10 ms·

Many of the patients here are dealing with serious illnesses as a result of not being able to get access to basic preventive care. This is part of why it matter

Many of the patients here are dealing with serious illnesses as a result of not being able to get access to basic preventive care. This is part of why it matters to make healthcare accessible: It's more expensive to not make it accessible. Ye olde "the horse was lost because the horseshoe was lost because a nail was lost" principle. It's not just that someone has an advanced illness, if they die and now their kid needs additional resources from the welfare system, the rest of us are paying for it. According to this piece, under EMTALA -- he Emergency Medical Treatment & Labor Act passed in the 1980s -- it's not illegal to treat undocumented immigrants.

Retric 4y ago
From what I have read preventative medicine has been tried as a cost saving measure and it only seems to reduce costs in dentistry, immunization, and a few other fairly narrow areas. “Prevention can reduce the incidence of disease, but savings may be partially offset by health care costs associated with increased longevity.” https://pubmed.ncbi.nlm.nih.gov/22052182/ https://pubmed.ncbi.nlm.nih.gov/22052182/
- arethuza 4y ago
  What counts as preventative medicine? A few years back I was hospitalised because of a bite on my arm from one of our cats (long story) and was given heavy doses of multiple antibiotics. If that hadn't been treated so promptly I might have required surgery or might even have lost my arm (a nurse told me about someone who lost a leg to a cat bite!). Edit: When I went to the hospital I had no idea how serious it was and turned up to the "Minor Injury Unit" - they had me in A&E and X-rayed within about 10 minutes! Edit: Of course, having been in the hospital for 3 days rather than the expected hour or so I was fretting about car parking charges - turns out they are free at the point of parking....
  - Retric 4y ago
    Preventative medicine is that which is done before significant symptoms. The basic issue, people tend to heal from most things. So the worst case of losing an arm to a cat bite is extremely unlikely. Meanwhile your hospital trip had an cost. Suppose the odds work out to 1:100,000 lost arm vs 300$ hospital treatment. Now a lost arm is expensive but it’s not 30 million dollars expensive. Those numbers aren’t based on anything but that’s the kinds of calculations involved. And as I mentioned the winners seem to be extremely cheap options like vacations.
    - arethuza 4y ago
      Vaccinations? :-)
      - pclmulqdq 4y ago
        That was one of the examples OP cited already as a place where preventative medicine works.
        i80and 4y ago
        I believe they are referring to a s/vaccinations/vacations typo
        lostlogin 4y ago
        The poor poster is likely getting hit by triggered HN users. On a brighter note, no one is anti-vacation.
    - interactivecode 4y ago
      If people don't get healthcare but still have costs of managing their symptoms. Or when people die at home, those costs aren't in the hospital books.
      - Retric 4y ago
        But they are largely on insurance companies/public healthcare systems books. This is why vaccines are generally free out of pocket, the ROI is very positive for the insurance company.
  - yamtaddle 4y ago
    > A few years back I was hospitalised because of a bite on my arm from one of our cats (long story) and was given heavy doses of multiple antibiotics. And of course there's an XKCD for that: https://xkcd.com/1775/ https://xkcd.com/1775/
- DoreenMichele 4y ago
  A. I spoke of other expenses, not merely health care, such as costs, both financial and non financial, of a minor child losing a parent. B. I have trouble believing this analysis is really looking at the whole picture. One of the costs of illness that is frequently cited is lost productivity. You are going to tell me that when people live longer, all of them are merely running up more medical bills without also working additional years to help cover those costs?
  - lotsofpulp 4y ago
