Friday, December 31, 2010

HW 26- Looking back & forward in our unit

-Over 50 million citizens in America today are living without health insurance.
-Of the people that do pay health insurance companies to pay for their medical needs, a large number will be rejected payment due to something like pre-existing conditions or the excuse that the treatment is merely "experimental."
-In countries like Canada, England, and France, all the citizens are provided with universal, free health care.
-The incentives of the health care system that is utilized my America today are to make sure less care is distributed to the people who need it in order to maximize the profit for the health insurance companies.

The source that has been the most helpful for me so far this unit has been the movie Sicko, despite its extreme bias. Although Michael Moore clearly has his own opinions and represents them much more than the opposing side in his movies, the amount of evidence for his side that he was able to present was too much to ignore. I enjoyed reading the book Mountains Beyond Mountains by Tracy Kidder, but it didn't necessarily educate me that much in the area of the dominant social practices that the United States embraces when it comes to illness and dying. However, the book did represent a situation of an extrodinary social practice, which was the way that Paul Farmer would treat all of his patients as well as his strong motivation to make a difference.

I think that one important question that we should explore is: what are the negative aspects to the health care systems in places like Canada, England, and France? In Sicko, Michael Moore does a very good job of emphasizing what is better about the socialist health care system in those countries than the system we are operating on today, but no system is perfect, so I think it would be a good idea to explore its flaws as well. Another question that might be worth looking into could be: When did the incentives of our health care system truly become to benefit the insurance companies at the expense of the people? I know that in Sicko, it was stated that when Nixon announced his new policy is when our health care system became corrupt, but what if it was actually before then?

Monday, December 20, 2010

HW 25- Response to Sicko

Summary:
The incentives of the current health care system in America are not meant to benefit the people, but they are only to help the health insurance companies make more profit by reducing the amount of care that the people recieve. There are millions of Americans in this country who do not have any kind of health care, and for many of the Americans that do have health care, it is hardly ideal. Insurance companies will charge huge sums of money for operations and treatment, and they will sometimes even deny patients the care that could be necessary to save their lives because for reasons like that the treatment is simply "experimental" or the fact that the treatment is so expensive. In many countries around the world, such as Canada, England, and France, health care is free of charge, including almost all the treatment and medication that the patients need.

Evidence 1: A recording of President Nixon's conversation with his chief advisor was revealed during the film. One of the things his chief advisor said was, "All the incentives are towards less medical care." Nixon responded by saying something along the lines of, "Well that sounds pretty good." This piece of evidence is essential to Michael Moore's point saying how the health care system is really just set up so that the people get less care and the health insurance companies made more money. It supports the idea that this is a corrupt system, that benefits the rich and harms the poor and middle class.

Evidence 2: Canada and Britain have something called socialized health insurance. In America we have a socialized education system, but only independent health insurance companies. All the doctors in a socialized medicine system work for the government, and the one that was interviewed in the film was living in a million dollar home and making over 100,000 dollars a year. The both the English and Canadian health care pays all the expences for care and treatment of its patients. This evidence supports the point that the health care systems outside of the United States have proven to be extremely effective, and are doing a much better job of making sure the people actually get care. At the same time, it also proves that working for the government is not such a bad thing, considering the amount of money that the doctors in Britain are getting paid and the satisfying moral aspect of the job that actually allows the doctors to treat all the patients that come to see them.

http://www.youtube.com/watch?v=9aZnlElJZpA
In this video, Nixon states that the doctors would be working for the patients rather then the government under his plan. However, how can the doctors work for the patients if they aren't even being allowed to treat them because of the restrictions that the health insurance companies are forcing on them? Also, what is so bad about doctors working for the government? People seem to be so afraid of having the government in their life, but by choosing to run health care this way, the government is choosing to not allow millions of people to get the care that they need.

This movie truly did open my eyes. Although I had my doubts at first, especially because Michael Moore seemed to be contradicting himself at times as well as the way he seemed to dumb himself down so that the American audience could relate, the amount and quality of the evidence and studies that were conducted was extremely extensive. I had always known that there were many terrible policies in this country, and that many of them were doing harm to the citizens (especially those who are less fortunate) instead of helping them. However, I honestly never thought that the system would have been specifically created with the intentions of making sure less and less people got the care that they needed just for the sake of the profit of the health insurance companies. My previous viewpoint on the situation was that I took the terrible health care system for granted, which is pretty easy to do when you (like myself) are one of the lucky ones who has health care that pays for most of your medical needs. However, after really taking a look, it is clear that the policies in this country truly are corrupt, and that the word is not merely an exaggeration. The most important excerpts of the movie in my opinion were the ones that showed us how bad our own health care companies are treating the people that pay them to take care of them, compared to the health care that ALL the citizens in Canada, France, and Britain are recieving. The most crucial idea I have specifically for my future after watching this movie is that I am now seriously considering moving out of this country, because it feels like the expense of living practically anywhere else in the world other than America is much less.

