# If Stephen Hawking was born in America, **URL:** \ **Category:** Great Debates\ **Created:** [August 13, 2009, 6:30am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263 "2009-08-13T06:30:35Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![The\_Flying\_Dutchman](https://avatars.discourse-cdn.com/v4/letter/t/9fc348/32.png) [@The\_Flying\_Dutchman](https://boards.straightdope.com/u/The_Flying_Dutchman)\ **Post date:** [August 13, 2009, 6:30am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/1 "2009-08-13T06:30:35Z")
would he have received sufficient health care to carry on as he has been ? I particularly wonder about the fact that he was diagnosed with motor neuron disease at the age of 21 while in school and hence would have had a preexisting condition prior to any employment. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [August 13, 2009, 6:53am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/2 "2009-08-13T06:53:04Z")
If he had money sure. I think Professor Hawking is reasonably well off. Even without that he would likely benefit from his company’s health plan. As a tenured professor he’s good to go pretty much as long as he lives. As an aside and just to throw some fuel on the fire here is a right wing nutjob (bolding mine): > [@](#): > > The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof are legendary. The stories of people dying on a waiting list or being denied altogether read like a horror movie script. > The U.K.'s National Institute for Health and Clinical Excellence (NICE) basically figures out who deserves treatment by using a cost-utility analysis based on the “quality adjusted life year.” > One year in perfect health gets you one point. Deductions are taken for blindness, for being in a wheelchair and so on. > The more points you have, the more your life is considered worth saving, and the likelier you are to get care. > \*\*People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless. \*\* > > SOURCE: [http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877](http://www.ibdeditorials.com/IBDArticles.aspx?id=333933006516877) :rolleyes: ---
**Author:** ![Starving\_Artist](https://avatars.discourse-cdn.com/v4/letter/s/aeb1de/32.png) [@Starving\_Artist](https://boards.straightdope.com/u/Starving_Artist)\ **Post date:** [August 13, 2009, 7:10am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/3 "2009-08-13T07:10:49Z")
Sounds like he might have been wrong about Hawking. What about the rest of his post? ---
**Author:** ![UDS](https://avatars.discourse-cdn.com/v4/letter/u/ecae2f/32.png) [@UDS](https://boards.straightdope.com/u/UDS)\ **Post date:** [August 13, 2009, 8:01am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/4 "2009-08-13T08:01:09Z")
> [@Whack-a-Mole](#): > > If he had money sure. I think Professor Hawking is reasonably well off. > > Even without that he would likely benefit from his company’s health plan. As a tenured professor he’s good to go pretty much as long as he lives. Except, as the OP points out, he had motor neurone disease long before he was a tenured professor, or indeed before he had employment of any kind. In the US, would his pre-exisitng, incurable and extremely expensive condition have prevented his being accepted into an employer’s health plan in the first place, or have meant that he would only have been acccepted subject to exclusion and exceptions regarding treatment for MND? For that matter, before he ever became an employee of anybody, in the US would he have received treament and support to enable him to complete his educatation and become a candidate for academic employment? As for being “reasonably well off”, I don’t think he inherited much, if any, money. I doubt if his capacity to earn money would have been the same if he had not completed his education and become a professor. ---
**Author:** ![UDS](https://avatars.discourse-cdn.com/v4/letter/u/ecae2f/32.png) [@UDS](https://boards.straightdope.com/u/UDS)\ **Post date:** [August 13, 2009, 9:12am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/5 "2009-08-13T09:12:37Z")
> [@Starving\_Artist](#): > > Sounds like he might have been wrong about Hawking. What about the rest of his post? Well, there’s a fundamental misconception – or possibly a deliberate lie. The NICE does _not_ decide “who deserves treatment” by looking at quality adjusted life years, or any other criterion. It does not decide who deserves treatment at all. It does not provide any treatments, or evaluate any patients. What it does do is to appraise the clinical effectiveness of _treatments_, in general or in the abstract, in part by looking at their