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Courage: The Life and Pain of Carmella

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This is the face of my mother. Please look closely at her face. She is a perfect example of what the present medical and insurance systems can do to you when given the chance. I have many pictures of her, much nicer pictures. These are the pictures you need to look at right now.

mom in hospital head shotCarmella De'Angelo was born in the year 1919 in White Plains, New York, and was not expected to live. She was a sickly baby and had more medical issues than any child deserved. She was petite, frail, and had a calcium deficiency.

She also contracted scarlet fever when she was seven years old. This illness caused a heart murmur. Her mother would force her to drink castor oil by the gallon and even that could not strengthen her brittle bones. Everything about her life cried out for help. Still she forged on and ahead because Carmella was not a quitter.

How my mother survived the medical community's efforts to save her is beyond my understanding. She had to have a total hysterectomy in her early teens in order to save her life; consequently my brother and I are her adopted children and we are both proud to call her mom. She forged on, trying her best to fit into this life given to her by God.

mom aloneShe was a devout Catholic girl who attended Mass almost daily, and she must have related to the old Italian widows in church all dressed in black better than the kids her own age the way the other children teased her. She wore her bowlegs and crossed eyes like badges of courage; children can be so cruel.

One of the largest failings we have as human beings today is the way we judge each other based on how we appear rather than what is in our spirits. If only we could all open our inner eye – what a world this would be!

She met and fell in love with a neighborhood boy when she was fifteen years old. Nicholas Moon was a special man indeed because he could see her inner beauty, and she blossomed to the point that the family noticed her. Many pictures of her were taken after meeting Nick, and they married in 1941.

She followed her husband to the state of Washington in 1946. Here she worked for the War Department as a canvas repair specialist until Sgt. Moon's return to civilian life in 1947. Once home they opened a small Mom & Pop grocery store in the poorer section of our town in 1948. They named their little store the B&E, which stood for "Buy and Eat." The name came to my Dad as they stood in an office at City Hall applying for a business license to operate the store.

They owned and operated the B&E for a total of 34 years. For eleven of those years, Mom ran the store primarily by herself after Dad died in 1970. Carmella worked twelve-hour days, six days a week, and half a day on Sunday, whether she felt good or not. She had a family to support. Her heart had started to give out under the enormous pressure, and her doctor assured her they could operate on her.

She went into Hamot Medical Center in Erie, Pennsylvania. A team of expert doctors and trained nurses set out to rebuild her. There in the operating room they gave her a new mitral heart valve made of space age plastic. The doctors told her it would still be in one piece long after she was little more than ash and bones.

This little thing inside of her heart could now open and close like a butterfly valve, carrying fresh oxygenated blood to her vital organs. It was a major medical miracle. Carmella would live another day to fight the world around her. The little valve used to keep her awake at night when the house was quiet and she lay in her bed alone. I listened to it quit a few times myself as I pressed my ear against her tiny chest. Tick Tick Tick. Oh, how I wish I could hear it one more time.

She lived for another 22 years taking the drug Coumadin to keep her blood thin enough so it would not clog her artificial valve. She broke countless bones in her body just going through the normal motions of life. Once, while walking on the icy sidewalk next to her front door, she slipped and broke her leg in three pieces, laying her up for a year and a half.

My brother Fred quit college to come home and work at the grocery store because someone had to do it! Mom went to a chiropractor once to relieve herself of the blinding migraine headaches she had suffered silently with for years, never complaining about them. The chiropractor broke three of her ribs that day in his office.

Carmella Moon went home without saying a word to him about what he had done, and there in her bedroom alone, she pulled out the ace bandages she kept in her vanity drawer and wrapped herself up until she could make it into her regular doctor's office to be treated. One morning while in a hurry to get to work, she tripped in the tiny bathroom of her second story apartment on a gold metal wire magazine rack. She lay halfway between the bathroom and the hall with a broken jaw and bleeding profusely from the compound fracture in her face until, miracle of miracles, my cousins Ralph and Georgiann found her.

Now she drank a liquid diet through a straw. She claimed it was the best diet she had ever gone on. Carmella could always see the bright side of the cross she bore. We tried one of these dinners with her one night. My brother and I sat at the dining room table trying to eat the pureed dinner of roast beef, green beans, and potatoes with Parmesan cheese. Every dish in our house had Parmesan cheese in it somewhere.

"This is awful," my brother exclaimed as he rolled his eyes and tried not to look at it. "This is a family meal," my mother quipped back from her seat at the head of the table. "Ya," Fred said, "the family with lockjaw!" Oh how we laughed! "Stop, you’re hurting my jaw!" the little woman who sat across the table from me exclaimed. I'll never forget that moment as long as I live. It crossed my mind then, how lucky we were to have a woman like Carmella Moon to call Mom.

The days melted into weeks, then months and years. At the ripe age of 80 my mother needed another heart operation to continue her life. Instead of letting her slow down naturally and accept the inevitable, her doctor advised her that they could operate once more. Since she had such a fine, self-funded insurance policy, the company's name will not be mentioned here. We all said with her, "Why not?" What transpired over the course of the next year will be forever branded on my mind and heart.

The irresponsibility and blind greed of the present medical system in this country make me sick. How they could take an 80-year-old woman in my mother's condition and operate for profit is beyond me. In my opinion, which I will express to my last dying breath, I say to you, "They knew in their heart of hearts that this operation was too much for her!"

Instead of doing the right thing, which would have been to educate us about the true risk involved, the medical team forged ahead along with the insurance company, drawing up lengthy and complicated disclaimers and medical malpractice forms for Carmella to sign if she wished to continue living!

We couldn't wake her up, and she wasn't dead either. There in the intensive care unit she languished while my brother, my husband, and the rest of our family stood watching in explicit agony as the medical machine groaned into motion. Her lungs had failed, so here was the respirator hissing and spitting it's rhythmic cadence of artificial life, forcing air into her small, fragile lungs through the plastic tube shoved down her throat.

Soon they would give her a tracheotomy so the hose of the respirator could be attached there instead. This would be more "comfortable." Her little kidneys had gone into renal failure, so here was the dialysis machine sucking all the blood from her small veins and forcing it back through a shunt they had implanted permanently in her arm’s artery after it had made its way through the machine plugged into the wall outlet. Still we could not wake her up, but she was still there.

Whenever my brother or I spoke to her she made the tiniest movement. A microscopic nod detected only by my brother and me. The medical staff thought we were nuts because whenever there was one of the many doctors, nurses, or technicians in the room, nothing could be detected from the tiny form lying in the bed surrounded by machines and sterile linens.

They wanted us to pull the plug now. "Mom can you hear us?" Fred whispered in his mother’s ear. His eyes were becoming darker now and the stress lines made his whole face and forehead look taut and stretched. He blamed himself for her predicament. If only it would become more than a passing thought. If only it would become his cross to bear. So we said no to unplugging Mom from the wall outlet. We just couldn't let go. Then one morning she woke up!

The day Carmela Moon woke up everyone working in the hospital knew a real miracle had now taken place at Hamot Medical Center. One by one they walked past the room peering in to look at the little Italian lady sitting in a chair, out of bed, with the respirator pumping on behind her back, and what was she doing? She was playing cards with her family!

The little woman who woke up was childlike and innocent and I don't think she had a sin left in her soul. She was washed clean and pure in my mind’s eye. I thank God for the time I had with my Mom after that. Day after day and night after night I sat, and slept, in a chair next to her bed. I was her "watchdog," and what little sense of normality that could be carved out of this new medical existence would be watched by me, her witness.

We spent a whole year in that part of the hospital. She couldn't go home until she was off the respirator. Trying over and over again she failed. Then one day that prayer was also answered and she was free of the machine. Now the trachea and the dialysis remained. Soon her kidneys returned and voila! She was off dialysis and the permanent shunt in her arm was removed. Now Carmella could finally go to medical rehab, and we left the hospital to go across the street to Health South.

Once there it started all over again – the medical machine: new nurses, new aides, new therapists, new everything. Carmella wanted to go home and we wanted to take her there, but we could not afford the private home care necessary to facilitate such a move. Then our insurance carrier forced a move back to New York to an inferior and less expensive rehabilitation facility.

Every decision made in for-profit health care is wrapped up and shrouded by one thing and one thing alone: how much will it cost them? My mother's health had come so close to allowing her to return home one more time to the life she so desperately wanted to live. Her life was sold short by an insurance company and by money-grubbing little accountants sitting in offices somewhere holding the power of life and death over Carmella Moon's head. They are blind to the outcome of their decisions to this day.

Carmela Moon died of pneumonia in our local hospital just two weeks after being moved to a facility that was ill-equipped for her complicated medical condition. Oh yes, they tried, but trying was not enough for my Mom, and she was so tired and we were so tired along with her. The medical machine that had swallowed her up had finally spit her out.

My mother whispers in my ear as I sit here, fretting over my grammar and sentence structure, trying to tell you this story: "Jeannie, Please don't let this happen to anyone else."

