American Politics XIII

[Foreverlad]

Gladney the Uninsured Activist

Over the last few days, a conservative activist in St. Louis named Kenneth Gladney seems to have become something of a cause celebre in far-right circles. Depending on which version of events you choose to believe, Gladney either initiated or was involved in a scuffle at a town-hall event late last week.

Gladney later went to the hospital, claiming to have sustained injuries to his "knee, back, elbow, shoulder and face."

Yesterday, about 200 conservative activists held a protest outside the SEIU office in St. Louis. Gladney was there -- bandaged and in a wheelchair -- as a featured guest. Some of the activists held signs that read, "Don't Tread on Kenny." Reader R.D. alerted me to this tidbit in the local news account of the protest:

Gladney did not address Saturday's crowd of about 200 people. His attorney, David Brown, however, read a prepared statement Gladney wrote. "A few nights ago there was an assault on my liberty, and on yours, too." Brown read. "This should never happen in this country."

Supporters cheered. Brown finished by telling the crowd that Gladney is accepting donations toward his medical expenses.

Gladney told reporters he was recently laid off and has no health insurance

. [emphasis added]

[Annelise]

Unemployment isn't the best stat to follow. It's a trailing indicator.

Right. Unless I've misunderstood, it's saying growth doesn't seem durable yet. I read that as it remains possible that this is a false start, so to speak.

[Annelise]

Gladney the Uninsured Activist

It would seem he's politically consistent at least, asking for private charity instead of a government bailout.

More seriously, don't you get COBRA if you're laid off or did he just opt not to spend the money?

[Shryke]

He my have also opted to not be able to afford COBRA.

[Annelise]

He my have also opted to not be able to afford COBRA.

Yeah that's true, he may have just not liked the price. But there's 1500 providers out there, surely one of those cares about his needs and will give him a square shake.

[turinturambar]

Rather than looking at infant mortality, which can and does vary widely not only from country to country, but state to state in the US, we could also look at maternal deaths. In 2005, the US's maternal mortality rate was 11 per 100, 000 live births.

http://www.who.int/whosis/mme_2005.pdf

In 1996, it was 7.5.

http://www.cdc.gov/mmwr/preview/mmwrhtml/00054602.htm

Why is this happening? Answer: lack of good access to prenatal health care. I can't count the number of women I've seen who come in the third trimester and have never been to a doctor. By then, many of them have hypertension, gestational diabetes, infections, kidney problems, you name it. These things put you and the baby at risk not only for pre-term birth but for complications such as infections. We send women home within 24 hours after delivery; how many of them end up back in the ER when they develop complications?

These are conditions that can be avoided if only we could get them better care right from the beginning.

But why are these women not receiving pre-natal care? It isn't difficult for low-income women to get their pre-natal care paid for through any of a handful of programs.

[LCOTNW]

The right wing continues its march over the Cliffs of Remarkable Stupidity:

DG - this quote needs to be in context to appreciate the full glory:

The U.K.'s National Institute for Health and Clinical Excellence (NICE) basically figures out who deserves treatment by using a cost-utility analysis based on the "quality adjusted life year."

One year in perfect health gets you one point. Deductions are taken for blindness, for being in a wheelchair and so on.

The more points you have, the more your life is considered worth saving, and the likelier you are to get care.

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

The British are praised for spending half as much per capita on medical care. How they do it is another matter. The NICE people say that Britain cannot afford to spend $20,000 to extend a life by six months. So if care will cost $1 more, you get to curl up in a corner and die.

The British are apparently a cold and heartless people.

[The Iceman of the North]

This is very true. The statistics for infant mortality include all children from birth up to 12 months of age. WHO defines a live birth as any born human being who demonstrates independent signs of life, including breathing, voluntary muscle movement, or heartbeat. UNICEF has a formula for minimizing the discrepancies between reporting countries, taking into account a lot of different factors like gestational age at birth, that kind of thing. It isn't perfect, but it minimizes errors and maximizes potential for seeing long term trends.

I believe the supposed "discrepancies" regarding how infant mortality is calculated is just the US right trying to explain how come the US have a worse infant mortality than Cuba.

