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Did anyone catch 60 Minutes last night?

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

Frightening Segment on some hopsitals closing their cancer facilities for people with no insurance but who are not on welfare or not rich. In other words, many people like us who are middle class and happen to lose jobs and insurance. This dealt with Las Vegas but it wasn't an encouraging piece. I hope that no one is offended by this*. I hope that all of us are OK and will not be affected by something like this. It comes down to the financial crisis that's been brewing for many years and finally boiled over.
-phil

*I feel I have to put a disclaimer in posts as to not offend anyone.

msccolon's picture
msccolon
Posts: 1956
Joined: Oct 2004

I didn't see the show, but the article is really scary. I know that if I wasn't able to get my insurance continued i was going to have to go to my local hospital for chemotherapy; presently I get my chemo at my oncologists' office. Can you imagine what it would be like to suddenly get a letter in the mail telling you that you are going to die because you have no way of getting the chemotherapy you need?
mary

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

I had seen a print article on this and was horrified. How awful that we'll allow people to die for lack of funds.

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

OK, I am going to take a break from the computer today... this article just boils my blood!! And yet, people are still resistant to having a law/plan that EVERYBODY has medical insurance. I don't know how anyone can read that article and not say, "Enough is enough! No one should have to go through that kind of cruelty and stress, when they already have a life threatening illness that possibly could be treated."

On an email group I'm on, one American friend said "we all have choices. If I choose to pay for medical insurance vs spending my money on vacations, nice cars, a summer home, etc. then that's the way it works. I have chosen to have medical insurance for myself and my family...others find they choose other options." But she's totally missing the point!! What if she loses her job? How is she going to afford her "choice"?? It's all fine and dandy to say, "Ok, I've lost my job so that means no more trips to Hawaii and now I may have to sell the fancy car and get a cheap one that gets me from Point A to B (or give up the car totally)". But to think that health care insurance is a "choice"??

I KNOW I'm going to offend a lot of people with this post because I know there have been those who are very vocal about National Health Care... and some feel that they shouldn't have to pay higher taxes so that the "bums on welfare" and the "illegal immigrants" get healthcare on their dime. I take it if that's your feeling, then the middle class, hard-working folk (I figure the majority of us on this board fall into that category) don't deserve health care insurance either be it because of a loss of job or just the fact they can't afford the cost of insurance. Too bad, so sad?
"Oh, you have cancer that may respond very well to treatment, but you can't have it because you can't afford insurance... too bad."

I have way too many American friends that I know this is going to affect and I bet you right here on this Board it will affect a lot of our friends here. I don't think it's the cancer that we have to be afraid of... it's the fact that you can get cancer and no one is going to help you because you don't have insurance... or the insurance you do have is going to expire.

I feel for you all!

Cheryl

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

It was unbelievable and difficult to watch. I think many of us are working in fields that may be affected by the economic crisis going on. Many people I hope, have insurance and many have put it through the paces and are doing OK. I've also read where some people do not have certain drug coverage due to something stupid like they are at the wrong stage. Oh, not quite close enough to being dead I suppose in the eyes of insurance companies. Something has to be done and if it means some sort of nationalization of the insurance/medical industry, then so be it. Most of these people who make these decisions are on the outside looking in. If THEY had cancer, it would be a different story. It reminds me of my PCP (primary care physician) who diagnosed me. He was an oncologist (BS) and had been giving me checkups for over 10 years. How the @$#& he missed the DX is beyond me, but when I wanted to start the treatment yesterday...he said "oh, we'll do it in a few weeks. You've had this for while, what's the difference". The difference is that if I listened to him I'd be dead. Yeah, stop cheering out there, you know who you are... ;-)
My point is that no one gives a rats you know what until it affects THEM. I felt so bad for those people that because of lack of funds to pay the incredible prices, $180 for Emend or $30,000 for Erbitux or whatever, they are basically sentenced to death. Our fate is too often in the hands of the Almighty Dollar.

Hmmm, I just had chemo today. I'm usually in a cranky mood - go figure

spongebob's picture
spongebob
Posts: 2598
Joined: Apr 2003

So you have been forewarned if you want to change the channel!

Phillie, mscolon, and Diane...

I hear what you're saying and I feel the emotional impact of stories like the 60 minutes segment you are referecing. But I must respectfully disagree with your assertions that a national healthcare plan would fix this...

Here's what I'm talking about;

1. A "County Hospital" (such as the one in the segment) is, in fact, the perfect example of a government healthcare facility! It's a government-funded hospital.

2. Uh... has anyone taken a look at the debacle that is Walter Reed Army Medical Center? And let us not forget that "Wally World" is the Crown Jewel of the Army's medical system. Another example of a government healthcare system.

3. Has anyone paid attention to how our warriors returning from Iraq and Afghanistan are doing with their health care? Not well - and they're faring better than our vets from other eras did. If you don't know a vet and can't relate to his or her situation, take a gander at the "Military Cancer Survivors" discussion board I started here at CSN a few years ago because of the many rocks and shoals people encounter navigating our system. Imagine if everyone in the coutry had as many problems and questions about their healthcare as those military folks and military retirees who are using the Veteran's Administration (read as "government") system.

4. And speaking of "vets from other eras", anyone recollect when the government reniged on their promise for "Lifetime Healthcare" that WWII vets signed-up for and served honorably for 20+ years to get? Yeah. You mean the US Government can chage the rules after you sign up for something... Yeah. Big surprise there. (OK, call me cynical. 28 years in the military might do that to one)

5. I realize I am focusing on military healthcare, but, let's face it, military healthcare IS an example of a GOVERNMENT healthcare system. I am not judging it here, I am reporting facts. I'm sure I could get spome facts together on the Federal Prison System's healthcare system. The military system treats a few. Think about this broken system treating everyone in America.