Sunday, December 19, 2010

HW 24- Illness and Dying Book Part 3

The book that I have read for the Illness and Dying unit is titled Mountains Beyond Mountains by Tracy Kidder. It was published in 2004 by Random House Inc.

Precis: Paul Farmer grew up in a less than ideal family situation, relocating multiple times in addition to other struggles. However, he was very gifted and intelligent, and ended up attending Harvard Medical School where he studied to be a doctor/anthropologist. Unlike typical doctors, (and people in general, actually) Farmer embarked on his image to do good by commuting from Boston to Haiti in order to treat infectious diseases, such as tuberculosis, during his time in medical school at Harvard. At his hospital in Cange, Haiti, Farmer offered free health care to any Haitian who needed it... he even formed his own organization called Partners in Health, which helped out with Farmer's mission by attempting to raise money for those who could not afford treatment or medication. One of the important players in the organization named Jim Kim offered to take the organization to Peru with a friend of Farmer's named Jack, who was a priest. Although, unfortunately Father Jack loses his life to a strand of Multi- Drug Resistant TB, the programs in both Haiti and Peru did an amazing job of providing care for those who would normally not be able to recieve it. This resulted in Farmer expanding the Partners in Health organization to Russia. The work that Paul Farmer has done in the field of medicine is the opposite of what we see in the current system today, and the way he treats his patients as people is a passion that would be amazing if all doctors could share it.

Gems:
"He was like a compass, with one leg swinging around the globe, and the other planted in Haiti,” (Kidder, 260). It is amazing how someone with so much success in a much more fortunate country would abandon their selfishness in order to help the people who really needed him. The man really is portrayed as a saint in the story.

"But Farmer seemed worried about the expense, and perhaps the precedent, of a medevac flight. He'd written back, 'Serena, honey. please consider the possibilities." (Kidder, 270) This quote seems to suggest that Farmer is actually implying that the cost to help these people is too great, and that their lives are not worth it! That doesn't seem like and idea Paul Farmer would have at all.

"Because, A, he's a human being, and B, because I didn't know he couldn't be treated, and C, why shouldn't he have a comfortable way to die, why shouldn't his mother have a private room without flies on her face to grieve in? Can we not have him in a place where people are trained in palliation? Isn't palliative care important?" (Kidder, 277) This quote pretty much describes the core beliefs of Paul Farmer on illness and dying. I couldn't agree with it more.

Thoughts:
When I first started reading this book, I read a quote from one of Doctor Farmer's patients saying that Farmer was a "fuckin' saint." When I first looked at it in the beginning of the book, I had my doubts. After all, treating a few patients like they are actually people shouldn't make you a saint, it should just make you a caring person. However, by the end of the book I have realized that the things Paul Farmer did for people are practically inhuman in how selfless they are. He treated all the patients he came across, and not only that, he treated them as if they were his closest friends. This kind of behavior was especialy suprising to hear about because he did not have the greatest childhood; its not like he started out with an advantage, he had to work his way to the top and from there, he gave it all back. His policies on medicine seems to be the opposite of what the United States has embraced today, and it is something that everyone can learn from.

HW 23- Illness & Dying Book Part 2

Mountains Beyond Mountains by Tracy Kidder. Published 2004, Random House Inc.

Precis- Paul Farmer is continuing to make his trips between Cange and Boston, but the grip of the military on Cange was getting tighter, which did not sit well with Farmer. He began sneaking thousands of dollars into Cange for anti-violence campaigns, as well as disrespecting soldiers. Farmer was eventually banished from Haiti for his actions, and established a permanent headquaters in Cambridge. He now began to look into a new disease, Multi-drug resistant tuberculosis, otherwise known as MDR. In fact, it was when he lost an old friend to the disease in Peru that sparked his passion to cure the disease. His friend was a man named Father Jack, a priest who had allowed Paul to stay with him in his church while he was still attending medical school in a dangergous neighborhood. Not too long after Jack moved to Peru, the priest became ill and was immediately flown back to America to be treated by Farmer. He passed away a month later, and Paul discovered that he was infected with a strand of MDR that was immune to all of the available tuberculosis treatments in existance.