typical or expected outcomes. Cost-effectiveness measure by quality-adjusted life years is part of that process, but the article is wrong, wrong, wrong in suggested that the fact that Hawkins is already wheelchair bound would be a negative factor. The appraisal looks at the improvement wrought by the treatment. The citation of Hawkings is particularly ironic. Diseases like MND are so very debilitating that, for such diseases, even treatments which have only a limited effect can make an enormous difference to a patient’s quality of life, and so are very likely to be approved. If a particular treatment is recommended by NICE on the basis of its appraisal, then local area health authorities are legally required to provide it (to those for whom it is clinically indicated). The selection of patients for whom it is clinically indicated is a clinical matter, and that decision is taken by clinicians. If a particular treatment is not recommended by NICE, then local area health authorities are not legally required to provide it, but they are free to do so, either generally or in specific cases. In fact a wide range of non-recommended treatments are routinely provided. The reason for this is that the NICE appraisal system was introduced to avoid what was called the “postcode lottery”, in which the availability of novel or expensive or disputed treatments was determined by where you happened to live, and what the policy of your area health authority was. Thus it is the novel, expensive or disputed treatments which tend to be referred to NICE for appraisal. The NICE process is not beyond criticism, but the article quoted is so far off the mark that it can hardly be taken seriously as criticism. The author plainly has no idea what NICE does, or why, or how. ---
**Author:** ![Starving\_Artist](https://avatars.discourse-cdn.com/v4/letter/s/aeb1de/32.png) [@Starving\_Artist](https://boards.straightdope.com/u/Starving_Artist)\ **Post date:** [August 13, 2009, 9:17am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/6 "2009-08-13T09:17:42Z")
Thanks. It’s late and my eyes are crossing. I’ll take another look at your post and try to learn more about NICE tomorrow, but it sounds like you know what you’re talking about and I thank you for the information. ---
**Author:** ![cckerberos](https://avatars.discourse-cdn.com/v4/letter/c/f0a364/32.png) [@cckerberos](https://boards.straightdope.com/u/cckerberos)\ **Post date:** [August 13, 2009, 10:54am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/7 "2009-08-13T10:54:28Z")
> [@UDS](#): > > For that matter, before he ever became an employee of anybody, in the US would he have received treament and support to enable him to complete his educatation and become a candidate for academic employment? As an undergraduate student, he’d be covered under his parents’ insurance. As a graduate student and researcher, his health insurance would be provided by the university. A quick scan of his wiki bio makes it appear that he’s been in academia since he was 18, so I don’t think health insurance would ever have been a big problem for him. Or did I miss something? ---
**Author:** ![Oswald\_Bastable](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/oswald_bastable/32/214_2.png) [@Oswald\_Bastable](https://boards.straightdope.com/u/Oswald_Bastable)\ **Post date:** [August 13, 2009, 11:04am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/8 "2009-08-13T11:04:46Z")
> [@cckerberos](#): > > As an undergraduate student, he’d be covered under his parents’ insurance. From what I understand this would only be case because he was born to middle class parents who would likely have had insurance. What if, for whatever reason, his parents did not have insurance? Would also just like to point out that Hawking’s himself appears to have stepped in to defend the NHS: > **[tollbit-host.com](http://ww38.tollbit-host.com/news/worldnews/northamerica/usa/6017878/Stephen-Hawking-I-would-not-be-alive-without-the-NHS.html)** > > This domain may be for sale! OB ---
**Author:** ![Bryan\_Ekers](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bryan_ekers/32/183_2.png) [@Bryan\_Ekers](https://boards.straightdope.com/u/Bryan_Ekers)\ **Post date:** [August 13, 2009, 11:30am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/9 "2009-08-13T11:30:37Z")
> [@Oswald\_Bastable](#): > > Would also just like to point out that Hawking’s himself appears to have stepped in … Well, rolled in. ---
