Tackling the health care gap
August 12, 2009 1:03 PM Subscribe
After the Remote Area Medical (RAM) Expedition visited Wise County in rural Virginia, they made their next stop at the Fabulous Forum, in urban Los Angeles.
As a Canadian, I don't feel qualified to comment intelligently about my own country's health care system, let alone that of the US. I bring this article from The Atlantic to your attention only because I happened to read it this morning and it's on what I think is the underlying topic of this post, that many people lack basic health care in the country that has arguably the world's best health care resources.
That being said, RAM's work must seem heaven-sent to the people who can avail themselves of RAM's services.
posted by angiep at 1:45 PM on August 12, 2009
That being said, RAM's work must seem heaven-sent to the people who can avail themselves of RAM's services.
posted by angiep at 1:45 PM on August 12, 2009
angiep: That Atlantic article was fascinating. Thanks for bringing it up.
It's a fairly long read, but definitely worth your time. This New Yorker piece, which I believe was the subject of a FPP a while back, also stuck with me.
Doctors are, as a class, treated as sacrosanct in much of the current healthcare debate. However, I'd put forward that they are—as a group, but in particular via the AMA in its role as a bald-faced supply cartel—as much to blame as just about anyone else for bringing about the incredibly high cost of healthcare services in the US.
Any "solution" that doesn't piss off the AMA and increase the supply of physicians in the US by opening more medical schools isn't going to work, and simply increasing health-insurance eligibility or coverage without increasing the supply of doctors risks actually increasing prices by creating more demand.
If we're not careful, we could easily create a system where everyone has "coverage," but it's effectively impossible to see a doctor in a reasonable amount of time without coughing up some cash to jump the line.
posted by Kadin2048 at 2:06 PM on August 12, 2009 [1 favorite]
It's a fairly long read, but definitely worth your time. This New Yorker piece, which I believe was the subject of a FPP a while back, also stuck with me.
Doctors are, as a class, treated as sacrosanct in much of the current healthcare debate. However, I'd put forward that they are—as a group, but in particular via the AMA in its role as a bald-faced supply cartel—as much to blame as just about anyone else for bringing about the incredibly high cost of healthcare services in the US.
Any "solution" that doesn't piss off the AMA and increase the supply of physicians in the US by opening more medical schools isn't going to work, and simply increasing health-insurance eligibility or coverage without increasing the supply of doctors risks actually increasing prices by creating more demand.
If we're not careful, we could easily create a system where everyone has "coverage," but it's effectively impossible to see a doctor in a reasonable amount of time without coughing up some cash to jump the line.
posted by Kadin2048 at 2:06 PM on August 12, 2009 [1 favorite]
Doubtless their work in Los Angeles will be badly needed, but they ought to amend their mission statement which says "providing free health care [etc.] to people in remote areas of the United States and the world."
Also, I see they're providing mammograms. If I were in a position to enjoy this offer, I'm not sure I'd take them up on it if I didn't have any way to obtain cancer treatment, ignorance being bliss. Or maybe we'll get health care reform after a couple of back-alley masectomies make the news.
posted by exogenous at 2:10 PM on August 12, 2009
Also, I see they're providing mammograms. If I were in a position to enjoy this offer, I'm not sure I'd take them up on it if I didn't have any way to obtain cancer treatment, ignorance being bliss. Or maybe we'll get health care reform after a couple of back-alley masectomies make the news.
posted by exogenous at 2:10 PM on August 12, 2009
It's awesome that they do this. That it's needed is rather sad.
posted by doctor_negative at 2:22 PM on August 12, 2009 [2 favorites]
posted by doctor_negative at 2:22 PM on August 12, 2009 [2 favorites]
I was all prepared to get all pissy about the lack of sales pitch in the post, but turns out 'twasn't needed. Health care reform protesters may some day come to realize that "death panel's" really only exist where the medical resourses either don't exist or are not affordable for so much of our (US) population, and that they are those panels due to their hysteria about "socialized medicine," as if that's going to lead to the end of the world as we know it. Having "socialized" highways has had many benefits for us, but that was a boon for commerce, with side benefits for individual mobility. To think we in the US think it's ok to encourage the movement of freight, but not so much the health of its citizens id pretty embarrassing to me.
posted by path at 2:34 PM on August 12, 2009
posted by path at 2:34 PM on August 12, 2009
As a Canadian, I don't feel qualified to comment intelligently about my own country's health care system, let alone that of the US.
I do. Let me give you a short list of some of the things I never, ever do here in Canada.