6. OK, let's assume it happens. Let's assume we adopt a national healthcare system that is similar to the existing national healthcare system we have in place for our military personnel, veterans and retirees. How will we pay for it? Interesting aside, did you know that the branches of the military actually budget for "x" number of people to get cancer each year. They HOPE that more people than "x" don't get sick because they will have to find the money some place else!) So what happens when we have a nationalized healthcare system and someone misses the mark on forecasting costs of cancer treatment? Will folks who are receiving paliative care have it terminated (because they're going to die anyway)? Will patients who are "just" stage 2 not get chemo because they are "just not that sick"? I respectfully submit that there are some former stage 2 folks here at the board who are now stage 4 because of that exact mentality.

Is our health insurance system broken? You betcha! But folks still come south of the border from Canada to get treatment - a comment on some pitfall(s) of the Canadian system? I don't know; I'm not a Canadian tax-payer so I will refarin from discussing their issues because I don't have a dog in that fight. Our healthcare insurance system is broken - in my humble opinion - largely because of two reasons: our letigious national bent and our broken legal system and our societal attitude of entitlement.

These are what we need to fix. A national healthcare system - which has not been much of a success on the small military and prison system and county hospital/medicaid level - is not the answer in my book. We can't make it work well on a small scale, and - based on the number of people who come to the US for treatment from abroad - a government healthcare system elsewhere isn't all that it's cracked-up to be. We need to think outside the box. We need to look for better answers than a knee jerk response to "create a national healthcare system". Your government can't fix everything; if they could, medicare, medicaid, social security, and a whole host of other government programs would not be the clusters they are presently.

My views have nothing to do with the wealthy not wanting to support the poor as others have suggested. In fact, I would suggest that the wealthy's tax dollars do much to buoy-up medicaid, medicare, social security, SSI, and other welfare programs. I'm middle class (there are those who would say I have no class though) and I don't have a problem with my tax dollars going to help people who are in a diffcult spot. What I have a problem with is subsidizing healthcare for people who are cavalier and/or who don't contribute to our society and who aren't going to be there for me if I need some help some day. What I have an even harder time with is a government that can't get it right on a small scale suggesting they should take on a national-size problem. Let's seek a solution where government can provide one - let's focus on regulating (with teeth) our broken legal system and how we dole out our limited social support services.

OK, stepping off my soap box now.

- SB

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

SB, You misunderstood me. I'm not in favor of national health care! My heart aches for those who cannot control their circumstances!

My family went without health insurance for 11 years. Hubby had to use the VA for his COPD, severe asthma, Rheumatoid arthritis, atropied/ neurogenic bladder (has had to catherize himself for over 25 years), high blood pressure/ cholesterol, 30 instances of skin cancer (basal cell/ 5 surgeries and 25 surgeries for early melanoma). We were thankful to have that available, tho care is substandard to say the least.

Hubby, a former Republican State Representative in Connecticut, lost his job after the company closed several years ago and is now getting his teaching certificate to teach middle school math. Jim is age 62 and working full time as a teacher's assistant, head coach in several sports and going to college full time. We are VERY low income (less than 175% below poverty level) but have insurance and are so very thankful for that! Two years ago, if I had been dx'd, I would be one of those left to die.

My heart breaks for those who have no jobs, through no fault of their own in many instances, and who cannot afford $600. a month for private insurance.

jsabol's picture
jsabol
Posts: 1156
Joined: Dec 2003

Yeah, but how do you really feel? Lots of emotion around this subject. I don't pretend to have good answers, but felt compelled to respond ('tho less eloquently than you!)The VA is a health delivery system, (not a national health insurance plan) and it falls woefully short. We have the best medical care in the world and don't need new hospitals. CHAMPUS, federal health insurance is a gem. Wish I had that kind of coverage.
Having worked as a nurse my entire life, including a stint in the Pittsburgh Veterans Hospital, I find it incredible that the richest country in the world does not work to insure the health of all its citizens. We have mandatory education requirements for the public good; seems that mandatory health care is also not just for indivudual gain, but in the public interest.
Linking health insurance to employment has put an incredible burden on employers and renders us less competitive in national markets. Either A)I pay $1000 a month for my family health insurance, B) my non-profit health care company picks that up, or C)we go uninsured. Not attractive choices; I pick A, but there are lots of folks I know who could not manage that choice and a mortgage or food. Again, not choices they should have to make in the richest country in the world.
There are ways to design a system that will work. Medicare has done more for the health of those over 50 than many modern advances. The real issue will be helping Americans to understand that spending more than $200,000 on the last 4 weeks of unwarranted aggressive treatment of terminally ill persons is just not what most folks would want for themselves. I say let the debates and planning contiue, cause what we got is really broken.
Good to hear from you; hope you and Katie are both well. Let me know when you head back up the Eastern seaboard.
Big hug, Judy

spongebob's picture
spongebob
Posts: 2598
Joined: Apr 2003

Judy -

Thanks for your good, respectful debate - this is what's healthy! You make some good points.

I have to say, I am not a big fan of TriCare (formerly known as CHAMPUS), but it is better than nothing and part of the reason I stay in the military.

I especially like and agree with your point about $200K in the last 4 weeks.

I would argue that, yes, while we have public education for the public good, we pay our teachers a pittance and we have private institutions of higher learning that people from around the world flock to attend!

So... keeping with your example, is Cleveland State as good as Harvard? Were we to abolish all private institutions of higher learning and allow the government to establish a national education system, would we be right to presume that the product offered students would be on par with Harvard? Would the government be willing to invest THAT much money? Remember, government has historically gone with the low bidder.

Will a government healthcare plan provide people with a Harvard-level of treatment? Or will folks get the Cleveland State special? I'm talking about meds here, not specifically where someone went to med school.

Just keeping the pot stirring - I want to hear the plan and know that folks are looking at a number of options not just one that seems to surface in years that are divisible by 4.

You know I love ya... We should be sipping on some wine while we have this debate!

Say hi to Robert for me.

