Dallas County Commissioner says race and no insurance are why Duncan was sent away by hospital

[pnwmom]

without treatment the first time he went there.

http://www.nbcdfw.com/news/local/Dallas-County-Judge-Jenkins-Not-Ebola-Risk-Health-Officials-278461321.html

Dallas County Commissioner John Wiley Price has now accused Texas Health Presbyterian Hospital of using race and money in the decision to send Ebola patient Thomas Eric Duncan back to the apartment after an initial emergency room visit Sept. 26.
"If a person who looks like me shows up without insurance, they don't get the same treatment," Price said.

[Fred Sanders]

1. Obamacare for a similar ER patient may well have prevented further contagion, that is a fact of

interest this election cycle.

Many folks who would have been medically cared for without Obamacare are now covered....if you have it, if your State accepted it......

Will folks now believe that the GOP has conned them on Obamacare, just as folks who believe the Ebola virus may become airborne must now also believe in evolution?

[targetpractice]

69. Now, that's a message. Maybe a bumper sticker.

Seriously, if Mr. Duncan was, in fact, uninsured... His tragic story is a concise case study for ObamaCare. A story that could really resonate with voters in the run-up to the election.

[Dreamer Tatum]

2. Let's see your data, Commissioner.

You'll need to provide matched case control studies to prove your point.

Got anything like that?

[pnwmom]

3. You don't think his lack of insurance affected his treatment? Of course it did. n/t

[Dreamer Tatum]

7. No.

Assuring me that it did does not equal proof.

[pnwmom]

8. Hospitals have a huge financial incentive not to take patients who can't pay.

The risk is obvious.

[Dreamer Tatum]

14. Ridiculous. They couldn't turn him away by law.

The man presented with respiratory problems and little else. Given that he didn't communicate that he had Ebola, did those symptoms merit admission? Hell no.

I've had gold plated insurance in the ER with similar symptoms and they treated me the same way.

Do YOU have data proving otherwise?

[pnwmom]

15. Yes, they can, as long as they do a "screening."

And he told them in this screening that he had come from Liberia -- which should have made them extra cautious.

http://www.kaiserhealthnews.org/stories/2012/february/19/hospitals-demand-payment-upfront-from-er-patients.aspx



Next time you go to an emergency room, be prepared for this: If your problem isn't urgent, you may have to pay upfront.

Last year, about 80,000 emergency-room patients at hospitals owned by HCA, the nation's largest for-profit hospital chain, left without treatment after being told they would have to first pay $150 because they did not have a true emergency.

Led by the Nashville-based HCA, a growing number of hospitals have implemented the pay-first policy in an effort to divert patients with routine illnesses from the ER after they undergo a federally required screening. At least half of all hospitals nationwide now charge upfront ER fees, said Rick Gundling, vice president of the Healthcare Financial Management Association, which represents health-care finance executives.

[Dreamer Tatum]

17. Separate argument.

They messed up the diagnosis, with help from the moron.
That has nothing to do with anything, unless you're also charging that the diagnosis was missed because he was black and uninsured.

It's ok. I know you can't prove wither case.

[pnwmom]

19. His lack of insurance could have kept them from running tests that would have given the diagnosis.

So there is a connection.

[Dreamer Tatum]

22. OK, then show me the hospital's protocols

for insured white people with those symptoms.

Got that handy?

Can you please come off it? They didn't know how sick he was. They erred. It happens. How would you like it if people attributed your errors to racism? How do you know the ER staff were all nasty racists trying to screw the guy? Why couldn't they be progressive kindhearted people who did their best with the information they had, including the little that guy gave them?

[jeff47]

31. How 'bout my experience as an insured white person?

Showed up at the ER with a dislocated shoulder last Saturday morning at 1am. For some reason, I didn't bother to shower and put on nice clothes first, so I came in looking rather disheveled and not exactly exuding "can pay".

