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How Doctors Die (2011)

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Re: How Doctors Die (2011)

#41

Post by meaty »

elemeno wrote: post #32
meaty wrote: post #31

Earlier quoted context omitted.

Yes this happened to my father. I remember the crunching sound of his ribs to this day. This was at waterloo station in London in 1993. He just keeled over. Fortunately for him, someone had just got stabbed 100 yards away so people were already on hand. The paramedic didn't even blink. Everyone else shit a brick. He survived though and after a bypass op is fine to this day.

It probably helped as well that St Thomas's is literally within a few hundred yards of Waterloo Station. The speed with which you can be in specialist care is absolutely critical when it comes to cardiac problems - which is a large part of the reason why survival rates are far higher in places like Central London where you've got both fast response time for paramedics (for London as a whole, ~75% of 'immediately life…

Very true regarding St Thomas' - that's where they took him.

Very lucky, but not for the poor guy who got stabbed. Not sure what happened to him at the end of the day.

Re: How Doctors Die (2011)

#42

Post by philwelch »

purplelobster wrote: post #29
philwelch wrote: post #21

Earlier quoted context omitted.

What happens in Sweden? Does the state assign a doctor to you? What happens if you don't like that doctor and want a different one? I wouldn't want to do away with the freedom of choice, convenient as it may be to have a default. Besides, once you've chosen all those things you can just stick with them for years on end.

I'm sure you can choose if you really really want to, but there are sensible default options. The way it should be in my opinion: 1. Go to nearest hospital, no need to worry about insurance or whether it's a "preferred" hospital for your insurance company. 2. Get assigned doctor(s) based on your needs. 3. Get treatment. No need to check what treatments are covered and if your doctor is trying to screw you over with u…

For regular doctor's appointments, I don't go to the hospital, I just go to my doctor's office.

I can imagine pretty well. When things are set up with good insurance coverage, it's hardly any different than what you described, maybe with the exception of preferred networks, but in my city I've never had any doctor fall outside of the preferred network for my insurance anyway. Everything is either covered from the insurance or you get a straightforward bill, and even then you can get an HSA to cover your out-of-pocket expenses with some insurance plans. I've never had to deal with insurance paperwork either, aside from collecting my insurance card from the mail and presenting it at the doctor's office. It can easily be much, much worse though.

Re: How Doctors Die (2011)

#43

Post by polymatter »

philwelch wrote: post #21
purplelobster wrote: post #15

Earlier quoted context omitted.

I wonder how much stress over money affects the health of patients. It's just the last thing you want to worry about when your body is failing. I also think the system puts too much stress on relatives and the patient when it comes to choices and bureaucracy. Coming from Sweden, just having to choose between 7-8 different insurance plans is headache enough, but to have to choose your doctor, your hospital etc is just…

What happens in Sweden? Does the state assign a doctor to you? What happens if you don't like that doctor and want a different one? I wouldn't want to do away with the freedom of choice, convenient as it may be to have a default. Besides, once you've chosen all those things you can just stick with them for years on end.

Also can't comment on Sweden, but in the UK its any qualified doctor you want. And its very quick and painless to change.

Re: How Doctors Die (2011)

#44

Post by djt »

ChuckMcM wrote: post #25
pitiburi wrote: post #17

Earlier quoted context omitted.

The OP posted on that thread, so he knew this was a repost. Interesting article, but i fear for HN if reposting an old and interesting link you remember becomes a way of getting easy karma.

I suppose if the goal was karma farming then to be complete you would first repost a highly ranked story and then you would repost the highest ranked comment on your repost. And presumably if the same people read it again and voted again then you would capture the most possible re-karma points :-)

Luckily karma doesn't mean anything :D

Re: How Doctors Die (2011)

#45

Post by aqme28 »

javert wrote: post #38
_delirium wrote: post #22

Earlier quoted context omitted.

I'm an American who typically values choice and being able to shop around, but I agree that it ends up creating this sort of unpleasant situation in healthcare. Lots of reasons, but two big ones are: 1) lots of buyers who cannot say no, e.g. someone in an ambulance on a way to a hospital is not in a strong negotiating position; and 2) the insurance model doesn't work that well, because incidents are strongly correlat…

Please realize that the current horrible insurance system is almost entirely a product of government regultory practice.

Can you explain this more please? I am under the impression that it's almost entirely the product of a bloated insurance industry and wouldn't mind some evidence set me right.

