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Author Topic: LIVING IN AMERICA - HOW DO YOU COPE?  (Read 13130 times)

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Offline UK_SL

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LIVING IN AMERICA - HOW DO YOU COPE?
« on: December 05, 2009, 01:26:13 AM »
How do you cope in the US with the financial burdon of HIV - I was looking on some sites and never realised the meds were so expensive and I imagine it must be hard to get insurance?

I am lucky enough to live in the UK and have all my meds / treatments paid by the NHS, when I hear people moaning in this country about the state of the health service it makes me so mad - I say to them "You don't know how lucky we are, at least we have a health service!!". In my experience I've had the best care you could get from my clinic.

Just needed to say that I admire you yanks for not only coping with the disease but the financial burdon too.
05/10/2009 ~ DIAGNOSED, CD4 = 8
22/10/2009 ~ CD4 = 11/VL = 430,000, STARTED ATRIPLA and SEPTRIN
26/11/2009 ~ CD4 = 121/VL = 840
22/12/2009 ~ CD4 = 184 (6%)/VL = 340
11/03/2010 ~ CD4 = 177 (12%)/VL = 72
01/07/2010 ~ CD4 = 247 (12%) VL = 76
20/01/2011 ~ CD4 = 350 / VL = 29

Offline Moffie65

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #1 on: December 05, 2009, 10:22:50 AM »
For those of us who are unable to pay, there is always the Ryan White Act, which was passed by congress in the early '90's, which covers our HIV medications, also there are those of us who are covered by the Veterans Administration fully for all our HIV care.  Those that have to find insurance through their employers are usually the ones that are stuck with the largest amount of out of pocket expenses with their medications, as most have large co-pays.

Other than that, we exercise a whole lot of faith that we all can somehow make it through.  Basicly our health care system in the United States is falling rapidly into complete failure for the working class.
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline Inchlingblue

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #2 on: December 05, 2009, 10:36:45 AM »
The situation here is very bad. There are currently, last I checked, 300 people on ADAP waiting lists. Eligibility requirements are getting stricter. People are losing their jobs and their health insurance. And as great as ADAP has been through the years, supplying life-saving medications to those who have HIV, it is not comprehensive health insurance. If someone on ADAP needs to go to the hospital, etc., ADAP does not cover that.

And if it weren't for these "Blue Dog Democrats," we'd at least have a chance at meaningful health reform. One of them Mary Landrieu from Louisiana was essentially bribed with $100 million to $300 million for her state's Medicaid if she agreed not to hold back the health care bill from going to debate! That doesn't mean she will vote for health care reform, she is simply agreeing not to stop it from going to debate, thank you very much. Can she not put 2 and 2 together and realize that the very legislation that she is obstructing is what will save the people of her state?

It adds a whole layer of stress and worry for anyone who has any sort of health condition, not just HIV. If you are either rich or very poor you can get coverage but if you are in the middle, it's scary.

To quote an Elton John song, "It's a sad sad situation, and it's getting more and more absurd."

Below is a recent article about ADAP in Utah, just one example of many:

Utah: Doctors, Patients Reeling From AIDS Medication Funding Shortfall

LINK:

http://www.thebody.com/content/news/art54707.html
« Last Edit: December 05, 2009, 11:42:35 AM by Inchlingblue »

Offline LordBerners

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #3 on: December 05, 2009, 10:51:25 AM »
UK SL, you have to remember that most Americans are used to living in a brutally repressive society, so they're at least conditioned to accept this sort of thing. 

When you tell the average American how things are for working class people in Europe, he really can't believe it.  The reactions range from 'how is that possible?' to 'why would They give you that?', but in any case nobody can believe happiness and well being for most is actually achievable in this life.  The next, of course.  They believe that.
Please, just call me Berners.. or Baron.

Offline sam66

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #4 on: December 05, 2009, 10:54:47 AM »


                              Thank God for the NHS
                               God save the NHS
december 2007 diagnosed +ve ,

Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #5 on: December 05, 2009, 11:05:13 AM »
we exercise a whole lot of faith that we all can somehow make it through.
getting my meds (and health care) through a mixture of state medicaid, ADAP, Ryan White, and federal medicare, not only do I worry about having HIV, worrying about adhering to my med regimen; but there's always a fear that I'll lose a piece of that assistance, lose my meds, and become ill - much less risk death from untreated HIV. In the nearly 20 that I've had AIDS, I've gone off meds several times (for various reasons) and seen first hand that within 6-9 months, I can be sick enough to have an OI and be hospitalized.

For the last decade, I have been on Social Security disability and still falling enough below the poverty level that currently the cost of all my meds is covered by those agencies without any copay. It's an uneasy balancing act and should any piece get pulled out from under me, Jingo! I could find my life crumbling down like a tower of blocks. To hedge my bet some, I try to collect and stash away "extra meds" when ever possible. An extra month or two could be the difference between developing resistance issues or even life and death.

If you are either rich or very poor you can get coverage but if you are in the middle, it's scary.
being poor is no guarantee either

Recently I moved from SC to OH and though I believed I had nearly every document needed to make the transition easy from state-administered federal program to state-administered federal program, one piece of paperwork from OH held up the transfer for 3 months (the situation still is not 100% resolved today, though I am working hard and hoping to have it all cleared up by Christmas. It's not always easy to get gov't employees to work faster when to them it's just a M-F 9-5 job. It doesn't mean life-n-death to them like it does to me). If I had not stashed meds while in OH and brought down nearly 3 months worth of "extra meds" I would have just gone 3 months with no medications at all waiting for this paperwork issue to be resolved. As it was, I was down to the last 3 days worth of my meds (and now my "stockpile" is gone!), when a case worker was finally able to arrange an "emergency" month's worth until I finally got my SC state medicaid case approved.

