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Texas’ Other Death Penalty
12-22-2013, 09:42 AM #1
Wayne5 Member
Posts:660 Threads:61 Joined:Nov 2013
The first patient who called me “doctor” died a few winters ago. I met him at the St. Vincent’s Student-Run Free Clinic on Galveston Island. I was a first-year medical student then, and the disease in his body baffled me. His belly was swollen, his eyes were yellow and his blood tests were all awry. It hurt when he swallowed and his urine stank.

I saw him every Thursday afternoon. I would do a physical exam, talk to him, and consult with the doctor. We ran blood counts and wrote a prescription for an antacid—not the best medication, but one you can get for $4 a month. His disease seemed serious, but we couldn’t diagnose him at the free clinic because the tests needed to do so—a CT scan, a biopsy of the liver, a test to look for cancer cells in the fluid in his belly—are beyond our financial reach.

He started calling me “Dr. Rachel.” When his pain got so bad that he couldn’t eat, we decided to send him to the emergency room. It was not an easy decision.

There’s a popular myth that the uninsured—in Texas, that’s 25 percent of us—can always get medical care through emergency rooms. Ted Cruz has argued that it is “much cheaper to provide emergency care than it is to expand Medicaid,” and Rick Perry has claimed that Texans prefer the ER system. The myth is based on a 1986 federal law called the Emergency Medical Treatment and Labor Act (EMTALA), which states that hospitals with emergency rooms have to accept and stabilize patients who are in labor or who have an acute medical condition that threatens life or limb. That word “stabilize” is key: Hospital ERs don’t have to treat you. They just have to patch you up to the point where you’re not actively dying. Also, hospitals charge for ER care, and usually send patients to collections when they cannot pay.

My patient went to the ER, but didn’t get treatment. Although he was obviously sick, it wasn’t an emergency that threatened life or limb. He came back to St. Vincent’s, where I went through my routine: conversation, vital signs, physical exam. We laughed a lot, even though we both knew it was a bad situation.

One night, a friend called to say that my patient was in the hospital. He’d finally gotten so anemic that he couldn’t catch his breath, and the University of Texas Medical Branch (UTMB), where I am a student, took him in. My friend emailed me the results of his CT scans: There was cancer in his kidney, his liver and his lungs. It must have been spreading over the weeks that he’d been coming into St. Vincent’s.

I went to visit him that night. “There’s my doctor!” he called out when he saw me. I sat next to him, and he explained that he was waiting to call his sister until they told him whether or not the cancer was “bad.”

“It might be one of those real treatable kinds of cancers,” he said. I nodded uncomfortably. We talked for a while, and when I left he said, “Well now you know where I am, so you can come visit me.”

I never came back. I was too ashamed, and too early in my training to even recognize why I felt that way. After all, I had done everything I could—what did I have to feel ashamed of?

UTMB sent him to hospice, and he died at home a few months later. I read his obituary in the Galveston County Daily News.

The shame has stuck with me through my medical training—not only from my first patient, but from many more. I am now a director of the free clinic. It’s a volunteer position. I love my patients, and I love being able to help many who need primary care: blood pressure control, pap smears, diabetes management. We even do some specialty care. But the free clinic is also where some people learn that there is no hope for the chemotherapy or surgery that they need but can’t afford. When UTMB refuses to treat them, it falls to us to tell them that they will die of diseases that are, in fact, treatable.

http://www.texasobserver.org/a-galveston...afety-net/
12-22-2013, 02:33 PM #2
JayRodney ⓐⓛⓘⓔⓝ
Posts:31,393 Threads:1,439 Joined:Feb 2011
This type of scenario plays out daily in many other States as well. It's not about saving lives, rather, this is saving about money on the part of healthcare providers.

Healthcare should be not for profit, like other western nations. Of course that won't happen due to the big pharma lobby lining the pockets of elected officials that conspire to keep drug costs from being regulated.

This entire cluster fekk would sort itself out far better if drug prices were brought under control like everywhere else on the planet that offers universal healthcare.