    It is possible, in the current environment, that people’s labor, on average, is not valuable enough relative to the healthcare they might receive. For example, how many people get coronary heart disease, and how many years of their work would be needed to pay for a bypass or stent or even open heart surgery? I assume these surgeries cost hundreds of thousands of dollars. Plus the ongoing costs after that. Same with effects of diabetes and hypertension, which might as well effect everyone. Of course, there is liability, patents, licensing costs, etc that can be changed.
    - DoreenMichele 4y ago
      If you live long enough, you are practically guaranteed to end up with cancer (say, past age 80). On the other hand, if you drink and drive while young and healthy, you can helpfully donate your organs to someone with a terrible condition and they can run up potentially a few million dollars in health care.
    - nradov 4y ago
      It doesn't have to be that expensive. Hospitals in India manage to do coronary bypass surgery for only $4,300 with good outcomes. I understand that costs and salaries are higher in the US, but still there is a huge amount of waste, fraud, and abuse that could be cut out. https://www.annfammed.org/content/12/5/470 https://www.annfammed.org/content/12/5/470
      - riahi 4y ago
- jvanderbot 4y ago
  I hear you, but reducing the incidence of someone's limbs dying because they were not allowed to get follow-up care from emergency surgery, or reducing the incidence of a 40 year old woman with advanced dementia because she didn't get basic treatment for her diabetes - that's worth it. These folks could be doing other, more productive things with their lives, rather than wasting away in the shadows while we debate the national merit of saving them. (These are examples from TFA)
  - coredog64 4y ago
    Treatment for diabetes is one of those narrow areas. We know this because private health insurance companies will pay for measures that improve compliance.
- bigbillheck 4y ago
  The second half of that quoted sentence is really doing some work, isn't it.
- carapace 4y ago
  > savings may be partially offset by health care costs associated with increased longevity This is the thinking of an insane person. Taking care of the elderly is what money is for, yes? I mean, "increased longevity" and caring for our sick and elderly is kind of the point of civilization?
  - s1artibartfast 4y ago
    Civilization has multiple goals. That may be one valid use for it but it is not the only one. For example, I might say that money is for feeding hungry children
    - carapace 4y ago
      > Civilization has multiple goals. No. There is only one goal: defeat entropy. ("Evolution".) > money is for feeding hungry children Who then (ideally) grow up and become (eventually) old, eh?
      - s1artibartfast 4y ago
        I'll be honest, I'm really struggling to understand what you're trying to say here. It sounds like you're saying these are Universal truths, but I certainly don't think they are. I don't think the goal of civilization is to fight entropy or Foster evolution, or prolong lifespan. I also don't think most people would agree with that. I also don't think longevity is a singular goal on an individual or civilization level. As a simple thought experiment would you rather live to 50 and absolute happiness and pleasure, or live to 100 in complete misery?
        carapace 4y ago
        Well, my original point was just that increased longevity and caring for our sick and elderly are, anthropologically speaking, what separated us from the primates and hominids, eh? In re: the (sole, underlying) purpose of civilization, well, do you believe in evolution? I don't mean that in a snarky or combative way. I do, and as a corollary to that it seems clear to me that, whatever else is going on, successfully getting into the future, aka "defeating entropy", is as close to a "Universal truth" as you're likely to get, outside of physics. Evolution may have changed form when the human brain, uh, evolved, but the fundamental structure of the situation didn't change: we're still evolving, still trying to find the best