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Poor Health, No Work, No Insurance, Poor Health
Newhouse News ^ | 3/18/2008 | Nikole Hannah-Jones

Posted on 03/19/2008 1:39:17 PM PDT by Incorrigible

Poor Health, No Work, No Insurance, Poor Health

By NIKOLE HANNAH-JONES
  Image

Joe Bellisle, left, comforts Terry Thompson on a recent evening at North by Northeast Community Health Center in Portland. Thompson suffers from severe asthma but says she has no money or insurance. (Photo by Stephanie Yao)

   

PORTLAND, Ore. — The job offer flooded Sebastian Williams with relief. He'd hunted for work since he was dismissed more than a year ago from a truck-driving gig for speeding.

The weight of overdue bills crushed him. He could hardly look his elderly mother in the eyes because he felt like her burden instead of her aid.

Williams had only to pass a physical, and he could have the cement-mixer job and full benefits. No sweat, he thought.

But minutes into the health screening, the doctor called it off. Dangerously high blood pressure and blood sugar meant he wouldn't pass.

"Please, I can get my blood pressure and sugar down," Williams pleaded. "Do you know how hard it is to be a diabetic with no insurance? I really need this job."

A few minutes later, the 41-year-old slid into the seat of his car, put his head in his hands and cried.

Williams, among the 47 million uninsured in this country, is stuck in a frustrating cycle: He's in poor health in large part because he doesn't have insurance. He doesn't have insurance because he doesn't have a job. He's been turned down for a job because he's in poor health.

Two-thirds of Americans younger than 65 get health insurance through employers. Yet as insurance costs for businesses have skyrocketed, fewer employers offer insurance as a benefit. Those that do are looking for ways to cut costs; employer-based health premiums have increased 87 percent since 2000.

Many companies are turning to pre-employment screenings. Insurance companies give discounts for employers who require physicals as a condition of employment, says Alan Lasky, a vice president at Kroll, a national company that coordinates health screenings for businesses. "I think we have more savvy employers. It's becoming more popular."

Lasky says companies aren't screening out sick employees but making sure that health problems won't cause workers to hurt themselves or others.

Donna Beegle, who runs a nonprofit called PovertyBridge that works to improve the lives of the poor, suspects that's not entirely true. But she also doesn't point her finger at businesses. She points her finger at society.

"You hardly ever hear us talking about health keeping people from working and health keeping people in poverty," she says. "Because we blame people who are in poverty, we are so silent around this issue."

Though no one knows how many people share Williams' situation, health care workers say his story is all too familiar.

"We see a bunch of these people," says Jill Ginsberg, who runs the North by Northeast Community Health Center in Portland, which gives free medical care to the indigent. "It's such a Catch-22. Here you have people who are able to work, who want to work, and when they find (job openings) they just get stymied."

The Oregon Health Plan provides free or low-cost health care to some 400,000 very low- or no-income residents, about 40 percent of them children. The federal government provides health care for those older than 65 and some others. Everyone else must fend for themselves.

Just before 11 on a Tuesday morning, Williams pulls his white Pontiac Bonneville with its dented bumper into the work force development parking lot in Northeast Portland. He's a squat man with a receding hairline, his face a mask of determination. He slings a blue backpack over his shoulder and heads inside, where he joins a dozen or so people seated at computers, searching for a chance.

Each day since Williams lost his job, looking for work has been his work.

He's never been rich, the best dressed or the most educated. But since he was 13, Williams took pride in working. It's what made him a man.

After graduating from high school, he got a job painting trucks for Freightliner. After getting laid off, he went to truck-driving school.

"I could pay my bills on time, keep my car up, help my family out," Williams says, scrolling through job Web sites. "You know, I had a little money to go out on the weekend and travel a bit."

When he lost his job truck driving, he not only lost his income but also the key to his health. Without insurance, Williams stopped going to the doctor even though he has diabetes. Sometimes, he says, he couldn't even pay for food. A $200 doctor's visit — out of the question.

Williams is like most of Ginsberg's patients at the North by Northeast clinic. He's an African-American man — among the least likely nationwide to be insured — middle-aged, with hypertension. A $5-a-month medication could easily control high blood pressure, Ginsberg says, but without forking over money to see a doctor, you can't get a prescription.