So it takes a lot of faith and trust that my gov't is going to assist me PLUS some very careful planning (ie skipping meds occassionally to hoard up a supply) to keep illness and possibly even the Grim Reaper at bay. That's how it's been the last 20 yrs of my life, and with some luck and barring any dramatic change, that's how precarious the next 20 yrs of my life will be also.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline rmgjunk

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #6 on: December 05, 2009, 11:51:49 AM »
Hi guys,

Here in Brazil we get all our meds and labs for free, but there are consequences.  Here is what I've heard/been through so far:

New drugs take some time to start being distributed, and there's a strong bias toward non-patented, cheaper drugs.  Generic Combivir plus Efavirenz or Kaletra are the first line therapy.  Integrase or entry inhibitors are only available if you have documented resistance (or high intolerance) to the regular combos.  There must be a valid reason to get the more expensive drugs.  Most Brazilians wouldn't be able to afford the drugs anyway, so better some than none (minimum wage here ~ US$3600/year, most people make less than 10K).  We only get genotype resistance tests if there is treatment failure, not on start of treatment.

For the public health system in general... well, sometimes it works, sometimes it doesn't.  It depends on the state and city you live in.  Being close to a public university hospital helps.  My mother uses the public system exclusively, does her yearly mammography/paps there, found a breast cancer, treated it for free including surgery, chemo and radio, and gets her tamoxifen for free now.  But people literally die on the lines on some places in the country.  Nevertheless, you can always walk into a public hospital and be treated, sometimes badly, but at no cost.

Leatherman/ComputerTutor/mIkIE: I'm glad that "the three of you" can manage all this so gracefully! :) That definitely takes planning, wits, and balls.

[]s
Roger
14-Sep-2009 Tested positive
Last labs: VL <47, CD4 441/29%
Current meds: AZT, 3TC, Nevirapine

Offline GSOgymrat

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #7 on: December 05, 2009, 12:15:27 PM »
It has been my experience that the people who have the hardest time with healthcare expenses are the people who are self-employed with preexisting medical conditions. My younger brother is in that situation. He can't afford health insurance and relies on his ex-wife, who is a physician's assistant for minor medical care. If he has a major medical problem he is screwed.

Online Miss Philicia

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #8 on: December 05, 2009, 12:43:26 PM »
I'm an American citizen who has been on public programs for the past eight years.  I get all my medications for free as well as treatment and lab tests.  Not only that, but because of the very progressed nature of my HIV I've been on things like Fuzeon which are also the very most (by far) expensive HIV medications.  I also went on recently approved new HIV meds (Prezista, Isentress) as soon as they were FDA approved.

My doctor is also as good, if not better, than any private doctor I had the first eight years of my treatment when I was employed.  As the actual medical director of the largest HIV clinic in the country's fifth largest city he's very involved in publishing papers and conducting studies, as well as attending lots of conferences.  He also taught a class or two at an Ivy League institution at one time, though I'm not sure if he is currently.  For example, when I went in for my appointment last week I was his last patient, and he was going to be the guest speaker at Princeton University's World AIDS Day dinner to discuss current HIV research and holistic treatment issues and how they impact a clinical practice.

So yeah, the bottom line is that for me personally I'm getting much better care now than I did when I had private insurance, and I even had a really good private insurance policy at the time.
« Last Edit: December 05, 2009, 12:47:57 PM by Miss Philicia »
"Iíve slept with enough men to know that Iím not gay"

Offline Inchlingblue

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #9 on: December 05, 2009, 12:56:55 PM »
I'm an American citizen who has been on public programs for the past eight years.  I get all my medications for free as well as treatment and lab tests.  Not only that, but because of the very progressed nature of my HIV I've been on things like Fuzeon which are also the very most (by far) expensive HIV medications.  I also went on recently approved new HIV meds (Prezista, Isentress) as soon as they were FDA approved.

My doctor is also as good, if not better, than any private doctor I had the first eight years of my treatment when I was employed.  As the actual medical director of the largest HIV clinic in the country's fifth largest city he's very involved in publishing papers and conducting studies, as well as attending lots of conferences.  He also taught a class or two at an Ivy League institution at one time, though I'm not sure if he is currently.  For example, when I went in for my appointment last week I was his last patient, and he was going to be the guest speaker at Princeton University's World AIDS Day dinner to discuss current HIV research and holistic treatment issues and how they impact a clinical practice.

So yeah, the bottom line is that for me personally I'm getting much better care now than I did when I had private insurance, and I even had a really good private insurance policy at the time.

It sounds like a person has to have AIDS and go on disability before receiving that kind of care. Not exactly a ringing endorsement for the state of health care in the US.

As I mentioned before, if you are poor or rich you can get coverage. Or if you have a job that has excellent benefits and you don't dare lose that job or risk changing jobs, etc. Keep in mind many jobs offer sub-par coverage. One guy was on here recently saying he has insurance but his Atripla co-pay is over $500/month. Woo hoo. What good is that? He's part of the many millions who are under-insured.

Leatherman: I understand you had to jump through hoops to re-instate coverage once you moved. This should not happen, a person should be able to move freely within their own country without those kinds of stumbling blocks. Having said that, you will at the end of the day, be covered. That's a lot more than can be said of many millions who can't get coverage no matter how many hoops they jump through.
« Last Edit: December 05, 2009, 01:03:26 PM by Inchlingblue »

Offline GSOgymrat

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #10 on: December 05, 2009, 01:43:26 PM »
. One guy was on here recently saying he has insurance but his Atripla copay is over $500/month. Woo hoo. What good is that? He's part of the many millions who are under-insured.

Being under insured is often worse than having no insurance. Our county mental health agency will often pay 100% for people who have no insurance to be hospitalized. However if you have a any kind of insurance, no matter how little they pay, you don't qualify. To be hospitalized psychiatrically at the community hospital where I work costs about $1000 a day so if your plan pays 20% you are looking at $800 a day. If you weren't depressed when you were admitted you will be when you get the bill.

Online Miss Philicia

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #11 on: December 05, 2009, 01:48:13 PM »

Leatherman: I understand you had to jump through hoops to re-instate coverage once you moved. This should not happen, a person should be able to move freely within their own country without those kinds of stumbling blocks.