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About Jeannie Danna

  • SD

    Jeannie…this is a wonderful accounting and such a great credit to your mom. Kudos to you! I understand how difficult this must have been to write becase it is so heartbreaking to read. Keep on writing you are doing a fabulous job!!

  • Cousin Fred

    Well done. Well done indeed. I live parts of this daily in my life as a insurance agent for seniors. I am trying to stop this from happening to others as I stand in the gap and touch as many lives as I can from my perch.

  • klondikekitty

    God will bless you, Jeannie, for telling your mother’s painful story to the world . . . please, everyone who reads this, find a copy of the documentary film, “Sicko,” produced and directed by Michael Moore, and watch it. DO EVERYTHING YOU CAN to support national health care for every man, woman and child in the United States, and break the stranglehold the insurance and pharmaceutical companies have around our nation’s very throat!!! Call your legislators, send emails to them, make them understand how VITAL this is to the entire structure of our country . . . please, do it for your children . . .

  • Jordan Richardson

    Another winner, Jeannie. Well done.

    Health care in America is a moral issue and, while callous some right-wingers may be apt to discard this tale and the countless others like it as “sob stories,” these are the stories and tales that make us human. They are SO important.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    I can’t even believe that my name is attached to this website, I feel so undeserving of all this praise. You see, I don’t think it’s me! I am compelled to write..
    I want to say thank you to everyone who ever reads my writing.
    I forgot to add one very important line to my Mom’s story!
    Please call your Senators, insist that they PASS HR 676 Single-Payer-Health-Care!!!!

  • http://twitter.com/tolstoyscat Cindy

    Jeannie,

    “One of the largest failings we have as human beings today is the way we judge each other based on how we appear rather than what is in our spirits. If only we could all open our inner eye – what a world this would be!”

    I wanted to ‘retweet’ you, as you would say. :-)

    In your piece there is a very important comment on the kind of society Capitalism creates and requires. Humanity is lost from consideration, where profit reigns. The hopes and needs of real human beings, like your mom’s wish to go home are made invisible and out of the realm of concern.

    And yet we all have moms and most of us, like you, would be right there fighting for that wish to be heard and to count above all other considerations. Because no matter what money (some thing we invented and worship) changes hands–one can never get back life. Sadly, we could watch a movie, or read a story about a situation such as the one in which your mom found herself, and it could move us to tears, but I don’t know why it doesn’t move us to action, to change ourselves.

    I watched a movie last night called Nights in Rodanthe. Not a very good movie, but there was one part about it that was very worthwhile and relevant to your article. It was a scene in which a doctor is able to move past his defenses and see the woman who died on his operating table as a real human being through the eyes of her husband.

    I like to look at things in terms of how they can change the world. For me, one of the most fundamental changes needed is the reclaiming of our human empathy. We need to put the hopes and wishes of real lives first. It’s what makes us human after all.

    This is an inspiring article for seeing that. Thanks for writing it.

  • Bliffle

    Excellent article! Well written and very moving.

  • Clavos

    Jeannie,

    Once again, you write evocatively and with great warmth and feeling. This article particularly struck me because my wife is a paraplegic with severe chronic pain issues who spends nearly as much time in the hospital (she’s in one now), as she does at home.

    That said, I do think, however that you contradict yourself in this piece.

    You say, on page 3, “At the ripe age of 80 my mother needed another heart operation to continue her life. Instead of slowing down naturally and accepting the inevitable, her doctor advised her that they could operate once more. Since she had such a fine, self-funded insurance policy, the company’s name will not be mentioned here. We all said with her “Why not?”

    “…The irresponsibility and blind greed of the present medical system in this country makes me sick. How they could take an eighty-year-old woman in my mother’s condition and operate for profit is beyond me. In my opinion, which I will express to my last dying breath, I say to you, “They knew in their heart of hearts that this operation was too much for her!”

    Instead of doing the right thing, which would have been to educate us of the true risk involved, the medical team forged ahead along with the insurance company, drawing up lengthy and complicated disclaimers and medical malpractice forms for Carmela to sign if she wished to continue living!”

    Yet, a bit further on, you tell us,

    “They wanted us to pull the plug now. “Mom can you hear us?” Fred whispered in his mother’s ear. His eyes were becoming darker now and the stress lines made his whole face and forehead look naught and stretched. He blamed himself for her predicament. If only it would become more than a passing thought. If only it would become his cross to bear. So we said no to unplugging Mom from the wall outlet. We just couldn’t let go. Then one morning she woke up!”

    And,

    “I thank God for the time I had with my Mom after that. Day after day and night after night I slept in a chair next to her bed…”

    Please understand. I’m not picking on you. On the contrary, having lived through four years (so far) of similar experiences, I understand all too well what you faced.

    There is much that is wrong with our present medical system, but as you point out, you did get another year with your mother, for which you are, naturally enough, grateful.

    We do already have a government-run single payer health insurance system in place. It pays most of my wife’s bills, which are substantial, but it also refuses, on the basis of “cost effectiveness,” treatments and/or tests and procedures recommended by her physicians. Faced with the choice of her receiving a surfeit of medical treatment as opposed to a scarcity, I, like you, would be grateful for the extra time with her provided by the surfeit.

    Under a government-run, single payer system you would not have had the year with your mom.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Clavos,
    I must disagree with you on one point here if I may. It is the private insurance industry that we are fighting in many Long-Term care decisions. You just said yourself that Your doctor’s hands are tied when they are the ones that know what treatments and tests your wife should have, not an insurance agency that looks only at the “cost effectiveness.” I am so sorry to hear of your wife’s medical condition and I hope you can override that insurance company altogether.
    I have VA medical care and I refuse to be signed on to my husband(Rick’s) plan at work. I believe contrary to some,I read your article, that the VA is an excellent model that the States could adopt so that we all could have coverage. Have you ever watched the documentary “Sicko” by Michael Moore? It is mentioned here by klondikekitty and after the film was over Rick and I were ready to move to Canada! with Jordan :)just kidding, we didn’t know Jordan yet!
    Fred(my brother) and I could not let Mom go because we sensed she was still in there! The hospital wanted to unplug her because they realized if she survived she would be in long term care. They had already made the bulk of their money from her initial operation and anything extra was going to cancel out their profit! Hence the words FOR-PROFIT-HEALTH-CARE
    One of my many attempts to work in this world led me to a company called “Combined Insurance”; it was an indemnity company so they were money for the patient not the physicians or hospital, but insurance is always a gamble and the whole idea is to take in more than you give out.
    I feel a blog coming on Clavos! But I have to get off this computer for awhile! I am honored that you came over to debate with me. :) I won!

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Thank you Bliffle! If my mom could only see us now!

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    CINDY,
    I retweet you very much for your words to me! :)

  • http://www.republicofdave.com Dave Nalle

    It’s a touching article, but it is indistinguishable from stories you can hear in any nation in the world. It’s just that in the other nations the author would be pointing the finger at government bureaucrats who had budgets to meet and disallowed necessary care because it wasn’t on the approve list or delayed care of the maltreated loved one.

    The truth is that a for-profit bureaucracy is no worse than a government bureaucracy, and it is at least responsive to consumer pressure and the need to maintain a positive public image. Plus a private company can be sued and in most cases the government healthcare managers will be immune from prosecution.

    Dave

  • Jordan Richardson

    The truth is that a for-profit bureaucracy is no worse than a government bureaucracy, and it is at least responsive to consumer pressure and the need to maintain a positive public image.

    Really? Governments don’t need to maintain positive public image? Gosh, Dave, how else do you propose they get elected?

    The government-run health care system here in Canada is responsible to those who fund it through their tax dollars: the public.

    Plus a private company can be sued and in most cases the government healthcare managers will be immune from prosecution.

    Yes, and when private companies are sued, what happens to the insurance rates?

    Also, what exactly is a government healthcare manager? Do you really think we get these individualized caseworkers that sit there and deliver and deny care up here under our system? Nope. We get our money that we’ve paid into the health care system. Simple as that. Our taxes get reimbursed to us through services we actually need and use. Your taxes, on the other hand, head over to Iraq for war purposes or to arm Israel or some other such junk.

    We’re not all suffering and dying up here because we have government supported public-funded health care, Dave. And we’re not all running down to America every chance we get. Some people do in order to receive non-essential care sooner and our system is not perfect, but I don’t know any Canadian who would trade it in for your system.

    Perhaps we’ve all been brainwashed by the CBC…

  • Jordan Richardson

    Also, we all have access to private care, private doctors, and private clinics anyways. Our system is public/government-run in funding only. Private physicians are essentially private corporations and thereby accountable to all forms of legal accountability.

    The only problem is that these private clinics and systems face less regulation than the public health care system and, as such, are not subject to a public standard of care. This can lead to many care discrepancies.

