to exemplary and state of the art medical treatment.
Which is something that the poor, whether in East Harlem or East Atlanta or East LA do not have. Even their slightly more fortunate brothers on the economic scale, those of the HMOs and group plans grudgingly “provided” by their employers fare little better, even as their co-pays and deductibles go up, their level of care does not.
In the next part of the series, we learn about why.
With much optimism, Beth Israel Medical Center in Manhattan opened its
new diabetes center in March 1999….But seven years later, even as the number of New Yorkers with Type 2
diabetes has nearly doubled, three of the four centers, including Beth
Israel’s, have closed.They did not shut down because they had failed their patients. They
closed because they had failed to make money. They were victims of the
byzantine world of American health care, in which the real profit is made
not by controlling chronic diseases like diabetes but by treating their
many complications.Insurers, for example, will often refuse to pay $150 for a diabetic to
see a podiatrist, who can help prevent foot ailments associated with
the disease. Nearly all of them, though, cover amputations, which
typically cost more than $30,000.Patients have trouble securing a reimbursement for a $75 visit to the
nutritionist who counsels them on controlling their diabetes. Insurers
do not balk, however, at paying $315 for a single session of dialysis,
which treats one of the disease’s serious complications.Not surprising, as the epidemic of Type 2 diabetes has grown, more than
100 dialysis centers have opened in the city.“It’s almost as though the system encourages people to get sick and
then people get paid to treat them,” said Dr. Matthew E. Fink, a former
president of Beth Israel….“If a hospital charges, and can get reimbursed by insurance, $50,000
for a bariatric surgery that takes just 40 minutes,” she said, “or it can
get reimbursed $20 for the same amount of time spent with a
nutritionist, where do you think priorities will be?”…One patient, Ella M. Hammond, a retired school administrator, recalled
standing up in the classroom one day in 1999.“Has anyone noticed what’s different about me?” Ms. Hammond asked.
Blank stares.
“Now, come on,” she said, ruffling the fabric of a black gabardine
pantsuit she had not worn since slimmer days, years earlier.“Don’t y’all notice 20 pounds when it goes away?” she asked…
“The center was a totally different experience,” Ms. Hammond said.
“What they did worked because they taught me how to deal with the disease,
and then they forced me to do it.”Two hours a day, twice a week for five weeks, Ms. Hammond learned how
to manage her disease. How the pancreas works to create insulin, a
hormone needed to process sugar. Why it is important to leave four hours
between meals so insulin can finish breaking down the sugar. She counted
the grams of carbohydrates in a bag of Ruffles salt and vinegar potato
chips, her favorite, and traded vegetarian recipes.After ignoring her condition for 20 years, Ms. Hammond, 63, began to
ride a bicycle twice a week and mastered a special sauce, “more garlic
than butter,” that made asparagus palatable…To fix Type 2 diabetes, experts agree, you have to fix people. Change
lifestyles. Adjust thinking. Get diabetics to give up sweets and prick
their fingers to test their blood several times a day.It is a tall order for the primary care doctors who are the sole health
care providers for 90 percent of diabetics.Too tall, many doctors say. When office visits typically last as little
as eight minutes, doctors say there is no time to retool patients so
they can adopt an entirely new approach to food and life.“Think of it this way,” said Dr. Berger. “An average person spends less
than .03 percent of their entire life meeting with a clinician…As a result, primary care doctors often have a fatalistic attitude
about controlling the disease. They monitor patients less closely than
specialists, studies show….Fewer than 40 percent of those with newly diagnosed diabetes receive
any follow-up, according to another study….This grim reality persuaded hospital officials in the 1990’s to try
something different. The new centers would provide the tricks for changing
behavior and the methods of tracking complications that were lacking
from most care.Instead of having rushed conversations with harried primary care
physicians, patients would discuss their weights and habits for months with a
team of diabetes educators, and have their conditions tracked by a
panel of endocrinologists, ophthalmologists and podiatrists….By all apparent measures, the aggressive strategy worked. Five months
into the program, more than 60 percent of the center’s patients who were
tested had their blood sugar under control. Close to half the patients
who were measured had already lost weight. Competing hospitals directed
patients to the program….Mount Sinai Hospital’s diabetes center hired an accounting firm to
calculate just how many bypass surgeries, kidney transplants and other
profitable procedures the center would have to send to the hospital to
offset the cost of keeping the center running, said Dr. Andrew Drexler, the
center’s director.Nonetheless, both of these centers closed for financial reasons within
five years of opening.In hindsight, the financial flaws were hardly mysterious, experts say.
