quote:Originally posted by Samprimary: Also, cause someone's going to have to say it eventually:
quote:Originally posted by capaxinfiniti: A rebuttal to the points presented would be more appropriate than speculation about possible alts and other ad hominem drivel.
Can we get some sort of agreement from you, for your sake as much as anyone else's, that you try not to use 'ad hominem' until you've really boned up on how not to use the term incorrectly?
No.
Show my incorrect usage. And since you obliviously think this is a recurring error, show previous posts where I've incorrectly used the term.
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Nope, it doesn't include taxes or amounts paid for insurance. (The rather contrived nature of this number should make you suspicious and thus ... http://www.oecd.org/dataoecd/52/32/38976612.pdf Voila )
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quote:Originally posted by kmbboots: Does that include what we pay for insurance?
No. What you pay for insurance doesn't count as an out-of-pocket expense in the context of healthcare financing, particularly within the framework of a third-party-payer problem.
(Note that I wasn't attempting to claim that we pay less individually for health care. Just that our low out-of-pocket share for services (rather than our overall costs of what we pay for health insurance + deductible + copays) contributes to the third-party-payer problem of inflating prices.)
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The idea behind the metric of out-of-pocket expenses, I would guess, is the hypothesis that in a non-socialized system costs are better kept low if the price of services is transparent to the consumer. That transparency should be maximized if more of the cost is out-of-pocket. So prices in a market-driven system should theoretically be lower if the ratio of out-of-pocket spending to total spending is high.
I'd be interested in testing that hypothesis. So, for instance, using the data in the link Mucus provided, does high out-of-pocket percentage correlate with lower overall healthcare prices? It doesn't jump out as immediately obvious to me that it does.
<edit>I guess that's the "third party payer" problem Syphon mentions in the above post. Syphon, do you have a useful link on the effect of the third party payer problem on healthcare spending? It seems like an intuitive conjecture to me, but the lack of clear correlation between low costs and high out-of-pocket expense percentage strikes me as evidence against the hypothesis.</edit>
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quote:Show my incorrect usage. And since you obliviously think this is a recurring error, show previous posts where I've incorrectly used the term.
1. your incorrect usage: it's on this page. It's not really hard to find. 2. Silly, where do I say it's a recurring error? I'm worried precisely because you've started using the term, and (already notoriously bad) arguers expanding their repertoire to start slinging out formal fallacy names with scattergun applicability is exactly the sort of thing I'd like to nip in the bud, if you don't mind.
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quote:Originally posted by Syphon the Sun: It measures quality of care in the same sense that it measures car ownership, smoking habits, obesity-related illness, alcohol consumption, crime rates, etc. That's precisely why it's such a useless metric and why it's rarely used as a measuring stick by anyone doing real research: it simply has too many non-quality variables to be useful. You can't control for all the factors to do any real measurements with it.
You can't control for all the factors in pretty much any metric we could possibly be using here, though. What I'm asking is why you are insisting that life expectancy cannot measure quality of care in ANY sense. This, as opposed to saying that it's a very poor metric to use due to x, y, z.
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Forgive me for not reading all the thread, I just wanted to pipe in and complain about something:
[sour grapes]My wife is the Medical Assistant for the head a specialist (I won't mention which) in the county in his (and his partner [omitted]ologists) private practice. My wife makes very little per hour while preforming the vast majority of the work, while the doctors make millions (seriously) while doing very little of the work. Yes, not only did he get all the schooling to be an MD, but then more to be a specialist, and then became the premier [omitted]ologist in the area, but his practice would grind to a messy halt without my wife and he pays her a pittance for her daily hard work while he just bought his second new car this year. [/sour grapes]
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quote:Originally posted by Samprimary: What I'm asking is why you are insisting that life expectancy cannot measure quality of care in ANY sense. This, as opposed to saying that it's a very poor metric to use due to x, y, z.