So, like Williams, they wake each day sicker than the last. And many don't learn how sick they are until a potential employer pays for a physical. It's often the first time they've seen a doctor in months. Sometimes, years.

About 40 percent of the unemployed don't work because of chronic illness or disease, according to the U.S. Census. "It's devastating for people to find out a problem they weren't aware of and that this could cost them this job or future jobs," Ginsberg says.

The cement-mixer job seemed like a lifesaver. It fit Williams' qualifications and paid close to $20 an hour. Often the jobs requiring health screenings are those with salaries that could lift a person from poverty's rim.

Now Williams considers settling for $8-an-hour jobs as a laborer. It won't pay his bills. Won't pay a doctor. But it's better than nothing.

Williams logs off the computer. His shoulders stoop as he fights a wave of the blues. He's worried about money and what the stress will do to his fragile health.

"I'm a Cancer," he says, grabbing a golden chain with a dangling crab from under his fleece. "You see a crab, when he's cornered, he's going to keep fighting to the death."

It's the only choice he has.

* * *

How poor health keeps people from working:

In 2004, the most recent data available, 79 million people had not worked in at least four months.

Of those ages 45-64, 38 percent were not working because of chronic illness or disability.

Of those ages 20-64, a fourth were not working because of chronic illness or disability.

Sixty percent of those reporting they were unable to find work lacked health insurance.

Estimates of productivity lost each year due to people going without health insurance range from $65 million to $130 million.

Health care is a key issue among voters for the upcoming presidential election. For detailed information on the three presidential candidates' health insurance proposals, go to Health08.org.

Sources: U.S. Census, Agency for Healthcare Research and Quality

(Nikole Hannah-Jones is a staff writer for The Oregonian of Portland, Ore. She can be contacted at nhannahjones(at)news.oregonian.com.)

Not for commercial use.  For educational and discussion purposes only.


TOPICS: Culture/Society; US: Oregon
KEYWORDS: healthcare; socializedmedicine
 

"You hardly ever hear us talking about health keeping people from working and health keeping people in poverty,"

Really?  Let's rewind the clock 200 years for some Ben Franklin quotes:

"Early to bed and early to rise makes a man healthy, wealthy, and wise."

"Money can help you to get medicines but not health. Money can help you to get soft pillows, but not sound sleep. Money can help you to get material comforts, but not eternal bliss. Money can help you to get ornaments, but not beauty. Money will help you to get an electric earphone, but not natural hearing. Attain the supreme wealth, wisdom, and you will have everything."

"An ounce of prevention is worth a pound of cure"

Health equals wealth and there is no doubt about that.

 

What I don't understand, and I fault the "journalist" who wrote this, is why the subject can't get his $5 diabetes drug because he needs a doctor's prescription.   She's meeting him at a health clinic for people just like him!  Here's their mission statement:

The mission of the North by Northeast Community Health Center is to improve health outcomes in a medically under-served community by offering health screening and basic medical services at no cost. Priority is given to low-income individuals without health insurance living in the surrounding inner N/NE neighborhoods.

It would be helpful if the writer would tell his how the clinic actually helped the man!

 

1 posted on 03/19/2008 1:39:18 PM PDT by Incorrigible
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To: long hard slogger; FormerACLUmember; Harrius Magnus; Lynne; hocndoc; parousia; Hydroshock; ...
Socialized Medicine aka Universal Health Care PING LIST

FReepmail me if you want to be added to or removed from this ping list.
2 posted on 03/19/2008 1:46:42 PM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
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To: Incorrigible

he was dismissed more than a year ago from a truck-driving gig for speeding


Do you get dismissed for one speeding ticket?


3 posted on 03/19/2008 1:47:09 PM PDT by PeterPrinciple ( Seeking the truth here folks.)
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To: PeterPrinciple

This article smells of aged BS. What a tear-jerker. Out of work for a YEAR as a truck driver? Riiiiight.


4 posted on 03/19/2008 1:48:40 PM PDT by L98Fiero (A fool who'll waste his life, God rest his guts.)
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To: PeterPrinciple

I have a hard time believing that one speeding ticket kills a trucking career. Truckers esp. longhaul are in big demand.

