HW 33- Comments

Ben H said...

"The way that dominant social practices around illness and dying connect with dominant social practices around dying has to do with making money." This quote from your post does a great job of summing up the American health care system. Although in places like England, the incentives are actually a bit more noble as far as care distribution goes, it is the perfect way to describe health care in America. Nixon said himself that making sure patients get less care is a good thing if it means more profit is getting reeled in. I also liked the way you connected the illness and dying unit to the food unit that we are doing now Good job!

 

Ben H said...

I liked the way you were able to connect this unit to your thoughts about certain health-related aspects of life in the future. I also really liked the way you used evidence from other peoples blogs in order to support the conclusions of your own opinions. "Our country needs to sort out its priorities." This was a very interesting line to me, because in my opinion, it seems like the country already has sorted out its priorities for health care. They just are not beneficial for most people in America.

 

TIM said...

Even though I do not go to the school you go to or take this class, I feel like you did a good job summarizing everything that you learned. It seemed like the main part of what you learned during the unit was directly related to what you did for your final project, and all the problems with the incentives of our health care system as well. Good job!

 

Jim Harker said...

"It is also unfortunate that our system invests practically all the money that it spends on health care on terminal patients, rather than preventive medicine that would help to keep patients from getting sick in the first place." This is an interesting point that I had never really thought about before. It would be interesting to do some more further research on something like this, but I think a strong case can be made supporting an increase in preventive care as well as health care outside of the United States, which you accomplished in your project.

HW 32- Thoughts following illness and dying unit

There are so many nightmarish dominant social practices associated with illness and dying that I have discovered this unit and so many of them go overlooked. The fact that the incentives of the American health care system are to benefit the large health insurance companies and make sure that the people get less care is sickening, and what is even worse is how little people know about it. It is also unfortunate that our system invests practically all the money that it spends on health care on terminal patients, rather than preventive medicine that would help to keep patients from getting sick in the first place. It seems like the most positive and promising alternative to our flawed system of medical care are the social health care systems in places like Canada, France, and England. Although the systems over there have issues as well, at least the intent of systems such as the National Health Service in England have honorable intentions, where as our system is immensely flawed and extremely corrupt. In connection to our previous food unit, part of a system of health care focused on prevention would be to try and help people change their diets to prevent diabetes. Instead, we focus on expensive equipment to sustain the lives of the sick and elderly in their final hours.

HW 32- Comments 3

AbdulM said...

For Ben, Your most beautiful line was " Overall though, the National Health Service in Britain is a much more effective and honorable system than whatever system we practice in America, and the idea of socialized health care is benefiting a much larger portion of England then the percentage of people in America that benefit from health care, which might have something to do with the fact that about 50 million people in America are not covered by heatlh insurance at all." Your presentation really made me want to examine and check out your blog. I wanted to check out some of your sources that you used for the NHS, and see how America measured up to them. You did a really god job of explaining both the negatives and the positives briefly in your presentation, which really made me want to read in depth more about this in your post later. Overall good job, and very interesting post.

 

NatalieK said...

I too had the same question after watching Sicko. It seemed odd that there could be such a perfect system out there that the United States refused to utilize - there had to be some catch. I can understand that there might be long wait times for care, but that definitely seems better in the long run compared to having to pay thousands of dollars. I think you did a good job of displaying the negatives but also the positives, reminding the reader why such a system would be worth having.

January 18, 2011 1:46 PM

TIM said...

I really liked the way that you were able to show both sides of the argument about the National Health Service. My favorite aspect of this project was probably how you pulled the scenario from the NHS website as well as all the information about the woman in the New York Times to counter Michael Moore's strong argument. Good Job!

January 18, 2011 3:22 PM

Jim Harker said...

