Poverty = lack of doctor visits = higher death rates?

St. Lawrence County ranks near the bottom in health outcomes.

Many people assume that the government helps low income people who really need medical care – people diagnosed with cancer or other potentially life-threatening illnesses. I used to think that, too.

But then I spoke with Ruth Fishbeck, director of the Health Initiative in Potsdam, for a story about health care needs in the North Country. She told me that a lot of sick people don’t get government assistance – even when they can’t afford medical care. So they go without doctor visits, lab work, and medications.

Fishbeck says this is having serious health consequences in St. Lawrence County. It’s ranked among the worst of New York’s 62 Counties by most health measures. Here’s what Fishbeck had to say…

“People are dying. We rank in health outcomes, we rank 58th or 59th out of 62, and that means premature death and sickness. And a lot of it is simply the lack of money to get adequate health care.”

Fishbeck says people who have health insurance just don’t understand how hard it can be to go to the doctor, when it might leave you without money for rent or food.

“So many people are under the impression that there are programs, that the government wouldn’t let somebody with cancer not get treatment because they don’t have money. But that happens every day because there is no program.”

Fishbeck thinks the new national health care law will help more people to afford insurance. The Supreme Court is expected to rule on the law in the next few weeks.

What do you think about health care in the North Country? Is lack of money the main issue – or do you have other concerns? And do you think attempts to make health insurance more affordable will help?

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75 Comments on “Poverty = lack of doctor visits = higher death rates?”

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  1. Susie says:

    Again, I do not agree with this, having first hand knowledge of the health care industry and the smoke and mirrors behind it. But having no leadership in Upstate NY, the numbers will continue look dire as our healthy young people leave for wealth generation, opportunity, and because they can. The largest employers in Upstate NY have the worst health insurers….not recognizing that shows how little regard there is for the people who continue to live here. Another grant opportunity so a headline can say someone is working on it….instead of each of us taking personal responsibility for our health and the toxins that surround us, and making our government work for us not big corporations. Look at our readily avail local food offerings….in a region abundant in agriculture….the new currency is the data large companies are grossing off of the poor who are feeding it to them…Chase Bank is the vendor for Food Stamps, Medicaid and Medicare tied into the new Health Information Exchanges and Accountable Care Organizations (ACO’S)….again too much money too be made…. The Health Care law written not by the Obama admin but the Bush administration post Hurricane Irene….Data the new currency.

  2. Peter Hahn says:

    This is an access law not a cost reduction law, but the estimates are that it will eventually bring down costs,somewhat. I too would prefer a cost reduction program, but many of those proposals were stripped by the republicans.

  3. mervel says:

    You can’t have access without lower costs, the reason we don’t have access now is the whole thing costs too much. I agree many Republicans want the status quo why would they want to lower the profits of an industry that is 20% of the US economy? The industry has a stranglehold on both parties thus to get this thing passed they had to make sure the health insurance companies got paid, the drug companies got paid, and the trail lawyers got paid, the ALL made out well with the new health insurance bill. So how could all of those three industries be happy with this bill?

  4. mervel says:

    I do think many health professionals are happier in France or Italy etc. Those systems don’t have hugely expensive medical schools and the government pays for medical education, those systems don’t have a tort system that allows doctors to be sued in the same way ours does, and they refuse to support drug companies by paying insanely high prices for drugs; the whole thing is much less stress for everyone and it provides better health for all. But everyone makes less, they all do. To do that in the US you have to take on the trail lawyers, the medical establishment, the medical education establishment, the unions, the AMA and the Insurance companies, also we have a culture that values materialism and careerism more than people do in Europe.

  5. SirLeland says:

    Sorry…but doctors in the U.K., where they have a National Health Service, do NOT make 40% to 50% less than that of their counterparts here in the States. They do very, very well for themselves. And one of the reasons they do very well for themselves is because they do not have anywhere near the overhead costs as doctors do here to operate their practices and their hospitals. They do not have have the cumbersome billing and collections process that we have in this country (which is an industry all in its own in this country), they do not have to waste their time and talents arguing with some insurance rep sitting in a cubicle two thousand miles away in order to get “permission” to prescribe a treatment or a surgery which they know that their patient needs, and they do not have the malpractice insurance requirements that they do in this country.

  6. SirLeland says:

    Also, the nurses and healthcare aids in the U.K. are unionized just as they are here.

    And I think it’s also worth mentioning that the U.K. created their National Health Service in 1948.

    This was less than three years after suffering through the worst war that country had ever endured. If it’s possible so closely on the heels of such carnage, and anguish, and pain, for a people to come together and create a fantastic health care system such as theirs, call me an optimist, but there is absolutely no reason why we cannot do the same.

  7. mervel says:

    Sorry Sir Leland your just wrong.


    The article makes a point though of showing that doctors in other countries pay far far less for their medical education than our doctors do and of course far far less in insurance etc.

    But anyway its going to be a hard hard sell. Union or not our unionized nurses do better than the UK, how are they going to respond to lower pay and benefits?

    There is no free lunch. To have a single payer lower cost system means those in the system will make less, its not hard math.

  8. SirLeland says:

    There is more than enough money in this country to pay for a single payer health care system.

    Contrary to popular opinion, America is not broke. No, sir. Not by a longshot.

    A little known or spoken about fact: Right now, as you sit and read this, there are 400 of our American citizens…400…who have more accumulated wealth than 150 million Americans (or half of the country) combined.

