August 9, 2009

Who Is Really Getting Euthanized

UPDATE: Health Care Protesters Largely From Out of District

The forces trying to keep us from getting a new health care system are bussing operatives in to disrupt congresspeople's meetings. These protesters are not people who live in the district. The pattern of using violence to shut down discourse is very disturbing. Contact your congresspeople and let them know you don't want policy set in response to gun toting people brought in from outside to threaten violence.

The right wing fringe is trying to frighten the public with the claim that health reform will mean those close to death will be forced to die because medical care will be withheld.

They prefer the old system, where only those who are poor, unemployed, or have a chronic condition are forced to die because care is withheld.

Shame on them.

Next time some fear monger tries to tell you that health reform means rationing care, remind them we already ration care.

Those with high status jobs get it. Those who work for small business, are laid off for more than 18 months, or are self-employed in businesses that don't earn enough to pay $12,000 a year for an insurance plan do not. Those with a preexisting diagnosis can't get insurance in many states no matter what they are willing to pay.

I get mail every week from people in their 30s and 40s who have LADA (a slow form of Type 1) and severe Type 2 diabetes who have lost their jobs or have jobs without health insurance who cannot afford to see a doctor or pay for the drugs they need.

The media tells you that there are programs for these people. Try finding one when you are faced with a person whose average blood sugar is running around 400 mg/dl but who the emergency room doctor diagnosed as "Type 2." Until they are in DKA or a hyperosmolar state, or have gangrene or kidney failure, they aren't considered in danger. So if cutting carbs doesn't bring down their sugars, they are SOL.

That looks a lot more like euthanasia to me than denying open heart surgery to a demented 90 year old who can no longer recognize her own family.

Who benefits from the current system? Someone, obviously, because a lot of money is going into funding the noisy rent-a-mob protests against health reform.

A country that can pay billions to bail out banks can afford to provide adequate health coverage for every single citizen. My stomach is turned by the arguments that health care reform must save money, while bank bailouts and car bailouts can lose as much as it takes to "keep our economy stable."

Where is it written that some people have a god given right to get wealthy off the sickness and suffering of others? What sick religious belief tells us that we should only help the suffering if we can do it without it costing us money?

The right wing uses fear, lies, violence and name calling when they have no real arguments left. Anyone familiar with the history of fascism should recognize the patterns. Perhaps the right wing is flinging the word "Nazi" around because they have been dipping so freely into the very techniques the Nazis used to rise to power. Scream your lie loud enough, gather a violent mob to attack those who attempt to argue with you, and you can take over a country. For a while.

I think the American people are better than that. If you agree, contact your representatives in congress and let them know what you want to see in health care reform. Let them know that you don't make death threats to those who disagree with you but that you vote and that your friends with diabetes vote and you will be voting for those who do not let the huge corporate interests define "health care" as "The right to profit from the wealthy, employed, privileged sick."


Stargazey said...

Where is it written that some people have a god given right to get wealthy off the sickness and suffering of others?

A licensed physician must have an education that costs hundreds of thousands of dollars to obtain. He or she must rent office space, buy office equipment, employ staff and buy malpractice insurance. He or she will eventually have children and other family members to care for. A physician typically works 10 to 16 hour days, so there is no time to moonlight at another job to earn spending money.

Do you believe it is permissible for a physician to be paid enough for his or her services to take care of all the expenses listed above? If you do, how much would be acceptable to you before the physician would become guilty of getting wealthy off the sickness and suffering of others?

Drs. Cynthia and David said...

I agree with you 100 percent. And I'm pretty sure you didn't mean Drs. shouldn't be able to earn a living wage. In fact, there has been considerable pressure to decrease income to Drs over the last years (unless perhaps they bring in lots of money for "procedures") but I don't think it is Dr salaries that are causing the problem! Rather it is the vested interests in the insurance companies, hospitals and HMOs, not the actual caregivers.

We are in the ranks of the uninsured too. We probably could have bought into a plan, but the rates were so outrageous, we saw no real benefit. We do our best to keep the chronic conditions away, thanks to websites such as yours that educate people to make healthy decisions, despite what the authorities say.

Thanks for all you do.


Susanne said...