- I am never afraid of what happens if the headache won't go away.
- I never worry about whether or not something is covered, ever.
- I have never had to lie to a doctor because an unrelated preexisting condition might mean I can't afford to get help for my current one.
- I am never stuck in a job I hate because of the fear losing my health coverage.
- I never fight with insurance companies about how much of whatever they'll pay.
- It never even occurs to me to wonder how we'll make ends meet if my daughter gets sick. It just doesn't even cross my mind; it's an irrelevant question.
- I am never afraid of losing my home or business because of medical bills.
There are literally hundreds of other things I don't do but the most important thing I never do, with respect to my health care system, is this:
- I do not live in fear.
My daughter's birth was far, far more exciting than it needed to be, and for a while there I thought I was coming home alone. But after three days in intensive care for both of them, in which a team of absolutely first-rate professional medical staff used the finest, most modern tools and techniques at their disposal, I got to go back to a home I could still afford with a recovering wife and child. The paperwork I received a few weeks later included information on how to apply for a birth certificate, some other government paperwork, and a bill for the private room we chose so that I could stay with my wife instead of having to go home at night.
I think it cost me $80 dollars. That and parking.
I pay a lot more than that, of course, year over year in taxes, and while I quibble about the details of how my taxes get paid as we all should, let me tell you: single-payer, socialized medicine is absolutely fucking fantastic. Not being terrified of the bill coming due for this nightmare at all, being able to give my wife and child 100% of my attention when they need it most and deserve nothing less, it is gold.
As far as I'm concerned, not having reliable, government-supported medical care is precisely the same as not having clean running water or electricity. It's a sign that you're far, far outside the bounds of civilization, in some godforsaken place where people live with their necks under the jackboot of random chance, where the barbarians are winning.
posted by mhoye at 3:15 PM on August 12, 2009 [17 favorites]
I do. Let me give you a short list of some of the things I never, ever do here in Canada.
- I am never afraid of what happens if the headache won't go away.
- I never worry about whether or not something is covered, ever.
- I have never had to lie to a doctor because an unrelated preexisting condition might mean I can't afford to get help for my current one.
- I am never stuck in a job I hate because of the fear losing my health coverage.
- I never fight with insurance companies about how much of whatever they'll pay.
- It never even occurs to me to wonder how we'll make ends meet if my daughter gets sick. It just doesn't even cross my mind; it's an irrelevant question.
- I am never afraid of losing my home or business because of medical bills.
There are literally hundreds of other things I don't do but the most important thing I never do, with respect to my health care system, is this:
- I do not live in fear.
My daughter's birth was far, far more exciting than it needed to be, and for a while there I thought I was coming home alone. But after three days in intensive care for both of them, in which a team of absolutely first-rate professional medical staff used the finest, most modern tools and techniques at their disposal, I got to go back to a home I could still afford with a recovering wife and child. The paperwork I received a few weeks later included information on how to apply for a birth certificate, some other government paperwork, and a bill for the private room we chose so that I could stay with my wife instead of having to go home at night.
I think it cost me $80 dollars. That and parking.
I pay a lot more than that, of course, year over year in taxes, and while I quibble about the details of how my taxes get paid as we all should, let me tell you: single-payer, socialized medicine is absolutely fucking fantastic. Not being terrified of the bill coming due for this nightmare at all, being able to give my wife and child 100% of my attention when they need it most and deserve nothing less, it is gold.
As far as I'm concerned, not having reliable, government-supported medical care is precisely the same as not having clean running water or electricity. It's a sign that you're far, far outside the bounds of civilization, in some godforsaken place where people live with their necks under the jackboot of random chance, where the barbarians are winning.
posted by mhoye at 3:15 PM on August 12, 2009 [17 favorites]
Look closer at what's happening with RAM events:
1. They obviously aren't following HIPAA requirements for patient privacy.
2. There are no medical records, except perhaps what might be generated on the spot.
3. There's nobody processing insurance paperwork.
4. All tests and procedures are done on the spot, in-house.
This suggests to me that, if we can't have socialized medicine, at least it should be possible for the market to provide a Wal-Mart level of service, instead of the exclusively Rodeo Drive level of service enshrined throughout the US healthcare industry.
Give me a hospital where I can choose a dormitory room, instead of a private room, for what should be a much lower cost. Let me have posession of my medical records, so the clinic/hospital/doctor doesn't have to manage them for me, thus avoiding those costs. Post a menu board with prices for the top 50 most frequent needs. It shouldn't cost any more than when I take my cat to the vet, really.
