Health Care Disparity in the United States of America

By Valiere Alcena M.D. M.A.C.P.

This book is written to bring to light the many wrongs that are going on in the health care insurance system in the U.S.

The U.S. health care insurance system is the most expensive health care system in the world and the most inefficient health care system of all the health care systems of other industrial countries in the world. The U.S. health care system is controlled by the HMOs. The HMOs run the health care system for financial gains as their only motives.

The CEOs of the HMOs device all sort of business models that en-able them and their share holders to pocket the lion share of the 2.3 trillion dollars allocated yearly to pay for this inefficient and costly health care system.

They have zero interest in quality patient care.

The drug companies must also share some of the blames for the problems afflicting the U.S. health care system because, they make drugs that are so expensive and many people cannot afford to pay for them.

It is time for people in the U.S. to demand change and for the government to say enough is enough and come up with new legislation to create a brand new health care system to provide health insurance coverage for all American citizens.

• Language: English
• Publisher: iUniverse
• Release date: Jul 15, 2011
• ISBN: 9781462031368

Valiere Alcena M.D. M.A.C.P.

Valiere Alcena is a practicing physician, medical scholar, medical educator, and author. He is clinical professor of medicine at the Albert Einstein College of Medicine Bronx N.Y. and Adjunct Professor of Medicine New York Medical College Valhalla N.Y. On May 15, 2008, Dr Alcena was inducted into the American College of Physicians as MASTER-MACP in a ceremony held in Washington DC On August 19, 2010, Dr Alcena became Fellow of the Royal Society of Medicine in London, England (Royal Society of Medicine was founded in 1773). Dr Alcena is a TV producer and TV Journalist.

Book preview

Health Care Disparity

in the

United States of America

Valiere Alcena,

M.D., M.A.C.P.

iUniverse, Inc.

Bloomington

Health Care Disparityin theUnited States of America

Copyright © 2011 Valiere Alcena,M.D., M.A.C.P.

Cover by Nick Nichols/Dr Alcena

All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher except in the case of brief quotations embodied in critical articles and reviews.

The information, ideas, and suggestions in this book are not intended as a substitute for professional medical advice. Before following any suggestions contained in this book, you should consult your personal physician. Neither the author nor the publisher shall be liable or responsible for any loss or damage allegedly arising as a consequence of your use or application of any information or suggestions in this book.

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ISBN: 978-1-4620-3137-5 (sc)

ISBN: 978-1-4620-3136-8 (e)

Printed in the United States of America

iUniverse rev. date: 7/11/2011

This book is dedicated to the fifty-two million uninsured people in the U.S. and to all patients, physicians, and others who have suffered so unjustly and unfairly at the hands of HMOs since the inception of the HMO program.

I acknowledge assistance provided by Alison Berry in proof reading the manuscript

Contents

Chapter 1

Health Care Disparity in the United States of America

Chapter 2

Third World Health Care in a First World Country

Chapter 3

Disparity in Hypertension

Chapter 4

Disparity in Stroke

Chapter 5

Disparity in High Cholesterol

Chapter 6

Disparity in Obesity

Chapter 7

Disparity in Diabetes Mellitus

Chapter 8

Disparity in Heart Diseases

Chapter 9

Disparity in Cancer

Chapter 10

Disparity in Kidney Diseases

Chapter 11

Disparity in Diseases of the Stomach and Intestines

Chapter 12

Disparity in Anemia

Chapter 13

Disparity in Urological Diseases

Chapter 14

Disparity in Eye Diseases

Chapter 15

Disparity in Arthritis

Chapter 16

Disparity in HIV/AIDS

Chapter 17

Disparity in Depression

Chapter 18

Disparity in Alcoholism

Chapter 19

Disparity in Drug Addiction

Chapter 20

Disparity in Lung Diseases

Chapter 21

Some Things That Might Help to Fix the Help Care Crisis

Preface

This book is written to bring to light the many wrongs that are going on in the health care insurance system in the U.S.

The U.S. health care insurance system is the most expensive health care system in the world and yet is the most inefficient health care system of the health care systems of all the other industrial countries. The U.S. health care system is controlled by the HMOs and HMOs run the health care system for financial gains as their only motives.

The CEOs of HMOs devise all sorts of business models that enable them and their share holders to pocket the lion share of the 2.3 trillion dollars allocated yearly to pay for this inefficient and costly health care system. They have zero interest in quality patient care.

Drug companies must also share some of the blame for the problems afflicting the U.S. health care system because they make drugs that are so expensive that so many people cannot afford to pay for them.

It is time for the U.S. population to demand change and for the government to say enough is enough and pass new legislation that creates a brand new health care system and provides health insurance coverage for all American citizens.