I too am uninsured. A trip to the emergency room would be an economic disaster for me.

I try to keep my carbs down, avoid risky sports, and in general lead a healthy life, despite my slowly increasing blood sugar levels.

I applied for Cobra when I left my job and the premium was over $1200 a month, which I could not afford.

In this great country it is a disaster that we don't have basic medical coverage for everyone. I have Canadian, British, French and Danish friends, all with national healthcare, and their world has not come to and end because of it. In fact, their life expectancy is longer than ours.

Stargazey said...

Here is an interesting article: Cancer Survival Rates Improving Across Europe, But Still Lagging Behind United States.

It says lots of sobering things, including this, The greatest differences were seen in the major cancer sites: colon and rectum (56.2% in Europe vs 65.5% in the United States), breast (79.0% vs 90.1%), and prostate cancer (77.5% vs 99.3%).

The healthcare plans being formulated in Congress are based on Tom Daschle's book, "Critical: What We Can Do About the Health-Care Crisis," which uses the healthcare system of the United Kingdom as its model. For the specifics of how well that works, here is another article: UK cancer survival rate lowest in Europe.

Thomas said...

Wow. I didn't subscribe to this blog to hear liberal media attacks parroted. I subscribed because I found some valuable information on diabetes. As a man who has been laid off twice in the last 8 months, I know what it means to be diabetic without insurance, and I know how much it costs. I'd rather bear those expenses than have the socialist health program that is currently proposed. Unless you have read the 1,000 page document that describes this trash system, you really ought to shut up. You have no idea how this health "reform" will screw our health system. As far as the so called "rent-a-mobs", I am a rally attendee. No one paid me, and not one supporter of this bill could explain even one facet of it, or clearly refute the facts that demonstrate just how damaging this plan is. Unfortunately, health care is not a right. It is also not the business of the federal government. Please, stick to diabetes information - at least you understand it.

Ian said...

Here in Australia, being a medical doctor is still a high prestige, high income job, in spite of the fact that we've had universal healthcare for many years.

There's still the option of taking out private health insurance to cover the things that Medicare doesn't (private room in hospital, shorter waitlists for elective surgery, etc.) but the basic health needs are available to all citizens.

Frankly, I'm amazed that anyone in the US still thinks that they can call themselves a civilised society when they're happy to deny basic medical attention to the poor and disadvantaged. It's a disgrace and has done nothing to raise your status in the rest of the world.

(Mind you, starting wars on abstract nouns, torturing prisoners, and the hypocritical treatment of your own economic crisis so differently to the World Bank's strictures, haven't exactly lived up to the historical "leader of the free world" label that used to have at least some justification...)

Anonymous said...

People who choose not to take care of their DB due to lack of healthcare are making a choice. Where I live, there are free clinics and the teaching hospital also welcomes those who cannot pay. Anyone who needs healthcare in this country has it available. Not taking advantage of that is either ignorance or a freely made choice.

Jenny said...

The availability of insurance varies from state to state. So just because you live in a state where people aren't left to die on the street, don't assume other states are the same.

In some states there are programs for the poor and availability of insurance. In others, nada.

I would not have written about this if I didn't personally know hard working people with middle class professional careers who are currently unable to get insurance that would cover drugs that could save their lives. One has a condition where the only effective drug costs $10K a month. Insured patients get it. She can't.

Why a drug company is allowed to charge $10K a month for a drug that means the difference between sitting immobilized in a wheelchair and living a normal life is another question. Especially when the insured's insurance company is NOT paying that $10K since the companies CAN negotiate the price. It is only everyone else who can't.

I also have a close relative who was in a terrible accident in another state and what she went through with her insurance company--she had insurance--while recovering from massive injuries
taught me just how evil insurers can be. When you are wondering if you are going to lose a limb you really don't need to be fighting with operatives who refuse to give their name on the phone who refuse to pay your hospital bills. When the insurer insists it will only pay for treatment by an incompetent family doctor instead of a specialist in that situation you see why we need major reform.

If you don't like my opinions, by all means please stop reading my blog.

Scott S said...