Conversely, I moved from NY to PA with no issues like he had.  However, I made a trip here two months in advance to meet with someone at an ASO to assure myself things would go smoothly.
"Iíve slept with enough men to know that Iím not gay"

Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #12 on: December 05, 2009, 02:12:30 PM »
As the actual medical director of the largest HIV clinic in the country's fifth largest city
It sounds like a person has to have AIDS and go on disability before receiving that kind of care.
of course,as they say, it's also all about location, location, location.

my city in Ohio had only one ID doc for the first 7 yrs I dealt with my HIV/AIDS. I firmly believe that the care I received during some of those early years could have been labeled "sub-par" compared to care others were receiving at the same time, say in San Fran or NY. That was more a fault of demographics than the doctor though. One of the disadvantages of living outside any large city is that there can be fewer people in an area with a medical issue and therefore fewer treating physicans with less up-to-date skills.

I switched to the 2nd ID doctor in town 4 months after he set up practice. However a few years later, the first doctor was no longer practicing (licenses revoked due to his alcohol problems), leaving only one ID doctor in the county once again. Then almost 2 years ago, my doctor added a partner to his pratice (my late partner was the 2nd patient for my doctor's practice partner). However, as it was in the past, there still aren't really any other choices in the county. In the past, you only had the choice of that one doctor or no doctor at all. Now if you don't like the doctor or feel you're not receiving proper treatment, you have the choice of no doctor or his partner.

the county I live in now in SC has about half the population of my old OH county (interestingly and sadly, according to the states' documents, there are approx 303 known HIV infections in this SC county, which is very close to a similar but smaller amount of 270 in that OH county), and there are only two ID docs here also. One, at the clinic I go to now, is only part-time and drives in from Charlotte NC two days a week, while the other doctor is on the other side of the county.

Conversely, I moved from NY to PA with no issues like he had.
all of my problems have come about because OH did not provide me with a piece of paper stating that they were no longer supplying me benefits.  ::) I had every other bit of information imaginable except that one thing. Matter of fact OH actually continued issuing me a medicaid card and food stamps for another two months before they finally closed my case though I had spoken on the phone and gone in personally to see my OH case worker before moving. It took 4 more phone calls and three letters from SC (including a letter from the health dpt and one from the clinic here in SC) to get OH to finally terminate my case. In October, I drove about 800 miles (up and back) to cross the state line and purchase nearly $500 worth of food with the OH food stamp benefits that they were continuing to give me. ::)

I finally received that termination notice on Nov 9 (three months to the date of when I arrived in SC) and got the SC medicaid card the day before Thanksgiving. I am hoping to have the food stamp issued resolved by Christmas LOL And that should happen as I have that OH notice in my hand, and an appt with the health dpt on Monday to resolve the food stamp application. At least when that goes through I won't have to drive so far for groceries  :D
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline aztecan

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #13 on: December 05, 2009, 02:32:17 PM »
of course,as they say, it's also all about location, location, location.
. . .  However, as it was in the past, there still aren't really any other choices in the county. In the past, you only had the choice of that one doctor or no doctor at all.

I think I mentioned this in another thread recently, but I am in this situation right now. The doctor we have here is the "Lone Ranger," so to speak.
I'm glad we have him and I am pleased with his care. But the poor guy wanted to retire three years ago and is nearing 70.

So what happens if he does retire or something? We get to drive 200 miles - one way - to the nearest other doctor.  I used to do that in the early 90s. It wasn't fun.

At least the nurses at the hospital no longer panic when an HIV positive person is admitted.

As for affording meds, we do have comprehensive insurance available with a program that will pay the premiums - if you fall under the income cap.

I have private insurance through my employer. It isn't bad, but I still pay $256 a month in copays for my meds. I don't have any assistance, that is all out of pocket expense.

I know others who, as someone mentioned have insanely high copays, like between $450 and $500 a month for Atripla.

There is a program that can assist with that, if you are eligible under the current income guidelines.

So, we play it by ear and do the best we can. We can't all live in big cities, nor do we all wish to.

But there are times I wish I had the services offered there.

For now, I am glad my doctor is here.  I have no desire to start making that 400--mile round trip again.

HUGS,

Mark

"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #14 on: December 05, 2009, 02:52:46 PM »
We get to drive 200 miles - one way - to the nearest other doctor.  I used to do that in the early 90s. It wasn't fun.
in the mid 90s, I had to drive my first late partner up to the Cleveland Clinic (roundtrip 120 miles) not only for the clinical trials he participated in (for which travel expenses were not reimbursed) but also a couple of times for actual treatment, as the doctor in Canton did not have the actual experience/knowledge. Thank goodness I was still well enough to drive and that we had a car back then.

But there are times I wish I had the services offered there.
My old Ohio city didn't even have an ASO (the Ryan White Fund was managed through a Family Support org) which is why it annoys me sometimes to hear people whining that no one will help them. When there isn't anyone to help, you learn to do it all on your own, or you accept the consequences.

Another issue concerning location (and similar to my food stamp issue) and to which I have a question, is that medical cards from one state are not usually accepted in other states.  Does actual insurance coverage cross state lines? Although the city of Charlotte is actually a few miles closer to my house than the city of Fort Mill (where my house address is because we live in SC, in  the county, and right next to the state line), I don't have coverage that extends to the doctors in that city in the other state.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline bocker3

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #15 on: December 05, 2009, 02:53:00 PM »
UK SL, you have to remember that most Americans are used to living in a brutally repressive society, so they're at least conditioned to accept this sort of thing. 

As for the health care issue -- yes, we have an extreme need to reform and make it both more affordable and  accessible to all Americans. 
I, however, don't see how the U.S. is a "brutally repressive society" -- and in fact find your assertion beyond absurd.  Myanmar is a "brutally repressive society" Sudan is a "brutally repressive society", not the U.S.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2013 691/31% <20

Online Miss Philicia

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #16 on: December 05, 2009, 02:56:28 PM »
We can't all live in big cities, nor do we all wish to.

But there are times I wish I had the services offered there.

For now, I am glad my doctor is here.  I have no desire to start making that 400--mile round trip again.

I'm sure I could find you a country place here where you'd only be driving 30 miles each way. 
"Iíve slept with enough men to know that Iím not gay"

Offline RapidRod

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #17 on: December 05, 2009, 03:17:34 PM »
We have 17 full time infectious disease doctors in our clinic and dozens of Interns in training. Don't have any complaints in service or treatments.