First treatment plan: give me painkillers and muscle relaxants, and schedule an appointment at an orthopedist's office for Monday.

Then they found out I have insurance. And I've blown through my out-of-pocket cap for the year.

So they took an additional X-Ray, admitted me, did a CT scan.....and then released me 7 hours later with painkillers and muscle relaxants with an appointment at an orthopedist's office for Monday.

[Dreamer Tatum]

38. Great. Now show me the black man who had those same symptoms

and his lack of treatment.

And I assume this was all at the same hospital as Duncan, or your post has no meaning.

[jeff47]

40. If you'd bother to read instead of desperately deflect

you would have noticed that my treatment changed when they found out I had insurance and no longer had a co-pay, so that the hospital made a hell of a lot more money. But in the end did the same thing.

[Dreamer Tatum]

45. Good on you. Now show me that disparate treatment, OK?

It amuses me that you think I'm deflecting when in fact I am trying to focus on the claim, that
Duncan was given substandard treatment because he was black and uninsured. Your experience is what
is kindly called an anecdote, and more directly called irrelevant.

DUers seem to love science, except when they prefer lazy, casual empiricism. It is possible that Duncan was
minimized because of his status, but I doubt actual data would support that claim.

The far more reasonable claim, which is less sexy because it doesn't involve race-baiting to such a degree,
is that the hospital wasn't diligent in pursuing his case and inferring that he might have been very sick. That
may have exposed others due to malpractice. That argument is easier to make and more compelling. But again,
it's not nearly as flashy as "RACISM!!" so few will pursue it.

[jeff47]

90. The disparate treatment was done TO ME.

Reading. Try it!

My treatment changed when they found out my insurance could pay.

Duncan wasn't turned away because he was black. He was turned away because he was uninsured.

DUers seem to love science, except when they prefer lazy, casual empiricism. It is possible that Duncan was
minimized because of his status, but I doubt actual data would support that claim.

So you're doing in the second sentence exactly what you decry in the first.

[7wo7rees]

83. personal experience with Presbyterian

All of my family have been treated there many times going back to late 60's.

In late 76 went there and because we had no insurance sent to Parkland. At this hospital, one of the "best", it does not matter what color you are. If you dont have insurance or the ability to pay they will send you to Parkland.

Sending this message from phone, cant copy and paste. Look for Jim Schutze., Dallas Observer. He is last best investigative journalist Dallas has. He has been writing about this since the beginning.

John Wiley Price, look him up. Opportunistic trouble maker every chance he gets.

We posted about this yesterday.

Not race. Just insurance. That is all it ever has been with Presbyterian. Ever.

If you have the money or means to pay.

By tbe way, i am white, all of family is white. Always insured and Presbyterian is where you went. The 1976 experience was a shock as was Parkland hospital tbat nite to a very sheltered person from North Dallas. Nothing has changed.

[LisaL]

37. Nurse in Spain worked with two Ebola patients.

Didn't make doctors cautious either. She had to demand an Ebola test from what has been reported.

[Dorian Gray]

86. That he told them

he was from Liberia and had just arrive to the US, they do, indeed, need to be questioned. They should have immediately flagged him RIGHT THERE.

People all over the place are blaming Duncan for coming to the US. The hospital, medical experts, should be blamed for NOT doing what they should have done.

Doctors and nurses do this all the time. They dismiss serious symptoms and explain them away as a respiratory illness. Unless someone is a strong advocate for themselves or their child, they'll be examined for three minutes and let go. It's frustrating.

And in this case, it had SERIOUS consequences.

[notadmblnd]

55. I'd bet you got pretty good insurance, huh?

I know, I do too. But I know people who have not fit the "criteria" for admission up close and personal. My sister who had no insurance attempted suicide and I was told by the Dr that she did not fit the "criteria" for anything more than having her drink the charcoal, a saline IV and a bed to let the pills she took wear off. Oh, and they tied her town til morning. She was released to me an my other sister and we had to deal with her violent suicidal behavior until she tired herself fighting us.

