Hospitals: The New Law Enforcement Agencies!

by B.J. on 8/03/2008 11:11:00 AM 0 comments Print this post

"What that does for us, it puts a strain on our system, where we're unable to provide adequate care for our own citizens," said Alan Kelly, vice president of Scottsdale Healthcare in Arizona

These US health care facilities seem to take the Hippocratic oath of "do no harm" to new unprecedented and broader levels each time I read about them in the news.

Characteristic of this culture of consumption and wasting, the new thing seems to be all about dumping patients.

First, stories of dumping patients on skid row in LA.


Now, hospitals are actually carrying out deportations.


"Many American hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance."


It's an American institution, if you can't find a way to fix the problem, you waste lots of resources to "dump" the "problem" elsewhere and have them fix it.

This is kind of like how Los Angeles County will soon run out of landfill space, and as of 2009 ship their trash over 200 miles by rail over to Brawley, CA never to deal with it again.

Hospitals seemingly running out of nursing home or rehab space, will go out of their way to ship their patients via plane to what appears to be their own country never to deal with them again.

The company line on these deportations seems to be the following:
1) immigrants take up our resources
2) nursing homes and rehab programs won't take them because they are uninsured
3) were federally regulated to put uninsured patients on Medicaid in "appropriate" care, so basically were trapped! Help!


1) The irony is that we already do a good job of taking other people's resources, but their complaints are never really taken into account. Naturally, when you take something away from people forcibly and without their mass consent, they will probably want to get things back. It's pretty much a social version of kharma.

Whether its logging, deforesting, mining, oil drilling, declaring war, it's probably safe to assue that were in some other country with borders, making agreements with people who run their countries like drug cartels, essentially stealing people's stuff for profit.

Wasting of resources? Americans already consume 25% of the world's electricity being only 5% of the world's population. It's vomit-inducing everytime someone says that "immigrants are consuming our resources" A lot of Americans do not have the right to EVER say this without being massively hypocritical.

The only thing is that our consumption and waste of world and other country's stuff never enters people's imagination unless they are dedicated environmentalists and can be safely identified eco-nuts.

2) What gets me is that according to these hospitals, deporting them is such a costly adventure.

In spite of costly litigation issues, cost of the flight, they still go through with it anyway! Twisted inspirational proof that even with limited funds as hospitals have, you can sort of make what you want happen, happen.

They've long violated the Hippocratic Oath when

It seems like a case where these hospital administrators are taking the opportunity to absolve themselves of responsibility, perhaps make an ideological statement while appearing to hold up to federal and ethical standards.

This issue in particular, of undocumented people in long-term health care, doesn't appear to be one of purely economics. The hospitals are not dealing with such an overwhelming amount of immigrants, that these immigrants are being ignored and falling through the cracks because there aren't many of these cases in the first place. Since the patients in these situations require long-term care, they aren't exactly patients that doctors can mindlessly sift through.

Judging from the quotes of one of the representative hospital administrators and the trends of hospitals who are more likely to deport immigrants, it doesn't appear to be cases of unintentional uncontrollable decisions, but actually rather calculated and intentional.

As usual, there's either a profit and/or ideologically-flawed Americanist mechanism at work. At any rate, the lack of care given to him is based solely on artifical, human-created boundary lines.

If a visitor from another planet were to assess our political stage, he'd probably seize upon that the concept: Artifical, human-created imaginary boundary lines.

Lines that only exist because humans decided that they need exist as if nothing of meaning happens outside those boundaries and nothing will benefit from it either.

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Making Sense of the Topic Are L.A.'s Hospital's Safe?

by B.J. on 7/16/2008 12:47:00 PM 1 comments Print this post

What I saw in this lecture was a very real tension between the real suffering of the patient and the heavy dose of expectations and standards to be met within these enormous factory-like hospital systems.

The topic centered around hospital-induced infections in Los Angeles.

The panelists, three. One from the people's perspective, a patients-rights advocate. Two from the practitioner's perspective, a director from UCLA Medical Center and some kind of Risk Management/PR person from Kaiser Permanente.