Chronic care is simply not as profitable as acute care because
insurers, and consumers, do not want to pay as much for care that is not
urgent…Patients are also more inclined to pay high prices when severe health
consequences are imminent….Indeed, former officials of the Beth Israel center said they
anticipated that operating costs would be underwritten by the amputations and
dialysis that some of their diabetic patients would end up needing anyway,
despite the center’s best efforts. “In other words, our financial
success in part depended on our medical failure,” Ms. Slavin said…The center also lost money, its former staff members said, every time a
nurse called a patient at home to check on his diet or contacted a
physician to relate a patient’s progress. Both calls are considered
essential to getting people to change their habits. But medical professionals,
unlike lawyers and accountants, cannot bill for phone time, so more
money was lost.And the insurance reimbursement for an hourlong diabetes class did not
come close to covering the cost. Most insurers paid less than $25 for a
class, said Denise Rivera, the secretary for the center.“That wasn’t even enough to pay for what it cost to have me to do the
paperwork to get the reimbursement,” she said….keeping customers who are diabetic is not the goal of
most health insurance companies, experts said. Avoiding diabetics is
actually more the point….Some preventive measures would, at first glance, seem sure money savers
for health insurers since they might eliminate or forestall expensive
diabetes complications down the road. But many insurers do not think
that way. They figure that complications are often so far into the future,
insurance analysts say, that many people will have already switched
jobs or insurers, or have even died, by the time they hit…With the center gone, Ms. Hammond said she has had to try to muddle
through. She goes to the podiatrist once a year, but she said she could
not remember the last time she visited an eye doctor. She has gained
about 40 pounds.Some days she wakes up and her blood sugar is high. Other mornings she
doesn’t bother to check, she said.“I couldn’t get to where I was before,” she said.
Two years ago, she said, she took a last look at that favorite
gabardine pantsuit she had once modeled for her class. Then, she said, she gave
it to her cousin….
link
Of course, providing care to the “indigent,” those who have no money for either practitioners or insurance companies, is not profitable, but surely, one would suppose, those who pay insurance premiums every month will be getting their money’s worth?
Well, yes, and no. Even with a prescription drug co-pay of $20 or $30 a pop, a low income worker taking several prescription medications daily can soon exceed in those costs alone, the cost of their monthly premium for a modest HMO. It may be, they think, an excellent value. Which in a way, it is, since the alternative would be to pay their entire salary for prescriptions alone, or go without. It is, you see, necessary to adjust one’s notions of “value” when discussing anything related to health care in the US.
But that low income worker who is managing to somehow come up with the co-pays for all that medicine, and is grateful to eat a little less to do it, is getting bit in the butt again by his HMO, who will deny him preventive or early stage care, betting that he will either get by without it, change jobs, or perish, before his condition requires them to fork over big bucks. The medical treatment industry itself is hoping the opposite, that the lack of that earlier care WILL result in the big bucks treatment, since it will be they who receive those big bucks. Whether he changes jobs or not, the only way they lose is when he becomes uninsured, at which point, depending on a variety of factors, they may have to admit him, stabilize him and send him back onto the street, or in some cases, actually treat him, and pass the big bucks he is unable to pay along to someone who is.
