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The World’s Cheapest Hospital Has to Get Even Cheaper

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Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#131

Post by notyourday »

dredmorbius wrote: post #125
notyourday wrote: post #86

Earlier quoted context omitted.

That's the only time when one cannot get quotes. Depending on a location ( ave/st in NYC and a time of day ) the ambulance would take one to a specific emergency room in a specific hospital chain. But again, that's not where most of medical services "waste" is occurring.

Most medical expense is care of chronic conditions and end-of-life care. Not elective procedures. https://www.qualityhealth.com/health-lifestyle-articles/10-m...

So if it is chronic there's even more reason to ensure that one does not overpay for what one would be consuming all the time?

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#132

Post by notyourday »

anigbrowl wrote: post #96
notyourday wrote: post #82

Earlier quoted context omitted.

Most of the problems in the health care are non-urgent. Most of people at the ER are not there "waking up and not knowing why they are in the ER". They walk into ER with something not working for them. That's exactly why it takes 3-4 hours to be seen by the ER doctor. People like you, who wake up in the ER, are rarities. Those people are either brought to the ER in ambulances or are triaged and seen immediately. It i…

I do not agree that most visitors to the ER do so for non-urgent reasons, although few complaints are so severe. I don't think you've fully grasped the point people are trying to communicate to you here.

I believe I understood it quite well. It just does not match either my experience or what I read.

There are lot of articles on the topic. Here's a random one:

https://www.wmpllc.org/ojs-2.4.2/index.php/ajdm/article/view...

Green triage means that there were no reason for the patient to be in the ER. With the over-triage, green is still over 70%.

So lets presume that between red and yellows it is actually 30% and none of them are triaged up ( based on the article that I linked it seems triaged up red is high single digit which is in the same ballpark that my friends who are in emergency medicine rotation say ). Those would be the only cases where one cannot pick a non-crazy expensive service ( in fact only reds cannot, and yellow probably can which is why their service is delayed ).

So at least 70% pay 7-10x because they showed up in ER rather than in a walk in center/doctors office.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#133

Post by kevhito »

naruvimama wrote: post #114
steve19 wrote: post #74

Earlier quoted context omitted.

I am not saying you should not be proud of Indian progress, but I suspect the experiences of a businessman in a big city in India are vastly different to a low caste woman with TB in rural India. A friend of mine is a nurse who did social work in rural India. What she told me about the local hospitals was horrifying, not just the condition of the hospital and how patients with infectious diseases were sleeping on the…

The use of the word "low caste" is in quite mean considering "poor" would be more appropriate. Just as Black or Native American would be a poor substitute for poor american. Or Roma/Eskimo/Greenlander/Sami for Europe Especially considering that the current prime minister and president of India are from so called backward communities. India has come a long way in social development and using the "caste card" is quite…

I'm very confused by your comment, and I hope you can clarify. I'm familiar with the colonial/European origin of the "cast system", but having been to India a few times and studied/read a bit, saying that the word has no proper native equivalent (to be blunt) seems both irrelevant and kind of disingenuous. Regardless of the word's origin or colonial reasons, it seems clear that caste-related issues are very visible and very present in India today. Do you agree? You seem to admit as much. But you also seem to downplay the entire existence of caste.

I'm really not familiar with the tribe/clan system in Iraq and Syria. My experience in some other former british and french colonies made it clear how the colonial system benefited from or even created and promoted ethnic rivalries, racism, tribalism -- yes absolutely -- but none of those situations seemed to really be a direct analogue of India's caste system. Do most people in India think of caste pretty much the same way as Americans think of ethnicity or racism?

Maybe you can also talk a bit more about Modi and his "low caste" background, because I've been curious about this myself. How much do you make of his "caste" as part his political identity? Do you see this as a sign that the caste system is dead/irrelevant/never-existed? Or that the low castes have triumphed? Or is he a pawn/token in a bigger game?

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#134

Post by notyourday »

bena wrote: post #17
notyourday wrote: post #9

Earlier quoted context omitted.