- SB

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Bob, Judy and Mike... you all bring up some wonderful (and opposing) viewpoints. But all of them, like Bob said, are healthy discussion and this is what your government officials (or is it the Administration?)... whoever is going to be involved with trying to fix the problem has got to have. I know one can never assume anything, but I am going to assume that the "Officials Who Be" understand that the "system" is broke, not the actual "care, treatments or research". There is no doubt that the USA has phenomenal surgeons, oncologists, specialists, researchers, etc. That is not what is needing fixed and those same phenomenal professionals will still be around no matter what/how the system were to change.

Bob, you used the example of Cleveland State vs Harvard. Ok, being the foreigner here, I don't know Cleveland State but I think the message you were trying to get out is that Cleveland State is a State-run college/university, whereas Harvard is the cream of the crop in educational institutions. Am I right in also assuming that Harvard is funded by private funds and does not receive any State or Government funding? Yes, everyone, even us out of country folk know that having a degree from Harvard or Yale is "Prestige". Both Harvard and Yale have a history of being fine institutions and if you say you have a degree from either, then I think the term is that you are "ivy league".

OK, so continuing to use that example... if someone gets their law degree from Harvard and someone else gets their law degree from Cleveland State... does that mean the Harvard lawyer is any smarter or better than the CS lawyer? They both have had to pass the Bar exam and both will have to have studied hard to be able to pass it (students from both Harvard and CS have not passed the exam and others have passed after 2 or 3 attempts).

The difference as I see it from an outsider, the Harvard lawyer has prestige on his side and one immediately thinks that he/she is so fortunate to have had parents who have money and can afford to send their kid(s) to Harvard and then it's up to the kid to succeed because opportunity only goes so far. The CS lawyer, one doesn't really think what their financial background is other than the first impression would be that he/she does not come from a family that has a lot of money, since he/she is not at Harvard/Yale. So maybe mom/dad could afford to send him to college/university but not the ivy league... or maybe he/she managed to get scholarships to see them through. The end result, they worked hard and graduated with their law degree... as did the kid who happens to come from money.

But healthcare... I think I see where those for a National Health Care system are banging heads against those are totally against one. It seems we are talking three totally different systems.

System 1: National Health Care, run by the government where the government supplies the funds to every hospital/medical institution and has a lot of say into how that money is used, hence making regulations, limits, rules, who has to see who, etc. In other words, all existing medical facilities would be run by the government, sort of like how they run their various departments.

System 2: Health Care itself continues being run exactly as it is now. VA has their rules/regulations (IE: Only vets are eligible, no civilians). Civilians choose their own doctor(s)/specialists or their doctors refer them to specialists. The Vets are covered financially by the VA and civilians are covered by whichever Insurance coverage they have... whether paid for by an employer or paid for by themselves. Others don't have any insurance because they can't afford it, so they tend to have to go without treatment (which plays havoc with survival statistics because maybe they would have survived if they had had care).

System 3: A National Health Care Insurance system. Everything continues running as in System 2. The government has no say as to which doctors you go to, not even to the extent that HMOs currently have. You, as an American citizen would be entitled to go to any doctor/specialist you need to (assuming they can take on more patients... but that's true as of today, so that's not really a change). The government's role is to adjust the collection of taxes so that they receive revenue for this National Health Care Insurance program and monitor other sources of revenue, and then distribute it to every State level of government who will have a Health Insurance dept. that looks after their State's plan. Doctors/Specialists/Hospitals/Nursing Homes, etc. would all BILL the State Health Insurance, and this State Dept. will pay the invoices. Basically the State Dept. is just an Insurance accounting department. Money coming in (Fed money from taxes, Citizen's portion from their State, money that the State budgets for their State's Health Insurance), money going out (IE: Doctors' invoices, hospital invoices, etc). That is all they are looking after. Doctors/Specialists/Hospitals/Nursing Homes/etc. would continue with business as usual, but now they have less paperwork because they are billing ONE insurance company and not a multiple of HMOs and a kajillion different insurance companies, all with different rules and regulations. The State Dept. is all about accounting for the money and making sure the invoices get paid.

Oh, and the one HUGE difference System 3 will make, other than the medical professionals only have to bill one insurance company for everything they do, is that EVERY citizen is entitled to have this insurance... so every citizen is entitled to get the same treatment everyone else gets.

System 1 is the system that most people seem to be afraid of... and if that is what is decided then I would be scared too. There is no way the government should EVER be in charge of making decisions about what is good for anyone's care/treatment. The government has the ability to collect and distribute money and set budgets and then monitor those budgets... but care/treatment decisions are to always be left up to the doctors and specialists with the agreement of the patient.

Now, how to take System 2 and convert it into a System 3, that will take someone, or a group of someones with a much better brain than I. And it will take a heck of a lot of healthy debate to figure it out so that everyone benefits.

Ok... gotta go! Speaking of Health Care... my poor little dog, Bridget, was at the Vet today because of what I thought were 2 loose teeth and a gum infection. Turns out she had 8 loose teeth that had to be extracted and a fairly severe gum infection. She had to be put under anesthesia to have the teeth extracted and the poor little thing is not comfortable tonight. The anesthesia has now worn off and I have given her her pain med, but the little darling is lying on her pillow and crying. So time for me to go have some doggy cuddle time.

Hugggggs,

Cheryl

spongebob's picture
spongebob
Posts: 2598
Joined: Apr 2003

Morning, Cheryl -

Your post was long so I only had time to skim it, but I think I pulled a couple nuggets out of it. Let me address the Cleveland State versus Harvard counterpoint you made.

First, I want to apologize to any CSU alums here. I have nothing against CSU - I grew up in Cleveland and several of my high school friends went to Cleveland State - in fact they actually did some good work in the NCAA BB tourney. Point is, I had to come up with a public college and CSU was the first place that popped into my head. I guess I could have mentioned Belleville (Illinois) Area College (where I went for a while).

Anyway, disclaimers aside...

You also asserted that the CSU student would be from less fortunate means than the Harvard student.

You asserted that the only difference between a law degree from CSU and Harvard really boils down to prestige inasmuch as both attorneys had to pass law school which isn't easy, both attorneys had to pass the Bar exam, so on and so forth.