way to ensure the future contains humans for the foreseeable, uh, future. Remember, all the other hominid species have gone extinct! We are not guaranteed to succeed, eh? There's a discussion we could have around around whether caring for the elderly is really the optimum strategy, but I don't think that's really very interesting? I'm spending a significant amount of my person time and resources caring for my elderly mother who has dementia. I could put her in a home, and use the extra time to work more hours, and I would make more money even after paying for her care. I may yet have to do that if she becomes more difficult to care for, so far we have been lucky. Our neighbor's father got dementia and would sometimes try to fight them. Like throw punches and such! Mom's a cheerful sweetheart. I'm very grateful for that. Anyway, if someone wants to tell me that I'm wasting my time caring for my mom, well, I'd question their sanity. - - - - > I also don't think longevity is a singular goal on an individual or civilization level. As a simple thought experiment would you rather live to 50 and absolute happiness and pleasure, or live to 100 in complete misery? Now I'm struggling to understand you. :) The thought experiment is so simple that it doesn't make sense. Do I really sound like someone who would choose the latter option? Can you imagine anyone who would choose the latter option?
- paulmd 4y ago
  Yes, this is the absurd part of the fat-hate movement, "you're wasting my insurance/tax dollars!" actually no fat people tend to die early, and US healthcare spending is absurdly weighted towards end-of-life care for terminal patients, something like 50-70% of your total life spending comes in the last 18 months of your life. Someone quietly dying at 50 of heart disease is really cheap compared to the person spending 10 years fighting lung cancer at 70. Not that it should really matter, if the goal is to "get them healthy", right? But it's not, it's about having someone to hate and look down on. Black Mirror nailed this vibe perfectly in Ten Million Merits. Anyway this is a specific problem with the US healthcare system though - we spend way too much on patients who are circling the drain and everyone else gets screwed. Broken bones and bad dentistry and missed immunizations are what produces the single largest improvement in health outcomes - Cuba really only has something like a 7-year reduced lifespan vs the US iirc, because they do well at delivering that basic care even if you're not going there for proton radiotherapy or other ultra-high-end treatments. And the US does the latter but sucks at the former.
  - PuppyTailWags 4y ago
    I don't think there's a fat-hate "movement" tbh. I think it's always been popular to make fun of fat people. Harry Potter and the Philosopher's Stone had a fat child be described as neglected, spoiled, and a bully, and therefore it was justified to magically force the child to grow pig parts that had to be surgically moved. Published 1997. I guess somewhat more recently we have people like Lizzo trying to push back on things like this, but the CDC has recently pushed a recommendation for bariatric surgery on children as young as 14 so. Shrug, I guess.
    - watwut 4y ago
      Growing up elsewhere, the stereotype of fat people was that they are nice and kind. The level of hate was quite surprising to me when I first encountered it.
  - masfuerte 4y ago
    Cuba and the USA have roughly the same life expectancy, with Cuba slightly ahead. https://en.m.wikipedia.org/wiki/List_of_countries_by_life_expectancy https://en.m.wikipedia.org/wiki/List_of_countries_by_life_ex...
rayiner 4y ago
I’m a supporter of universal healthcare but that trope about preventative care reducing cost isn’t true: https://www.nytimes.com/2018/01/29/upshot/preventive-health-care-costs.html https://www.nytimes.com/2018/01/29/upshot/preventive-health-...
- Eumenes 4y ago
  See: Canada
  - weberer 4y ago
    I have no idea what's happening in Canada. What do you mean?
- pookha 4y ago
