
Meet Paulo Machado, the man who has lived in hospital for 45 years - McKittrick
http://www.bbc.co.uk/news/magazine-23364127
======
vxNsr
Sweet.

I only know one person who contracted polio, when he was 10 or eleven polio
was nearly over in the US, he was one of that last children to get it here,
and his case was relatively mild, he basically just lost functionality of his
left calf muscle. He showed me his leg once, it's a really interesting
contrast, one leg is full and normal looking and the other looks like it was
taken from one of those starving african children, it's really just skin and
bone.

He's been a judge in Philadelphia for more than 30 years.

------
hkmurakami
The unanswered question upon reading this article for me has been, "how do
these two afford this kind of care for decades?" Wealthy parents? Generous
relatives? Great national healthcare coverage in Brazil?

It's just unthinkable for a normal family in the United States (I understand
that these two are in Brazil) to be able to afford this, at least in this day
and age.

~~~
nikatwork
Genuine question - what happens for these types of cases in the US if the
patient isn't rich? Does the patient get turfed out onto the street once they
run out of money?

~~~
ars
Medicaid pays for it. (And eventually Medicare when they get old enough.)

People have such a strange view of medical care in the US. Medicaid is
available to anyone who needs it (i.e. financially plus special medical
circumstances).

And all children in the US are able to have medical coverage - if they can't
afford it the government pays for it (or gives a pro rated discount).

There is no such thing as not [being able to] have coverage for your kids
because you can't afford it.

So basically the old and the young are both covered. The gap is in the middle.

~~~
Luc
Not a wonderful situation, though, is it? $78k for a hip replacement will make
one hell of a dent in the money you saved up for retirement, but hey, once
you're poor you can get Medicare.

[http://www.nytimes.com/2013/08/04/health/for-medical-
tourist...](http://www.nytimes.com/2013/08/04/health/for-medical-tourists-
simple-math.html?_r=1&)

~~~
ars
You don't have to pay $78K though. If you are old enough medicare will pay
almost all of it.

And if younger you should have catastrophic insurance which will pay all but a
few thousand of that - and that type of insurance is very cheap.

PS. No one - at all - pays list price for medical care. So completely and
utterly ignore such numbers unless your goal is to be disingenuous. The
numbers billed by medical providers are from the output of a random number
generator, they have no basis in reality, and no one pays it.

~~~
Luc
> If you are old enough medicare will pay almost all of it. And if younger you
> should have catastrophic insurance

You ignore the situation this man was, at 67, not eligible for Medicare and
not insurable.

> So completely and utterly ignore such numbers unless your goal is to be
> disingenuous.

He already pulled strings to get the price of the implant in the US down to
$13,000, 'list price, no markup'. Crazy.

~~~
ars
Medicare starts at 65. I don't know what's going on with this person. I
suspect we are not being told everything in order to make a good story.

And that's something to keep in mind: The strange stories you read are in the
news precisely because they are so unusual.

> $13,000, 'list price, no markup'. Crazy.

That's what he paid out of the US as well, I guess that's what it costs.

Please explain why you said $78k in your original post.

~~~
Luc
> That's what he paid out of the US as well, I guess that's what it costs.
> Please explain why you said $78k in your original post.

No no, you're mixing up different numbers. By the way, the $78k ($13 + $65k)
didn't even include the surgeon's fee:

"[...] he reached out to a sailing buddy with friends at a medical device
manufacturer, which arranged to provide his local hospital with an implant at
what was described as the “list price” of $13,000, with no markup. But when
the hospital’s finance office estimated that the hospital charges would run
another $65,000, not including the surgeon’s fee, he knew he had to think
outside the box, and outside the country."

" [...] he ultimately chose to have his hip replaced in 2007 at a private
hospital outside Brussels for $13,660. That price included not only a hip
joint, made by Warsaw-based Zimmer Holdings, but also all doctors’ fees,
operating room charges, crutches, medicine, a hospital room for five days, a
week in rehab and a round-trip ticket from America. "

"The Belgian hospital paid about $4,000 for Mr. Shopenn’s high-end Zimmer
implant at a time when American hospitals were paying an average of over
$8,000 for the same model."

------
beloch
Polio doesn't always leave visible long-term side-effects. My father had it
and was partially paralyzed for a couple of years as a child, but is normal
now. He got lucky! One can only hope that, when we're so close to the final
goal, people continue supporting vaccination efforts to finally put an end to
this disease.

~~~
swixmix
I just wanted to add some more information to your comment. The long-term
side-effects are called Post Polio Syndrome and there's a International Polio
Network at [http://www.post-polio.org/](http://www.post-polio.org/)

~~~
jacalata
The more obvious long term side effect is nerve damage/paralysis, as in the
case of the article, which is distinct from post-polio syndrome.

------
ars
This jumped out at me:

"The danger of infection means that they have to live in hospital."

Isn't a hospital like the worst possible place in regards to infection?

~~~
carlob
I believe the author refers to the danger of infecting others.

~~~
ars
Is polio really contagious 50 years later?

~~~
jacalata
No, it is not. They do not "have" polio now, they were paralyzed by the
disease and the paralysis remains after the disease is gone. My mother had
polio as a child and is crippled in one leg, but otherwise of normal health.
I'm not sure what the infection worry is - it might be something to do with
the paralysis/use of the iron lung?

------
rurounijones
One short article that was equal parts inspiring, heart-rending and heart-
warming.

I look forwards to the animation.