Of course if you compare the IMR by only looking at the official statistics from different countries, the criticism might be valid. But comparing infant mortality from country to country using UN data, where they use the same definitions in all countries, the data is comparable for all developed countries were data collection is reliable, the

Methodology and definitions used by the UN

The fact is that the IMR in the US is surprisingly high compared to the GDP per capita. No country with a GDP per capita within 65% of the US* have an IMR as high as the US. While its possible to question the statistics from Cuba, for some reason I do trust the meta data collected in a country like Portugal, which have 80% of the IMR as the US, but less than half the GDP per capita.

* Except oil-rich Arab states with no UHC

[LCOTNW]

I just heard an interesting debate on NPR on the provision that some are saying calls for euthenasia. There is one interesting element that I hadn't really considered before which is that physicians are supposed to report on a few items back to the government in order to get paid. It still does not mandate that the physician or the patient even have end-of-life discussions. Just that they will reimburse the physician if they do.

Was that on TOTN? I heard a bit of that at lunch. First they had one guy who explained the section of the House bill that is the source of the controversy and he explained just like you did. Medicare apparently doesn't compensate doctors for the time spent discussing things like living wills, medical directives, etc. If the Dr. wants to have that conversation, and the patient agrees, the Dr. should get paid for their expertise. If the patient doesn't want to talk about it, just like anything else, all they have to do is say, "I don't want to discuss it." and that ends it. If the Dr. pursues it, just like with anything else, the patient can go find another Dr. No mandatory filling out advanced directives, or any of that crap.

Then, later, they had someone opposing it trying to say that since the Dr. can get paid for talking about end of life decisions, they might "force" patients to talk about it and sign living wills, etc. Which is bizarre since there is no additional compensation whether the patient decides to do anything or not. Apparently, we can't trust the Dr. to not succumb to the profit motive in end-of-life decisions, but it is perfectly okay to introduce a profit motive in, well, every other area of medicine. Remember that Dr.s are never concerned with the health of the patient, only what they can charge to the patient's insurance. :rolleyes:

I was surprised to learn that the gov. was collecting data on whether patients did anything or not as a result of these conversations with their Dr. but it doesn't concern me. Is there any logical reason not to try and entice people to think about their end-of-life decisions, or to even encourage people to tell their family about their choices? Complete a DNR or don't complete one, but at least think about it and make an informed decision before the guy is standing over you with the paddles wondering what you would want if you could talk.

According to what I heard on the show, the Dr. only gets paid once every 5 years for having that conversation unless the patient has a terminal illness or other serious condition that makes having an advanced directive logical.

[awesome possum]

Gladney the Uninsured Activist

How in the hell is anyone with a decent sense of logic supposed to take clowns like this seriously?

[Elrostar]

Yes, this 'euthanasia' proposal is a huge misunderstanding. And to be honest, having seniors talk about end of life decisions (living will, DNR, etc.) is probably a good idea. Having this be a 'billable procedure' once every five years, if the patient wants it, seems like a fantastic idea. I can't see why anyone would really be opposed to it. Or do people not think that it's a good idea to address things like living wills and DNRs and stuff like that? To me it seems like another one of those preventative care issues that will make things much easier in the long run. But that's just based on my personal experience of dealing with my grandmother, of course.

It's kind of like it would benefit people to have doctors spend more time with individuals talking about preventative care, general health, lifestyle, and that sort of thing. But those aren't as easily billable procedures as tests and labs, so they end up being prioritized less highly.

[Bill Foote]

Nice to know that the recession's almost over. Only 6-8 million more unemployed over the past year...hopefully the euthanasia panel can see to that.

I can cherry pick stats too! Ever country in Europe has a lower child mortally rate then the U.S. does. There are many factors that go into surviving cancer, like early detection, prevention as well as quality of care. It's almost as bad as comparing crime statistics. What's your point?

He tried that in the last thread.

[The Real Will]

I have no idea why they are slagging off the NHS. Sure, mistakes are made there, but on the whole, the NHS is an excellent organisation providing an astonishing high level or care. And this is to my extremely picky, Swedish eyes where we pride ourselves of high standards of care.

So far the NHS has exceeded my expectations in almost every area. Short to no waiting times, friendly and helpful staff, good doctors and a lot of choice. I really wish some of the people who insist on holding up the NHS as some sort of Frightful Example actually had some experience with the level of care you can get in the UK, which is normally very high.