    Americans can have the same system with ease, but the myths about publicly-funded health care need to be defeated. Lots of people still don’t recognize that a hybrid system like ours in Canada is possible and largely preferential in that it provides an equal standard of care for all and still enables those with more money to receive private care and see private doctors. The states can be responsible for care, like our provinces are, and there can be assurance of access to general universal health care for all citizens. It’s not hard and Americans won’t slide into communism because of it. It would also be cheaper than the current system, which tops the developed world in amount spent per person and nearly doubles Canada’s per-person spending but still doesn’t offer every citizen basic care.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Dave, LOOK [Instead of doing the right thing, which would have been to educate us of the true risk involved, the medical team forged ahead along with the insurance company, drawing up lengthy and complicated disclaimers and medical malpractice forms for Carmela to sign if she wished to continue living!] You said private insurers could be sued? This not the case and also…

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Dave READ @ what Jordan wrote![what exactly is a government healthcare manager? Do you really think we get these individualized caseworkers that sit there and deliver and deny care up here under our system? Nope. We get our money that we’ve paid into the health care system. Simple as that. Our taxes get reimbursed to us through services we actually need and use. Your taxes, on the other hand, head over to Iraq for war purposes or to arm Israel or some other such junk.

    We’re not all suffering and dying up here because we have government supported public-funded health care, Dave. And we’re not all running down to America every chance we get. Some people do in order to receive non-essential care sooner and our system is not perfect, but I don’t know any Canadian who would trade it in for your system.]
    Now Dave, in-order for the above plan to work.
    We would all have to PAY OUR TAXES! Even the wealthy corporations would need to pay instead of running off-shore to the Cayman Islands and setting up phony companies while at the same time having their hands out to take OUR TARP MONEY and any other CORPORATE WELFARE they can get their hands on!
    Leona Helmsley was right when she proclaimed “Only the little people pay taxes” …

  • http://www.republicofdave.com Dave Nalle

    Really? Governments don’t need to maintain positive public image? Gosh, Dave, how else do you propose they get elected?

    So Jordan, when was the last time you got to vote for a Bureaucrat? They do that in Canada, do they?

    The government-run health care system here in Canada is responsible to those who fund it through their tax dollars: the public.

    And they take care of them by sending them over the border for service in huge numbers, either by denying services or long waits, or by actually putting them in an ambulance and driving them to the US.
    Yes, and when private companies are sued, what happens to the insurance rates?

    They go up, but it’s spread among millions of people and the impact is minimized.

    Also, what exactly is a government healthcare manager?

    The bureaucrat who writes up the list of what the government will cover and will not cover, who gets to live and who gets to die.

    Do you really think we get these individualized caseworkers that sit there and deliver and deny care up here under our system?

    If they were individualized it might be better. But they write rules and protocols and draw lines between those who get to live and die.

    Nope. We get our money that we’ve paid into the health care system. Simple as that.?

    So do they hand it to you in cash or as a check?

    Our taxes get reimbursed to us through services we actually need and use. Your taxes, on the other hand, head over to Iraq for war purposes or to arm Israel or some other such junk.

    Which is regrettable, but entirely irrelevant.

    We’re not all suffering and dying up here because we have government supported public-funded health care, Dave. And we’re not all running down to America every chance we get. Some people do in order to receive non-essential care sooner and our system is not perfect, but I don’t know any Canadian who would trade it in for your system.

    So explain to me why ambulances cross the bridge to the US with emergency patients from Windsor and other border cities on a daily basis?

    Dave

  • Jordan Richardson

    And they take care of them by sending them over the border for service in huge numbers

    Define “huge numbers,” Dave.

    They go up, but it’s spread among millions of people and the impact is minimized.

    Putting actual insurance all the further out of reach for those who can’t afford it.

    The bureaucrat who writes up the list of what the government will cover and will not cover, who gets to live and who gets to die.

    Name one. Name the position. Give me something tangible. What is the title of the bureaucrat(s) who does this?

    But they write rules and protocols and draw lines between those who get to live and die.

    Like what? Name a “rule” that has been written in public-funded single-payer system that “draws lines between those who get to love and die.” For the love of Christ, Dave, America’s not the only country in the world that somehow has it right when it comes to healthcare.

    So do they hand it to you in cash or as a check?

    Nice deflection, chief. They “hand it to you” in providing for your healthcare needs, something the American government consistently decides not to do.

    Which is regrettable, but entirely irrelevant.

    On the basis that this discussion is about public (read: tax) funded, government supported health care, I fail to see how this is “entirely irrelevant.” This is, instead, entirely relevant and speaks to the priorities in how our respective tax dollars are spent.

    So explain to me why ambulances cross the bridge to the US with emergency patients from Windsor and other border cities on a daily basis?

    I don’t know, but I would like to see some sort of substantiation to this statement. Why do Americans come to Canada for the health care? I don’t know that either. Our system is not perfect.

    When people get turned away from hospitals, it isn’t because the government refuses to cover their care. It’s because the hospitals are overcrowded and some regions have staff shortages. The solution for this is not to regress to an American-style system, but rather to improve funding and open the borders for more doctors and nurses who want to come to Canada. Some provincial governments are already meeting this problem and offering incentives to those who want to become doctors or nurses.

    Why do people get turned away from hospitals in America? Why are they saddled with enormous bills for the simple accident of suffering from disease or injury? Why do people have to sell their homes in order to pay their medical bills?

  • Jordan Richardson

    LOL @ myself. “Those who get to love and die” should be “Those who get to live and die,” although Dave probably thinks our government also decides that.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Your wrong Dave. Canadian citizens enjoy very good health care. They do not cross the border in droves! What fantasy are you trying to weave here?
    Perhaps you should try watching that LEFT wing documentary film by Michael Moore it’s called “sicko” :)
    I would like to read one of your articles Dave. I am going to find one right now so I can understand where you are coming from. My brother is a staunch conservative and we get along. Perhaps you and I could find some common ground.m Ya think?

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    I’ll probably be back shortly… :)wink

  • Jordan Richardson

    A few more questions, just cuz:

    Why are uninsured Americans SOL when it comes to seeking emergency care? Why do so many of them simply not go to an emergency room when they have an accident at work or at home?

    Why do so many Americans neglect preventive care and, because of this neglect, why are so many of them likely to experience more serious medical conditions that effectively cost the system more than treating the same condition in its earlier stages?

    Why did the American Cancer Society release a study that demonstrated that countless uninsured Americans wind up being diagnosed with late-stage cancer in comparison to those blessed with larger incomes and insurance that are able to catch it earlier? Again, this puts a strain on the system and makes the eventual treatment much more expensive.

    Why is it okay that the insured health care customers must pay more insurance because the cost of those with a lack of insurance keeps driving the prices up? (Careful with that link, btw, it’s 14 pages).

    Why does 31%, at least, of the American health care dollar go to administrative costs and overhead? What’s efficient about that?

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    DAVE,
    I almost threw you in your little pool just now! My husband is the president of his schools UNION. I want to remind you that The American Medical association, And The American Bar Association are also UNIONS! I bet you do not refer to them as special interests! As far as who has the worse Public education in the Country! South Carolina takes the cake. You have schools so run down and antiquated that the teachers have to stop class when a train passes by! I bet your little Ivory Tower Elementary was not that close to a Train TRACK!!!!
    And the FIRST CHILDREN go to private school for safety! Do Ya Think?
    common ground?

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Dave, READ THIS [Why do so many Americans neglect preventive care and, because of this neglect, why are so many of them likely to experience more serious medical conditions that effectively cost the system more than treating the same condition in its earlier stages?]Jordan is right!
    For-Profit health care is keeping us sick! but your little video shed light on the reason you don’t give damn! You have what you need in this life don’t cha?
    I bet if there was a huge natural disaster or a catastrophic illness that took all those toys away you would change your tune!

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    And here I was going to be nice to you…sorry I just can’t understand why conservatives are so ….. can’t even find a word

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Jordan,
    I drove him away I guess

  • Jordan Richardson

    He’ll be back. He’s just taking a steam.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    I’ll feel bad now for my words :(

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Have you seen that video? I was freaking out! & reading a zillion statistics doesn’t prove a damn thing!

  • Jordan Richardson

    Dave’s poolside chat video? Yep. Erm, no comment.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    What’s that Noam Chomsky Video about?

  • Jordan Richardson

    The Chomsky video in the other thread? That’s from the Ali G Show. Just a bit of comedy for the politics crowd.

  • http://www.republicofdave.com Dave Nalle

    Jordan and Jeannie. I refer you to my article A Chill Wind from the North for details on the numbers of patients brought over the border for treatment and other failures of the Canadian healthcare system, substantiated with links, including to newspapers in Canada.

    And just so you know this isn’t some sort of past problems, complainst about inadequate facilities are ongoing.

    Here’s another troubling article about how many Canadians are waiting for necessary operations. It has a great quote from a Canadian MP, too: “access to a waiting list is not access to healthcare.” Sums things up perfectly.

    Oh, and you asked who the bureaucrats were? They’re people like the Health Services Review Board whose job is to review cases and deny those which cost too much or aren’t on the approved list. Canada has a health care rationing system and bureaucrats are at the heart of it determining what care can and can’t be given — and that’s often a life or death situation.

