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ashling

(25,771 posts)
Tue Apr 2, 2013, 07:45 PM Apr 2013

Health Care: The New American Sadism - NYRB

http://www.nybooks.com/blogs/nyrblog/2013/apr/02/new-american-sadism/

****

Put simply, Brill says, these bills tell us there’s no free market in our healthcare system, that hospitals set their rates knowing that someone in pain or in fear for his or her life is not going to ask to see the price list first before agreeing to some test or treatment. It’s no wonder that 60 percent of our fellow Americans who file for personal bankruptcy each year do so because of medical costs.

****

Today, when the acquisition of wealth, quickly and in large amounts, is admired above any other human endeavor, every medical emergency or catastrophic illness is seen as an opportunity for some to enrich themselves beyond their wildest dreams. It’s no wonder that our healthcare is so much more expensive than that of every other developed country in the world, where the costs are not only much lower, but people also live longer than we do. Unlike us, other countries have the peculiar notion that profit has no place in any situation in which the basic decencies that human beings owe to one another ought to be the first consideration, and for that reason regulate the cost of lifesaving drugs and operations. In other words, they are less greedy than we are and far more humane.

****

In the past, even the most venal among our politicians would now and then show that they have hearts. No more. Now that money rules politics more than ever before and those for whom private gain outweighs public good every time fill the coffers of both political parties, any mention of the plight of the sick, the homeless, and the old borders on political suicide. Polls show that most Americans do not quite share the callousness of our political class to the suffering of the less fortunate members of our society. But some do. We all remember, I hope, the cheers that went up in the audience during the GOP’s presidential debate last spring in Tampa when Ron Paul, the libertarian candidate and former doctor, stated that he would let an uninsured man lying in a coma die without lifting a finger. “That’s what freedom is all about, taking your own risk,” he said. “This whole idea that you have to compare and take care of everybody…” at which point, a few members of the audience shouted “Yeah,” cutting off the congressman in mid-sentence.