It does happen. It is SOP for many ER's. Hell, a few years back there was a big scandal about a hospital in CA dropping ill patients off on skid row. In my opinion, it is simply naive to believe that people with no insurance are not treated differently in this country when it comes to medical care.

[Dreamer Tatum]

59. Cool story. Don't see the relevance.

This is a story about malpractice, at best. If the malpractice was motivated by race and class,
data presented in the trial will bear that out. If there is a trial. I understand that there are a lot of
anecdotes of disparate treatment, but they are just anecdotes.

I went in once with abdominal pain. They sent me home after giving me an antacid. Couple days later I
had shingles. They didn't know it was shingles when I was there.

[notadmblnd]

63. Only because you choose not to see.

But I do believe in Karma and that someday, you'll have some sort of experience that will bring back recollections of this conversation.

[Dreamer Tatum]

66. I believe in analytical thinking, no matter how inconvenient it may be.

As far as the bullshit hocus pocus made-up religious bunk known as "karma" goes, right back at you.

[840high]

32. Nope.

[noiretextatique]

12. if you care to, you can see the proof daily

if you don't care to see it, you can keep asking for proof.

[Dreamer Tatum]

25. Because you just know. Oooh. nt

[noiretextatique]

27. yes...i know ameriKKKa is a racist cesspool

for anyone who cares to see. as for this incident...i don't know for sure what happened. but i would not be shocked if he was turned away because of race and lack of insurance.

[Dreamer Tatum]

28. Hah.

thanks for clarifying.

[moonbeam23]

34. Where's your sarcasm thingy??

Obviously you forgot something...

[tammywammy]

4. You should take anything and everything Price says with a huge grain of salt. n/t

[pnwmom]

5. I think it's likely Duncan's lack of insurance had an effect on his treatment, or lack thereof.

[tammywammy]

9. that's fine that you think that.

But you shouldn't use Price to bolster it. His credibility in general is lacking.

[Throd]

6. That's certainly productive.

[Barack_America]

10. "I'm visiting from Liberia"

"I'm sorry, did you say you're uninsured?"

"No, from LIBERIA".

"Okay, uninsured. Funny, you speak good English for being foreign".

[seabeyond]

11. they knowingly sent an ebola man home with a check up, antibiotic (misdiagnosis, not non treatement)

because he did not have insurance and was black?

i call bullshit. i want proof.

sure enough. when they found out he was a prime candidate for ebola he was put in the hospital, quarantined and cared for until his death.

[pnwmom]

13. There will never be proof. But when there is a financial incentive to deny treatment,

there should be a high degree of suspicion.

I'm not saying they knew he had Ebola. But they knew he was sick and the system incentivized him to turn him away.

http://www.kaiserhealthnews.org/stories/2012/february/19/hospitals-demand-payment-upfront-from-er-patients.aspx



Next time you go to an emergency room, be prepared for this: If your problem isn't urgent, you may have to pay upfront.

Last year, about 80,000 emergency-room patients at hospitals owned by HCA, the nation's largest for-profit hospital chain, left without treatment after being told they would have to first pay $150 because they did not have a true emergency.

Led by the Nashville-based HCA, a growing number of hospitals have implemented the pay-first policy in an effort to divert patients with routine illnesses from the ER after they undergo a federally required screening. At least half of all hospitals nationwide now charge upfront ER fees, said Rick Gundling, vice president of the Healthcare Financial Management Association, which represents health-care finance executives.

[Dreamer Tatum]

16. We aren't talking about HCA.

We're talking about a specific claim that you insist is true because you say so.

Show me the data. Show me that white, insured people at that hospital with those symptoms are given extensive tests or are admitted. Because that would be the standard of proof required for this to elevate above the level of bullshit.

[pnwmom]

18. If a white, insured person had turned up there insisting that he'd recently been to LIBERIA,

and had abdominal pain and a fever, I think it is likely that person would have been treated differently.