Re: How Doctors Die (2011)

#46

Post by javert »

_delirium wrote: post #39
javert wrote: post #38

Earlier quoted context omitted.

Please realize that the current horrible insurance system is almost entirely a product of government regultory practice.

I disagree; government regulatory practice is mainly taking some of the worse edges off the inherently broken model of "healthcare as insurance". I'm thinking particularly of major conditions. I think regular office visits could probably be paid for out of pocket, but the real money is going towards hospitals, and that's also where free-market solutions don't work at all. In particular, I don't see how an unregulated…

Risk pooling is supposed to happen at the insurance company level, not at, e.g., the corporate level. i.e. the insurance company is pooling risk across a lot of individual clients. That this only sort of happens now is an offshoot of the regulatory system. Of course, a large company will always be able to negotiate slightly better rates.

In a free market, whenever it is financially rational to insure someone, it would happen. So, someone probably couldn't get insurace that covers their preexisting condition (which wouldn't be fair to the insurer), but they could get coverage for other things.

And that's the way it should be. Nobody should force someone else to take care of them. People are not owed anything by the universe.

Re: How Doctors Die (2011)

#47

Post by javert »

purplelobster wrote: post #40
javert wrote: post #36

Earlier quoted context omitted.

making choices all the time for everything is very taxing and energy consuming, and at some point I just want to be taken care of That seems shockingly lazy to me, and possibly dangerous.

Let me clarify that when I'm sick, I just want to be taken care of, I'm not saying that should apply to everything. On to choices, having many choices do not make people happier, but rather the opposite, there is plenty of research backing this up. Obviously having no ability to choose makes people unhappy as well. I don't think it's laziness realizing and acting on what makes us happy and what doesn't.

If one doctor or hospital is objectively better than the other, I want to be able to choose the better one, even if having to actually choose is not fun.

Re: How Doctors Die (2011)

#48

Post by javert »

aqme28 wrote: post #45
javert wrote: post #38

Earlier quoted context omitted.

Please realize that the current horrible insurance system is almost entirely a product of government regultory practice.

Can you explain this more please? I am under the impression that it's almost entirely the product of a bloated insurance industry and wouldn't mind some evidence set me right.

bloated insurance industry

Which is a product of government regulation.

Seriously. This is historically factual, and very clearly explained in [1].

[1] http://www.theobjectivestandard.com/issues/2007-winter/moral...

Re: How Doctors Die (2011)

#49

Post by purplelobster »

philwelch wrote: post #42
purplelobster wrote: post #29

Earlier quoted context omitted.

I'm sure you can choose if you really really want to, but there are sensible default options. The way it should be in my opinion: 1. Go to nearest hospital, no need to worry about insurance or whether it's a "preferred" hospital for your insurance company. 2. Get assigned doctor(s) based on your needs. 3. Get treatment. No need to check what treatments are covered and if your doctor is trying to screw you over with u…

For regular doctor's appointments, I don't go to the hospital, I just go to my doctor's office. I can imagine pretty well. When things are set up with good insurance coverage, it's hardly any different than what you described, maybe with the exception of preferred networks, but in my city I've never had any doctor fall outside of the preferred network for my insurance anyway. Everything is either covered from the ins…

Well, obviously there are exceptions, but I wouldn't measure or defend a system based on the best case, but the average and standard deviation. Unfortunately, a huge amount of people are falling through the cracks. Sweden's system might be worse for rich/upper middle class people, but the average case is more than acceptable and the deviation is small. For instance, if you come in with a non life threatening condition, you will have to wait. That could mean waiting months for a specific surgery that you might get instantly in the US if you had good insurance. That kinda sucks when you have to wait and you're in pain, but is understandable unless you want to spend 50% of GDP on health care, or prioritize people based on how much they earn.

Re: How Doctors Die (2011)

#50

Post by DanBC »

javert wrote: post #47
purplelobster wrote: post #40

Earlier quoted context omitted.

Let me clarify that when I'm sick, I just want to be taken care of, I'm not saying that should apply to everything. On to choices, having many choices do not make people happier, but rather the opposite, there is plenty of research backing this up. Obviously having no ability to choose makes people unhappy as well. I don't think it's laziness realizing and acting on what makes us happy and what doesn't.

If one doctor or hospital is objectively better than the other, I want to be able to choose the better one, even if having to actually choose is not fun.

How do you know which hospital is better? What metrics are you looking for?
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