Introduction

The U.S. health care insurance system is in a crisis and is broken. This system costs 2.3 trillion dollars per year and yet it is extremely inefficient. There are 52 million uninsured Americans and many million more with insurance who cannot receive timely and efficient treatments when they are sick. The HMOs stand between patients and their physicians to dictate when and what types of tests, medications, and treatments physicians can or cannot prescribe for patients. Physicians spend several hours per week for no pay, arguing with HMOs and their representatives to get needed care and services for their patients. HMOs pick and choose whom to insure in their insurance companies.

HMOs go to the greatest extent possible to prevent certain people from joining their health plans and in so doing, avoid spending too much money for actual health care. Evidence exists to show that some minority physicians are not allowed to join HMO panels with the excuse that these physicians are not Board certified. In fact, the hidden reason is the fact that many of these physicians provide care for Blacks and Hispanics and other minorities, many of whom have serious chronic medical conditions that are quite costly. By keeping these physicians off the HMOs’ panels, these patients are kept away from participating in the HMO plans.

In addition, for years many HMO companies used a fictitious Database Ingenix owned by United Health to set payments for physicians and certain subgroup of patients.

A lawsuit brought by the AMA, Medical Society of the State of New York and others was settled recently with the help of New York State Attorney General to stop the HMO’s involved from using this Database.

HMOs have over the years devised many software and business models to use to cheat and take billion of dollars from patients and physicians. HMOs have been allowed to operate unchecked by both the Federal and State Governments. The HMOs, because of their extensive wealth, have been in the position to hire lobbyists to represent their interests in Congress and in state capitals all across the country. They have contributed many million of dollars over the years to politicians to influence them to support their way of doing business.

All these things are done while ignoring the health care needs of patients. Anyone who dares to challenge the wrong doings of the HMOs runs the risk of being black mailed by them.

Some of these HMOs behave like GANGSTERS and use GANGSTER-like means to have their way. They have absolutely no respect for practicing physicians. They use practicing physicians only as objects that enable them to make money. HMO’s call practicing physicians PROVIDERS, to demean them. If you are a physician and you are working for an HMO, you are called A PHYSICIAN.

If you are a practicing physician, the HMO calls you a PROVIDER. How regretful and how shameful!

It is now time to bring the HMOs to the carpet to account for all the wrongs they have done to destroy the U.S. health care insurance system because of corporate greed.

The kidnapping of the U.S. health care insurance system could not have been possible without the help of many retired and practicing physicians, nurses, government agencies, and others who have benefited and are still benefiting financially from the HMOs.

Although Congress passed and President Obama signed into law the Affordable Act, the HMOs have devised all sorts of different business models and maneuvers to make even more money than before. Some examples include:

1. Increased premium fees

2. Creation of plans that allow employers to provide insurance coverage for employees with very high annual deductibles, ranging from $3000-5000 per year. Because of these very high deductibles, many employees simply stop going to physicians for needed examinations and treatments for diseases like

Headache

Hypertension

Sinusitis

Low back pain

Chest pain

Diabetes

Glaucoma

Abdominal pain

Swollen joints

Constipation

Hemorrhoids

Urinary frequency

Chronic cough

Asthma

Anemia

Depression

Insomnia, etc.

In addition, many women are not getting annual mammograms and pap smears. Many people are not getting necessary chest x-rays, EKGs, blood tests, urine tests, colonoscopies etc, because they will have to pay out of pocket for these things until they meet their deductibles. The end result is that the cost of health care, which is already too high, will go up even higher, because many of these people will end up in the emergency room and then get admitted to hospitals due simply to the failure to get routine medical care.

Since the world began, money has had a tendency to corrupt. The cynical, uncaring, conscienceless, and heartless people who agree to work and sell their souls to the evil of the HMOs are just as responsible for the mess that the U.S. health care insurance system is in, as are the CEOs and the share holders of the HMOs and other private health insurance companies.

Chapter 1

Health Care Disparity in the United States of America

Of all the forms of inequality, injustice in health care is the most shocking and inhumane. Martin Luther King, Jr.

HEALTH CARE IS A RIGHT AND NOT A PRIVILEGE

Valiere Alcena, M.D.; M.A.C.P.

To have a clear picture of the health care crisis and the health care disparity that exist in the U.S., it is important to understand some of the things that ail U.S. society and their association with both the lack of health care and the poor quality of the care that some people receive.

The U.S. is the richest, most powerful, most generous, and greatest country on earth and yet 50 million of its citizens have no health insurance. In fact, this year, there were 59.1 million uninsured people in this country. In addition, 42 million of its citizens are living in poverty. Fourteen million American children go to bed at night with no food to eat. There are 3.5 million homeless people in the US, many of whom are veterans who fought in wars on behalf of this country.

