It's so sad that the country where Richard lived, worked and paid taxes for about 30 years can't provide for him. I'm glad to be able to help. But what happens to those that don't reach the front page of HN? No one enduring the stress of a terminal cancer should have to stress about getting ends to meet during their last months alive. EVER
My family is one of them (stressing about getting ends to meet).
My momma, 55, otherwise ridiculously healthy, has terminal brain cancer among other things. She was diagnosed five days before her 55th birthday (10/25) this year -- [seemingly] out of the blue.
While her and my father have insurance (through United Health Group), there's no smooth sailing because her treatments are so "specialized".
I, at 22, cleaned out my savings and checking just to make sure that her treatments will be paid for, and additionally hire a wicked-awesome in-home PCA to make sure that she's living comfortably when I'm not able to be there.
I won't get into the logistics of why my father / her husband won't pay for things.
Never been so proud to eat Ramen Noodles.
Edit: you guys make me tear up. Thanks for the support and kind words.
You need to contact a lawyer. If you're clearing out your savings to pay for her treatment (but not for the in-home PCA), there's a good chance her insurer is committing a number of violations regarding her coverage. For many insurers, having a lawyer breathing down their necks about coverage decisions also tends to be a good way to get them to approve treatment without giving you the runaround.
So they would have spent that money on a lawyer instead. It doesn't matter what you do, you can't escape the astronomical cost of healthcare in the US.
As someone who has been in this situation, I can attest the only difference between the two situations is that if you go to a lawyer your mom doesn't get all treatments in the meantime.
Fortunately for me, the people at Mayo Clinic are amazing and gave treatment they knew we couldn't even start to dream to pay for. Not everyone is so lucky.
Ended up dropping the whole thing though. And lawyer said it was slam dunk malpractice, but reality bites and it's amazing what hospitals can do.
You're barely older than me, and I can't begin to fathom how I would handle that situation. Your actions demonstrate incredible selflessness, and a startling degree of competence in the face of something no one your age should have to consider.
Your efforts are truly amazing. I hope one day in the face of such challenges I could be half the person you are now.
This is certainly terrible news. I cannot imagine being in that situation. My thoughts with him and his family.
Just to answer the question above, the US provides SSDI insurance as part of the social security program to cover people with disabilities who cannot work. And many (most?) professionals also have additional long term disability insurance to cover the difference between SSDI and what their normal living expenses are.
Yeah, that's the pretty answer, kind of like "Cops are there to protect you" or "Poor smart kids get scholarships." That stuff exists in theory, but whether it materializes for you is arbitrary. The government can fight you for any length of time to refuse or minimize benefits, or they can make you provide prohibitive amounts of documentation you can never fulfil. People have to get lawyers to get benefits. Or you might luck out and deal with an SS office that's more accommodating.
In USA it's still much better. In many countries including India for example, people pay taxes for their whole life but if they lack money in the end, there's no health/food/shelter security - you are basically on your own. Legislative Bills are there, but they are just that - dormant bills. Nothing exists in reality.
I am also from a developing country (Uruguay) but if any of my family ever has cancer all our concern will be in the emotional issues, the economic issue are already resolve: basically the health system coveres all diseases that you could get.
I do not understand the countries that don´t have this, it is just logical that if you pay when you are healthy you must be 100% covered when you are sick (without excuses or having to justify anything). The most strange thing is that what I pay for my health insurance is less of what I heard it is pay in USA (I pay 70 USD per month) but the difference is big: I live assured that whatever happens I'll be covered, no disease will make me lose my house.
The problem is not about beeing a developing country or not, it is about political decisions that obligate insurances to do what they must do.
Uruguay isn't really a developing country. Not like India, that's for certain. Anyway, the health care system in the US isn't something that was willed into existence. It came from a series of accidents and circumstances.
I am a Canadian who occasionally complained about long (several hour) emergency waits for broken limbs from mountain bike downhill racing. The triage system prioritizes people who are dying, not adrenaline addicts.
... However ...
I got diagnosed with Cancer (lymphoma) in 2008. I was xrayed, CT scanned, blood tested and ultrasound guidance biopsied so fast that my head spun. From initial lump discovery to the onset of chemo was only a couple of weeks. Quality of care was first rate, and it's been 5 years. My experience with Canadian health care for a life threatening condition was extremely good.
I should also note that the cost of my medication was a significant $100k+ figure, not including chemo drugs, and this was all covered to an out of pocket of under $1k.
I was a working as a contractor, and didn't have any private medical insurance of any kind.
Needless to say, looking at the cost of treatment, and the ruinous effect it would have had on my (and my wife's) finances, I am very glad I live in Canada.
Sorry if I wasn't clear. I went from "Hmm, that's a weird lump" to chemo in just over two weeks. The quality of care was stunning, and the success rate is one of the highest in the world.
There are medications I need that cost an entire order of magnitude more in the US than in Canada. I'm not exaggerating. They're about $80 full price from Canada and $800 here in the US.
