I was in an emergency room for a couple hours last night

[proud2BlibKansan]

My kid got kicked in the head. He's okay now but it was touch and go for a while there.

Anyhow, people watching in the ER.

A man came in carrying a little girl. She was about 10. There was a woman with him and a couple other kids and they were running and screaming that the little girl couldn't breathe. The nurse asked for her name and the woman says 'Chantelle'. The nurse said 'what's her last name' and the woman screams 'she's in your system!' The nurse says I need her first and last name. The woman screams 'she's going to die, please help her breathe!' So another nurse comes over and tells them all calmly that they want to help her breathe but they have to know her name. This whole time one of the nurses is trying to calm the little girl down and help her to breathe. So then the man says her name and another nurse looks her up on the computer and within 10 seconds he has her records. Whole incident took maybe 30 seconds. And everyone is calm. It was amazing how quickly it moved from hysteria to calm.

So then the nurse at the computer asks if they brought the little girl's inhaler with them. And the woman says 'we never got it because we couldn't afford it'.

I wanted to cry. And I wasn't too worried about own my kid for a few minutes.

[Maru Kitteh]

1. Oh shit.

1) Prayers for the little girl, I hope she's O.K.
2) I'm glad your son is alright.
3) This has got to stop.

[Liberal_in_LA]

2. How much does an inhaler cost?

[proud2BlibKansan]

4. I have no idea

Too much for that family.

[Wiley50]

5. Without insurance? could be 30 or 40 dollars depending on the type

Food for a poor family for a week

[XemaSab]

26. My inhaler is about 80

Plus the Singulair and the 'roids.

We're talking close to 300 a month.

The asthma tax sucks. x(

[Liberal_in_LA]

37. ouch!

[Fire_Medic_Dave]

10. Local health department would probably either give it to them or charge a minimal fee.

[proud2BlibKansan]

40. I wondered about that

Hopefully they were referred to the health dept. And it is still open.

[Posteritatis]

32. One of mine's $20, another's six times that

The latter is a long-term thing and about a month's supply for when my asthma gets especially bad (2-3 times a year; I'm good for a long time after it runs out), the other is a standard rescue inhaler that lasts me about a year.

Canadian side of the border there, though; I have no idea what they'd be in the states.

[tblue37]

84. The long-term steroid one, Advair, is $48 with my good insurance.

$229 without insurance.

[formercia]

43. My co-pay is $32.50 US per inhaler of Albuterol

It used to be $10., but the FDA ordered that Freon couldn't be used as a propellant because of Global Warming.

Fucked-up Bush priorities. Of course, it's patented by Big Pharma, so go figure.

Even with medication, I ran up over $14,000 US in Emergency treatment last Year.

It stresses me out just to think about it. Time for a Lorazipam. Fuck.

[tavalon]

44. When I was without insurance, they ran between 60 - 80

depending on whether it was the rescue inhaler or the corticosteroid, both are needed if one has frequent asthma attacks. Unfortunately with our fucked up health care "system", there is an inadequate safety net for poor people to get their necessary medications and often regular doctors won't accept medicaid but the emergency room must treat them (and that is quite as it should be) but the medicines would cost under $100 and the emergency room visit will cost about $500 each time. Our "system" is shortsighted. The poor do what they must to save their children and themselves but it the highest cost way there is and it just doesn't have to be that way. As well, most emergency rooms are overloaded because poor people can often only get seen there (rather than a regular doctor) if they have medicaid or worse, no insurance at all.

[truedelphi]

85. The worst situation of all is to be the working poor

You can make (just barely) enough that the County won't help you.

Sometiems a sympathetic health profesional might ahnd over some "samples" or what not.

But people in our country do die from lack of things like $ 80 inhalers.

[Le Taz Hot]

57. Depends on the medication

My Abuterol is about $17.00 at Wally World (cheapest) but my Advair, which keeps me breathing, is over $200.00 for one month worth of treatment.

On edit: That was 3 years ago -- apparently, like everything else, it's gone WAY up.

