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I got dysentery so you don’t have to

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

#71

Post by tetha »

blahedo wrote: post #38
cheschire wrote: post #32

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…

I've been through this with a broken finger joint. I don't know if I'm a smooth talker or she remembered me as non-problematic, but the MFA at the clinic quite frankly told me: Don't try to go there without an urgent emergency, and ideally a document from a doctor confirming that it's an urgent emergency. If I wanted an appointment without confirmed urgency, I could have one in January - and it might be postponed for urgent cases. That's how booked they are. On the other hand, if my surgeon raises the correct alarm bells, I could also be in surgery next week. It's a roller coaster.

Even though this does make sense if you think about it as a tiered support system. If my finger joints don't come back up, my general practitioner can see that, poke at the fingers a bit and decide if guided physio makes sense - no need for more expertise. If there are subtle breaks in the joint requiring attention - more expertise is needed.

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

#72

Post by foobarian »

foldr wrote: post #62
foobarian wrote: post #50

Earlier quoted context omitted.

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.

> which can be extremely complex.

What gets me about the insurance billing is that besides being complex for me, it is also complex for the insurance company - people on the other side are just people, after all, not some infallible super-intelligent aliens. And the failures that come out of that are kind of hard to believe for people used to nationalized health care; my favorite example was a $15k bill I received months after a surgery that I called back to get more details, upon which the agent said something like "oh that's coded wrong" and after a few keyboard taps I owed $500. What if I had paid the original amount without asking? How many people do not ask? And the cynical question, how often do the "coding errors" happen the other way?

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

#73

Post by renewiltord »

GJim wrote: post #58
renewiltord wrote: post #54

Earlier quoted context omitted.

I’d go to somewhere like India that has medical tourism. Any procedure that you can wait long enough to fly to Europe will have a long waitlist there. Besides I was completely blown up in the US on my motorcycle with fractures all over and in the ICU for days and I paid a grand total of $2k. I think it was pretty cool honestly. There was some therapy afterwards that cost a little more but overall I’m back to normal e…

> 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.

Yeah, that's what I mean. I would gladly pay $2k in an emergency to make the hundreds of thousands of dollars more every year. That's a trade I consider reasonable. To save $2k in an emergency I'm not eager to be making £200k.

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

#74

Post by cnewey »

akhosravian wrote: post #59
GJim wrote: 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…

I think you're glossing over a few details here which - although understandable - deserve a little clarification.

The poster is referring to cost at the point of care - which under the UK's NHS model is £0. The "£3000" per year should really be viewed as the cost of an insurance policy (in fact, NHS funding comes from a progressive tax called National Insurance - at least in theory). This "£3,000" on average then compares to the average cost per person of a health insurance policy in the US of around $7,700 [0] - plus of course in the USA you generally have point-of-care costs too.

Additionally tax by its nature in the UK is progressive and the income distribution is fairly heavy-tailed, so it's not really a cost of "just under £3,000pp" - the average citizen pays far less than that, and even most high earners will pay less. For example someone on £100,000 (top 1-2% of salaries in UK) will pay just over £4,000 in NI [1] - but NI funds more than just the NHS and also funds social care and state benefits.

Of course in the UK some people choose to supplement NHS care with some form of private insurance - either paid for privately (uncommon) or provided as an in-kind benefit through an employer (still not ubiquitous but recently more common). Private care is typically used for things like skipping waiting lists for certain treatments or access to alternative care not offered by the NHS.

These private policies tend to have a lot less coverage than the NHS, so I would say aren't directly comparable to the NHS - nor are they generally totally adequate as standalone insurance policy so aren't comparable to an insurance policy in the US either.

The model is just very different in the UK and the US, and it's hard to compare them directly. However, what is inarguable is that the NHS provides very good value for money, especially when compared with other G7 nations [2] - on average less than half of the expenditure per capita of the US.

[0]: https://www.william-russell.com/blog/health-insurance-usa-co...

[1]: https://www.which.co.uk/money/tax/tax-calculators/national-i...

[2]: https://www.oecd.org/en/data/indicators/health-spending.html

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

#75

Post by kjellsbells »

echelon wrote: post #45
bilekas wrote: post #37

Earlier quoted context omitted.

