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A homeless person in the US today does not have access to better health care than the president did in 1960. Is a homeless person likely to have up-to-date heal

A homeless person in the US today does not have access to better health care than the president did in 1960. Is a homeless person likely to have up-to-date health insurance information (I'd imagine its pretty tricky to get your health insurance card when you don't have an address). Are they likely to have enough cash on hand for a copay? What about for prescriptions? Are they going to have reliable transportation to a medical office? Are they going to have a reliable phone number where they can get messages from the doctor? For all of these practical reasons, I would imagine that many homeless people would probably forgo all but the most essential medical care, which they would receive at an ER. They're probably going to be waiting hours to see someone at the ER and when they do it will be an overworked resident. The president in 1960 would be able to see any doctor he wanted at the time of his choice. Also, a lot of homeless people probably wouldn't be homeless in the first place if they were able to access mental health care.

danielweber 12y ago
I can't give a precise date, but you might compare what a homeless person would get for a heart attack in 2014 with what Eisenhower got for his heart attack in 1955.
- lilsunnybee 12y ago
  Maybe for immediate, urgent care, but definitely not for recuperation or follow-up.
  - danielweber 12y ago
    Eisenhower's recuperation was "spend six months in bed." It looks pretty sad from here.
- GabrielF00 12y ago
  I think that a lot of the advances in treating heart disease have to do with preventing a heart attack in the first place by recognizing what risk factors a person has and having them change their lifestyle and take medications such as statins. Improvements in the area of prevention are going to be difficult for a homeless person to access since they require the ability to visit a primary care doctor, get medication and make lifestyle changes. It's pretty hard to eat healthy if you're on a very tight budget for food and don't have access to a kitchen. The treatment that a homeless person gets when they actually have a heart attack may be better since they would presumably have access to a defibrillator in an ER.
tptacek 12y ago
What does it matter if they have insurance, or cash for a copay? Public hospitals are required to treat them, with an extremely high standard of care, regardless of their ability to pay. Not only do they not need to pay to get care, but they don't even wait longer in the ER; ER triage (at least, where I've asked, but I assume this is true everywhere) is need-blind.
- GabrielF00 12y ago
  I doubt very much that the president would receive the same level of attention and prioritization at an ER as a homeless person, but even if you substitute a wealthy person in 1960 for the president you're still wrong. Let's say that the homeless person develops a form of cancer that was incurable in 1960 but can now be treated with a very low rate of recurrence with chemotherapy. Your point, I assume, is that because this new treatment exists, this homeless person will receive better healthcare than anyone in 1960. But that presupposes that this homeless person has access to that treatment, which means that they need reliable transportation to a medical office on a regular basis for an extended period of time, they need someone to take care of them when they're really sick, they need some ability to get their medication and to take it regularly.
- lilsunnybee 12y ago
  Those same hospitals are also incentivized to rush an uninsured patient out the door as soon as possible. Serious, painful, but not immediately life-threatening problem: give a random diagnosis and tell them to follow up with their nonexistent primary care doctor as soon as possible, and escort them out. In many states in the US, Medicaid or other insurance is not available to the homeless or indigent, not unless you have a disability diagnosis from the doctor you can't pay to see, and can get the necessary help to have that diagnosis recognized legally by the government. Otherwise cursory, rushed visits to the free clinic and ER are all that's available. Hospitals may be as minimally need-blind as required by law (if that, its not like the homeless can sue), but they only offer just that. The number of options and quality of medical treatment is vastly greater for those who can pay than for those who can't.

danielweber 12y ago

I can't give a precise date, but you might compare what a homeless person would get for a heart attack in 2014 with what Eisenhower got for his heart attack in 1955.

lilsunnybee 12y ago
Maybe for immediate, urgent care, but definitely not for recuperation or follow-up.
- danielweber 12y ago
  Eisenhower's recuperation was "spend six months in bed." It looks pretty sad from here.
GabrielF00 12y ago
I think that a lot of the advances in treating heart disease have to do with preventing a heart attack in the first place by recognizing what risk factors a person has and having them change their lifestyle and take medications such as statins. Improvements in the area of prevention are going to be difficult for a homeless person to access since they require the ability to visit a primary care doctor, get medication and make lifestyle changes. It's pretty hard to eat healthy if you're on a very tight budget for food and don't have access to a kitchen. The treatment that a homeless person gets when they actually have a heart attack may be better since they would presumably have access to a defibrillator in an ER.

tptacek 12y ago

What does it matter if they have insurance, or cash for a copay? Public hospitals are required to treat them, with an extremely high standard of care, regardless of their ability to pay. Not only do they not need to pay to get care, but they don't even wait longer in the ER; ER triage (at least, where I've asked, but I assume this is true everywhere) is need-blind.

GabrielF00 12y ago
I doubt very much that the president would receive the same level of attention and prioritization at an ER as a homeless person, but even if you substitute a wealthy person in 1960 for the president you're still wrong. Let's say that the homeless person develops a form of cancer that was incurable in 1960 but can now be treated with a very low rate of recurrence with chemotherapy. Your point, I assume, is that because this new treatment exists, this homeless person will receive better healthcare than anyone in 1960. But that presupposes that this homeless person has access to that treatment, which means that they need reliable transportation to a medical office on a regular basis for an extended period of time, they need someone to take care of them when they're really sick, they need some ability to get their medication and to take it regularly.
lilsunnybee 12y ago
Those same hospitals are also incentivized to rush an uninsured patient out the door as soon as possible. Serious, painful, but not immediately life-threatening problem: give a random diagnosis and tell them to follow up with their nonexistent primary care doctor as soon as possible, and escort them out. In many states in the US, Medicaid or other insurance is not available to the homeless or indigent, not unless you have a disability diagnosis from the doctor you can't pay to see, and can get the necessary help to have that diagnosis recognized legally by the government. Otherwise cursory, rushed visits to the free clinic and ER are all that's available. Hospitals may be as minimally need-blind as required by law (if that, its not like the homeless can sue), but they only offer just that. The number of options and quality of medical treatment is vastly greater for those who can pay than for those who can't.