Obamacare and public health

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   Anne Pettitposted 8 years ago

   If Texas had Obamacare, the Ebola victim would have had a greater likelyhood of bring admitted promptly.

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      Quilligrapherposted 8 years agoin reply to this

      Good evening, Ms.  Pettit. I am so sorry but Texas does have Obamacare! Healthcare plans in Texas and in every other state, plus the District of Columbia, all comply with the Affordable Care Act (Obamacare).
      
      Perhaps you meant to say circumstances might have been different “if Texas had chosen to extend its Medicaid coverage as provided under the ACA (Obamacare).” However, not knowing the victim’s personal eligibility for Medicaid, we have no way of knowing for sure. More details are necessary before there can be any speculation about any other possible likelihood.
      

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         wildernessposted 8 years agoin reply to this

         Not sure what either Obamacare OR medicaid had to do with anything - both are a matter of costs, not treatment, and treatment seems to have been rendered in a hospital.
         
         Not the RIGHT treatment of course, but then hindsight is always 20/20 and the hospital does say that communication was lacking.

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            Quilligrapherposted 8 years agoin reply to this

            I agree with you but will wait to read Ms. Pettit's reply rather than guess further about what exactly she had in mind.
            

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         2. 64

            Anne Pettitposted 8 years agoin reply to this

            The cost of health care incurred by the hospital, and the cost that Mr. Duncan would not have been able to pay has a great deal to do with this situation because it caused Mr. Duncan to be denied urgently needed treatment.

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            1. 59

               John Holdenposted 8 years agoin reply to this

               Anne, I think that you should give us full information on this matter rather than just dropping hints.
               You started off with what seemed like a general comment but then went on to allude to a specific case.

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                  Anne Pettitposted 8 years agoin reply to this

                  The treatment or lack of treatment of the Ebola Victim is big news here in the U.S.  Since this is a forum, I do not think it is necessary to write an entire article.  I threw out a comment because I am interested in a dialogue, or a thread, as it may be.

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                     John Holdenposted 8 years agoin reply to this

                     Well it does seem that both Quilligrapher and Wilderness, both as far as I know citizens of the USA, seemed to be unaware of the specific circumstances that you allude to in your later posts maybe it is necessary to maybe not write a full article, but at least give enough information to avoid guessing.

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                     1. 64

                        Anne Pettitposted 8 years agoin reply to this

                        John Holden,
                        
                        I think Mr.Wilderness and Mr.Quillographer are very aware that on the 26th of September, a man visiting from Liberia (Mr. Duncan) went to a hospital with symptoms that included fever and vomiting.
                        
                        The hospital admitting staff asked for his social security number which would have given them health insurance and possibly payment ability information.  Mr. Duncan told the staff person that he had just arrived from Liberia ( he could not have had a social security number).  He was sent away with an antibiotic prescription.
                        
                        2 days later, on the 28th of September, Mr Duncan was brought to the hospital by ambulance.  Within a few hours, the Ebola diagnoses was official. 
                        
                        I am very angry about this incident because our health system relies on profit to operate.  Obamacare has helped, but many states (such as Texas where Mr. Duncan is) have rejected efforts to expand Medicaid which guarantees payments to hospitals who treat people who are unable to pay for treatment.
                        
                        
                        Also, the occupants of the apartment where Mr. Duncan fell ill are in quarantine and cannot leave.  There are 5 people imprisoned in this apartment where I understand the dirty sheets are still in a plastic bag waiting for officials to take away. In addition to the fear these people must have of getting the Ebola Virus, no assistance has been provided to help sanitize or give food and supplies to these poor people who are not allowed to leave this apartment.
                        
                        I am disgusted with the culture of our country that allows situations like this to occur and continue. 
                        
                        If the hospital had not been concerned about payment, Mr Duncan's welfare and public safety would have been a priority much sooner.

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                        1. 91

                           GA Andersonposted 8 years agoin reply to this

                           Greetings Anne Pettit, I hope you won't mind if I jump in with a comment.
                           
                           Beginning with your OP, it appears your contention is that money makes the difference between levels of emergency room medical care. As in, if you are poor and need stitches - you will get a bandaid, or if you have money and need stitches you will get them - plus corrective cosmetic surgery.
                           
                           While there may be some degree of validity to that point when discussing elective or non-life threatening medical treatment - I do not believe that it has any bearing, (generally speaking), on emergency room treatment.
                           
