Hacker News Folks Get Long Overdue Thanks • Hacker News Board

Re: Hacker News Folks Get Long Overdue Thanks

#71

Post by rdouble » Sat, Jul 20, 2013, 7:32 PM UTC

raganwald wrote: post #21

nwenzel wrote: post #11

Great story of compassion and triumph. So... How do we make it scale? Is it mandatory insurance? Insurance doesn't make everything affordable, but it probably wild have been helpful. Though maybe the co-pay would have been $50k. Universal tax-payer funded insurance? The term "tax payer" is interesting because politicians and pundits forget that we're all tax payers in one form or another. Granted some pay more, some…

Single-payer or government provided healthcare? Pretty sure that no one would identify the government as the picture perfect example of efficiency. Plus, putting elected officials or their appointees in charge of handing out goods and services doesnt seem to be sustainable. It seems odd to me that so many Americans seem pessimistic about their own government. I could understand if the attitude was, "We could make uni…

It's because of "American Exceptionalism." Single payer health care was not invented in America, therefore it could not possibly work in America. Education is similar. There are always at least 20 countries ranked ahead of the USA in primary and secondary education. Yet none of the successful approaches used in those countries can even be experimented with in the USA, because they "would never work here." Things are just different here, you see.

Knowing this, if one really wanted to implement single payer care in America, it would be more likely to succeed if the program was marketed as something like "Super Patriot America Care, just like our boys get in the US Military!" rather than calling it single payer care, which is some Euro/Canada not-invented-here thing that can't possibly ever work, because of America.

Re: Hacker News Folks Get Long Overdue Thanks

#72

Post by bebop » Sat, Jul 20, 2013, 7:38 PM UTC

wozniacki wrote: post #52

Nursie wrote: post #29

Earlier quoted context omitted.

Pretty sure us Brits still get a claim on the empire thing. Pretty sure...

He meant the benevolent kind of empire. Since the US doesn't annex territories for itself and keep them as colonies as part of some Commonwealth Realm. Although the US could have if it tried, with the slightest flex of a myoblast, in the last great war. It still can. Pretty sure that's what he/she meant.

Puerto Rico, US Vigin Islands, American Samoa, CNMI, Guam, and most importantly Hawaii are all annexed territories of the United States. Not to mention California and most of the west really.

Re: Hacker News Folks Get Long Overdue Thanks

#73

Post by Vivtek » Sat, Jul 20, 2013, 7:40 PM UTC

pyre wrote: post #42

happy_dino wrote: post #23

Earlier quoted context omitted.

I still can't decide what's more embarrassing: That the US have a third-world health care system or that people act like it is a hard, unsolved issue to implement something better.

It's not third-world. If you have the money, it's first-class. It's just the 'if you have the money' part that causes issues.

That's essentially what "third world" means. You think there are no billionaires in the third world?

Re: Hacker News Folks Get Long Overdue Thanks

#74

Post by krrrh » Sat, Jul 20, 2013, 7:42 PM UTC

dantheman wrote: post #62

mixmax wrote: post #49

While this is a great and heartbreaking story that makes me proud to be an active member of HN it's also a symptom of the totally broken US healthcare system. From wikipedia: The United States life expectancy of 78.4 years at birth, up from 75.2 years in 1990, ranks it 50th among 221 nations, and 27th out of the 34 industrialized OECD countries, down from 20th in 1990. Of 17 high-income countries studied by the Natio…

Damn lies and statistics - it's very difficult to compare countries on Infant Mortality because they have different definitions of alive. From wikipedia: The World Health Organization (WHO) defines a live birth as any born human being who demonstrates independent signs of life, including breathing, voluntary muscle movement, or heartbeat. Many countries, however, including certain European states and Japan, only coun…

In addition, if you limit the data to single child births, eliminating twins and other multiple births, the US actually ranks number one for child mortality. Multiple child births are inherently more risky, as are births to women over the age of 30. Due to wealth, cultural, and lifestyle factors the number of multiple-child pregnancies in the US is much much higher than in other countries. More American women choose to have children later in life and sometimes this includes fertility drugs which results in more riskier twin pregnancies.

When you remove car accidents and suicides from the death rates, factors that are largely independent from the health care system, the US actually has the highest life expectancy in the world.