While I enjoy the fact that you'd rather play a game of semantics than actually discuss the topic, I'm not sure what you're trying to accomplish, other than distract from the actual issues involved.
The value of using life expectancy as a metric for quality of care is so very close to zero that I don't think it's that outlandish to, for simplicity's sake, call it zero, particularly given the context in which it is called such. Indeed, you might note that I originally just called it a "terrible metric."
The fact that quality of care has an effect on life expectancy doesn't mean that you can reasonably use it to measure quality of care any more than you can reasonably use it to measure violent crime simply because violent crime has an effect on life expectancy.
Of course, if you'd like to defend your use of life expectancy as a metric, I'd be open to discussing that. If not, it's really not worth my time to continue playing your trivial game.
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quote:Originally posted by SenojRetep: I guess that's the "third party payer" problem Syphon mentions in the above post. Syphon, do you have a useful link on the effect of the third party payer problem on healthcare spending?
I'm actually on my way to a conference, and will be out of town for the next few/several days, but as soon as I'm back home to my desktop and research cache, I'd be happy to.
If I get a few free moments with internet access, I'll try to find some alternate links so you folks don't have to wait.
(And I apologize in advance for the fact that my responses are going to be at least somewhat delayed until I get home.)
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SW, sadly, that problem is not limited to the medical field. People who appreciate good support staff -- and put their money to back up that appreciation -- are few and far between. Posts: 32919 | Registered: Mar 2003
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quote:Originally posted by Stone_Wolf_: Forgive me for not reading all the thread, I just wanted to pipe in and complain about something:
[sour grapes]My wife is the Medical Assistant for the head a specialist (I won't mention which) in the county in his (and his partner [omitted]ologists) private practice. My wife makes very little per hour while preforming the vast majority of the work, while the doctors make millions (seriously) while doing very little of the work. Yes, not only did he get all the schooling to be an MD, but then more to be a specialist, and then became the premier [omitted]ologist in the area, but his practice would grind to a messy halt without my wife and he pays her a pittance for her daily hard work while he just bought his second new car this year. [/sour grapes]
I have been smarter and more generally competent than every boss I've ever had, save one or two. But the value of my time was measured by the availability of replacements, and their ability to do the work I was being payed to do, at the same rate of pay. You're a capitalist, you know how that works.
The only thing these experiences have taught me is that I typically find employment below my actual potential, but for various reasons, personal, circumstantial and economic, I have still worked these jobs. Ive worked for a few too many companies who were addicted to freelance work- underpaying for and undervaluing their primary product. That's actually something I've been working to change recently. It sounds like your wife could also find greater satisfaction in another job.
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quote:Originally posted by Syphon the Sun: While I enjoy the fact that you'd rather play a game of semantics than actually discuss the topic, I'm not sure what you're trying to accomplish, other than distract from the actual issues involved.
A game of semantics, versus a game of questioning an individual prioritization of data analysis? You can think it to be whatever you want. I'm trying to figure out what importance you want life expectancy to have when discussing healthcare system. You apparently want it completely disregarded, so that draws forth some inevitable new questions.
- what, to you, is the potential value of analyzing adjusted life expectancy by removing infant mortality, accidents, assault from overall mortality stats, and comparing life expectancy for various groups (diabetics, etc) between countries?
- likewise, what about analyzing life expectancy among our population 65 and older, which even the AEI (no friend of nationalized anything, mind you) believes is a valuable piece of data to incorporate into the study of the efficacy of our system versus others? Because, well, we do get some useful numbers out of that, honestly.
quote:Even if we look at life expectancy for sub-populations relatively less affected by the reasons people use to try and discredit the metric as a quality measure, we still look pretty bad.