"These kind of stories make you wonder if the Pharmacist from Sicko was telling the truth when Michael Moore (questioning the price for amount and type of drugs being purchased) asked, "What if it's like an HIV drug, or a cancer drug?" and the pharmacist responded, "Six pounds 65." I'm sure that Debbie Hirst would not agree with this 'standard price'." This quote is a perfect example of my favorite part of your project. You questioned both the argument that Michael Moore made in Sicko while also explaining that in the long run he was pretty much correct. Good work

Ben H said...

Wow, it's great how you were able to include so much detail in this account; it really makes the whole thing feel more personal. "At some points in the conversation, it almost seemed liked she wanted to die, wanted it to be over, so that she could live in heaven with her faith." I thought this sentence did a great job of summing up what the woman you were speaking with had said, and also made clear the way that many Christians might feel about dying. Great job!

Ben H said...

I really loved how personal your presentation felt, and the written part of your project was the same way. I feel like it played a big part in making your research so strong. "Death is such a foreign and distance concept to us. We do not know when it happens or how it happens, and not knowing is the scariest part." This was probably my favorite line, because it explains why humans have come up with all these different theories to try to explain what happens after death; because we are really just afraid of the unknown.

 

Ben H said...

I really liked the way that you used certain statistics to get the reader interested and draw them in, such as "According to the World Health Organization, the US ranks 37th in the world for it's healthcare system." In my opinion, your most beautiful line was "This means we are paying to help people after they get sick rather then taking effective cautionary steps to try to prevent sickness." This represents a key problem with our health care system that people might overlook the most, and really sums up a huge chunk of your project. Good job!

Ben H said...

"The significance of my findings could be that since people are living longer and longer, they are more interested in not dragging out a painful dying experience or a dying when they have lost control of body functions or their minds." I think this is an extremely valuable insight, because it also brings up the idea that all human's desire eternal existence, and yet your studies indicate that most people would be willing to give that up just because they are in pain. My favorite part of your project is the amount of evidence you used and how thorough your analysis was. Great job!

HW 30- Illness & Dying- Culminating Experimental Project

The amount of dominant social practices associated with the human processes of illness and dying that go overlooked by the majority of people in this country is extremely extensive. Practices such as our dualist methods of utilizing anesthesia to "put the mind in another place" while the body is being opened up and operated on by surgeons, or how the real incentives of the American health care system are to benefit the large health insurance companies and to make sure the people get less care. However, one aspect of illness and dying that even less people look into the the ones that are stated above are the incentives of health care systems in countries that utilize a socialist health care system, such as Canada, France, and England. More specifically, what flaws could the health care systems in these countries possibly have? Michael Moore did an excellent job in his film, Sicko, of showing us all the great things about how illness and dying are handled in Canada, France, and England. Unfortunately, there is no such thing as a perfect health care system, and by observing the flaws in not only our own imperfect system, but also those of the countries that have better methods then us, one can gain insight into what aspects of health care are beneficial to all different groups of people.

My first bit of research came when watching Sicko by Michael Moore. After he finished speaking on how the American system of health care was designed to get the public less care and giving examples of how horrible it was, he moved on to what the health care systems were like in countries that practice a socialized health care system such as Canada, France, and England. Although he "tried very hard" to find flaws in these systems when he was interviewing citizens in all three of those countries, he was only able to tell us about all the good things such as how even though the doctors were living under state control, they never had to decline any patients their treatment and are inspired to help patients do things like quit smoking because of the way that the system works. The more patients that a doctor in Britain can get to stop smoking, the more money he will be paid, not to mention the fact that any patient can get any number of their prescribed pills for the standard price of just over six and a half pounds (according to the NHS it is actually currently at 7.20.). 