Offline skeebo1969

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #18 on: December 05, 2009, 04:20:20 PM »


When you tell the average American how things are for working class people in Europe, he really can't believe it.  The reactions range from 'how is that possible?' to 'why would They give you that?', but in any case nobody can believe happiness and well being for most is actually achievable in this life.  The next, of course.  They believe that.

  The reason I feel cheated after all those years of saying the pledge of allegiance to the flag in grade school.
I despise the song Love is in the Air, you should too.

Offline aztecan

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #19 on: December 05, 2009, 04:39:09 PM »
I'm sure I could find you a country place here where you'd only be driving 30 miles each way. 

I may take you up on that one of these days.  ;)
"May your life preach more loudly than your lips."
~ William Ellery Channing (Unitarian Minister)

Offline Moffie65

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #20 on: December 05, 2009, 05:59:26 PM »
Hey Mark,  Try looking up Carl Salka in Durango.  He was working for the VA when I was dying with PCP, and his creativity and stuborn "give a damn" kept me alive to now give you his name.  I know there is a state line involved, but I bet NMAS, and Santa Fe would find a way to make it work for you guys up in the four corners.  I have no idea if he is still in infectious disease, but I would bet he still is, and he is literally an angel.  Cute too.  :)
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline Moffie65

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #21 on: December 05, 2009, 06:08:35 PM »
UK SL, you have to remember that most Americans are used to living in a brutally repressive society, so they're at least conditioned to accept this sort of thing.  

OH Lord, you are certainly the pot calling the kettle black!!!  From a country that still has perverted, unelected Kings and Queens, demanding everything but a normal life; an underclass that is neither healthy or inviting, a country that is so affixed in the past they have to sell their bridges to capitalists in Arizona to raise cash.    

Sorry Lord, you shouldn't condemn things you know nothing about.  I may be poor, but I certainly know how to raise myself out of my current state and find an economic and healthy peace.  It might just take a few years.  

Mine are not the words of a poor man in a "Brutally Repressive Society"?
« Last Edit: December 05, 2009, 06:11:56 PM by Moffie65 »
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline Ann

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #22 on: December 05, 2009, 07:41:03 PM »
As someone who has lived under both the US medical system and the UK medical system, I sure know which one I'd rather have.

From what I see here in these forums, one of the big differences between the socialised medicine in the UK and the socialised medicine (I'm calling a spade a spade) in the US is that in the UK, I don't ever have to beg for my care. In the US you have to periodically fill out reams of paperwork and hope that the correct paperwork lands on the correct desk. Then you get to wait - and if they screw something up on their end, you get to beg them to have another look. It's the worst thing you can do to people who aren't well in the first place. From what I've seen here, this begging paperwork goes on with insurance as well. You guys can't win. Appalling.

All I ever had to do to qualify for medical care in the UK is to prove that I'm a legal resident. Once. Nineteen years ago. Never again since.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline tokyodecadence

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #23 on: December 05, 2009, 07:46:11 PM »
Hi guys,

Here in Brazil we get all our meds and labs for free, but there are consequences.  Here is what I've heard/been through so far:


I almost moved back to Brazil when I found out for the health care. But the wages there would make me so sad. :p My sister moved back though, and she loves it. But then again, she also doesn't have the hivy.
[.Fod„o.]

Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #24 on: December 05, 2009, 10:12:26 PM »
From what I see here in these forums, one of the big differences between the socialised medicine in the UK and the socialised medicine (I'm calling a spade a spade) in the US is that in the UK, I don't ever have to beg for my care.
wow. you ain't just whistling Dixie. ;) That's a good observation there Ann ;)
I was just talking to my Mom about my situation the other day and explaining how the very agencies (especially the gov't ones) set up to "help" people in bad situations are the worst ones about de-humanizing those very people.

back in 1993 when I saw how the system treated Randy as he "begged" for assistance, I swore I would never stoop to those levels. However, 2 days fresh out of a 5-day hospital stay with PCP, having nearly met death put a different perspective on it all, and I was sitting in an OH welfare office ready to do my begging for medical help. (and it took 2 months before I got that help and was able to get onto newer HIV meds rather than the AZT I had been on beforehand)
leatherman (aka mIkIE)


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Offline Cliff

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #25 on: December 06, 2009, 05:06:22 AM »
OH Lord, you are certainly the pot calling the kettle black!!!  From a country that still has perverted, unelected Kings and Queens, demanding everything but a normal life; an underclass that is neither healthy or inviting, a country that is so affixed in the past they have to sell their bridges to capitalists in Arizona to raise cash.
This Lord is not British.  He, apparently, lives in Thailand and is American.

Regarding the original message, it's based on a flawed assumption about health care in the US.  When I first moved here, I was constantly asked how could I afford to pay for my health care out of pocket.  I think a lot of British thinks that ALL Americans have to pay for their health care out of pocket, which is not the reality of the situation, even more so for those living with HIV.
« Last Edit: December 06, 2009, 05:25:28 AM by Cliff »

Offline carousel

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #26 on: December 06, 2009, 05:37:02 AM »
When I saw this thread yesterday, I winced at the message.  I wouldn't do without our National Health Service, but it seems a bit strange to message your pity about the US system to a group mainly living there.

The other thing is that I do hope Moffie was being ironic.  But on the surface, I read your message as pure bile directed back at all of us living over here, rather than at the person, who's message you took offence at.  I think that's unfair.

Offline BT65

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #27 on: December 06, 2009, 07:30:58 AM »
Well, here in Indiana, they do have disability Medicaid.  But, a person has a spend-down they have to meet in medical bills each month (yes every month) before Medicaid will pay anything.  My spend-down amount was $!38/month.  What results from this quite often (at least for me it did) was being billed whatever Medicare doesn't pay, because of being unable to meet the spend-down each month.  Like, right now, I owe a bill of a little over $300.00 to the huge organization my doctor's office is owned by.  Luckily, they'll accept $10/month.
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Offline Inchlingblue

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #28 on: December 06, 2009, 10:24:27 AM »
Miss P & Leatheman: I was wondering, when moving to another state, doesn't a person first have to establish residency (usually takes 6 months) in order to be able to apply for any benefits offered by that state? Is that what you had to do?