The reporter gives eight minutes as the average visit length accorded a patient visiting his primary care physician (or increasingly, his primary care nurse practioner or physician’s assistant), however in doing my own anecdotal research I discovered that people found this figure extremely comical. “More like eight seconds,” one Blue Cross HMO patient told me when she stopped laughing. “OK,” she admitted, “it is not that bad. But it is usually under a minute, maybe a little over a minute sometimes, of the time I am actually with her.” She has learned, she says, to write down her symptoms and concerns, and read them off when the practitioner enters the room, so that she will not get distracted in detailing the first one and forget other questions.
That particular lady is quite healthy, and did not really feel her care had suffered from this “speed treatment,” since she only went to see the doctor a couple of times a year, and that for a pap test and maybe a stubborn cough or sinus infection. Her neighbor, however, an older lady with diabetes, reported a similar lightning round experience with her primary care provider, and though a member of a group health plan supposedly a step up from an HMO, reported experiences similar to those recounted by the East Harlem patients, in terms of time spent and education provided. She was diagnosed, she told me, with the 3 words, “you have diabetes,” advised to “cut down on sweets” and given prescriptions to lower blood sugar. No nutritional counselling, no endocrinologist, no classes not even a book or pamphlet!
I have also spoken to other diabetics who told me that even when they developed complications, they were not referred to specialists, but treated perfunctorily by the same physicians’ assistant/nurse practitioner model. No one I spoke to, even a couple of people who paid for doctor visits out of their own pockets, were advised to consult an opthalmologist to check for damage to their retinas! (It has since been suggested to me that perhaps some of these patients’ primary care providers did not have referral arrangements with the corresponding specialists, so since no referral fees would be involved, or loss of reciprocal ones, there was no benefit seen in making the referral).
This custom of negligence is not confined to diabetics, if my own (again, anecdotal) research is any indication. I spoke with several overweight middle aged (over 50) smokers, both male and female, whose payment status ranged from HMO to self-insured, who reported making initial as well as follow-up visits to primary physicians for everything from a “checkup” to complaints of abdominal pain and assorted routine upper respiratory and musculo-skeletal injuries, and not one was given, or even recommended, either an EKG or an X-Ray, even though their patient histories indicated they had never had one!
In fairness, the out of pocket payers in this category were visiting “urgent care clinics,” or “McDoctors.” I have been informed by a number of knowledgeable sources that had these individuals been affluent enough to pay for a consultation with a regular private practice physician, they would have been urged to have not only Chest X Rays and EKGS, but as many diagnostic tests as they were able to pay for at time of service.
As the recent Georgetown study found, uninsured individuals face more than substandard care, when they are able to obtain any at all:
A group of Georgetown medical students recently posed as either low-income, uninsured adults or as the parents of low-income uninsured children who needed a wellness exam. The students visited 311 clinics, doctors’ offices and community health centers in the District.
Nearly half of these pretend patients were unable to get an appointment; those who were able to get one usually had to wait 2 1/2 weeks to see a doctor.
Providers also asked the students for a pre-visit deposit averaging $190 — a quarter of the gross monthly income of a minimum-wage worker. Only one in 40 sites was willing to see an uninsured patient without payment at time of service, and four out of five required payment in full at the time of the visit. The students further reported that more than one in five of the personnel with whom they interacted were rude or very rude….
Next: The Deadly Melting Pot
it anyway. Reading is not so bad. In fact, some say it is fundamental.
Hey hun.
I read this article earlier in the week and thought about you. I also thought about me and stayed on the treadmill a little bit longer…Lord knows I have to get the excess weight off!!
I also thought about your entry on katiebird’s Eat 4 Today. Very well done blog, even though I didn’t have time to log in and tell you so there.
Gotta run–have an early AM flight tomorrow. Hope to be able to check in though I doubt I’ll be close enough to a computer ’til Tues.
