and imminent sentence of death for 33 patients on Aug 31 2010. Interview by Grady physician Neil Shulman MD

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Interview of me by Neil Shulman MD about my experiences with the pharmaceutical industry. Exclusive footage you won’t see on the mainstream media.

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The situation at Grady Hospital in Atlanta of cutting off dialysis for poor patients without insurance (which will make them, um, die) is an echo of the national political farse of throwing out public option health insurance and throwing more good money after bad (Karen Ignagni and her group of health insurance criminals). I am glad to see that Max Baucus (D-Mont) who was the author of the bogus healthcare reform bill (and a top recipient of pharma contributions) was able to get some extra healthcare money for some miners from Libby, Montana, as well as shell out even more profits to the pharmaceutical industry, health insurance, etc. Here he is in action shelling out the pork.

Max Baucus is keeping the industry guys well fed.

Here is an update on the Grady story from Neil Shulman MD:

IT IS SAD.  I had a meeting with the woman who wrote the book THE GRADY BABIES and a woman who works at Channel 11 and the nurse from Nigeria who has been here ten years, Is married to an American and just got her Green card.  SHE NEEDS TO BE HERE 5 MORE YEARS BEFORE GEORGIA MEDICAID PAYS FOR HER DIALYSIS.  The Channel 11 lady and the author (WROTE A GREAT BOOK WITH DICK GREGORY) are connecting with Dorothy to get the book on the dialysis crisis rolling (30 people who may lose their lives after Jan 3rd when the inner city hospital stops supporting dialysis for their kidney failure.)  They are planning on putting personal stories about the patients on the internet.

In the meantime,  there is a movement by some docs within Grady Hospital to change things such that humanization takes precedence over monetazation. ALSO,  THERE IS A PLAN TO TAKE A BUS LOAD  OF THE DIALYSIS PATIENTS TO A HOSPITAL EMERGENCY ROOM ……….ALL AT ONCE…EVERY FEW DAYS ……after Jan 3rd.

 ON another front,  the medical volunteerism conference WWW.EMORYIMVC.ORG  is MOVING ALONG VERY WELL…………..we have some fantastic presenters,  the first edition of the book about  these heroes is almost ready,  the White House is sending folks………….AN OUTPOURING OF SUPPORT FROM HUMANIZERS.

IF YOU HAVE SOME TIME,  WE SHOULD AT LEAST CHAT ON THE PHONE TODAY.  I AM AT 404-321-0126.  IF NO ANSWER,  JUST LEAVE YOUR NUMBER AND I WILL RETURN YOUR CALL SHORTLY.

NOW A SHORT OVERVIEW OF THE CURRENT CIVIL WAR IN THIS COUNTRY:

We are in the middle of a war in this coutry between the monetizers and the humanizers.  Sadly,  the victims of this war are poor sick people.  IF everybody was a humanizer as the folks involved in the medical volunteer activites………….there would be no problem.  We would have peace and poor sick people would not suffer and die……. One of the major obstacles to winnning this war is the barrier between the poor sick patients and everybody else.  The caring nurses and doctors AND LAY FOLKS who are on the front lines Understand the current atrocitIES.  The further one is away from connecting with poor sick people,  the less likely you can empathize with them.  It is easy to use words like “ILLEGAL ALIENS”  OR “LIMITED RESOURCES FOR POOR SICK AMERICANS”  and just let people suffer and die when you don’t have to look in the eyes of these people or hear their stories. 

One of the free clinics in South Atlanta struggles with getting patientsurgent health care by specialists every day.  Recently, there was a case of a man needing back surgery before “he became paralyzed.”  The community clinic (docs, nurses, and pastors) FOUGHT HARD AND got the patient into Grady Hospital for the surgery.  On the other hand, there are folks like the 23 year old woman who recently died in Grady because she was shut out of her access to steroids for her Lupus.  She did know how to overcome the new barriers (more paperwork and more upfront fees to be seen for a few minutes so she could get her refills).  She ended up in Grady’s ER very very sick. She was admitted and died. Medical students and staff docs told me the story.  Many folks are familiar with this recent tragedy.  There are many folks in similar situations every day who die at home without even getting to the emergency rooms.

