Why We Need Healthcare for All: The Idiocy of Self-Diagnosis

Patients without healthcare make bad self-diagnoses. I’m shocked.

The NY Times has a heartbreaking story about people under 30 who can’t afford healthcare. It’s pretty horrific: juvenile diabetics who have to switch from insulin pumps to injections (which lowers blood sugar control), a woman who went to the emergency room for 46 hours and wound up owing the equivalent of a year of college tuition, and so on (that I can say “and so on”, and you can probably come up with your own examples is indictment enough). But this gobsmacked me:

Ms. Polec’s roommate, Fara D’Aguiar, 26, treated her last flu with castoff amoxicillin — “probably expired,” she said — given to her by a friend.

That repeating thudding noise you’re hearing is me smacking my head against the wall. ‘Flu’–probably winter vomiting disease and not influenza (although how could one know? There was no medical professional involved)–is a virus. Amoxicillin is an antibacterial–that is, ineffective against viruses–and can occasionally cause nausea or diarrhea (and severe allergic reactions in very rare cases). Not only is this is irresponsible use, but inappropriate antibiotic use can harm patients.

This is why we need a health system where sick people can contact trained medical personnel.

But at least Wall Street will still get some bonuses. Good thing we have that covered.

This entry was posted in Antibiotics, Basic Human Decency, Healthcare, Public Health. Bookmark the permalink.

22 Responses to Why We Need Healthcare for All: The Idiocy of Self-Diagnosis

  1. Sam C says:

    It’s intriguing to see in your medical dramas how whole story-lines can be based around patients’ ability to pay.
    That just doesn’t happen in most countries of Yurrp. We even have little cards when we go abroad so that other European countries know we’re in a state system (and not a “health tourist” from outside looking for free care). Unless things get very sticky and you want ultra-expensive drugs or cutting-edge (ha!) surgery, the problems are of supply, not of price.
    Yet right-wingers in the USA seem to think it’s a really brilliant thing that you don’t have universal access to health care. Do they hate the poor, are they stupid, crazy, or what?
    In the UK, the NHS (National Health Service) was set up by a Labour government after the second world war, but it’s interesting that ALL political parties make it absolutely clear that they think it’s A Good Thing. They argue about how it should be run, and about value for tax money, but all know how unforgiving the electorate would be if access to basic healthcare was rationed by ability to pay.
    Why doesn’t the US electorate think like that?

  2. Martin says:

    I don’t understand how the U.S. can not have universal health care, but what I find even more inexplicable is the fact that you still spend more on health care than we do… Where is the waste going?

  3. Julie Stahlhut says:

    We also have a lot of people in the situation where they don’t get paid sick time off from work. So, they wind up in the workplace while sick with contagious illnesses. Then, you eat in the restaurant where the sick person is serving food, or sit on the bus next to the fellow commuter who is coughing and sneezing, and you get sick too.

  4. Colin says:

    I’m fairly certain that part of the high costs is 1) malpractice insurance and 2) capitalistic insurance companies. I can’t readily find numbers for #1 and I’m generally fine with #2 since companies should exist to make money.
    If you have an ethical issue of profiting off of health then you have an entirely different argument to make against both insurance companies and doctors.
    I would venture a guess that a lot of the overhead goes to tests. The need of which may come from being thorough enough to avoid malpractice.
    “Hating the poor” is such an ignorant, flame-bait comment if I ever saw one. I whole-heartedly disagree with the position that health care is an entitlement. As a fairly strong libertarian I am appalled at the slippery-slope the US is in toward socialism. Nationalized health care is but example of such. The “American Dream” dies when you are entitled to all of its benefits.
    I think I’m entitled to a brand new car every year, aren’t you? I want to know when someone will pay for my 15,000 square-foot house. The recent stimulus and bailouts are getting me there.
    Why should you have to work hard, or work at all, when you can get retirement, health care, college, food, and housing all handed to you because you “deserve” it?

  5. Julie Stahlhut says:

    … um, because too many people are working their asses off at one or more jobs and STILL can’t afford health care? Or because many people who WANT to work are too debilitated by illnesses that they — or their parents — couldn’t afford to treat?
    I have a definite American Dream. It’s a dream that we’ll finally catch up with the civilized world, and no longer throw away talent because we’re too miserly to help keep it healthy.