The structures of daily life promote poor diet, lack of exercise, and medical misinformation. The healthcare structures quite vividly promote getting sicker than is necessary, for bald profit to all but the patient. We see similar processes at work in contemporary maternity care. Pregnancy and childbirth are intensely medicalized, in ways that profit doctors and hospitals but don’t improve survival rates for babies or mothers. The cesarean rate in the 1970s was about 5% — today it is pushing 30%. Insurance often won’t cover midwives or homebirth, the inexpensive but equally safe and effective model of maternity care —… Read more »
And you are absolutely on the money. The NYT series may focus on diabetes, which is an epidemic and is capable, all by itself, of bringing down the show as if there weren’t so many other contenders for that honor. But reproduction is just as epidemic, and the damage, irreparable damage, that is done to the health of these babies, let alone their mothers, is a bill that will come due just as the diabetes bill is coming due now. Those babies will grow up to be more likely to have all kinds of health problems, and those health problems,… Read more »
A demurral about pre-eclampsia, which I had a severe case of, resulting in my daughter weighing 1250g and being 10 weeks premature. I don’t think there is good evidence that nutritional approaches are effective in prevention, although some claim it. Getting pregnant after years of trying, I was near-obsessive about healthy diet and exercise during my pregnancy. And, feeling guilty that I must have done something wrong, I researched it quite a bit after my daughter was born. What I found out then was that no one knows what causes it, and there doesn’t seem to be any way to… Read more »
that experience. Two of my own friends have had pre-eclampsia and emergency cesarean births at around 30 weeks gestation. They were both dangerously hypertensive and risked kidney failure, and the disease moved with frightening speed — healthy happy pregnant ladies one week, life-and-death crisis the next. Both had cesarean births and both of their babies had extended NICU stays, of course. I’m sure this was the most traumatic and devastating experience to date in my friends’ lives. And they are among the fortunate ones, with adequate insurance and other resources, and with good results in that they both recovered and… Read more »
Thank you for your gentle concern. However, my concern is for women who may try unproven and possibly dangerous diets out of fear of suffering this very devastating condition. I went to the link you provided and see no credible evidence that this diet will prevent pre-eclampsia. The only scientific articles provided in the bibliography are from the 1930’s through the 1970’s, and most (perhaps all – it’s hard to tell, since the articles are so old that they cannont be accessed on-line) seem to be on topics other than the effectiveness of extremely high protein diets on preventing preeclampsia.… Read more »
A few years back, here in MI, the Graholm administration decided to label some medical exams as elective/cosmetic, as opposed to being medically necessary. An elective/cosmetic procedure is not covered by Medicaid. One of the procedures that was considered to not be medically necessary was a podiatrist’s/foot doctor’s exam. And, there was no exception if a person had diabetes, as you have illustrated: Begin on the sixth floor, third room from the end, swathed in fluorescence: a 60-year-old woman was having two toes sawed off. I believe, but, I am not 100% certain that this has been changed, possibly due… Read more »
dental patients, if they provide anything at all. This is particularly stupid, since a person who is missing teeth is less likely to obtain employment and thus become able to pay for dental work. Although, to be fair, their chances of getting a job that would pay for restorative dental work is pretty small, it, like all other medical treatment, is a high-profit commodity. There are, as you say, some physicians who believe in medical treatment as a human right, but the medical industry profits from the current system as richly as does its parasitic twin, the insurance cartel. And… Read more »
A civilized society cares for those who are unable to produce profit, whether that be due to childhood, age, or infirmity, physical or mental. You nailed it w/that one! And, although your diary was long (as was my post), it is definitely worth the time to read it, as you have painted a horrifying, but necessary picture of the situation(s) by your descriptions. some physicians who believe in medical treatment as a human right I have one of those physicians. Although the practice is approximately 30 miles from me, I gladly make the trip. I have been referred to… Read more »
I remember mentioning the dental problem before and how someone with either rotten teeth or missing front teeth can’t get hired..same way with Medicaid paying for eye glasses…they do but only every two years and if they somehow get broken you are shit out of luck..thus maybe also not now able to work or even drive….all kinds of things like that that most middle class people simply don’t think about when they talk about people who should just get a damn job(at Wal-mart no doubt where you still are on medicaid usually anyway)
Also, the co-pays for everything have increased. A few bucks a month sound like no big deal to the average middle class person who also has to pay increased co-pays. But, to a person w/an income at or below the federal poverty level, a few bucks a month is a hell of a lot. Especially considering the increase in everything due to the higher price of gas! (That is passed onto the consumer.)
