U.S. transition to 988 suicide and crisis lifeline begins Saturday • Hacker News Board

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#241

Post by yellowapple » Sun, Jul 17, 2022, 1:22 AM UTC

lotsofpulp wrote: post #203

yellowapple wrote: post #195

Earlier quoted context omitted.

> Assuming that was under the deductible, so the ambulance provider did not get paid anything else Hm? The insurer would've paid the difference (minus some additional discounts depending on the size of the insurer and its bargaining power). That the patient paid $500 does not in the slightest bit indicate that the insurer negotiated the rate down to that pricepoint. Even at $500 (and let's assume that was an hour-lon…

I doubt the $12k that was billed was paid by insurance company. Typically, the provider bills a ludicrous amount, and then they apply a ridiculous “adjustment” for being a subscriber to the insurance plan, and then you pay per your deductible/coinsurance/out of pocket maximum situation. I have no idea how much ambulances and personnel cost, but I do know that whatever the costs are, they have to be distributed amongs…

> I doubt the $12k that was billed was paid by insurance company. Typically, the provider bills a ludicrous amount, and then they apply a ridiculous “adjustment” for being a subscriber to the insurance plan, and then you pay per your deductible/coinsurance/out of pocket maximum situation.

That doesn't make the fact that they bill such a ridiculous amount in the first place any less unacceptable.

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#242

Post by kromem » Sun, Jul 17, 2022, 1:23 AM UTC

I wonder at how proving a legal path to ending life for anyone (with a lengthy waiting period and multiple psych sessions) would reduce the instances of impromptu suicide.

My suspicion is that the availability of a legitimized path to the same result, but with a far less traumatizing method for both the individual and their loved ones, might allow for transitioning people into getting help when that's not the outcome they really want and provide a respectful and humane exit for those that clinically and chronically find living unbearable.

I'm not sure that the most ethical approach to life is forcing people to continue with it against their will, it is clearly not working, and by pushing the pursuit of death underground we're likely missing tens of thousands of people each year who would turn away from that downward spiral through treatment.

The people I knew that eventually committed suicide due to chronic depression spent many years thinking about it - a year waiting list for a state authorized humane option I'm sure would have been fine with any of them. But the ones that committed suicide in response to temporary circumstances didn't have any outlet other than admitting the intent to commit a crime and facing the social and economic consequences of that being outed.

Even the number of stories I've heard from survivors about the regret as soon as it was too late to take back is harrowing.

I'd have to wonder how many push the button for the nitrogen chamber (the likely method for state authorized suicide) only to regret it in the last moment where someone could successfully abort the procedure to save them. The low level of repeat attempts would be promising for the availability of "suicide with emergency break" alone.

The religious puritanism surrounding suicide has doomed us to adopt policies and attitudes towards it as a society that probably do more harm than good.

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#243

Post by lotsofpulp » Sun, Jul 17, 2022, 1:34 AM UTC

yellowapple wrote: post #241

lotsofpulp wrote: post #203

Earlier quoted context omitted.

I doubt the $12k that was billed was paid by insurance company. Typically, the provider bills a ludicrous amount, and then they apply a ridiculous “adjustment” for being a subscriber to the insurance plan, and then you pay per your deductible/coinsurance/out of pocket maximum situation. I have no idea how much ambulances and personnel cost, but I do know that whatever the costs are, they have to be distributed amongs…

> I doubt the $12k that was billed was paid by insurance company. Typically, the provider bills a ludicrous amount, and then they apply a ridiculous “adjustment” for being a subscriber to the insurance plan, and then you pay per your deductible/coinsurance/out of pocket maximum situation. That doesn't make the fact that they bill such a ridiculous amount in the first place any less unacceptable.

It is a well established practice in the US that billed prices have no bearing on reality and if you are insured, you have no liability to pay them, hence out of context for the purpose of discussing the reasonableness of the insurance negotiated price (which is well established to be real).

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#244

Post by lotsofpulp » Sun, Jul 17, 2022, 1:36 AM UTC

mindslight wrote: post #232

lotsofpulp wrote: post #154

Earlier quoted context omitted.

My intention was the opposite. By pointing out the $500 being reasonable, meaning that the insurance company negotiated a decent price. Obviously, the $12k is ludicrous, proven by them being willing to accept $500 for people who belong to an insurance plan. Health insurance in the US is not just insurance against a one time high cost event. One aspect of it is paying a business to gain access to lower pricing due to…

> One aspect of it is paying a business to gain access to lower pricing due to volume that you would be unable to get as an individual It only makes sense to talk about volume discounts when there is actual savings from providing volume (for example, less packaging). Many different instances of individual care do not create such savings, for anything but handling the make-work billing paperwork that this system itsel…

>This idea that individuals shouldn't be market participants is a broken assertion that underlies much of our healthcare dysfunction

I do not assert this. I would much prefer transparent pricing and people being able to shop around.

> In the situation you're describing, the "insurance" company has zero market leverage over the ambulance provider, and so you're championing a specious "negotiation".

If this was true, then the ambulance company would not have accepted $500, and would instead demand the $12k they billed. It may be that the leverage is simply political or PR, but it must exist in order for them to come down from their fantasy list price.

I agree with your last paragraph, and that is the situation as of recent due to new laws passed about surprise billing and out of network restrictions for emergencies. As well as publicly listed prices.

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#245

Post by TechBro8615 » Sun, Jul 17, 2022, 1:36 AM UTC

kromem wrote: post #242

I wonder at how proving a legal path to ending life for anyone (with a lengthy waiting period and multiple psych sessions) would reduce the instances of impromptu suicide. My suspicion is that the availability of a legitimized path to the same result, but with a far less traumatizing method for both the individual and their loved ones, might allow for transitioning people into getting help when that's not the outcome…

No, if someone has lost their motivation to live, that is the fault of the community around them, and it’s the responsibility of society to fix the failures that led to that loss of motivation. The path to fixing these failures is not to offer state-sponsored (or at least state-sanctioned, as your comment implies) lethal injection for anyone who asks for it. That’s sweeping the problems under the rug.

