Health care for rich people.
Health care for poor people.
This Monday, the New York Times decides to run two stories on health care. First, and not too surprisingly, we find out thatit’s hazardous to your health to be poor:
A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival.
The study by researchers with the American Cancer Society also found that blacks had a higher risk of late diagnosis, even after accounting for their disproportionately high rates of being uninsured and underinsured. The study’s authors speculated that the disparity might be caused by a lack of health literacy and an inadequate supply of providers in minority communities. The study is to be published online Monday in The Lancet Oncology.
Previous studies have shown a correlation between insurance status and the stage of diagnosis for particular cancers. The new research is the first to examine a dozen major cancer types and to do so nationally with the most current data. It mined the National Cancer Data Base, which began collecting information about insurance in the late 1990s, to analyze 3.7 million patients who received diagnoses from 1998 to 2004.
The widest disparities were noted in cancers that could be detected early through standard screening or assessment of symptoms, like breast cancer, lung cancer, colon cancer and melanoma. For each, uninsured patients were two to three times more likely to be diagnosed in Stage III or Stage IV rather than Stage I. Smaller disparities were found for non-Hodgkins lymphoma and cancers of the bladder, kidney, prostate, thyroid, uterus, ovary and pancreas.
The study’s authors concluded that “individuals without private insurance are not receiving optimum care in terms of cancer screening or timely diagnosis and follow-up with health care providers.”Advanced-stage diagnosis, they wrote, “leads to increased morbidity, decreased quality of life and survival and, often, increased costs.”
The study cites previous research that shows patients receiving a diagnosis of colon cancer in Stage I have a five-year survival rate of 93 percent, compared with 44 percent at Stage III and 8 percent at Stage IV.
“There’s evidence thatnot having insurance increases suffering,” said Dr. Otis W. Brawley, the American Cancer Society’s chief medical officer.
Yeah. There’s a little more. Now, this might not be the biggest revelation ever, but it seems that people who don’t pay a lot for their health care get lesser-quality care. I can hear the wingers already screaming that this is obviously a failure of public insurance, as private insurance leads to better care. Well ha ha, fuck you very much, assholes. If you cover everyone publicly, there’s no two-tiered system of payments, and no incentive for doctors and hospitals to cater to the privately insured. Check out, oh, the rest of the industrialized world for examples. Take that tired-ass “argument” somewhere else. What stories like this one say is that we are depriving some citizens of those inalienable rights we’re supposed to learn about in grade school–that is, you can’t have liberty and the pursuit of happiness if you’re not alive. Oh, and if you’re a hard-nosed, all-dollars-and-cents type, our “system” is more expensive, too.
I am still amazed that anyone can defend the health care “system” of the US. Alright, let me back up. I am still amazed that anyonewho isn’t a paid shill for the insurance companies can defend the health care “system” of the US. There. That’s better.
The other story today revolves aroundsports injuries in children. It turns out that anterior cruciate ligament tears are becoming more common in children involved in sports. Why? Good question, and there’s no one reason. Partly, doctors are more aware of the injury. Partly, increased use of magnetic resonance imaging (among those who can pay for it, that is) makes the diagnosis easier. And, finally, (some) children are increasingly involved in sporting events year-round, with more intensive training, thus increasing the probability of injury.
Now, I tend to shy away from blaming individuals for larger social trends. But, in this case, I think the parents of these (mostly privileged) children need to step back and evaluate what they’re doing to their offspring. The parents of the boy profiled in this article (why the author chose a boy, when the injuries are more common in girls, I don’t know) live in anextremely wealthy suburb of Houston, TX, known as, and I am not making this up, The Woodlands. The name is written with the definite article, always. The child’s parents took the boy to a doctor in Houston, and didn’t get the answer they wanted. So they took him to one in Dallas. Finally, they took him to Boston, Massachusetts to get surgery. Here’s his mother, in the final sentences of the article:
Having the operation “was a difficult decision to make,” Mrs. Link said. “But if they can play sports, it’s the only option.”
What the hell? The only option? Why don’t you tell your child that, you’re sorry, but he won’t be able to play sports anymore. There are lots of other ways to live a fulfilling life–and, for the hyper-competitive types, there are other arenas in which to compete. Here you have people who are hardly powerless in the world who refuse to exercise their considerable influence to keep their (and other people’s) children healthy. Start an organization, raise awareness, get people to understand that they don’t need to have their children in thirty hours of extracurricular activities per week. That shit isoptional. Walking, on the other hand, tends to be more necessary.
I can understand parents wanting to get the best possible care for their children. But the juxtaposition of these stories does a good job of illustrating those “Two Americas” that John Edwards talks about. On the one hand, you have people dying because they can’t afford to get routine checkups and catch cancers in their early stages. On the other, you have people crisscrossing the continent to get extremely expensive operations so that their children can continue to engage in after-school sports. It just doesn’t seem right to me.