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Texas’ Other Death Penalty

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  • Texas’ Other Death Penalty

    This is a long and brutal article that shows where the real death panels are.

    Texas’ Other Death Penalty

    A Galveston medical student describes life and death in the so-called safety net.

    The first patient who called me “doctor” died a few winters ago. I met him at the St. Vincent’s Student-Run Free Clinic on Galveston Island. I was a first-year medical student then, and the disease in his body baffled me. His belly was swollen, his eyes were yellow and his blood tests were all awry. It hurt when he swallowed and his urine stank.

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

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

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

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

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

  • #2
    Such a sad set of stories, all of which won't be solved by this crappy law. Our current government is too inept to fix this stuff.
    "Faith is nothing but a firm assent of the mind : which, if it be regulated, as is our duty, cannot be afforded to anything but upon good reason, and so cannot be opposite to it."

    -John Locke

    Comment


    • #3
      Originally posted by scott View Post
      Such a sad set of stories, all of which won't be solved by this crappy law. Our current government is too inept to fix this stuff.
      Texas opting out of Medicaid expansion saw to that.
      Enjoy.

      Comment


      • #4
        They met in New Orleans when she was 18. She was working cleaning motels, and he took her on a tour of the tugboat he was captain of. Vanessa says they came to St. Vincent’s because the shipyard Jimmy worked for opted out of providing insurance even for full-time employees like him. They looked for insurance on the open market, but couldn’t afford it.

        [....]

        If the Affordable Care Act had been in effect last year, they would have been able to afford insurance, get treatment early and avoid bankruptcy.



        Tugboat captains average $70K per year, and I would not for a second buy that a tug captain in New Orleans is not union, which would mean excellent health coverage.

        Jimmy could have afforded health insurance, but he chose not to.


        Pity meter pegged at negative infinity.
        Bask in the warmth of the Deep South
        No one will be denied:
        Big law suits and bathroom toots;
        We're all getting Dixie-fried.
        But somewhere Hank and Lefty
        Are rollin' in their graves
        While kudzu vines grow over signs that read "Jesus Saves."

        Comment


        • #5
          I was wondering what you would find to enable you to dismiss the issue.
          "There are four lights!"

          Comment


          • #6
            Originally posted by Billy Jingo View Post
            I was wondering what you would find to enable you to dismiss the issue.
            I'm not dismissing the issue. I'm pointing out that the author has the wrong issue. The issue isn't that we didn't have Obamacare soon enough. The issue is that Jimmy chose to be irresponsible and then the bill came due. Or, the author just made shit up to try to create something that isn't there.
            Bask in the warmth of the Deep South
            No one will be denied:
            Big law suits and bathroom toots;
            We're all getting Dixie-fried.
            But somewhere Hank and Lefty
            Are rollin' in their graves
            While kudzu vines grow over signs that read "Jesus Saves."

            Comment


            • #7
              Originally posted by Norm dePlume View Post
              Texas opting out of Medicaid expansion saw to that.
              Go ahead and blame the states for a bad law and an even worse rollout.

              How's Oregon's exchange doing?
              "Faith is nothing but a firm assent of the mind : which, if it be regulated, as is our duty, cannot be afforded to anything but upon good reason, and so cannot be opposite to it."

              -John Locke

              Comment


              • #8
                Why assume that Medicaid would be any better? There's no incentive to diagnose a disease that still wouldn't be aggressively treated given the reimbursement rate.

                I've never known a Medicaid patient who thought their treatment was good. Now, they are probably out there. People with simple fractures, uncomplicated deliveries, minor infections, and cheap, easily treated chronic illnesses like hypothyroid.

                But if you have lupus or cancer or neurological issues, well that seems to be different but that's exactly when you want better treatment.
                "Alexa, slaughter the fatted calf."

                Comment


                • #9
                  Originally posted by scott View Post
                  Go ahead and blame the states for a bad law and an even worse rollout.