Obviously, nobody can protect themselves fully against mistakes, but I'd be amazed if mistakes aren't made in all systems. Doctors, nurses and health professionals are after all people wherever they work, and sometimes they will make failty predictions, or they will not fully understand the symptoms the patient has. I don't see why this should be different in a private system or in an UHC system, unless somebody wants to argue that the health professionals in a UHS system are not adequately trained compared to those in a private system.

Comparing the quality of care in places like Australia, Sweden, Canada and the UK to the US shows that this is clearly not the case. The lack of training angle doesn't hold water.

What really pisses me off about this (and the Stephen Hawking stuff), is that it's blatant propaganda aimed at winning over the uninformed and the interlectually incurious. It's not actually designed to convince anyone who knows anything about UHC systems generally, it's not intended to engage anyone in debate. The people spewing this crap are either deliberately slandering the national healthcare of other nations, or they actually don't know what they're talking about. Either way they need to shut up.

[BloodRider]

Gladney was there -- bandaged and in a wheelchair -- as a featured guest.

Gladney told reporters he was recently laid off and has no health insurance.

Who then, pray tell bandaged him. Who decided that he was so injured that he had to be in a wheelchair?

I smell a rat.

[BloodRider]

He could have received treatment from the ER if he was in rough enough shape.

Watch the video. Dude was not hurt any worse than if he had taken a tumble off the curb.

Oh - and the ER does NOT hand out wheelchairs.

I guess my point is that he is likely joe-plumbing it up for the cameras.

[Merentha]

He could have received treatment from the ER if he was in rough enough shape.

Not an upstanding American like that! Surely he'd refuse treatment if he was unable to pay! (ER's don't give away wheelchairs.)

[Lyanna Stark]

What really pisses me off about this (and the Stephen Hawking stuff), is that it's blatant propaganda aimed at winning over the uninformed and the interlectually incurious. It's not actually designed to convince anyone who knows anything about UHC systems generally, it's not intended to engage anyone in debate. The people spewing this crap are either deliberately slandering the national healthcare of other nations, or they actually don't know what they're talking about. Either way they need to shut up.

I agree, the slagging off is absolutely shocking.

The prostate cancer numbers for the UK are very high, but as it seems it is more common in Northern Europe and Scandinavia than in many other countries, and it is the most common cause of cancer in men, it's not very surprising. As a matter of fact, they are discussing introducing screening for prostate cancer just like they have for women and breast cancer, but they are as of yet weighing the pros and cons. And it would be available to everyone, free of cost. Even the most deprived.

One issue with cancer is detection and people's willingness to go to the doctor and actually get tested. There is this misconception that because the NHS is free, people will go there all the time. In many cases people still won't go see a doctor and then end up in such a critical state that nothing can be done. Case in point is my SiL's boyfriend's mother who died a couple of weeks ago from lung cancer. It would have been treatable, but she refused to go see a doctor, even when she was obviosuly not feeling well at all. The cost or lack thereof was never even an issue there, she just wouldn't go.

The Stephen Hawking stuff is...mindboggling.

Also, one thing these people forget: there is nothing to stop you from paying yourself for the six months of extra treatment if you think it is worth it to live a bit longer. It just won't be funded by the NHS. So basically, it is the same as they have now, only for "normal" people, it will be better, since they will be covered for the majaority of things that can happen.

[Hereward]

Also, NICE decisions are subject to legal challenge. On the subject of the cold-heartedness of the British, well absolutely. But does anyone really think discussions on the cost of treatment don't take place in commercially driven insurance providers in the States. At least NICE tries to come up with rules that balance patient need, cost and benefit.

[The Real Will]

Also, NICE decisions are subject to legal challenge. On the subject of the cold-heartedness of the British, well absolutely. But does anyone really think discussions on the cost of treatment don't take place in commercially driven insurance providers in the States. At least NICE tries to come up with rules that balance patient need, cost and benefit.

But this NICE crowd isn't declaring that blind people have a lower quality of life and therefore should have less access to healthcare... right?

[Hereward]

Right.

I've just realised that I said it issues rules. Of course, it's an independent body and it issues guidance. People challenge the guidance in the courts.