My counter-argument to point 1 is No. Just because someone graduates from Harvard doesn't necessarily mean that their parents are wealthy (although that is often the case). Classic example is the US First Lady, Michelle Obama. She is from middle class America. Not from the high society side of Chicago. My own son wants to go to Harvard - and he has a darn good shot at an awesome scholarship (which is good because on my salary, I can't afford to send him). People from less than acme means attending Harvard is commonplace. But they all have one thing in common; they are the TOP of their academic game. My youngest son (yeah, I'm bragging a bit here, but it's to make a point so please bear with boastful dad for a minute) took his college boards exams at age 12; scored high enough to get into a special program at the Johns-Hopkins University and has now been selected to attend the Virginia Governor's School for his junior and senior year of high school. He will start college as a junior and skip his first two years. He will graduate college two years ahead of his peers. He is in excellent standing to get a full ride to a number of schools. THESE are the type of kids who end up in Harvard. On the contrary, my friends in high school were a great bunch of guys. We played music together, drank beer, some of smoked pot (others just didn't inhale), and many got through high school with a 2.0 grade point average (my kid's GPA is 4.7). THEY went to Cleveland State - oh... and three of them have gone on to be attorneys.

Which leads me to my second answer about Harvard vs CSU = "prestige" versus substantive education. My answer is "well... kinda yes and kinda no." Yes, there is a certain amount of prestige associated with Harvard or other Ivy League schools. But I think that prestige and branding is due to the caliber of student they attract. I also think that there is a significant delta between the education one gets at Harvard versus Cleveland State.

Here's my litmous test for you:

I realize Canada does not have the death penalty, but here in the states we do, so please play along as if you were in the US.

You have been arrested and accused of a capital murder that you did not commit, but you don't have a string alabi and the circumstantial evidence is stacked against you. The prosecutor will be putting the death penalty on the table as his recommended sentence at your trial. You need a lawyer and there are only two who can represent you: My son who graduated from Harvard or one of my high school garage band mates who graduated from Cleveland State. Both are willing to represent you pro bono as a personal favor to me so it will cost you nothing out of your pocket regardless of which attorney you pick. If you lose your case you will be executed by lethal injection. Which attorney will you pick?

Also, skimming your post I see you mention some alternatives for health care - have you read-up on what the state of Mass (I won't try to spell it out without spell checker) did for a statewide health insurance initiative? Judy, I'm curious what your thoughts are on that. On the face it seems like a pretty good start.

Be well!

- SB

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Hahaha Bob... ok, I was going to try and make this a quick response... but I failed!! LOL!

Ok... let's look at the sample exercise you gave (and yes, I am going to try and play along as if I were in the US and was an American, but keep in mind there are differences in our countries' cultures so there may be some things I miss or don't understand).

Exercise: I've been accused of murder that I didn't commit. I'm in shock, terrified, don't know which way to turn, don't even know how one goes about getting a lawyer since this has not been something I've ever had to do before. You come along, pull a few strings, and have two lawyers that have agreed to represent me pro bono. And, because you know both these lawyers, I'm assuming they are both criminal lawyers and both are qualified to represent me for the type of crime I've been accused of (IE: one is not a criminal lawyer and one is a Tax lawyer). So, all things being equal, the only difference is where they went to school... one to Harvard and one to Cleveland State. And we'll also throw into the equation that I am very much aware of the reputation of Harvard and Cleveland State (I state this because other than I've heard of these Ivy League Universities, I really and truly did not realize that someone with a Harvard degree has been given a better education than someone from the State Universities).

So, I'm assuming that I'm going to get the chance to meet both of these lawyers before I have to choose. Then yes, I can honestly say that the school would make no difference to me... it's when I met them, which one do I feel believes me, which one do I feel will fight for me, and which one do I feel the most comfortable with. If Mr. Harvard comes across as Mr. Pompous "I don't care if you are guilty or not but I'm so clever, I can probably get the charges dropped or get you off" and Mr. CS says, "I believe you are innocent and Cheryl, we are going to fight this thing with everything we've got. This is so wrong that you have been caught up in the middle of this", chances are I'm going to go with Mr. CS because he believes in me.

If both were to come across as very genuine and willing to fight for me, then I would want to know what their plans are for my defense. I'm no lawyer, so I'm hoping I would be able to understand what they are talking about and they don't speak to me in legalese.. and again, I will go with the one who I think has the best defense.

If I don't get the chance to talk to either of them before choosing (which would be totally unrealistic) then I would be in just as much a quandry of how to pick as I would in how do I go about shopping for a lawyer. I would then turn to you and say, "Bob, I don't know either of these lawyers... you do. YOU tell me which one I should go with".

A situation similar to this happened to me in real life (no I was not accused of murder ). Long story which I won't go into here, but suffice it to say, I ended up having a complete hysterectomy by accident. The lab had mixed up my biopsy slides with another gal's so I was diagnosed with Stage II Endometrial cancer and had to have a complete hysterectomy (no waitlist, by the way, I was set up for surgery within the week). Everything came out, I was still in shock of having been diagnosed, and then the report came back from pathology... no cancer. Further investigation they found the mixup. So, even though the lab admitted fault, I had to find a lawyer.

Seriously... when you need to find a lawyer for a particular situation, where do you start?? If you have lawyers in the family, fine... maybe one of them could do it or recommend other lawyers that specialize in this kind of law... but how do you know who you should pick? If you don't have lawyers in the family or as close friends, what do you do... go through the yellow pages? If I pick a couple and they've all gone to different schools, is that going to enhance my decision? No! I don't care what school they went to... prestige/ivy league doesn't impress me... I just want to know if they are going to work for me and that we see eye to eye.

I know people ooooh and ahhhh at the "You son/daughter is going to XXX? Wow, that's impressive!" But I don't see it that way. I also happen to know a lot of very good athletes get into good schools on scholarships and they do not have acadamia as their strong point but the sport they excel in. And then again, there are some extremely smart athletes who get into a school because of their sport, and that gets them through financially so they can get their degree in what they really want.

So see, this turned out longer than I wanted it to, but there would certainly be a lot more that I would base my decision on that just which school the two lawyers went to that I had the choice of using.