In developing countries where there is lack of access to health care………..at least there is not a COVER-UP.  When we brought a little girl from Kenya to Univ of Alabama Med Center for heart surgery…………..the Kenya media, the local Kenya politicians,  the local roatary club,  THE HAVES AND THE HAVE NOTS…..ALL JOINED TOGETHER AND HELPED SAVE THIS LITTLE GIRL’S LIFE.  IT WAS AN ENTIRELY DIFFERENT CULTURE.  THERE WAS NO HIDING OF “THE FACTS.”  THERE WAS NO INTIMIDATION OF THE CARING FOLKS BY  MONETIZERS.  We are experiencing a larger and larger class of HAVE-NOTS in this country because of the economy.

DAILY MEDIA ATTENTION SHOULD BE FOCUSED ON EFFORTS OF THE HUMANIZERS TO HELP POOR SICK PEOPLE.  THIS WOULD GALVANIZE EVEN MORE PEOPLE TO JOIN IN.  THIS WOULD GALVANIZE MORE PEOPLE TO ADVOCATE FOR LEGISLATION TO ELIMINATE THESE ATROCITIES.  Maybe we could even get the Georgia Legislature to allow poor people to get medicaid coverage BEFORE THEIR CANCER SPREADS.  THE MEDIA WILL NOT INFOMORM THE PUBLIC THAT IF YOU HAVE A MALIGNANT MELANOMA ON YOUR SKIN AND YOU ARE POOR…………..THE STATE MEDICAID EMPLOYEES ARE FORCED TO TELL YOU “SORRY MEDICAID DOES NOT COVER YOU UNTIL YOUR CANCER SPREADS THROUGHOUT YOUR BODY.” 

 We need more media attention, legal action, and MORE folks EDUCATED AND involved.  IT IS A STRUGGLE WHICH CAN ONLY BE WON WITH AN ARMY OF HUMANIZERS.  I have found that people with resources who are humanizers are MUCH HAPPIER than people with resources who are monetizers.  You are surely one of the humanizers.

 IF THE MAJORITY OF MEMBERS OF THE US CONGRESS WERE NOT MONETIZERS………….THEN TRULY MEANINGFUL NEW LEGISLATION WOULD BE PASSED TO ELIMINATE THE BASIC HEALTH DISPARITIES BETWEEN  THE HAVES AND THE HAVE-NOTS.  WE CAN STILL HAVE PEOPLE WITH BIG HOUSES AND SMALL HOUSES, PEOPLE EATING AT FANCY RESTAURANTS AND PEOPLE EATING BASIC HEALTHY FOOD AT HOME,  PEOPLE GOING ON  EXPENSIVE VACATIONS AND FAMILIES DOING MEDICAL MISSIONS………..BUT AT LEAST WE WOULD HAVE A COUNTRY WHERE POOR SICK PEOPLE HAD ACCESS TO BASIC HEALTH SERVICES AND BASIC MEDICAL THERAPIES……….WHICH ARE AVAILABLE TO MOST PEOPLE IN EUROPE, CANADA, JAPAN, KOREA, ETC.

AND BY THE WAY,  IT WOULDN’T HURT IF MEDICAL LITERACY WAS AN INTEGRAL PART OF OUR EDUCATIONAL SYSTEM………..WHY DO JUST DOCTORS AND NURSES LEARN HOW TO EXAM THE HUMAN BODY, WHAT SYMPMTOMS ARE IMPORTANT, HOW TO PERFORM SIMPLE PROCEDURES LIKE TAKING BLOOD PRESSURES?……………..WHY NOT EMPOWER CONSUMERS SO THEY CAN USE THE HEALTH CARE SYSTEM MORE EFFICIENTLY.  READING, WRITING AND ARITHMETIC ARE IMPORTANT BUT YOU CAN’T DO ANY OF THOSE IF YOU ARE DEAD.  MARTIN LUTHER KING EMPOWERED FOLKS BY TEACHING THEM HOW TO VOTE.