  6. frog says:

    Colin: Why should you have to work hard, or work at all, when you can get retirement, health care, college, food, and housing all handed to you because you “deserve” it?
    Why? Because you have pride? Because you have an active mind? This is where the libertarians lose people — (and why folks will summarize with “you hate the poor”): the underlying assumption that folks are almost entirely motivated by vulgar greed — that we’re all a bunch of cheating scumbags. Yes, most libertarians I know, when in vino veritas do come out with that basic emotional orientation.
    Now regarding whether private companies should or shouldn’t profit from healthcare: you’ve just turned a practical question into a moral one. Of course private companies should try to maximize profit; but now much we should allow them to is a separate question. And not for moral reasons, but a simple question of bang for the buck — are health outcomes in actuality (and not just in some ambiguous philosophical theory) improved by one system, relative to cost?
    Do Europeans live longer? How much do they pay for that extra life? How much of that is due to their health care system? No one cares what Hayek or Marx has to say about this — bullshitters extraordinaire. I want to see the cold hard numbers of life-spans, money spent and the feedback between life-style choices and medical regimes. We know that the Brits have life-style choices as poor as Americans — yet they still live longer at a lower cost!
    That’s what you need to explain Colin, not muttering some simplistic philosophy of human motivation, where we’re all reduced to mere consumption machines — it’s as insulting as Marxist attempts to reduce us to production machines.

  7. Yet right-wingers in the USA seem to think it’s a really brilliant thing that you don’t have universal access to health care. Do they hate the poor, are they stupid, crazy, or what?

    As evident by the dumbass libertarian, Collin, healthcare is considered a luxury item. They think that it only affects the indidual, and so the rest of society shouldn’t worry if their neighbor is carrying some infectious disease because they can’t afford to go to the doctor. If had any inkling of the meaning of the phrase “opportunity cost” they would be able to grow up past this adolescent fantasy Ayn Rand objectivism.
    I hope you don’t lose your job or your investments get tanked because of a madoff wannabe, Collin, cause I don’t want you sneezing on me.

  8. KeithB says:

    Many PCP’s (like my recently retired one) will give you a perscription for an antibiotic if you have a virus “just in case”. Though more likely it is because people want something more proactive than “lie down for a few days.”

  9. dean says:

    So apparently the only thing that keeps Colin working hard is the fear of not being able to retire, the fear of not being able to get health care, the fear of not being able to eat or feed his family, and the fear of being homeless. That sounds like indentured servitude to me, not a life of freedom.

  10. Colin says:

    It’s hard to be motivated to continue discussion with someone who calls you dumbass and then misspells your name. If you want to boil down an entire political philosophy into a single post then you’re likely to make assumptions. If you think you can boil down your position on something so monstrous as “health care” into a couple paragraphs then I challenge you to do so. But, frankly Mike, your response is hardly indicative of that you can because your response is filled with hyperbole and vague, unexplained philosophical references.
    I have no issues with making health care more affordable. I have no issues with wanting everyone to have health care. I have no issues with wanting people to be healthy. I want my neighbors to be healthy (at the very least: not sick). I recognize this is a social issue and people do not exist as isolated spheres of existence.
    What I have issues with is having to pay for others’ anything (health care, retirement, whatever). I have to spend my time to earn money and some of that is forcefully taken from me. I make it a goal to be self-sufficient and consider it a failure if I can’t. And there is no need to muck up the discussion with ambiguous words like “luxury” because it is a highly subjective word. Cable TV is a luxury to some but “just tv” to others. Health care is a luxury to some but “just health care” to others.
    Julie, I don’t see the link between how hard you work and entitlement to anything. It’s hard to see your point when you discuss of an undefined “civilized world”. That said, do you make a personal goal to help those without health care? Did you become a medical professional and give your services away for free? You volunteer at a free clinic or something? Anything of the sort? Basically: do you walk the talk?
    frog, so one of the reasons people work is “pride”? And barring your inability to work your “pride” should be sufficient enough to have things you can’t gain on your own (regardless of the reason)? “Pride” is all you need? I do not work because of greed (love the Rand association by Mike because all libertarians believe in Rand, yup, it’s in the Code of Libertarians) but because there are things in life I enjoy and they cost money. Seeing my parents requires gas money. If you could answer the “health care problem” by boiling it down to numbers then this game would be over, but you can’t and it’s not. If it’s a numbers game then why does pride matter at all?
    Is it human decency to rob Peter through taxes to pay Paul’s health care? How much do you take from Peter before it is no longer acceptable? Is it ok to take money for health care? Health care + housing? Health care + housing + food + retirement?
    If you think this debate is void of moral/ethical issues and can be solved by numbers alone (frog) then there’s no point in calling me a dumbass because you can show me some numbers, be done with it, and prove me one outright. Like frog said: show me the numbers.

  11. Colin says:

    Dean, as I said in my previous post I work for money to do the things I like. I believe it also expected that I pay for my own health care, my own housing, my own food, my own retirement, my own…anything. I expect to be self-sufficient to the extent of the things I can.
    I can’t raise my own army to defend myself so I don’t and health care is not on the order of military protection.

  12. llewelly says:

    Colin:

    Cable TV is a luxury to some but “just tv” to others. Health care is a luxury to some but “just health care” to others.

    How many people have died because they didn’t have cable tv?