This is so a “woe-is-me-we-need-socialized-healthcare” article.


5 posted on 03/19/2008 1:49:45 PM PDT by jjm2111 (Are we going to have a Daily Dose of McCain?)
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To: Incorrigible

My Dr. gave me Blood Pressure medicine samples for 3 years.

$86 a month prescription.

He got ‘em free from the Eeeevil drug company


6 posted on 03/19/2008 1:50:57 PM PDT by digger48 (http://prorev.com/legacy.htm)
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To: Incorrigible

We’ve been hearing the same shallow crap for years. If they just had a “chance,” and some “help,” they could make it...

For 40 years, we’ve had one entitlement program after another with very little change in the poverty rate. What we do have is a large group of people who are dependent on the government and the taxpayers.

How little we know of history! The tyrants have often used “the needs of the people” to gain popular power.

Take a look at Hugo Chavez. He doing the same things, in fast forward.


7 posted on 03/19/2008 1:51:04 PM PDT by rightinthemiddle (The Mainstream Media Controls Our Party. Go, RINOS!)
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To: Incorrigible
If the company wasn't forced to provide health insurance by unions and govt and if he had his own insurance, he might not have to take the physical or would have the medicine and he would have a job.
8 posted on 03/19/2008 1:52:42 PM PDT by PeterPrinciple ( Seeking the truth here folks.)
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To: Incorrigible

“...47 million uninsured in this country...”

The Left and the Media throw this number around with ease. Many of these people can AFFORD health insurance, but choose not to pay it.

Cable, smokes, booze, beer, and burritos are more important to them than health insurance.

So be it.


9 posted on 03/19/2008 1:53:35 PM PDT by rightinthemiddle (The Mainstream Media Controls Our Party. Go, RINOS!)
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To: rightinthemiddle

Don’t forget we could cut the number of uninsured in half if illegal alians were not included in that amount.


10 posted on 03/19/2008 1:57:25 PM PDT by Incorrigible (If I lead, follow me; If I pause, push me; If I retreat, kill me.)
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To: rightinthemiddle
Good point.
Many of those 47 million are:
*young and choose not to have insurance
*Medicaid eligible but are too lazy to sign up and know that they can sign up when/if they get sick and be covered retro
*illegals
*didn't have insurance for a short time (job change) but do now yet are still tallied
11 posted on 03/19/2008 1:59:09 PM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
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To: Incorrigible
"A $5-a-month medication could easily control high blood pressure, Ginsberg says, but without forking over money to see a doctor, you can't get a prescription."

Oh, pullleeeaassseee....get off your duff, quit eating processed food (you can check out the DASH DIET for year - the gov't will send you the diet for FREE!) The Dash diet results are amazing - 70% of those who go on it are OFF their bp meds in 3 months.

12 posted on 03/19/2008 2:00:52 PM PDT by goodnesswins (Being Challenged Builds Character; Being Coddled Destroys Character)
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To: L98Fiero

According to Barack Obama, Ashley’s mother’s Cancer got better after she ate Mustard and Relish sandwiches for a year.


13 posted on 03/19/2008 2:01:47 PM PDT by massgopguy (I owe everything to George Bailey)
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To: socialismisinsidious

I provide full health coverage, dental, retirement, etc., to all my employees.

They don’t even think about it anymore, although the costs average more than $8000 per employee.

Just, for one year, I wish they all had to pay their own taxes, insurance, etc. We just give them a check for their full level of salary and benefits.

My guess is, many of them would drop their health insurance and 401K contributions!


14 posted on 03/19/2008 2:02:41 PM PDT by rightinthemiddle (The Mainstream Media Controls Our Party. Go, RINOS!)
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To: Incorrigible

What a load!!!


15 posted on 03/19/2008 2:03:32 PM PDT by gogeo (Democrats want to support the troops by accusing them of war crimes.)
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To: PeterPrinciple
Do you get dismissed for one speeding ticket?

Yes, in a job that requires a good driving record and without union protection. The unions as a rule, are trouble, but they can protect workers from frivolous firings. Management jobs are probably the most precarious.

For those crying "BS"...apparently you haven't been in the real world lately.

16 posted on 03/19/2008 2:13:18 PM PDT by madison10
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To: Incorrigible
Let's rewind the clock 200 years for some Ben Franklin quotes:

...

