Google almost convinced me to spend $400 on useless laser treatments • Hacker News Board

Re: Google almost convinced me to spend $400 on useless laser treatments

#391

Post by jjeaff » Thu, Apr 28, 2022, 2:45 AM UTC

asdff wrote: post #349

bcoughlan wrote: post #277

Earlier quoted context omitted.

So tired of these "European" comments feigning cluelessness to try to feel above others. There is huge variety in healthcare quality across EU countries (waiting lists are years long in my country) and no one can speak of Europe as a monolith and make much sense. People in my (EU) country who have serious illnesses often seek to go to the US for treatment because they have facilities and doctors that specialise in th…

I think it depends on the context of the treatment and how specialized it needs to be. For example, I've had relatives from the U.S. who have gotten dental work done in Croatia because its cheap enough to the point where they can buy a transatlantic flight and spend some time visiting family members along with getting the root canal and crown done. A lot of people in southern California also opt to drive to Tijuana f…

Sometimes that can be a good idea. But many times, you are also getting riskier, out of date treatment for less. For example, root canals and crowns are kind of the cheaper and less effective way to treat a bad tooth. The gold standard is usually extraction and a new implant.

And considering that you can find a dentist to do a root canal for $300 without too much trouble, I'm surprised anyone would be able to fly to Croatia and get treated for that little.

Re: Google almost convinced me to spend $400 on useless laser treatments

#392

Post by kcplate » Thu, Apr 28, 2022, 2:48 AM UTC

asdff wrote: post #363

kcplate wrote: post #64

I have two “Cadillac” dental insurance plans. When I sit down in the chair I just inform them that I am not interested in any service that is not fully covered by my insurances, and if its partially covered, I want a pretty detailed breakdown of why I need it before I will agree to the service. Usually this stops the service upselling.

Dental insurance is sort of crappy in that what we think might be important treatments are sometimes classified as cosmetic and not covered (like implants). This is why there is a cottage industry of dentists doing implants for cheap in Tijuana.

My insurances do a good job of covering things that are related to my oral health. If I want a cosmetic improvement over a covered service, I dont have a problem paying for it. I’d rather the occasional outlay than my dental insurance being prohibitively expensive to account for a possible expensive covered cosmetic change.

Re: Google almost convinced me to spend $400 on useless laser treatments

#393

Post by xzel » Thu, Apr 28, 2022, 3:11 AM UTC

DrBoring wrote: post #263

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

In my experience as a software developer, I've grouped my peers into a few different categories. This is just a rough estimate based a small sample set, there are probably various gradients in-between. 1. Super coders: These are the coders who write the algorithms that pave the way for coders below them. 2. Natural coders: Competent coders who take to the craft easily. Can easily learn new things, but probably won't…

I totally agree with you but I'm pretty sure you just described the Normal distribution. People need to stop putting certain occupations on a pedestal. I've had good doctors and bad doctors, largely the latter. Tbh, most doctors don't have the time to be good doctors, due to how most hospitals operate, so it's really tough to judge them fairly. Also to add I'm only discussing US hospitals I haven't had enough experience outside the US for any of this to be applicable outside of it. My small amount of experience with Drs in Tokyo and Prague were great.

Re: Google almost convinced me to spend $400 on useless laser treatments

#394

Post by PolygonSheep » Thu, Apr 28, 2022, 3:11 AM UTC

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

Litigation/malpractice probably plays a role too. I imagine doctors are under a lot of pressure to do everything by the book. If it works, awesome. If it fails, they can say they followed best practices and it's not their fault. If they deviate for any reason, they do so entirely at their own risk if/when it blows up in their face. It's just not worth it (in the expected value sense) to step out of line.

Re: Google almost convinced me to spend $400 on useless laser treatments

#395

Post by WalterBright » Thu, Apr 28, 2022, 3:27 AM UTC

FollowingTheDao wrote: post #387

WalterBright wrote: post #385

Earlier quoted context omitted.

Yes, in the US before the government took over health care. BTW, no government is going to spend unlimited sums to save your life.

> Yes, in the US before the government took over health care. When did that happen? If you are thinking Obama care, uhm, no. > BTW, no government is going to spend unlimited sums to save your life. You are missing the point. Supply and demand curves break when it comes to life and death matters. That is why prices should not be dictated by a free market. Well, I guess that is fine if you are a sociopath.

> When did that happen?

Not all at once, but decision by decision. One big change was when the AMA was granted a monopoly over the education of doctors. Then there was when companies got around wage controls in WW2 by tying health insurance to employment. Then in the 1960s there was enormous expansion of the FDA, and then Medicare and Medicaid. Then there were laws that required emergency rooms to treat people for free.

All these measures sound great, but they completely mess with the structure of how markets work. And so we have the very expensive, and often dysfunctional, system today.

> That is why prices should not be dictated by a free market.

The free market doesn't dictate prices. Governments dictate prices, which always leads to shortages.

> I guess that is fine if you are a sociopath.

If you have a case, you should be able to make it without insults.