That's the pharma industry's 'America pays' system. Canada receives subsidized costs on medications like much of the world, and America picks up the tab.
Not sure what point you're trying to make here. The pricing on the medication was exceedingly high, about $200/dose, but as far as I can tell, that is the same price as in the USA:
The cost of the drugs was just picked up by the medical system instead of my pocketbook.
I have seen this argument before; American health care is expensive because everybody else is a slacker who can't pay. It's obviously false. US pharma companies aren't subsidizing Canadian drugs, the Canadian government is. That Canadian drug prices are lower is more a function of the broken US medical system than anything else.
Here in Fiji we've always had universal healthcare. When people need surgery/treatment they can't get here, the government sends them to India (Used to be Australia/New Zealand, but not any more).
Context: Australian and NZ relations with Fiji have seriously deteriorated (expelled diplomats, aid cuts, trade sanctions) since the military coup in 2006, and the resulting dictatorship there. [0]
Despite the diplomatic meltdown between Fiji and the western world, Australia and NZ continued to offer healthcare to Fijians. It was a decision by the Fijian government to start sending people to India instead. [1]
Also, Fiji has very large ethnic ties with India. [2] The country has a history of deep social and religious divisions as a result. [3]
I don't think there's any suggestion or indication that it's actually preferable to have surgery or treatment in India rather than Australia or NZ.
As an Australian, I'm sorry that Fijians can't come here anymore under their healthcare program.
The choice to send patients to India is purely based on financial, rather than political reasons. Even with the higher airfares, it often turns up significantly cheaper to send patients there. Of course in outlier cases where its thought that there is a higher chance of survival in Aus/NZ, patients are sent there instead.
Australia and New Zealand only deny medical visas for people in the Fiji government and military (and their family).
Yeah. Thanks to India's affordable health care, we don't have to be dependent on this national scam called health insurance. We just go to doctors, they give us treatment, we pay money, that's it. I remember how here in US I had to go to a doctor to be told "You don't have any disease, that happens to everybody" (no diagnosis) and charged $400. Insurance paid $300, I paid $100.
Right.. That "national scam" is working great all over Europe. It's cool when you can pay your treatments, but cancer treatments are in the 6 figure range - enjoy paying that from you bank account.
The funny thing is, at least here in the US, even if you have medical insurance you are totally ripped off your pockets if you have something like cancer. Mostly, you just don't pay the price which was anyway artificially inflated by this scam I'm talking about. There was an article only a few days back about this guy who had his appendix treated:
http://imgur.com/a/WIfeN
He had to pay $11k out of the total $55k bill, rest was paid by insurance. ($7000 for a CT scan? $4500 worth of Anesthesia? I'd be surprised if one still doesn't think these are artificially inflated prices)
I'm not sure how much would he be charged if this whole insurance thing was not there - may be ~$11k?
(Just for the curious: In India, that operation in the best of hospitals would have cost him may be around $1600 without insurance. With insurance, he'd save most of even that. )
That image is insane. $7,500 for a couple of hours in a recovery room. Not sure how that can be justified, they're clearly just getting as much money out of people as possible. As the services are not exactly optional.
>On the other hand, if you adjust the costs for purchasing power, the unfortunate result is that most of the people are pretty much fucked.
They are not. As I said, this was the cost in the best of hospitals. In government hospitals, poor people get medical care for a fraction of it. Of course, the health care system is still not good, but I'm convinced that a US like system of insurance is not a solution either. Canada and some other countries have it much better.
>In fact the US would look cheaper for the majority of the population.
No, it's not. Had this system been working, millions of Americans wouldn't go outside USA to get basic treatment (many of them go to India). Something is fundamentally wrong here ([1], [2], [3], [4]).
I agree with some of your points here, but this has to be noted.
It's not 7.5 million US residents per year, it's 750,000.
And this:
"The nonpartisan Fraser Institute reported that 46,159 Canadians sought medical treatment outside of Canada in 2011, as wait times increased 104 percent — more than double — compared with statistics from 1993."
Calculated upwards, that would be 404,000 or so on a population equal basis with the US. A lot of Canadians are seeking treatment abroad too.
Humm ... That's a mistake on my part. But this is because I'd seen another article from 2009 [5] which clearly said it was 6 million. And this article was from 2014 so I quickly read that as 7.5 million.
See my reply to markdown for context on his/her comment (if you're not aware).
You should clarify your comment by mentioning what state and city you live in, how much you earn a year, and how many multiples that is of the average income in India, and in your state.
Healthcare in India is operated by the states; there is no national program. Care is not consistent. [0]
In India, can doctors provide food? I'm serious. 42% of Indian children are malnourished [1] - a frighteningly higher rate than the average malnourishment rate of sub-Saharan African countries.
This is but one figure representing India's overall healthcare system (or lack thereof), and unhealthy populace.