There's countries out there with worse health habits and more dangerous lifestyles overall, countries with higher obesity rates than us. What with us unambiguously paying more of our overall productivity into ours than theirs, we should be seeing better results for that if we want to claim a superior system or (as is often the case) the 'framework for a superior system' if we could just get rid of a few hiccups here and there, such as allowing better coverage competition across state lines, or whichever vanishing-point market correction ideal is in vogue. We should be seeing better outcomes in the end-point, end-user categories, senior citizens living longer, 'less waste than a government bureaucratic nightmare,' any of these things. We should probably have also been improving vis a vis other countries what with the significant downturn in murders and other violent crimes across the decades. We have none of that!
Which is why, of course, I end up returning to cost to benefit ratio. Which is interesting to note (and begin using as a chorus piece) in light of the, as mucus said, notably intriguing presented number figure for .. I guess, Pay Less Out Of Pocket As A Percentage Of Total Health Care Spending.
quote:Originally posted by Samprimary: 1. your incorrect usage: it's on this page. It's not really hard to find. 2. Silly, where do I say it's a recurring error? I'm worried precisely because you've started using the term, and (already notoriously bad) arguers expanding their repertoire to start slinging out formal fallacy names with scattergun applicability is exactly the sort of thing I'd like to nip in the bud, if you don't mind.
I said 'no' because your accusation is incorrect.
There have been previous discussions where I've identified ad hominem fallacies and I assumed you were only now commenting on those instances. You're clearly unaware of those 'recurring' uses.
Either you've suffered a moment of intellectual retardation or you really are ignorant as to the nature of this particular logical fallacy. Again, instead of showing the error, as I requested, you've reiterated what you said in the previous post. Hopefully you can see how condescending that behavior is and 'nip it in the bud.'
And all this is getting old. Your needlessly antagonistic comments are the real 'shame' in these discussions.
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I'd settle for knowing where the ad hominem attack in this thread was that you initially referred to, capax. I still generally disagree with you, but lately you've appeared-to me at least, for what that's worth-an honest participant in discussions.
Complaining about ad hominem attacks from others to a third party while slinging them yourself is, well, pretty weird and smacks of dishonest discussion.
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I'm a little late to the sock-puppet game, but I just wanted to say that I joined Hatrack many years ago and posted very, very rarely for the first several years. There are a lot more lurkers here than you might expect.
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quote:Originally posted by capaxinfiniti: Either you've suffered a moment of intellectual retardation or you really are ignorant as to the nature of this particular logical fallacy.
is literally, with no sense of irony, posted right alongside this:
quote:Originally posted by capaxinfiniti: Your needlessly antagonistic comments are the real 'shame' in these discussions.
Please, continue trying to show me what your version of high ground looks like.
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rivka: Thanks...yea, a good boss is hard to come by.
Orincoro: Thank you for the thoughtful answer. I don't actually classify myself as capitalist...more of a middle of the road, I like freedom although it can get messy kinda guy. Kinda like, I'd rather the government set the rules of the game and then not play it.
My wife has been talking about a change...I encourage it, but accept that while I'm not voiceless in this category, it is her career and she who has to live with the daily consequences of these choices.
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quote:Originally posted by Dan_Frank: There are a lot more lurkers here than you might expect.
Lurkers are one thing. Someone with 0 posts who pops out to post long posts on a hot-button topic . . . that doesn't meet the usual definition of a lurker, nor the usual pattern. StS may indeed be a lurker (or more likely, someone who created an account, wandered away, and now came back), but I stand by the assertion that it's potentially suspicious behavior.
It's no Chinese menu, though.
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quote:Originally posted by Stone_Wolf_: My wife has been talking about a change...I encourage it, but accept that while I'm not voiceless in this category, it is her career and she who has to live with the daily consequences of these choices.
Yeah. For my part, having been in that kind of situation, I can only say it helps to have other encourage you to move forward. If she really is the key to making that office work smoothly, and she isn't satisfied with her pay, then she can find another position with more responsibility and better pay.
