Kenyan hospital markets in everything

The Kenyatta National Hospital is east Africa’s biggest medical institution, home to more than a dozen donor-funded projects with international partners — a “Center of Excellence,” says the U.S. Centers for Disease Control and Prevention.

The hospital’s website proudly proclaims its motto — “We Listen … We Care” — along with photos of smiling doctors, a vaccination campaign and staffers holding aloft a gold trophy at an awards ceremony.

But there are no pictures of Robert Wanyonyi, shot and paralyzed in a robbery more than a year ago. Kenyatta will not allow him to leave the hospital because he cannot pay his bill of nearly 4 million Kenyan shillings ($39,570). He is trapped in his fourth-floor bed, unable to go to India, where he believes doctors might help him…

The hospitals often illegally detain patients long after they should be medically discharged, using armed guards, locked doors and even chains to hold those who have not settled their accounts. Mothers and babies are sometimes separated. Even death does not guarantee release: Kenyan hospitals and morgues are holding hundreds of bodies until families can pay their loved ones’ bills, government officials say.

Dozens of doctors, nurses, health experts, patients and administrators told The Associated Press of imprisonments in hospitals in at least 30 other countries, including Nigeria and the Democratic Republic of the Congo, China and Thailand, Lithuania and Bulgaria, and others in Latin America and the Middle East.

Here is the full story by Maria Cheng, via Daniel Lippman.


And yet there are people against the second amendment...

@Massimo -do you have a Youtube account? There's a very cool channel there on crime encounters captured on CCTV, the "ASP" channel, subscribe! It's literally addictive; videos added nearly every day, with the host, a self-defense gun expert, commenting on each video. Most people there are like you, gun nuts, but what I find interesting is that in nearly every single video the strategy of "run-fu" (running away) would have been more effective. Shooting it out with the bad guy is usually not effective, since as Pastor John (the host of ASP) points out, in a gunfight usually the first person to get a shot on target wins. And remember, the bad guy has the element of surprise on their side. Just beat it, as M. Jackson once sang.

It's amazing how groundlessly optimistic some people are. No matter how many times you shoot a certain type of person in the back of the head in a computer game they still seem to think things will turn out differently in reality.

And remember, this is somebody apparently saying that a hospital is appropriate place to be be armed - and that those carrying weapons in a hospital are willing to use them.

Barbarism is never that far away from becoming a norm, but I always thought that the U.S. was less likely than Europe to indulge in it.

"Let me tell you, when I see a bunch of green robed weirdos wearing masks who are carving up a guy with knives, I shoot first and ask questions later."

-- Lieutenant Frank Drebin, Police Squad.

we have seen that show it is a little creepy but your conclusion
runfu nearly always more effective ?

the show makes it looks way more complicated than that

In which Massimo suggests folks get their health care at gunpoint.

Capitalists with their own money, socialists with the world bank money! Why am I not surprised?

Well, in defense of the hospitals, the USA does the same thing: try not paying the IRS for a while and you'll be 'involuntarily imprisoned' as well. Also I notice that people who lose money get prison. Do the CEOs of Enron, Worldcom and others really deserve life in prison for misstating their books? When everybody in the late 90s was doing it? (AOL's Steve Case is fine and never was jailed).

Debtors prison is alive and well, see the list of countries here, including the USA:

You will not be jailed for being unable to pay the IRS.

Lying to the Federal government is a felony, and the method used to prevent the IRS from collecting what you owe.

Interesting hypothesis, I suggest an experiment: Fill out your tax return accurately, then do not send a cheque. You have to now, for science! Report back.

He will receive a letter from the IRS asking for payment - and likely, they will be at least polite, and possibly not even assess any penalty (interest is another question) assuming he pays promptly.

What they will not do is break down his door and arrest him for non-payment.

They may not arrest him for non-payment if he pays; but that's not particularly insightful. I said 'don't send a cheque', not 'wait for a polite letter to send the cheque'. Please refer to the experimental procedures and begin again.

'but that's not particularly insightful.'

Well, your 'experiment' was banal in the extreme, as the IRS is niot a bunch of jack booted thugs - that is AFT, apparently.

And here is the experiment - 'Fill out your tax return accurately, then do not send a cheque.'

IRS asks for payment, without any need to fill out a return and not send a check. Basically, an exceedingly poorly designed experiment. The better one, which of course would not prove the point you are apparently trying to demonstrate, is do not pay the IRS anything. At which point they are still exceedingly unlikely to start any criminal proceedings, though they will basically seize any assets you have to pay your taxes.

Where the IRS gets exceedingly cranky is for those who go anything beyond not sending a check. Tax resisters are not simply people who are not sending checks, and in their cases, the IRS can be brutal.

Hospitals in the U.S. are required to treat patients who appear in the ER. But the hospitals are not required to treat them for free. Indeed, it often comes as a surprise to the patient who was treated in the ER to receive a large bill from the hospital for the services, and more of a surprise when aggressive bill collectors hound the patient constantly, and even more of a surprise when the hospital garnishees the patient's wages. Why would the hospital detain a patient until the patient pays the bill: the patient has no wages to garnishee if the patient can't work.

Lots of Kenyans have no wages, working outside the formal economy, is one reason.

Also that the money is typically paid by friends & family of the patient. Who are better placed to collect the debt, they know where he lives for a start.

Emergency room visits in the USA can be hazardous to your financial health. One of the "gotchas" is, even if the emergency room is in a hospital that is in-network on your insurance plan, the physicians who work there may not be.

And if they're not then they need not charge you the rates negotiated by your insurance company, and after the insurance pays them its out-of-network fee you'll get hit with a very hefty balance bill.

As for Kenya, is it necessary to use the word "ransom"?

It's really strange to hear, that Lithuania is in that list. I'm from Lithuania and it is first time I hear such issue and I really doubt that this is true as most of hospital bills are paid by tax payers money.

What the article doesn't mention is that these policies create a vibrant market for bribery for patients to "escape," which some of my respondents in a large panel study in Kenya did. $300, and you can walk away from a bill of tens of thousands more. There are definitely many private individuals benefiting from detaining the destitute.

This is the system advocated by conservatives for the US: health care like car repair.

He is being handled just like he was a car in for repair. Try to get your car back without paying for repairs made. Mechanics will rarely agree to return your car based on you needing the car to work to earn money to pay the repair bill.

Africa has the health care system advocated by conservatives for the US, except the US is a big source of charity funds in Africa, but it would not be if the US adopted Africa's health care system which relies on government charity from the US and Europe.

No, this is the healthcare system liberals want: hospitals funded by force, threats of imprisonement and at the barrel of a gun. Only difference is liberals want to lock up people who haven't even received the expensive care if they don't pay for it.

No, this is exactly the system libertarians want, private hospitals, directly paid for by the patient, if you can't pay the provider gets their fee however they can. Or more likely if you don't pay up front you don't get treated.

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