  If you watch what you eat, avoid obesity and some of the practices that lead to heart disease, and if you can moderately exercise you can avoid expensive health procedures. I don't even think that's debatable...
  - wil421 4y ago
    None of what you just described is preventative care from a doctor. Everyone knows about exercise and junk food that doesn’t mean someone will chose to do or not to do those things.
  - runako 4y ago
    This is simply not true, to a significant degree, as people age into and past middle age. (And even that is ignoring that accidents happen to healthy people of all ages. Eating well and exercising don't eliminate the need for expensive medical care after being in a serious car accident.)
    - s1artibartfast 4y ago
      I don't think the point is that eliminates every single cost, but offset some very major costs. Hope you see and obesity derived illness are real.
dangwhy 4y ago
> It's more expensive to not make it accessible. I was under the impression that USA healthcare has out of control costs due chronic diseases[1] . None of which have any 'preventative care' that you get at an hospital( cancer maybe an exception) . What can a hospital do about 'physical inactivity' ? We can blame this or that but mind boggling half the population in USA is obese. What can any healthcare system possibly do about that. https://www.cdc.gov/chronicdisease/about/costs/index.htm https://www.cdc.gov/chronicdisease/about/costs/index.htm
- DoreenMichele 4y ago
  This is true and not really relevant to the point that people who can't afford healthcare get very sick before they go to a doctor and then their care is more expensive and has worse outcomes. One hospital was having so many resources consumed by a relatively small number of very ill homeless people and concluded that housing them would be cheaper and more effective, so it did. Health care really shouldn't be used to mean medical care per se. And that's one of the things that complicates such discussions. https://news.ycombinator.com/item?id=34397790 https://news.ycombinator.com/item?id=34397790
  - 908B64B197 4y ago
    > Health care really shouldn't be used to mean medical care per se. And that's one of the things that complicates such discussions. Exactly. Whole hospital floors are completely dedicated to patients with completely preventable diseases with proper lifestyle choices (uncontrolled type-II diabetes, most cardiac and vascular surgeries...). What these people needed a decade or two ago was someone to coach them/engage in a long term discussion about their labs and deteriorating health with them. I can't help to think that defining healthcare exclusively as medical care is an attempt at further gatekeeping from a profession already known for these practices... I mean, what brings in more dollars for the provider, a series of hospitalizations and vascular surgeries or a few hours of consulting and coaching?
- PuppyTailWags 4y ago
  When I was fat, my insurance wouldn't cover any weight loss procedure (including just visiting my primary physician to discuss my options for weight loss-- a lovely $250 surprise) because I had no obesity-related health problems (heart disease, diabetes, joint issues, etc). So a hospital can actually do a lot for fatties. Being able to talk to a nutritionist, set up a plan, gain access to any applicable medication, addressing out underlying inflammation/hormone/disordered eating...
mhardcastle 4y ago
"Federally qualified health centers" (FQHC) are required to treat people regardless of ability to pay, and are able to provide preventive care to non-citizens. A list of such health centers is available here, and there are quite a number in Houston (where the subject of the article is based): https://www.findahealthcenter.hrsa.gov/ https://www.findahealthcenter.hrsa.gov/ Whether would-be patients are sufficiently informed of this opportunity is another question, but resources for preventive care are not completely unavailable to these folks.
classified 4y ago
> It's more expensive to not make it accessible. Exactly. More people are making more money which is way more important than providing healthcare to those with not-enough-money. Not saying that it should be like this, but it is.