[HamdenRice]

62. A dollar or so in Cuba -- see Sicko. nt

[Javaman]

63. 5 cents in Cuba. nt

[tblue37]

83. With or without insurance? Wanna bet she doesn't have nsurance?

I pay about $30--and I have good insurance. My guess is about $150 without insurance.

[babylonsister]

3. "We couldn't afford it." Jeeze. So sad.

And positive thoughts to your son.

[proud2BlibKansan]

7. He got in the middle of someone else's fight

Just in the wrong place at the wrong time. Doctor was amazed he didn't have a concussion. But he has 2 black eyes.

Cops came and arrested everyone but my kid. They took him to the ER. And the kid who kicked him is going to prison. Battery. It's a felony.

[renate]

65. how scary

You must have been terrified. I'm so glad he's going to be okay. :hug:

[Egnever]

67. prison?

I mean I would certainly be a raging lunatic if anyone hurt my son but prison seems a little harsh for a fight.

[proud2BlibKansan]

73. It is battery plus the guy was already on probation for something else

So the detective said he will be going to prison.

[doc03]

6. Name? The first question I ever hear is, "Can I see

your insurance card?"

[proud2BlibKansan]

8. They didn't ask anyone that

I watched them check in a dozen people while I was there. And all they asked them for was their name. Most were in their computer.

[doc03]

11. This was in the US of A? n/t

[proud2BlibKansan]

39. Yes

[tavalon]

45. Probably a public facility then?

One of the reasons I have always liked working in public hospitals (and miss it right now) is because, while we hope to get paid, we put the patient first. Private hospitals put the insurance first and as a nurse who doesn't see it that way, I'm often at odds with the administrators.

[SmileyRose]

12. respiratory distress on a child is a whole other thing.

When my husband dropped last month and the life squad guys decided life flighting him the 20 miles in rush hour traffic to Atlanta was a better call........ when I got to the hospital no one asked me for insurance information for about 7 hours - and even then she was so apologetic to pull me away from his bedside. Even the life flight billing people are just now worried about who to send the bill to. He's so critical they put him in the surgical recovery area so he can have 1 nurse to himself at all times. He's been there for 47 days and counting. Our insurance company hasn't grumbled once. It's eerie.


I have no doubt when someone walks in reasonably coherent with a bloody towel on their hand or assorted limping and purple places, they would ask about insurance straight off.

[XemaSab]

30. I hope your husband is going to be ok

:pals:

[Fire_Medic_Dave]

9. We got called to a house for respiratory distress one day.

We could hear the guy gurgling from the bottom of the driveway as soon as we stepped off the fire truck. Obvious congestive heart failure. We had to ask his wife and his brother to put out their cigarettes as we walked up, they had 2 packs laying there. As I started assessing him I asked if he had been taking his lasix. He said no he couldn't afford it. His wife and brother who live in his house can smoke a pack a day but they can't afford a prescription that cost $5 for a month supply. So instead of getting his $5 prescription he called an ambulance ($1200) and went to an ER (who knows how much). That kind of stuff needs to be fixed otherwise any system will go broke.

David

[SmileyRose]

13. You know

I'd like to put that wife in the emergency room......

sorry, I'm not normally violent...........

[Fire_Medic_Dave]

14. Sometimes it's really hard to keep your mouth shut.

[nadinbrzezinski]

18. Yes and I am surprised you haven't learned the other lesson the field teaches

many a times our first impressions are way, and I mean this, WAAAYYYY off.

By the way, you know what cigs are good for? Hunger control...

Did you know that?

They could have been smoking partially for that reason... poor people sometimes do. Or war victims... long family story regarding that

[Fire_Medic_Dave]

22. Sometimes they are.

Thanks for the condescension though. Sometimes we get to know our patients really well too. You know the ones we go to every other day or so.