"Money can help you to get medicines but not health. Money can help you to get soft pillows, but not sound sleep. Money can help you to get material comforts, but not eternal bliss. Money can help you to get ornaments, but not beauty. Money will help you to get an electric earphone, but not natural hearing. Attain the supreme wealth, wisdom, and you will have everything."

Obviously a blatant misquote. There were no "electric earphones" in Franklin's day, or (I would estimate) for the better part of a hundred years thereafter.

17 posted on 03/19/2008 2:15:41 PM PDT by wideminded
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To: jjm2111

I don’t know about Oregon laws, but in AZ one speeding ticket that isn’t properly handled can kill your truck driver license, so it could kill a career.


18 posted on 03/19/2008 2:17:31 PM PDT by discostu (aliens ate my Buick)
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To: Incorrigible

bump


19 posted on 03/19/2008 2:17:32 PM PDT by VOA
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To: Incorrigible
Slightly off topic, but Frieghliner, Portland Oregon shipped off a lot of jobs to Mexico. The temp agency that supplied my shop on occasion advised me I could get any skilled person I wanted for $8.00 per hour (to employee),
What's ironic, if this guy were a illegal he could walk into any hospital and get free health care. But as he appears to be an American, they won't touch him till he supplies a valid SSAN.
And due to the free care they pass out to illegals, they have to hound the poor guy - even garnishing his $8.00 an hour check.
Can anyone say “Thanks a lot President Bush?”
20 posted on 03/19/2008 2:27:03 PM PDT by investigateworld ( Abortion stops a beating heart.)
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To: L98Fiero

It happened in the case of my friend.

He was a long-haul trucker for Schneider, making a really good income, when he was diagnosed with congestive heart failure, the result of chemo he had when he got non-Hodgkins lymphoma thirty years earlier. The chemo had destroyed his heart.

Well, the doctor told the DMV that he had CHF, so they yanked his CDL.

He couldn’t get health insurance as he now had a prior health condition, and he wasn’t employed any more, so he didn’t have insurance that way.

He lost his house, his truck, everything he owned. He ran up $200,000 in credit card bills paying for the many operations. The hospitals forgave a lot, as did the doctors, but he still ran up huge bills for medical needs.

He applied for disability. The doctor told him he’d make it, as he’s in stage 4 heart failure, and is in really, really bad health, but it’ll take a year to get any payments, and another year before they pay for any operations.

This, for a proud man who’s been a trucker since he was 21, and has paid extremely high taxes for many decades.

I’m in kind of the same way, although I am healthy, with one exception. I have high blood pressure, which is fine as long as I’m on medication. But because I have high BP, and am self-employed, no one will give me health insurance.

I make a fairly good income, within middle-class ranges, yet just to see a doctor and pay for visits and meds it’s difficult to do.

In the last two months I had very bad flu. I saw the doctor three times, at $175.00/visit, and got medication of $200.00, plus blood test at $225.00.

I ended up spending almost $1,000.00 for a simple case of flu. God forbid if I ever get heart disease (my cholesterol is only 170, so I’m okay there, hopefully) or cancer. If I do, I have no way to pay the hundreds of thousands of dollars that will be needed to survive.

I know there’s some Freepers who say it’s our duty to die if we cannot get health insurance, but that’s really not the answer, not in a civilized country.

There really has to be a better way for things to work with keeping people healthy and alive in this day and age.

Ed


21 posted on 03/19/2008 2:46:51 PM PDT by Sir_Ed
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To: Sir_Ed
I know there’s some Freepers who say it’s our duty to die if we cannot get health insurance, but that’s really not the answer, not in a civilized country. There really has to be a better way for things to work with keeping people healthy and alive in this day and age.

I know how you feel. My wife and I have our own company, and we pay $1400/mo. for health insurance. Mostly, I'm fine, but she's had two cancers and diabetes (triggered apparently by a bunch of operations in a short period of time, which can shock the system and cause diabetes). And that doesn't even cover the co-pays. I'd take a chance with no insurance, but I don't dare because of my wife.
22 posted on 03/19/2008 3:08:39 PM PDT by BikerJoe
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To: Incorrigible; socialismisinsidious; Sir_Ed
A $5-a-month medication could easily control high blood pressure, Ginsberg says, but without forking over money to see a doctor, you can't get a prescription.

