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I Now Have a Cardiologist

joecieplinski.com

121–130 of 189 posts

Re: I Now Have a Cardiologist

#121

If you put a popular device, with a medical detection tool into the wider population, it would be logical that the device would pick up on patients who would other not notice the symptoms (at least initially, if any). So then the question becomes what other daily device(s) could be made to do automatic health checks of certain specific indicators, which would give an early indication to the possible condition, thus i…

This will lead to a massive increase in false positives, unnecessary treatment and worry; par for the course for precautionary screening and preventive medicine generally. https://www.nytimes.com/2018/01/29/upshot/preventive-health-... > Preventive Care Saves Money? Sorry, It’s Too Good to Be True > The idea that spending more on preventive care will reduce overall health care spending is widely believed and often pr…

Funny, that doesn't remotely fit with my experience.

I estimate I'm saving between $200k and $500k annually by doing things like eating right and getting enough exercise.

Well, TBF, that's really for two people eating right etc. I, personally, am probably saving only half that.

Re: I Now Have a Cardiologist

#122
post #8

> resting heart rate being in the 113-120 bpm That seems insanely high

I'd consult if mine was over 90 at night for no apparent reason (usually below 50, but went as high as 80 during a hard hiking week). Monitoring my nightly heart rate (Samsung Watch) gave me quite an insight on my general shape. When sickish, definitely not going as low as usual...

Re: I Now Have a Cardiologist

#123

It is odd to me how he keeps describing his $500/month insurance as being useless: he is generally in excellent health and his yearly expenditures are low enough that he is always paying down the deductible. Does he feel car insurance and home insurance are useless since he didn't total his car last year and his house didn't burn down? He knows this (as he mentions it obliquely) that he could lower his deductible but…

When compared to health insurance almost anywhere else in the world, it's dire value for money.

It’s pretty good for my daughter. She was born with Spina Bifida and we’re paying $300 a month for an ACA plan. She’s cost probably a million dollars by this point so it’s worked out pretty well for us. In a country with socialized medicine they’d probably have just let her die, as the doctors had given her a prognosis that she might not last a year. My wife dug up some research on some treatments they hadn’t considered, and now our daughter’s condition is greatly improved, and her prognosis adjusted to slightly below average lifespan (Spina Bifida adults have kidney problems because they often have to catheter themselves and suffer long term backing up into the kidneys, which eventually causes kidney failure).

It’s a weird case too because if she gets the care she needs she stands to live a long life, be of normal intelligence, she has a good chance of walking, etc. She’s so darned cute and gregarious, cooing and laughing, you’d never know she had all these problems if you saw her out and about.

So I guess my daughter is the reason insurance is so expensive. But after getting page after page of “100% covered $3000” pages for each day she’s spent in the hospital, I’m really glad to have the insurance I do, because a place where the government decides how much to spend on care would have given up on her months ago.

Re: I Now Have a Cardiologist

#124
post #8

> resting heart rate being in the 113-120 bpm That seems insanely high

It's not "insanely" high. And blanket statements like this can cause undue alarm. If you're worried about an elevated resting heart rate, go get an ECG done. Don't let random people on the internet talk you into health anxiety.

it's insanely high.

Re: I Now Have a Cardiologist

#125
post #59
post #27

While this is great for Afib detection it's its very rare CDC says 2.7-6 Million people[1]. Still great for those people! I still think we need to do much better. High BP and hypertension is way more important to measure since they can be diagnostic in a larger percentage. My dad is a triple bypass heart patient. ECG and stress tests did diddly squat to detect it, until it was too late and it was diagnosed by a CT An…

Do you know how many sieverts you get each time? I had one of those and I think I got one year's worth of background radiation in those few seconds that it lasted.

People worry too much about radiation. A year's worth of background radiation is not that much radiation.

Re: I Now Have a Cardiologist

#126
post #99
post #82

Earlier quoted context omitted.

> $20k a year is peanuts compared to the out-of-pocket expenses of a serious medical emergency. And that’s the most annoying part. The fact that $20,000 is considered peanuts in a medical condition is already outrageous. My friend’s wife had a c-section child delivery and was billed $38,000...for a 3 days stay at the hospital. No complications just a planned c-section. I understand that’s the reason why the insurance…

> No complications just a planned c-section There was a lot of effort, planning, and training that goes into making sure that there aren't any complications. Not to mention the fact that even routine procedures can have unexpected complications that have to be planned for and addressed. I think that $38k for a surgical procedure with post-operative care for the mother and child isn't necessarily that outrageous. Just…

Another data point: Japan is a first-world country with one of the lowest infant mortality rates in the world. Births are not covered by insurance. We paid US$5,500 out of pocket, for a birth in a private clinic that ended in an unplanned C-section and 10 days in hospital (in a premium upcharge private room). $3,500 was later refunded in a birth stipend from the city.

Re: I Now Have a Cardiologist

#127
post #83
post #63

Earlier quoted context omitted.