Offline UK_SL

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #29 on: December 06, 2009, 10:26:03 AM »
Well I'm sincerely sorry if I have offended anyone with this post - I can honestly say that it was not my intention to.
05/10/2009 ~ DIAGNOSED, CD4 = 8
22/10/2009 ~ CD4 = 11/VL = 430,000, STARTED ATRIPLA and SEPTRIN
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Offline Inchlingblue

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #30 on: December 06, 2009, 10:36:05 AM »
Well I'm sincerely sorry if I have offended anyone with this post - I can honestly say that it was not my intention to.

I think it's good to bring this topic up, it's a valid area of discussion. You should not have to apologize.

Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #31 on: December 06, 2009, 10:51:35 AM »
Miss P & Leatheman: I was wondering, when moving to another state, doesn't a person first have to establish residency (usually takes 6 months) in order to be able to apply for any benefits offered by that state? Is that what you had to do?
establishing residency is easy between the states. basically, along with your birth certificate and Social Security card, you just need to obtain a state drivers license/ID card for which you need either a utility bill in your name and new address, a piece of mail forwarded from your old address to the new address with an offical Post Office change of address label, or a gov't check with your name and address. Many states will also take other documents like mortgage papers or military orders also. Usually the process takes a month or less until you can get one of those documents.

Since I moved in with family and the utilities where already in their names, I couldn't use that form of ID. That is usually the quickest way since those services usually send you the first bill within a few weeks of establising service. Instead I had to wait (nearly the same amount of time) for a forwarded piece of mail or until the first of October to receive my Social Security disability check with the new address. When the SS check arrived first, I became an official South Carolinian on Oct 2 (just 3 weeks after my arrival into the state on Sept 9) after filling out a short form, taking the eye test, surrending my still valid Ohio drivers license and having my pix taken for my new license.
leatherman (aka mIkIE)


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Offline Inchlingblue

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #32 on: December 06, 2009, 10:55:09 AM »
So they don't require you to live in the new state for at least 6 months before officially becoming a resident there?

Online Miss Philicia

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #33 on: December 06, 2009, 10:55:54 AM »
Miss P & Leatheman: I was wondering, when moving to another state, doesn't a person first have to establish residency (usually takes 6 months) in order to be able to apply for any benefits offered by that state? Is that what you had to do?

No, I did not have to do that.  My ADAP coverage was seamless when I moved here (well, there was a flub up due to my new PA case manager's husband getting run over by a bus and killed a few days after I filled out all my forms and then the entire file was lost.  Lots of mayhem, but the person filling in eventually got me my meds the first month with an "emergency form" that they use here... but that situation was so odd that it doesn't count!).

The only stuff I had to do was fill out a couple of forms, provide income verification (easy in my case on SS) and show something with my new address on it.  I didn't even have a real lease or even utility bills at that point as I was living with a friend, but I must have explained that and maybe showed them my cell phone bill.

Really, it wasn't that big of a deal.  Maybe the states in the northeast are just a bit more sane with things.
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Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #34 on: December 06, 2009, 11:08:23 AM »
Well I'm sincerely sorry if I have offended anyone with this post - I can honestly say that it was not my intention to.
there's plenty of healthcare in America, but you made a valid point. whether it's through state/federal assistance, or private insurance, there are a lot of hoops to jump through to obtain healthcare (and if you screw that up you can be denied or find that even more hurdles are put in your path) and obtaining healthcare often costs quite a bit.

The shame of our system I think is that quite often when you are the sickest and need healthcare the most, the challenges to getting it are overwhelming and the procedures to obtaining it are de-humanizing. Of course, anyone in America can go into any ER and get healthcare immediately; but if you don't already have coverage through a gov't or private agency, you quickly become a second-rate patient and are treated as such, until you can obtain some sort of coverage.
It has been my experience that the people who have the hardest time with healthcare expenses are the people who are self-employed with preexisting medical conditions.
The "best" way to experience that second-rate patient treatment I spoke of is to be labeled as "self pay" (that's no insurance or state coverage, where you are paying the costs out of your own pocket)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Nestor

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #35 on: December 06, 2009, 05:42:16 PM »
For me--and it is ironic that I should have to say this--getting HIV was a big step up in terms of health care.  I had never had insurance in my life; at the job where I worked through most of my years in the U.S., I would have had to pay several hundreds of dollars a month for insurance, and it just didn't seem reasonable.  Since I didn't anticipate any health problems, I think I was being reasonable in not having insurance.  In those years I met many people who, either through self-righteousness or sheer gloom, delighted in telling me that one day I would be sorry.  The fact is that I was already living very humbly and spending that extra several hundred dollars a month would really have pushed me over the limit into poverty.  

The problem, of course, is that the millions of people in the situation I was in then do not go to the doctor when they have a small problem--for the uninsured, a simple doctor's visit of three minutes cost, ten years ago, seventy-five dollars, plus another twenty or thirty for whatever medicine the doctor prescrubed) and so small problems can grow into large ones.  

Once I had a terrible toothache.  The dentist insisted that I needed a root canal, which would have cost more than a thousand dollars.  This was impossible, and he finally agreed to give me a temporary filling, for a mere three hundred or so.  I have never needed a root canal; whether the "temporary" filling is still good all these years later, I do not know, but at the only subsequent dentist visit I have had--which was about six years ago and three years after the one that gave me the filling) they said that there was no tooth in need of a root canal, and if there ever had been, then the tooth must have remineralized on its own.

At the only other dental visit I have had in my adult life--this one in 1995--they insisted on removing my wisdom teeth, and I refused.  "If it ain't broke, don't fix it", said I.  In the fourteen years which have elapsed since then have, my wisdom teeth have revealed no need to be removed.  I have learned never to trust a dentist.

The problem I have with our system here is the idea of "pre-existing conditions."  This means that if I have HIV, or have had cancer or a heart attack, no insurance company will sell me insurance: as a for-profit company, they want to get more from us than they give.  The point is, I suppose, to intimidate people like the young me into paying those three hundred a month, every year for twenty or thirty healthy years, so that when we do need health care we shall already have paid more into the system that we shall have gotten out of it.   I simply wasn't prepared to make that sacrifice, and when I think of the few pleasures I had in my twenties, and how I would have had none of them had I been paying into that system, I am very heartily glad that I did not.  