As a friend of mine told me a few years ago: Every year, double your rates, and fire your worst client. It's an exaggeration, but at the time I was making about US $18 an hour (consider, not in the US) and hated some of my clients. Now I make more than twice that with some clients, and I don't work with the ones I used to hate. And I know people who still make what they did 3 years ago in the same field. They've had the same job since 3 years ago, and I haven't.
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quote:Originally posted by Dan_Frank: There are a lot more lurkers here than you might expect.
Lurkers are one thing. Someone with 0 posts who pops out to post long posts on a hot-button topic . . . that doesn't meet the usual definition of a lurker, nor the usual pattern. StS may indeed be a lurker (or more likely, someone who created an account, wandered away, and now came back), but I stand by the assertion that it's potentially suspicious behavior.
It's no Chinese menu, though.
I may have been mistaken, but when I first saw StS's posts I saw two in this thread but the post count read 3. I checked post history and just saw those two posts in here. So, they must have made a single post back when they made the account.
I guess my first posts were in controversial topics too. Maybe that's why it doesn't seem odd to me.
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quote:Originally posted by Dan_Frank: There are a lot more lurkers here than you might expect.
Lurkers are one thing. Someone with 0 posts who pops out to post long posts on a hot-button topic . . . that doesn't meet the usual definition of a lurker, nor the usual pattern. StS may indeed be a lurker (or more likely, someone who created an account, wandered away, and now came back), but I stand by the assertion that it's potentially suspicious behavior.
It's no Chinese menu, though.
Syphon the Sun is a pwebber.
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quote:Originally posted by Dan_Frank: when I first saw StS's posts I saw two in this thread but the post count read 3.
When I read his first post, the count was 1. The fact that it's off by one now implies that he deleted a post.
And many Hatrackers' first posts are on controversial topics. Not generally after 3 years of nothing, though.
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quote:Originally posted by Rakeesh: I'd settle for knowing where the ad hominem attack in this thread was that you initially referred to, capax. I still generally disagree with you, but lately you've appeared-to me at least, for what that's worth-an honest participant in discussions.
quote:Argumentum ad Hominem (abusive and circumstantial): the fallacy of attacking the character or circumstances of an individual who is advancing a statement or an argument instead of trying to disprove the truth of the statement or the soundness of the argument.
To put it in simpler terms, presenting "character flaws or actions that are irrelevant to the opponent's argument." (wikipedia)
Speculation of a negative slant regarding the person, their motivations, and/or circumsatance, in no way advances the discussion. Syphon's identity - when he registered; if he's an alt - is irrelevant to the credibility of the arguments he presented. Saying things like "I wonder who you're an alt for?" or "You don't have any credibility here, because nobody is familiar with you" or claiming that "the real issue is not whether they are new, but whether they are not" all serve to undermine the credibility of the person presenting the argument, not the argument's logic or accuracy. The ad hominem attack doesn't have to be intentional or effective in order to qualify as such.
A simple test: Does anyone's registration date have any bearing on the facts and arguments of the healthcare discussion? No.
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Except this isn't a formal debate. A lot of meta-conversation is the norm. A person who appears under unusual circumstances is worthy of discussion, regardless of the merit of their arguments. Orincoro pointed out that a new user is not going to have credibility in the community, which is true. No one said the arguments were invalid because of that fact and some explicitly noted that it was irrelevant. In fact there had been some substative response prior to your comments about ad hom. Your snarky comment was a bit late.
Yes, I know what an ad hominem fallacy is. That wasn't my question.
When you made your initial claim, the closest thing I could find to such a thing was Orincoro stating he (Syphon) had no credibility in the community. Rivka and I were (I think I can speak for her in this, but she'll correct me if I'm wrong) pointing out that it was odd and a bit worrisome that Syphon's history was what it was. I thought to myself, "OK, there's another hot-button political issue poster who is likely an alt for someone else around here." Rivka specifically rejected the idea that for Syphon to have credibility, s/he'd need long history here.
