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I got dysentery so you don’t have to

eukaryotewritesblog.com

61–70 of 88 posts

Re: I got dysentery so you don’t have to

#61
post #38

Earlier quoted context omitted.

Sure you might not have the financial burden but actually getting attention is not as straightforward as I infer from your wording. Wait times in much of Europe are kind of ridiculous. One isn’t better than the other. There are trade offs. Your preference appears to be financial.

Wait times in the US are also ridiculous. A couple years ago I tried to make a doctor's appt, at the clinic where I was regularly a patient, and had decent insurance, but it was for check-up stuff and to ask some questions. I called in July; the first available appointment was December . On the other hand, when I've gone to that clinic with urgent issues, they see me the same day. I gather it is much the same in syst…

It takes like two years to get in with a rheumatologist, or get a psychiatric evaluation where I am in the US, and other, less in-demand specialists are easily 6-9 months from your initial referral from your primary physician. I think it took about ten for my first dermatology appointment.

ER visits are an all night endeavor.

Re: I got dysentery so you don’t have to

#62
post #44

Earlier quoted context omitted.

> I mean how much would your son’s specific situation cost you in a comparable area of America for a family of comparable income? That's the fun thing about the US system. The only way to find out how much it costs is to wait for the bill. So while your question is a fair one, logically speaking, it's unanswerable in practice.

I wouldn't go that far. But it is true that there are far many more possible outcomes because of how diverse the private insurance system is. At the very least one guaranteed difference is that you would NOT not get a bill. Then, a common scenario is a health insurance setup that covers 100% of the cost beyond a threshold, while the individual is responsible for the cost below that threshold. My threshold is $6k for…

You might know that you won't have to pay more than $X, but you generally can't find out beforehand the theoretical cost of the procedure as billed to the insurer. So if you're on the hook for any fraction of that (as in your second scenario) then you're very much in unknown territory.

There is also the question of how well you really understand the terms of your insurance policy, which can be extremely complex.

Re: I got dysentery so you don’t have to

#63

Earlier quoted context omitted.

Since you have a specific anecdote as an argument, could you expand on your “American approach” concept and how it applies to your situation? I don’t mean talk in vague assertions about how you have read some other specific yet unrelated anecdotes about childbirth costing $125,000 or something. I mean how much would your son’s specific situation cost you in a comparable area of America for a family of comparable inco…

I can speak to even routine things like a childbirth still costing thousands of dollars with "good" insurance with a "low" out of pocket maximum and 100% coverage after the deductible. It still cost 3 or 4 thousand dollars. So it's not necessarily those six figure costs that are tough to deal with but even routine hospital care that gets very expensive in the US. I'm fortunate that we can afford that cost. But for a…

My daughter was premature and spent weeks in the NICU.

My family paid exactly $0 for this experience, with good US insurance.

People paying thousands of dollars with insurance have chosen to purchase cheaper insurance premiums, and then bear higher costs when there’s an expensive event.

This is a fine choice to make. It does not mean the US healthcare system is especially expensive for middle class people.

Like many parts of the US economic system, the US healthcare system isn’t very good for poor people. But don’t go thinking it performs poorly for the upper half of the income distribution.

Re: I got dysentery so you don’t have to

#64

Earlier quoted context omitted.

This seems too strong. Assuming they're 100% indoor, you could say they don't have any pathogens that haven't at some point been present in your house. But that's not so comforting.

I hope you never look at household dust under a microscope

Why?

Re: I got dysentery so you don’t have to

#65
post #16

Earlier quoted context omitted.

> And nations that do not tolerate dogs are healthier. Yeah, the furry bastards force people to walk every day, two times a day, train their launching skills, make people laugh, alleviate boredom and mental issues, save children from their bad ideas, and drag its owners directly to interact with other dog owners and make friends. Social interaction, exercise, security, happiness... just the opposite to following a he…

Dogs are the biggest source of domestic violence in America...

At this point I think it's safe to ask - what happened between you and a dog/dogs at some point in your life to prompt you to take this stance?

Re: I got dysentery so you don’t have to

#66
post #26

Earlier quoted context omitted.