It always amazed me what Medicare doesn’t cover(or even Medicaid)…I’ve said before I have a hereditary neuro-muscular disease. It started and is the worst in my feet and the nerve damage problems are exactly like diabetes. However Medicare will not cover anything to do with foot care for me or corrective shoes etc-it only recognizes diabetes in that respect-that’s just incredibly fucken ignorant. Medicaid covers a little more to take up the slack but not much. Add to that about 99% of the doctors I’ve seen, even neuro-muscular specialists have never even heard of HNPP-and have refused to read up… Read more »
I guess if you catch the shugga dye bead eaze at some point, they will pay for your podriatist, etc. And as the NYT article points out, your chances of catching it are pretty good. If you have Africa or America in your blood, you’re almost a shoo in!
I’m curious about these alleged doctors who have not heard of it and prefer not to read about it. To what do they attribute your documented nerve damage?
Had a doctor tell me that my traumatic brain injury (tbi) was all in my head…not the kind of thing you say to someone when they are going thru tbi rehab! I cussed him out big-time. Then the asshole told me that a tbi can caise emotional problems!!!
rrrrrrrrrrrrrrrrrrrrrrrrrr]
So believe me, ci, I sympathize!
on the human brain being located, in most cases, in or near the head area.
about brain functioning was held!
I’ve been an RN for 40 years. In that time, I’ve watched patient centered care be completely replaced by profit centered care. The outcome, for all but those rich enough to have top of the line insurance, is nothing short of societally sanctioned genocide, in my opinion. The chronically ill and/or disabled, the poor elderly, kids, the mentally ill, all the uninsured, all are being invited to sicken and die off. There is no other conclusion I can reach, based on up close, hands on participation from the inside. over my career. It would take volumes for me to tell… Read more »
and lately HIV, and of course, diabetes. Actually finding a cure would not be business friendly.
On the contrary, the strategy is to use these tools to eliminate the poor and infirm.
After all, there is a near-limitless supply of healthy labor, more than enough to meet demand.
And this way is so much subtler than rounding people up and stuffing them in trains for transport to camps.
And this way is so much subtler than rounding people up and stuffing them in trains for transport to camps.
And the mindset in this country now is the blame game–that is it’s a person’s own fault if he/she is in need of medical treatment and unable to afford it. That’s the real definition of that personal responsibility crap!
scribe!
“It would take volumes for me to tell all the stories of unnecessary suffering and deaths I’ve witnessed, all because of cost cutting measures designed to serve the corporate bottom line.”
Is there anything we can can do? This makes me sick! I don’t understand how we came to this point. I really don’t.
IMO, its all about the money involved, especially the influence of the pharmaceutical industry on policy. The increase in health care costs effect everyone, so it is difficult for a middle class family who is also freaking out over their medical bills to understand what a person on Medicaid/Medicare/or uninsured faces. The policies of the past are history and what there was of a public health care system (Medicaid/Medicare) is slowly being dissolved as a budget-balancing measure. I remember getting the runaround from social services, as I was recently sick. So I asked if it was my patriotic duty… Read more »
Katie, I think we got to this point because we live in a culture where money is God, and where making as much of it as possible, however one can, no matter who is harmed in the process, is the accepted “norm”. Capitalism has run amuck and is showing it’s ungliest underside. We’re at this point because of greed and corruption and politicians who have sold out our government to special interests. And because way too many of us have become used to our luxuries and aren’t about to stop supporting the systems that provide them. Because it’s always the… Read more »
It’s only going to get worse
Exactly what my caseworker said when I asked her a few questions re: the status of social services in the future. IMO, the pharmaceutical industry is to blame for this situation. Yes, I have a doctor who believes that health care is a right, not a privelege. And the colleagues of my doctor who I have been referred to share my doctor’s beliefs and values. And the horror stories that I have read about and heard of are terrifying.