LET’S EMPOWER AMERICANS BY TEACHING THEM MEDICAL LITERACY………….LET’S EDUCATE THE SCIENCE TEACHERS SO THEY ARE MEDICALLY LITERATE, SO THEY CAN TEACH OUR FUTURE GENERATIONS ON HOW TO EFFICIENTLY USE THE HEALTH CARE SYSTEM.

BEST,

NEIL SHULMAN

INFRINGEMENT: FREEDOM OF SPEECH: MEDICAL PROFESSIONALS

The United States is a country where freedom of speech is supposed to be a basic right. Administrative power and personal wealth should not give any American the right to infringe on one’s freedom of speech. MANY DOCTORS FEEL THAT a downturn in the economy can create an UPSWING IN VOLUNTEERISM. LACK OF MONEY DOES NOT HAVE TO MEAN A LACK OF SERVICES. MANY OF THESE DOCTORS
ARE VERY CRITICAL OF BLATANTLY INSANE POLICIES BUT ARE AFRAID TO SPEAK OUT FOR FEAR OF PERSONAL REPERCUSIONS.

There are many caring doctors and other health care professionals who intentionally take lower paying jobs and/or volunteer their services because their goal in life in NOT TO MAXIMIZE THEIR BANK ACCOUNT OF MONEY BUT RATHER TO MAXIMIZE THEIR BANK ACCOUNT OF GOOD DEEDS. Many of these people have more global insights into the life-threatening impact and economic inefficiences of certain institutional and political policies. HOWEVER, IN MANY INSTANCES, THERE ARE ATTEMPTS TO INFRINGE ON THE FREEDOM OF SPEECH OF THESE HEALTH CARE PROFESSIONALS. Even well meaning journalists who wish to expose certain inefficiencies in humane health policies are often restricted from reporting.these stories. The executives of these media outlets are too often fearful of “losing revenue” from advertisers when such ‘CONTROVERSIAL” news stories are reported.

THE FOLLOWING ARE A FEW EXSAMPLES OF INSANE POLICIES WHICH FRUSTATE MANY “CARING” HEALTH CARE PROFESSIONALS EVERY DAY:

1. Medicaid rules which DO NOT ALLOW COVERAGE TO REMOVE AN EARLY CANCER BUT REQUIRE PATIENTS TO WAIT UNTIL IT SPREADS THROUGHOUT THEIR BODY.

2. Managers of health care institutions who prohibit cooperative institutional volunteeerism in order to address health care needs of the poor. Example: Executives of dialysis clinics NOT JOINING TOGETHER to keep uninsured patients with kidney failure alive.

3. Executives of hospitals not joining together to provide a few weeks supply of free essential medications to hospitalized uninsured poor patients upon discharge. The reality is often that these patients DO NOT HAVE INSTANT ACCESS TO MONEY OR TRANSPORTATION TO OBTAIN THESE MEDS thus they bounce back to hospital emergency rooms …………uneccesary personal suffering and avoidable expensive rehospitalizations.

4. Incremental increases in upfront fees for outpatient visits with NO EXCEPTIONS.
Therefore patients with VERY LIMITED RESOURCES can’t get essential refills of medications thus they suffer/bouncing back for expensive emergency room visits when their chronic illnesses become life-threatening.

5. Pharmaceutical companies often blast the public with PR CAMPAIGNS about
free medication programs for the poor HOWEVER the companies often create so many time-consuming roadblocks for instant access to these medications that health care professionals cannot get the meds to the patients in a timely manner.

I DO NOT SPEAK FOR MYSELF ALONE BUT FOR MANY HEALTH CARE PROFESSIONALS WHO ARE AFRAID OF NEGATIVE PERSONAL CONSEQUENCES IF THEY SPEAK OUT ON THESE ISSUES.