    And before people fling the “socialist” or “wealth re-distribution” labels at me, no…that is not what I am suggesting. What I am suggesting is that as part of our health-care overhaul efforts, there needs to be included in it a much more fairly structured tax code. A tax code where everyone pays the same percentage of their income, no matter how low or how high that income may be.

    Take social security for example. Right now, an average middle-class person pays about 6% of their income to social security. Someone earning $1million pays 0.06% of their income to social security. If the wealthy simply paid the same percentage of their income as a middle class person does, that’s all I am suggesting, we would never be at risk for social security insolvency, and the same principle can apply to a single-payer healthcare system.

  9. mervel says:

    Sure there is plenty of money to pay for a single payer system, from a national standpoint it would be cheaper, but all parties in the current US health care industry will have to accept earning less money. Right now our system is the most expensive in the world. Where do you think all of that money is going? It goes to doctors, nurses, hospitals, medical schools, insurance companies, drug companies and tort lawyers. All of them want a part of the action and will fight tooth and nail to prevent their incomes from gong down. It think it is worth the fight, but it WILL be a fight and Obama did not fight any of these groups he appeased them all and thus the current law is essentially a joke.

  10. SirLeland says:

    Well, Mervel, you’re not getting an argument from me there.

    “but all parties in the current US health care industry will have to accept earning less money”.

    You are correct. If a single payer system becomes enshrined through legislation and then law, then yes, all parties will need to accept. That’s sort of part of the whole point. That’s the only way it’ll happen.

    And secondly, the chart in your referenced article, if correct, and I have no reason not believe so, if I am reading it correctly, indicates that doctors in the U.K. (which was my specific example to you) earn about $125 to every $160 for doctors in the U.S. Not exactly an enormous income disparity, my friend.

    Take away the overhead costs in this country which they don’t have to contend with, they can each equally afford a pint of Guinness and a Jag (or two).

  11. mervel says:

    I personally think they do fine and I think they are less stressed. I think it is about 30% less in the UK. However the point is as you show; that in the UK they don’t have the overhead or education costs that our doctors have.

    The key is going to be totally overhauling our cost structure from medical education through tort reform through how we pay for drugs.

    In the UK they built their system back in 1948 after the war, they had a clean slate and a model from the military to use, we don’t have that.

  12. SirLeland says:

    You may be onto something. Perhaps that’s the answer.

    Maybe we just need to have the crap bombed out of us by someone for a few years in order to bring ourselves together and make something positive happen for us.

    (not advocating)

  13. Working RN says:

    One of the most overlooked issues in this debate is not the medical cost but the pharmaceutical cost. People have been making the choices between food, fuel, and their medications for too long. If folks know they cannot afford their medications, they fail to take them or fail to see a Doctor all together. Even with medicaid/medicare or even insurance, there are many of my clients who simply cannot afford the outrageous costs.

  14. mervel says:

    I agree, drug costs are outrageous. Also you drive across the border and they are less, you fly to the UK and the same drugs are less, why? There is no cost reason, the reason is the US is the profit center, the drugs are priced higher here, simply because they can.

  15. PNElba says:

    Drugs costs more in the USA because the largest purchaser of medications, the government, is not allowed to negotiate a price with the drug companies.

  16. mervel says:

    Who is not allowing them to negotiate? I ask that seriously, is it a choice that we have made or is it a law? In other areas the government tries to get a decent prices not always successfully but they try. I just don’t get why the exact same drug can be sold in France or Canada at a lower price than in the US?

    The only explanation I can see is that the US government wants to ensure that our drug companies make a specific amount.

  17. Walker says:

    How American government works these days…

    “By the design of the program, [Medicare Part D] the federal government is not permitted to negotiate prices of drugs with the drug companies, as federal agencies do in other programs. The Department of Veterans Affairs, which is allowed to negotiate drug prices and establish a formulary, has been estimated to pay between 40% and 58% less for drugs, on average, than Medicare Part D.”

    “Former Congressman Billy Tauzin, R-La., who steered the bill through the House, retired soon after and took a $2 million a year job as president of Pharmaceutical Research and Manufacturers of America (PhRMA), the main industry lobbying group. Medicare boss Thomas Scully, who threatened to fire Medicare Chief Actuary Richard Foster if he reported how much the bill would actually cost, was negotiating for a new job as a pharmaceutical lobbyist as the bill was working through Congress. A total of 14 congressional aides quit their jobs to work for the drug and medical lobbies immediately after the bill’s passage.” (Wikipedia)

    Of course, none of this is considered illegal.

  18. PNElba says:

    Walker – there’s the so-called “free-market” for you.

  19. Walker says:

    You mean the market in senators and congressmen?

  20. mervel says:

    There you go! This is the reason that Obama built in the drug companies into his so called reforms.

    The market is indeed working and as Walker points out there is a market for votes and a market for politicians.

    So if anyone thinks that we have just passed a law that has change anything they indeed are deluded. In fact I would say that this health care bill “Obama Care” is the essence of crony capitalism.

  21. knuckleheadedliberal says:

    Crony Capitalism is all we’ve got.

  22. myown says:

    Not that Obama doesn’t have his own set of crony capitalists but Medicare Part D was part of the Medicare Modernization Act signed by George Bush in 2003 – essentially a gift to the drug companies.

  23. mervel says:

    Agreed, its been built into the system for a long time. Its not about politics and Republicans or Democrats; its about interest groups. Right now the major interest groups support both parties so this will be a challenge.

    Within the health care industry I basically agree knuckle, we don’t have much of a market mechanism at work at all.

  24. Walker says:

    “…its about interest groups.”

    No, it’s about the corruption of government by money.

  25. mervel says:

    Exactly; its about the interest groups

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