    You can pretend the problem doesn’t exist, but you’re sticking your heads in the sand. and I can come up with statistics and stories as bad or worse from most major industrialized nations with socialized medicine.

    And I’m not even arguing here that our system is better, just that it isn’t necessarily any worse. We pay more, some aren’t covered, but for those who are covered the treatment is generally superior. That adds up about the same overall as the many systems in the world which provide lower cost sub-par service to everyone.

    Dave

  • Clavos

    Jeannie #9, (sorry for the delayed response, I’ve been at the hospital with my wife)

    You said:

    You just said yourself that Your doctor’s hands are tied when they are the ones that know what treatments and tests your wife should have, not an insurance agency that looks only at the “cost effectiveness.”

    But you must have missed my last paragraph in #8:

    We do already have a government-run single payer health insurance system in place. It pays most of my wife’s bills, which are substantial, but it also refuses, on the basis of “cost effectiveness,” treatments and/or tests and procedures recommended by her physicians. Faced with the choice of her receiving a surfeit of medical treatment as opposed to a scarcity, I, like you, would be grateful for the extra time with her provided by the surfeit.

  • http://www.republicofdave.com Dave Nalle

    And here I was going to be nice to you…sorry I just can’t understand why conservatives are so ….. can’t even find a word

    Rational? Well informed?

    Dave

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    I am not tribal or culturally deficient Dave!

  • Clavos

    Sorry, Jeannie, forgot to include the name of the government insurer: Medicare.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    And here I was going to be nice to you…sorry I just can’t understand why conservatives are so ….. can’t even find a word COLD

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    I won!

  • Clavos

    Jordan asks:

    Why are uninsured Americans SOL when it comes to seeking emergency care?

    They aren’t. Read on.

    Why do so many of them simply not go to an emergency room when they have an accident at work or at home?

    Because they are stupid. The law requires they be treated, regardless of ability to pay.

    Even illegal aliens know that — they use ERs as their primary care centers.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    We lack preventative care because we don’t have national health care!

  • http://www.republicofdave.com Dave Nalle


    Why are uninsured Americans SOL when it comes to seeking emergency care? Why do so many of them simply not go to an emergency room when they have an accident at work or at home?

    They aren’t SOL and they do go to emergency rooms. No hospital denies emergency service to the uninsured. They even treat illegal aliens. If they truly cannot pay the costs are generally covered by Medicaid, but the hospital often ends up eating the cost in the cases of those who can pay but choose not to.

    Why do so many Americans neglect preventive care and, because of this neglect, why are so many of them likely to experience more serious medical conditions that effectively cost the system more than treating the same condition in its earlier stages?

    Because as a nation we don’t like going to the doctor and think we’re immortal. It’s a mental anomaly. It’s the same reason why so many of us who CAN afford insurance choose not to make it a priority.

    Why is it okay that the insured health care customers must pay more insurance because the cost of those with a lack of insurance keeps driving the prices up? (Careful with that link, btw, it’s 14 pages).

    I agree that it’s not ideal, but it’s the price we pay for the kind of system we have. It’s either pay that cost, or pay in long waits and less service as people do in countries with socialized medicine.

    Why does 31%, at least, of the American health care dollar go to administrative costs and overhead? What’s efficient about that?

    Bureaucracies are inefficient and greedy and there has been too little oversight. I’m all for changing that.

    I almost threw you in your little pool just now! My husband is the president of his schools UNION.

    You say that like it’s a good thing.

    I want to remind you that The American Medical association, And The American Bar Association are also UNIONS! I bet you do not refer to them as special interests!

    Of course I do. That’s exactly what they are.

    As far as who has the worse Public education in the Country! South Carolina takes the cake. You have schools so run down and antiquated that the teachers have to stop class when a train passes by! I bet your little Ivory Tower Elementary was not that close to a Train TRACK!!!!

    Of course not. My parents paid to make sure it wasn’t. Though to be truthful, I rather like trains.

    And the FIRST CHILDREN go to private school for safety! Do Ya Think?

    I sympathize. I wouldn’t wish the DC public schools on my worst enemy’s kids.

    Dave

  • Clavos

    Why do so many Americans neglect preventive care

    Same answer as above, Jordan, because they are stupid millions of americans with insurance only go to the doctor when they are sick; why do so many americans eat at Mickey D’s? Same reason. Why do so few exercise? Ditto. Whay are so many obese? Same reason.

    You watch. When the USA does get UHC, it will also have to pass laws (as it did about seat belt use) forcing people to seek preventative care.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    So this is the sinister cable! I want you to remember the little woman that’s picture is above your words! show some respect…

  • Jordan Richardson

    Dave,

    The link to the newspaper article (Globe and Mail) in your March ’08 article has expired. What’s more, I actually refuted a whole lot of that article at the time you wrote it in March of 2008. A huge portion of the comments in that article exposed the flaws in your reasoning then and those flaws are the very same today, well over a year later. Your thinking, not surprisingly, has not evolved. It was weird, too, because I asked a guy for his research on the topic and he never came through.

    Anyways,

    The first link, an example of complaints over inadequate facilities, refers to the shutdown of the Chalk River nuclear reactor and its impact on nuclear imaging scans. This is certainly true, but the Chalk River reactor is being shut down because of a water leak. You’ll note from the article I linked, by the way, that the “inadequate conditions” you reported on using this example are already being addressed as the providers in the area look to Europe for some assistance and take measures to maximize supply until alternatives can be provided. That’s called dealing with a situation, Dave, and it’s what people do. Incidentally, the Chalk River reactor supplies 30% of the world’s medical isotopes. This means that the trouble from the water doesn’t just impact Canada and it also means that this situation is not indicative or reflective of Canadian health care in general.

    But that’s neither here nor there, is it? I can combat your examples with examples of American hospitals, perhaps some in the inner cities, running low on supplies and vaccines and the like. We could run on the shortcomings of our hospitals and doctors all day long, couldn’t we? The truth is that most of those examples are do not occur because of systemic flaws but because of normal, everyday, unavoidable shortcomings. My wife works in health care (has worked in both Canadian and American health care) and this simply occurs. It’s a part of life.

    Now, the second article from The Monitor on our “troubling wait times” provides no points of reference. It also comes from the CON side in what is essentially a PRO vs. CON gimmick. Its author, Sally Pipes, is, as the article says: “the president and CEO of the Pacific Research Institute (www.pacificresearch.org), a free-market think tank funded in part by the health-care and pharmaceutical industry.

    Gosh, Dave, I wonder what she could have to gain by keeping things the way they are.

    There are provincial groups, like the Health Services Appeal and Review Board in Ontario that deals in the following:

    “You are eligible to have the Ontario Health Insurance Plan (OHIP) pay for your health care services if you qualify under the Health Insurance Act. Not everyone is entitled to be an insured person and the Health Insurance Act does not cover all health services.”

    Now, that deals with provincial health insurance…not universal health care. The main focus of the aforementioned group is to determine if people can pay for their health coverage. If they can, they are required to in accordance with Ontario’s provincial health laws. That does not shut people out from surgeries, nor does it decide who should “live or die.”

    Other than that, we have Health Canada, which “is the Federal department responsible for helping Canadians maintain and improve their health, while respecting individual choices and circumstances.”

    Try as I might, I couldn’t find a single agency recognized by the federal or provincial government(s) that dealt in the stock and trade of what you suggest. And what is this rationing system? Who mandates that? The same “Health Services Review Board” that doesn’t exist in your presentation?

    You can pretend the problem doesn’t exist, but you’re sticking your heads in the sand.

    Yes, you’re quite good at that. I don’t ignore the problems with Canada’s health care system, however. In fact, I addressed them in my posts in this topic and waaaaay back in March ’08. It’s you who isn’t prepared to apply your own good advice, sir.

    We pay more, some aren’t covered, but for those who are covered the treatment is generally superior.

    Define “some” who aren’t covered. Crunch some numbers. Tell me what percentage of your population lacks coverage. And what happens to them? How much of the “generally superior” treatment do they have access to? How much does that cost in the end, both to the patient and to your insurance? How much does that system jack up the price tag on general insurance?

    That adds up about the same overall as the many systems in the world which provide lower cost sub-par service to everyone.

    Really? You still think that? Why?

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Now, that deals with provincial health insurance…not universal health care. The main focus of the aforementioned group is to determine if people can pay for their health coverage. If they can, they are required to in accordance with Ontario’s provincial health laws. That does not shut people out from surgeries, nor does it decide who should “live or die.”

  • Jordan Richardson

    They aren’t SOL and they do go to emergency rooms. No hospital denies emergency service to the uninsured.

    They can go to emergency rooms. A huge majority of them do not. I know you didn’t read the links I provided for you, but what I cited is actually supported by facts. I didn’t suggest that they can’t or that hospitals turn them away into the streets to die. I said that they don’t go because they can’t afford to pay for it when it’s all over, so they neglect preventive care. Simple. If the facts are wrong or if the organizations coming up with the findings are lying, prove it. Don’t just say it’s not true and move on without supportive evidence.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Isn’t that great! seeing all those peoples faces at the top of the page? All covered all treated with the same dignity and respect. HEALTH CANADA! Teach me to do that HTML Jordan OK?

