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Ask HN: How can you buy high quality healthcare?

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Re: Ask HN: How can you buy high quality healthcare?

#81

Post by giantg2 »

okr wrote: post #69
shiftpgdn wrote: post #53

Earlier quoted context omitted.

It's worth keeping in mind that the quality of Xray and MRI machines vary greatly and the facility doing the scans typically won't be upfront with what machines they're using. You are the only person who is ever going to advocate for the treatment you get so you'll need to be very firm but polite to get this information.

How i would i be able to differentiate the quality of the machines?

Depends on the type of machine/imaging to be done. For MRIs, you typically want higher Tesla values for better detail. There are also other types of imaging tech too like DTI or functional MRIs depending on what you want to look at.

Re: Ask HN: How can you buy high quality healthcare?

#82

Post by [deleted] »

legitster wrote: post #73
orev wrote: post #49

Earlier quoted context omitted.

By “Fitness Instructor” I think you mean “Physical Therapist” (and definitely not a Chiropractor). In the US, a fitness instructor can be literally anyone who runs an aerobics class, while a physical therapist actually has medical training.

No, I mean a fitness instructor. Or perhaps a "personal trainer". There are certain certifications that exist (And some people are both trainers and physical therapists). In my (limited) experience, physical therapists tend to have much broader recommendations. Like a PT might tell you to walk an hour a day, but a trainer might recommend a specific kind of crunch that targets the actual muscles in question. And to OP…

[deleted]

Re: Ask HN: How can you buy high quality healthcare?

#83

Post by Moto7451 »

legitster wrote: post #73
orev wrote: post #49

Earlier quoted context omitted.

By “Fitness Instructor” I think you mean “Physical Therapist” (and definitely not a Chiropractor). In the US, a fitness instructor can be literally anyone who runs an aerobics class, while a physical therapist actually has medical training.

No, I mean a fitness instructor. Or perhaps a "personal trainer". There are certain certifications that exist (And some people are both trainers and physical therapists). In my (limited) experience, physical therapists tend to have much broader recommendations. Like a PT might tell you to walk an hour a day, but a trainer might recommend a specific kind of crunch that targets the actual muscles in question. And to OP…

Boosting this comment, you want to talk to someone with a Masters or Doctorate in Kinesiology. Some Physical Therapists will have this or equivalent training. Some other specialists will fit the bill as well but not all.

My wife had back pain due to a disfigured vertebrae. That’s something they do not want to operate in until every other option is exhausted. Much of her pain and numbness is caused by imbalanced muscle development from a lifetime of incorrect posture and movements that compensated for the defective vertebrae. She’s worked with both a Physical Therapist and a Trainer to improve her strength and how she moves to the point that she is pain free 90% of the time. Both were referred to her by her doctors. They’re not part of a PT chain or gym.

Re: Ask HN: How can you buy high quality healthcare?

#84

Post by jamil7 »

persedes wrote: post #24
countrymile wrote: post #5

consider moving to Europe where there are multiple countries with excellent free healthcare systems

german, currently living in the US here: the scenario OP describes would unfortunately be the same in germany. The healthcare is good, but slow. And any non-obvious diagnosis can take a while / several specialists to figure out. Dunno if the private health care would be any better (wait time aside), but if anything I'm surprised you can't just throw money at the problem while in the US. Did something similar to what…

This is true but is it also the case with private health insurance? I've only ever been on public in Germany but others tell me it's much easier on private health insurance.

Re: Ask HN: How can you buy high quality healthcare?

#85

Post by mattlondon »

bowsamic wrote: post #54
mattlondon wrote: post #46

Sounds like you are paying for what the NHS in the UK will offer - they'll get you there but it is often slow and quite convoluted, but it is free! Private care in the UK can be very fast - e.g. I went from an initial consultation with a doctor for "knee pain" to having two sessions with a consultant and an MRI complete and booked in for physiotherapy within 48 hours. Things are often done the same day or within 24-4…

Unfortunately private care in the UK may not be so great when the NHS starts to fully break down

I don't think that is imminent. They've been saying it has been on it's knees constantly since the 1990s at least (and probably longer but I personally cannot remember any further back). It got through Covid without collapsing aswell- I don't think it is going away any time soon.

Re: Ask HN: How can you buy high quality healthcare?