David

[nadinbrzezinski]

25. Like the seven year old we paid his casket for

after he died from ashtma during a cold spell? They could never afford the rescue inhaler, we left them when we had them

Or our favorite alcoholic, that we took to the hospital every week or so... and prayed to god took a shower, lice are nasty

Or the homeless woman I treated many a times for her uncontrolled diabetes

Yes, been there done that

And I learned not to judge

[Fire_Medic_Dave]

29. I never judge my patients.

Not the convicted child molester with chest pain. Not the gang banger that gets shot. Peoples relatives that ignore the health needs of their children or loved ones on the other hand are fully deserving of some judgement. Since they aren't my patient I have no obligation to them.

David

[nadinbrzezinski]

35. They are part of the unit you treat

Trust me, took nine years for me to get that lesson

IN fact, I probably owe that lesson to a drug dealer's wife... who I didn't want to listen to (in non medical matters) for my own and my crew's safety

She was my patient, her husband was not shot, and her son was killed

The family was responsible for thousands of deaths, directly and indirectly.

Over the next two months I learned that we are not judges... and cannot really truly understand the UNIT we treat

As I said, that patient and the lasix, you do not know if they were smocking to control hunger.. seen that too

Why this is a social problem... and to be honest, single payer is just part of the solution... not the full solution, especially at the lowest tier of society (and in some few cases, at the upper tier)

[w8liftinglady]

64. Dave -a sympathetic ear from a nurse

...and a former smoker

I cannot tell you how many times I have had to hunt patients down that have rolled outside to smoke,or were smoking in their hospital room.Now,we have a comprehensive program in my hospital to help smokers quit-including free nicotine patches for a year,and I always try to get a chill pill for my patients to help them get over the first few days....and yet,you would be surprised how many young,pregnant unemployed patients I have had who refuse treatment,which is free of charge.I still treat them with love,like all my patients,but I find it puzzling.

[Le Taz Hot]

60. I call BS.

A pack of ciggies are what, $5.00 now? I can feed a family of four for a day on $5.00 -- easy!

[Egnever]

68. WTF you feeding four people for $5

[orleans]

86. 4 people at $5 per day? will you please come and cook for me? n/t

[704wipes]

81. Nicotine also helps schizophrenia, actually

but the patch may be the way to go on that one, if the person is not already a smoker. But a LOT of schizophrenics, who are only partially controlled by meds, also are heavy smokers. At least in my experience. And, I would deny them almost everything/anything else before the smokes.

[ConsAreLiars]

15. The obvious answer is not to condemn the victim and family.

First of all, whether the meds would have averted the emergency is not something you are in any position to know.

Secondly, if your diagnosis is accurate, then providing for free what you claim is a $5/month supply to every patient who claims the cost would be a burden would obviously be the cheaper choice as well as the moral one.

Thirdly, a quick check of online prices suggests your price estimate is also wrong, as expected, given that misrepresenting the facts is a usual and necessary tactic for those of your ideological bent.

[nadinbrzezinski]

16. Here are links to online pharmacies

http://www.77canadapharmacy.com/buy/furosemide.php

http://www.drugstore.com/qxn00781181810_333181_sespider/furosemide/lasix/furosemide.htm

It could be five bucks on the lowest dosage, ordering from Canada... that does not take into account Shipping and Handling

On a co-pay it could be cheaper

But you are right,

We need single payer, universal health care

And like him, I faced families that also could not afford the familie's medicines. Hell, one of my young patients died because they could not afford the damn inhaler for his ashtma (he was seven) In fact, they could not afford the casket either, or the good suit ... so we medics passed the hat around.

I learned not to be judgmental, and actually to be thankful for what I had and still have.

It is high time we join the rest of the civilized world in that respect... well past time...

[Fire_Medic_Dave]

20. The patient was on a state health care program similar to medicaid.

[nadinbrzezinski]

21. I understand that, but as I said, I learned this a long time ago

do not judge

There is a lot that we, in an hour of interaction at most, can never get or understand.

A few times we are right, and a few times we have to talk to the local cops, and you know what calls those are.