All these good things about the socialized health care system caused me to wonder if there even were any flaws. It doesn't seem possible to have a perfect health care system where everyone is covered and happy about their coverage, but I could be wrong. It turns out that the main principle of the British health care system, otherwise known as the National Health Service, (NHS) is that, "there should be a free, comprehensive health service for everyone according to need, regardless of their income." (http://neamh.cns.uni.edu/MedInfo/bhs.html) It is clear that the positive aspect of the NHS in England is that all the citizens qualify for care no matter what their income/living conditions are. However, the result of this extensively broad coverage is that man patients have to wait a long time to be seen for treatment as well as surgery. "In fact the waiting lists have become so long the the NHS has started paying for people to cross into the European Union for treatment." (http://neamh.cns.uni.edu/MedInfo/bhs.html) So it seems that despite the noble intentions of the National Health Service, treating everyone in a country is not quite as easy as it sounds, and it has been proven to cause long waits for patients in hospitals.

A complaint made on the National Health Service website is stated below-

My friend had been robbed and physically assaulted on Saturday. He suffered a serious injury to his eye, as well as scull bone fracture under the eye. NHS emergency doctors have identified the need for my friend to be inspected by a specialist doctor and considered for a possible operation. Now, one detail. My friend's phone was taken away by the criminals when he was robbed. NHS didn't ask if the contact details were still valid, when they were telling him he would be referred to another doctor. He and I were still on shock which was quite reasonable. So we left later. Now a doctor from the King's hospital is supposed to contact my friend but the details they gave are incorrect. We tried to call the original Lewisham hospital, but after being transferred between different lines for five times my friend had been told to call the first line again. This happened two times. At the King's hospital they cannot do anything and are advising to call the Lewisham hospital. Now, how is my friend is going to find out if he needs an operation at all, if he's being told off everywhere? Is it not going to be too late while all these people who are supposed to help are transferring the lines, and responsibility?

(http://www.nhs.uk/choiceintheNHS/Rightsandpledges/complaints/Pages/NHScomplaints.aspx)

Although this complaint seems to be directed at the specific receptionists who are repeatedly transferring the call to someone else in order to avoid the responsibility of dealing with the problem, it is still a definite case of denying a patient care, though not as blunt as the health insurance companies in America would make it. Who is to say that this kind of situation does not occur on a daily basis at all the hospital's in England? Although I cannot say for sure if it does or not, I can say that the situation above is not the only case of a patient being denied care. There was a story in the New York Times on February 21, 2008, that addressed another example. "One such case was Debbie Hirst’s. Her breast cancer had metastasized, and the health service would not provide her with Avastin, a drug that is widely used in the United States and Europe to keep such cancers at bay. So, with her oncologist’s support, she decided last year to try to pay the $120,000 cost herself," (http://www.nytimes.com/2008/02/21/world/europe/21britain.html) It says in the article that Ms. Hirst had raised 20,000 dollars and was planning on selling her house to raise more just so she could pay for a part of her medication, in the hopes that the health service would cover the rest. But when she was talking to her doctor, the conversation went like this, “I said, ‘Where does that leave me?’ He said, ‘If you pay for Avastin, you’ll have to pay for everything’ ” — in other words, for all her cancer treatment, far more than she could afford." These kind of stories make you wonder if the Pharmacist from Sicko was telling the truth when Michael Moore (questioning the price for amount and type of drugs being purchased) asked, "What if it's like an HIV drug, or a cancer drug?" and the pharmacist responded, "Six pounds 65." I'm sure that Debbie Hirst would not agree with this 'standard price'.

Although these examples do sound very similar to the kind of rejection that so many Americans here all the time, it would be inaccurate to say that the National Health Service in Britain is similar to America in any way as far as what the incentives of the health cares system are. I have a friend who is currently living in England and has lived there for over 10 years, and is in her late 40's. (that has asked to remain anonymous for this project) When I asked her about how she felt about the National Health Service in England, being someone who had previously experienced the American health care system, she said that it was wonderful in comparison. "When I was working as a full-time bartender making a pretty low salary[compared to what I make now], I recieved all the same coverage as the coverage I recieve now, even though I am paid almost twice the amount while acting that I was previously being paid as a bartender." She went on to describe how she had only been sick enough to need antibiotics about five or six times throughout her years in England, but that when her general practitioner had prescribed her medication, she never even had to pay a single pound.