This is the new face of American sadism: the unconcealed burst of joy at the thought that pain is going to be inflicted on someone weak and helpless. Its viciousness, I believe, is symptomatic of the way our society is changing. Everything from the healthcare industry, payday loans, and for-profit prisons to the trading in so-called derivatives, privatization of public education, outsourcing of jobs, war profiteering, and hundreds of other ongoing rackets all have that same predatory quality. It’s as if this were not their own country, but some place they’ve invaded in order to loot its wealth and fleece its population without caring what happens to that population tomorrow. The only interest these profit-seekers have in us is as cheap labor, cannon fodder for wars, and suckers to be parted with our money. If we ever have a police state here, I’ve been thinking, it won’t be because we’ve become fascists overnight, but because rounding up people and locking them up will be seen as just another way to get rich. If the hell that Jonathan Edwards and other Puritan divines described in such gruesome and graphic detail is still up and running, I hope that’s where many of them are headed for.
51 replies = new reply since forum marked as read
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Health Care: The New American Sadism - NYRB (Original Post) ashling Apr 2013 OP
correction: it's not "new" noiretextatique Apr 2013 #1
good point, but remember: ashling Apr 2013 #7
With respect to this quote: mahina Apr 2013 #2
true, but that's not so much a "correction" as ashling Apr 2013 #9
You are right. I revised my post. mahina Apr 2013 #49
Rush and his fellow hate mongers have been very effective n2doc Apr 2013 #3
Under the heading of so-called "personal responsibility" n/t DissidentVoice Apr 2013 #42
American Journal of Medicine: About half of bankruptcies... johnnyreb Apr 2013 #4
My friend decided to let herself die, naturally, instead of pauperizing her family; only in America. DhhD Apr 2013 #5
The business of America is business johnnyreb Apr 2013 #14
The last time I saw a doctor, she offered to recommend a place where I could get a lower-cost winter is coming Apr 2013 #15
My mother more or less did the same thing tularetom Apr 2013 #27
I've thought about that NJCher Apr 2013 #28
Capitalism is OK in some things... DissidentVoice Apr 2013 #43
Regarding checking prices prior to tests or treatments, Curmudgeoness Apr 2013 #6
I had the same experience. zeemike Apr 2013 #12
What a way to run our health care system! Curmudgeoness Apr 2013 #13
Same thing happened to my dad OwnedByCats Apr 2013 #34
My dad... DissidentVoice Apr 2013 #44
I can answer why "it can't work here" Curmudgeoness Apr 2013 #45
Not necessarily so DissidentVoice Apr 2013 #46
Too bad Curmudgeoness Apr 2013 #48
They've been working on rationalizing cruelty & perversity for decades. DirkGently Apr 2013 #8
I've always admired the way in which John Kenneth Galbraith ashling Apr 2013 #10
Sadism. This answers a question I've had for a long time: enough Apr 2013 #11
My redneck brother in NJ is very proud riverbendviewgal Apr 2013 #17
There are too many like him DissidentVoice Apr 2013 #24
It is a good country riverbendviewgal Apr 2013 #25
Stephen Harper DissidentVoice Apr 2013 #30
I do like the canadian polictical system better riverbendviewgal Apr 2013 #37
Correct on minority government DissidentVoice Apr 2013 #41
OK. Currently, the best band on the entire planet is 'Arcade Fire' from Montreal. Webster Green Apr 2013 #51
They're also just fine with tens of thousands of their fellow citizens being slaughtered Arugula Latte Apr 2013 #29
Reminds me of the time from the campaign trail nobodyspecial Apr 2013 #16
powerful SHRED Apr 2013 #18
I've always thought that the rich don't want everyone insured watoos Apr 2013 #19
So true. This just makes me sad. Marie Marie Apr 2013 #20
Let me tell you about my experience with my cat's deadly illness riverbendviewgal Apr 2013 #21
The hospital I am paying is interested in helping me live another 100 years. Manifestor_of_Light Apr 2013 #22
Ron Paul's Hypocritical Oath DissidentVoice Apr 2013 #23
I don't think Ron Paul will be OwnedByCats Apr 2013 #36
Nor do I have a lot of faith DissidentVoice Apr 2013 #39
The hippocratic oath and $1.00 will get you sorefeet Apr 2013 #26
My point exactly DissidentVoice Apr 2013 #31
I disagree that the medical professionals are the culprits. Quantess Apr 2013 #35
The medical professionals are part of it DissidentVoice Apr 2013 #40
Message auto-removed khushivis Apr 2013 #32
This should be obvious to us all, by now: Quantess Apr 2013 #33
This: CrispyQ Apr 2013 #38
What it's going to take is REVOLT DissidentVoice Apr 2013 #47
Kick for this important issue. n/t area51 Apr 2013 #50

mahina

(17,652 posts)
2. With respect to this quote:
Tue Apr 2, 2013, 08:02 PM
Apr 2013

Last edited Thu Apr 4, 2013, 11:34 PM - Edit history (1)


"...that hospitals set their rates knowing that someone in pain or in fear for his or her life is not going to ask to see the price list first before agreeing to some test or treatment. "

Actually, even when we are in that dire situation and do step out of the comfort of their process and ask for price information, we are looked at like an insane person, and sometimes are spoken to very rudely.

Getting well should be the only concern.

Universal single payer now!

n2doc

(47,953 posts)
3. Rush and his fellow hate mongers have been very effective
Tue Apr 2, 2013, 08:10 PM
Apr 2013

They have sold hatred of our fellow Americans (and others) as the 'right' thing.

johnnyreb

(915 posts)
4. American Journal of Medicine: About half of bankruptcies...
Tue Apr 2, 2013, 08:15 PM
Apr 2013
The American Journal of Medicine
June 2009

Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; .... Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance.
http://www.amjmed.com/article/S0002-9343(09)00404-5/abstract

DhhD

(4,695 posts)
5. My friend decided to let herself die, naturally, instead of pauperizing her family; only in America.
Tue Apr 2, 2013, 08:39 PM
Apr 2013

johnnyreb

(915 posts)
14. The business of America is business
Tue Apr 2, 2013, 09:24 PM
Apr 2013