Another way to put this is that the poor are discouraged from seeking preventative care.  A minor problem that would be cheap to fix goes ignored until it becomes a major problem.  This is one reason why we spend so very much more on health care here than people in any other country do.  

Now I have HIV.  Anyone in New York who makes less than, I think, 45,000 dollars a year--and I make far, far less than that--gets ADAP.  This pays not only for my periodic blood tests and doctor visits, and, I assume, any HIV medications I might one day take, but I shall in the next two months be visiting, alas, both a dentist (my doctor insists) and a dermatologist.  Both will be paid for entirely by ADAP.  I almost feel guilty accepting all of this for free.

Why do I feel guilty?  Because my poor mother's life, in its last two years, was clouded not only by cancer but by incessant struggles for health care.  Here, Ann hit the nail on the head: the horrible system made her beg for everything.   A woman who could hardly stand was forced to fill out reams of paperwork and have endless phone conversations pleading for a solution.  Two months before she died she was sitting up at night studying a hundred pages of impenatrable prose that contained the "fine print" of some new insurance scheme.  That is what is wrong with our system.

The health care she did recieve was very, very shoddy--until near the end.  When she had deteriorated to the point where she had become an "emergency" case, then suddenly a great deal of adequate health care became available to her.  It was too late.  I remember seeing the state-of-the-art facility that magically opened its doors to her when it was already too late, and wondering what might have happened had such care been provided two years earlier.  I am convinced that a rich woman with my mother's cancer would still be alive today.  

One of the first times I really liked something President Obama said was when he mentioned his own mother experiencing something very similar.  

But is this reprehensible?  I always like to put things in historical context.  In China, traditional medicines are often very cheap, but certain items--rare ginsengs or herbs from remote mountains--are quite costly.  There is a legend about a girl who spent seven years travelling to the western mountains to find herbs that would cure her lover--if you couldn't didn't have someone willing to do that, and you couldn't afford the rare ginseng or herb where you lived, you didn't get them.  In Europe in the 19th century medical care often took the form of being sent to take a cure in the medicinal waters of some town like Baden or in a sanitorium in the Alps; if you couldn't afford to go, too bad.  In The Brother's Karamazov, Snegiryov's family, besides living in crushing poverty, are afflicted with the worst health.  When a rich neighbor pays for a doctor to see them, the doctor decides that the son must go to Syracuse in Sicily, the daughter to the mountains of the Caucasus, and the mother must consult a specialist in Paris.  When Snegiryov points out that he can barely afford bread, the doctor replies: "That, alas, is not my business."  (Later on in the same novel, Dostoievski subjects the cult of the specialist--plus ca change!--to outrageous parody when the Devil, in Ivan's nightmare, mentions a bad cold which sent him to a specialist in Paris. The doctor was able to cure his left nostril, but to cure his right nostril he had to seek another specialist in Vienna.)  

In other words, neither in the East nor in the West has there been, historically, any conviction that health care is something to which all people have a right regardless of their income; on the contrary it has been a luxury and accepted as such, although from Dostoievski we can see that there was some resentment against this.  Yet we, today, do have such a conviction, and I think it is a reasonable one.  When our whole society being as wasteful and extravagant as it is, and when our governments spend as much as they do on frivious or vicious pursuits (the Monica Lewinsky trial, or ten years and millions of dollars to "study" the feasibility of high-tech voting machines--whereas as high-tech a country as Japan does just fine with people writing the name of their preferred candidate on a slip of paper--or foreign wars) it seems obscene that some level of basic health care should not be provided for everybody.  

 I wonder whether it would be of interest to anybody who cares about these issues to glance at the following articles.  The first two are both from Deroy Murdock, neo-conservative who states essentially that the health care in the United Kingdom is far worse than ours; the next two, from Nicolas Kristof of the New York Times, state that ours is far worse than that of the United Kingdom.  The odd thing is that each backs up his case with facts, and yet their cases are diametrically opposed.  

Pro:

http://article.nationalreview.com/?q=NjhmOGU0MDdhM2Y5YmEyMzVmNjZhZWZiMTA3ZTQyOTA=

http://www.realclearpolitics.com/articles/2009/08/07/government_medicine_should_horrify_americans_97810.html

Contra:

http://www.nytimes.com/2009/11/05/opinion/05kristof.html?_r=1

http://www.nytimes.com/2009/09/13/opinion/13kristof.html

Finally, this article that purports to refute Kristof's arguments in the first of the two articles above:

http://blog.cleveland.com/letters/2009/11/nicholas_d_kristofs_health_car.html.

I have not found any response to Murdock's articles from anyone on the "other side".  

Any comments from anyone who enjoys analyzing data of this kind would be very interesting.  

« Last Edit: December 06, 2009, 05:46:48 PM by Nestor »
Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Online Miss Philicia

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #36 on: December 06, 2009, 06:17:02 PM »
Nestor, do you think people read your posts when they're that long?
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Offline bocker3

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #37 on: December 06, 2009, 06:47:46 PM »
I simply wasn't prepared to make that sacrifice, and when I think of the few pleasures I had in my twenties, and how I would have had none of them had I been paying into that system, I am very heartily glad that I did not.  

When our whole society being as wasteful and extravagant as it is, and when our governments spend as much as they do on frivious or vicious pursuits (the Monica Lewinsky trial, or ten years and millions of dollars to "study" the feasibility of high-tech voting machines--whereas as high-tech a country as Japan does just fine with people writing the name of their preferred candidate on a slip of paper--or foreign wars) it seems obscene that some level of basic health care should not be provided for everybody.  

So, let me get this straight -- you didn't want to pay for health care because you weren't willing to sacrifice your "few pleasures".

Yet, it is obscene for the government to not make different choices and allow enough money to pay for health care?