The fireworks officially set ablaze when the patients-rights advocate demands transparency in hospitals.

"Transparency" in the sense that the general public know of the shortcomings and limitations that hospitals and doctors have. Transparency is just another means of making sure that the hospitals are "accountable." "Accountable" meaning reliable and trustworthy.

Trustworthy hospitals mean that doctors, nurses, and other caregivers are treating their patients/everyone well.

Treating their patients/everyone well. Keyword "/everyone."

Meanwhile, on the flip-side, from a doctor or health-care giver's perspective, what the patients' rights advocate was advocating was probably just one more teardrop of annoyance to a bucket load of them. I felt that with every joke the UCLA Medical Center guy was making and the corresponding audience laughter on topics such as making the patients pay for their care.

Years of medical school, internships, paying loans, generally in attempt to help people's wellbeing, 24-hour workdays, no holidays or weekends, seeing countless patients a year and having to treat everyone individually. It's only a matter of time before everyone becomes anyone, which you don't mean to, but you're too tired to care. On top of that, hospitals in LA are going bankrupt and closing down. There seem to be less and less doctors and other resources around to do anything.

But these people on the outside, the patients, their advocates don't see any of this struggle. They probably struggle to, but that isn't seen at all and even more variable outside of the hospital context. Not when that medical practitioner's top-rated hospital is moving into a billion-dollar state-of-the-art facility in the broken neighborhood of Westwood. This prestige and wealth only serves as fuel to the fire --- more reason for the advocate to run full force at the system yelling at the practitioner to stop fucking up! If they can fight the big fish, the patients will be heard.

All that the UCLA dude and Kaiser woman could talk about were the way they managed their hospitals. He was keen to point out that he was like a "mayor" of a small town. The woman was proud to report that they had taken steps in Kaiser to improve safety as adapted from the airline industry, which I thought was something of an odd connection to make from a patient/consumer perspective because airlines give no shit at all about how you're doing even if you do pay to be pampered. Actually, on second thought, maybe there is a connection after all!

They were very specific about the management improvements they've implemented in each of their hospital systems. They were very much in love with the systems implemented. UCLA dude was happy to talk about all the numbers achieved in his time as top dog. #3 rated Medical Center in the United States. Hitting the 99th percentile on public health measures intra-hospital.

Essentially, he was hitting on stuff that patients don't give a beer dump about, which he actually knows intuitively and mentions, but as a defense mechanism has to bring up anyway. All he could point out were these rankings and numbers, which is impressive. But anytime someone's argument of defense relies entirely on numbers, usually there's something weak underneath the argument. Numbers and standards ideally should never be an ends to meet, especially in a field that depends on individual well-being.

...but unfortunately it seems that's what these large bureaucratic systems inevitably entail...some blind adherence and satisfaction to an abstraction, numbers that are highly relative, which say virtually nothing about the quality of care. There's nothing wrong with him or any other hospital manager focusing on numbers as a means to show that you're doing well, but as long as these hospitals are overworked and remain underresourced thanks to the HMO system, they're never going to progress to a level where doctors en masse will see eye to eye with patients.

Inicidentally, UCLA guy mentioned that 1 out of 3 people still wouldn't recommend UCLA Medical Center to a friend, but it's odd that this wasn't a focus of the discussion.

Inevitably, the UCLA and Kaiser people's involvement with the management end elicits talk about the responsibility laying with individuals. System works fine, our standards work fine, its the individuals who fuck up. Individual doctors, whom they weren't going to talk about at all in this public lecture setting. And the faceless individual impatient patients. This is where the tension flares up.

In addressing the specific concern of hospital-induced infections, Kaiser woman could only stress the importance of washing hands, as if this was the cure to AIDS. UCLA man said washing hands was important but not visiting the hospital was probably best. Patient advocate presses on these big level administrators to give more specifics about how things apply to the patients.

With so much rancor flying between the patients-rights advocate and the hospital admins, it usually means that both sides expect too much from each other and don't get what they want.