**Author:** ![MilTan](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@MilTan](https://boards.straightdope.com/u/MilTan)\ **Post date:** [August 13, 2009, 11:42am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/10 "2009-08-13T11:42:39Z")
Considering that Hawking has been receiving treatments for 45+ years now, and that treating ALS is very expensive, there’s a decent chance that he would have hit up against the lifetime cap of whatever insurance policy he would have been on in the US. Edit: Sorry, it’s early, and I completely forgot this point: Americans diagnosed with ALS [get covered under Medicare](http://www.alsaga.org/getinvolved/getinvolved_medicare.asp), so Hawking would have been covered by the government, even in the US. ---
**Author:** ![jjimm](https://avatars.discourse-cdn.com/v4/letter/j/ba8739/32.png) [@jjimm](https://boards.straightdope.com/u/jjimm)\ **Post date:** [August 13, 2009, 11:52am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/11 "2009-08-13T11:52:05Z")
That is the most unintentionally hilarious editorial fuckup I’ve ever heard. Sadly they have re-edited the piece, and misrepresent their idiocy with the following disclaimer: > [@](#): > > This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK. Not mentioning that “live in the UK” illustrates very strongly that he had been successfully treated by the very body they were attacking, for four decades. The exceptionalism! It burns! ---
**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\ **Post date:** [August 13, 2009, 11:52am UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/12 "2009-08-13T11:52:12Z")
> [@MilTan](#): > > Considering that Hawking has been receiving treatments for 45+ years now, and that treating ALS is very expensive, there’s a decent chance that he would have hit up against the lifetime cap of whatever insurance policy he would have been on in the US. > > Edit: Sorry, it’s early, and I completely forgot this point: Americans diagnosed with ALS [get covered under Medicare](http://www.alsaga.org/getinvolved/getinvolved_medicare.asp), so Hawking would have been covered by the government, even in the US. Although only once they qualify for Medicare - which means they pretty much need to go bankrupt first - then Medicare would cover him. And Medicare would only cover him as long as he qualified, so he’d probably have to go in and out of bankruptcy several times as he spent book royalities on his own treatment when he had them. ---
**Author:** ![RitterSport](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rittersport/32/6326_2.png) [@RitterSport](https://boards.straightdope.com/u/RitterSport)\ **Post date:** [August 13, 2009, 12:44pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/13 "2009-08-13T12:44:36Z")
> [@UDS](#): > > In the US, would his pre-exisitng, incurable and extremely expensive condition have prevented his being accepted into an employer’s health plan in the first place, or have meant that he would only have been acccepted subject to exclusion and exceptions regarding treatment for MND? I think (but I’m not positive) that group health insurance has to take all comers. So, he would be accepted as part of an employer’s health plan, but not necessarily an individual health plan. (Why does group health have to do that? Well, the gummint mandated it. Some bureaucrat stopping those death panels at the insurance companies, I guess.) ---
**Author:** ![Nars\_Glinley](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nars_glinley/32/8177_2.png) [@Nars\_Glinley](https://boards.straightdope.com/u/Nars_Glinley)\ **Post date:** [August 13, 2009, 1:39pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/14 "2009-08-13T13:39:39Z")
> [@RitterSport](#): > > I think (but I’m not positive) that group health insurance has to take all comers. So, he would be accepted as part of an employer’s health plan, but not necessarily an individual health plan. > > (Why does group health have to do that? Well, the gummint mandated it. Some bureaucrat stopping those death panels at the insurance companies, I guess.) In Hawking’s case under HIPAA (which of course didn’t exist when he was diagnosed), his pre-existing condition might have been excluded. It would depend on when he was diagnosed and treated. [QUOTE=Department of Labor] Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. Specifically, the law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to your enrollment date in the plan. As an example, you may have had arthritis for many years before you came to your current job. If you did not have medical advice, diagnosis, care, or treatment – recommended or received – in the 6 months before you enrolled in the plan, then the prior condition cannot be subject to a preexisting condition exclusion. If you did receive medical advice, diagnosis, care, or treatment within the past 6 months, then the plan may impose a preexisting condition exclusion for that condition (arthritis). In addition, HIPAA prohibits plans from applying a preexisting condition exclusion to pregnancy, genetic information, and certain children. [/QUOTE] From [here.](http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html) ---