  • Clavos

    I said that they don’t go because they can’t afford to pay for it when it’s all over…

    They don’t have to pay for it, Jordan. Ask any illegal Mexican (I’m legal, so I pay).

  • Jordan Richardson

    Who does pay, Clavos?

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    I wish all these comments were actually about my essay..

  • Jordan Richardson

    Bah, I’ll save myself the time and answer my own question:

    The cost of treating those without insurance gets absorbed by providers in what is called “charity care.” This money doesn’t just vanish into the thin air. Instead, those with a lack of insurance are treated and then either taxes go up or health insurance premiums go up.

    This page has a few surveys and facts that discuss how the uninsured cost the American health care system and how that drives up the cost to the insured consumers of the system.

    And this represents another perspective fromthe American College of Emergency Physicians.

    As you can see, there is evidence to back up both my claim that the uninsured are more likely not to seek out preventive care or go to a hospital with an injury and my claim that treating the uninsured represents a considerably large cost to the American health care system. Estimates for those costs in the future keep rising, too, with treating the uninsured charting in the billions of dollars.

    UHC makes sense on just about every single level, but there are those who continue to oppose it on the basis of outdated philosophies, fears of “socialism,” fears of wait times or erosions of choice, or other myths that have long since been refuted by those with evidence.

    The fact is that the industrialized world chooses a system akin to UHC for a reason. And the United States rejects that same system and its variants for a reason, too.

    If I could make some adjustments to the Canadian system, I would. But the further I can get from American health care, the better.

    Anyways, there’s only so far this all is going to go. People are set in their ways and that’s that. I’m both glad and truly sorry that your article became a platform for this typical, redundant political debate, Jeannie. But I think you for opening up your heart and sharing your story nonetheless.

    See you around.

  • Bliffle

    Jeannie:

    I think you were very lucky to have this woman as your mother, and I think she was very lucky to have adopted such fine children. Clearly, you learned empathy from her when you were young. Empathy without pity, just the fine human capacity to put yourself in anothers place.

    Pay no attention to the Peanut Gallery characters of BC: Nalle, Clavos, etc., you know the names. They are shriveled by their parsimonious attitudes.

  • Jordan Richardson

    *thank you, I mean.

  • http://www.republicofdave.com Dave Nalle

    The link to the newspaper article (Globe and Mail) in your March ’08 article has expired.

    It worked when I clicked on it a few minutes before posting it.

    What’s more, I actually refuted a whole lot of that article at the time you wrote it in March of 2008.

    You need to learn the difference between denial, ignoring and refuting things. What is in the article is fact. You can’t just say you don’t agree with a fact and expect it to go away, which is essentially what you did in your original responses.

    A huge portion of the comments in that article exposed the flaws in your reasoning then and those flaws are the very same today, well over a year later.

    Except that the article was not particularly a work of “reasoning” in which there were flaws to be exposed. It was a catalog of facts which are just what they are.

    Your thinking, not surprisingly, has not evolved.

    Because the facts remain the same.

    This means that the trouble from the water doesn’t just impact Canada and it also means that this situation is not indicative or reflective of Canadian health care in general.

    Yet of the 676 articles on this subject on Google, every single one refers solely to the problem being in Canada. That suggests that your argument that it’s a worldwide problem is more in the nature of an excuse than a fact.

    My wife works in health care (has worked in both Canadian and American health care) and this simply occurs. It’s a part of life.

    8 month waits for surgeries are a part of life in Canada, but not generally in the US. Nor are 2 month waits to see a GP or being driven to another country because your local hospitals have no cardiac surgeons.

    Now, the second article from The Monitor on our “troubling wait times” provides no points of reference. It also comes from the CON side in what is essentially a PRO vs. CON gimmick.

    That’s just the way the newspaper presents the articles. It has nothing to do with the content. The content is based on research and it can be verified from multiple other sources.

    Conveniently the Canadian government has assembled the data on wait times and made it available online. Perhaps they are working for a right-wing think tank too?

    Here are some quick numbers from the CHI. In Manitoba a hip replacement takes a minimum of 4 months to as long as a year. N ova Scotia, a median of 9 months to a maximum of almost 2 years. Ontario, which ought to be one of the best — 9 months. Those numbers are just ridiculous and they bear out the articles I’ve referenced.

    And that’s just one example. Catscan or MRI — 126 days in Ontario, 133-182 days in Saskatoon. Oops, that mass we wanted to check out metastasized and you’re dead in the 6 months you waited for a scan.

    I mean come on — 3 or 4 weeks for an angioplasty? Sorry Ma’am, your husband died because he got out of his chair too fast in the month he waited for an operation people in the US get within 24 hours.

    Stop with the excuses and justifications. The facts are real and they are overwhelming. Yes, the US falls short for those who can’t afford or choose not to get insurance, but that’s hardly worse than putting almost every patient at risk with huge wait times for critical care.

    Try as I might, I couldn’t find a single agency recognized by the federal or provincial government(s) that dealt in the stock and trade of what you suggest. And what is this rationing system? Who mandates that? The same “Health Services Review Board” that doesn’t exist in your presentation?

    Then your research skills suck. The Health Services Review Board is a part of the OHIP and they are both well documented as are their procedures for rationing and denying care.

    Define “some” who aren’t covered. Crunch some numbers. Tell me what percentage of your population lacks coverage.

    Currently by the most generous estimates about 20% of the population lacks coverage. Of those about a third are uninsured by necessity and most of those qualify for Medicaid. The remaining 2/3 are considered to be uininsured by choice because they could afford health insurance but are young or healthy or have other priorities and choose not to spend the money on it. Maybe unwise, but their choice.

    And what happens to them? How much of the “generally superior” treatment do they have access to? How much does that cost in the end, both to the patient and to your insurance? How much does that system jack up the price tag on general insurance?

    I’d have to research these things in more detail and I’m not going to do it all now. I never claimed the US system was perfect. We just don’t have the same problems that Canada does.

    Dave

    That adds up about the same overall as the many systems in the world which provide lower cost sub-par service to everyone.

    Really? You still think that? Why?

  • Jordan Richardson

    Dave, the article you linked pertaining to wait times actually describes a plan the government is implementing to diminish wait times. Nobody has denied this problem. Solutions have been proposed – hell, I’ve even proposed some solutions and yet you conveniently keep bringing up “wait times” like they’re the crushing blow that makes the American system better and like your system is immune to them. How do you account for this lack of reason?

    You can’t just say you don’t agree with a fact and expect it to go away

    Good advice. I could go with the obvious snarky reply about how you don’t seem to apply said advice or I could go with asking you to prove where I’ve “disagreed” with a fact.

    Yet of the 676 articles on this subject on Google, every single one refers solely to the problem being in Canada.

    You read 676 articles, Dave? Wow. I’m impressed. The problem, the water leak in the reactor, is located in Canada. Why would the articles state otherwise? It impacts Canada considerably, of course. This I also admitted. It is, however, more convenient for you to parse one portion of the volumes I wrote about the Chalk River situation so that you can appear to have received the upper hand. Congrats!

    Stop with the excuses and justifications. The facts are real and they are overwhelming. Yes, the US falls short for those who can’t afford or choose not to get insurance, but that’s hardly worse than putting almost every patient at risk with huge wait times for critical care.

    More patented Dave Nalle thinking. Take some statistics, add hyperbole and panic, and come up with an unreasonable conclusion that you can flip on those who disagree with you to suggest that they’re the illogical ones not seeing what you’re seeing.

    You say that the Canadian system puts “almost every patient at risk.” What? Where are you finding this? Find me statistics that prove people died waiting for a scan. Use facts, not your conclusions. There are wait times in some regions that are massive and inexcusable, yes. I have, AGAIN, talked about this already.

    But that’s not enough for you, sir. Instead, you elect to make unsubstantiated claims – that the Canadian health care system puts ALMOST EVERY patient at risk! – based on your own conclusions from the facts. But your claim isn’t factually supported and you know it.

    Then your research skills suck. The Health Services Review Board is a part of the OHIP and they are both well documented as are their procedures for rationing and denying care.

    I talked about that Board already, Dave. If they are “well documented” for “denying care” on the basis you are suggesting, not on the basis that I already discussed (that they deny INSURANCE not CARE for those who can afford the INSURANCE!), show me the documentation. If my research skills “suck,” what does it say for yours when you can’t provide a single backing fact for your conclusion. If you have the documentation, show it.

    Maybe unwise, but their choice.

    Considered to be uninsured “by choice.” Yeah, Dave, that “choice” is the choice to pay rent or buy food over purchasing health insurance. What does that tell you? What does it say when people would gamble with their health care like that? That the system works…?

    Don’t answer that because I know what it’s going to be: they chose, tough luck, the system is the best in the world, it’s their fault they can’t afford it, they’re stupid, etc.