Or -- to paraphrase -- you did not want to pay for your health care by giving up other things, but everyone else should pay for your health care by giving up other things.  I mean, our system is not a good one, but it's what we have today -- so it seems a bit ironic that you take "the government" to task for not being willing to do what you, yourself, admit to having been unwilling to do.

Now, I DO believe that we should provide healthcare to all Americans, however I had to point out your logic here because I do believe that it gets to the crux of why it is so difficult to get health reform done.  Quite simply -- too many want everything, but want others to pay for it & so few are willing to make any sacrifices for the greater good.

(Sorry, Miss P, I guess there was at least one who read this long, rambling post)

Mike
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Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #38 on: December 06, 2009, 07:05:49 PM »
Nestor, do you think people read your posts when they're that long?
my, my. testy today aren't we?  ;) :-*

I often read a whole book in a day, so it only took a few moments to read all of Nestor's post. (though I will admit I wasn't too interested in following his links; but more power to him for pursuing a subject - that's one of the great advantages to having an internet connection and instant access to knowledge) Having written many a long post myself, I just had to put in my 2 cents to defend the long-winded. ;) Often, I think people need to write a bit more to explain their thoughts so that we readers know where they are coming from. Quite frankly, I've often seen the quick little one-liner quips create quite an unwarranted dust-up. Plus around here, you should know that if you don't explain, link, and footnote nearly everything you type, someone will try to tear it to sheds.

Since I didn't anticipate any health problems, I think I was being reasonable in not having insurance.  In those years I met many people who, either through self-righteousness or sheer gloom, delighted in telling me that one day I would be sorry.
Though I might agree with your sentiment if we were discussing car insurance (a blatant rip-off that forces good drivers to pay for the mistakes of bad drivers who are allowed to continue being bad drivers), however nearly 100% of humans have health issues/problems at some point, so your logic was definitely not right there.  ;)
leatherman (aka mIkIE)


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Offline northernguy

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #39 on: December 06, 2009, 08:02:38 PM »
It really is heartbreaking to be on the outside looking in at the US system, and read some of the panicked posts here about losing their medical coverage and faced with the choice of bankrupting themselves and going on welfare or getting meds.  Its a false choice. 

Here the approach is that meds will keep you (hopefully) a healthy and working member of society.  However, while British Columbia covers the cost of HIV meds, some Canadian provinces require co-pays.  Its too bad there wasn't a national standard, but that would mean the Federal government stepping on the powers of the provincial governments.
Apr 28/06 cd4 600 vl 10,600 cd% 25
Nov 8/09 cd4 510 vl 49,5000 cd% 16
Jan 16/10 cd4 660 vl 54,309 cd% 16
Feb 17/10 Started Atripla
Mar 7/10 cd4 710 vl 1,076 cd% 21
Apr 18/10 cd4 920 vl 268 cd% 28
Jun 19/10 cd4 450 vl 60 cd% 25
Aug 15/10 cd4 680 vl 205 cd% 27
Apr 3/11 cd4 780 vl <40 cd% 30
Jul 17/11 cd4 960 vl <40 cd%33
April 15/12 cd4 1,010 vl <40 cd% 39
April 20/12 Switched to Viramune + Truvada
Aug 2/12 cd4 1040, vl <40, cd% 38
Oct 19 cd4 1,110 vl <40 cd% 41

Offline Assurbanipal

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #40 on: December 06, 2009, 10:36:04 PM »
...- that's one of the great advantages to having an internet connection and instant access to knowledge) ...

I think what Nestor had was instant access to opinion.  And the opinions of Mr. Murdock seem rather ... um .., let's say ...unpersuasive... what one might call poorly thought through special pleading.

Let's just start by saying that if the US spends 50% more of its gross domestic prodiuct on health care than other countries one would expect the US to be better in most categories of health care and to have overall better health outcomes.  Mr. Murdock's argument is that the US performs many more procedures (not a good thing if they are not necessary -- unless you believe in recreational medicine  ;) ) and that the US treats some diseases better.  Unfortunately he cannot make the case that most outcomes are better -- because they aren't. 

In essence, it is not surprising that if someone looks through the evidence with both hands, that even when the average care in the US is worse there are some places where it is better.  But, spin as you may, that is not a great argument for keeping the US healthcare system unchanged -- that's a pure logical flaw in his argument.

And when you look into the details, his case that US care is better is a bit shaky.  It rests mainly on cancer fatality rates as a percent of cancers diagnosed.  It is common knowledge that the US is much more aggressive at screening for cancer, and catches many cancers that are so minor they will not kill you.  So the US number of total cancers is bigger, because it includes less serious cases.  But that makes the stats he cites meaningless -- to look at the real comparison you'd need to look at total cancer deaths per hundred thousand, adjusted for the relative population ages.

His heart disease stats are better, although they should be adjusted to reflect  the relative ages of the populations -- but actually heart disease is likely a comparative strength of US medicine according to various studies -- but that doesn't make US health care in total measure up to what is available on average overseas.



5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline Inchlingblue

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #41 on: December 06, 2009, 11:25:02 PM »
Assubanipal,  your mind on these boards is always very clear and your opinions well-thought out and beautifully expressed.

Offline leatherman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #42 on: December 06, 2009, 11:27:28 PM »
I think what Nestor had was instant access to opinion.
quite right. not everything you read on the net is true. Thankfully though, I believe that more good factual data exists out there actually than biased opinions. It just takes some work to sift through the chaff.

And the opinions of Mr. Murdock seem rather ... um .., let's say ...unpersuasive... what one might call poorly thought through special pleading.
but Nestor never quoted Mr Murdock, nor said he agreed with that opinion. Nestor just mentioned the comparison between Murdock's and the contra opinion as issues worth looking into (shifting through the chaff, so to speak).

I took enough math/statistics courses in college to understand that numbers can be, and are, twisted to mean just about anything. You pointed out yourself the discrepancy in this kind of data by how cancer diagnoses and cancer outcomes are counted. I just finished reading "The numbers game : the commonsense guide to understanding numbers in the news, in politics, and in life" by Michael Blastland and Andrew Dilnot. Though it took me two days to finish, it was an interesting book about this very subject.