It kills me how nobody is addressing the elephant in the parlor, but everyone will pay for it in one form or another.

wonder.gif
12-22-2013, 06:57 PM #3
Softy Incognito Anonymous
 
One of the biggest problems,,,and one politicians really don't want

to talk about,,,is the fact that healthcare is advanced enough to keep

people alive for a very long time,,,this is a good thing,,,it is also a very

expensive thing to do,,,and we want this for everyone,,,and yet simple

math tells us that we can't,,,even for those who have worked hard all

their life,,,and paid taxes heavily,,,in good jobs,,,they have barely

covered the costs,,,so,,,some lines are going to have to be drawn,,,

and no one,,,including me,,,wants to draw them...

(:X
12-22-2013, 11:04 PM #4
Wayne5 Member
Posts:660 Threads:61 Joined:Nov 2013
Softy, I don't know where to draw the line as well. I just know that the line in Texas is in the wrong place. I think its not hard to figure out where to draw the line. Every other industrialized country on earth had done a better job than us at figuring it out. Why not just use Canada's line? or Finland's? Both of them spend less per person than we do.

I could fill the page with articles like this and it wouldn't convince some on this forum that it is true.

I'm trying to save some from eternal regret. Anyone that influences a person to not get insurance by their talk about how the web site doesn't work when it does, is in a real way responsible for what happens to that person.

coffeetime.gif
12-22-2013, 11:25 PM #5
JayRodney ⓐⓛⓘⓔⓝ
Posts:31,393 Threads:1,439 Joined:Feb 2011
(12-22-2013, 11:04 PM)Wayne5 Wrote:  Why not just use Canada's line? or Finland's? Both of them spend less per person than we do.

I could fill the page with articles like this and it wouldn't convince some on this forum that it is true.

No convincing me required, I have first hand experience.
It just works.
You don't pay anything unless you see a doctor, and then it's based on your income.
I'm all about single payer/universal healthcare and my politics lean toward conservative.
Unfortunately, the ADA is the furthest thing from universal healthcare one can get and there are no controls on drug prices. 13.gif

wonder.gif
12-22-2013, 11:34 PM #6
j browsing Member
Posts:5,158 Threads:1,098 Joined:Jul 2012
(12-22-2013, 11:04 PM)Wayne5 Wrote:  Softy, I don't know where to draw the line as well. I just know that the line in Texas is in the wrong place. I think its not hard to figure out where to draw the line. Every other industrialized country on earth had done a better job than us at figuring it out. Why not just use Canada's line? or Finland's? Both of them spend less per person than we do.

I could fill the page with articles like this and it wouldn't convince some on this forum that it is true.

I'm trying to save some from eternal regret. Anyone that influences a person to not get insurance by their talk about how the web site doesn't work when it does, is in a real way responsible for what happens to that person.

coffeetime.gif

it is a matter of survival wayne..when they took half a trillion out of medicare to pay for the aca..the whole thing stinks to high heaven and the insurance companies will just get richer and no one is on this forum has the power to prevent someone from signing up for the aca..you under estimate the brains of people ..we still have free speech 13.gif

"when life gives you lemons..throw them at someone"...Grumpy Cat good.png
12-22-2013, 11:37 PM #7
Softy Incognito Anonymous
 
Hi Wayne5,

Not trying to differ with you here,,,in fact agree,,,think England

draws the line at 80,,,and others,,,maybe they pull it off,,,

and things are too expensive here,,,by comparison,,,and yeah,,,

should say website is not working when it is,,,by the same token,,,

not saying anything,,,when security is compromised,,,or when it

doesn't handle enough to get everybody signed up,,,is not a good

thing either...

Hi JayRodney,

Glad you have something that works,,,I would still prefer private,,,

with a little competition for performance and price,,,single payer

universal sounds to much like Veterans Administration here,,,

well .gov run system,,,Australia sounds better with a bit of both...

(:X
12-22-2013, 11:39 PM #8
Wayne5 Member
Posts:660 Threads:61 Joined:Nov 2013
I agree Jay. The ADA is all those things. But the web site worked for me. And lots of people die in Texas because they don't have insurance. Hundreds of thousands of people are not on medicaid because Rick Perry wants to look good for the Tea Party. Of course all the taxpayers in Texas will help pay for the medicaid people of other states. If this is conservative leadership I want nothing to do with it.

coffeetime.gif
12-22-2013, 11:46 PM #9
Softy Incognito Anonymous
 
that should read,,,should not say website is not working when it is,,,

of course only reason anyone said that,,,

was because it didn't work,,,and kinda where I see alot of

this heading...