And one teeny tiny other point, still using education as the example. I don't know the ins and outs of the American education system but if the private expensive schools DO give a much better education than the public schools, shouldn't the goal be then to bring up the standard of the public school system to that of the private school system as far as education goes?

Which gets back to the health care system... wouldn't it be better that everyone has access to "affordable" health care rather than only those who can afford it get treated and those who can't get inferior or no treatment?

Just something to think about.

Hugggggs,

Cheryl

msccolon's picture
msccolon
Posts: 1956
Joined: Oct 2004

Although I think the idea of not being allowed treatment because you have no insurance is a travesty, I DON'T believe the government ever does anything right, so i would NEVER entertain the idea that the national health plan being touted is going to solve ANYTHING!
mary

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

If you had no insurance Mary, what would happen to you?
Be/stay well
-phil

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

Hi Sponge Bob,
I don't have any answers here but I was appalled by the story just as I was the Walter Reed Medical Center story. Hopefully that was a blip on the radar. The military soldier deserves the utmost respect for what they do. As someone else mentioned, here we are being the greatest nation on earth (my opinion) yet we have people dying because they can't afford health care? If the govt can bail out banks and cars (hmmm, real estate and oil) then I would hope they can bail out the medical system. I wish they would legalize pot. Do you realize how much revenue could be created by a tax on that? It's California's along with quite a few other states biggest cash crop. I'd pay a few bucks for for legal pot that I could use for my chemo side effects. I'd rather do that than throw $180 per pill to a pharmaceutical company for Emend or some other ineffective drug.

From the source I have in Canada, it seems that the system they have works quite well. There must be a way to learn from that system.

Good points you bring up though SB.
Be well,
-p

spongebob's picture
spongebob
Posts: 2598
Joined: Apr 2003

Ahoy, Phil -

I agree that there is a lot to learn from a lot of systems. Again, I'm not Canadian and I don't have much knowledge about their system so I won't comment on it. I will report some facts though; Monica went to Argentina from Canada to get treatment because the system there wouldn't give her the treatment she needed (same thing might have happened with a health insurance company in the states, I don't know); a dear friend "andreae" who is no longer with us wanted to badly to get to the states to get treatment that I even offered to let her stay at my house in DC for free so she could; I know several folks who can't seem to get a scope even scheduled due to the long wait time.

Regarding your hope about Walter Reed being an isolated case/blip on the radar... I'm afraid it isn't. That's been my experience, anyway. I was blessed when I was treated at Bethesda - my onc was a National Cancer Institute Fellow (NCI is right across the street and they are in a joint oncology research practice w/Bethesda) and the doctor who did my annual scopes was the same gastro doc who did the President's scope. I have to say, however, that Bethesda is TRULY the exception to the rule.

Again, I'm not Canadian and I'm not trying to throw rocks - everyone's system has issues, but you're right, we can learn from all of them. What are your thoughts on the mandatory healthcare insurance initiative in Massachusetts? It sounds like they have a pretty good thing going there. Maybe not, I try to stay away from cold weather as much as possible and it's COLD up there!

Be well

- SB

Mike49's picture
Mike49
Posts: 269
Joined: Nov 2008

I get my cancer care at the VA hospital and I think its great. I am a hospital administrator, a Fellow in the American College of Health Care Executives and I don't say that to brag but to say I am no naive consumer. I don't know what the right answer for our American non system. We don't have a health care system we have many system components, not necessarily working in tandem.

I think care should be patient centered and safe. In my 30 years in this industry, I have met some great providers and care givers, I have also met some elitist SOBs that I wouldn't let treat my pets. Consumer driven healthcare may give us short lines for those that pay but as the Institute for Health Care Improvement touts, over 100,000 patient a year in the U.S. die from health care errors. We spend over 16 percent of our GDP on this product and have infant mortality that compares to third world countries. The government does not have to run health care but some guarantees of access to affordable coverage and transportability without penalty for pre-existing conditions would be nice. Not only nice it would allow employees to move around the workforce without concern for loss of coverage.

Just my thoughts and I have continuously maintained my coverage for my whole worklife, but I know plenty of people that were caught by job change as uninsurable if they had a chronic disease like, Asthma, Diabetes, and other common things that can be easily managed . VA bills my insurance for my care, and I am happy to see them collect and spend that money on other vets.

I believe I live in a great country, but I also think all great countries have to continue to change and adapt. Our health care system has been stagnating in its finance processes for over 25 years. Its time for us to have a healthy debate in America I am glad to see us all talking.

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

Your comment
"I don't know what the right answer for our American non system. We don't have a health care system we have many system components, not necessarily working in tandem." makes a lot of sense. Somewhere, things are not working as the could and should.
be well,
thanks for your input
-p

CynthiaA's picture
CynthiaA
Posts: 21
Joined: Feb 2004

20 years ago I was going through a divorce, bankruptcy, my job was tied into the divorce so no job. I had to apply for public assistance just to get my first cancer diagnosis. I had to go to the county hospital for medical care. About to be divorced (with no children), and having a college degree put me in the rare category of 'how could you possibly NOT be hiding something and need help,' and was grilled every 3 mos just to get my medical care. It was awful and remains a horrible system. As someone who has been found to have cancer as a chronic illness, living on SSDI, Food Stamps, but too wealthy albeit living below the poverty level to get state medical assistance, I would be glad to have you walk in my shoes during recertification time. 60 Minutes was not frightening...I've been living that life for 20 years. My only offense that I am guilty of is not dying soon enough. Try that one on for size and have it last the rest of your lifetime.

*Disclaimer...not meant to offend. I just wanted to let people know that this isn't a new phenomenon that has just appeared. It has been going on for years.