I most am most likely going to need an ACL surgery in a couple of months so we will see how it goes. So far I found out that pretty much every "X is difficult" is a gospel peddled by lazy. This is my first relatively major incident so I'm running pretty blind -- I'm approaching it as I approach needing to do something in business. Instead of going to the ER ($2,500), I went to a walk in medical center ($120), got see…

How did you know it was an ACL injury? Did you injure yourself and went to a medical center and they told you to go to a radiology center who then told you you had an ACL injury? I ask because at the end, you said you searched for "sports medicine surgeons" which already looks like you have _some_ knowledge about what was going on. Which is great. But part of the problem we have is education. Most people don't even k…

> How did you know it was an ACL injury?

Crash on a Super-G, followed by a quick prelim diagnostics of knee stability. Diagnosed as a possible tear of MCL or ACL and possible fractures.

> Did you injure yourself and went to a medical center and they told you to go to a radiology center who then told you you had an ACL injury?

You might find it interesting: all such diagnostics is actually done only using an X-rays and MRIs. Physical evaluation is just used to decide what to X-ray and what to MRI.

> Which is great. But part of the problem we have is education. Most people don't even know of other options available to them and don't have the vocabulary to effectively search for what they want.

Probably, but this is a vastly different problem from "Something unknown costs too much"

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#135

Post by kevhito »

npmn wrote: post #126
naruvimama wrote: post #114

Earlier quoted context omitted.

The use of the word "low caste" is in quite mean considering "poor" would be more appropriate. Just as Black or Native American would be a poor substitute for poor american. Or Roma/Eskimo/Greenlander/Sami for Europe Especially considering that the current prime minister and president of India are from so called backward communities. India has come a long way in social development and using the "caste card" is quite…

It is not out of taste. Caste System(Jati System) though weakened still alive and kicking in India. (Dalits) Lowest caste layer in India is still subjugated to things like Cow vigilantism, Honour killing, Social boycott, Caste clashes and discrimination in various/all forms of life. It is interesting to note that Dalits are almost always on the receiving end of these issues. Giving example of the Prime Minister/Presi…

> I became an Software Engineer and now live in a major city, thanks to the affirmative actions adopted by India...

You mean from reservations in school / university admissions? Or does that even extend to private employment? Is there widespread resentment?

I'm really curious about the parallels (or not) between racism in the US and caste in India, esp. affirmative action. The US never really went all-in on AA like India did with reservations -- more like pretending if we mostly ignore race then racism will go away -- but it seems like neither approach has really gotten to good place (yet).

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#136

Post by barry-cotter »

naruvimama wrote: post #114
steve19 wrote: post #74

Earlier quoted context omitted.

I am not saying you should not be proud of Indian progress, but I suspect the experiences of a businessman in a big city in India are vastly different to a low caste woman with TB in rural India. A friend of mine is a nurse who did social work in rural India. What she told me about the local hospitals was horrifying, not just the condition of the hospital and how patients with infectious diseases were sleeping on the…

The use of the word "low caste" is in quite mean considering "poor" would be more appropriate. Just as Black or Native American would be a poor substitute for poor american. Or Roma/Eskimo/Greenlander/Sami for Europe Especially considering that the current prime minister and president of India are from so called backward communities. India has come a long way in social development and using the "caste card" is quite…

What do you mean caste is a European concept? Hinduism has the four varnas and Dalits. How are those European concepts? Europeans didn’t invent varnas, the avarna, Hindu purity concepts, or the jatis. The jatis are Islam so for Europeans to have invented them would be quite impressive.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#137

Post by riahi »

anigbrowl wrote: post #96
notyourday wrote: post #82

Earlier quoted context omitted.