Damn it, there are people dying out here and its like no one cares!!!!
ulcer cocktail?
I recieved it by coincidence. It saved my life.
Nurses I know say it’s been suppressed and replaced with Tagamet® et. al.
The discoverer finally got his Nobel Prize just last year.
What can be counted on in this fact : no drug, no vaccine, no medical tretment at all, no matter how effective it is, or how desperately needed it is, will ever be easily avaialble to all who need it, UNLESS it turns enough of a profit for the it’s maker.
That’s just how profit based free market healthcare works.
And that sums up what’s really wrong with our healthcare system right there. The insurance companies don’t want to PAY for the more expensive, specialized drugs or treatments — they want cheap, generic medication and one-size-fits-all low-cost solutions. But the pharmaceutical industry in particular wants profits, and that means expensive, specialized medications with high profit margins — not cheap, generic or lowcost anything. And patients (and doctors) are caught in the middle, and both are deluged with advertising from pharma companies pushing specific products. (I really wish consumer drug advertising was still illegal… or that companies were required to match… Read more »
(But the pharmaceutical industry in particular wants profits, and that means expensive, specialized medications with high profit margins — not cheap, generic or lowcost anything.) I think they make plenty of profit on “regular drugs” by increasing the volume of sales to a captive consumer base. It is common for people in long term care settings to be on 15 or 20 different medications at the same time: a good number of them being necessary to treat the side effects of the other half. Most of these folks hardly ever see a doc except in emergencies. Drugs are usually the… Read more »
In my instance, generic rx’s (anti-convulsants) don’t control my seizures–in addition to being a traumatic brain injury survivor, I also have had epilepsy since age 9. So my rx’s must be written and filled DAW (dispense as written). According to my doctor and pharmacists, that is not uncommon. The active ingredients in generic rx’s are the same, but the inert ingredients differ. Also, there are many rx’s where there is NO generic substitute, and, some rx’s warn of complications if abruptly changed. My pharmacist was carrying on awhile back about the changes that have been made re: funding… Read more »
Not suppressed, although it was very difficult to convince most gastroenterologists that ulcers are a bacterial (H. pylori) disease and can be cured fairly quickly with antibiotics. For one thing, it just seemed so damned implausible that bacteria could survive in gastric juice, which has a pH of 1-2 (seriously acidic – kills almost all other bacteria). And they did have a real financial motivation to keep treating ulcers as a chronic disease (patient is a long-term income source), rather than a curable one (cured and then no more office visits, etc). Tagamet and such are for acid reflux –… Read more »
Whoever at the NYT wrote this article certainly did so in a way as to not vilify poor people or write in a condescending way-very very good article in that respect. The problem with diabetes and it’s ever growing epidemic proportions is endemic to the whole health care(hahahahaha)system in general. Little or no care and expecting people to somehow become super geniuses regarding how to manage their own health care when they are many times as the article implied just trying to live day to day. What hasn’t been mentioned so far exactly is that the sugar lobbyists are some… Read more »
That goes for health care in general, just navigating through all of the rules/regulations of any insurance policy, let alone the changes in Medicaid/Medicare D that now covers rx’s. To do so, a person has to know almost as much as a doctor/pharmacist/medical biller to determine what plan is the right one for him/her. God knows how I did it. And God help anyone who is still trying to decipher it, as the Medicare D was made to be so complex, it is virtually impossible for the average person to understand. If a person has any questions, he/she is… Read more »
no kidding…another supposedly helpful tip by that asshole little Scotty’s big brother McClellan in charge of that whole new drug plan was to tell seniors if they have questions to make an appointment with their doctor and that doctor will go over what is the best plan for them..believe I was turning the air blue and wanted to throw things at the tv when he spouted that shit…yeah some doctor(who knows less and cares less I’m sure about all those plans)is going to spend several hours each with all his patients who are seniors..and as mentioned above if we get… Read more »
another supposedly helpful tip by that asshole little Scotty’s big brother McClellan in charge of that whole new drug plan was to tell seniors if they have questions to make an appointment with their doctor and that doctor will go over what is the best plan for them On the advice of the medical assistant at my doctor’s office, I asked my pharmacists. The reasoning was that as the pharmacy was responsible for the billing, they would know more about the specifics of the plans than the doctor’s office would! Received a booklet re: the plans that said absolutely nothing… Read more »
I live in a large senior apartment complex and spent a whole afternoon this week attending Senior Federation sponsored session on part D. A volunteer outfit called ‘Medicare Matters” had set up seven computers to help people investigate the drug plans.