    I’d have to research these things in more detail and I’m not going to do it all now.

    I’ll wait.

    I never claimed the US system was perfect.

    You sure have trouble admitting to any flaws with it, Dave. At least I’m more than willing to examine, admit, and discuss the broken portions of the Canadian system in order to achieve better care for all Canadians. You, on the other hand, remain fixated on keeping things as they are. Shit, dude, you admitting wrong would be something I’d have to mark on my calendar.

    We just don’t have the same problems that Canada does.

    You don’t think you have wait times? Product shortages? Incompetent doctors? Corruption?

    You don’t think your system has its own full set of problems too?

    Hell, nobody’s trying to sell you on the Canadian health care system. I’m not, that’s for sure. It’s imperfect, like all systems. But it is, in my view and in the view of the majority of the world, fundamentally preferential to the system you cling to. It provides a combination of private and public care to its citizens at lower cost per person than your system does. It mandates that all citizens should receive care. Those are the fundamentals. Due to human error and natural shortcomings, the system does not always work. But I’m much more comfortable working with our fundamentals than yours and working to improve our system as opposed to yours. The ground from which we work is better, I think.

  • Jordan Richardson

    8 month waits for surgeries are a part of life in Canada

    This depends on the region you examine.

    This table for general surgery from Vancouver General Hospital is up-to-date as of March 31, 2009 and shows the median wait times in weeks. As you can see, there are no wait times for urgent surgeries. You will note that the surgical procedures are arranged on a priority basis (there is a legend at the bottom of the chart) and will see the wait times increase with the less severe cases.

    Interestingly, the Canadian federal government sent considerable money to the provinces to handle their various issues (some provinces needed more money for imaging, others for cardiovascular research) on the basis of establishing a guaranteed wait times system by 2010. And in 2005 a Wait Time Alliance was formed and tabled a resolution to each province for reduced wait times with several recommendations that are being implemented with new funds.

    As a part of that initiative, every single province has now posted their wait times. Manitoba, for instance, has a COMBINED wait time of 27 days for ALL cardiac surgery at Winnipeg’s St. Boniface hospital. Those 27 days are spread out, again, by priority.

    Looking at Ontario, you can see that they are posting province-wide reductions in wait times for the emergency room.

    In terms of surgery in Ontario, they actually have a pretty neat website here. You can go through and check out the wait times for various procedures.

    I checked out the average wait for brain cancer surgery in the busiest health system in the province, the Niagara Health System, and found no wait time. Around the province, however, you find different wait times. A hospital in Sudbury, for instance, has a 74 day wait time for the same surgery. A Hamilton hospital posts 37 days. Obviously these results are impacted regionally, as I’ve expressed throughout this conversation. General surgery wait times were very poor, with the longest waits being in North West Ontario at 184 days. I think those were the highest wait times in the entire country that I could locate.

    A CT scan (diagnostics) featured wait times anywhere from 11 days to 18 days on average. MRIs were not so good, with waits for those diagnostic tests ranging in the hundreds across the province of Ontario. In BC, the MRI wait times were significantly lower.

    Again, this evidences the regional impact. That the most-populated province in Canada should have the longest wait times by far is not surprising. More than anything, this speaks to the need for more funding and more doctors in our densely-populated areas.

    Try as I might, an honest perusal of the various wait times demonstrated that 8 month wait times for surgeries were far from a “way of life” in Canada. While there were extensive, vile, disturbing wait times for diagnostics in Ontario, the surgical times even there came nowhere close to Dave’s alleged norm.

    Interestingly, the same Fraser Institute that offered the study I critiqued on your older article, Dave, produced an updated study that found that the average wait times across Canada had diminished considerably. Of course, the Fraser Institute has an interesting method when it comes to collecting those stats: they use physician opinions of how long they think their patients will wait to determine wait times between referral from a GP to receiving treatment. This calls into question when a wait time starts and there is also much discussion to be had pertaining to that.

    But enough hijacking.

    One final remark that speaks to this said by both Dave and Clavos earlier:

    they are stupid millions of americans with insurance only go to the doctor when they are sick

    Wouldn’t it be reasonable to assume that most people want to avoid using their insurance coverage if they don’t have to? Wouldn’t they lose an amount of coverage in going to the hospital for, say, a nail in the hand or a deep cut because the insurance company would have to pay out? Most people would not want to lose coverage if they don’t have to, I’d assume.

  • STM

    I thought we’d also established previously that many of those visits to US hospitals by Canadians, which are pumping up the statistics Dave quotes, occur in conurbations that just happen to be split by an international border and where the closer major hospital might be across the border.

    My understanding is that many visits to Detroit area hospitals, for instance, by Canadians are the result of this because Windsor and satellite towns like Chatham are closer to Detroit (as close as five minutes in the case of Windsor) than Toronto in the case of, say, major trauma or life-threatening medical emergency such as cardiac arrest.

    Toronto is a fair distance even by helicopter from Windsor and Chatham, while London’s about halfway between Detroit and Toronto.

    I just had a look at the map and also noticed some small Canadian towns in southern Ontario are also closer to Buffalo than to Toronto, and so on and so forth.

    I know for a fact that in the case of trauma, car accident for instance, the paramedics contact the nearest hospitals to see who can take who.

    That happens in the US too across state borders, as it does in Australia – especially on the Gold Coast, which is a conurbation that straddles the NSW-Queensland border and has hospitals run by the two different states on either side.

    They go to the closest or the least busy or the one with beds available.

    Canada, BTW, at least pays the bills when Canadians go to US hospitals in those situations.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    STM >[Canada, BTW, at least pays the bills when Canadians go to US hospitals in those situations.] I really like what you said in #60 And Canadians, I would like to add to this thread, also PAY THEIR TAXES! This is how they can afford a superior HEALTH CARE SYSTEM TO THE ONE WE ARE CURRENTLY STUCK WITH! support HR676 Single-Payer-Health-Care

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    OK Peanut Gallery Read what Jordan Wrote >
    [UHC makes sense on just about every single level, but there are those who continue to oppose it on the basis of outdated philosophies, fears of “socialism,” fears of wait times or erosion of choice, or other myths that have long since been refuted by those with evidence.] This is the reason intelligent men & women vote against themselves time and time again in this country. I SAY “Let’s all be SOCIALISTS! like CANADA AEY” OOOoo big scary word! doesn’t work here anymore…

  • Jordan Richardson

    The facts are all here, that much is clear. Dave will play the same tune and talk about “wait times,” ignoring not only the progress made but the infinite amount of progress that can be made. Dave with also continue to perpetuate the myth of government control and will suggest that there is a “review board” that decides whether or not you can have care. The board cited does not do that. I referenced what the board does instead and Dave provided no counter evidence to back his claim that the board “decides life and death matters.”

    Dave also provided no evidence, despite being asked more than once, to back his claim that most Canadians were at risk under the Canadian system. He also provided no evidence to suggest that people are dying as a result of UHC. I could cite evidence of people dying due to a lack of UHC, but I see no reason to continue citing evidence here.

    Dave continues to play the same ridiculous game he always plays. He accuses those who disagree with him of “ignoring the facts,” while he conveniently proves very selective in what he responds to. He has ignored the largest portions of my posts, choosing instead to lead repetitive attacks against components of Canadian health care that we agreed upon, ie. wait times. Dave is so obsessed with winning arguments that he cannot even understand when people agree with certain aspects of his argument.

    But agreement in part does not equal agreement in total and that’s where we run into problems. While I did not once disagree with any of Dave’s evidence, so long as it was evidence and not opinion about evidence, I vehemently disagree with his conclusions because they are not based on the evidence.

    The essence of this debate is the same as the essence of the oil debate as pertains to the environment. While it might be that a majority of the population wants alternative energy or universal health care, those in power and those with money do not. They don’t want to change because they like the way things are.

    Dave likes his health care coverage and he should. If I had his coverage, there is NO WAY I would trade it for basic Canadian health care. His coverage is vastly superior and I can understand why he is holding on to it with both hands.

    That said, the attitude reflected here is one of selfishness. It doesn’t matter if there is no equal care or if people don’t want to raise their premiums by going to hospitals or if insurers try to get out of paying and so on. It doesn’t matter to Dave because Dave gets what he wants out of his insurance because Dave can afford it.

    Me, on the other hand, want everyone to have the same care opportunities I do. And I don’t mind paying higher taxes to do so, especially if the system is, as ours is, constantly subject to scrutiny, peer review, and amendment to create better service and diminish wait times. The Canadian system is vastly superior in its transparency, access, cost-effectiveness, and equality. Users can then opt for higher insurance and can receive private care from private facilities that will enable them a higher standard of care beyond the basic care mandated by law.

    We are not “all at risk.” We are not denied care by a Board of Directors. We are not told which hospital to go to and which one not to go to by anyone. We are, instead, expected to pay more of our own way if we are able to do so. What we cannot cover, the publicly-funded system covers.