**Author:** ![Sinaijon](https://avatars.discourse-cdn.com/v4/letter/s/dc4da7/32.png) [@Sinaijon](https://boards.straightdope.com/u/Sinaijon)\ **Post date:** [August 13, 2009, 2:05pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/15 "2009-08-13T14:05:54Z")
I brought this up in a different thread, but a good deal of Hawkins care has come from private foundations. He says as much on his own website. His 24hr nursing care, his wheel chair, his synthesizer, etc, all were donated from private foundations. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [August 13, 2009, 2:25pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/16 "2009-08-13T14:25:54Z")
> [@Sinaijon](#): > > Hawkins Tony, the skateboarder? ---
**Author:** ![Sinaijon](https://avatars.discourse-cdn.com/v4/letter/s/dc4da7/32.png) [@Sinaijon](https://boards.straightdope.com/u/Sinaijon)\ **Post date:** [August 13, 2009, 2:40pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/17 "2009-08-13T14:40:01Z")
> [@Squink](#): > > Tony, the skateboarder? Yeah. No way would he have gotten a rad skate board from NHC. Sponsors all the way. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [August 13, 2009, 2:52pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/18 "2009-08-13T14:52:23Z")
> [@MilTan](#): > > Edit: Sorry, it’s early, and I completely forgot this point: Americans diagnosed with ALS [get covered under Medicare](http://www.alsaga.org/getinvolved/getinvolved_medicare.asp), so Hawking would have been covered by the government, even in the US. As I understand it, if he is “disabled,” he would be covered under Medicare. But if he start earning good money, he wouldn’t be “disabled” according to the Medicare rules. Disability is about how much money you can make, not about how ill you are. ---
**Author:** ![athelas](https://avatars.discourse-cdn.com/v4/letter/a/5e9695/32.png) [@athelas](https://boards.straightdope.com/u/athelas)\ **Post date:** [August 13, 2009, 4:05pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/19 "2009-08-13T16:05:32Z")
Hawking may not have suffered, but others [have](http://www.marginalrevolution.com/marginalrevolution/2009/08/debbie-hirst-not-stephen-hawking.html): > [@](#): > > > [@](#): > > > > One such case was Debbie Hirst’s. Her breast cancer had metastasized, and the health service would not provide her with Avastin, a drug that is widely used in the United States and Europe to keep such cancers at bay. So, with her oncologist’s support, she decided last year to try to pay the $120,000 cost herself, while continuing with the rest of her publicly financed treatment. > > > > By December, she had raised $20,000 and was preparing to sell her house to raise more. But then the government, which had tacitly allowed such arrangements before, put its foot down. Mrs. Hirst heard the news from her doctor. > > > > “He looked at me and said: ‘I’m so sorry, Debbie. I’ve had my wrists slapped from the people upstairs, and I can no longer offer you that service,’ ” Mrs. Hirst said in an interview. > > > > “I said, ‘Where does that leave me?’ He said, ‘If you pay for Avastin, you’ll have to pay for everything’ ” — in other words, for all her cancer treatment, far more than she could afford. > > > > \*Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones. \* > > I’m not saying Obama wants to do this, I am saying there are some unacceptable features of Britain’s NHS (update: the policy was reversed in 2008). The point is not to compare those features to the problems with the U.S. system. The point is that everyone is gainsaying the Hawking example without recognizing there have been other people in similar predicaments. How could such a policy ever have been adopted in the first place? This is just a reminder, it’s not a prompt for you to repeat the familiar story that the U.S. pays more without getting better health care outcomes. It is far easier to nitpick at the opposition rather than meet their arguments head-on. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [August 13, 2009, 4:10pm UTC](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263/20 "2009-08-13T16:10:36Z")
That’s priceless. [Next page](https://boards.straightdope.com/t/if-stephen-hawking-was-born-in-america/506263.md?page=2)