It doesn't even appear that Syphon took the questions as nearly as insulting as you did on his behalf.
I don't really think someone stating, "You don't have credibility within the community as a poster," qualifies as an attack like you described as 'other ad hominem drivel'. It appears as though your outrage was largely because Syphon was criticizing a set of policies you also disagree with...which, when we're speaking of poster histories, is a bit up your alley.
I wouldn't have added that last bit in the post, btw, if you hadn't decided to lecture about personal attacks while...y'know, flinging some explicit personal attacks yourself. More than a little silly and hypocritical.
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Also to note (what led me to critically comment in the first place) is that capax said "speculation about possible alts and other ad hominem drivel"
Why the 'and' is important is that it makes sure that we know he's saying that speculation about possible alts is 'ad hominem drivel'
and, well, orincoro was not speculating specifically (and appropriately, IMO, unless we like to play the 'fool me 15 times' game) on potential altiness. You and rivka were. And to have fingered those two posts as ad hominem drivel is a perfect example of starting to sling around a formal declaration of fallacy loosely and stupidly, so.
But here, let me make the alt conspiracy witchhunt derail more fun, just for kicks.
quote:Originally posted by capaxinfiniti: There have been previous discussions where I've identified ad hominem fallacies and I assumed you were only now commenting on those instances. You're clearly unaware of those 'recurring' uses.
Like I said, you've just now started using the term ad hominem. I'm 'unaware' of recurring use of the term, because there is no recurring use of the term. Perhaps you accidentally thought that you had used it before on this account, but you're getting your alts mixed up? (dramatic music! rabbit hole! inception! m. night shyamalan!)
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quote:Kyle Willis, a 24-year-old man from Ohio, died on Wednesday from a tooth infection, Cincinati's WLWT reported.
According to the station, Willis' wisdom tooth began hurting two weeks ago, and dentists said it needed to be removed.
Willis, however, was a single father without health insurance, and couldn't afford the procedure.
After developing severe headaches and facial swelling, he went to the emergency room.
Although doctors recommended antibiotics and pain medication, Willis could only afford one.
Patti Collins, Willis's aunt, told WLWT what happened next.
"'The (doctors) gave him antibiotic and pain medication. But he couldn't afford to pay for the antibiotic, so he chose the pain meds, which was not what he needed,' Collins said. Doctors told Willis' family that while the pain had stopped, the infection kept spreading -- eventually attacking his brain and causing it to swell."
Willis leaves behind a 6-year-old daughter, and family members are hoping to create a fund for her future college education.
Dr. Irvin Silverstein, a dentist at the University of California told ABC news that Willis' story isn't uncommon.
"People don't realize that dental disease can cause serious illness.The problems are not just cosmetic. Many people die from dental disease. When people are unemployed or don't have insurance, where do they go? What do they do? Silverstein said. People end up dying, and these are the most treatable, preventable diseases in the world."
Four years ago, 12-year-old Demonte Drived died after his mother, Alyce, couldn't find a dentist who took Medicaid and bacteria from a tooth abscess spread to his brain.
A Kaiser Family Foundation report found that between 2007 and 2008, the number of uninsured adults rose by 1.5 million.
ABC news added that in April the same foundation also found that 33% of people skipped dental care because they could not afford it.
posted
Also, here's that (extremely tardy) sourcing, which seems to have been conveniently packaged for me.
Seems the renal disease issue our system has has jumped out to far more than just me, so I guess it's not just a random plucked-from-the-aether stat. It's worth some notoriety.
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I finally have dental coverage again after not having it for about eight years. That reminds me, I need to schedule a checkup...my first in several years.