> Wait times in much of Europe are kind of ridiculous. It's prioritized as per need, for example elective/preventative operations or procedures will be delayed if there is a new higher level emergency, this makes practical sense given the nature of healthcare and I have never had a problem with that. It's slightly off topic though, my comment was off the cuff but it's a reality. > Your preference appears to be financ…

> 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.

Re the comment about the US doing a lot of the very expensive parts of drug development...

Where are the costs, and what would it take to break tyem down?

For example if the costs are in screening molecular candidates, that could be done in a lab on a computer in India or Vietnam just as easily as in New Jersey. If its clinical trials, Europe is cheap and Asia cheaper still, both with high quality medical staff. Etc.

Any commenters understand where the major costs are?

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

#76

Post by scrozier »

GJim wrote: post #58
renewiltord wrote: post #54

Earlier quoted context omitted.

I’d go to somewhere like India that has medical tourism. Any procedure that you can wait long enough to fly to Europe will have a long waitlist there. Besides I was completely blown up in the US on my motorcycle with fractures all over and in the ICU for days and I paid a grand total of $2k. I think it was pretty cool honestly. There was some therapy afterwards that cost a little more but overall I’m back to normal e…

> 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.

Well, she paid nothing at the time. But she and you and your countrypersons paid for it, nonetheless.

It's interesting to me that you think about it as free.

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

#77

Post by adrianN »

Throw83489i7 wrote: post #31
bregma wrote: post #30

Earlier quoted context omitted.

I live in a rural area. It is filled with all kinds of wildlife from earthworms to bears, all of whom leave their metabolic waste in large quantities everywhere. Should they all be eradicated and all the fields and forests be cleansed in the name of Good Hygiene?

Not in forests! But in cities and houses yes, absolutely! And we actually do that, if dangerous bear wanders into town, it gets removed! In cities we eradicate rats, cockroaches and all sorts of filthy animals! Dangerous predators belong to nature and forests. Public city parks are not nature (or toilet)!

There is not a single city on the planet that managed to eradicate rats, and the only cities without cockroaches are in climates where they don't survive.

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

#78

Post by switch007 »

retsibsi wrote: post #46
switch007 wrote: post #13

Shigellosis is god awful. I've had it three times, from sexual contact. Let's just say I won't do anything more than a peck on the cheek unless I've witnessed the person shower first as many people's hygiene standards are disgusting

This is possibly way too personal, and obviously I get it if you don't reply. But I'm curious -- was the sexual contact of a sort that would obviously carry this risk? Or a sort where you had to get very unlucky, or something in between?

Something in between. But ya know, it’s /really/ a short distance between the front and the back.

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

#79

Post by echelon »

kjellsbells wrote: post #75
echelon wrote: 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.

Re the comment about the US doing a lot of the very expensive parts of drug development... Where are the costs, and what would it take to break tyem down? For example if the costs are in screening molecular candidates, that could be done in a lab on a computer in India or Vietnam just as easily as in New Jersey. If its clinical trials, Europe is cheap and Asia cheaper still, both with high quality medical staff. Etc.…

> For example if the costs are in screening molecular candidates, that could be done in a lab on a computer in India or Vietnam just as easily as in New Jersey.

The market can do this right now. The US has a lot of the talent and expertise, though.

> If its clinical trials, Europe is cheap and Asia cheaper still, both with high quality medical staff. Etc.

While the FDA has accepted foreign drug trials as long as they are held to FDA standards, they still prefer to have trials conducted in the US that represent a US population. And no matter the case, it's still extremely expensive to meet these requirements.

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

#80

Post by admissionsguy »

admissionsguy wrote: post #23
lqstuart wrote: post #4

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. If you need a reason to be grateful in spite of mundane crap like housing costs and white collar jobs, the developing world offers some lessons in humility and gratitude.

> if shit REALLY hits the fan someday You mean when it hits the fan

Downvoted to hell for some reason even when I am not trying to be nasty. What I mean that the end of human civilisation is inevitable by natural law. I would argue that the number of possible ends that involve breakdown of civilisation and presence of the misery the cited post mentioned is much larger than the number of ends of a different nature (sudden end or some sort of transformation).
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