Gems-
"Farmer was a TB expert. When he was still just a residant at the Brigham, he'd written a treatment manual for the house staff. He had been diagnosing and treating the disease ever since he'd first set foot in Haiti, where nearly everyone was infected and active cases were rampant." (Kidder, 138) Farmer is one of the best in the world at treating this disease. So I can only imagine how much of a wake up call it must have been to realize that a close friend had died from a strain of the disease that he was supposed to be an expert at treating that could not possibly have been cured by any of his known methods.

"Others [who hadn't been able to afford their drugs] had given up and gone back to their shacks on the barren, dusty hillsides and were waiting there to die." (Kidder, 140) When I read this it really made me think about the different ways that people deal with illness and dying. How some people can just accept there fate and will embrace death when it approaches, and others will reject the idea ferociously.

"Meanwhile, here in Peru, where the government made debt payments of more than a billion dollars every year to American banks and international lending institutions, experts in international TB control had deemed MDR too expensive." (Kidder, 141) This sounds a lot like the men and women in "Sicko" who were denied treatment because the health insurance companies would come up with excuses not to allow them treatment, when really the only thing going on is that the health insurance companies are trying to make more money.

Thoughts- This section of the book did an excellent job of reinforcing some of the ideas that the movie "Sicko" had presented to me. Although I never really blamed doctors for the terrible American system of dealing with illness and dying, I always sort of thought of them as machines, who would just treat patients with the resources they had without actually making an effort to change things. In "Sicko," we heard from a doctor who moved to London because he liked the way that they had their health care system set up, and by treating patients in Great Britain, not only was he able to help more people but he was also making a lot more money for himself. Paul Farmer has taken the concept of actually helping people through medicine to a whole new level, and the selflessness in his work is something that defys the human trait of greed, which is something I thought no human, let alone American, would be able to push aside.

Tuesday, December 14, 2010

HW 21b- Comments

NatalieK said...
I liked that you made a lot of connections in your post, but maybe you could've elaborated a little more. For instance, did it seem to help your mother's friend feel more positive when you avoided the subject of death? Or maybe, why was it so spectacular to you that Beth had her 13 year old son help her? I can imagine why, but it would be interesting to hear about it too. Otherwise I thought your post was really interesting considering the fact that you seemed to be able to understand Beth's motives through your own personal experience.
Devin said...
I liked your first connection about visiting your good friend's mother with ALS in the hospital and how you would chat about the Patriots (cannot believe you're a Patriot fan) in order to keep the conversation upbeat. I know that ALS is a terrible disease and it would be interesting to hear how seeing someone with it firsthand affected you. I myself have never been with anyone with a serious disease. I think that having that experience must be powerful and important in the way that it makes death and dying more real, making us aware, as Beth said, of our own mortality. I also liked the connection you made to Beth's taking care of her husband with only the help of her son when you told us that your aunt took care of your sick grandmother all by herself. I think it must be true that many more women take care of sick and dying relatives than men do. It's obviously much nicer for a sick person not to have to be in the hospital but it must have been a huge burden in this case for your aunt.
Jim Harker said...
"For as long as I can remember ... She was ill for her entire life..." This is a really powerful image - that all we may really know or remember about a grandparent is the time when they were sick, frail,or incapacitated by disease at the end of their lives. You knew your grandmother for the eight years of her final illness, but didn't have the chance to know her life prior to the illness. I think it's the relationship and history of people BEFORE the illness that gives both the patient and the caregiver the strength to stay positive and loving as you fight against the disease. That's what makes it possible to chat about the Patriots - some things you may not be able to share anymore, but you look for all the things you still CAN share. A sick person's 'road' is a much slower journey than young, healthy, busy people 'walk'. You have to slow way down to the sick person's pace, and look for ways to 'walk' together.
TIM said...
I really liked when you said "I imagine that the fact that Evan and Josh were so close to their father was a very good thing, but it also probably made it harder for them when he passed away." I know from experience that when you are not as close to a family member, it is not as hard to deal with their death when the time comes. So it would make sense if the closer you are to someone the harder it is to deal with their passing. I also liked the way you were able to connect the ideas that Beth had to your own life and it would have been nice to hear more about her experience if she said anything else.
Ben H said...
I love the depth of thought that you put into this homework. For instance, when you said "Without relationships, maybe you would treat death as an old friend, ready to finally take you away. We seem to only fear death because of fear of what we’ll miss." That statement really got me thinking, and was more insightful than anything I could have thought of. I also really liked the way that you represented many of your ideas. You asked the reader a lot of questions, a technique that for me, adds more meaning to what you're saying and certainly captures my attention more than just ordinary statements. Great Job! Ben H said...
My favorite thing about this homework is what a good job you did using the insights of Beth and connecting them to your own life. For instance, I thought it was very interesting how you were able to relate something like the time standing still in Erik's situation to your own experience in a soccer game, when normally the two situations would be completely different. I also like when you said, "I like the idea of people having some kind of awareness of their own death and being brave enough to fight it or brave enough to want to accept it and go to it like some new part of the world not yet visited," because it really got me thinking about the way I vew death. Great job!