  13. frog says:

    Colin: one of the reasons people work is “pride”? And barring your inability to work your “pride” should be sufficient enough to have things you can’t gain on your own (regardless of the reason)? “Pride” is all you need?
    That’s the kind of reductionism that libertarians always produce — it’s really reminiscent of Marxism. Is “pride” all you need? Did I say all? Where? I need to eat, I need beauty, I need love, I need pride, I need solidarity, I need to be productive — some of those things are economic in nature, and some are not. They can’t be reduced to a monotonic order — even Mises recognized that!
    Here’s the simple numbers — Americans pay significantly more for shorter life spans. Something is wrong there. We can argue about methods — centralized versus decentralized — but the market is clearly not correlated with good health care results. You can google it all yourself; it’s not in the least bit controversial.
    And for the robbing Peter to pay Paul — well, that’s so naive as to be laughable. There are no clear economic lines between Peter and Paul in the first place. Neither Peter nor Paul produced the environment that made Peter wealthy, and most of Peter wealth is dumb luck — any survey of the wealthy shows that; merit based distinction are minimal, maybe justify a wealth gap of 2x or 10x, but not 100x or 1000x; no one is worth a thousand other people, it’s just an unavoidable structural defect.
    Let’s look at reality without vast ideological blinders. Let’s follow the lines — where did every penny come from, what was every exchange, every bit of information and every bright idea, every calorie expended. Very quickly it becomes obvious that any ideological approach is just bullshitting. Let’s look at the results.

  14. Stig says:

    Hey Colin, I agree with what I believe is the essence of your argument, freedom isn’t free. But listen up man, I can get it for 25% off if I can convince some of my friends to pitch in and if they can get their friends to join in we can save another 10. No doubt freedom isn’t free, but at the same time it need not be so usuriously expensive……dumbass.

  15. Troublesome Frog says:

    Is it human decency to rob Peter through taxes to pay Paul’s health care?

    I’m not sure about human decency, but if the net effect is that Peter and Paul pay less overall for the same results by cooperating (however asymmetric that cooperation might be), it may be worth considering as a purely practical matter.
    My problem with the moral calculus of pure libertarianism is not that it makes control over one’s private property a good worth pursuing. It’s that it often makes it the only good worth pursuing.
    Is losing control over the change in your couch morally equivalent to the deaths of a hundred million people? Should I be taxed into poverty so somebody else can afford a bigger house? We all draw lines somewhere. An ideology that thinks that such line-drawing is morally reprehensible tends to get in the way of good practical solutions.

  16. bybelknap, FCD says:

    Hey Colin,
    If you want to live in a civilized society then you pay taxes in exchange for services. Even services you don’t consume. If you don’t like it, fuck off. Go live in the woods and shit in a hole in the ground. If paying taxes is taking your hard earned money by force then don’t pay them. Don’t expect to live with other people though. Jackass.

  17. Apologize for misspelling your name. I stand by my assessment of the libertarian position on healthcare, and substitute a less nasty word for you than dumbass that has the same intent. You choose.

  18. MikeB says:

    Even here in Yurrp we have people trying to self medicate rather than see a doctor. There has even been a recent spate in the UK of people even trying to do their own dental work, although this is not so much due to cost as trying to find an NHS dentist (due to our governments attempt to make our system more ‘efficient’).
    We also suffer from idiots using old antibiotics, etc, although apparently, according to this article http://www.guardian.co.uk/commentisfree/2008/dec/16/comment-france-health-colds-poirier if your French, doctors will give you antibiotics for virus’s, thus saving you the bother (the French healthcare system being the best in the world, even at encouraging antibiotic resistance). They will also ask you to undress entirely if you are young and female, in order to examine you properly – Oooh La La!
    Colin – as my fellow Brits have already pointed out, we like our NHS, despite the best efforts of our politicians to screw it up. We pay taxes. Some of them pay for the NHS. We pay less per person than you do for healthcare. And in return its free. No co-payments. No insurance companies suddenly jacking up prices. No healthcare tied to a job. No denial of care. What’s not to like?
    Why do libertarians make reality such hard work?

  19. MPL says:

    Dear Colin,
    I assume you have private insurance, or insurance provided by your employer. If that is the case, you quite frequently “pay for someone else’s health care”, and sometimes they pay for yours—that’s what insurance is. The question is not whether or not you should pay for someone else’s health care, but whether the government should run the insurance program. The evidence suggests that government insurance is both cheaper and more effective.
    In fact, insurance is one of the things government does best. Consider the FDIC, which all but ended bank runs permanently.
    Funny you should mention cable TV. Local governments are often heavily involved in the business of cable TV. In fact, one would almost think that Americans are more inclined to support “socialized” entertainment than health care.

  20. katastrofa says:

    Colin,
    I want universal healthcare so that I have less chance of getting tuberculosis from some I meet on the street.

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