                           The tone of your response indicates you have a perspective that won't be swayed by any opinion or information that does not agree with your own.
                           
                           As already mentioned, the details to this point indicate misdiagnosis during the initial ER visit. Your contention that it was a "brush-off" because the fellow did not have medical coverage is too cynical for me.
                           
                           And speaking of misdiagnosis, I know assumptions are dangerous things, but, if you are so aware of the details of this event, then surely you should also be aware that in recent preceding weeks the US has seen a semi-alarming number of flu-like respiratory illnesses, (particularly among children), that are readily treated with conventional antibiotic treatments, (like the ones Mr. Duncan received). Providing links to this point would probably be fruitless, but perhaps a mention that those symptoms are similar to ebola symptoms might be worth noting relative to the current criticism of the ER's initial misdiagnosis. Would a question  about whether or not this particular ER had seen previous cases like this had any affect on their diagnosis have any bearing in your mind?
                           
                           Or is it still all about the ability to pay?
                           
                           Reading your responses tell me the only true facts are the ones you believe, and the only reason this man was not quarantined immediately was because he did not have health insurance...
                           
                           But, here is just one detail that is at odds with yours;
                           
                           
                           
                           
                           
                           The reporting on his "vomiting" indicated it happened in the parking lot outside his residence after his initial ER visit.
                           
                           Then there is your insistence that the fact he was asked about his Social Security number and health insurance coverage were determining factors in the level of treatment he received. That seems to indicate a lack of knowledge about the sequence of events in an ER visit - from entry to exit.
                           
                           It goes something like this;
                           
                           1) If patient condition allows, (can they talk, is immediate concern life-threatening), An intake person records personal data; reason for visit, symptoms, medical history, and yes, SS# and health coverage info.
                           
                           2) Vitals are taken and an initial determination is made regarding who sees patient next; a PA, (physicians assistant), for typical and minor problems, or doctor or specialist, (ie. cardiologist), for more severe conditions.
                           
                           3) Patients vitals and symptoms and statement information are forwarded to PA or Doctor.
                           
                           *Note that SS# and health coverage info is not included in evaluation charts forwarded to PA or doctor. Also note that unless pertinent to symptoms, (in this case it appears it would have been), recent travel info is also not included. Sharp doctors might inquire, but it is not data automatically forwarded to them.
                           
                           Of course, there may be the possibility that the initial ER intake person has some secret mark they enter somewhere that conveys this information to the examining doctor or physicians assistant, (PA), but typically what they see is an overview of symptoms and patient stats and comments.
                           
                           Geesh, and with such an obvious agenda you introduced this mislabeled forum topic expecting an "intelligent" discussion? You would have been much more correct to title this thread "Having to pay for medical care is discriminatory!" or something along those lines, and probably found many more like-minded souls that would agree with you.
                           
                           Just sayin'
                           
                           ps. Thanks for opening a thread that provided an opportunity for me to participate, and welcome to HP's Topical forums
                           
                           GA

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      2. 64

         Anne Pettitposted 8 years agoin reply to this

         Texas may be in compliance with the ACA, but the state can only boast about having the highest rate of uninsured residents in the U.S. Clearly, the “healthcare for everyone” spirit of Obamacare is not in Texas.
         Mr. Duncan, the Ebola Victim is a visitor to the U.S., and not a legal resident anyway, so he could not have Medicaid.  The staff member of the hospital who initially evaluated him on the 26th of September asked about his social security number which demonstrates concern about his ability to pay as opposed to his current state of health at that time.

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            wildernessposted 8 years agoin reply to this

            Bet they asked for his insurance, too, before they treated him.  They always do.
            
            And he WAS treated although that treatment was the wrong thing, mostly due (apparently) to a lack of communication in the hospital staff.

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               Anne Pettitposted 8 years agoin reply to this

               Yes, obviously there was a lack of communication.  Hospitals are trusted to know what to do with sick people.  Lack of communication is not an excuse that should be accepted, any more than the standard procedure of hospitals wanting to know ability of payment before health condition is assessed should be acceptable.
               I also suspect that the admitting staff was not aware that “Liberia” is in Africa which goes to our education system, which is another fiery topic.

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                  wildernessposted 8 years agoin reply to this

                  True, but that also has nothing to do with Obamacare.  The patient got the same care he would have if insured (and we don't know he wasn't, either).

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            Quilligrapherposted 8 years agoin reply to this

            Good evening again, Ms. Pettit.
            
