"Funny" how uncritically recycling right wing snark concealed an important data point in the health care debate!

"Funny" also how uncritically recycling right wing snark made for a missed opportunity to catch Obama throwing another constituency -- the poor -- under the bus!

Well done! Right wing snark is designed to disempower and destroy the left. That's why we shouldn't ever use it.

it is true, you cannot incorporate the talking points of the health neglect system without sounding incoherent.

if you're not there as a result of, say, falling down foaming at the mouth for no apparent reason in a crowd or at your office (cf "Brothers and Sisters" and the 'heartthrob' Rob Lowe storyline recently) or of being slaughtered in a tangle of vehicular collision.

First, you or your child is what a doctor would call "uncomfortable." (Again I say, let me park my truck on your tongue, doc, and we'll talk about discomfort in a couple hours, okay?).

Second, you lack insurance, or the copay cash, or both, that would cover seeing your PCP or your child's pediatrician in a timely manner. (This is in defense of those folks who actually do have transportation of their own in their control and at their convenience 24/7/365, which is less likely among the impoverished, btw, as well as having an in-network PCP or pediatrician available if some insurance does apply, which is increasingly out of reach for what the media genteelly refer to as "lower middle income" families.)

Third, you hope it will go away if you don't go to a doctor immediately. (Human nature, I suspect, if not outright fear -- perhaps based on previous experience with physical therapy, injections, or other medicaments -- keeps people from going to the doctor at the drop of a hat even if they can afford it.)

Fourth, you try something OTC or passed down (old wives' tale or OWT) through your culture, which doesn't solve the problem.

Fifth, something goes spectacularly awry -- a major fever, a massive emesis, an accident that results in a sprain or break or other injury you simply cannot 'live with' until you can find affordable treatment -- and there you are:

Stuck in the ER waiting.

The ER is not allowed to turn away patients. The ER does do triage. Triage means that the sickest or most seriously injured patients are seen before patients appearing to triage personnel to be less seriously ill or injured. However, because the ER operates all the time, and because its personnel and equipment are very specialized, its costs are often more expensive than would be treatment for the same condition in a family clinic or a pediatrician's office IF a patient had that option.

Now, let me point out one thing, again. By law (federal law, actually) the ER is not allowed to turn away patients. This means that even if you have NO funding you can get an evaluation and treatment in the ER regardless.

The population of the US is about 250 million persons, IIRC. As of 2004, there were 47 million uninsured residents in the US. I would bet that as of today that number has increased to 50 million, or 1/5th of the population.

If one fifth of the nation's population has no recourse except the ER in dire circumstances, is it any wonder the ER is crowded all the time?

Wouldn't it make more sense to provide an option for patients who need care that could be done efficaciously by non-trauma-specialists? You'd think so.

Budget constraints affect every institution in this country. In the state of Texas we often have one school nurse in a small district who must divide work hours among multiple campus offices. This is not safe or sane, but it's how "no new taxes" forces districts to cope with the budget. Over the past 15 years public health clinics (not to mention private practice clinics, particularly in rural areas) have closed across Texas and New Mexico (I suspect this is also true in other states; cf Big Charity hospital in NOLa).

So the problem comes back to money. If there's no money to keep the doors open, the clinic closes. If the clinic closes that's one less option for folks who need treatment. If the only option left is the ER, how is that a patient's fault?

This uniquely American health care system traps the patients.

they're poor. What more of a reason do you need to demonize people?

Seriously, having gone to an ER, I cannot imagine anyone thinking any one would choose to get healthcare that way. That's why people with insurance start with their own doctor - not because it's cheaper, but because it's generally less of a pain in the ass. For starters, I've never sat all night at my doctor's office waiting to be seen. And most Americans know that the people flooding the ERs are not doing so because they want to. I think this could really backfire as more Americans lose their jobs and health insurance or are worried about losing them. Because they know the people they're talking about could be them, poor or not.

I only went to the emergency room once. that night there was a young man there who clearly was in the very late stages of tuberculousis. It was truly grim. I am really sick of a society that puts people in untenable situations and then proceeds to bleat about cost control. They don't have this problem in Canada. How many of those people in the ER voted for Obama? Maybe he should do something for them.

mindset.