#86

Post by weswilson »

Another more traditional approach, similar to concierge medicine, is executive medicine.

I think a lot of the big medical universities offer something like this:

https://www.emoryhealthcare.org/centers-programs/executive-h...

They have the connections and services available to do it all in-house and thus can make diagnosis' quicker.

Re: Ask HN: How can you buy high quality healthcare?

#87

Post by ianai »

manacit wrote: post #36
decafninja wrote: post #16

Concierge healthcare. It's also gotten more widespread than when it first became a thing, so even there I would make sure to do due diligence to see what level of service you're getting. But if you're willing to fork over the money, the level of care that you're supposedly given seems far better than even anything in stories you hear about in Europe or Asia. Seems like you should expect to pay five digit amounts per…

This is what I came here to say - the answer is "Concierge Medicine" In my experience, that's generally a primary care doctor that has on the order of 1/4th or fewer as many patients, but they all pay a membership fee in order to make that sustainable. That means they can spend significantly more time - like hours every week - with you. That doctor is then well connected in the community, and can call up a friend at…

How to locate such providers? Hundreds/month is worth it for a lot of cases.

Re: Ask HN: How can you buy high quality healthcare?

#88

Post by decafninja »

lefstathiou wrote: post #20

From my observation, the best way to access top doctors is via referrals from people who have legacy wealth, as opposed to being just rich.

This seems to be a useful piece of advice in general. Rubbing shoulders with such people opens a lot of doors.

Of course, getting into such a relationship with such people in the first place isn't exactly easy to begin with unless you are already a member of the club. But if you're a really good networking type, something to keep in mind.

Re: Ask HN: How can you buy high quality healthcare?

#89

Post by mr337 »

If you are open to medical tourism, from experience would recommend Mexico private healthcare.

I have been very impressed with private facilities and doctors. Out of pocket costs are very affordable including lab and imaging (ultrasound, CT, and MRI). No insurance needed as long as you have proof of payment. They may request this for intensive surgical operations etc.

Another benefit is results are immediately given to you, for example say you got a CT as hospital/provider A and want to see a specialist in B, no problem just bring the findings/imaging with you. No filing petitions to get your own medical records which you may or may not get in 2-3 weeks....if they honor it, then have to file HIPPA requests etc. All this wastes time, normally in weeks in the US.

A thing that completely surprises me is the doctors provide their cell phone number, so if you have issues after hours or weekends, or they receive lab results and want to provide a recommendation, after hours, just a message away. I wish we did this in the US.

One of the better things since you are self pay is to not deal with insurance. Want to try a different medicine, don't need approval for that. Want a second opinion, don't need to run it by insurance.Is this facility/doc in my network?, no worry there. You control the entire experience.

My recommendation is to look for cities that are expat hot spots as they have medical tourism facilities, normally all speak English including the local people to cater to expats. Yucatan, Quintana Roo (cancun) and I think Jalisco.

If you are interested in more info please email me, email in my profile. My SO has problem and we have played the bounce around game along with a few ER visits mixed in. Few things are more frustrating then experiencing the US medical system first hand with no results and being helpless. Best of luck!

Re: Ask HN: How can you buy high quality healthcare?

#90

Post by r_hoods_ghost »

forvo101 wrote: post #66
bowsamic wrote: post #54

Earlier quoted context omitted.

Unfortunately private care in the UK may not be so great when the NHS starts to fully break down

Can you elaborate please? Why will the private care in the UK suffer if NHS starts to break down? And, will NHS really break down? I know it has been considered many times but enough of the population seems to be against the idea that I suspect it may not break down soon. Do you have any reason to believe it may break down?

Not the OP but most private healthcare in the UK is delivered by doctors, nurses and other healthcare practitioners who have either been trained by or are still working for the NHS. If you need anything more serious than minor surgery you are likely to be treated in an NHS facility by NHS staff, and many of your tests will be done in NHS labs, so even as a private patient you are still relying on the NHS being functional. Chunks of the NHS have already been privatised and compared to the systems in most other European countries it is chronically underfunded and has poor outcomes. Will it break down? Arguably it already is, but this is mostly due to a decade of ideologically driven cuts, two decades of part privatisation and three decades of continuous reorganisations that waste vast amounts of money and benefit no one.
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