I think the biggest irony is the fact that right-wingers are suddenly playing the "fiscal conservative" card. I would like to ask these same people where they were during the last 8 years and approving deficit-after-deficit to pay for a war that was clearly not supported by all Americans. Now, when it comes to the health and well-being of those who actually pay these taxes, apparently money needs to ... suddenly ... be rationed. This debate is looking more similar to what happened in 1993, except that some parties now claim to support reforms, provided, of course, that their profitable business models are not altered in any way!

Stargazey said...

In case uninsured and underinsured people are reading this--I deal with coverage-related issues in my husband's medical office all the time.

If you are uninsured and need a particular drug, the drug companies often have a Patient Assistance Program. Ask your physician to refer you to the local drug rep, or you can look in the front of the Physicians' Desk Reference (PDR) for contact information. Catholic Family Services is also a good resource, even if you're not Catholic.

If your insurance company fails to live up to its contract, contact your state's Department (or Board) of Insurance. You will be asked to provide copies of correspondence, and date/name logs of telephone conversations as well as a clear, concise narrative of your experiences and an explanation of what you want the insurance company to do. (Emotional appeals are not helpful. Try to be as businesslike as possible.) I do this about twice a year for my husband's patients. Because the State Insurance Board can yank the license of noncomplying companies, the insurance companies snap-to very smartly and take care of the problem. I am always amazed at how efficiently this happens.

Jenny said...


Your reply assumes that the patient has the energy and education to pursue the long, complex process involved in fighting a recalcitrant insurer.

When I had a child with a severe condition requiring two surgeries and an insurer who refused to pay for them (and bragged in the Wall Street Journal that they were so profitable because of their legal department which fought customer claims so well) I did not have the resources to go through the process you describe.

When my insurer paid 50% of claims for another procedure instead of the 80% my contract said they'd paid, and I was in intense chronic pain, again, I did not have the energy to deal with it. The insurers know this.

Try fighting with them when you have advancing cancer. Not to mention advancing dementia.

And many people in our society don't have advanced degrees like I do and do not have the capability to understand the processes needed to get the care they are due.

The compassionate program doesn't work for all drugs, and people who are not critically ill often don't qualify. If you wait until the damage is done by chronic illness you may be eligible for services but preventing the damage the chronic disease causes is much harder. So you'll get your dialysis covered but no insulin as a Type 2 with no beta cells left to prevent the kidney failure.

Jenny said...


Your argument also assumes that the patient can afford to see the doctor in the first place. Back before Massachusetts instituted its full coverage program endos in my region were billing $450 for a first appointment, and not offering free appointments to those who couldn't afford them. I'm sure it is like that other places.

The doctors may not even know of the people who called needing care they can't afford because the desk staff screen those calls and they don't ever get past those high school educated clerks.

Stargazey said...

Jenny, if a patient has difficulty filling out forms, there is often a family member or a friend who can assist them.

I realize that there are inequities in the system. Are you advocating that those with good insurance be required to accept Medicare-level insurance so that everyone will be able to have some level of insurance coverage? The bill as it is written now mandates that if a commercial insurance company makes any change in a patient's policy (or if the patient changes jobs) the patient must go on the national health insurance plan.

Stargazey said...

Two more thoughts:

You said, Your reply assumes that the patient has the energy and education to pursue the long, complex process involved in fighting a recalcitrant insurer.

No. Don't fight with the insurer. Let the State Board of Insurance do it for you. Appeal once to the insurer, so you have documentation that you did it. Then go to the State Board. They don't have to put up with the hoo-ha that the insurance companies dish out to policyholders.

You said, Your argument also assumes that the patient can afford to see the doctor in the first place.

Often a needy person can present his or her situation to their church and the church will step in and help.

Jenny said...

You are making assumptions based on your own locality. Many people aren't church goers. Or they attend churches that have no political clout.

And if you live in Connecticut, where I used to live, the state insurance board is a wholey owned subsidiary of the insurance industry which is so huge an employer in Hartford everyone is afraid to challenge them.

Your posts really point out to me how limited people's viewpoints are by where they live and the specifics of that area.

California is very different from Arkansas, Texax, or Massachusetts, in terms of access, regulation, and how doctors operate. This is one reason we need a national health insurance policy that ensures everyone access independent of income or intellectual attainment.

I personally find it horrifying to think a person's access to a doctor might depend on their choice of religion and church affiliation.