The whole "prescription" scheme is adding many billions of dollars a year to the cost of health care in this country. You need $100 (or you need your insurance company to spend $100) to see a doctor to write a prescription for something you can easily figure out on your own that you need (in many cases because it's the same medication, for the same condition, that you were taking when you had insurance). You also need transportation to the doctor. And time off work, if you're working.

THIS is the number one thing that people fighting socialized medicine should be focusing on. What kind of "free" country is this, when an adult can't just walk into a drug store, say what they want, plunk down the cash, and get it? The list of medications that genuinely pose a danger to PUBLIC health and safety -- the only legitimate reason for government to restrict access to drugs -- is actually very short, and those are the only ones that should require any kind of professional intermediation to obtain.

23 posted on 03/19/2008 3:08:55 PM PDT by GovernmentShrinker
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To: socialismisinsidious

Could you please add me to your ping list?


24 posted on 03/19/2008 3:15:03 PM PDT by Huntress (“When you have to shoot, shoot, don’t talk.”--Tuco)
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To: GovernmentShrinker

Or you can just establish a good relationship with your doctor. My wife’s doctor writes her scrips without seeing her all the time, she’s worked with him a while, he knows what kind of ailments she tends to get and has learned that she’s good at self diagnosing. So she can call him up say “I have a sinus infection” and he has his nurse call in the scrip to her favorite drug store.

Most prescription medications are pretty intense. Between their own side effects, the dangers when you take too much, the dangers when you take too little, and the reactions many of them have to other drugs there’s actually a very good reason to have some level of supervision.


25 posted on 03/19/2008 3:18:31 PM PDT by discostu (aliens ate my Buick)
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To: Huntress

Done.


26 posted on 03/19/2008 3:26:52 PM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
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To: rightinthemiddle
I think you're exactly right. I used to be a partner in a small law firm, and one of my responsibilities was to administer employee benefits. We (the firm) had a group health plan with good coverage and paid 50% of the employees’ premiums. Even so, many of the employees b*tched and moaned about having to pay the other 50%. My solution was to give them the number of our insurance broker and tell them to ask him about the cost of individual health insurance policies.

Another of our employees was just out of school and had fully absorbed all the politically correct views of her college campus. She was mad because her premiums were so much more than those of a man the same age. I gave her the obvious explanation, which is that young women her age tend to have babies. She said that was discriminatory, because men make babies, too. My response: 1) men don't incur any medical bills for their part of baby making process; 2) I don't make the rules; and 3) quit griping and be glad I didn't hire a man to do your job because he's cheaper to insure.

27 posted on 03/19/2008 3:28:29 PM PDT by Huntress (“When you have to shoot, shoot, don’t talk.”--Tuco)
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To: socialismisinsidious

Thanks!


28 posted on 03/19/2008 3:28:50 PM PDT by Huntress (“When you have to shoot, shoot, don’t talk.”--Tuco)
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To: GovernmentShrinker

I see your point, but in my case I went through four tyopes of meds for my HBP before I found one that worked.

The ACE inhibitors made me dizzy and feeling like I was going to pass out all the time. The Beta-Blockers made me cough all the time, the channel-blocker had another bad effect.

Finally we tried an ARB. It works great, the side effect isn’t as bad as the others, only bad thing is it’s kind of expensive.

If I had just gone in to a drug store and said “give me something to stop my HBP, they prolly couldn’t have worked so effectively at finding something that works.

Ed


29 posted on 03/19/2008 3:31:59 PM PDT by Sir_Ed
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To: GovernmentShrinker
Works for me for the routine stuff although some meds like antibiotics are overused and resistance has become a problem; people running out to buy an antibiotic every time they have a cough or have an earache or sore throat (b/c it could be strep) isn't a good idea. Also I have to wonder about how liability would be affected...one would think it would decrease but we do live in a society where trial lawyers are talking about smokers suing their doctors if they get a smokers' disease b/c the doctor didn't do enough to make them quit. What if the pharmacist gives them a medication that is harmful or deemed worthless? Guess whose fault it would be...
30 posted on 03/19/2008 3:42:10 PM PDT by socialismisinsidious ( The socialist income tax system turns US citizens into beggars or quitters!)
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To: Sir_Ed; discostu; socialismisinsidious