Huge condolences, my American neighbor. Most of us know such episodes-- it's just barbarism, er, business.

song:



winter is coming

(11,785 posts)
15. The last time I saw a doctor, she offered to recommend a place where I could get a lower-cost
Tue Apr 2, 2013, 09:30 PM
Apr 2013

mammogram. I told her that I couldn't afford treatment if the mammogram showed anything, so there was no point. I got the impression that she'd heard other patients say the same thing.

tularetom

(23,664 posts)
27. My mother more or less did the same thing
Tue Apr 2, 2013, 11:09 PM
Apr 2013

Age 86, diagnosed with lung cancer, she instructed the doctors to administer only palliative medications. She was in severe pain with rheumatoid arthritis for the last 5 years of her life and had no desire to go on.

I'm told many doctors and others in the medical profession make a similar decision when confronted with a serious illness.

NJCher

(35,667 posts)
28. I've thought about that
Tue Apr 2, 2013, 11:10 PM
Apr 2013

And whether I would do the same thing if the situation were similar. I will certainly say that your friend had courage. Facing death would be something very hard to do.

But in thinking further about it, it would be very hard to watch one's financially devastated family try to survive after they exhausted their means. I don't think I could do that.

It makes me sick that your friend had to make this decision.

I hate capitalism. There has to be another way.


Cher

DissidentVoice

(813 posts)
43. Capitalism is OK in some things...
Wed Apr 3, 2013, 04:44 PM
Apr 2013

...like selling a used car, TV set, etc.

But for things like medical care, where a person's life or death is at stake, or for ensuring all people have adequate food, water and clean air to breathe, it sucks mightily.

There is another way...but the far-right cabal in this country won't permit it.

Curmudgeoness

(18,219 posts)
6. Regarding checking prices prior to tests or treatments,
Tue Apr 2, 2013, 08:54 PM
Apr 2013

I tried that.....and was told that there was "no way to know how much it would cost" until they did it.

I was sent to physical rehab for a rotator cuff problem. I have a $5000 deductible, so I would be paying for this treatment out of my own pocket up to that amount, then 20% after that, so cost was a concern and a limiting factor. After the initial evaluation, I was told that I should have 10 weeks of treatment, 2 days a week. Twenty treatments in all. So I asked how much each treatment would cost. No one knew, and they said that it "all depended" on what they did, and they could not know what they would have to do before they did it. I asked for a ballpark figure for treatment. After about 15 minutes, they finally found the person who does the billing for them, and the costs usually run from $250 to $350 per visit. That is more money than I bring home a week, so I would have to work for nothing for ten weeks, plus possibly hit savings just to cover the cost.

I did not go back. I came home and made up my own physical therapy routine. But that is not the way I should have to live. I could have caused myself more injury, since I didn't know what the hell I was doing....but luckily I did get function back.

zeemike

(18,998 posts)
12. I had the same experience.
Tue Apr 2, 2013, 09:12 PM
Apr 2013

I asked how much it was going to cost me....they did not know...it seems they send it to some company that charges Medicare and they determine how much I will pay extra...after the treatment of corse...

It is just a blank check...they get to fill in the amount and you sign the check.

Curmudgeoness

(18,219 posts)
13. What a way to run our health care system!
Tue Apr 2, 2013, 09:19 PM
Apr 2013

And we are told that it is our fault for not "caring" enough to check prices.

I find the same problem with pharmacies, I cannot find out how much a prescription will cost until they fill it----or so I am told. And that is even for my freaking cat, who has no health insurance to deal with.

God damn it.

OwnedByCats

(805 posts)
34. Same thing happened to my dad
Wed Apr 3, 2013, 03:58 AM
Apr 2013

He went to see a specialist to look at a nasty infection on his leg. They wanted to test a sample if his skin for cancer. He asked the "how much is that going to cost?" question, they did not know. A few weeks later he got the bill because his insurance wouldn't pay it. The test and visit was $2,000. He called the insurance company and they had the nerve to tell him he should have asked. WTF? Number one, he did ask, and number two, what if he did have cancer? If they thought it was important enough to check, he was supposed to go without if it was too expensive? Luckily his test was negative but oh my God - $2,000??