A good source of info on this is the work of Scott Atlas. This econtalk includes a good look at the statistical biases in the micro rankings that get so much undue attention in the media.

http://www.econtalk.org/archives/2012/07/scott_atlas_on.html

Re: Hacker News Folks Get Long Overdue Thanks

#75

Post by Vivtek » Sat, Jul 20, 2013, 7:49 PM UTC

WasimBhai wrote: post #22

I have often wondered given the kind of cost involved in good health care in USA, along with college fees, why don't more Americans move to Europe for health care and education where it is probably free most of the time? P.S.: I am from Pakistan.

Mostly because Americans are terrified of foreigners and have absolutely no concept that the rest of the world isn't just a figment of Hollywood's imagination.

I'm living in Budapest partly for low tuition - my wife is Hungarian, which makes it less random than it seems.

Also, very few people in America can understand that life outside the United States could possibly be fulfilling. Or that tuition in much of Europe is free - I tell friends and family and they just boggle. There is such a strong feeling in the States that we have everything better than anybody else in the world.

When we were talking about moving to Budapest last year, I was asked by the plumber, "But is there enough food there?" He honestly believed, apparently, that everyone else in the world is starving except for the well-known massive foreign aid we provide. (That's tongue-in-cheek; most foreign aid is money specifically earmarked for the purchase of American industrial output, so it's really a handout to American industry, not to foreigners - and it's a tiny fraction of our annual budget to start with, but many people in America think that's where a substantial portion of their taxes goes.)

Re: Hacker News Folks Get Long Overdue Thanks

#76

Post by DanBC » Sat, Jul 20, 2013, 7:52 PM UTC

tptacek wrote: post #70

lifeisstillgood wrote: post #63

Earlier quoted context omitted.

Edit: It has been (correctly) pointed out downthread that I have helped hijacking a very personal post for political point scoring - which I think is fair. However we lack a decent history function in HN so I leave it here otherwise the thread will read strangely. Thank you - as a Brit I read this too. I cycled through emotions - fear and sympathy for the diagnosis, hope as some of our best professionals consider new…

The UK has notoriously poor cancer outcomes. http://www.telegraph.co.uk/news/uknews/1560849/UK-cancer-sur...

You understand we've done a lot since 2007, right?

EDIT: specifically, "survival rate" is just "how many people lived for 5 years after diagnosis". Thus, you detect a lot of slow growing prostate cancer and your survival rates go up, even though nothing has been done to reduce the incidence of cancer, or stop any more people from dying of cancer.

When you look at US cancer mortality rates they look pretty good, until you restrict the numbers to the under-65s, when suddenly the numbers look pretty average. This might be because poor americans don't get access to treatment until they're 65 and qualify for some aid.

Re: Hacker News Folks Get Long Overdue Thanks

#77

Post by dantheman » Sat, Jul 20, 2013, 8:10 PM UTC

ewoodrich wrote: post #69

dantheman wrote: post #62

Earlier quoted context omitted.

Damn lies and statistics - it's very difficult to compare countries on Infant Mortality because they have different definitions of alive. From wikipedia: The World Health Organization (WHO) defines a live birth as any born human being who demonstrates independent signs of life, including breathing, voluntary muscle movement, or heartbeat. Many countries, however, including certain European states and Japan, only coun…

From your article: "However, in 2009, the US CDC issued a report that stated that the American rates of infant mortality were affected by the United States' high rates of premature babies compared to European countries. It also outlined the differences in reporting requirements between the United States and Europe, noting that France, the Czech Republic, Ireland, the Netherlands, and Poland do not report all live bir…

Yes it doesn't explain it away, there are other problems too that aren't related to health care: More teenage pregnancies (higher likely hood of low birth weight), more single mother pregnancies, more obese pregnancies). These are underlying cultural issues that while related to healthcare are different.

In no way am I trying to blame the victim or excuse a bad system. I'm only pointing out that these comparisons are very hard to do correctly and can be misleading. We have an urge to compare so that we can make better decisions, but it can be tough to do this. From the stats originally posted it could be argued that we need to spend more money on the healthcare system, when in reality we just need to educate people to wait to have kids.