Look I get the anger... trust me, been there done that. And that not judging patients was the hardest lesson I learned... it took over nine years to learn that...

As I said, you don't know all the details... nor can hope to

You could send social services... we both know how many trees that at times takes as well

[Fire_Medic_Dave]

23. I didn't judge the patient, I judged his selfish ass brother and wife.

[nadinbrzezinski]

36. and I will ask you again, why were they smoking? You don't know

you judged the complex unit that is a family.

You may not like this, and it may appear condescending to you... but get over yourself. You have no clue what the dynamic is, or why things happen

You feel that strongly, kill the damn tree and send social services... (done that too)

[Fire_Medic_Dave]

66. I appreciate your input.

I was merely trying to offer a little different perspective on things so as to facilitate a discussion on how family or personal choices may affect the cost or even the possibility of universal health care. Thanks again, be safe out there.

David

[nadinbrzezinski]

69. You be safe out there, I gained my sanity a while ago

and stopped doing this a while ago

;-)

Suffice it to say it gives me a different outlook in life

(I also did it in a country when the war on drugs was just getting hot, so got shot at more often than I care. I think it was the last round going to close to me that I went, what the hell are you doing?) That's when I went... enough of going to work and perhaps not coming home... something civies don't appreciate, unless they did it at one time.

What is true, not sure for you, for me... sharing in the lives of thousands of patients over ten years was a special privilege... and one that lets me appreciate even more life and having my family...

[Fire_Medic_Dave]

75. I feel very blessed.

I have been fortunate enough to hopefully make a difference for thousands of patients also. It was frustrating and disappointing sometimes to see the same patients making decision that adversely affected their health. I still always treated them with respect and gave them the best care I could give them, you just want the best outcome possible for your patients and sometimes they are they ones not allowing that to happen. That is one aspect of freedom though. Take care.

David

[nadinbrzezinski]

77. You too

Funny stories from those years too... and touching too

Funny, I'm not religious, but at times I do find myself saying a prayer when the FD rolls by lights and sirens, and have bought coffee to more than one fire\ems crew...

[marions ghost]

70. Maybe the point is....

that there are a LOT of things a family could do to sacrifice for family members in need. They could forgo meat (which they probably don't get much of) or soft drinks, or beer, or toiletries--any number of things at that level of consumption. But you are asking people on the edge to make sensible judgments. People scraping by (whether hooked on legal & exploitative drugs like nicotine or not) are often lucky to get through a day. Anyone who's ever been very poor knows that "personal choices" are a luxury more suitable for people with more hope and less hardship. I don't judge the poor for lack of self-discipline. It is crushing to be without in this society, no matter how one got there.

[Fire_Medic_Dave]

76. and the question is how could that affect universal health care?

[Marrah_G]

42. Just a thought:

I'm getting the feeling this is more about blasting you then it is about defending the family. Just a vibe I am getting.

[nadinbrzezinski]

71. And you'd be wrong

it is about not judging the unit we get to treat when we go to the field

That is actually one of the hardest lessons that an EMS worker should learn, and one that no instructor, trust me I tried, can teach

[tavalon]

47. I remember one time having an order from a doctor for a whirlpool

bath TID for wound care on a patient. When I got to her home, I quickly realized she had no running water. I was astounded that she got out of the hospital without anyone assessing if the home orders were even viable. I can't remember what we improvised but it broke my heart.

Poverty takes so much out of people, I was always glad when I could at least leave them space for dignity.

Our system is so broken that calling it a system is a sad, sad joke.

[ConsAreLiars]

31. We agree. This is a clear case

when the irrational results, easily avoidable costs in money and suffering, of a "for profit" heath care system are glaringly apparent. If everyone who moans and whines about the costs "to the taxpayer" of people using the ER for conditions that could have been prevented would be equally outraged about our failure to have a health care system in which such preventative care and medications was equally provided to everyone, regardless of income or any other factor, results would improve and costs would go down. But the profits of the parasites who now prevent universal care would also go to zero.