I'm truly disgusted with how things are here. When people tell me universal health care won't work here - that's bullshit. For one thing, if all the other developed countries can do it, why the hell can't we? Also when you consider all the money that the government has wasted in the last, oh I don't know, several decades, that money would have paid for health care no problem. Other countries can keep the costs lower and pay for all to have healthcare, there is absolutely no reason we can't. I lived in a country with single payer, my husband had cancer twice and we never had to worry about the money. Makes me wish I hadn't come back home.

DissidentVoice

(813 posts)
44. My dad...
Wed Apr 3, 2013, 04:47 PM
Apr 2013

...was fighting with his Medicare supplement insurance while he was being wheeled in for colonostomy surgery. Not with Medicare, with the "private" insurance the Republicans are so fond of touting. Finally an orderly had to take the phone out of his hand.

Unless there is some kind of revolt, nothing will change.

Curmudgeoness

(18,219 posts)
45. I can answer why "it can't work here"
Wed Apr 3, 2013, 06:52 PM
Apr 2013

At least, I can tell you why I think that the PTB say it can't.

There is no stomach on the part of our "leaders" to throw out the private insurance companies. And that is what would have to happen. Private insurance companies would disappear. They would be gone......and who is willing to do that? (Well, besides you and me.)

DissidentVoice

(813 posts)
46. Not necessarily so
Wed Apr 3, 2013, 07:47 PM
Apr 2013

Australia has single-payer for all citizens (Medicare Australia), though it doesn't cover everything.

http://www.humanservices.gov.au/customer/information/welcome-medicare-customers-website
http://en.wikipedia.org/wiki/Medicare_%28Australia%29

For what Medicare Australia doesn't cover, there is Medibank Private, which I believe is sliding-scale and not allowed to exclude.

http://www.medibank.com.au/
http://en.wikipedia.org/wiki/Medibank_Private

Curmudgeoness

(18,219 posts)
48. Too bad
Wed Apr 3, 2013, 08:01 PM
Apr 2013

that the private insurance companies would not disappear. I can see how this would be a compromise that would not put them out of business, although I have a feeling that the market for it and the profit would be a lot less than they enjoy now.

DirkGently

(12,151 posts)
8. They've been working on rationalizing cruelty & perversity for decades.
Tue Apr 2, 2013, 09:01 PM
Apr 2013

Just as the poor who get the least from society are somehow "moochers," now the old, the sick, and the injured will be derided as weak and needy. Whatever it takes to get enough people to go along with inflicting pain and deprivation for profit.

Great piece.

ashling

(25,771 posts)
10. I've always admired the way in which John Kenneth Galbraith
Tue Apr 2, 2013, 09:12 PM
Apr 2013

crystalized the conservative essence (Libertarian, Republican, Tea Party - works for all of 'em)

“The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.”



&feature=player_embedded#!

enough

(13,259 posts)
11. Sadism. This answers a question I've had for a long time:
Tue Apr 2, 2013, 09:12 PM
Apr 2013

WHY are Americans proud to live within a system where so many people suffer, go bankrupt, and die from lack of healthcare that is provided in every other "developed" nation.

I think this writer may have found the answer. That "unconcealed burst of joy."

riverbendviewgal

(4,252 posts)
17. My redneck brother in NJ is very proud
Tue Apr 2, 2013, 10:06 PM
Apr 2013

to be ignorant of every country in the world but America. He does not want to help any person who has no health care.. He says for them to go to the emergency. Half of america is like him.
Glad I live in Canada

DissidentVoice

(813 posts)
24. There are too many like him
Tue Apr 2, 2013, 10:37 PM
Apr 2013

Unfortunately, your brother's attitude is endemic among much of this country.

I live near the Canadian border, within walking distance.

I look across sometimes and nearly burst into tears at what it would be like to live in a free, humane country.

riverbendviewgal

(4,252 posts)
25. It is a good country
Tue Apr 2, 2013, 10:52 PM
Apr 2013

but right now we have Stephen Harper running it and he is trying to sell it away to all the big corporations.

