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The unanswered question upon reading this article for me has been, "how do these two afford this kind of care for decades?" Wealthy parents? Generous relatives?

The unanswered question upon reading this article for me has been, "how do these two afford this kind of care for decades?" Wealthy parents? Generous relatives? Great national healthcare coverage in Brazil? It's just unthinkable for a normal family in the United States (I understand that these two are in Brazil) to be able to afford this, at least in this day and age.

ks 13y ago
According to Wikipedia it seems that Brazil has universal free health care http://en.wikipedia.org/wiki/Health_in_Brazil http://en.wikipedia.org/wiki/Health_in_Brazil
- eitally 13y ago
  Yes, but it's generally crap and everyone who can afford private insurance (or just paying list prices at private clinics), does. <-- works with many Brazilians and spends about a month of each year there.
  - leandrod 13y ago
    Worse than that — it is universal in theory but not in practice, as often there will be no doctors around in the State‐run health system, and not enough medicine and other medical supply.
nikatwork 13y ago
Genuine question - what happens for these types of cases in the US if the patient isn't rich? Does the patient get turfed out onto the street once they run out of money?
- ars 13y ago
  Medicaid pays for it. (And eventually Medicare when they get old enough.) People have such a strange view of medical care in the US. Medicaid is available to anyone who needs it (i.e. financially plus special medical circumstances). And all children in the US are able to have medical coverage - if they can't afford it the government pays for it (or gives a pro rated discount). There is no such thing as not [being able to] have coverage for your kids because you can't afford it. So basically the old and the young are both covered. The gap is in the middle.
  - DominikR 13y ago
    So he would be kicked out of care after reaching the age of 18 in the US?
    - ars 13y ago
      The age varies (the younger the age the higher the income limits are) but in any case if he needed special medical care he would be shifted to a different program, but the coverage would stay.
  - Luc 13y ago
    Not a wonderful situation, though, is it? $78k for a hip replacement will make one hell of a dent in the money you saved up for retirement, but hey, once you're poor you can get Medicare. http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?_r=1& http://www.nytimes.com/2013/08/04/health/for-medical-tourist...
    - ars 13y ago
      You don't have to pay $78K though. If you are old enough medicare will pay almost all of it. And if younger you should have catastrophic insurance which will pay all but a few thousand of that - and that type of insurance is very cheap. PS. No one - at all - pays list price for medical care. So completely and utterly ignore such numbers unless your goal is to be disingenuous. The numbers billed by medical providers are from the output of a random number generator, they have no basis in reality, and no one pays it.
      - Luc 13y ago
        > If you are old enough medicare will pay almost all of it. And if younger you should have catastrophic insurance You ignore the situation this man was, at 67, not eligible for Medicare and not insurable. > So completely and utterly ignore such numbers unless your goal is to be disingenuous. He already pulled strings to get the price of the implant in the US down to $13,000, 'list price, no markup'. Crazy.
leandrod 13y ago
I actually collaborated with the Evangelical chaplaincy in that hospital for a few years, when I lived at that city. I knew Paulo and we became friends, but I have not kept in contact since I first left São Paulo and got married. When I did return to the city for a few years, I had a child and had a nervous breakdown, so I feared the traffic to reach the hospital. Paulo and Eliana live at the Hospital das clínicas. It is the school‐hospital (or whatever you call that in English) of Brazil’s biggest, oldest, most influential university, the University de São Paulo. It is also Brazil’s biggest hospital, which makes it probably the biggest at least in South America. Quite naturally, it is the reference hospital for the whole of South America. I never knew of family involvement in maintaining them. As mentioned, he lost his mother even before contracting polio; I do not know if his father is still alive, or if he has any other family. Same for Eliana. It would have been quite natural for the Medicine school of USP to care for them as case studios, as polio was once prevalent and a mutant outbreak is still to be feared. But I suspect that, more than that, being a state‐run hospital no one ever thought of ceasing care or returning them to their families, if these are still available. It is not that expensive, as they share a section with other patients — they do have their own room — and need quite common medical equipment. Many doctors and other caregivers, such as chaplains — both are practising Christians, he Evangelical and she Romanist — volunteer time, and a few persons do brave the city’s insane traffic jams (usually measured in peak rush hours kilometers of jams; anything over 100km gets in the news, and that is not rare at all; going over 200km is rare) to visit them in the restricted alloted visit times. This does not mean we have ‘great national healthcare coverage’. Just that these two were blessed by being referred to the Hospital das clínicas de São Paulo. As the cliché goes, it is a country of contrasts, an euphemism for inequality, often cutting in ways that some foreigners have difficulty in grasping.