Retric 4y ago

From what I have read preventative medicine has been tried as a cost saving measure and it only seems to reduce costs in dentistry, immunization, and a few other fairly narrow areas. “Prevention can reduce the incidence of disease, but savings may be partially offset by health care costs associated with increased longevity.” https://pubmed.ncbi.nlm.nih.gov/22052182/ https://pubmed.ncbi.nlm.nih.gov/22052182/

arethuza 4y ago
What counts as preventative medicine? A few years back I was hospitalised because of a bite on my arm from one of our cats (long story) and was given heavy doses of multiple antibiotics. If that hadn't been treated so promptly I might have required surgery or might even have lost my arm (a nurse told me about someone who lost a leg to a cat bite!). Edit: When I went to the hospital I had no idea how serious it was and turned up to the "Minor Injury Unit" - they had me in A&E and X-rayed within about 10 minutes! Edit: Of course, having been in the hospital for 3 days rather than the expected hour or so I was fretting about car parking charges - turns out they are free at the point of parking....
- Retric 4y ago
  Preventative medicine is that which is done before significant symptoms. The basic issue, people tend to heal from most things. So the worst case of losing an arm to a cat bite is extremely unlikely. Meanwhile your hospital trip had an cost. Suppose the odds work out to 1:100,000 lost arm vs 300$ hospital treatment. Now a lost arm is expensive but it’s not 30 million dollars expensive. Those numbers aren’t based on anything but that’s the kinds of calculations involved. And as I mentioned the winners seem to be extremely cheap options like vacations.
  - arethuza 4y ago
    Vaccinations? :-)
    - pclmulqdq 4y ago
      That was one of the examples OP cited already as a place where preventative medicine works.
      - i80and 4y ago
        I believe they are referring to a s/vaccinations/vacations typo
        lostlogin 4y ago
        The poor poster is likely getting hit by triggered HN users. On a brighter note, no one is anti-vacation.
  - interactivecode 4y ago
    If people don't get healthcare but still have costs of managing their symptoms. Or when people die at home, those costs aren't in the hospital books.
    - Retric 4y ago
      But they are largely on insurance companies/public healthcare systems books. This is why vaccines are generally free out of pocket, the ROI is very positive for the insurance company.
- yamtaddle 4y ago
  > A few years back I was hospitalised because of a bite on my arm from one of our cats (long story) and was given heavy doses of multiple antibiotics. And of course there's an XKCD for that: https://xkcd.com/1775/ https://xkcd.com/1775/
DoreenMichele 4y ago
A. I spoke of other expenses, not merely health care, such as costs, both financial and non financial, of a minor child losing a parent. B. I have trouble believing this analysis is really looking at the whole picture. One of the costs of illness that is frequently cited is lost productivity. You are going to tell me that when people live longer, all of them are merely running up more medical bills without also working additional years to help cover those costs?
- lotsofpulp 4y ago
  It is possible, in the current environment, that people’s labor, on average, is not valuable enough relative to the healthcare they might receive. For example, how many people get coronary heart disease, and how many years of their work would be needed to pay for a bypass or stent or even open heart surgery? I assume these surgeries cost hundreds of thousands of dollars. Plus the ongoing costs after that. Same with effects of diabetes and hypertension, which might as well effect everyone. Of course, there is liability, patents, licensing costs, etc that can be changed.
  - DoreenMichele 4y ago
    If you live long enough, you are practically guaranteed to end up with cancer (say, past age 80). On the other hand, if you drink and drive while young and healthy, you can helpfully donate your organs to someone with a terrible condition and they can run up potentially a few million dollars in health care.
  - nradov 4y ago
    It doesn't have to be that expensive. Hospitals in India manage to do coronary bypass surgery for only $4,300 with good outcomes. I understand that costs and salaries are higher in the US, but still there is a huge amount of waste, fraud, and abuse that could be cut out. https://www.annfammed.org/content/12/5/470 https://www.annfammed.org/content/12/5/470
    - riahi 4y ago
jvanderbot 4y ago
I hear you, but reducing the incidence of someone's limbs dying because they were not allowed to get follow-up care from emergency surgery, or reducing the incidence of a 40 year old woman with advanced dementia because she didn't get basic treatment for her diabetes - that's worth it. These folks could be doing other, more productive things with their lives, rather than wasting away in the shadows while we debate the national merit of saving them. (These are examples from TFA)
- coredog64 4y ago
  Treatment for diabetes is one of those narrow areas. We know this because private health insurance companies will pay for measures that improve compliance.
bigbillheck 4y ago
The second half of that quoted sentence is really doing some work, isn't it.
carapace 4y ago
> savings may be partially offset by health care costs associated with increased longevity This is the thinking of an insane person. Taking care of the elderly is what money is for, yes? I mean, "increased longevity" and caring for our sick and elderly is kind of the point of civilization?