The only way to know what drugs each plan covers is online or phone. and phone calls aren’t working well. The fact is..nationally only 12 % of senious have computer acesss/skills. But it’s all an exercise in futility anyway, because the plans can change thier list of covered drugs at will, with a 60 day notice.
This was written earlier (November). It contains a listing of rx’s that, at the time that I wrote it, were not covered under Medicare D. It is my understanding that some of this has changed, although I do not know all of the details–I am saying that because I have received refills on my rx’s yesterday. I have absolutely NO idea on how others would be affected by this information or how changes that may have been implemented. Now, I am beginning to wonder if this may have been a part of a “divide-and-conquer” game that bushco and the repubs… Read more »
Obviously I am in favor of old people learning to enjoy the internet. 🙂 However, I know many old people who do not, they do not use computers at all, they have no interest in it, and they will not. Now I am tempted to digress into a rant about the myth that after the passage of a certain number of years, human beings simply cannot do this or that, because it is just a myth, but the point is, as long as there are telephones, as long as there are printing presses, and as long as people who are… Read more »
In this whole fucked up piece of crap drug plan this is one of the most insidiously evil…of course all these insurance plans have several options and for more money you can-if of course you can afford it-pay for coverage that will cover this stupid ‘donut hole’ shit.
And like you duct, I’m wondering just what is going to happen when so many hit that ‘donut hole’…god what a stupid name even…
larger problem. songbh already mentioned the pre-natal/maternal/neonatal aspect, and Janet and Gooserock have told us about gastric ulcer disease, but the bottom line is that medical treatment as a commercial product kills people.
And you are right about the sugar industry, and I wish somebody would do a diary on that. Maybe you?
Make it a real long one. You don’t want to just sit idly by and let me hold the record for the longest BooMan diary, now do you? 😉
Thank you, Ductape. Very important diary… and frightening. That is the state of our healthcare system — it’s all focused on profit, no matter at whose expense that profit is made. And if there isn’t profit — or enough profit to interest the big corporate machine — then there is no incentive to provide care. It’s scary and it’s overwhelming. But I need to be scared — otherwise it’s hard to get up the gumption to tackle the morass of the system, to get what I can out of it (and I have insurance). Eight minutes is about right, so… Read more »
We farm grains, starches etc. not because they’re best for us, but easiest. Europeans and some others got lazy and successful early, therefore we’ve been poisoning our own people longer and have therefore adapted farther towards refined carbos, milk and alcohol than other populations–especially natives in many lands who only learned of our so-called diet recently. Then there’s the extra special problem of our discovery that distinctly-colored people were profitable as slaves. So we put masses of them onto a caloric starvation doglike diet for 2-10 generations before returning to Personhood, and now we sell them high energy, high appetite… Read more »
But “War and Peace” wasn’t all that bad, either.
Thanks for posting this…even though it is long!
The second part is one of the best descriptions I’ve ever seen of the cultural barriers facing many people who are trying to getting the diabetes under control. (I’m going to send a link to the original to some of my colleagues so they can read it too.)