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

But it was dead in the water. I had never been "sick" either. Sounds like you've been through a lot.
Be well
-p

Monicaemilia's picture
Monicaemilia
Posts: 455
Joined: Nov 2006

I am a Canadian who used to boast about how much better and equitable our health care system is in Canada, until I was diagnosed with Stage IV cancer. Wow, what a wake up call!!! As you are all aware, I travel to Buenos Aires, Argentina (yes, sometimes deemed a third world) for surgeries. Why do I do that? Because in Canada, once you are considered 'not curable', the only treatment available to me is chemo (and we all know how well that works in the long term). My surgeon in Argentina believes in treating the disease as if it is a chronic disease that can be managed with a combination of surgery and therapy. If I had not come to Argentina I would have been gone almost two years ago. My own oncologist in Canada said to me, at least twice, 'yet, you are still here'. Those five words spoke volumes to me.

The problems as I see them are as follows:

A universal health care system works on the idea that everyone is to be treated equally, but in order to be able to accomplish this financially, that means limiting the resources and being extremely cautious about recommending costly procedures that according to oncologists, 'may not help you'.

The government has a big say in what drugs are approved, therefore between the government stonewalling due to high costs, and an overly cautious Canadian system that has to test out everything themselves in order to recommend it, access to drugs can take years to get to us. Erbitux has just been approved in a few of our provinces, but not all. Avastin is only approved for first line treatment, otherwise a patient needs to pay for it.

A universal health care system means ridiculously long wait times for tests. I have a friend who had to wait a year to do an investigative MRI. We have a lot of surgeons, but they have limited amounts of time in the operating room. Another acquaintance had to wait almost a year to have shoulder surgery that could have been done quicker in Montreal. My favorite 'hair pulling' example is that it is almost impossible to get a PET scan in Ontario. You can obtain one faster for your dog or cat than you can for a human being. I have been battling for three years and the only PET scans I have had were in Argentina (and yes, I had to pay for them.)

As always, there is another side to it:

It is true that all Canadian citizens and residents have access to health care, and I truly don't mind paying the taxes to allow this to happen. I don't believe it is up to me to judge who deserves it and who doesn't, as I believe healthcare to be as necessary as breathing.

However....I do believe there is a middle ground:

A public health care system that ensures that everyone receives good health care.

The option of a private system for people who are willing to pay for a more aggressive approach to their illness, whether it be in eliminating wait times by having a test done sooner, or having access to surgeons/oncologists/specialists whose hands are not tied by a public system.

These are just some thoughts, from someone north of the border. The grass is not always greener on the other side. Monica

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

That seems a long way to go. Is there nothing in the US that could help you?
Be well
-phil

Monicaemilia's picture
Monicaemilia
Posts: 455
Joined: Nov 2006

Hi Phil: Unfortunately when I got second opinions in the US, both opinions concurred with Canada and did not recommend surgery. I was also born in Argentina and have family there, including my dad and his wife, so it makes it much easier for me especially when I have long stays. The most important issue is the doctors. I have an oncologist that is extremely aggressive and a surgeon that is world renowned and I would trust my liver to no one else. Monica

PS - it doesn't hurt that the currency exchange is $3.5 pesos to US$1. It really helps when paying hospital bills and tests such as PETs, CT scans, etc.

msccolon's picture
msccolon
Posts: 1956
Joined: Oct 2004

interesting discussion. I have a friend who is from El Salvador and when her mother was first diagnosed with ovarian cancer, she traveled to El Salvador to have her surgery and treatment. She had the same things to say as you do about Argentina; the doctors were very well trained and willing to be more aggressive than her onc here in the states. I was in shock when she told me how much more open they are there; they even brought the tumor out to show to the family after it was removed! We as Americans think of medicine outside of the states as second rate, but it appears this is another aspect of truth that is bent by the media and those standing to gain (or lose) the most money were we to go elsewhere! It's like the comments Cheryl made a while back about the controversy of going to Canada for pharmaceuticals. I can remember listening to the comments of how we just can't trust the Canadian regulations and how to be safe you just have to get them from a reputable pharmacy (translation: american). When the powers that be have something they really want to sell, they use the time-honored method of fear of the unknown and the assumption that what isn't American is sub-standard! We as Americans have to become smarter and understand that we have to make our decisions from our OWN research and stop listening to the hype! This type of discussion on health care reform should be happening all over the states, and in serious attempts to come to a solution that will truly resolve the WORST of the problems we face!
mary

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Hey Monica... thanks for joining the conversation as a fellow Canadian. Hahaha... sometimes I feel that I'm the token Canadian entering the fray and yet my opinion/experience is only one of the millions that live in Canada. Of course, we are all going to have different experiences (horror stories and miracles).

Let it be known that this is not the first time that I have talked about the Canadian system AND also said that as much as we have a National "Subsidized" system, I'm not advocating that the States looks to ours and in anyway copies it because our system certainly has more than it's fair share of problems that needs fixing up too. What I do use our system for in comparison is the bottom line... every Canadian citizen, no matter which province you are in, has the right and access to fair health care without the fear of "How are we going to afford this???" And, of course, we have choices of going elsewhere if one wants/needs to do that.

Now, having said that, I think I'll point out one (of many) weakness in our system that would be something to seriously consider when thinking of going to a National system. And that is having the individual Provinces/States in charge of their own Health Care Insurance system. In Canada, we have 10 provinces and 3 Territories... and the population in those areas varies big time. But it means we have 13 mini-systems under the umbrella of one National system.

In plain layman's terms, the Canadian National Health Act basically says, the federal monies will be allocated to each province/territory depending on population (IE: how much tax can be collected from a Province with 10 million people vs a province with 200,000 people? Hence, how much money would be allocated to said provinces is dependant on how much (percentage-wise) each province puts into the system). The Feds allocate X amount of dollars to each province/territory and then the province/territory has to either match or come up with how much more they need. If for any reason a province would decide to use that money elsewhere and not provide adequate healthcare, then the Feds would pull their money (and the province would be in huge doo-doo since it is the law that each Canadian citizen has access to affordable health care).