The poor economic situation has just about destroyed the middle class. Many people who used to consider themselves middle class are on food stamps or getting food from food pantries. There are 58 million people on food stamps in the US. The overall unemployment rates is 9.6%, but for black women it is 14.3%, for black males it is about 25% and 25% of all blacks live in poverty.

There are 2.3 million people in jail in the US. More than 80% of them are Black and Hispanic men. One out of every 100 Americans is in jail; one out of every 15 Blacks is in jail and one out of every 36 Hispanics is in jail in the U.S., leaving the Black and Hispanic communities in an un-healthy and impoverished state with so many of their men incarcerated and not around to provide for their families. Only 5% of African Americans attend colleges and only 47% of African Americans graduate from High School in the U.S.

The US health care system is the richest in the world. It is a 2.3 trillion dollar industry and it represents the second largest industry in the U.S. next to the military industrial complex. The U.S. health care system costs twice as much as that of other health care systems in other developed countries, and yet, compared to other industrial countries, health care in the U.S. is not as good as that of these other countries.

In 2006, The Commonwealth Fund published its first annual scorecard comparing the U.S. health systemwith that of the top 10% of other industrialized countries in the world.

The researchers used 37 indicators and found that the U.S. health care system scored only

66 on a 100 point scale. For example, the US health care system scored

71 on Quality

71 on Equality

69 on long, healthy, and productive lives

67 on access, and

51 on efficiency

In 1994, I wrote the book The Status of Health of Blacks in The United States of America; A Prescription for Improvement. Things were bad then, but now the U.S. health care system is in a crisis. This health care crisis is born out many years of neglect, incompetence and cooperate greed.

The factors that caused this health care crisis and the disparities they cause are many and varied. This crisis touches every one in one form or another, but those who are most affected are minority citizens. It is not surprising that Blacks, Hispanics, and Native Americans/Alaskan Natives bear the brunt of the disparities in the health care system in the U.S. because racism and cultural insensitivity are at the core of the health disparities that affect these segments of the population.

It is part of the American culture for members of the majority community to discriminate against minorities. If you are a member of a minority group in America, it is a given that you will be discriminated against by most people in the majority community for no reason other than the difference in the color of your skin.

When blacks show up in the emergency room, in the U.S., they usually get less attention. They wait longer before they are seen. Their symptoms receive less attention and in many instances, they receive poorer medical care than do Whites.

To illustrate:

Minorities get admitted less often to the ICU/CCU.

They are offered less coronary angiogram and as a result, they are offered less coronary bypass surgery to treat coronary heart disease.

If they need an organ transplant, they are less likely to get it because the person making the decision is likely to be a 35 year white resident physician. This is the reason that most organ transplants are given to White men and Women in this country.

Recently an important report came out in the literature showing that when Blacks show up in the ER suffering with pain, they are less likely to be given prescriptions by white physicians for pain for fear that they might take the medications and sell them. These same white physicians gave many more prescriptions for pain to white patients who show up in the ER.

It turns out that more white patients abuse these prescriptions by a much larger percentage than do black patients.

Blacks suffer more from the following diseases than Whites do:

1. Heart disease

2. Hypertension

3. Stroke

4. Cancer

5. High cholesterol

6. Obesity

7. Diabetes

8. Anemia

9. Asthma

10. COPD/Emphysema

11. Prostate cancer

12. HIV/AIDS

13. Glaucoma

14. Crack cocaine abuse

15. Depression

Poverty is associated with:

1. Racism

2. Poverty

3. Poor education

4. Health illiteracy

5. High un-employment

6. Welfare dependency

All this adds up to the Status Syndrome: The Haves and The Rich have everything and the Haves Not and the poor have nothing. If you are rich in America and you become ill, you will have access to the best doctors, the best hospitals, the best tests, the best medications, and the best machines to diagnose your problems and treat them. If you are poor, you are out of luck, period. That is what The Status Syndrome means.

The U.S. health care system is top heavy with expensive medical technologies, unique medical machines and procedures but these are set aside for the rich people who feel that they are superior individuals (VIP’S) and are entitled to the best care that money can buy and damn the poor folks. This is how most of them feel and this is how most of them behave. Unfortunately many physicians and other allied health care professionals give into this false concept because it mirrors what is happening in American society.

Some of the other factors that contribute to the health disparities in the U.S. are:

The business practices of the H.M.O’s and their greed for money for themselves and their shareholders.

H.M.O.’s is a multibillion dollar industry with a lot of financial and political clout that was set up during the Nixon Republican administration under the pretense that it was going to save money for the Medicare program. This whole H.M.O. fiasco turns out to have been a rouse put forth to take over the health care industry in this country and sadly and most regrettably,