[tavalon]

49. Amen! You said it perfectly!

I don't call them insurance companies any more, I call them the parasites.

[Marrah_G]

56. I do agree with you completely- We need nationalized insurance YESTERDAY!

[Fire_Medic_Dave]

17. The family is to blame for choosing cigarettes over medicine. I don't care how you feel about that.

The doctor that prescribed the medication made the diagnosis. The diuretic lasix would have likely reduced the amount of fluid in his lungs, that's what it's for. He still may have had to go to the doctor, he likely wouldn't have had to go to the ER. My local health department will fill a generic prescription for lasix for $5. Poor choices such as this make medicine more expensive for everyone, idiots that don't see that are none of my concern.

David

[Maru Kitteh]

24. Thanks David, for laying it out flat. You are correct.

[ConsAreLiars]

33. You missed my point entirely.

Not surprised.

[Fire_Medic_Dave]

91. and you missed mine. Willful blindness I guess.

[Marrah_G]

41. I have to agree with you dave

The notion that they are smoking to mask hunger is absurd.

The only time that makes sense is when the cigarettes are cheaper then the food.

That 5-6 bucks a day X2 could have kept them from going hungry.

[tavalon]

50. I've never smoked

but I've been told it is one of the hardest addictions to kick. I've seen plenty with that monkey on their back and I wouldn't wish it on anyone. It's a slippery slope of blame that can rapidly lead to all of us being condemned for some lousy habit that we haven't kicked and end up with health consequences from.

[Marrah_G]

54. You don't have to tell me

I quit on Jan 1st. It's the hardest thing I've ever done. I didn't even want to quit. Shit- if I could afford it I would still be smoking. Every day I want to smoke. But I know if I buy that first pack...that's 40 bucks a week I am recommitting myself to. My hours at work were cut and I was JUST barely getting by. I quit because I could not justify spending food money for my boys on cigarettes.

At some point people HAVE to take some responsibility for themselves. People make shitty choices in life all the time. We cannot always excuse those choices away. I have made plenty of poor choices in life. Many of us have.

I know about being poor. I know about smoking.

But just one less pack...1/2 a pack for each of them per month, could save their loved ones life.

Bottom life though is that we need Universal single payer socialized medicine.

No one should ever die from lack of medical treatment due to money in this country.

[nadinbrzezinski]

78. Really, does not kill hunger? Ok

tell you what, true story

My dad's sister was hiding with her dad in a hole in Poland, you know the Germans would kill them otherwise

She started smocking to dull the hunger from chronic malnutrition. Not only her, but the whole family picked up the habit. That is an extreme example, granted, but a true one. To the day she died she'd gladly tell you that, and explain it slowly to you so you could understand it Perhaps if we ever meet with my dad, and it is not too painful, he can explain it to you.

By the way, this is purely anecdotal, but the google is your friend, here is some scientific data on this

http://www.springerlink.com/content/yh222422016wt641/

Between the addiction to nicotine and this little side effect many chronic poor do smoke... to kill hunger pangs and get whatever else crack nicotine gives them. It is a side effect many people are unaware off, and one that I saw more than once around the working poor that I encountered on a regular basis. Well that and a liter bottle of ahem coke, sugary, full of crap coke, since caffeine also has that secondary effect.

[Marrah_G]

79. I think you read my remarks incorrectly

When cigarettes are more expensive then food the notion that you smoke to relive hunger is absurd.

Now in some places where tobacco is easier to get then food, either through cost or availability, the issue of reducing hunger pains is indeed valid.

[nadinbrzezinski]

80. And I am not prepared to judge others

and that is my point

[seejanespottdick]

88. Do you walk on water, too?

[EFerrari]

28. Sometimes people make excuses for not going to the doctor or taking their meds

but the real deal is, they're afraid to be sick.

My whole family is like that. We even have a joke about it -- how many Castanedas does it take to get one Castaneda to go to the doctor's? It's not rational and only rarely about money -- or at least, not initially about money.

[tavalon]

46. It's hard not to get really annoyed at the choices made there

and yet, until we've walked in their shoes.........