  Researchers from the NCHS found that low birthweight 
  and short gestational age births—a leading cause of 
  infant death internationally were more common in the 
  United States than in Europe.  Although outcomes for 
  these births were similar, they found that the U.S. 
  rate of low birthweight and short gestational age births
  was double that of Finland and Sweden.29 After adjusting
  for potential recording differences by excluding very 
  short gestational age births, they found that the U.S. 
  IMR would be 3.9 if the United States had the same rate 
  of low birthweight and short gestational age births as 
  Sweden. 

  https://www.fas.org/sgp/crs/misc/R41378.pdf

Re: Hacker News Folks Get Long Overdue Thanks

#78

Post by dfc » Sat, Jul 20, 2013, 8:14 PM UTC

DanBC wrote: post #76

tptacek wrote: post #70

Earlier quoted context omitted.

The UK has notoriously poor cancer outcomes. http://www.telegraph.co.uk/news/uknews/1560849/UK-cancer-sur...

You understand we've done a lot since 2007, right? EDIT: specifically, "survival rate" is just "how many people lived for 5 years after diagnosis". Thus, you detect a lot of slow growing prostate cancer and your survival rates go up, even though nothing has been done to reduce the incidence of cancer, or stop any more people from dying of cancer. When you look at US cancer mortality rates they look pretty good, until…

Dan I am not challenging your statement I am just curious if you have seen any figures about the new outcomes. I did a quick look at the UK Cancer research page and it does not look like many of the statistics have been updated recently.

That being said it would be nice if the disparity in survival percentages on this side of the pond looked more like the stats from your side:

http://www.cancerresearchuk.org/cancer-info/cancerstats/surv...

Re: Hacker News Folks Get Long Overdue Thanks

#79

Post by jaggederest » Sat, Jul 20, 2013, 8:23 PM UTC

foobarbazqux wrote: post #31

jaggederest wrote: post #30

Earlier quoted context omitted.

I've actually worked with health insurance billing. The way it works is that they bill ridiculously large amounts, which nobody without insurance can pay. They know this. The insurance companies negotiate it, other people pay what they can, and it all more or less works out in the end. I'd much, much prefer to see a single payer system. Seeing every specialist is different than being in treatment with a doctor and ha…

Do doctors make individual decisions about working pro bono, and does it come directly out of their paycheque, or does the hospital cover it for them?

It's basically up to the people involved, everything is so baroque and ad-hoc there's not much standardization besides with medicare/medicaid and even that makes my eyes water.

Re: Hacker News Folks Get Long Overdue Thanks

#80

Post by bittired » Sat, Jul 20, 2013, 8:23 PM UTC

lifeisstillgood wrote: post #63

mixmax wrote: post #49

While this is a great and heartbreaking story that makes me proud to be an active member of HN it's also a symptom of the totally broken US healthcare system. From wikipedia: The United States life expectancy of 78.4 years at birth, up from 75.2 years in 1990, ranks it 50th among 221 nations, and 27th out of the 34 industrialized OECD countries, down from 20th in 1990. Of 17 high-income countries studied by the Natio…

Edit: It has been (correctly) pointed out downthread that I have helped hijacking a very personal post for political point scoring - which I think is fair. However we lack a decent history function in HN so I leave it here otherwise the thread will read strangely. Thank you - as a Brit I read this too. I cycled through emotions - fear and sympathy for the diagnosis, hope as some of our best professionals consider new…

I cannot believe that the #1 comment responding to his thanks is basically a political one to raise awareness of the "broken" U.S. healthcare system, so I'll respond in-kind.

What was broken in this case was described by his statement: "I had no medical insurance and the few benefits I had with the VA would take months of paperwork to get me in." You can blame that on Ted Kennedy, btw. He is the one that made health insurance an institution in the U.S. The best chance we have at good healthcare here has nothing to do with government or health insurance, it was to do with doctors that are willing to say F.U. to the system and provide healthcare directly to paitents without middlemen. So, that's the other side of the politics. Now back to what we really should be talking about...

I think it is wonderful that his cancer was treated and that people here helped. Cancer really fucking sucks. I hate Cancer with a deep passion that some of you out there understand. Others of you like to think of how great your resume looks and how you are going to land a fat house on the beach. I used to also.