I’m not suggesting that people should never see a doctor, but:

1) Doctors are largely going on guesswork (and on pharma salespeople’s pitches), when prescribing and don’t have nearly as much time to figure out all the details of what your new symptoms and other conditions are and how that might dovetail with the different possible side effects of several possible medications for your new complaint. And they are constantly prescribing antibiotics without doing a culture to determine whether there’s really a bacterial infection present (as well they should be, and that’s why they do it!). With the Internet, people without medical training can be remarkably effective at researching their symptoms, test results, and the pros and cons and various medications that might be helpful. You can check for drug interactions at http://www.drugdigest.org/DD/Home (and no doubt other sites as well).

2) Doctors often wildly misdiagnose symptoms and end up prescribing medications that are useless or worse. If people were more in the habit of doing their own research, self-diagnosis, and drug selection, they’d be much better equipped to challenge doctors who are going down the wrong path. Things that aren’t common knowledge now would become common knowledge, promoting a culture in which people know how to take care of their own health, and how to decide when it’s time to consult a medical professional.

You might well have been able to try out the same array of blood pressure medications on your own, and land on the right one just as soon if not sooner. And you can be sure that if you’d tried out some ACE inhibitors that you got from a friend and they made you dizzy and light-headed, and headed to a doctor, you’d have been given a lecture about “This is why it’s important not to try to treat yourself; only a doctor can determine what medication will be safe and effective for you.” And your family and friends would like have given you the same lecture. Never mind that, as you found out, things like this happen all the time when doctors prescribe medication.

But at any rate, now you know what works. Why should you need to see a doctor to get a prescription for it? The real reason is that health insurance companies and promoters of government-paid medical care and the bulk of the medical profession WANT the medical care industry to be a gazillion dollar industry. More jobs for them! Read up on the recent research on the effectiveness of aspirin vs. Coumadin as a blood thinner. The overwhelming majority of people who have been taking expensive prescription Coumadin, with prescriptions obtained via trips to the doctor paid for either out of pocket or via insurance or via the taxpayer, would have gotten results at least as good from plain old aspirin.


31 posted on 03/19/2008 4:33:16 PM PDT by GovernmentShrinker
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To: PeterPrinciple
The phrasing “for speeding” leads me to believe it was not a one-time occurrence. More likely he had two or more in a specified length of time. No company that depends on having insurance for its fleet and drivers will keep someone who doesn't meet the insurance carrier's qualifications. Seems to me if he knew he had serious medical problems that he would have been a bit more careful to keep an eye on his speed. Of course with today's level of journalism it could be almost anything that did him in.
32 posted on 03/19/2008 5:08:18 PM PDT by jwparkerjr (Sigh . . .)
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To: rightinthemiddle

50 years ago I worked for a funeral home in Alabama where the owner paid in cash each week, the full amount with no deductions. Then he made you stand there and pay him back, out of your stash of cash, the various things he had to withhold and deduct. If you made $100 he would give you the $100 plus his part of the benefits and the matching SS funds, etc. Then he would point out to you that it cost him, say, $110 of his money to have your working for him, but then he would take back the deducts and when he was through, and you had only $70 or whatever the amount, he made sure you understood that although you only got $70 your payday cost him $110. It was very effective!


33 posted on 03/19/2008 5:21:19 PM PDT by jwparkerjr (Sigh . . .)
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To: GovernmentShrinker

“What kind of “free” country is this, when an adult can’t just walk into a drug store, say what they want, plunk down the cash, and get it? The list of medications that genuinely pose a danger to PUBLIC health and safety — the only legitimate reason for government to restrict access to drugs — is actually very short, and those are the only ones that should require any kind of professional intermediation to obtain.”

Oh? What about the dangers that it would pose to you? Not that, by your argument, should I be concerned. You and your family would be looking for someone to blame when you croak due to the Angioedema from the Hypertensive medication or find yourself in a hypoglycemic coma from the $5 diabetes medication; Both medications you demanded from the pharmacist, because, hey, this is a free country, and you know what’s best for you, and it sure ain’t a public health concern.