Public health clinics cost money. Privatizing them puts them at the mercy of profit.
Either way, the "no new taxes" and "no entitlements" rhetoric and the accompanying demand for reducing government spending brought us where we are today.

I am very disappointed to find this kind of talk coming from the President now.
I wish I were surprised.

We have not had a President who genuinely and unselfishly advocated for poor people in the United States since LBJ. Whatever you care to say about his escalation of the war in Viet Nam, it was President Lyndon Baines Johnson who brought us Medicare and Medicaid, advocated for Social Security, and tried hard to create a Great Society for the betterment of all Americans -- particularly those historically impoverished.

I reckon we ought to revisit LBJ in some depth.

It was why I was so put off by Obama's campaign, squandering a perfect storm of public outrage at the failures of "conservatism" and legendary oratorical gifts on this half-assed triangulation and praise for the "transformative" Reagan.

wasn't it just conventional wisdom less than six months ago that everyone had the right to be treated at the emergency room - so there was no such thing as people without access to healthcare and therefore it was perfectly fine to fill up those EDs?

Ahh, now I see the difference between Republicans and Democrats...

in one of the our nearby private hospitals (I live in the Baltimore area and you can't swing a dead cat without hitting a medical facility - which is good, in that there is excellent care to be had - Hopkins, as well as Univ. of MD, the place where the "golden hour" of trauma medicine was born) which I think was three or four years ago, with my mother, I noticed that on the main wall near the triage desk was a big sign that more or less said, "We can't turn you away because you can't pay, but once we assess you, and stabilize any urgent/acute condition, we don't have to keep you and can ship your ass to the nearest public hospital, which will get stuck with the bill."

And then there's this, in a FactCheck.org analysis of an ad from Conservatives for Patients' Rights (hint: I think the title is akin to the Clear Skies Initiative or the Healthy Forests Act) which just made me want to throw something (emphasis is mine):

Conservatives for Patients’ Rights is, as its name indicates, a conservative group, and it’s also quite obviously not a proponent of government-run health care. Its minute-long ad was launched April 27 with what the group said was a month-long $1 million buy. (We've seen it on CNN several times this week.) CPR was launched this year and is led by Rick Scott, former head of Columbia/Hospital Corporation of America.

The ad states that government-run health care systems, in particular those in Britain and Canada, take control away from patients and ration health care. CPR is certainly entitled to state its own view. But the ad implies that the U.S. Congress wants to implement a health system like those in Britain and Canada. That's contrary to what President Obama and Democratic leaders in Congress have said.

Obama hasn’t called for such a government-run plan, also called a “single-payer" plan. In fact, he has flatly rejected it. The administration has said on the White House’s “Health Care” Web page (and previously on its transition site) that “President Obama and Vice President Biden believe” that government-run health care is “wrong.” And they also believe, the administration says, that the other extreme, “letting the insurance companies operate without rules,” is wrong. (The White House redesigned its health care page on April 30; a cached page with the quoted language is attached to this article.)

Obama has long said he would allow individuals or small businesses to buy insurance through a public plan – like the one now available to members of Congress. But nobody would be forced to drop his or her current insurance, and private plans would exist as they do now. This was the health care plan he promoted as a presidential candidate.

Obama has perfected the bamboozle: he tells people just enough to make them think he is on their side, and he does that primarily because he has no core beliefs to which he has any commitment.

He's going to completely fuck this up and, to use an Obama-ism, "a whole buncha" Democrats are going to help him.

Why is it that money spent on health care is considered by everyone to be wasted? I don't understand. I know that we spend twice as much as anyone else already, but even if we spend more, why is that a problem, if we get good health and peace of mind in return? Doesn't the money contribute to the overall economy as much as, for example, if it were spent on Pet Rocks or Jimmy Choo shoes? Please enlighten me, someone.

and yes, IMNVHO, 99.99 1/2 % of that money is wasted. What exactly does a health insurance company do, make, produce, or provide that actually assists, empowers, or improves conditions for either their direct customers (premium payers) or their so-called beneficiaries (docs, clinics, hospitals)?

(For that matter I could make the same argument about life insurance and several other flavors of the suit-and-tie confidence games, but I digress).