    It is no great sin, nor is it any great stupidity, to put the needs of others before the needs of yourself. Our system is based on the Canadian desire to do that, whereas the American system is based on the American desire for profit above all else. Those are the fundamentals. And I’ll never find agreement with them.

  • Jordan Richardson

    Me…want everyone to have the same care opportunities I do

    Gah, that’s what I get for recently writing about the Cookie Monster.

    Just to clarify: the point is that the health care quality in America is mostly better than the health care quality in Canada. That’s a given; it’s going to happen when you pump LOADS of money into it (double that of Canada and nearly triple that of everywhere else). If that was the case and I could have Dave’s standard of care while ensuring others had it too, I wouldn’t be trading it for Canada’s system.

    America will probably come up with a better system than we have if they ever get their shit together and start prioritizing what really matters. That may never happen as long as insurance companies collect massive profits and refuse payments to those in need. But if it does, with America’s health care architecture and a UHC system like ours, there’d be no question in mind that the U.S. would possess the better system in terms of quality. I don’t and haven’t disputed that.

  • Jordan Richardson

    Just to wrap this up (I promise), this article from Canadian Liberal MP Keith Martin kind of approaches my feelings towards Canada’s health care.

    We are certainly structured as the mixed system I have been discussing, but we lack integration in support of the public system. We can also learn a lot from Europe’s information technology systems. I have always argued that our system needs to continue to evolve and that the basic standards set forth by Tommy Douglas should be kept at the forefront. I have never said that ours is the model or the best, only that it is preferential the American system in terms of equality of coverage and access. In terms of access, most European systems best both Canada and the U.S. significantly, by the way.

    Okay. Done. :)

  • Clavos

    Jordan,

    Wouldn’t it be reasonable to assume that most people want to avoid using their insurance coverage if they don’t have to? Wouldn’t they lose an amount of coverage in going to the hospital for, say, a nail in the hand or a deep cut because the insurance company would have to pay out? Most people would not want to lose coverage if they don’t have to, I’d assume.

    Not sure if I understand your point here, but if you’re saying that using one’s health insurance here means losing it, that’s simply not so. I’ve had the same health insurance (with the same company) for years, and go to several doctors regularly (in addition to the free health care I get from the VA), both for routine checkups as well as ailments.

    The insurance company actually has a service they employ to call me periodically (an RN with physician access calls) to discuss my serious ailments and their management with me. They make suggestions and give advice. They do it because they’re interested in keeping me as healthy as possible to reduce their own costs.

  • Clavos

    America will probably come up with a better system than we have if they ever get their shit together and start prioritizing what really matters.

    Not if it’s to be run by our shit government, which is my only objection to UHC here. I have no problem with the government (i.e. taxpayers–the government has no money of its own) paying for it, but I don’t want bureaucrats who cannot be fired planning for and making decisions about my health care.

    I believe you and Stan when you talk about the Canadian and Aussie systems (except that Dave is right about the wait times — I have NO wait time for anything here), but both the Canadian and Australian governments are far more efficient and far less corrupt than the US.

  • Bliffle

    The US government is corrupt because we allow open bribery of elected officials through so-called “campaign contributions”.

    Thus, financial vested interests control the corrupt government that extracts tribute from citizens and also denies them the benefits of society.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    That’s right. Nothing has changed.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    If we could take back our media and allow them to represent us then maybe we would have a chance…
    I was very impressed with Bob Schieffer today on “Face The Nation” while interviewing General Collin Powell Bob actually said that Rush Limbaugh was just an entertainer. If the rest of America could muster up that kind of courage we could move forward another step towards rational thought!

  • STM

    Jordan: “Me, on the other hand, want everyone to have the same care opportunities I do. And I don’t mind paying higher taxes to do so, especially if the system is, as ours is, constantly subject to scrutiny, peer review, and amendment to create better service and diminish wait times”.

    This is why I like universal health care in Australia. It denies nothing to anyone, despite not being perfect … although it’s pretty damn good all things considered.

    Aussies were sceptical when it was first introduced in the ’70s, much like Americans are now.

    However, 30-odd years down the track, no one would change it.

    It’s worth noting here too that it’s not free. We pay a bit more in taxes, but it’s worth not ever having to worry about how you are going to pay bills – or whether you’ll go bankrupt – if you get sick or worse, lose a job and then get sick.

    I like the idea that my government, while it falls flat on its arse in most other respects, can at least offer us that kind of peace of mind through Australia’s Medicare UHC system.

    And it’s a waaaaay more legitimate use of our tax dollar than beefing up expenditure on the military.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    STM, (I like the idea that my government, while it falls flat on its arse in most other respects, can at least offer us that kind of peace of mind through Australia’s Medicare UHC system.)Have any of our Senators or Congressmen proposed the Australian model as a solution? I would be interested in offering it up to them. Right now I support HR676 because it is the only Single-payer solution I know about. They really keep us out of the “loop” here.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna
  • Jordan Richardson

    Clavos, thanks for answering my question. I wasn’t sure how various plans worked in the United States.

    I also know that my mother-in-law has experienced significant wait times in a Seattle hospital. So, like other health care systems, it is possible that the primary reason behind wait times is more related to regional impact and less related to the actual structure of the system. To say it isn’t related to the structure of UHC is to be blind to part of the problem of course, but there are ways to work within the structure of UHC to diminish wait times. As you can see by the evidence I’ve shown from our health care system, improvements can be made rather steadily with the right adjustments.

  • Jordan Richardson

    I think Americans need to stop being so afraid of their governments and start making their governments afraid of them.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Jordan, Good point! That is why I have no wait time at Buff VA or all the VA clinics I have access to “So, like other health care systems, it is possible that the primary reason behind wait times is more related to regional impact and less related to the actual structure of the system.”

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Jordan,#73 That sounds too militant for me :(

  • Clavos

    Jordan,

    I’m not afraid of either of my governments, but I do despise both of them; the US more than the Mexican, though, because it’s more divergent from its society’s cultural values.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Good night Jordan And Clavos, Remember don’t swear! My mom’s watching…

  • Clavos

    ‘Night, Jeannie.

    ¡Hasta mañana!

  • STM

    Jeannie,

    Our system in Australia is very simple but probably quite hard to explain to a foreigner (sorry :)

    I’ll try. Medicare operates on a schedule basis, which sets a payment for most services … ie, it might cover 90 per cent of one surgeon’s fee, and 100 per cent of another’s, depending on what the surgeons themselves decide they’ll charge. (It does keep them close in terms of cost though just because it gives a nod to free-market practices).

    How it works is: I might go to my doctor, who will “bulk-bill” me. In other words, I pay nothing, and just get my Medicare card swiped like a credit card.

    Then I might have to get some tests done, which are, say, 85 per cent covered by the Medicare schedule. I go to a Medicare office and get that money paid back (in cash, if I want) by presenting the receipts and filling out one simple form.

    This is where it gets a bit more complicated: In my case, I also have family private health-insurance, which covers the gaps in cost and things like ambulance, and entitles me to a tax break. Without it, I would pay about an extra $1000 levy on my income tax for Medicare in my yearly return simply because of the amount of money I earn.

    If I had no private cover, I wouldn’t mind that, though, as I believe in the system either way you approach it, and it’s equally good.

    For instance, my daughter about 18 months ago suffered an epileptic fit in the shower. A paramedic in a 4WD was there in a flash (no cost for that), followed by the ambulance (a small fee), which rushed her to the local public hospital (free) where she was admitted to a nice, new paediatric unit.

    Because we also had private cover, we asked if she could have her own room. They gave us one anyway. She was seen by the specialist on duty, who then became her doctor. She was given a battery of tests and remained (all covered on the public system) there for three days.

    Total out of pocket cost to me: zilch, with everything (including the private room) but the ambulance covered by the free public system.

    A few years back, I needed emergency surgery and went to the local private hospital because it was closer.

    I had doctors of my chopice and their fees’ and all the tests were covered by Medicare with the small gap in the doctors’ fees covered by my private insurance, while my private insurance also covered 100 per cent of the hospital accomodation.

    Total out of pocket cost, again: zilch.

    There is also a Medicare safety net. That means that if you are required to use a doctor regularly over 12 months, or to have regular treatment in that period and the fee is above the Medicare schedule, after a few visits or a few treatments, Medicare covers the entire cost.

    It’s a hybrid system geared mostly towards a public hospital system. But even those with private cover often find themselves using the public system without need to use their private cover.

    It’s very fair, but also offers some choice.

    My wife works in a world-leading heart/lung transplant unit at a major teaching hospital in Sydney. There are no queues for life-threatening conditions, and no queue jumping for those required to wait a little while. The transplants cannot be carried out in the private system.

    Even the “rich” go through the same public wards, although some of them might move to the private hospital next door to recover later.

    I like the whole thing, especially the bit that says I can have a choice … but also the bit that says I don’t have to exercise it if I don’t to because I know I’m going to get identical or very similar treatment anyway to someone who doesn’t have private cover. I also like the bit that says the government is putting my tax dollar to work to make sure that no one goes bankrupt or settle for second-rate treatment if they get sick.