But there is no data because we have never had to worry about Ebola before.

[Dreamer Tatum]

20. You're changing the argument.

You are assuming they suspected ebola. They missed that. So they thought the man merely had the flu or some other virus. You must prove that under the caregiver assumptions, his skin color and lack of insurance led to different care than a white insured person would have gotten.

Unless you're saying that they knew he had ebola and sent him packing. Is that it?

Either way, show us your proof.

[pnwmom]

47. Since he told them twice that he came from Liberia, they should have SUSPECTED Ebola.

That's the whole reason they're supposed to collect the information.

Why do you think they sent him away, knowing he had been in Liberia?

[Dreamer Tatum]

50. You are implying they suspected ebola and sent him away due to lack of insurance and race.

I won't even dignify that with a response.

[pnwmom]

52. No, I'm not. I'm saying they didn't dig deeply because their mission was to get him out.

If they had consciously thought Ebola, they would have been more likely to have kept him, but it never got that far.

[Dreamer Tatum]

54. Because he wasn't symptomatic enough.

This ground has been covered already. You are making an argument for malpractice, not racism.

If you don't think they suspected ebola, but didn't delve deeply enough, that is called malpractice.

[pnwmom]

58. The commissioner mentioned race, but I've been focusing on the lack of insurance.

But I am curious. Racism seems to infect police departments around the country. Are you so sure it is restricted to police? That some health care workers can't be affected by racism, too?

[Dreamer Tatum]

61. I'm sure they are. Please present evidence that the one(s) who saw Duncan are racist.

We can bullshit all night. Proof has criteria that are stringent. Not just in court, but to be convincing in general.

Of course there are probably racist nurses and doctors. Do you know if any saw Duncan? (Telling me that Dallas
has a lot of racists won't cut it, but someone surely will)

[LisaL]

43. These doctors never saw a case of Ebola before.

They missed the diagnosis.
Just like in Spain nurse was not taken seriously when she developed symptoms.
Do you really think they would have send him home because he had no insurance if they suspected he had Ebola?

[Dreamer Tatum]

48. Yes, because in the racism narrative

anyone who works in that hospital is an awful, unreconstructed racist, to the degree that
public health doesn't matter.

Which when you think of it in terms of Dallas' sheer demographics, it makes NO sense whatsoever.

[pnwmom]

49. I don't think they consciously suspected he had Ebola. I think they could have been motivated

by the lack of insurance just to get him out of there and not dig too deeply.

[LisaL]

53. What motivated the ones in Spain to not test the nurse for Ebola?

Her symptoms developed on September 30th. She complained a number of times, but was not tested for Ebola.
They gave her paracetamol when she went to the hospital the first time.
This woman was in direct contact with Ebola patient. And nothing.
But now Spain killed her dog. So all is well, apparently.

[pnwmom]

68. Stupidity. n/t

[Dreamer Tatum]

75. Why not racism? nt

[pnwmom]

77. She was white and so were the staff who turned her away. So where would the racism be? n/t

[Dreamer Tatum]

78. Boy you sure do know a lot. nt

[notadmblnd]

62. well you saying it isn't so, doesn't make it not true either.

[Dreamer Tatum]

64. Well that settles it.

Because it isn't NOT true, raving beancounting racists turned the poor man away with just pills,
which were probably just cyanide anyway.

[notadmblnd]

65. show me the evidence

[Dreamer Tatum]

67. The burden of proof is not on me.

The burden falls on those making the claim.

[notadmblnd]

72. However, you are making a claim too.

And you are providing no evidence for your claim either.

[Dreamer Tatum]

74. No, I'm not. I'm challenging a claim. nt

[notadmblnd]

70. you're awful touchy on this subject

I think that your outrage over feelings of defensiveness for the health care workers, keeps you from gaining a wider perspective. The data entry person behind the desk at the intake window doesn't have to be a racists to send someone away and neither does the Dr or nurse. What they have to do is follow guidlines and procedures the hospital has laid down (and don't think for a minute that they don't use code words such as "criteria&quot if they want to keep their jobs.