Too be honest, I pointed out that I hadn't even bothered looking through the links. Just seeing the profit margins of the insurance companies tells me that the money for American health care is mismanaged and far too much of it ends up as profits rather than back into the system for healthcare.

overall the American education system is that way too. The baptist high school I attended still charges a tuition of less than $5000. When I read that we are spending on avg of $10k per student in the public system resulting in worse test scores and worse graduation rates (which sound like decent markers to judge the data by), I know money is being squandered somewhere.

I'm a firm believer that a "public option" with basic care, and a general participation requirement (young people paying into the system as they will be withdrawing from the system at a later date) would help push our healthcare system into being a better system.

Another way to put this is that the poor are discouraged from seeking preventative care.  A minor problem that would be cheap to fix goes ignored until it becomes a major problem.  This is one reason why we spend so very much more on health care here than people in any other country do.
Nestor's opinion doesn't read like he agrees with Mr Murdock's opinions anyway, rather his post seems to point toward his belief that our American system does not function properly, so I think we're actually all in agreement here. ;)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Inchlingblue

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #43 on: December 06, 2009, 11:45:27 PM »
As dissatisfied as I am with the health care system in the US and as bad as insurance companies can be, part of the reason the system does not work is that the young and healthy opt out because they can't afford it. I did it too when I was in my 20s and my job did not offer it, I could not afford out-of-pocket premiums on health insurance.

That's why a single payer system that forces everyone to be on it, such as in the UK etc., makes sense from an economic standpoint. The pool has to be big enough in order for it to work.

This is something that private insurance companies wanted as part of health reform since it would mean so many more new customers, many of them young and healthy. But if it means they can keep premiums affordable and that they can't deny for pre-existing conditions then maybe it would work, even with private insurers.

I have a question for those in the UK: if someone can afford it can they purchase extra coverage over and above what NHS would cover? If so, is it offered by private carriers or by the government?
« Last Edit: December 06, 2009, 11:48:41 PM by Inchlingblue »

Offline leese43

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #44 on: December 07, 2009, 08:08:13 AM »

I have a question for those in the UK: if someone can afford it can they purchase extra coverage over and above what NHS would cover? If so, is it offered by private carriers or by the government?

Yes there is also private healthcare that can be paid for monthly, giving those that can afford it the choice. Some of the larger companies pay for their employees. It's private, not government.

Edited for typo
« Last Edit: December 07, 2009, 03:10:42 PM by leese43 »
Oct 04 - Neg
Aug 05 - infected
Oct 05 - cd4 780, vl 60k
Apr 08 - cd4 430, vl 243
Jul 08 - cd4 550, vl 896
Nov 08 - cd4 730, vl 1.8k
May 09 - cd4 590, vl 1.5k
Sep 09 - cd4 460 vl 34k
Dec 09 - cd4 470 vl 42k
April 10 - cd4 430 vl 88.5k
July 10 - cd4 330 vl 118k
Aug 10 - started reyataz/truvada/norvir
Aug 10 - cd4 380 vl 4k (12 days after starting meds :))
Sep 10 - cd4 520 vl 1.5k
Oct 10 - cd4 590 vl 44
Jan 11 -cd4 610 vl <40 cd4% 50
May 11 - cd4 780 vl UD

Offline J.R.E.

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #45 on: December 07, 2009, 09:19:00 AM »
also there are those of us who are covered by the Veterans Administration fully for all our HIV care. 


Tim,


I was surprised to read that the VA cares for 23,000 HIV patients:

http://www.myhealth.va.gov/


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 12/10/14,  t-cells are at 350,  Previous 8/25/14--- 402/ Viral load remains <40

 Current % is at 13% / Previous 8/25/14 11%

  
 63 years young.

Offline dixieman

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #46 on: December 07, 2009, 11:27:29 AM »
I have insurance (group policy) through my place of employment... plus I'm vested and when I retire I can continue my coverage at a small cost for retirees... 4 more years to retire but, I'll keep working until I am no longer useful... I'm very fortunate many are not...

Offline Wagner

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #47 on: December 07, 2009, 02:53:42 PM »
OH Lord, you are certainly the pot calling the kettle black!!!  From a country that still has perverted, unelected Kings and Queens, demanding everything but a normal life; an underclass that is neither healthy or inviting, a country that is so affixed in the past they have to sell their bridges to capitalists in Arizona to raise cash.    

Sorry Lord, you shouldn't condemn things you know nothing about.  I may be poor, but I certainly know how to raise myself out of my current state and find an economic and healthy peace.  It might just take a few years.  

Mine are not the words of a poor man in a "Brutally Repressive Society"?

I'd rather have an unelected King or Queen, unbiased and non-partisan, as our Head of State than an elected, partisan figure.  Regardless of Lord's ridiculous statement, yours is equally wide of the mark and not terribly current.

Offline buffaloboy

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #48 on: December 09, 2009, 09:24:46 PM »
I was thinking about this issue recently when the US healthcare reforms made the international news.
Like the OP, I honestly don't know how people cope in the US, having been used to the UK system where you can literally just saunter from one clinic, or one city, to another, and still receive all of your treatment free. I don't think of this as a privilege or luxury, I see it as my right, especially with a disease such as HIV where the efficacy of the treatment depends on rigid adherence.

I find it genuinely shocking that someone here has stated they sometimes skip taking their tablets so they can build up a back-up supply; I would expect this in the developing world, not a country as wealthy as the USA.

I don't know exactly how the Democrats healthcare reforms would impact on people with HIV but, from what I could work out, it seemed like a far fairer system than the one currently in place.

Staying healthy and alive should never come down to how much money you have in your bank account.

Online Miss Philicia

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Re: LIVING IN AMERICA - HOW DO YOU COPE?
« Reply #49 on: December 09, 2009, 09:38:42 PM »

I find it genuinely shocking that someone here has stated they sometimes skip taking their tablets so they can build up a back-up supply; I would expect this in the developing world, not a country as wealthy as the USA.

You may have read that incorrectly.  Even public programs here like ADAP allow one to refill their prescriptions five days early.  Doing so consistently builds a one month contingency supply in six months.

Private insurance is even more lenient than five days.
"Iíve slept with enough men to know that Iím not gay"

 


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