I’m not religious in any way, but the ideas you suggest in your comment make me deeply uncomfortable, because they strike me as the ultimate betrayal of the miracle of random chance that led to our existence, with an almost lackadaisical disregard for human suffering, to the point of systemizing the process of ignoring it.

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#246

Post by zahma » Sun, Jul 17, 2022, 1:48 AM UTC

TexanFeller wrote: post #222

zahma wrote: post #215

Earlier quoted context omitted.

I am a Crisis Text Line volunteer. So the short answer is yes we do call EMS when we have to. I posted this longer answer in a different parent on this thread, but I'll re-post it since it directly speaks to your question and sheds some light on the criteria we use to determine if someone might harm themselves. "...We are trained to risk assess each and every texter, irrespective of our intuition about their mental s…

Calling the authorities under _any_ circumstances where the person is not planning to harm anyone else is unacceptable. The way you talk seems to presume that all suicidal people are out of their mind and irrational and need to be protected from themselves, which allows you to rationalize neglecting respect for their bodily autonomy. My body, my choice. It’s a person’s goddamn right to make the choice whether it’s be…

You're viewing this rather myopically. If someone texts us, we're operating under a valid presumption that they value their life, otherwise why text for help? We can't call EMS on someone we're unaware even exists.

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#247

Post by sovnade » Sun, Jul 17, 2022, 1:48 AM UTC

TechBro8615 wrote: post #245

kromem wrote: post #242

I wonder at how proving a legal path to ending life for anyone (with a lengthy waiting period and multiple psych sessions) would reduce the instances of impromptu suicide. My suspicion is that the availability of a legitimized path to the same result, but with a far less traumatizing method for both the individual and their loved ones, might allow for transitioning people into getting help when that's not the outcome…

No, if someone has lost their motivation to live, that is the fault of the community around them, and it’s the responsibility of society to fix the failures that led to that loss of motivation. The path to fixing these failures is not to offer state-sponsored (or at least state-sanctioned, as your comment implies) lethal injection for anyone who asks for it. That’s sweeping the problems under the rug. I’m not religio…

If someone has lost their motivation to live, then there could be many reasons for that. Society failure? Maybe. Could also be terminal illness, chemical imbalances, PTSD, or other things that are untreatable or uncurable.

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#248

Post by throwntoday » Sun, Jul 17, 2022, 1:52 AM UTC

TechBro8615 wrote: post #245

kromem wrote: post #242

I wonder at how proving a legal path to ending life for anyone (with a lengthy waiting period and multiple psych sessions) would reduce the instances of impromptu suicide. My suspicion is that the availability of a legitimized path to the same result, but with a far less traumatizing method for both the individual and their loved ones, might allow for transitioning people into getting help when that's not the outcome…

No, if someone has lost their motivation to live, that is the fault of the community around them, and it’s the responsibility of society to fix the failures that led to that loss of motivation. The path to fixing these failures is not to offer state-sponsored (or at least state-sanctioned, as your comment implies) lethal injection for anyone who asks for it. That’s sweeping the problems under the rug. I’m not religio…

Even with a loving community, there are those that just want to check out. Often they have trauma that is insurmountable.

I am totally against suicide, but I thank God I'm not in a position today where it feels like my best choice. I've been on that ledge, but what it would do to my family, and fear of divine retribution kept me here long enough to realize my problems had solutions. Religion does have its merits, namely the belief that all life is valuable, and no one is beyond saving.

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#249

Post by cmg » Sun, Jul 17, 2022, 1:52 AM UTC

sterlind wrote: post #219

cmg wrote: post #30

Earlier quoted context omitted.

I have experience in this field: I ran technology for one of the only hotlines in the US that didn't engage in non-consensual active rescue [0] [1]. I've written about this a little on this site in the past, when Crisis Text Line was caught sharing data. Many, if not most, of these places give the operator full access to your phone number and whatever geolocation data they can get based on that. They also have polici…

what's the deal with Trans Lifeline? I had their number saved when I was transitioning and had a lot of depression going on from bullying and family not accepting. are they not a good resource for us? edit: why am I being downvoted?

I explained a little elsewhere in this thread: https://news.ycombinator.com/item?id=32121332

Re: U.S. transition to 988 suicide and crisis lifeline begins Saturday

#250

Post by ryanwaggoner » Sun, Jul 17, 2022, 1:56 AM UTC

TechBro8615 wrote: post #245

kromem wrote: post #242

I wonder at how proving a legal path to ending life for anyone (with a lengthy waiting period and multiple psych sessions) would reduce the instances of impromptu suicide. My suspicion is that the availability of a legitimized path to the same result, but with a far less traumatizing method for both the individual and their loved ones, might allow for transitioning people into getting help when that's not the outcome…

No, if someone has lost their motivation to live, that is the fault of the community around them, and it’s the responsibility of society to fix the failures that led to that loss of motivation. The path to fixing these failures is not to offer state-sponsored (or at least state-sanctioned, as your comment implies) lethal injection for anyone who asks for it. That’s sweeping the problems under the rug. I’m not religio…

There are forms of suffering that society is powerless to prevent or treat, no matter the priority we place on it or the resources we put behind it. Whether genetic or due to random chance, some people will have little hope of happiness or even temporary alleviation of suffering, and it’s wildly unjust for society to declare that our collective values supersede those of that person’s, and so therefor their suffering must continue indefinitely.