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Hacker News Folks Get Long Overdue Thanks

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Re: Hacker News Folks Get Long Overdue Thanks

#121

Post by refurb »

mixmax wrote: post #91
refurb wrote: post #89

Earlier quoted context omitted.

I know I must sound like a broken record, but life expectancy is a poor proxy for quality of healthcare. There are many factors which impact life expectancy which have nothing to do with healthcare. For example, if you correct for the number of car accidents (which is high in the US due to the number of cars on the road), the US comes out near the top in terms of life expectancy. The other thing is that to say that t…

I just copied the first paragraph from the Wikipedia article, which happpened to be about life expectancy which is often seen as a proxy for quality of healthcare. Fair or not. Here are some other excerpts from the article: - The United States is among the few industrialized nations in the world that does not guarantee access to health care for its population. - lack of health insurance causes roughly 48,000 unnecess…

You won't get any argument from me that the US healthcare system is broken (both the private and public systems).

However, using flimsy statistical arguememts to make the arguememt isn't helping anyone.

Btw, the 62% of bankruptcies stat is also misleading. Whether the person had $10 or $100k medical debt is included. It's not surprising that if someone went bankrupt due to a failed business they wouldn't pay their medical bills either. Thus for many of those 62%, medical expenses had nothing to do with their bankruptcies.

Re: Hacker News Folks Get Long Overdue Thanks

#123

Post by vidarh »

rdouble wrote: post #71
raganwald wrote: post #21

Earlier quoted context omitted.

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…

The funny thing is that the "father" of socialized welfare is Bismark, and the German system is largely private, and that too works far better. It doesn't have to be single payer: Pretty much every model that has set out with the requirement of providing universal coverage, in a country with enough money to fund it decently, has ended up better.

Re: Hacker News Folks Get Long Overdue Thanks

#124

Post by ippisl »

NoodleIncident wrote: post #115
Noxchi wrote: post #95

Earlier quoted context omitted.

http://en.akinator.com/ That web app can name any person you think of by asking 20 or so questions. Just imagine what you could do if you made that but for diseases.

That's exactly what Watson is doing these days, right?

Similar things have been done before, for example Isabele health care, and other medical decision support systems.

Re: Hacker News Folks Get Long Overdue Thanks

#125

Post by ippisl »

bencollier49 wrote: post #97
Noxchi wrote: post #95

Earlier quoted context omitted.

http://en.akinator.com/ That web app can name any person you think of by asking 20 or so questions. Just imagine what you could do if you made that but for diseases.

Let's do it. I had this idea that each medical field could have a sort of Global Subject Expert AI online to make diagnoses, and the more people using it, the more sublime it would become in its assessments.

If you're interested in building something, I think an automated medical interview app, for use by consumers, focused on some subset seems more practical.

Re: Hacker News Folks Get Long Overdue Thanks

#126

Post by flexie »

tptacek wrote: post #67
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…

On cancer outcomes, the US outranks many (most?) of the countries that beat it on life expectancy. And, as pointed out downthread, life expectancy is a dodgy stat; it's heavily weighted by infant mortality, which isn't uniformly measured, and by accidental and violent deaths which, while tragic and perhaps symptomatic of other US problems, don't implicate our health care system.

You can use a table like this to see that US life expectancy doesn't get much better if you calculate it at age 10 or 20 instead of at birth and US ranking is not much different (actually the US drops a few places): http://www.worldlifeexpectancy.com/your-life-expectancy-by-a... For 'first world' countries with low infant mortality rate life expectancy at birth and at age 10 is nearly the same.

Re: Hacker News Folks Get Long Overdue Thanks

#127

Post by Crake »

twstws wrote: post #18

This is truly a wonderful story. But it makes you wonder how many others in a similar situation weren't so fortunate. I lived in the US for two years, and I never understood the aversion to government healthcare. The Canadian system is far from perfect, and I know there are failures. But it's still a lot better than soliciting for online charity on a case by case basis. I'm impressed and humbled that it worked in thi…

When I was obviously ill and in pain in class the other day (I have some ongoing health issues), I had one of my classmates tell me that Obamacare was going to "destroy the entire country" (exact words) because people like me having health insurance would make doctors become underpaid. I mentioned that my health insurance paid $40,000+ to a certain hospital lately, and he complained that it all went to the hospital, not the doctors.

Then he went on some rant about how all the Canadians have to come down here for health care, and that was why you never hear of Canadians having surgery up there. I mentioned I had a Canadian friend who had a 3 part bowel surgery done recently, with very reasonable waiting times, and that of my several dozen Canadian friends, all but one was satisfied with their system, and he was just like, well, that's anecdotal, the statistics don't bear that out. That's not true at all, but he wouldn't hear of it.

Even before my health problems started, I was pro-single payer. But people like my classmate are everywhere, and seem to think that health care SHOULD be expensive and hard to get. It's inordinately cruel.

I've lived here all my life, but I'm actually moving out of state next month partially because my state's refusing to accept federal funds to cover my demographic next year, and I can't live without the medication I'm on. (Plus going to college out of state is cheaper than going to college in state (!). And they wonder why they have such a brain drain problem...)

Re: Hacker News Folks Get Long Overdue Thanks

#128

Post by Crake »

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.

I'd move in a heartbeat if they'd take me, but it's hard when you can't afford education and most countries want you to have a bachelor's at least. So I got to live without either college or health care for five years instead. :( Now I have nervous system problems, so I'm sure they'd want me even less...

Re: Hacker News Folks Get Long Overdue Thanks

#129

Post by parasubvert »

btilly wrote: post #41
Moto7451 wrote: post #19

Earlier quoted context omitted.

Not defeated, it just hasn't rolled out fully yet. States are figuring out how to implement everything, and of course the partisan foes of his health plan stage votes in Congress to repeal it (which never pass) every month or so.

It gets worse. According to CBO estimates, the plan underestimated the costs of the original rollout severalfold. Republicans are gleefully attempting to guarantee failure by refusing to approve any additional funds for that purpose.

Citation please.

As of February, it was about $130 billion off over 10 years (i.e. $1.3 trillion vs. $1.17 trillion). That is not 'severalfold'.

http://www.californiahealthline.org/articles/2013/2/6/cbo-up...

And insurance premiums on ACA exchanges are coming in 20% lower than expected:

http://aspe.hhs.gov/health/reports/2013/MarketCompetitionPre...

I do agree Republicans believe this thing is going to fail and are trying hard to encourage that.

Re: Hacker News Folks Get Long Overdue Thanks

#130

Post by parasubvert »

meowface wrote: post #37
SeanDav wrote: post #17

Earlier quoted context omitted.

I don't begin to understand the US health system (I live in the UK with its National Health), but didn't Obama try bring in compulsory health insurance to counteract just this sort of thing and it was defeated?

It was not actually defeated, but if a Republican wins the next election (which is possible) and the senate and house can achieve a Republican majority, it will almost definitely be repealed.

It's highly unlikely they would repeal it unless they had an alternative. No serious proposals have been forthcoming (party because the ACA was actually the conservative proposal in the 1990's...)

It would be political poison, especially given the rollout will have had a few years to cement by March 2017 (the earliest anything could be taken to floor). Hard to tell what public opinion will be like in 3.5 years, but I'd wager it will be net-positive on ACA.

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