The patients expect too much from the hospital admins/doctors/staff, and hospital admins/doctors/staff expect too much from the patients.

Patients expect doctors to be nice, they want better working facilities, they expect everything to be perfect, they don't pay etc. etc.

However, it's always easy to blame the individual patient for being in the wrong. What makes it appear this way is that patients usually aren't the united front and powerful organization that a hospital is. An impersonal, methodologically organized group of people who have been in the business for years dealing with numerous people can't possibly be wrong over some individual patient's judgement can they?

Moreover, there's this American idea that you must pay for everything with money. Like other industries, it also seems as though patients should pay for all the work and extra anguish that doctors go through. It's a business, no free lunch. Patients should be grateful for whatever service they get and being so open to taking patients in.

Patients are "consumers" in the sense that they do demand a limited resource --- the doctors' service. However, they are NOT consumers in the sense that they will keep demanding a good or service. They are not really ready, willing, and able consumers, but people who believe that they are not well and thus seek an avenue to be well.

There is not much sympathy in American public discourse for patients, and this extends towards the attitude toward the patient in the hospital.

Judging from my mom's stories and the discourse in this dialogue, hospital staff seem to expect that patients should understand what they personally go through as doctors/etc. They seem to expect patients to know how things in the hospital work. They expect patients to check for conditions online as if they were the ones who went to medical school and could diagnose and treat themselves. And the kicker is that they actually want people out of the hospital. Doctors thinking everyone is invested in healthy like they are, expect too much of their patients, so they get tired and frustrated as well.

Thus the equilibrium of tension between doctors and patients in LA hospitals continues. It seems that nobody really gets what they want at a hospital, but it's there because it's business. What strikes me is that doctors really don't want patients to come to the hospital cause they have enough people coming over, but they also want to make sure that they keep up business, especially if they could pay for it.

In the end, the management folks at UCLA and Kaiser could only talk about how patients need to "arm" themselves with information.

There isn't much taught in the public discourse about handling health crises yourself. The internet and google search might be changing that a bit, but not everyone has the internet nor search abilities necessary quite yet. People generally aren't wired to practices of folk remedies, etc.

In America's education system and public discourse, we see and we learn that it is hospitals that we must go to first for any and all health care needs. It's the most visible object. So then here comes the patient expectation system. It's big, it's grand, somebody's got to know something when you go there, right? Doctors know what they're doing, they're rich, they'll help me.

People generally DO NOT want to be in the hospital, but they simply do not know any viable options and hospitals seem to have been marketed as the place to be when sick. There isn't any curriculum in schools for home remedies, alternative medicines, and public health measures are kind of a joke.

The business of healing strikes me as crisis-oriented, kind of like calling a plumber to unclog your sink. It makes me wonder whatever happened to the home visit doctor that I would see in Lassie and other assorted 50s television shows.

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American Health Care System: Were Last in Preventable Deaths!

by B.J. on 1/08/2008 03:52:00 PM 0 comments Print this post

Not anything people don't already know, but nonetheless still scary. I got this in an email and thought I should post it in its entirety.

"U.S. Ranks Last Among Industrialized Nations for Preventable Deaths, Study Finds (1/08/08)

The United States places last among nineteen industrialized countries when it comes to deaths that could have been prevented by access to timely and effective health care, a new report funded by the Commonwealth Fund ( http://commonwealthfund.org/ ) finds.


Published in the latest issue of Health Affairs, the study, Measuring the Health of Nations: Updating an Earlier Analysis, finds that while other nations dramatically improved their preventable death rates between 1997-98 and 2002-03, the United States rate improved only slightly. If the United States had performed as well as France, Japan, and Australia -- the top three countries in the survey -- there would have been 101,000 fewer deaths per year by the end of the study period.

Authored by Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine, the report, which looked specifically at deaths "amenable to health care before age 75," found that while other countries saw these types of deaths decline by
an average of 16 percent, the United States experienced only a 4 percent decline. "It is difficult," Nolte and McKee noted, "to disregard the observation that the slow decline in U.S. amenable mortality has coincided with an increase in the uninsured
population."