> Articles like this are a nice reminder of just how wonderful life is in America, and just how far civilization has to fall if shit REALLY hits the fan someday. While I agree its cool to see progress. If I get sick in the US and need medical attention, just fly me back to Europe. Id rather not go bankrupt.

Sure you might not have the financial burden but actually getting attention is not as straightforward as I infer from your wording. Wait times in much of Europe are kind of ridiculous. One isn’t better than the other. There are trade offs. Your preference appears to be financial.

Waiting times are a big "it depends" in Europe. Depends of severity/urgency. And yes there are private clinics as well

But if you're on the US, just go to Mexico (or maybe some central american country or Brazil)

Re: I got dysentery so you don’t have to

#67
post #55
post #45

Earlier quoted context omitted.

> Well regardless of financial accessibility if you can justify why in the US the markup of pharmaceuticals is so extraordinarily high for everything vs the rest of the world ? We do a lot of the (very expensive) drug discovery and testing.

And that means those same drugs, from those same companies are now cheaper outside of the US? That makes zero sense. That's like Amazon charging their employees 100x to use AWS vs outside people. They charge more in the US because they can, because of people who gleefully accept it and defend it by saying "we do a lot of expensive drug discovery and testing"

> And that means those same drugs, from those same companies are now cheaper outside of the US?

Drug development essentially results in the creation of very expensive intellectual property. A wide variety of drugs are easy and cheap to manufacture [1].

The cost to develop a drug can range from $314 million to $2.8 billion [2]. Fewer than 8% of drugs make it through the development and trial process [3]. It's super expensive and risky.

Other countries do not have to respect US drug IP and can produce these drugs for near zero cost. They benefit from the expensive drug discovery and vetting that the US pharmaceutical industry perform and the US FDA requires, but they don't have to pay for any of it.

When countries do pay for US drug IP, they do a lot of strong arm bargaining. If this happened in the US, many of the drugs, especially for rarer illnesses, wouldn't be developed in the first place.

[1] Gene therapies, monoclonal antibodies, viral vectors, and other types of treatments not so much.

[2] https://pubmed.ncbi.nlm.nih.gov/32125404/

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC10173933/

Re: I got dysentery so you don’t have to

#68
post #55
post #45

Earlier quoted context omitted.

> Well regardless of financial accessibility if you can justify why in the US the markup of pharmaceuticals is so extraordinarily high for everything vs the rest of the world ? We do a lot of the (very expensive) drug discovery and testing.

And that means those same drugs, from those same companies are now cheaper outside of the US? That makes zero sense. That's like Amazon charging their employees 100x to use AWS vs outside people. They charge more in the US because they can, because of people who gleefully accept it and defend it by saying "we do a lot of expensive drug discovery and testing"

In some cases. But the point is other countries enforce lower prices, and they make up the margins in the US. On the one hand it is obscene but on the other we do see a pretty regular supply of miraculous new drugs. Something clearly needs done but the system does make sense (whether or not its optimal).

Re: I got dysentery so you don’t have to

#69
post #2

Title-typo: I got dysentery so you don’t have to https://news.ycombinator.com/item?id=41911099

Whoops - fixed. Thanks!

Edit: since https://news.ycombinator.com/item?id=41911099 was the first submission of the article, I'm going to merge the comments thither and re-up that one. But only the on topic comments. There is way too much dross in this thread—perhaps a fresh start will make for a healthier discussion.

(Sorry, l1n — not your fault at all, and I'm sorry we don't have karma sharing implemented yet.)

Re: I got dysentery so you don’t have to

#70
post #58

Earlier quoted context omitted.

> in the ICU for days and I paid a grand total of $2k My wife paid a grand total of £0 The very _idea_ we would need to pay money for such medical treatment is bizarre.

The idea that it costs nothing somehow is bizarre. If you divide the NHS budget for 2024 (192 billion) by the UK population (67 million) you’ll find it works out to just under 3000 pounds per person just for 2024. Assuming your wife’s visit was this year your family paid about 3x what the poster you are responding to did. I’m also working from the assumption most posters here are in high tax brackets; I understand te…

And people I know in the uk, at least those working for large US companies, also have private insurance in addition to NHS.

Probably not a bad idea to get travel insurance if vacationing in the US. The other way around you may want some sort of additional insurance if traveling from the US to Europe.

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