(:X
12-22-2013, 11:56 PM #10
UniqueStranger Art in my heart
Posts:15,061 Threads:428 Joined:Jun 2012
I think the Director of the free clinic should start campaigning for donations to help get the surgeries and whatever else is needed to save lives. I think if people were aware of the plight of those among us, then those that are able to help, will help.
12-23-2013, 12:04 AM #11
Wayne5 Member
Posts:660 Threads:61 Joined:Nov 2013
(12-22-2013, 11:34 PM)j browsing Wrote:  
(12-22-2013, 11:04 PM)Wayne5 Wrote:  Softy, I don't know where to draw the line as well. I just know that the line in Texas is in the wrong place. I think its not hard to figure out where to draw the line. Every other industrialized country on earth had done a better job than us at figuring it out. Why not just use Canada's line? or Finland's? Both of them spend less per person than we do.

I could fill the page with articles like this and it wouldn't convince some on this forum that it is true.

I'm trying to save some from eternal regret. Anyone that influences a person to not get insurance by their talk about how the web site doesn't work when it does, is in a real way responsible for what happens to that person.

coffeetime.gif

it is a matter of survival wayne..when they took half a trillion out of medicare to pay for the aca..the whole thing stinks to high heaven and the insurance companies will just get richer and no one is on this forum has the power to prevent someone from signing up for the aca..you under estimate the brains of people ..we still have free speech 13.gif

I agree about the medicare cuts. I know your situation is effected directly by this turmoil. But I run into people weekly that intended to just gave up because they thought the web site didn't work. What we say here influences people. We don't force them but we can effect their behavior. A lot of people read this forum that never post. I'm not saying people should stop pointing out the bad things about the ACA, I'm saying what I always say, you don't have to distort the facts to make your point.

A lot of people believe that uninsured people get the treatment they need by going to the emergency room. They do not.

coffeetime.gif
12-23-2013, 12:08 AM #12
j browsing Member
Posts:5,158 Threads:1,098 Joined:Jul 2012
(12-23-2013, 12:04 AM)Wayne5 Wrote:  
(12-22-2013, 11:34 PM)j browsing Wrote:  
(12-22-2013, 11:04 PM)Wayne5 Wrote:  Softy, I don't know where to draw the line as well. I just know that the line in Texas is in the wrong place. I think its not hard to figure out where to draw the line. Every other industrialized country on earth had done a better job than us at figuring it out. Why not just use Canada's line? or Finland's? Both of them spend less per person than we do.

I could fill the page with articles like this and it wouldn't convince some on this forum that it is true.

I'm trying to save some from eternal regret. Anyone that influences a person to not get insurance by their talk about how the web site doesn't work when it does, is in a real way responsible for what happens to that person.

coffeetime.gif

it is a matter of survival wayne..when they took half a trillion out of medicare to pay for the aca..the whole thing stinks to high heaven and the insurance companies will just get richer and no one is on this forum has the power to prevent someone from signing up for the aca..you under estimate the brains of people ..we still have free speech 13.gif

I agree about the medicare cuts. I know your situation is effected directly by this turmoil. But I run into people weekly that intended to just gave up because they thought the web site didn't work. What we say here influences people. We don't force them but we can effect their behavior. A lot of people read this forum that never post. I'm not saying people should stop pointing out the bad things about the ACA, I'm saying what I always say, you don't have to distort the facts to make your point.

A lot of people believe that uninsured people get the treatment they need by going to the emergency room. They do not.

coffeetime.gif

they do get the treatment..my husband was dying in dec of 2007 and taken to the emergency room having lost half of his blood volumn ..he didn't have insurance at the time ..they saved his life ..they applied to a charity that paid a good portion of his bill ..I have a grant from a charity that pays for my medigap

"when life gives you lemons..throw them at someone"...Grumpy Cat good.png
12-23-2013, 12:10 AM #13
Wayne5 Member
Posts:660 Threads:61 Joined:Nov 2013
(12-22-2013, 11:37 PM)Softy Wrote:  Hi Wayne5,

Not trying to differ with you here,,,in fact agree,,,think England

draws the line at 80,,,and others,,,maybe they pull it off,,,

and things are too expensive here,,,by comparison,,,and yeah,,,

should say website is not working when it is,,,by the same token,,,

not saying anything,,,when security is compromised,,,or when it

doesn't handle enough to get everybody signed up,,,is not a good

thing either...