- s1artibartfast 4y ago
  Civilization has multiple goals. That may be one valid use for it but it is not the only one. For example, I might say that money is for feeding hungry children
  - carapace 4y ago
    > Civilization has multiple goals. No. There is only one goal: defeat entropy. ("Evolution".) > money is for feeding hungry children Who then (ideally) grow up and become (eventually) old, eh?
    - s1artibartfast 4y ago
      I'll be honest, I'm really struggling to understand what you're trying to say here. It sounds like you're saying these are Universal truths, but I certainly don't think they are. I don't think the goal of civilization is to fight entropy or Foster evolution, or prolong lifespan. I also don't think most people would agree with that. I also don't think longevity is a singular goal on an individual or civilization level. As a simple thought experiment would you rather live to 50 and absolute happiness and pleasure, or live to 100 in complete misery?
      - carapace 4y ago
        Well, my original point was just that increased longevity and caring for our sick and elderly are, anthropologically speaking, what separated us from the primates and hominids, eh? In re: the (sole, underlying) purpose of civilization, well, do you believe in evolution? I don't mean that in a snarky or combative way. I do, and as a corollary to that it seems clear to me that, whatever else is going on, successfully getting into the future, aka "defeating entropy", is as close to a "Universal truth" as you're likely to get, outside of physics. Evolution may have changed form when the human brain, uh, evolved, but the fundamental structure of the situation didn't change: we're still evolving, still trying to find the best way to ensure the future contains humans for the foreseeable, uh, future. Remember, all the other hominid species have gone extinct! We are not guaranteed to succeed, eh? There's a discussion we could have around around whether caring for the elderly is really the optimum strategy, but I don't think that's really very interesting? I'm spending a significant amount of my person time and resources caring for my elderly mother who has dementia. I could put her in a home, and use the extra time to work more hours, and I would make more money even after paying for her care. I may yet have to do that if she becomes more difficult to care for, so far we have been lucky. Our neighbor's father got dementia and would sometimes try to fight them. Like throw punches and such! Mom's a cheerful sweetheart. I'm very grateful for that. Anyway, if someone wants to tell me that I'm wasting my time caring for my mom, well, I'd question their sanity. - - - - > I also don't think longevity is a singular goal on an individual or civilization level. As a simple thought experiment would you rather live to 50 and absolute happiness and pleasure, or live to 100 in complete misery? Now I'm struggling to understand you. :) The thought experiment is so simple that it doesn't make sense. Do I really sound like someone who would choose the latter option? Can you imagine anyone who would choose the latter option?
paulmd 4y ago
Yes, this is the absurd part of the fat-hate movement, "you're wasting my insurance/tax dollars!" actually no fat people tend to die early, and US healthcare spending is absurdly weighted towards end-of-life care for terminal patients, something like 50-70% of your total life spending comes in the last 18 months of your life. Someone quietly dying at 50 of heart disease is really cheap compared to the person spending 10 years fighting lung cancer at 70. Not that it should really matter, if the goal is to "get them healthy", right? But it's not, it's about having someone to hate and look down on. Black Mirror nailed this vibe perfectly in Ten Million Merits. Anyway this is a specific problem with the US healthcare system though - we spend way too much on patients who are circling the drain and everyone else gets screwed. Broken bones and bad dentistry and missed immunizations are what produces the single largest improvement in health outcomes - Cuba really only has something like a 7-year reduced lifespan vs the US iirc, because they do well at delivering that basic care even if you're not going there for proton radiotherapy or other ultra-high-end treatments. And the US does the latter but sucks at the former.
- PuppyTailWags 4y ago
  I don't think there's a fat-hate "movement" tbh. I think it's always been popular to make fun of fat people. Harry Potter and the Philosopher's Stone had a fat child be described as neglected, spoiled, and a bully, and therefore it was justified to magically force the child to grow pig parts that had to be surgically moved. Published 1997. I guess somewhat more recently we have people like Lizzo trying to push back on things like this, but the CDC has recently pushed a recommendation for bariatric surgery on children as young as 14 so. Shrug, I guess.
  - watwut 4y ago
    Growing up elsewhere, the stereotype of fat people was that they are nice and kind. The level of hate was quite surprising to me when I first encountered it.
- masfuerte 4y ago
  Cuba and the USA have roughly the same life expectancy, with Cuba slightly ahead. https://en.m.wikipedia.org/wiki/List_of_countries_by_life_expectancy https://en.m.wikipedia.org/wiki/List_of_countries_by_life_ex...