After conducting this research, my conclusion is that I was correct in saying that there is no way to have a perfect health system, and that saying there will be coverage for every citizen in an entire nation is a lot easier than actually making it happen. Overall though, the National Health Service in Britain is a much more effective and honorable system than whatever system we practice in America, and the idea of socialized health care is benefiting a much larger portion of England then the percentage of people in America that benefit from health care, which might have something to do with the fact that about 50 million people in America are not covered by heatlh insurance at all.

HW 29- Reading and noting basic materials

Being sick is something all of us have to go through at some point in our lives. In many cases, the most amount of time that we will spend in a hospital is in the last few weeks or months of their lives, but that does not mean it is the only time. Earlier today, I myself made a trip to the hospital for a small surgery on my heel. However, while I was waiting for my doctor to show up, all of the other patients around me were senior citizens. Although I waited for about two and a half hours to actually see a doctor, once I was being treated, the procedure went perfectly. In other words, it felt like all the patients were being made to wait for a very long time in order to receive care, but because I am lucky enough to qualify for health insurance, the quality of the care was actually very good. Another thing that I noticed about my experience in the hospital is that for a large portion of the time that I was waiting, my mother and I were either reviewing or filling out new paperwork. So although it is true that all humans will experience illness and dying at usually multiple times in their lives, that does not mean that all of their experiences going through that process will be the same.

The process of dying is yet another inevitable circumstance that all of us will experience eventually. There are so many different causes of death and situations regarding family and environment that everyone's experience with dying will certainly be different. However, in Death and Hospital Culture, it is stated that, "Today, more Americans die in hospitals then anywhere else, and the most frequent response to critical illness there is to try to stave off with the most sophisticated technological means available." (Death and Hospital Culture, 25) As a result of this, in America, the idea of dying can often be associated with a hospital bed surrounded by many machines. This is not necessarily the case though; when our guest speaker Beth came in to speak about the passing of her husband, she talked about how for the last days of his life she took him back to their house and took care of him there by herself. The difference between dying in a hospital and dying at home can have a great impact on that person's experience. "Thus, while patient and family decision-making is considered paramount, decisions, when they are made at all, are constrained by hospital rules reimbursement mechanisms, and standards of care." (Death and Hospital Culture, 28) It seems that by choosing to die in a hospital, neither the patient or the family of the patient will have much power over the treatment of the one who is dying, while if that same patient was being taken care of in his/her home, they would have complete freedom at the cost of less machinery and trained staff.

There is not always a choice for patients whether or not they want to receive care in the hospital. Unlike countries like Canada, Britain, and France which have socialized medicine systems, good health care in America is not so easy to come by. In Sicko, a film created by Michael Moore, he describes how about 50 million Americans are without health insurance. He also speaks about a man who severed both his middle and his ring finger in an accident and was offered a choice of paying 60,000 dollars to re-attach his middle finger or 12,000 dollars to re-attach his ring finger. On the other hand, Beth did not have to pay a single penny for the care that Erik received throughout the time that he was dying, because their family did have health insurance. Many citizens who are covered by health insurance in America are not as lucky as Beth was, however. Things such as pre-existing conditions that patients may have forgot to mention when filling out paperwork can give health insurance companies a reason not to cover the costs of care. The reason for this is because the incentives of our health care system are for the benefit of the large companies, not the people. At a later point in the flim Sicko, Michael Moore showed us a recording of President Nixon having a conversation with chief advisor, who was describing his proposal for the new health care system to the president. What he said was basically that, "The whole idea of the new health care system is less care." Nixon responded by saying, "Well that doesn't sound too bad." It is clear that the American system of health care is making it harder for people to acquire health insurance, and equally as difficult to make sure that you receive care even when you are insured.

HW 28- Comments 2

Ben H said...