ks 13y ago

According to Wikipedia it seems that Brazil has universal free health care http://en.wikipedia.org/wiki/Health_in_Brazil http://en.wikipedia.org/wiki/Health_in_Brazil

eitally 13y ago
Yes, but it's generally crap and everyone who can afford private insurance (or just paying list prices at private clinics), does. <-- works with many Brazilians and spends about a month of each year there.
- leandrod 13y ago
  Worse than that — it is universal in theory but not in practice, as often there will be no doctors around in the State‐run health system, and not enough medicine and other medical supply.

nikatwork 13y ago

Genuine question - what happens for these types of cases in the US if the patient isn't rich? Does the patient get turfed out onto the street once they run out of money?

ars 13y ago
Medicaid pays for it. (And eventually Medicare when they get old enough.) People have such a strange view of medical care in the US. Medicaid is available to anyone who needs it (i.e. financially plus special medical circumstances). And all children in the US are able to have medical coverage - if they can't afford it the government pays for it (or gives a pro rated discount). There is no such thing as not [being able to] have coverage for your kids because you can't afford it. So basically the old and the young are both covered. The gap is in the middle.
- DominikR 13y ago
  So he would be kicked out of care after reaching the age of 18 in the US?
  - ars 13y ago
    The age varies (the younger the age the higher the income limits are) but in any case if he needed special medical care he would be shifted to a different program, but the coverage would stay.
- Luc 13y ago
  Not a wonderful situation, though, is it? $78k for a hip replacement will make one hell of a dent in the money you saved up for retirement, but hey, once you're poor you can get Medicare. http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?_r=1& http://www.nytimes.com/2013/08/04/health/for-medical-tourist...
  - ars 13y ago
    You don't have to pay $78K though. If you are old enough medicare will pay almost all of it. And if younger you should have catastrophic insurance which will pay all but a few thousand of that - and that type of insurance is very cheap. PS. No one - at all - pays list price for medical care. So completely and utterly ignore such numbers unless your goal is to be disingenuous. The numbers billed by medical providers are from the output of a random number generator, they have no basis in reality, and no one pays it.
    - Luc 13y ago
      > If you are old enough medicare will pay almost all of it. And if younger you should have catastrophic insurance You ignore the situation this man was, at 67, not eligible for Medicare and not insurable. > So completely and utterly ignore such numbers unless your goal is to be disingenuous. He already pulled strings to get the price of the implant in the US down to $13,000, 'list price, no markup'. Crazy.

leandrod 13y ago

I actually collaborated with the Evangelical chaplaincy in that hospital for a few years, when I lived at that city. I knew Paulo and we became friends, but I have not kept in contact since I first left São Paulo and got married. When I did return to the city for a few years, I had a child and had a nervous breakdown, so I feared the traffic to reach the hospital. Paulo and Eliana live at the Hospital das clínicas. It is the school‐hospital (or whatever you call that in English) of Brazil’s biggest, oldest, most influential university, the University de São Paulo. It is also Brazil’s biggest hospital, which makes it probably the biggest at least in South America. Quite naturally, it is the reference hospital for the whole of South America. I never knew of family involvement in maintaining them. As mentioned, he lost his mother even before contracting polio; I do not know if his father is still alive, or if he has any other family. Same for Eliana. It would have been quite natural for the Medicine school of USP to care for them as case studios, as polio was once prevalent and a mutant outbreak is still to be feared. But I suspect that, more than that, being a state‐run hospital no one ever thought of ceasing care or returning them to their families, if these are still available. It is not that expensive, as they share a section with other patients — they do have their own room — and need quite common medical equipment. Many doctors and other caregivers, such as chaplains — both are practising Christians, he Evangelical and she Romanist — volunteer time, and a few persons do brave the city’s insane traffic jams (usually measured in peak rush hours kilometers of jams; anything over 100km gets in the news, and that is not rare at all; going over 200km is rare) to visit them in the restricted alloted visit times. This does not mean we have ‘great national healthcare coverage’. Just that these two were blessed by being referred to the Hospital das clínicas de São Paulo. As the cliché goes, it is a country of contrasts, an euphemism for inequality, often cutting in ways that some foreigners have difficulty in grasping.