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quote:Originally posted by Parkour: Oh yeah, remember fish antibiotics, cocaine, and american dental care?
to share with the class, have some real stories about the uninsured managing dental care in the US.
quote:one of my partially erupteds erupts a little bit more, tearing through the gum and generally just causing my face swelling and misery. After a week of hourly orajel applications, I decided to cut out the pharmaceutical manufacturing middleman and buy cocaine off the street to put on my ragged gums. Which worked amazingly well, truth be told, but STILL...
quote: in regards to the antibiotics on Amazon...it says it is for fish use, not for human consumption, but I take it from the tone that humans actually CAN take it and it works and you won't die?
quote:I don't have allergies to this kind of stuff, but to me this is a big ****ing deal, as me and my wife don't have any kind of medical insurance at the moment and we might find ourselves in need of something like this in the future...I mean, Clindamycin for $40, Amoxicillin for $11, holy ...
quote:it is still a goddamn embarrassment that people in this country even know how to convert doses of fish antibiotics to human size doses.
I've done it with my cat's meds before. His meds are much cheaper, as are his doctor visits.
quote:Jesus guys, fix your goddam system.
How why ugh my mind can't comprehend how a supposedly civilized country can be so underdeveloped when it comes to helping its own citizens. I just ...
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SA's GBS thread on the article about Kyle Willis.
Which has allowed some more of those dirty furrigners to have their own chance to be shocked and appalled at discovering the ins and outs of America's Wonderful Not Dirty Socialism System Which Totally Works.
quote: Seriously? This thread has made me realise that I actually have no idea how your healthcare system works. I knew you had to pay for it but Jesus. I've had a tooth removed and paid fifty quid for the whole thing (and I still think that's a bit steep). How can healthcare providers be charging a price that bears absolutely no relation to the actual cost of pulling a tooth?
Sorry again America
quote:We're just mind-blown by how bad health-care in the richest country in the world is. When you see an entire population digging themselves into a hole, you can't help but scream at them to stop, even if it has no effect.
quote:It's stories like this which always go some way to making me question my long-term plan to move to the USA from Europe, mainly to help my career. I just don't know how I could live somewhere where I'd have to give serious thought whenever planning something to whether I could afford it if something went wrong. I did a whole load of hiking last year which ended up with an injury: doing something which kept me fit, healthy and fulfilled could have ended up bankrupting my family if we'd lived in the States.
quote:It's funny. We reject UHC, yet we've taken our privatized model and unevenly patched it over with unofficial socialized medicine to soften the brutality. The result is a bewildering patchwork where you can get things for free if you know the system well or if you've got a good provider.
quote:I'm so sorry that people in the US get properly financially screwed over because of health problems. My Dad is currently undergoing rehab after a major brain aneurysm and has been in hospital since March. I cannot even begin to imagine how much worse the situation would be if my Mum was having to worry about money right now on top of everything else. Our evil socialist government is actually giving my Mum extra money at the moment because she's with Dad in hospital a lot and can't work as much.
Sorry US. Hope the situation gets better... Some time? Is there actually any chance of you guys getting anything like UHC any time soon?
One thing I've known for a while: the brits and their stereotypically bad teeth can mock us gleefully now. We have worse teeth than them on account of the dysfunction in our dental coverage. Not even joking.
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Yeah, but Samp, see, if we had UHC, then we might have to WAIT FOR THINGS!
We might not live in constant fear of being bankrupted by a sudden illness that isn't covered by our healthcare provider or that they will refuse to cover us or that we will lose our jobs and the only possible way of getting health care we can afford because we're 61 and our spouse is suffering from dementia and diabetes and we have chronic arthritis, and although we've saved diligently for our entire lives for our retirement, that won't matter if we suddenly find ourselves laid-off by a company wanting to save an extra billion dollars for a rainy day and there are no options for paying for your own health insurance that are anywhere near affordable, and there is no way to pay for the things we need medically because the prices are all hyperinflated for cash customers because we don't come packaged as part of an HMO that dials down those costs, so you find yourself at the end of a 40 year career in which you worked and saved, and it could all be gone in a year, but WE WOULD HAVE TO WAIT FOR THINGS!