Bernard said...

Thanks Jenny. I've an appointment with someone from my congresswoman's office next week. Her town hall meetings are being disrupted by those astroturf demonstrations. But I'll tell them in person what I hope will come out of that legislation and the rules that will be developed to implement it.

Jenny said...

My mother's medicare coverage (which I oversee) costs her a lot less than what I pay for my insurance and covers more.

If everyone might have to use the same insurance as those without powerful political friends the quality of that insurance would improve quickly.

Personally I'd like any legislation to ensure that our lawmakers have to use whatever plan is the worst they come up with.

Stargazey said...

Jenny, you and some of the commenters seem to confuse health insurance with access to health care.

If 40 million uninsured plus all the currently insured are placed into one national health insurance plan, that does not mean they will all receive optimal treatment.

Providers will be even more stressed for time than they are now. Troublesome or complicated patients will find that their folder drops to the bottom of the stack. When a difficult patient wants to see a particular doctor, that patient will be even more subject to the whims of high-school level office staff who don't want to be inconvenienced.

The rich will obtain excellent medical care, offshore, if necessary. Everyone else will find long lines, overworked personnel, and limitations on the treatments and medications available to them unless they have a position of privilege that allows them to jump the line and ignore the rules that the common people have to obey.

Lover, not a fighter.... said...

**The right wing fringe is trying to frighten the public

They prefer the old system, where only those who are poor, unemployed, or have a chronic condition are forced to die because care is withheld.**

No, they recognize a change is needed. WHat they fear is a new system being rushed though congress without input from the American people...just as so many other things have been rammed thru congress.

What concerns Righties is that they will use healthcare as another way to institute social policy. (Do jailed inmates have access to sex change operations?)

What concerns Righties is that the Government will decide if you get a meter...can have more than 2 A1C's per year.

If you LOVED the Registry of Motor Vehicles...You'll LOVE Obamacare!

If you liked how they handles the "Cash for Clunkers"'ll LOVE Obamacare!

Again, the biggest problem that Righties are worried about is that this is being rushed/rammed through congress and into law without details or citizen input....just like the Tarp funds or Wall St. bailouts.

Thomas said...

My mother's medicare coverage (which I oversee) costs her a lot less than what I pay for my insurance and covers more.

Who do you suppose pays for your Mom's Medicare coverage?

Susanne said...

I don't think any of us are talking here about sex-change operations for inmates. We are talking about metformin, insulin and needles for diabetics, immunuzations for children, pap smears, mammograms and birth control for women, PSA tests for older men, high blood pressure medications to prevent stroke, basic health care that will do a world of good keeping Americans healthy. Insulin is much cheaper than an amputation, a statin drug much cheaper than a heart attack or stroke. We are ALL paying for the lack of good basic health care.

Stargazey said...

Susanne, my husband and I pay for all of those things (except birth control and immunizations) out of our own pockets. Compared with something like high speed internet, they are not very expensive.

Nevertheless, if the items listed are still unaffordable, Medicaid has means testing to allow people to get services that way. Churches and charitable organizations will also provide financial help in many cases.

An Astute Observer said...

"I don't think any of us are talking here about sex-change operations for inmates."

Of course you're not. But that's the point, you will not have a say in what they will cover.

In my state the government covers such foolish things...including hormones for inmates in "transition" and electrolysis.

Who decides these things? Politicians. When the government takes over health care, all it takes is a few crazy politicians to legislate whats convered and whats not covered.

We are talking about metformin, insulin and needles for diabetics, immunuzations for children, pap smears, mammograms and birth control for women, PSA tests for older men, high blood pressure medications to prevent stroke

We all have our wishlist, don't we? You are willing to go along with anything Obama says, because you are convinced the end result will be your (and my) idea of what is good healthcare.

Have you seen any details that Obamacare will give you these things? Of course not, there ARE no details.

Politicians will decide if you "deserve" a pump, because your A1C is not high enough. And since you are a TypeII you can only have 1 A1C lab done a year. And Type II's might have to use only dietary therapy, since insulin and RX's cost so much.

It all comes down to those who WANT something from the government with the hope that someone else will pay for it.

There is no free ride.