Most of the problems in the health care are non-urgent. Most of people at the ER are not there "waking up and not knowing why they are in the ER". They walk into ER with something not working for them. That's exactly why it takes 3-4 hours to be seen by the ER doctor. People like you, who wake up in the ER, are rarities. Those people are either brought to the ER in ambulances or are triaged and seen immediately. It i…

I do not agree that most visitors to the ER do so for non-urgent reasons, although few complaints are so severe. I don't think you've fully grasped the point people are trying to communicate to you here.

Sibling commenter is correct. The majority of ER visits are actually not emergencies; rather they are frequently used/abused as a convenience (open 24/7) or because payment is not required prior to care due to the unfunded mandate that is EMTALA (debt collectors are a separate discussion).

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#138

Post by BucketSort »

thatoneuser wrote: post #99
jrochkind1 wrote: post #47

He succesfully performed a complicated surgery for $10K that would cost $200K in the US. And India still can't afford to pay those prices. The problem is obviously not that THIS guy is not working efficiently. It's that the distribution of wealth under our planetary economic system is deeply unfair.

Idk if I'd agree that it's "unfair" because that implies there's some natural balance we've disrupted, when in reality wealth is largely the result of labor and ingenuity. If a group of people gets together and creates wealth for themselves and their offspring, is it unfair that they are wealthier than the rest of the population? That kind of thinking at some level is fundamentally unfair itself - if you go collect a…

Does it appeal to your sense of justice that within the same society some live opulently, yet others live in constant fear of not having the basic necessities of life? Not only would I say this is unjust, but that it is also unsound and a danger to society itself. The worst qualities of humans emerge when they are fighting for survival.

I'm fine with a system that has wealth inequality, I don't see any way around that and it's great for causing innovative pressure, but I find it hard to justify the fact that some people are deprived the basic necessities of life.

> Wealth isn't distributed, it's created. I mean you can distribute after that but it would be theft.

So are you one of those people that believe taxation is theft? Are you a self-made man? Are you Caesar without Rome? It strikes me as incredibly foolish when people ignore the fact that their success is entirely dependent upon their society.

Did you create your own school, did you create your own language ... are you really that unaware of the great debt you have to others? Without society, you'd be a degenerate caveman, you owe everything you have to it.

Actually, it doesn't strike me as foolish, it strikes me as incredibly useful for rationalizing ones station in life. It must make it easy to walk past the homeless and suffering, feeling like you are innocent and not complicit at all in the silent tragedies the system sustains.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#139

Post by riahi »

notyourday wrote: post #84
Frondo wrote: post #34

Earlier quoted context omitted.

I had my gallbladder removed in a emergency surgery over a decade ago. It happened on a Wednesday night. I had excruciating pain, enough to nearly black out -- and a friend took me to an emergency room, where they did an ekg, ultrasound, put me on a morphine drip and operated the next day. Once the pain set in, I was in no position to do research for a variety of reasons. I'm not sure what kind of shopping around cou…

It will not work for emergencies however that's not where most of the money is burned. Most of the money is spent on non emergency medical care that can be priced using a phone or an email. That's exactly why medical tourism is possible. It is a case of vertical capture: should you walk into a Mount Sinai hospital, the $600 MRI of Lennox Hill will cost you between $1800 and $2800. It will be done using the exact same…

Final signed American radiology reports are not dictated in India, especially at academic medical centers.

They've tried; it's blown up in their faces.

https://www.nytimes.com/2003/11/16/business/who-s-reading-yo...

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#140

Post by thatoneuser »

drewblaisdell wrote: post #116
thatoneuser wrote: post #99

Earlier quoted context omitted.

Idk if I'd agree that it's "unfair" because that implies there's some natural balance we've disrupted, when in reality wealth is largely the result of labor and ingenuity. If a group of people gets together and creates wealth for themselves and their offspring, is it unfair that they are wealthier than the rest of the population? That kind of thinking at some level is fundamentally unfair itself - if you go collect a…

> in reality wealth is largely the result of labor and ingenuity The greatest trick the devil ever pulled was convincing people that this is true.

OK so if humans didn't toil to create tools and housing and technology then how did it arise?
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