[Dreamer Tatum]

73. Oh, but we've now been assured repeatedly that it WAS because of race.

it either was, or it wasn't.

[notadmblnd]

79. I believe institutional racism is at the root of it.

I don't necessarily believe any particular bigoted individual (Dr. or nurse) was responsible . There is a difference and if you are not aware of what those differences are, I suggest you take a breather from all your outrage and refresh you memory inregards to what those differences between a racist and institutional racism are.

So no it is not as simple as you stated, "either it was, or it wasn't"

[Dreamer Tatum]

80. In other words, you got no specifics to back anything, but you just "know."

I can accept that as your opinion and I can hope that you aren't a judge or sit on a grand jury.

[notadmblnd]

81. I guess all I can say is- back at ya

have a good evening.

[freshwest]

42. I've seen this personally. They come out and ask questions, say one needs to be hospitalized...

Not talking GSW, where one is in immediate danger of dying right there and they'll get caught, doing what some say is illegal. Then they check on insurance. All they said before they realized the person didn't have any insurance morphs into:

Praise the Lord! You're Cured! Now go home and Sin no more! Etc..

Slog through the misery and on the next day go to their regular doctor. Who, hearing about it says:

"He should have been hospitalized, but he failed the wallet biopsy."

I hate seeing doctors after going through this bullshit several different times. I'd rather get a root canal. At least the dentist is honest and upfront with you.

So while the case of this poor man may or may not have been about race, it sure was about money.

Anyone who hasn't been without insurance in a place like that doesn't want to believe it. They can keep their illusions.

This is a direct result of Perry's fighting the ACA, Medicaid and gutting everything.

[pnwmom]

51. Thanks for the reality check. It's hard to believe that DUers are so trustful that people

without insurance get equivalent care in hospitals.

For example, a doctor I know told me that in the hospital where he did his residence, women without insurance didn't get help with pain during labor. Nice.

[jeff47]

33. No, they didn't know he had ebola yet.

They knew he had a low fever, abdominal pain, had no insurance, and did not appear that he would die in the next day. So they sent him home with antibiotics.

They didn't bother to test for ebola until he came back.

[notadmblnd]

76. here's a question

Did they draw any blood to determine whether or not he had a virus or did they just surmise that?

Everyone who goes to a Dr and has been diagnosed with a virus is told that antibiotics will not help, so why were they prescribed for Mr. Duncan, if not to placate him and hope that if it was something other than a virus that the script for antibiotics would take care of it?

[jeff47]

89. They were hoping it was some random minor issue

say, indigestion. Or a bacterial infection. So they threw some antibiotics at him to get him out the door.

Did they draw any blood to determine whether or not he had a virus or did they just surmise that?

First visit, no. Second (and final) visit, yes.

[babylonsister]

21. No brainer. Anyone with no insurance, not just a black man.

They will regret not pursuing further, and he should have been more honest. Lose/lose.

[Hoppy]

23. Race and being poor as a reason to get kicked out of hospital? Who'da ever thunk it?

[Dreamer Tatum]

24. Kicked out? He was seen, treated, and was given meds.

In which world is that 'kicked out'?

[Hoppy]

29. Treated, after his condition deteriorated.

[Dreamer Tatum]

30. Being seen and given meds = treated.

I am sorry they didn't give him the grape-flavored Uncle Jack's Old Timey Ebola Solution, but as has been well established,
he didn't say he was exposed and he didn't yet have enough symptoms to rule out simpler things. Yes, the hospital could
have been more diligent, and you can bet they are now.

Given that this is the first misdiagnosis in the history of medicine, I can see how it might be hard to understand.

[notadmblnd]

82. he wasn't kicked out of the hospital

the very minimum was done for him and he was sent on his way. And yes, being poor and his race was the reason for it.