                  How's Oregon's exchange doing?
                  From what I read, it seems that Oracle saw a poorly written rfq and turned it into a poorly written contract that lets them deliver a dysfunctional product, get paid, and then charge some more to fix it.

                  But I don't think the exchange is the only way to sign up for Medicaid.
                  Enjoy.

                  Comment


                  • #10
                    Originally posted by Gingersnap View Post
                    Why assume that Medicaid would be any better? There's no incentive to diagnose a disease that still wouldn't be aggressively treated given the reimbursement rate.

                    I've never known a Medicaid patient who thought their treatment was good. Now, they are probably out there. People with simple fractures, uncomplicated deliveries, minor infections, and cheap, easily treated chronic illnesses like hypothyroid.

                    But if you have lupus or cancer or neurological issues, well that seems to be different but that's exactly when you want better treatment.
                    Meh

                    LOTS of Medicaid patients here get the same care as those who pay for it. The complaints are as severe as those on other plans and it's certainly good care. The problem with Medicaid is that it's unsustainable with the escalating rates of participation. $0 co-pay for primary care physicians and specialists eat up a lot of resources.
                    "Faith is nothing but a firm assent of the mind : which, if it be regulated, as is our duty, cannot be afforded to anything but upon good reason, and so cannot be opposite to it."

                    -John Locke

                    Comment


                    • #11
                      Originally posted by Norm dePlume View Post
                      From what I read, it seems that Oracle saw a poorly written rfq and turned it into a poorly written contract that lets them deliver a dysfunctional product, get paid, and then charge some more to fix it.
                      Which is the problem with such big-government problems, as I said it would be. I was mocked by you and others for drawing comparisons between this cutting edge proposal and the DMV.

                      Originally posted by Norm dePlume View Post
                      But I don't think the exchange is the only way to sign up for Medicaid.
                      Probably not. That's another problem with such big-government programs. Someone on the dole gets immediate benefits, someone marginal is prioritized, and someone who makes "too much" gets fucked.
                      "Faith is nothing but a firm assent of the mind : which, if it be regulated, as is our duty, cannot be afforded to anything but upon good reason, and so cannot be opposite to it."

                      -John Locke

                      Comment


                      • #12
                        I recently took an uninsured friend to the hospital. She was seen immediately and has been in specialized nursing , the PCU, or the ICU for the last two weeks. She is currently on life support. She is clean, well cared for, and has a team of doctors working very hard to find out what is wrong with her. This is Florida, a state not known for its generosity in public charity. She would not be getting better care with private insurance. The hospital would consider that unethical.
                        The year's at the spring
                        And day's at the morn;
                        Morning's at seven;
                        The hill-side's dew-pearled;
                        The lark's on the wing;
                        The snail's on the thorn:
                        God's in his heaven—
                        All's right with the world!

                        Comment


                        • #13
                          Originally posted by Novaheart View Post
                          I recently took an uninsured friend to the hospital. She was seen immediately and has been in specialized nursing , the PCU, or the ICU for the last two weeks. She is currently on life support. She is clean, well cared for, and has a team of doctors working very hard to find out what is wrong with her. This is Florida, a state not known for its generosity in public charity. She would not be getting better care with private insurance. The hospital would consider that unethical.
                          And who do you suppose ends up paying for all of that?

                          I'm glad she's being taken care of, by the way.
                          Enjoy.

                          Comment


                          • #14
                            Originally posted by scott View Post
                            I was mocked by you and others for drawing comparisons between this cutting edge proposal and the DMV.
                            Always with the personal grudge. Actually, within the last couple of months I renewed my drivers license and vehicle tags online. The DMV website works just fine.
                            Enjoy.

                            Comment


                            • #15
                              Originally posted by Norm dePlume View Post
                              And who do you suppose ends up paying for all of that?

                              I'm glad she's being taken care of, by the way.
                              The taxpayers without the crony capitalism of the current ACA.
                              "Faith is nothing but a firm assent of the mind : which, if it be regulated, as is our duty, cannot be afforded to anything but upon good reason, and so cannot be opposite to it."

                              -John Locke

                              Comment

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