Saturday, December 11, 2010

HW 22- Illness and Dying Book Part 1

The book that I am reading is titled Mountains Beyond Mountains by Tracy Kidder, published in 2004 by Random House Inc.

Precis- Beginning Section: I was in Haiti 2 weeks before Christmas in 1994, the reason being to report on American soldiers. This is when I first encountered Paul Farmer, a doctor who worked in a hospital a few miles north of Mirebalais. I learned some more about him and ended up sending some donations to his hospital over the next five years, which he responded to with hand written letters of thanks. The next time I saw him was in 1999, in Boston. He was dealing with a patient named Joe who had previously been diagnosed with HIV and other diseases. Farmer wasn't just trying to cure him, though. It seemed like he was really trying to make his life better. In 2000, he invited me to see his oeuvre in Haiti.

"As Farmer was leaving the shelter, he heard Joe say to another resident, just loudly enough to make Farmer wonder if Joe meant for him to overhear, 'That guys a fuckin' saint." (Kidder, 16) This quote inserted a question into my head: how does helping someone to have a better life make them a saint, and what does that say about how considerate are people are of others in general?

"P.J. said: 'But Dad, white people don't pick citrus.'
'Yeah? I'll give you white people." (Kidder, 51) I thought this was interesting because growing up in New York City, what P.J. said is something I never would have said to my father. It also helps us understand why Farmer does not have a problem healing Hatians; because his father knew about them and explained them to him as equals.

"I became aware of the logistical facts of Farmer's life only gradually so they didn't seem completely unusual until I totaled them up." (Kidder, 22) This makes sense to me, because as I was reading in the beginning about Farmer's life, it did seem pretty odd to me why he would have chosen the life that he did.

The most interesting thought that I have had while reading this book so far has had to do with the idea of kindness, and is related to the first quote that is listed. Considering the way that all Paul Farmer did for Joe was his duty as a doctor and a little bit more by trying to make him as comfortable as possible made Joe feel like Farmer was a saint seems to represent that kindness is not something that we experience very often, or not for him. However, the quote goes on to say, "It wasn't the first time Farmer had heard himself called that." (Kidder, 16) It seems like many of those who have been treated by Farmer believe that he is something that he feels he is not only because he did what any doctor should do; cure patients but also treat them like people, and not just test subjects. It feels like many other doctors that Farmer's patients had seen in the book were probably just treating the patients, and not the people, which really just points out that what they're doing is bad and not that what Farmer is doing is saintlike.

Wednesday, December 8, 2010

HW 21- Expert #1

Insights-
1. One thing that I thought was interesting was how neither Beth or Erik ever used the words death or dying in order to provide positive energy.
2. Another experience that Beth shared with us that I thought was interesting was how she chose to take care of him, with only the help of Evan.
3. Finally, one of the more subtle insights in Beth's story was how she said Evan and Josh were very close to their father.

The fact that the words death and dying were never used in the hospital or at any time around Erik is something that I am very familiar with. Every time I have ever visited someone I know in the hospital, words like those were never mentioned. For instance, when my family and I went to visit a good friend of my mother's who had ALS, all we talked about were postive things like how everyone was doing and how the Patriots game went, things like that. Also, the way that Beth took care of her husband with only the help of her 13 year old son is spectacular to me, and also something that I am familiar with. When my grandmother was ill (which was really for as long as I can remember her being alive), my aunt took care of her all by herself for years. They lived on the same property in two different houses, and the only time anyone other than herself would take care of her mother was when she needed to go to work. The third insight about how close Erik was to his to children is actually sort of different from my own life. Although I was always close to my father, he was always out working when I was younger. I imagine that the fact that Evan and Josh were so close to their father was a very good thing, but it also probably made it harder for them when he passed away.

The first question that Beth's presentation sparked for me was something like: How do people's experiences differ when talking about how they were treated by their doctor? The reason this question popped into my head is because Beth said that the oncologist was very cheerful and agreed to treat him with confidence that it would by him some time. However, on many TV shows and even from a lot of family friends that I know, I have heard stories about horrible doctors and bad treatment. In the case of Erik, on the other hand, no medication or treatment was never denied and Beth never even had to pay a hospital bill!