Re those cultural barriers, the closing of the diabetes centers are a crime all unto itself. They worked, precisely because they overcame those cultural barriers, by combining medical treatment with plain old fashioned education and peer group support, but I think the real secret ingredient was the idea that somebody gave a damn. Today, there are diabetes education centers associated with many, if not most, large hospitals, but they are even mentioned only to patients with the “high end” insurance programs, as the others simply will not pay for them, for business reasoned outlined in the third part of the… Read more »
I did my clinical rotations in an inner city hospital…I could tell you stories about the “low end” of the insurance spectrum that would make your hair curl. Part of the problem, IMO, is that the insurance companies increase their profits by not treating/preventing diseases, while the society winds up footing the bill for the lack of preventive care/treatment in terms of paying for more people on SSI/disaility. One of the benefits of nationalized care would be that the same entity who has to pay for preventive care (ie, the government) would also be the one to reap the… Read more »
summary of health care recent diaries on dkos and mlw
Included excerpts from this one! Really feel this has to be brought out into the open!
Somehow not on dkos, computer screw up I guess. but it is on mlw.
I don’t go to kos anymore, or post there.
What is MLW?
Clarification: I posted excerpts of a few diaries that I saw on dkos re: Medicare fuck-ups–same diary that I posted here at Booman Tribune, (actually a x-posting) included some from this one (linked to it) some of the comments. I had an idea in my head that just HAD to be written–know what I mean?
mlw=My Left Wing, Mary Scott O’Connor’s blog
link
(I sometimes go to dkos, more to find out if I missed anything elsewhere.)
wanting them poor, hungry and hurtin’…
Diabetes, asthma, autism (which is reaching epidemic numbers now)
Asthma and autism I think one day they’ll find those were poisoning the population productions.
We are seeing more and more illnesses and allergies mostly due to toxins and poisoning our planet and les and less people able to treat themselves for those afflictions.
Mission Accomplished.
but it’s not just the poor -it’s middle America. My son’s story from Dec 2004. My son almost died due to this. There are two errors in the story. 1. it took 3 months not one and we were LUCKY. The initial appt wasn’t for May 18th of the following year! Can you imagine anyone waiting to have their teeth cleaned that long?? Let alone waiting with two root canals and 4 impacted teeth? 2. There is only ONE hospital now in Northern California willing to provide anesthesia to the neurologically disabled. This doesn’t just mean Downs or Autism..… Read more »
for months, in which it is lauded and heralded as a heroic wonderful thing if the child’s mandatory agony time can be cut to one month, is not functional, and is indicative of a failed state.
If this society happens to be in the richest country in the world, it can no longer be called a society.
Janet, I am sorry for his suffering, and very glad he finally got the treatment he needed. This is just not something that needs to be that difficult.
We have the means – it’s the will that is truly lacking. Let me tell you – I took alot of ventage out on Patty Berg a local politician who promised universal health care and then started touting “death with dignity” which is fine… but I started hounding her beacuse in the poor area of Lake and Mendocino counties… I was demanding “health care with dignity FIRST”. I hounded her in writing, in calls and even got her on KQED radio. If HER health care is good enough for her and her kids… than it should be good enough for… Read more »
we were getting passports crap worked out so that I could take him out of the country and try and get him some relief.
We learned that many of our military familes go to MEXICO for dental needs on their disabled children.
God bless America?? Fuck that and their rockets red glare. We need health care not bombs.
I had Governor Schwarzeneggar’s office sent papers of me charging him and his staff with child neglect.
It is sick that a child had to wait 3 months and that there was some last resort help is scene is “heroic”.
Wanna hear about all the mid teen Down’s girls that are held down by force and sometimes bounded and gagged…. why?… it’s “easier” and “more cost effective”a way of giving them a pap smear and gyn visit…
:*(
this is all happening in American in the year 2005. It’s sick!