Re: Google almost convinced me to spend $400 on useless laser treatments

#396

Post by hnburnsy » Thu, Apr 28, 2022, 4:21 AM UTC

gehwartzen wrote: post #24

matsemann wrote: post #12

Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly different advice. Some of that can be ascribed to some being in the school of pro-active, so they want to fix your teeth at the first glance of issues. But in the end, most of the things being quoted were unnecessary. They all seemed very intent on removing wisdom teet…

At least in the US its because dental insurance isn't part of normal health insurance. Dental insurance mostly just covers the bare bones (teeth?) treatments like regular cleanings and an xray every couple of years. SO in order for the Dentist to make money they ahve to upsell every other treatment not covered by insurance. With regulars health insurance the doc is payed for pretty much any specific treatment they de…

In the US, many consider dental insurance a pre-paid, discount dental plan, not really insurance in the traditional sense.

Re: Google almost convinced me to spend $400 on useless laser treatments

#397

Post by tyrfing » Thu, Apr 28, 2022, 5:22 AM UTC

ClumsyPilot wrote: post #375

tyrfing wrote: post #312

Earlier quoted context omitted.

> Right now I am on a six month wait to see a rheumatologist. Why? Capitalism. Typically that's anti-capitalist: there are very strong government and regulatory limits on who can perform the services, and for self-serving reasons, they maintain shortages of supply. The free-market capitalist solution would be for prices to rise to a point where supply and demand are balanced, either by supply increasing (people switc…

> for prices to rise to a point where supply and demand are balanced Is there a limit to the amount of money you would pay to save your life? Is there a predatry loan you wouldn't take to pay for life-saving surgery for your child? Has this ever been demonstrated to work in healthcare in the real world, outside free-market fantasy land?

The limit is approximately what you would be capable of paying. Putting value on life is a common practice, particularly in single-payer healthcare, mostly relevant to certain drugs.

There are, of course, problems with a system like this. "I would pay literally everything to not die, but can't find treatment" is just not one (assuming certain values of everything), because people will take your money. Problems are things like rich people getting better treatment (happens just about no matter what, but we'd rather pretend otherwise), and evaluating treatment performance as a customer/patient (a reason for most supply restrictions.)

Re: Google almost convinced me to spend $400 on useless laser treatments

#398

Post by Varriount » Thu, Apr 28, 2022, 5:39 AM UTC

exo-pla-net wrote: post #301

smileysteve wrote: post #169

Earlier quoted context omitted.

> Is it best to go ahead and get those fillings now? Probably, as far as your dental health is concerned. Modern science says no, you should apply topical fluoride for most early cavities; and if the teeth use a modern pronamel (cough stuck behind USDA approval) should be able to recover quickly.

Could you add more regarding pronamel, so I can begin my negotiations with The Algorithm?

I think the poster might be referring to "Sensodyne Repair & Protect with NovaMin"

Re: Google almost convinced me to spend $400 on useless laser treatments

#399

Post by argonaut » Thu, Apr 28, 2022, 6:17 AM UTC

joshowar wrote: post #66

donatj wrote: post #17

Earlier quoted context omitted.

I went to a new dentist for a broken filling and they tried to tell me I had 14 cavities and set me down with a finance person to set up a payment plan for how I was going to pay for them over the next 5 years. I went to a second dentist, they fixed the broken filling and said my teeth were otherwise fine. I have the paperwork to back this up. I’d been seeing another dentist for a while and he suddenly wanted to crow…

Its complicated. Technically speaking, if there's any decay in your teeth, that's a cavity. The deeper it is, the faster it'll get worse. When you want to get that filling though, is a judgement call that a lot of dentists make for you sadly. Is it best to go ahead and get those fillings now? Probably, as far as your dental health is concerned. Can it be delayed though and done later? Almost certainly. Just a bigger…

> Is it best to go ahead and get those fillings now? Probably, as far as your dental health is concerned.

This is mostly untrue. Fillings don't last forever, so prematurely filling cavities "starts the clock" on the longevity of the filling. When the dentist is replacing a broken filling, the dentist has to remove more of the tooth. Eventually you will need a root canal and/or crown. So for maximizing your health, the dentist still has to make a judgment call on how early or late to fill.

I say mostly because mercury amalgam fillings do seem like they can last effectively forever (20+ years), but they have fallen out of favor.

Re: Google almost convinced me to spend $400 on useless laser treatments

#400

Post by Ma8ee » Thu, Apr 28, 2022, 6:28 AM UTC

donatj wrote: post #17

matsemann wrote: post #12

Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly different advice. Some of that can be ascribed to some being in the school of pro-active, so they want to fix your teeth at the first glance of issues. But in the end, most of the things being quoted were unnecessary. They all seemed very intent on removing wisdom teet…

I went to a new dentist for a broken filling and they tried to tell me I had 14 cavities and set me down with a finance person to set up a payment plan for how I was going to pay for them over the next 5 years. I went to a second dentist, they fixed the broken filling and said my teeth were otherwise fine. I have the paperwork to back this up. I’d been seeing another dentist for a while and he suddenly wanted to crow…

My dentist is very busy. That often means that I have to wait a couple of months before I can get an appointment, if I'm not in active pain. That is of course sometimes annoying. The flip side of that is I'm quite confident that she won't suggest anything that isn't necessary since she already have a full schedule.