rayiner 4y ago

I’m a supporter of universal healthcare but that trope about preventative care reducing cost isn’t true: https://www.nytimes.com/2018/01/29/upshot/preventive-health-care-costs.html https://www.nytimes.com/2018/01/29/upshot/preventive-health-...

Eumenes 4y ago
See: Canada
- weberer 4y ago
  I have no idea what's happening in Canada. What do you mean?
pookha 4y ago
If you watch what you eat, avoid obesity and some of the practices that lead to heart disease, and if you can moderately exercise you can avoid expensive health procedures. I don't even think that's debatable...
- wil421 4y ago
  None of what you just described is preventative care from a doctor. Everyone knows about exercise and junk food that doesn’t mean someone will chose to do or not to do those things.
- runako 4y ago
  This is simply not true, to a significant degree, as people age into and past middle age. (And even that is ignoring that accidents happen to healthy people of all ages. Eating well and exercising don't eliminate the need for expensive medical care after being in a serious car accident.)
  - s1artibartfast 4y ago
    I don't think the point is that eliminates every single cost, but offset some very major costs. Hope you see and obesity derived illness are real.

dangwhy 4y ago

> It's more expensive to not make it accessible. I was under the impression that USA healthcare has out of control costs due chronic diseases[1] . None of which have any 'preventative care' that you get at an hospital( cancer maybe an exception) . What can a hospital do about 'physical inactivity' ? We can blame this or that but mind boggling half the population in USA is obese. What can any healthcare system possibly do about that. https://www.cdc.gov/chronicdisease/about/costs/index.htm https://www.cdc.gov/chronicdisease/about/costs/index.htm

DoreenMichele 4y ago
This is true and not really relevant to the point that people who can't afford healthcare get very sick before they go to a doctor and then their care is more expensive and has worse outcomes. One hospital was having so many resources consumed by a relatively small number of very ill homeless people and concluded that housing them would be cheaper and more effective, so it did. Health care really shouldn't be used to mean medical care per se. And that's one of the things that complicates such discussions. https://news.ycombinator.com/item?id=34397790 https://news.ycombinator.com/item?id=34397790
- 908B64B197 4y ago
  > Health care really shouldn't be used to mean medical care per se. And that's one of the things that complicates such discussions. Exactly. Whole hospital floors are completely dedicated to patients with completely preventable diseases with proper lifestyle choices (uncontrolled type-II diabetes, most cardiac and vascular surgeries...). What these people needed a decade or two ago was someone to coach them/engage in a long term discussion about their labs and deteriorating health with them. I can't help to think that defining healthcare exclusively as medical care is an attempt at further gatekeeping from a profession already known for these practices... I mean, what brings in more dollars for the provider, a series of hospitalizations and vascular surgeries or a few hours of consulting and coaching?
PuppyTailWags 4y ago
When I was fat, my insurance wouldn't cover any weight loss procedure (including just visiting my primary physician to discuss my options for weight loss-- a lovely $250 surprise) because I had no obesity-related health problems (heart disease, diabetes, joint issues, etc). So a hospital can actually do a lot for fatties. Being able to talk to a nutritionist, set up a plan, gain access to any applicable medication, addressing out underlying inflammation/hormone/disordered eating...

mhardcastle 4y ago

"Federally qualified health centers" (FQHC) are required to treat people regardless of ability to pay, and are able to provide preventive care to non-citizens. A list of such health centers is available here, and there are quite a number in Houston (where the subject of the article is based): https://www.findahealthcenter.hrsa.gov/ https://www.findahealthcenter.hrsa.gov/ Whether would-be patients are sufficiently informed of this opportunity is another question, but resources for preventive care are not completely unavailable to these folks.

classified 4y ago

> It's more expensive to not make it accessible. Exactly. More people are making more money which is way more important than providing healthcare to those with not-enough-money. Not saying that it should be like this, but it is.