Health care in India has a lot of issues, but it's affordable for most part. And if you read my reply to plaguuuuuu below, I wrote that it's still not good - but going the US way of insurance lobbying is not a solution either (because certainly, it's not working). Unfortunately, there are a lot of people who don't even have money to pay food, understandably they won't have money to pay for medicines. They get free government treatment in many cases (though no free food). There is a new Food Security bill passed late last year which is made to tackle those 42% undernourished children and other poor people. Implementation of that, in a populous country like India will take time. Poverty is a complex problem to solve.
Per the article you linked [1], the wifi is funded by a donation from the Fuhrman Family Foundation, not public funds. Additionally the quote from Bloomberg included substantially more than the Knicks and Nets: "Our new Harlem wireless network brings critical connectivity to residents and visitors, giving them 24/7 access to everything from education materials for kids, to information about Harlem’s rich history and attractions, to everyday needs like paying bills, checking library hours — or even just keeping tabs on the Knicks and Nets"
1) Larger risk pools are better. Let's say you have your ten closest family members and friends, and they're willing to spend an arbitrary amount to save your life. Despite that, a diagnosis like brain cancer or a severe heart attack with complications is likely to bankrupt all of them. Make it hundreds of millions of people, and the bumps are smoothed out to oblivion.
2) Lots of people are embedded in communities that have fewer resources available than other communities. You're damning them to die--or, in this case, die in a significantly less dignified way without proper palliative treatment--just because their friends and family happen to be poorer.
3) What about the people who don't have many family members or friends? Do we just want to condemn them to suffer, merely because they thrive with only a few friends instead of many?
Private insurance helps with these problems. Some people, however, aren't willing, knowledgeable, or rich enough to purchase health insurance. Even if you hold them in contempt and think that they deserve to die because of their lack of insurance, as a society we don't like that. So we can either (a) provide everyone with public health insurance/care or (b) require everyone to purchase insurance. Some countries go with (a), some with (b), most a mixture of the two.
It's best that whatever country we're in, we look at the countries that have had the best results in health outcomes and copy them as best we can in new local contexts.
You (and the downvoters) don't get it: my surprise is that bestham's first reaction was not human sympathy for someone suffering; his first reaction wasn't to try to help; his first reaction was to score a cheap political shot.
That's awfully sad, albeit not as sad as the fact that it was successful.
You're right, I don't get it. We're not politicians, we're developers. He's pointing out the fact that he's paid taxes for $x years and in the moment he needs the most help, his government is not here to provide for him.
He's not saying Obama or Bush or Clinton or Bush or $foo, he's saying the government.
My first reaction was to provide some help for him, I did and boy am I sorry for him and everyone in his predicament. While doing that I could also identify an underlying problem in the way he has to beg for help and how unfair a system like this is to everyone that is suffering from similar diseases, terminal or not.
If Richard and his family would not have to care about the money, this thread could be about nothing else beside him and his achievements.
Not to be rude, but that doesn't obligate the government to provide that particular service. Just because I pay taxes doesn't obligate the government to provide me a house. Why is that the case for health care?
To answer your question seriously and without any implied political bent, the reason is: healthcare in the first world has become considered a right or entitlement. It's really no more complex than that.
>To answer your question seriously and without any implied political bent, the reason is: healthcare in the first world has become considered a right or entitlement.
That's the thing though. It has only become a right or entitlement in the places that provide it. I'd wager people would feel the exact same way if their government provided housing when compared to countries that don't provide housing.
It's a purely subjective priority issue, is what I was saying. All things that are entitlements only become such because they're first provided, naturally (can't have an entitlement without it first existing). I suppose your implication is meant to be that if it weren't provided, it could have never become an entitlement - that's true, but it wouldn't prevent the population from looking across the border or oceans and yearning for the entitlements others have in first world nations.
No doubt entitlement priorities vary based on the development level of the country, the culture, and so on ad infinitum. There is hardly a social safety net in China for example, the population is heavily expected to handle its own savings. Most likely their population will gradually demand more entitlements, looking to copy what others have done.
There are obviously all sorts of arguments that focus on bankruptcy, high costs, the burden of being without a job, and so on when it comes to healthcare - that sound far more reasonable than other entitlement arguments (eg should everyone be given a free yacht).
America of course does provide free and or heavily subsidized housing (not free house ownership mind you), in every state in the union in fact (along with federal programs). Mostly it's a matter of what you qualify for, and where (varying based on what's available in your location, and what your income is, etc). I don't think all entitlements are created equal in terms of demand or import; the population of a country is going to regard some as far more important than others.
Well, it's in the best interest of society as a whole to keep people in good health. For many reasons but in particular public health, because if people don't get vaccines or don't cure infectious diseases it can spread and potentially affect everyone.
This is why in France we have universal healthcare, that goes beyond legal residents but also benefits illegals (with AME, Aide Médicale d'État).
A point i think is important that hasn't been explicitly raised in any other reply to you is that a a societal reliance on friends and family as the measure of last resort is significantly less egalitarian than nation state support could be.