Hi JayRodney,

Glad you have something that works,,,I would still prefer private,,,

with a little competition for performance and price,,,single payer

universal sounds to much like Veterans Administration here,,,

well .gov run system,,,Australia sounds better with a bit of both...

(:X

Softy, the woman that worked at the convenience store down the street from me died at 50 because she couldn't get a bypass operation. She could barely walk and she was still behind the counter working a week before she excepted hospice and died.

The line is in the wrong place. Texas isn't number 50 in healthcare for nothin.
12-23-2013, 12:12 AM #14
Wayne5 Member
Posts:660 Threads:61 Joined:Nov 2013
(12-23-2013, 12:08 AM)j browsing Wrote:  
(12-23-2013, 12:04 AM)Wayne5 Wrote:  
(12-22-2013, 11:34 PM)j browsing Wrote:  
(12-22-2013, 11:04 PM)Wayne5 Wrote:  Softy, I don't know where to draw the line as well. I just know that the line in Texas is in the wrong place. I think its not hard to figure out where to draw the line. Every other industrialized country on earth had done a better job than us at figuring it out. Why not just use Canada's line? or Finland's? Both of them spend less per person than we do.

I could fill the page with articles like this and it wouldn't convince some on this forum that it is true.

I'm trying to save some from eternal regret. Anyone that influences a person to not get insurance by their talk about how the web site doesn't work when it does, is in a real way responsible for what happens to that person.

coffeetime.gif

it is a matter of survival wayne..when they took half a trillion out of medicare to pay for the aca..the whole thing stinks to high heaven and the insurance companies will just get richer and no one is on this forum has the power to prevent someone from signing up for the aca..you under estimate the brains of people ..we still have free speech 13.gif

I agree about the medicare cuts. I know your situation is effected directly by this turmoil. But I run into people weekly that intended to just gave up because they thought the web site didn't work. What we say here influences people. We don't force them but we can effect their behavior. A lot of people read this forum that never post. I'm not saying people should stop pointing out the bad things about the ACA, I'm saying what I always say, you don't have to distort the facts to make your point.

A lot of people believe that uninsured people get the treatment they need by going to the emergency room. They do not.

coffeetime.gif

they do get the treatment..my husband was dying in dec of 2007 and taken to the emergency room having lost half of his blood volumn ..he didn't have insurance at the time ..they saved his life ..they applied to a charity that paid a good portion of his bill ..I have a grant from a charity that pays for my medigap

One question. Was he in Texas?
12-23-2013, 12:14 AM #15
j browsing Member
Posts:5,158 Threads:1,098 Joined:Jul 2012
(12-23-2013, 12:10 AM)Wayne5 Wrote:  
(12-22-2013, 11:37 PM)Softy Wrote:  Hi Wayne5,

Not trying to differ with you here,,,in fact agree,,,think England

draws the line at 80,,,and others,,,maybe they pull it off,,,

and things are too expensive here,,,by comparison,,,and yeah,,,

should say website is not working when it is,,,by the same token,,,

not saying anything,,,when security is compromised,,,or when it

doesn't handle enough to get everybody signed up,,,is not a good

thing either...

Hi JayRodney,

Glad you have something that works,,,I would still prefer private,,,

with a little competition for performance and price,,,single payer

universal sounds to much like Veterans Administration here,,,

well .gov run system,,,Australia sounds better with a bit of both...

(:X

Softy, the woman that worked at the convenience store down the street from me died at 50 because she couldn't get a bypass operation. She could barely walk and she was still behind the counter working a week before she excepted hospice and died.

The line is in the wrong place. Texas isn't number 50 in healthcare for nothin.

that pisses me off to hear this ..no reason for that at all damned.gif my husband was in Michigan

"when life gives you lemons..throw them at someone"...Grumpy Cat good.png



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