    The health insurance funds didn’t go broke either when UHC came in. They just upped the ante on the services they provide.

    They now cover all kinds of stuff like gym membership and alternative health practitioners.

    Peace of mind is a mighty good thing, and one of the best things a government can provide for its citizens.

    Universal health care is one way of doing that.

  • Jordan Richardson

    Canada’s health care system is generally very similar to Australia’s, by the way. Ours is also a hybrid system, although we need more connectivity between the public and private care so that we can diminish some of the wait times. There are many in Canada who are working on that.

    Bear in mind, too, that as flawed as our system can be at times, there has never been any serious discussion of making it more like the American system. The vast majority of Canadians are desperately fearful of such a thing happening.

    For Jen and I, we offset our remaining health care costs with work health care benefits packages. Her union provides her with insurance that offers 80-90% coverage on dental, vision, and something else I can’t recall at the moment. It’s very convenient in that it covers a lot of what the basic UHC doesn’t. If we didn’t have the work benefits, which most every job in Canada provides for workers who put in at least 30 hours a week (even Tim Horton’s workers get health benefits!), we could still purchase a similar package for a very small cost on a monthly basis.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    STM, Thank you for taking the time to write this excellent example of what Australia’s UHC plan looks like. I hope your daughter is well today :)and has your wife read my essay. I would love her opinion on it. Did I capture the hospital setting correctly? Could I post this detailed comment in my Blog “@ Home With Rodiogal”?
    It is ironic that the two people this morning besides me who want Universal Health Coverage for the United States are not citizens of “named blind country.” Wake up America! :(

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Jordan, You also give so much of your time and energy to this issue of such a poor and greedy For-Profit-health-Care system your neighbors to the south of you are stuck with!
    I am embarrassed by my fellow citizens, most of them anyway, there are some people here at BC who see Universal Health Coverage is the only humane answer to our health care crisis and that it is long overdue.
    This morning I woke up thinking about Charles Manson of all people! because “Charley” enjoys the same Health Care as our illustrious Senators and Congressmen. Tell me, WHAT’S WRONG WITH THIS PICTURE?

  • http://ruvysroost.blogspot.com Ruvy

    Jeannie,

    I read the article you wrote in honor of your mother, may her memory be for a blessing. You blasted another home run out of the park. Great job! Great read!

    A profit-driven health care system will abuse people the way your mother was abused. But Israel, which has a system not dissimilar to Australia’s (OI just p[aid the 441 shekel health insurance premium today at the post office) can be just as abusive. I’m not arguing in favor of establishing a profit-based system here. It would be a total disaster. But if the fellow who suffered heart failure who lived a couple of buildings down from us when we lived in Jerusalem was given proper treatment, instead of being ignored in a warehouse and left to die, his wife and daughters would have hope instead of bitterness in their lives.

    Bureaucracies are concerned with their existence and little else; this is true of all bureaucracies. Sometimes, one gets lucky and runs into a medical team that cares. But doctors and nurses are people, just like teachers are. Sometimes, you run into the teacher who inspires you for life (like my fifth grade teacher) – or you run into a miserable clock-watcher who does not give a damn for here charges (like my oldest son’s first grade teacher).

    Once, my wife lost a baby in its 16th week. The gynecologist pulled the dead fetus from her body and told her, “Congratulations! You have a son!”

    My wife still tears up thinking about this, and the way that son of a bitch behaved to her still angers me over twenty years later. Schmucks and vicious bastards infest the planet, Jeannie.

    As for the United States adopting health care, I would note for you that the first universal health care bill was submitted to Congress by Meyer London (Soc. NY) in 1904. Had an intelligent universal health care program been adopted in the States after WWII when the country was at the height of its power, it would have worked well. Unfortunately today, the United States is broke – this according to the Blessed of Hussein (that is what Barak Hussein means in Arabic), not me.

    Any owner of a mom and pop store will tell you you can only buy what you can afford to pay for; and America can no longer afford to pay for an universal health care system. I’m not being snide or nasty. I’m being truthful.

    Anyway, congratulations again on a wonderful and deeply touching article.

    You are a talented woman who has a true writer’s gift, and a remarkable story-teller’s style. I may not agree with your point of view all the time, but do keep writing! And write what your conscience tells you to, no matter what. You write very well.

  • Jordan Richardson

    It is hardly possible for America to spend any more money on health care than it already does. It nearly doubles the second most expensive health care system in the world (Canada’s) with obscene amounts of money dedicated to managing the complications and processing all of the various types of insurance. There are literally thousands of insurance companies offering different types of “coverage.”

    So while it could be argued that America couldn’t afford UHC, it probably should be argued (and could be argued with greater evidence) that America can’t afford to continue pouring the money it does into the health care system it saddles its citizens with. In other words, America can’t afford not to attempt some form of UHC.

    Of course, thus enters what I refer to as the Clavos Variable: the government sucks and is worse than anyone’s and blah blah blah. That may be true and I won’t argue that, but that doesn’t automatically remove the issue from the table of fair discussion. Simply having an incompetent government shouldn’t halt all discussions of change; it should prompt more of them!

    Changing the system in UHC to make it more cost effective would mean filing down insurance companies considerably, cutting admin costs greatly, and adopting information technology by the crate to manage health care data and crunch the numbers. Operating a hybrid style of private and public care ensures everyone gets taken care of and still keeps that American spirit of competition alive and well. Everybody wins and it’s much cheaper in the long run.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Ruvy, I agree with you that there are good and bad people in this world. I lost my breath on that one sentence you wrote with brutal detail and I hope his licence was pulled. I am sorry for Mrs. Ruvy…

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Jordan,
    Can you see the “war-heads” from your front door like Palin sees Russia?
    What I mean is we have a huge Industreal War Complex here and they are all happily flexing their muscles right now because North Korea is testing a nuclear missile.
    We do need to act in unison with the rest of the world to curb North Korea and we need China to be on board here!
    Our domestic needs get shoved to the back burner when ever the military sneezes and there will not be one Conservative, Republican, or Conservadem crying about the money today!

  • http://ruvysroost.blogspot.com Ruvy

    I am sorry for Mrs. Ruvy…

    Jeannie,

    My wife’s name is Adina (ahDEEnah).

  • http://ruvysroost.blogspot.com Ruvy

    Jordan,

    I do not conceptually disagree with what you say. I believe in universal health care, and it is obvious that once set in place, it would be cheaper than the present bloated system. But in an economy as fragile as that of America’s, the question needs to be asked: where do all those shaved off employees of the bloated insurance bureaucracies go? How do they keep a roof over their heads? If they have families to support, that is a serious question. Who pays to help them retrain?

    It’s not that I feel sorry for these people, per se, but in a virtually no-growth economy (which is what the USA appears to be these days), causing a person’s unemployment means you need to support him somehow until someone else with the capital to take a risk on an idea can support his as an employee….

    In a no-growth economy, serious dislocation purposely caused as a matter of government policy can cause a revolt – or a revolution – to break out.

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Hi Adina :)

  • STM

    Jordan: “Canada’s health care system is generally very similar to Australia’s”

    Wonder why that is??

    Oh, that’s right, we were both spawned by a liberal democracy and given a system of government that kept evolving :)

  • Bliffle

    Jordan is right:

    84 – Jordan Richardson
    May 25, 2009 at 10:22 am

    It is hardly possible for America to spend any more money on health care than it already does. It nearly doubles the second most expensive health care system in the world (Canada’s) with obscene amounts of money dedicated to managing the complications and processing all of the various types of insurance. There are literally thousands of insurance companies offering different types of “coverage.”

    Indeed, the burden to the US economy for our partial and capricious system is about 16% of GDP vs. 6-8% for other western countries. And when you consider that our GDP is higher per capita than other nations it emphasizes the distortion.

    We spend a lot of money for the pleasure of seeing millions deprived of health care.

  • Ruvy

    Bliffle,

    Jordan is right – conceptually. Universal helath care is a cost saver for most countries where it is in place, whatever its faults. And so are you. But the questions I raised here still have not been answered. Where do the laid off employees of the insurance companies go? What do they do for a living, now that they can no longer shuffle papers and process unnecessary forms? In a no-growth economy with little options and a capital shortage (a polite way to describe a country that is flat broke) laying people off is not a good idea. Ask the government that has been trying to keep the incompetent fools in Detroit employed….

  • Susan Danna Myer

    Great article about your mom, Jeannie! You truly have a gift for writing! I enjoyed learning about your mom’s early years. That is a great black and white photo! Thanks for sharing her life with us!

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    Thank you Sue! I just discovered that you made a comment here under all this other “stuff” I really am learning to write better now and I know if I stick with it an remain teachable then someday I’ll get paid….

  • http://jeanniedanna.wordpress.com/ jeannie danna

    Here I thought, alright , someone has just read my article, written for my mother and all who have been desicrated by this for-profit medical industry, and, what do I find?

    Poorly worded spam.

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