It is scary...

Many of us are concerned and the next election will hopefully kick the PC from power.

THe country is going downhill since they came in power. Harper is a George Bush boy.

DissidentVoice

(813 posts)
30. Stephen Harper
Wed Apr 3, 2013, 12:42 AM
Apr 2013

Stephen Harper is an Alberta Tory...somewhat of a Canadian equivalent to a Texas Republican, but not as extreme, I think?

However...he does not seem to be anywhere as extreme as George W. Bush or the Republican Party. Just thank God you don't have a Republican Party in Canada - it'd be redundant anyway, since you're a constitutional parliamentary monarchy/Commonwealth Dominion, not a republic!

And, after all, you've produced utterly brilliant musical artists over the years...Rush, Triumph, April Wine...all of which still remain firm top-spins in my CD collection. Of course, you've also produced the luminously lovely Tracy Spiridakos of NBC series Revolution ( ), but that's another matter.

A big difference is the way our respective Governments are set up. There is very, very little accountability here, either for a President or (as now) a Congress that won't shit or get off the pot. You, at least, as an independent nation with a modified Westminster system, have a vote of no confidence option (as a "nuclear option" if nothing else) which is a check/balance we don't have. We also have the same person being Head of State and Head of Government, whereas with you Stephen Harper is just Head of Government and your Head of State is, of course, Queen Elizabeth II.

Mr Harper will come and go eventually, but Canada will still be there. I'm not sure this country can survive the Republican Party, Wayne LaPierre, Grover Norquist and Rush Limbaugh.

riverbendviewgal

(4,252 posts)
37. I do like the canadian polictical system better
Wed Apr 3, 2013, 08:45 AM
Apr 2013

I like when the three parties do not a have a majority. This puts a tight rein in all the parties. Right now Harper's PCs have a majority. I agree with you about harper being George w. Bush light. My two favorite politicians are Pierre Trudeau and JACK Layton. They are gone but not forgotten. Harper's eyes give away his sneakiness. They say different than what comes out of his mouth.

we do have great Music. My favorites are The Band. I like the blues band Down child Blues. Of course I like Corey hart and Anne Murray, Celine Dion and k.d. lang.
There are many others who aren't as famous. Toronto has so much in concerts and music festivals.

:-I am thankful we don't have the huge amount of crazy right wingers. Ours are mostly from alberta Where Harper is from.

DissidentVoice

(813 posts)
41. Correct on minority government
Wed Apr 3, 2013, 02:52 PM
Apr 2013

A friend of mine in Canada says that he prefers minority governments, because then they have to form coalitions and cut deals. Majority governments kind of just ram through everything they wish.

It would be like during the George Bush years up until '06 when the Republicans controlled the WH and both houses of Congress.

Webster Green

(13,905 posts)
51. OK. Currently, the best band on the entire planet is 'Arcade Fire' from Montreal.
Fri Apr 5, 2013, 06:39 AM
Apr 2013

They are absolutely amazing! I've seen them live a couple of times, and was totally blown away.

 

Arugula Latte

(50,566 posts)
29. They're also just fine with tens of thousands of their fellow citizens being slaughtered
Tue Apr 2, 2013, 11:12 PM
Apr 2013

by guns every year -- just as long as the killers ain't Muslims.

Sadism is right.

nobodyspecial

(2,286 posts)
16. Reminds me of the time from the campaign trail
Tue Apr 2, 2013, 09:50 PM
Apr 2013

when the crowd cheered at the thought of a man dying because he didn't have insurance.

 

watoos

(7,142 posts)
19. I've always thought that the rich don't want everyone insured
Tue Apr 2, 2013, 10:10 PM
Apr 2013

because then there may be poor people in line ahead of them.

riverbendviewgal

(4,252 posts)
21. Let me tell you about my experience with my cat's deadly illness
Tue Apr 2, 2013, 10:14 PM
Apr 2013

In Canada I have my health care for doctor/hospital/lab etc paid for and my prescription drugs, now that I am 65. I never have health care bills.