The part about this post that I enjoyed the most was the way you were able to connect the insights you made from visiting Gloria to the insights you had previously came up with while reading Mountains Beyond Mountains and while listening to Beth. For instance, when you said, "Both of them wanted to give their family member the most dignified dying experience possible. Both also had a lot of pictures in the room to give visitors of sense of the person and also to make the dying person have good memories," you did a great job of connecting to specific things that Beth said when thinking of your own experience in the hospital. I also really liked the way your writing had a very personal touch to it.   Ben H said...

My favorite aspect about this post was how you were able to draw so many insights from a time that you visited the hospital where the patient's life was not exactly at risk. You were able to look at an experience that many people did not choose that is, in a way, more challenging, and still observe many things. For instance, you said, "She didn't want to be "babied" or given special treatment from anyone, she basically wanted us to treat her as if nothing had happened." Even though she was going to be fine, you were still able to observe changes in behavior.

 

TIM said...

I think you did a very good job on this post. I especially liked the part where you wrote how Jim was feeling about the way he was being treated by the nurses. Like when you said, "and although in this particular situation their job required them to make sure the patients stay was as comfortable as possible, it was clear that they were making an extra effort and actually felt for Jim. However, apparently there were others who were not nearly as considerate as they could have been." This really showed how even though the patient was not able to move or speak at all, he was still able to communicate the way he felt about what was going on, and it is very good that you were able to observe that.

 

Jim Harker said...

"More than anything, he was curious as to what was going on in our lives.... Jim would be smiling at times as well, because I'm sure he was happy to see us. However, we knew perfectly well that the only reason he was choosing to be kept alive was because he wanted to see his daughter grow." Very interesting observation. Jim seems to have kept trying to hold onto the good, 'normal' things as an anchor in the face of such a terrible, debilitating disease. Even when he was so incapacitated, he knew his daughter could give him joy, and (I think) that he could be a positive presence/memory for his daughter.

HW 27- Visiting an unwell person

When a good friend of my mother named Jim, who I had known for almost my whole life, was sick with ALS, we went to visit him in the home that he was being kept in after he was released from the hospital. At this point, they knew that there was no way to cure him, so the were really just using machines to sustain him and make the last few weeks or months slightly more comfortable. I remember when Andy was talking to us at one point, i believe he said that he had a friend who was a doctor and had told him that the last 6 weeks of a persons life is always when they recieve the most medical treatment. This probably contributed to the way my family and I acted around Jim. I visited him a few times, but for all of the times I was fully aware of the situation and that he would probably not be alive for much longer.

Despite the seriousness of the disease that Jim had, he was still able to keep relitively high spirits. More than anything, he was curious as to what was going on in our lives. In the beginning, visiting him was a little bit awkward because I was not really sure how I should act. It was also extremely hard to understand what Jim was saying because he couldn't actually speak at all, he was only capable of mouthing the words. My parents would act extremely pleased to see him and were constantly smiling. Not to say that they weren't, but there is no way that they could have been as happy as they looked knowing that their old friend was going to die soon. Jim would be smiling at times as well, because I'm sure he was happy to see us. However, we knew perfectly well that the only reason he was choosing to be kept alive was because he wanted to see his daughter grow.

There were many nurses who were helping to keep Jim as comfortable as possible, and he had things to say about almost all of them. Some of the nurses were very kind to him, and although in this particular situation their job required them to make sure the patients stay was as comfortable as possible, it was clear that they were making an extra effort and actually felt for Jim. However, apparently there were others who were not nearly as considerate as they could have been. The whole situation seemed extremely similar to what the guest speaker that visited our class, Beth, was dealing with. Everyone around the hospital knew that Erik was not going to have much more time to live, but for the most part, people sill made an attempt to keep a positive attitude which resulted in the patient feeling better about everything that was going on. Also, even though it is hard to be as caring as Paul Farmer in Mountains Beyond Mountains, all of the staff that I saw every time I visited were very welcoming and kind. At least from my point of view.