Since both the Feds and the individual Provinces/Territories are responsible for Health Care monies, this explains why our Canadian taxes (Federal as well as Provincial) are higher than the average American's taxes, no matter which State you live in. We have some of the oddest taxes and it can make one grind their teeth when it seems taxes are constantly going up but income remains the same or goes down. Ha! Every Canadian may have medical coverage, but is having a hard time buying a loaf of bread and milk ... and we won't even discuss Gas prices ;)

But I digress. So here we have Monica with her situation (Monica, I'm going to assume you live in Ontario because of your one comment about how hard it is to get a PET scan?). I'm on the west coast, in BC, so we are in two different provinces... two provinces that handle their Health Care systems very differently it appears.

In all fairness, I really and truly don't know how easy it is to get a PET scan when needed in BC, if say you live up north, or in central BC. I know that if I need a PET scan, then the appt. is made and if it is not an emergency (IE: just part of the follow up checking), then I would get it in a couple of weeks. The first one I needed because it was obvious my CEA was rising, I got within a week. BUT, I must add here that I live in the heart of the city (Vancouver) and the BC Cancer Agency where I go for treatments has a PET scan in the building (as well as CAT, XRAY, etc). So we are not dependant on going to a hospital for these scans. Would someone living up North have a machine close by? I don't know but if they don't then they would have to fly down to where the closest one is. So one could say that this is not good or fair... on the other hand, they are given access, it's just they may have to do a lot of traveling to get to it :/

Now, I'm particularly interested in your comments/situation...

Because in Canada, once you are considered 'not curable', the only treatment available to me is chemo (and we all know how well that works in the long term).

I think that comment should be changed to "Because in some places in Canada" and not all of Canada. I am also Stage IV "not curable" (don't you HATE those two words???" and have found it to be the exact opposite. My oncologist was very upfront when my DX was changed from Stage III to Stage IV. She told me that Stage IV was the last stage of colon cancer, there is no stage V. It does mean I'm "incurable" and when they found that my cancer had spread to the adrenal gland and the lungs, I was told the prognosis was not good. Certainly not as good as if I had remained a Stage III. I, of course, freaked out and I'm sure everyone who has been diagnosed as Stage IV knows exactly the feeling and panic you go through when told you are Stage IV, the cancer has spread, and you are now incurable.

She did take my case to the "Tumour Board" (although I think they call it something different here... I think she called it "case conference")... and the bunch of oncologists/surgeons/specialists sit around and discuss these "incurable" cases. It was at this case conference that it was determined we would start with surgery to remove the adrenal gland, and then we should look at surgery or RFA for the lungs. Obviously, chemo is also an option, but the recommendation was for removal before thinking of chemo. This had to be decided fairly quickly because typically, when cancer spreads, it can be quite aggressive and grow very quickly. Turns out, my adrenal gland cancer was not spreading and we got that out successfully and my lung nodules are growing so slowing, it's almost that they aren't growing at all. So the recommendation now is not to do invasive surgery until we know what we are dealing with. The one nodule that did light up (two PET scans) we dealt with RFA instead of surgery. Now, I still have nodules, but none of them are lighting up the PET scan.

The reason I re-wrote all of the above in my own situation is to show that our two provinces obviously handle things differently. My oncologist is very positive and has said for me not to even think about chemo and what combos I should be thinking of because we are going to stay off chemo for as long as possible... and if any of the nodules decide to start growing, then we have various options of how we will treat them. Whereas it sounds like your oncologist and doctors pretty much said, "You are Stage IV, incurable, chemo is the only option. Period."

Of course, your condition and mine are probably vary different so we can't compare situations. Interesting that your doctors told you this, opinions from American doctors agreed with the Canadian... and yet Argentinian doctors were willing to try some other options, including surgery. I think if I were not happy with the care I am being given, my first choice of out of country options would be for me to go to India. Although we all hear about the poverty, third-world conditions... their technology and medical field surpasses both Canada and the States. I have no idea what their health care system is for their own citizens but their facilities, research and specialist are phenomenal. Now I might have to add Argentina to my list :)

As for not being able to get meds (Avastin/Erbitux, etc)... I guess I'm in one of the provinces that they are readily available. In another topic, I posted the link to an article and it mentioned the couple of provinces that those drugs are not available and I can't remember which provinces but I'm thinking it was the smaller ones like PEI, Nova Scotia and ? I didn't think Ontario was on that list.

Again it comes down to "insurance" decisions and how that works. The province sets up an insurance company and someone (committee or dept. made up of doctors, government and insurance folk?) determines just what the insurance will cover and won't cover. The "won't covers" are probably then negotiated on an individual case by case basis... the doctor would have to convince the "payer" that a treatment not covered by insurance would, in fact, be of benefit to the patient and then that treatment would be covered... but this is not the case in all requests.

Hehe... I don't know and don't have the answers. I am not a doctor, lawyer or government person who makes these kinds of decisions or is involved with the Health Care Insurance plan. I am willing to bet the countries that have the best system, still have problems and individuals have hassles.

But one more thing that I have to add before I forget and that's the long waiting lists that we hear about. I am not doubt or saying they don't happen... they certainly do!! I, personally (knock on wood) have never been affected by them... when I've needed treatment or surgery (not just cancer-related but prior to my diagnosis), I have gotten it within a week of being told I need it. I don't know of anyone, personally, who has had to wait, but like everyone else I certainly have heard about it, read about it and have had friends say that "friends of friends" have been told of outrageous waits and had to go to the States to get their surgery (again, not cancer-related but just surgery in general). I don't doubt that this does happen, although I am not sure it happens as often as we think it does. I also happen to know, that the same thing happens in the States, where people can't get in for their treatments/surgeries because of a wait list (we've heard of that right here on this board). So, in all fairness... both systems have that problem and I think it is part of all medical systems... when there are more people that need surgery/treatment than there are working hours in the day, a backlog starts, some worse than others.