After all, everyone knows that all black people are just lazy shiftless, jobless, thugs just living off welfare who don't deserve to live. Right? Hell, all you have to do is look at Trayvon Martin, Michael Brown and others like him to know that it's true. If they weren't all just subhuman animals who deserved to die, their murderers wouldn't have gotten away with it. No?

[whereisjustice]

26. and Dallas ready to prosecute him for getting sick. Guilty of getting sick while black.

meanwhile white kids are spreading this and not being threatened with prison time:

The symptoms of EV-D68 include achy limbs and muscles, fever, runny nose, sneezing and coughing — much like a common cold. Almost all of the confirmed cases of EV-D68 are in children — and the CDC is looking into the deaths of four patients in whom EV-D68 had been detected. Earlier this week, the CDC confirmed that the death of a nearly asymptomatic 4-year-old New Jersey boy last month was from the virus, making him the first person whose death was directly linked to EV-D68. In the other deaths, it’s not clear what role the virus played, the CDC said.

The CDC is also looking into a connection between EV-D68 and child paralysis, after a dozen Colorado children were treated for paralysis-like symptoms.

Ebola, while deadly and frightening, is relatively hard to spread. It’s transmitted mainly by exchanging bodily fluids with a person who is sick with Ebola, or through contaminated syringes.

http://www.marketwatch.com/story/never-mind-ebola-be-scared-of-this-virus-that-has-paralyzed-and-killed-children-2014-10-07

[LisaL]

36. Seriously?

You think kids should be threatened with prison time?

[whereisjustice]

39. sigh.... no, I didn't use the sarcasm thingy because never occured to me that

someone might think I was serious.

[Hoppy]

87. You'd be surprised about what is posted and taken as being serious.

Hence, my disclaimer at the bottom of my posts.

[freshwest]

46. Someone told me about this yesterday. Thanks for posting this.

[LisaL]

35. The nurse in Spain wasn't admitted into the hospital for like a week.

Ebola mimics a lot of diseases in the beginning.

[Fearless]

41. Still waiting for single payer... n/t

[whereisjustice]

44. +1, never forget when they told us "we'll fix it later" lol, it's the lie that protects the lie

that usually gets politicians in trouble.

[Fearless]

60. +1

[DemocratSinceBirth]

56. I had tingling in my ear and right side of face which I attributed to my uncontrolled hypertension.

I didn't have insurance and went to the ER at Kaiser in L A. I was treated like a king, got iv hydration, an ekg, and a blood test which were all negative. My blood pressure was high so I was given a script for blood pressure medicine. Because I was medically eligible I was given a free month of medical insurance which i didn't need because the symptoms resolved on their own.

[Aerows]

57. Fomenting racial discord

due to a lack of preparedness, funds and personnel.

That's an excuse that has never been used before.

[valerief]

71. We people who "aren't posting from the other side" inferred that from day 1. nt

[ZombieHorde]

85. It's speculation, but seems likely to me.

I would be surprised if black people without insurance were treated equally to other people most of the time they go to the ER.

[RedCappedBandit]

88. Likely that being uninsured contributed to misdiagnosis early on

Only makes sense that more attention will be given to patients who are insured. Which is why we need single payer.

[Scuba]

91. This is the same issue as sick days for food service workers. We either care ....

... about our collective health or we care about maximizing profits for insurance, drug and other medical industry corporations while keeping taxes low on the wealthy. These are the choices we make.


I think the national Democratic Party is remiss for not making our collective health a major plank in the Party's platform. It should start with Medicare for All, including dental, optical, hearing aids and mental health services. Add to that paid sick time, better oversight of the healthcare industry, better preparedness for disasters (including epidemics), and better training for our healthcare professionals.

And yes, we can afford it.

[librechik]

92. ahah--my feared "insurance issues will fuck us over in US over ebola" thing

is a thing. I'm not a crazy idiot, like some implied.

We are so screwed.