While the United States ranked fifteenth out of the nineteen countries on the "mortality amenable to health care" measure in 1997-98, it had fallen to last place by 2002-03, with 109 deaths amenable to health care for every 100,000 people, compared to 64 in France and 71 in both Japan and Australia.

"It is startling to see the United States falling even farther behind on this crucial indicator of health system performance," said Commonwealth Fund senior vice president Cathy Schoen. "By focusing on deaths amenable to health care, Nolte and McKee strip
out factors such as population and lifestyle differences that are often cited in response to international comparisons showing the United States lagging in health outcomes. The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals, and efforts to improve health systems make a difference."

"New Study: U.S. Ranks Last Among Other Industrialized Nations on Preventable Deaths." Commonwealth Fund Press Release 1/08/08.

http://fconline.foundationcenter.org/pnd/10010635/story

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by B.J. on 6/18/2004 08:48:00 AM 0 comments Print this post

Access for All: Restore Funding to California's Higher Education Outreach Programs

University of California and California State University Outreach Programs Are Necessary
Who's affected?

An E-Mail first and then my own commentary.

(Take Action Here)

UC and Cal State outreach programs try to reach out and provide opportunities to three groups of students:

Students from lower-income families
Students who attend low-performing schools
Students who are the first in their families to attend college
Many, but not all, of these students are African American, Latino, and Native American, groups underrepresented on California campuses. Poverty, attendance at a low-performing school, and being the first in your family to attend college are all strong barriers to preparing adequately for the competitive admissions process. A severe shortage of guidance counselors in California's schools exacerbates the challenges these students face.

Do the outreach programs work?

Yes. UC and CSU outreach programs are currently providing tutoring, academic enrichment, and guidance to 85,000 California students in grades K-12. Many of these students go on to UC or CSU campuses. 35.8% of African American and 46.6% of Latino students who enrolled as freshman at a UC campus last year had participated in a UC outreach program.

Are the outreach programs costly?

No. UC and CSU outreach programs have a high impact at a low cost. These programs are projected to cost $110 million over the next year and a half. This is a tiny fraction of our higher education budget. The programs were already cut by $46.6 million last year.

How do the outreach programs make a difference to individual students?

Maria Robles, 17, attends Pittsburg High School in the Bay Area. Because of her participation in the Puente Project, she learned about admissions to UC and about the campuses themselves. She plans to attend the University of California.
Carla Mena, a UC Berkeley senior, reports that she would not be at UC Berkeley without the outreach program she participated in. "I didn't know about other opportunities," she says.
Why do outreach programs matter for an entire university -- and for all of California?

Even the conservative U.S. Supreme Court recognized this year that the benefits of diversity "are not theoretical but real, as major American businesses have made clear that the skills needed in today's increasingly global marketplace can only be developed through exposure to widely diverse people, cultures, ideas, and viewpoints."

Finally, California benefits when qualified students who would otherwise miss the chance are given the opportunity to achieve.

What I Say (Just in Case You Might Care)

You are more prepared for college when you're white, from the suburbs and not from some impoverished neighborhood.

Take a look at the difference between Crenshaw High School in South Central Los Angeles (infamous epicenter of the Los Angeles Riots) or "South Los Angeles" full of "minorities" vs. San Marino High in a super-Republican white and Asian suburb of Los Angeles in just their web pages.

At first glance, Crenshaw looks like they're trying to empower their students while San Marino is trying to prepare their students for futures in colleges and careers from the start.

In it's first page, Crenshaw tries to stir up school pride by saying "we're" number one. Then you click on enter, and are taken to their page, with their Cougar logo and motto "striving for excellence" plastered underneath that logo. Beneath the motto and logo is a picture of a handful of predominantly black and brown students and one white guy. All this evokes feelings of solidarity and unity as some kind of success.

Meanwhile, San Marino shows off their building and blueness, casually stating their excellence. There are barely any pictures of the students, and when they are it's because they somehow got in the way of the luxurious, pretty facilities.