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Well, British dentistry is still not totally fantastic - limited by the fact that there just aren't enough dentists willing to work for the NHS. They make a lot more money going private.
But if you can get hold of an NHS dentist, you get everything 'for free', even orthodontistry if your teeth are badly misaligned. Plus, the private dentists pass their patients into the NHS system for more serious problems, so you still don't need to have dental insurance.
When I had my wisdom teeth taken out (it wasn't exactly an emergency), I had to wait about a month between first consultation and the operation, spoke to a specialist about what they were going to do, had the teeth taken out in one of the best hospitals in the country under general anaesthetic, was given all the right medicines to take home, and it didn't cost me anything - which was lucky because I was a poor student at the time.
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One more reason why Cancer statistics are a bad way to compare the US health care system to those in other countries. Cancer is an old peoples disease. Most of the people who get cancer in the US (53.25%)are over 65 and are therefore covered by "socialized" medicine (i.e. Medicare).
83% of cancer patients are over 50 at the time of diagnosis and 93% are over 40. Only 5.6% of all cancer patients are between the ages of 20 and 40 at the time of diagnosis. This is the age group that is most likely to be uninsured in the US system.
This is important for several reasons. The key one being that cancer survival rates are less likely to be sensitive to the weaknesses in US health care than other diseases. The next being that it raises serious concerns future of cancer diagnosis and treatment in the US since we are likely to see a big increase in the number of uninsured over 50 people due to changes in the economy and attitudes toward entitlements programs.
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quote:Originally posted by Bella Bee: Well, British dentistry is still not totally fantastic - limited by the fact that there just aren't enough dentists willing to work for the NHS.
Yeah, I watch the work that the NHS goes through to try to keep a ready enough supply of treatment available to the british public, but 'not totally fantastic' is a matter of leagues over our own 'totally dismal' — to wit, the article I quoted earlier from mg:
quote:Tooth decay begins, typically, when debris becomes trapped between the teeth and along the ridges and in the grooves of the molars. The food rots. It becomes colonized with bacteria. The bacteria feeds off sugars in the mouth and forms an acid that begins to eat away at the enamel of the teeth. Slowly, the bacteria works its way through to the dentin, the inner structure, and from there the cavity begins to blossom three-dimensionally, spreading inward and sideways. When the decay reaches the pulp tissue, the blood vessels, and the nerves that serve the tooth, the pain starts—an insistent throbbing. The tooth turns brown. It begins to lose its hard structure, to the point where a dentist can reach into a cavity with a hand instrument and scoop out the decay. At the base of the tooth, the bacteria mineralizes into tartar, which begins to irritate the gums. They become puffy and bright red and start to recede, leaving more and more of the tooth’s root exposed. When the infection works its way down to the bone, the structure holding the tooth in begins to collapse altogether.
Several years ago, two Harvard researchers, Susan Starr Sered and Rushika Fernandopulle, set out to interview people without health-care coverage for a book they were writing, “Uninsured in America.” They talked to as many kinds of people as they could find, collecting stories of untreated depression and struggling single mothers and chronically injured laborers—and the most common complaint they heard was about teeth. Gina, a hairdresser in Idaho, whose husband worked as a freight manager at a chain store, had “a peculiar mannerism of keeping her mouth closed even when speaking.” It turned out that she hadn’t been able to afford dental care for three years, and one of her front teeth was rotting. Daniel, a construction worker, pulled out his bad teeth with pliers. Then, there was Loretta, who worked nights at a university research center in Mississippi, and was missing most of her teeth. “They’ll break off after a while, and then you just grab a hold of them, and they work their way out,” she explained to Sered and Fernandopulle. “It hurts so bad, because the tooth aches. Then it’s a relief just to get it out of there. The hole closes up itself anyway. So it’s so much better.”