BUT...there is no universal health care for animal care. My cat in 2001 was a very seriously sick cat with a cat pneumonia.. I took him to the vet, who said it would require tests and treatment costing over one thousand dollars.
My husband just died a month before and our son 18 months before that. I got down on my knees crying like a baby and talked to my cat and said to him that he would be joining my husband and son. I was not going to pay that amount.

The vet was so moved and started crying too. She said she could eliminate some tests and the bill came to about $400.

The cat is still living and he is now in England with my older son. that is 12 years ago.

My point is they will charge what the market bears.. and some have morals and will lower their prices.
It is sickening, isn't it that there is so much profit in health care, human or animal.

 

Manifestor_of_Light

(21,046 posts)
22. The hospital I am paying is interested in helping me live another 100 years.
Tue Apr 2, 2013, 10:23 PM
Apr 2013

because at the rate I am paying it off, I will have to live another 100 years to pay it off in full.

I was in the hospital for 8 days in ICU in a strange city I was visiting at Thanksgiving. I had 2 life threatening conditions. Either one of them WOULD have killed me, without doubt, within 24 hours.




DissidentVoice

(813 posts)
23. Ron Paul's Hypocritical Oath
Tue Apr 2, 2013, 10:34 PM
Apr 2013

For a physician to say what he did about letting someone die without lifting a finger to help them is in violation of his Hippocratic Oath, though well in line with his obscene Ayn Randian philosophy.

"Dr" Paul should have his licence revoked.

Unfortunately it's all too typical of the increasing cruelty of American culture.

OwnedByCats

(805 posts)
36. I don't think Ron Paul will be
Wed Apr 3, 2013, 04:12 AM
Apr 2013

practicing medicine again, but I see your point. To be honest, I'm mad at the government as a whole over what health care has become. There is plenty of blame to go around outside of the politicians too but we should have got single payer. Anyone with the power to make that happen doesn't give a shit about those of us struggling. Even middle class people are struggling. Things keep up the way they are, only millionaires and above will be able to afford it. I know ACA hasn't been fully implemented yet, but I don't have a lot of faith in any scenerio where for profit insurance companies are in the equation.

DissidentVoice

(813 posts)
39. Nor do I have a lot of faith
Wed Apr 3, 2013, 02:49 PM
Apr 2013

I wish Mr. Obama would have pushed for single-payer. He should have known he wasn't going to get any Republicans on board, so why make the effort to include "private enterprise?"

sorefeet

(1,241 posts)
26. The hippocratic oath and $1.00 will get you
Tue Apr 2, 2013, 10:55 PM
Apr 2013

a cup of coffee. That oath means absolutely nothing. The money comes first.

Quantess

(27,630 posts)
35. I disagree that the medical professionals are the culprits.
Wed Apr 3, 2013, 04:01 AM
Apr 2013

It's the whole system! Besides, I would sooner place blame on Health Care Administrators and Insurance Execs.

DissidentVoice

(813 posts)
40. The medical professionals are part of it
Wed Apr 3, 2013, 02:50 PM
Apr 2013

Those who won't take Medicare/Medicaid patients are in it for the $$$.

Response to ashling (Original post)

Quantess

(27,630 posts)
33. This should be obvious to us all, by now:
Wed Apr 3, 2013, 03:44 AM
Apr 2013
"It’s as if this were not their own country, but some place they’ve invaded in order to loot its wealth and fleece its population without caring what happens to that population tomorrow."

CrispyQ

(36,463 posts)
38. This:
Wed Apr 3, 2013, 11:34 AM
Apr 2013
Today, when the acquisition of wealth, quickly and in large amounts, is admired above any other human endeavor

Money is our God.

This thread is very sad.

DissidentVoice

(813 posts)
47. What it's going to take is REVOLT
Wed Apr 3, 2013, 07:52 PM
Apr 2013

By that, I mean refusal across-the-board to pay medical bills.

The non-system will crash in one way or another.

It is going to take that to build something new in its place.

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