Again, I can only say that I have no answers or solutions to the problem, but I am a firm believer that EVERYONE should have access to affordable health care, however that can be arranged. One shouldn't necessarily copy one country's system, but if one is going to start from the bottom up, then look at all the systems that are working, take the best parts and form one super system that will benefit everyone... and let the rest of us then envy the new Super System :)

Hugggggs,

Cheryl

Monicaemilia's picture
Monicaemilia
Posts: 455
Joined: Nov 2006

You are so right, Cheryl. We always use BC as an example of the province to go to for treatment. You also make a very good point about how different the provinces approach what is supposed to be 'universal health care'. It should not be so, but it is. And I am so happy that you have obviously found doctors that make you feel as if they are working with you. I had to debate for one hour with my lung surgeon to have the surgery done. At the end of it, I was left feeling very depressed because he spent that hour telling me how it would not help me, but with an appointment to have the surgery done three weeks later.

I was always one of the biggest opponents to a two-tier system, until I really needed it (isn't that sadly always the way?). I now would love to see the possibility of a system that offers more choices than we currently have available to us, while still maintaining our universal health system. Monica

lisa42's picture
lisa42
Posts: 3661
Joined: Jul 2008

Hi Everyone,

After reading all of these posts, I feel more confused on what I think/believe on the national healthcare idea. Yes, the sad truth is that so many Americans who have good insurance coverage don't think of others who don't have coverage, or even that they might find themselves in that situation some day. I'm currently paying $1375 per month to continue using the health plan that was once paid in full for my entire family by my employer. Most of you have probably heard of COBRA- it's the federal law/program that requires that someone who has left a job has the right to pay for their insurance (to continue their current/same plan), regardless of the reason, for up to 18 months. I don't know about what other states have, but there is a state program in California that, once my federal COBRA's 18 months are up, I can buy into the state program (CalCOBRA)for an additional 18 months, extending my time on "COBRA" to a total of 36 months. For federal COBRA, the customer pays 101% of the premium amount & for CalCOBRA, I will need to pay 110%. So when my federal COBRA expires in October, my premium would be raised even more. Now, the $1375 is for my whole family- medical (very good coverage), dental, and vision. When the CalCobra kicks in, it can be only for the former employee and would cover just the medical. With that said, I'm in the "investigating" stage of trying to find out if I would be better off switching to the plan that my husband's company offers or staying with the COBRA. The reason we decided to keep our whole family on the COBRA plan through my former employer is because the plan offered by my husband's company is even more expensive than what I'm already paying- if we had our whole family on his work plan instead of my former employer's plan through COBRA, we'd be paying over $1500 a month instead of "just" $1375. Outrageous!!!!
We may do a combo of having my husband and our three kids on his work plan & just myself on the COBRA, but I'm thinking that may end up costing even more that way. Once the additional 18 months are up, then I'd not qualify any longer to be on the COBRA anyhow. If we didn't have to pay this outrageous price for insurance each month, then we'd be doing okay financially. Just to think what we couldn't do with an extra $1375 a month!

We're one of the fortunate ones who can afford to do this (but barely). I know that a HUGE number of people in this country cannot & we may find ourselves in that situation some day too.

SOMETHING HAS TO BE DONE ABOUT IT!! I have always been very conservative in our beliefs and ideologies, as well as financially (I'm a former "army brat", myself & my mom is a recepient of military insurance/CHAMPUS- now "Tricare")BUT I guess I have a more "liberal" bent when it comes to views on shouldering responsibility of caring for people in need in our country. I strongly feel and believe that it's our job as humans to care for one another ("whatever you do to the least of my brother, that you do unto me"- quote from Jesus about caring about those in need).

So, I guess the question isn't really WHETHER some people need help with medical care (although some in our country might debate that), but the question is HOW we go about doing that! What Cheryl outlined in her option #3 is something that could be considered. Yes, even doing something as that will raise taxes. NO- I don't like paying more taxes, but every citizen has a right to medical care. That's also a HUGE issue- every CITIZEN. Currently, noncitizens get all sorts of medical care that poor citizens may not have access to. It's quite commo knowledge that someone who lives south of our border might choose to come have a baby in our country- the hospitalization and birth is paid for and the baby is awarded instant citizenship for being born here. I know it's that kind of sitation that makes so many Americans leery of expanding. I won't go into my feelings too much on that- a human is a human and all humans need basic care but, at the same time, too many extra humans who are not contributing to the tax base that would be paying for all this puts an undue burden on the system.

It's definitely a huge mess & I wish I could be a wise sage with the perfect solution. It's going to take time and perhaps some mistakes will be made while setting up some kind of system. In spite of my frustrations with the government running things ineptly and not wanting to pay more taxes, I STILL think I'm now won over to the idea of some kind of national health care system- perhaps an optional system- like Cheryl outlined in her plan #3.

Oh well- those are my thoughts on the matter.

Have a good day everyone- TAKE DEEP BREATHS- stress isn't good for us :)

Lisa

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

I am so glad I don't have to sing kumbaya again!!!! Congrats on not making this all about politics even though it could easily be.

Like most of the others here, I agree that what we are doing with the US Health Care system is not working for everyone.

I go to a state (not federal) supported teaching hospital at the Univ. Of North Carolina (yes the ones who won the men's bball tournament last night....GO HEELS. We needed it after last year). Duke University and hospital is only 10 miles away but it is a private hospital. I asked my surgeon what Duke did when someone showed up in their emergency room without insurance and he said "they put them in an ambulance and send them here and bill us for the ambulance". I thought he was joking but he was very serious. Guess who pays that bill (NC tax payers) and I wonder how many have died before they get there? It seems like if we don't pay now (earlier detection and screening), we will pay much more later since most don't go to the emergency room until things are really bad.

I don't have the answers but welcome all ideas, something does need to be done. That said, I don't see anything happening until we stop making disease and illness such "good business". It seems like the ole USA has gotten so greedy and everything is based on how much you can make off of others, for better or worse.

Lisa P.

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spongebob's picture
spongebob
Posts: 2598
Joined: Apr 2003

Creating new bureaucracies and raising taxes is definitely not something I would be a proponent of. There is definitely no easy answer. Likewise, I do not see an easy answer to being able to spell; Masschoos... Masyshoo... Massatuche... MA!

If we could just abbreviate healthcare reform life would be so much easier, don't you think?

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