Another major and THE striking difference between the two is that Crenshaw talks about simple "graduation requirements" under the News Section while yuppy San Marino is all about "college" in their career center page.

Now, gee I wonder why it's like that.

Maybe because it's tough in a neighborhood like South Central Los Angeles ? And they're trying to empower them to survive ? Survival sure as hell isn't an issue in that nice lil Republican town. Their issues are fat white kid bullies pushing you over for lunch or something, not gang members with knives (I admit that those are my own stereotypes and imaginations, but that's likely to be a stereotype from the regular American. And I'm trying to bring you into that situation)

More opinions of Crenshaw High

More opinions of San Marino High

Now in college this is what the handful of these kids do.

I know some people from crappy neighborhoods and low-performing schools who started out engineering but have since switched to less practical subjects such as sociology. The reason they have switched has largely been because the math is way too hard in college. They didn't learn how to prepare straight out of their low-performing school. They thought "studying" meant one hour and be done with it like in high school when it actually meant a prostitution of yourself to your work for 10 hours a day like I learned in my ritzy yuppy private high school education.

Outreach programs at least help to let these kids know what's up. It won't completely stop all failing, but at least it helped let these kids know what they're getting into. Heh, I know it helped welcome at least one Latina girl who cried because the Filipino Student Association's outreach was so touching. Outreach gives them folks an immediate support system.

Groups and support systems like that in such an individualistic society are probably something hard for white America in general to understand. The most moderate of folks think its so easy to turn off all color and that we minorities ought to assimilate (why do we adapt to their culture anyway ?). Even the most liberal of white folks have trouble comprehending because they're all plentiful and can thus easily ignore their histories (while "minorities'" heritages and practices are always put in question), the white guy thing to do is to be "unique." They try and be "unique" on their own, especially on the largely liberal UCSC campus. Being unique is great and all, but minorities come from a different spectrum in which they are already unique, already exoticized to the point where it becomes fuckin' annoying.

Basically, outreach weclomes and helps kids get a feel for the surrounding environment and enables them to make necessary adjustments in their minds that they wouldn't get if they just plugged themselves into this white and Asian (and I don't mean the dark ones) wave of craziness called the UC and CSU systems.

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by B.J. on 6/17/2004 03:22:00 PM 0 comments Print this post

Health Care for All Californians

Email from ACLU:

URGENT ACTION NEEDED TO SUPPORT UNIVERSAL HEALTH CARE BILL

The Health Care for All Californians Act (SB 921) is just one
vote away from passage in the Assembly Health Committee. We have
until June 22 to act! Find out more about how SB 921 reforms
California's broken health care system at
http://www.sb921campaign.org

Please take action! Call the Speaker of the California Assembly,
Fabian Nunez, and urge him to do everything he can to help this
bill pass in the Health Committee. Even though he does not sit
on the committee, he has tremendous influence in the
legislature.

Here's a toll-free number for Speaker Nunez:

1-888-834-6556

Tips:

1. If you've never called a legislator, don't be nervous: the
staff person who answers your call doesn't want to debate you or
put you on the spot. You'll probably spend only a minute or two
on the phone, once you connect.

2. Be friendly and acknowledge the Speaker's leadership in the
past in expanding access to health care.

3. Tell the Speaker's staff passage of SB 921 would advance the
dialogue on health care for all and is a matter of critical
importance to all Californians, especially to working families.

4. Ask the Speaker to do everything possible to help SB 921 pass
the Health Committee on June 22.

5. Thank the staff member.

Thanks for your help! We're so close to a critical victory.

Heather, Christopher, Elvia, & Clarissa
ACLU/SC Take Action Team
--------------------------------------------------

Please spread the word as widely as possible in these last few
days before the hearing.

http://ga1.org/join-forward.html?domain=aclu_sc_action&r=L7__cK51q1TP

If you received this message from a friend, you can sign up for
ACLU/SC Take Action at:

http://ga1.org/aclu_sc_action/join.html?r=L7__cK51q1TPE

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