People without health insurance have bad teeth because, if you’re paying for everything out of your own pocket, going to the dentist for a checkup seems like a luxury. It isn’t, of course. The loss of teeth makes eating fresh fruits and vegetables difficult, and a diet heavy in soft, processed foods exacerbates more serious health problems, like diabetes. The pain of tooth decay leads many people to use alcohol as a salve. And those struggling to get ahead in the job market quickly find that the unsightliness of bad teeth, and the self-consciousness that results, can become a major barrier. If your teeth are bad, you’re not going to get a job as a receptionist, say, or a cashier. You’re going to be put in the back somewhere, far from the public eye. What Loretta, Gina, and Daniel understand, the two authors tell us, is that bad teeth have come to be seen as a marker of “poor parenting, low educational achievement and slow or faulty intellectual development.” They are an outward marker of caste. “Almost every time we asked interviewees what their first priority would be if the president established universal health coverage tomorrow,” Sered and Fernandopulle write, “the immediate answer was ‘my teeth.’ ”
The U. S. health-care system, according to “Uninsured in America,” has created a group of people who increasingly look different from others and suffer in ways that others do not. The leading cause of personal bankruptcy in the United States is unpaid medical bills. Half of the uninsured owe money to hospitals, and a third are being pursued by collection agencies. Children without health insurance are less likely to receive medical attention for serious injuries, for recurrent ear infections, or for asthma. Lung-cancer patients without insurance are less likely to receive surgery, chemotherapy, or radiation treatment. Heart-attack victims without health insurance are less likely to receive angioplasty. People with pneumonia who don’t have health insurance are less likely to receive X rays or consultations. The death rate in any given year for someone without health insurance is twenty-five per cent higher than for someone with insur-ance. Because the uninsured are sicker than the rest of us, they can’t get better jobs, and because they can’t get better jobs they can’t afford health insurance, and because they can’t afford health insurance they get even sicker. John, the manager of a bar in Idaho, tells Sered and Fernandopulle that as a result of various workplace injuries over the years he takes eight ibuprofen, waits two hours, then takes eight more—and tries to cadge as much prescription pain medication as he can from friends. “There are times when I should’ve gone to the doctor, but I couldn’t afford to go because I don’t have insurance,” he says. “Like when my back messed up, I should’ve gone. If I had insurance, I would’ve went, because I know I could get treatment, but when you can’t afford it you don’t go. Because the harder the hole you get into in terms of bills, then you’ll never get out. So you just say, ‘I can deal with the pain.’ ”
posted
This is reminding me I need to find a dentist for a checkup. I'm in the UK, which is actually better than being in Canada because, as discussed above, dentistry is covered in the UK under the NHS, whereas it's not covered in Canada.
Posts: 8473 | Registered: Apr 2003
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posted
Going to stash this here. It's a pretty neat way of graphing the effectiveness of countries that spend more or less on healthcare in terms of how it affects life expectancy.
quote:Originally posted by Mucus: Going to stash this here. It's a pretty neat way of graphing the effectiveness of countries that spend more or less on healthcare in terms of how it affects life expectancy.
It's already been established - here and elsewhere - that life expectancy isn't an effective way of judging the quality of healthcare in the country. There are other metrics which better address that question. Simply looking at life expectancy ignores a great deal of other very relevant variables.
Posts: 570 | Registered: Sep 2009
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Handy that this is the precise thread where people were hashing out metrics like "Pay Less Out Of Pocket As A Percentage Of Total Health Care Spending" versus cost/benefit Posts: 7593 | Registered: Sep 2006
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posted
Yes; you can say 'life expectancy isn't a useful metric!' — okay, great, we've got all these other ones which demonstrate exactly the kind of direly pathetic results our health system provides, so.
Posts: 15421 | Registered: Aug 2005
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posted
I stand by my unwillingness to wait for things that are freely available as a reason to maintain a system in which a large percentage of people have no access to care at all, and in which others pay enormous premiums and sacrifice their social mobility in favor of employer provided slavery... Er, healthcare.
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