The point I’m trying to make about your point is that this is a familiar theme we see on this board, the libertarian argument to its’ logical end. Many talk about the privileges extended in such a society, but very few lead off with owning the responsibility and the resulting consequences.


34 posted on 03/19/2008 5:23:30 PM PDT by Harrius Magnus (Pucker up Mo, and your dhimmi Leftist freaks, here comes your Jizya!)
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To: GovernmentShrinker

“But at any rate, now you know what works. Why should you need to see a doctor to get a prescription for it? The real reason is that health insurance companies and promoters of government-paid medical care and the bulk of the medical profession WANT the medical care industry to be a gazillion dollar industry. More jobs for them! Read up on the recent research on the effectiveness of aspirin vs. Coumadin as a blood thinner. The overwhelming majority of people who have been taking expensive prescription Coumadin, with prescriptions obtained via trips to the doctor paid for either out of pocket or via insurance or via the taxpayer, would have gotten results at least as good from plain old aspirin.”

I was totally with you until this paragraph (I’m an Internist) as the more educated patients are the better.

Private insurers and gubmint health insurance have very little incentive to channel patients into doctors offices. This is intuitively correct, and in practice is certainly true. Doctors are the ones who have the incentive for return visits. You end up balancing it, but trust me, there are plenty of patients who would see a doctor weekly if allowed, and most are thrilled to have a responsible patient who can intelligently and succinctly communicate over the phone, as to whether something works or not. There is a large shortage of primary care providers currently.

The Coumadin business gave you away as someone who is getting bad information (and unsound economics). Coumadin has long been a generic (Warfarin). The risk of bleeding is many-fold greater than that of aspirin. There are also some select conditions where there are clear numbers to support the superiority (survival, events) of coumadin over aspirin (prosthetic valves, afib). The monitoring is expensive. Medicare reimbursement for an in office check by fingerstick (vs. a tube of blood) is $7. The reagents/supplies cost me $5 per test, and then add the time it takes for an assistant to do the “procedure.”

The final point is that if I were to make a list of medications that I hate dealing with, number one would be coumadin, and most doctors would feel the same. It’s all risk, no profit, just a bad deal all around. I cannot wait until there is an alternative.

You are correct that there are many conditions where aspirin would be nearly or as good as coumadin. There is no incentive for a doctor to choose coumadin over aspirin (as explained above). The implication that this is some type of health care ruse with all parties involved to grease hands is preposterous, and you shouldn’t mislead readers with your armchair doctoring and conspiracy garbage. You should find a better source and then sound it off with someone who knows health care, prior to spouting off.


35 posted on 03/19/2008 5:45:01 PM PDT by Harrius Magnus (Pucker up Mo, and your dhimmi Leftist freaks, here comes your Jizya!)
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To: Harrius Magnus

Acetaminophen is the leading cause of acute liver failure requiring transplant in the US, and yet any kid can walk into a drug store and buy it off the shelf, no questions asked. This is the sort of thing that should arouse suspicion that the prescription requirements for a huge array of drugs are not based on a need to protect us from ourselves. Wasn’t that long ago that you couldn’t get Claritin without a prescription. And long after the FDA had declared it safe enough to be non-prescription, maker Schering-Plough kept fighting like hell to stop it from being changed to non-prescription status, because they couldn’t make nearly as much money that way.

People buy lots of medications just because their doctor prescribed it and their insurance company picks up so much of the cost that it ends up being as cheap to the patient as non-prescription drugs out on the open shelf. Of course that’s one of the reasons that insurance coverage is so expensive, but most people have employer-paid health insurance and see little or none of that cost — the salary they were quoted when they were offered the job already had the massive insurance tab deducted. Pharma companies make oodles of money on this scam. They, and the physician lobby, push the “but you could hurt yourselves” line because it’s very profitable for them, not because it’s better for your health.

I’m not suggesting stuff like vancomycin should be non-prescription, but probably at least 95% of the current prescription drugs should be non-prescription. Most people have enough common sense not to buy and take something that’s covered with warnings about its dangers without doing some research — in many cases including consulting with a physician — to find out if it’s really likely to do them more good than harm. And people who don’t have that much common sense are the same ones who will pop 10 times the maximum recommended dose of acetaminophen because smaller amounts didn’t make their massive hangover headache from Friday night drinking go away fast enough, and it’s already sundown on Saturday and almost time to start drinking and “partying” again.