I would prefer to have socialized medicine. But if we can't have that, then let's have an actual market for medical services. You can't call it a market if there are no bottom-tier providers.
posted by yesster at 4:25 PM on August 12, 2009 [3 favorites]
1. They obviously aren't following HIPAA requirements for patient privacy.
2. There are no medical records, except perhaps what might be generated on the spot.
3. There's nobody processing insurance paperwork.
4. All tests and procedures are done on the spot, in-house.
This suggests to me that, if we can't have socialized medicine, at least it should be possible for the market to provide a Wal-Mart level of service, instead of the exclusively Rodeo Drive level of service enshrined throughout the US healthcare industry.
Give me a hospital where I can choose a dormitory room, instead of a private room, for what should be a much lower cost. Let me have posession of my medical records, so the clinic/hospital/doctor doesn't have to manage them for me, thus avoiding those costs. Post a menu board with prices for the top 50 most frequent needs. It shouldn't cost any more than when I take my cat to the vet, really.
I would prefer to have socialized medicine. But if we can't have that, then let's have an actual market for medical services. You can't call it a market if there are no bottom-tier providers.
posted by yesster at 4:25 PM on August 12, 2009 [3 favorites]
Thanks for posting this. I volunteer with RAM and yes, I'm currently manning the Triage station at the Forum. There's a great spirit to our missions -- our staff and patients are enthusiastic and motivated -- but I look forward to a day when we're not needed in the US anymore.
posted by grounded at 5:18 PM on August 12, 2009
posted by grounded at 5:18 PM on August 12, 2009
As a Canadian, I don't feel qualified to comment intelligently about my own country's health care system, let alone that of the US.
When in doubt, I link this with part two.
posted by Evilspork at 5:47 PM on August 12, 2009
When in doubt, I link this with part two.
posted by Evilspork at 5:47 PM on August 12, 2009
I would prefer to have socialized medicine. But if we can't have that, then let's have an actual market for medical services. You can't call it a market if there are no bottom-tier providers.
My GF works at a vet hospital. A few years ago I got a nasty spider bite. I went to the Dr. to get it checked out and I got a staff infection from the Dr.'s office. After being bounced around various hospitals and overhearing them discussing taking my leg off (the infection was on my upper thigh) I got desperate. I went to the vet and asked one of them to take a look.
She gave me an antibiotic cocktail and some cream that cleared up the infection in about a week. None of it approved for humans, but hey, it only cost me a bottle of Johnny Walker Black as payment.
posted by Ludi at 6:09 PM on August 12, 2009 [2 favorites]
My GF works at a vet hospital. A few years ago I got a nasty spider bite. I went to the Dr. to get it checked out and I got a staff infection from the Dr.'s office. After being bounced around various hospitals and overhearing them discussing taking my leg off (the infection was on my upper thigh) I got desperate. I went to the vet and asked one of them to take a look.
She gave me an antibiotic cocktail and some cream that cleared up the infection in about a week. None of it approved for humans, but hey, it only cost me a bottle of Johnny Walker Black as payment.
posted by Ludi at 6:09 PM on August 12, 2009 [2 favorites]
I got desperate. I went to the vet and asked one of them to take a look.
Oh wow. How did you talk them into it? They won't buy my argument that I'm just an ape with some alopecia. I'd much rather go to the vet than any MD I've ever seen.
posted by dilettante at 6:46 PM on August 12, 2009 [1 favorite]
Oh wow. How did you talk them into it? They won't buy my argument that I'm just an ape with some alopecia. I'd much rather go to the vet than any MD I've ever seen.
posted by dilettante at 6:46 PM on August 12, 2009 [1 favorite]
My former dentist (she graduated) is volunteering with RAM at the Forum now. Even if she hadn't just done my root canal and finally ended my mysterious jaw pain, I would completely adore her just for getting up that early every morning and hauling down to help the folks in my town who don't have the same access to care.
posted by fairytale of los angeles at 6:51 PM on August 12, 2009
posted by fairytale of los angeles at 6:51 PM on August 12, 2009
This group is wonderful, and I wish it were not so desperately needed. That being said...
Does Canada need more librarians and web designers?
Will work for freedom from health-related terror.
Oh, and poutine.
posted by wowbobwow at 7:32 PM on August 12, 2009
Does Canada need more librarians and web designers?
Will work for freedom from health-related terror.
Oh, and poutine.
posted by wowbobwow at 7:32 PM on August 12, 2009
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posted by wadefranklin at 1:41 PM on August 12, 2009