Cottage Responds to Series on Hospital Discharges of Homeless

Everybody always wants the best health care Other People's Money can provide. It's expensive to provide goods and services. People don't have the right to goods and services provided by others. It's not a right. It's a privilege to be able to have these free services.

We have some safety nets in place. The medical community has always provided lots of charitable care and services to those in the area who need it. No one will be turned away from an Emergency Dept if they seek care there.

Why does ITW think that all the onus and responsibility lies on Cottage's shoulders? A recent article by ITW in this Indy disclosed that the woman who spent three nights outside after discharge from Cottage had a sister and a daughter.

Why is there no responsibility of these family members to take care of their own in a time of vulnerability and need? Were they unable or unwilling themselves? Or not even contacted as possible resources to help smooth out the transition from hospital to independent living?

Perhaps ITW can interview the families of these patients and see what responsibilities they could help take over (financial and helping with getting the patient up to the bathroom) for these patients who are fragile when it's time to leave the acute care hospitals.

The homeless have free medical so they pay for nothing. They go to the Hospital ER for a stubbed toe or an ingrown toenail, minor things that most people don't even seek medical attention. Their biggest desire is to have someone fuss over them, to treat them with respect. A problem here is they don't respect the people of SB, but think they deserve our respect. When someone is released from the hospital, they are released to the environment they came from, whether it's the street, a shelter, a house or apartment.

I am a homeless student who completed a Masters with honors, and start my second quarter of a PhD with a 4.0 GPA. Yet, my student financial aid does not cover housing. During school, I was sick, had no access to healthcare, and got so ill that I ended up at Cottage Hospital 13 days ago unable to breath and an infection that made it difficult to walk. Yet, 3 days later I was on the road to recovery. Since released, the last 10 days is the best breathing days in the last 3.5 years, lung capacity should be 625, and I scored 800 today. The infection in my leg is 20% of its original size. In other words, the hospital made my recovery from illness possible. The hospital attempted to facilitate temporary housing, but realized that the options would be worse, because I do not fit the typical profile and could sleep in a warm car. In addition, the attempted to assist with a follow up doctor appointment, and a way to pay for prescriptions. However, the County of Santa Barbara denied me credit to pay for $600 worth of prescriptions and a follow up doctor appointment. The result was I did not qualify for any government aid, did not get any prescriptions, and did not get to see a doctor.

Nevertheless, Cottage Hospital did what was possible, and cured my illnesses. They cannot control local, state, and federal policies governing aid to needy, and had no options for referrals since I would not qualify for any, because my income is a before tuition income. In other words, there are no programs for anyone fitting my demographic profile.

Thus, the blaming of government agencies, Hospitals, nonprofits, political parties, the economy, or any other entity is a waste of time. The system is an imperfect one that will have those that fall through the cracks like the poor woman who died, and individuals such as myself, but the system is the democratic system we choose to have to govern our social, political, and economic practices that come at a price. In my case, the price is applied to over 4000 job posting, will continue to apply for jobs, continue to maintain honors in my studies, and keep plugging away instead blaming an imperfect system I choose to live in.

More importantly, the solution requires more collaboration between private, public, nonprofit, and NGO sectors to prevent people from falling through the cracks. In other words, there is not enough collaborations that identify the issues that lead to the woman and me falling through the cracks. Once the problems are identified, solutions developed, solutions implemented, and implementations evaluated, then can we begin to come to real progress.

Moreover, if being homeless is what is required to live in our democratic system while getting PhD in Organizational Psychology & Development then that is something I will gladly do just be a be an American whose father enlisted here in Santa Barbara on December 7, 1941 to defend our way of life and system.

Lorenzo Ramirez
lramirez1963@yahoo.com

It certainly is a sad state we have gotten ourselves into. Only the weathy can afford the best of medical care while the poor sleep out in the cold and get weaker every day.
And now we have to employ a middle guy, our insurance company, who has no medical knowledge, telling us what kind of medical service we can have.
Then there's all the medical facilities and doctors charging huge sums of money to the patient to feed their Thursday golf game along with funding their lawyers to avoid malpractice suits.
Oh, and let's not forget the bio medical groups who are the real drug pushers and capitalists in control of keeping us all medicated. Ever notice how much of the media is sponsered by these guys?
Yes, there are a few heroes and do-gooders out there, but the for the most part it's agressive, it's ugly and it's way out of control.
Anybody got any ideas what we can do here in the USA, land of the free, other than to move to Canada or Sweden?

JDBarnes, you are wrong about the doctors. They are struggling too. Read an article by this same author, ITW about primary care going the way of the dodo (extinct) written in the past year or so.

Doctors who take insurance are then beholden to take whatever the insurance company will "reimburse" them. Doctors have to hire staff to learn how to code diagnoses (required by the insurance companies and there are ever changing rules) and do paper work and hire staff to keep track of the bookkeeping and accounts receivable.

Medicare is about to go bankrupt and is not sustainable. Patients keep paying higher and higher health insurance premiums but it's not like the doctors get a part of that pot of cash.

Doctors get paid measly contracted rates decided by the insurance company monopolies and Medicare. When you see your accountant, attorney, hairdresser or caterer you pay him or her his asked-fee at the time of service. Not so with doctors who accept insurance. They get "reimbursed" pennies on the dollar months later.

Don't blame the doctors for the expensive prices of things in healthcare these days. They're the foot soldiers who keep motoring along as the job keeps getting harder and harder and buried in paperwork and frustration. The doctors these days are much worse off economically than they were ten and twenty years ago.

It's not such a smooth go for healthcare in Canada and many of their citizens who can afford to come to the States and are willing for state-of-the-art medical expertise. Go live in Sweden and pay more than 50% of your earnings to taxes.

Don't get me started on Canada and Sweden again...thanks for offering some facts sez_me to keep this stream oriented in reality.
We have a huge problem but offering examples of other systems that are fatally flawed as a solution is equally stupid.

An anecdote about the German system, which is also used as a model we should adopt:
I am starting a project in Germany and I was speaking with another physician that oversees 12 hospitals. I asked him what the success of his system was based on. His response "we controlled immigration and discharge people back to work as fast as possible so that everyone contributes".

LorenzoR: " am a homeless student who completed a Masters with honors, and start my second quarter of a PhD with a 4.0 GPA. Yet, my student financial aid does not cover housing. During school, I was sick, had no access to healthcare"

If you're a UCSB student you have access to the Student Health Center. Granted, it ain't the Mayo Clinic, but it's better than nothing & your lock in fees pay for that service :) henry

Hank,

I am not at UCSB, instead at Walden University which is like Antioch or the University of Phoenix. They do not offer that like the University of California, which I am aware of as a graduate of the University of California Berkeley that required the purchase of healthcare insurance as a condition of enrollment when I was there. The school is just as challenging, but does of any such services. Thanks for the information!

Lorenzo Ramirez