As for aspirin vs. warfarin/coumadin, there are a lot of people getting the latter who ought to be getting the former, and testing of the relative benefits always seems to be specific to preventing some particular type of vascular event. If the research says warfarin is better at preventing a type of event that a certain patient appears to be at risk for, then warfarin is prescribed, usually without regard to the other factors, not least of which are the effects of telling elderly people to avoid green leafy vegetables. Both of the doctors who have prescribed warfarin (always referred to as “coumadin” due to the lasting effects of pharma sales rep indoctrination) for my now 85 year old father warned him to avoid leafy green vegetables, apparently strongly enough that he almost never eats any at all, but never mentioned that this sort of diet is likely to lead to folate deficiency and that folic acid supplementation is indicated. The effects of long-term folate deficiency don’t overlap much with the adverse events for which warfarin vs. aspirin are tested, and aren’t factored into the choice if the choice is based on published research. And when warfarin really is the better choice, it should certainly be supplemented with non-prescription folic acid, but somehow that non-prescription stuff always seems to get forgotten.

No, I don’t think that the whole medical profession and the whole pharma industry are just big conspiracies to get our money. I’ve benefitted a great deal from both, but especially when I added my own research and judgement to that of physicians, and pursued a course of treatment “against medical advice”. However, the “medical/pharma/government industrial complex” is very susceptible to abuse due to the combination of overwhelming third party payment and third party decision-making. This susceptibility attracts a lot of the sort of people who want to exploit it, and we should be on guard against laws and policies that make that easier, and that encourage people to be sheep-like, and rely on the government-licensed professionals for everything.

From your own profile page: “In casinos, the odds of surviving a cardiac arrest is over 50%. In contrast, the odds of surviving cardiac arrest in a hospital, according to this new study, is only 34%”. You left out the main reason behind that statistic, namely that hospitals rely on non-automated defibrillators that only physicians are authorized to use. In a casino, a gaming floor staffer grabs an AED and saves your life, but in a hospital a nurse stands by waiting for a doctor and a giant unautomated defibrillator to arrive — often too late to save your life — because only the doctor is deemed expert enough to do such things.


36 posted on 03/19/2008 7:06:44 PM PDT by GovernmentShrinker
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To: GovernmentShrinker

Plus....did you know that blood pressure meds only cost something like pennies to manufacture for a month’s worth.....


37 posted on 03/19/2008 7:37:26 PM PDT by goodnesswins (Being Challenged Builds Character; Being Coddled Destroys Character)
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To: GovernmentShrinker

You didn’t really address my concerns, but it is less important to me after reading what you wrote, nothing of which I have a problem with. You’ve obviously done much of your homework, and you might be surprised to find how much of a delight it is for your physician to know you have looked into these things thoughtfully.
However, you’d have to admit that you cannot be counted as the rule, but very much the exception. My post was for the purpose that it seemed you were implying what was best for others/US healthcare, at large. You chose not to address my complaint, and I stand by it: While you may be your (and your family’s) best caretaker, your recommendations, while perhaps decreasing overall cost, are not wise and very likely not in any random patient’s best interest. Therefore you should refrain from making even indirect specific health recommendations. Furthermore, your explanations belie your understanding of basic economics.
Also, there are many good possibilities why cardiac arrest favors the gamblers. It is unfortunate and revealing that you chose the one that you did. Some doctor must have buggered you good, once upon a time.


38 posted on 03/19/2008 9:31:53 PM PDT by Harrius Magnus (Pucker up Mo, and your dhimmi Leftist freaks, here comes your Jizya!)
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To: L98Fiero

My brother is a truck driver and seems to be able to get new jobs easily, and lose them just as often. There’s something else going on IMHO.

The other thing is someone with insulin dependent diabetes has no business operating heavy equipment, so darn straight they should pass a physical. Those dang greedy employers, doncha know. Puhleeze.


39 posted on 03/30/2008 4:55:37 PM PDT by Wicket (God bless and protect our troops and God bless America)
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