[gbate]

72. Criminal.

The first thing that came to mind when reading this is why the family didn't have the child on the free children's health insurance plan??

People make wrong choices all the time regarding health issues. No amount of legislation can fix neglect or stupidity.

[ConsAreLiars]

19. Good work by the ER staff.

And utterly evil work by our health system as a whole. Any just society would do everything possible to make certain that no person gets denied routine preventative medicines, and any economically rational system would be able to reduce expensive ER visits by providing the care needed to prevent such avoidable costs. Unfortunately, Corporatism and Transnational Capitalism is neither just nor sane.

[XemaSab]

27. I've had asthma since I was four

and that is one of the most sad stories I have ever heard. :cry:

[goclark]

38. Me too

:cry:

[tavalon]

51. I spent many a night in the ER as a child for asthma as well

My mother died of status asthmaticus when I was eight. It isn't something to take lightly and since they didn't have the inhaler, they did exactly what they had to.

[Mollis]

34. I was friends with a girl who's family said that.

I was with her once when she had an attack, and it was scary.
But, her parents were just assholes. They could afford an inhaler for her. They just didn't. It's so sad.

Glad to hear your son is ok.

[Forkboy]

48. Bush turned this country into a banana republic.

There's no excuse for stuff like this. None.

[tavalon]

53. He put the cherry on top, but the health care system

has been falling apart since before I signed up and I'm coming up on my 20 year anniversary in the "system". Despite the scare stories, we should have had universal health care since the Depression but no dice. No money to be made by insurance and big pharma if we have UHC. Following the money is all it takes to realize we've been lied to.

[mwooldri]

52. Oh boy.

Yet another reason why we need UK style NHS *NOW*.

It knocks out the "We can't afford it" argument right out the window. That inhaler for that little girl would have been free. If the girl hadn't been so little (18+) her maximum cost per inhaler would have been about $13 in US money. Depending on circumstances even this cost can be reduced or eliminated.

We *NEED* a healthcare system that's free at the point of delivery.

Mark.

[Marrah_G]

58. Yes we do !

[nichomachus]

55. Not unusual at all -- not unusual at all

When I worked on an ambulance squad, we would often encounter people who took their meds much less frequently than was prescribed in order to save money. You'd ask them what meds they were on and they'd tell you. The next question was "Did you take it today?" I can't tell you how many times people said they took it every other day in order to cut costs. The problem is that with some meds, taking them every other day is ineffective. They might as well not take them at all. With other meds, it's worse, taking them every other day can actually make you worse.

I was in the pharmacy the other day waiting for a prescription -- a woman in front of me was at the counter. The pharmacist put three little bottles into a bag, punched some numbers in the computer, and said "That will be $685.00." And, you want to know why some people don't buy their meds.

Also -- you only spent a "couple of hours" in the ER. Good for you. Around here, waits of 6,8, or 10 hours aren't uncommon. If you're not in danger of immediate death, it could be longer.

[ThatsMyBarack]

59. Whatever happened to, "First do no harm"?

:shrug:

[proud2BlibKansan]

87. She was getting good care.

At least it looked like it it me.

I don't understand why you think she was being harmed (if that indeed is what you were implying).

[ThatsMyBarack]

90. No, not at all!!

"First do no harm" is how the doctors' Hippocratic Oath starts.

[dembotoz]

61. makes you proud doesn't it?

If you don't have decent health insurance you live
in a GOD DAMN THIRD WORLD COUNTRY
a Fucking banana republic

Best county on earth???
hardly

[applegrove]

74. That is really sad.

[ddeclue]

82. One reason we have so much asthma is that we have so much pollution.

We need to get rid of coal fired power plants and reduce particulate emissions requirements around the world for internal combustion engine powered vehicles.

[seejanespottdick]

89. If parents would stop feeding their kids dairy products, along with refined grains and knew how to

properly combine food, this would not be an issue. Asthma is just the body drowning in MUCUS!