            Unfortunately, nothing you posted suggests the OP statement is true. The victim’s care does NOT appear to have been limited in any way by Obamacare or Texas’ Medicaid participation. Judging by everything we know, Obamacare should not be part of this discussion. This makes me wonder why Obamacare was even mentioned in the OP statement.
            
            Secondly, you are convinced that the hospital’s actions were motivated only by concerns about payment. However, you provide no evidence to support this conclusion and none of us have any reasons to believe this claim is true.
            
            Finally, you know nothing, it seems, about Mr. Duncan’s healthcare insurance coverage nor have you revealed any knowledge about his ability to self-pay for his treatment. You have made many assumptions that you are unable to substantiate including the false claim that asking for a Social Security number during triage “demonstrates concern about his ability to pay.”
            
            
            Thank you very much for starting this topic, Ms. Pettit. I am looking forward to your sharing more of your thoughts with us here in the future. 
            

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            1. 64

               Anne Pettitposted 8 years agoin reply to this

               "America's special vulnerability to Ebola is its limitations on access to health care. In times of contagion, societal risk rises with every uninsured or underinsured individual who struggles to work or go to school with a fever, and avoids bankrupting visits to health providers. One doesn't need to have a political position up or down on "Obamacare" to recognize and solve this."
               http://www.foreignpolicy.com/articles/2 … from_ebola

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               1. 57

                  retief2000posted 8 years agoin reply to this

                  I can think of no better country to be in when an Ebola treatment is perfected than here, as it is most likely that treatment will emerge from an American laboratory.

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                  retief2000posted 8 years agoin reply to this

                  http://www.myplainview.com/article_3c94 … 872be.html
                  
                  America specializes in treatments for frightening and intractable ailments. Obamacare, Medicare and Medicaid are a burden upon a first rate medical system. Before Obamacare, 47 cents out of every medical dollar spent was provided by taxpayers resulting in the very system Obama criticizes. His solution is to further burden that system. If one wishes to see where Obamacare will take us, look to the VA scandal. Imagine a massive bureaucracy dealing with Ebola.
                  
                  http://virus.stanford.edu/uda/

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               retief2000posted 8 years agoin reply to this

               Quill, good to see you are well.
               
               A rhetorical question for everyone, how do hospitals pay their staff? Isn't the necessity of providing medical care to as many as possible made possible by the ability of as many of those, to whom medical care is provided, paying for that care through a third party - as is typical or "out of pocket?" Money makes the world go 'round, the world go 'round and keeps the nurses and doctors treating patients. I am confused as to how all of this wonderful medicine happens without money.
               
               
               Yours,
               JR

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      retief2000posted 8 years agoin reply to this

      His insurance information would have been gathered at the beginning of the process, no matter what its source. He would have received treatment, even if he was unable to pay, because refusing medical treatment in an emergency is illegal. He was evaluated by medical staff at the time, though incomplete information was given to them about his travels. He had a low grade fever and some abdominal discomfort. He did not say he had been in contact with someone who had Ebola.
      
      Obamacare would have done nothing to change any of this. He would not have had his Obama-surance, as he would not have registered on the Obama-website. If a fully actualized Federally operated medical system was in place, it is far more likely he would have been on a Veteran's Administration waiting list and left there to die along with other victims of government provided healthcare.
      
      Obamacare is not healthcare it is a health insurance system. It does not make the administration of health care more efficient. It does not guarantee the truthfulness of patients.
      
      The failure is in the Executive Branch and its Department of Homeland Security permitting passengers from Ebola infested countries easy passage to America without thorough back ground and health screenings.
      
      Just to help make it really clear, no neon red letters appear on the infected persons forehead spelling out E B O L A. The initial symptoms of Ebola, a heretofore unknown ailment on American shores, are similar to many,many, many other ailments, including bad shrimp.

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2. 59

   John Holdenposted 8 years ago

   GA, even one as cynical as I would be hard pressed to believe that any hospital however money orientated would knowingly turn away somebody with a life threatening and contagious disease.

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      retief2000posted 8 years agoin reply to this

      http://www.cnn.com/2014/10/01/health/eb … index.html
      
      Occum's Razor - When one hears hoof beats one things horses not Zebras. When presented with a low grade fever and a little abdominal discomfort one things the extremely common gastroenteritis not Ebola, despite the news. Ebola has been, until now, isolated to Africa.

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