Neil Shulman MD
Atlanta,Georgia

Last week I wrote about the situation of the Grady dialysis clinic which the Grady Board voted to close last week. This means certain death for patients treated there without insurance as the private dialysis clinics won’t treat the patients, and emergency rooms will only treat them if they are within two days of death (see “I Need the Dialysis. I Think I will Die.”) This struck some of us in the healing professions as particularly cruel and inhumane, and some of our readers from other countries said we didn’t have the right to call ourselves a civilization if we treated people like that. The 90 or so patients represent a mix of undocumented aliens, people waiting for their green cards, and those who haven’t lived in Georgia for five years and don’t qualify for Medicaid. So far efforts to get private clinics and local teaching hospitals to provide compasionate care have been to no avail.

Last Wednesday local attorney Lindsay Jones, working pro bono, was able to get a court injunction to keep the clinic open. Last Friday the local AJC did some slam dash journalism by picking up the phone and getting someone from the New Jersey Medicaid department who said that they did not provide care for undocumented aliens, in spite of what a spokesman for Grady said. His response was “Nah-ah”.

Tomorrow there is a court date at Fulton County court on Central Ave between Prior and Martin Luther King Blvd in downtown Atlanta. There will be a protest at 8:15 am on the courthouse steps.

This afternoon we met with the lawyer and the dialysis patients.

Neil Shulman MD discusses situation with dialysis patients

I spoke with a woman from Nigeria named Ade Abner. She is 43 years old and has been on dialysis for 10 years. She is married to an American who was born in Georgia who is also on dialysis. She works as a registered nurse and is waiting for a green card. She is therefore not an undocumented alien.

Ade Abner
Some of the patients from Mexico said that some people had already gone back to Mexico. The Mexican Consulate, who Grady has been working with, told one woman that she had to leave now or she wouldn’t be able to return later. Feeling pressured to leave she went back. One woman went to Birmingham AL and is currently getting dialyzed in an ER. Others had been offered $2,000 to go back to Mexico, where they would be dialyzed for only three months.

June 17, 2009

PRESS RELEASE

From Neil Shulman MD

AN ECONOMICALLY IRRATIONAL HEALTH CARE SYSTEM WHICH TORTURES THE POOR

The State of Georgia and the US Government are operating a Medicaid program in Georgia which often results in psychological and physical torture of low income American citizens. When a Georgian discovers that they have an early stage cancer–for example kidney cancer, skin cancer, prostate cancer—they often will apply for Medicaid coverage in order to get the cancer removed before it spreads. The Medicaid rules specifically state that one has to not only be poor but also disabled to be eligible for Medicaid coverage. For example, if a financially eligible person’s cancer has not spread or metastasized throughout their body, then they are not considered to be disabled. They and their family must go through the psychologically torturous state of knowing that they have a curable cancer and being forced to wait months or a couple of years for the cancer to spread before they can get treatment. The second phase of “the torture” is physical in nature. In many cases, during this phase the patient has become eligible for Medicaid and then for chemotherapy. Well meaning doctors, nurses, and other health professionals are often cornered by the state of the patient’s illness. Their only choice of therapy to extend the patient’s life is to bombard them with drugs which cause hair loss, nausea, weakness, high susceptibility to infection, etc.

The irony is that these insane Medicaid regulations often cost tax payers more money. Early stage removal of the cancer often costs much less than extensive hospitalizations necessary when very disabled patients require toxic treatments…treatments which may only extend their life a few months or a year or two.

Is Georgia’s Medicaid program unique? On many fronts Georgia is unique. The residents of many other states need only be “poor” to be eligible for Medicaid coverage. Also, Georgia is near the top of the list in rejecting Medicaid coverage among the states requiring that the resident be “disabled.”

Unfortunately, the segment of our population who experience this torture often do not speak out because of limited resources, a lack of understanding of how to access the media, and/or physical disadvantages. Of course, there are many Georgia doctors who can share the sad stories about these patients. Also, the Georgia-based national office of the American Cancer Society has been an outspoken advocate for these people.

Sadly, the current state of the economy is increasing the number of folks who slip into needing Medicaid coverage.

CONTACT:

Neil Shulman MD

Associate Professor,

Emory University School of Medicine

Author: Your Body’s Red Light Warning Signals, Random House

nshulma@emory.edu

404-321-0126