I honestly find this baffling that there is a "limit" on how much treatment you can have done based on an arbitrary $ cost. Australia generally has great "free" healthcare but even then it is complicated with rebates and gaps etc, its not completely "free" but there isn't exactly a limit on what you can have done under Medicare. If you have private medical insurance (an option not a requirement) then you can get a ni…

> Australia generally has great "free" healthcare No, the Australian medicare system is not remotely close to being great. When a simple CT scan/MRI can take 4 months waiting time [1], I wouldn't jump up and defend such a failed system. It is not great, it is the complete opposite of that. Ever tried to do some dentals using that "free" healthcare you mentioned or ever tried 12-18 months elective surgery waiting time…

OK, so this is Australia's system (from patient's perspective). I'm a T2 diabetic, obese, 55, have had one heart attack, angiogram/stent, second angiogram, quad bypass:

0. Everyone pays a 1.5% "extra" tax for Medicare, but that's actually just a cover. The actual cost to government is much higher, but is paid out of general revenue.

1. GPs and specialists are reimbursed by the government at a govt decided rate for different procedures.

2. The GPs/specialists can "bulk bill" in which case patients don't pay, or there is a "gap" that has to be paid by the patient. The gap cannot be covered by insurance (by law).

3. Medicines that are approved by an independent body are subsidized on the Pharmaceutical Benefits System (PBS). Once on that list (and most meds are), the cost to the patient is $35 for a prescription, subsidized to $6 for those on welfare. My meds (statin, beta blocker, ACE inhibitor, metformin etc) cost me about $100/month.

4. Public hospitals are free at point of use by patients. This includes all ER, surgery etc. However, because this is a limited resource, there are waiting lists for different procedures, managed based on urgency. If I'd gone to a public hospital ER for my heart attack, the treatment would have been as quick and as good as what I got when I went to a private hospital ER. Oh, except that the private ER cost me $400.

5. Private insurance is available. For me, the insurance costs $300/month (ie, $3600 pa). This allows me to use private hospitals within a wide network (with a $400/per admittance excess), ancilliary benefits like optical ($200 pa) etc. It also allows me the choice of specialist/surgeons in hospital and things like private rooms.

It may not be "great", but compared to the US it's much much better. There are no/zero/nada cases of "medical bankruptcy" here. ER costs are not in the thousands, bills aren't ridiculous, my entire treatment regime over 2 years and 2 admittals to hospital cost me less than $10K because I chose my cardiologist and surgeon. If I'd gone "public", the cost would have been $0.

Our public hospitals are the "teaching hospitals" and our medical research and results are world leading. Our GPs are primarily focussed on care and patient outcomes, they now spend a lot of time as case managers, for example, my T2 care plan is managed by my GP but involves a dietician, an endocrenologist etc.

Re: I Now Have a Cardiologist

#128

Earlier quoted context omitted.

Pretty much the entirety of the article you're selectively quoting is praising preventative care. The byline is "Contrary to conventional wisdom, it tends to cost money, but it improves quality of life at a very reasonable price." and the article closes with this But money doesn’t have to be saved to make something worthwhile. Prevention improves outcomes. It makes people healthier. It improves quality of life. It of…

I’m not arguing over affect, I’m arguing over truth claims. The article leads with the facts and then argues that despite being a poor use of money we should still pay for preventive medicine for the warm fuzzy feelings it gives us. Pay attention to the facts, not the argument that we should ignore the facts for the warm fuzzy feelings. If we’re going to spend huge amounts of money we should spend it better than on p…

> I’m not arguing over affect, I’m arguing over truth claims. The article leads with the facts and then argues that despite being a poor use of money we should still pay for preventive medicine for the warm fuzzy feelings it gives us. Pay attention to the facts, not the argument that we should ignore the facts for the warm fuzzy feelings.

That's a very disingenuous summary born out of a "economics trump everything" mentality. If you believe that humans are more important than money it is wrong and the original articles byline is a better summary:

Contrary to conventional wisdom, it tends to cost money, but it improves quality of life at a very reasonable price.

Re: I Now Have a Cardiologist

#129
post #123

Earlier quoted context omitted.

When compared to health insurance almost anywhere else in the world, it's dire value for money.

It’s pretty good for my daughter. She was born with Spina Bifida and we’re paying $300 a month for an ACA plan. She’s cost probably a million dollars by this point so it’s worked out pretty well for us. In a country with socialized medicine they’d probably have just let her die, as the doctors had given her a prognosis that she might not last a year. My wife dug up some research on some treatments they hadn’t conside…

In a "country with socialized medicine" that is in the 1st world (ie US/CA/UK/AU/NZ/EU etc) she'd probably get exactly the same treatments. Oh and the cost of that hospital room would have been literally a tenth of the cost.

I (or my insurance) wasn't charged half of that for a post-operative 48 hours in an ICU after quad bypass surgery.

The US already has a third of its population covered by "socialized medicine". That's what Medicare/Medicaid/Tricare /VA are. The "socialized" adjective is a canard introduced by the health care "industry" in the US to scare people.

US Medicare admin costs are below 5% pa, the health insurance "industry" doing the same thing, are 20% of their revenue.

Re: I Now Have a Cardiologist

#130
> It’s also worth noting at this point in the story that Atrial Fibrillation is extremely rare in men my age. Less than two percent of people in my demographic have it. Go figure. When I do something, I go big I guess.

This is looking at it backwards. How many serious health problems have similar rates of affliction? If there are 50 different potential health problems then he has a 2 in 3 chance of having at least one of those.

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