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That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

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Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#121
post #68
post #43

Earlier quoted context omitted.

> (note: if you don't really understand healthcare, e.g. what self insuring means, please don't respond with comments that the insurance company pays the bills, this is what insurance is for, etc.). Could you explain more about how self insuring works?

> Could you explain more about how self insuring works? In normal insurance, the policy payments go into an investment pool that benefits the corporation's stockholders. In self-insurance, the set-aside funds go into an investment pool that benefits you (or your company). The drawback to self-insurance are outlier claims that can more than wipe out the set-aside (as in the case under discussion). Obviously an insuran…

How often do self-insuranced companies run out of their set-aside? When that occurs, do their employees simply go without health care?

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#122

Earlier quoted context omitted.

Just curious, do you have kids? I might have agreed with you before I held my preemie (only 5 weeks, nothing like the baby we are talking about) in my hand: http://www.mcvoy.com/lm/photos/1999/04/16.html It's easier to make the calls before you have a kid, they are calls in theory. After you have a kid you are changed, what was an obvious call becomes much much more complex. If you can make that call after holding yo…

For your reference: I don't have children of my own. When I was 16, my mother gave birth to twins, so I have more parenting experience than the typical childless American, including that of holding closely-related infants. > It's easier to make the calls before you have a kid, they are calls in theory. After you have a kid you are changed Very true, but I don't see myself reversing on this.

Not sure if this helps or not but before we had our first my wife and I sounded a little like we were on the same page as you, more black and white. For example, we were mid 30's when "we" got pregnant so there were concerns about Downs and other stuff that happens when the eggs are older. We were pretty darn sure that if there were any "major" problems such as Downs, we would abort. It seemed pretty obvious what the right call was.

After having the first one? Things changed. Downs really didn't seem that bad compared to a life. I'm still pro choice and I don't think you could pay me enough to judge someone else's decision, that's their choice and it's hard enough without my irrelevant opinion in the mix. But for me personally? The bar on where I would go with an abortion went WAY up after having a kid. Way up.

Just trying to say having a kid really changed my thinking and I suspect I'm not that unusual in that respect.

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#123
post #36

Earlier quoted context omitted.

The race to keep younger and younger babies alive is fueled with ego and dollars. If you actually look at the global data on neonatal mortality [1], that doesn't seem to be true. Countries like Finland, France and Cuba perform better than the United States on this metric. These countries offer completely free healthcare to babies and pregnant mothers. Frankly, I find your assumption borderline offensive. Maybe you sh…

You can look at the data, but you can't conclude much from it; those numbers are not comparable to each other. From 2008: http://pjmedia.com/blog/the-doctor-is-in-infant-mortality-co... Some (OK, rather extensive) points from the link: > In the United States, all infants who show signs of life at birth (take a breath, move voluntarily, have a heartbeat) are considered alive. > In Belgium and France — in fact, in most…

The article you quote is out of date. Many of the countries mentioned, like Germany and Austria, are self-aggrandizingly wasting time and tax money pumping life into You can verify this by looking at the Tiniest Babies Registry [1], which was also mentioned in the article (those 52 surviving babies -- but the toll today is already at 155). The numbers are not so skewed towards the US as they were in 2008. In recent years, about half of these tiny babies were born in Europe, Japan or South Korea.

[1] http://webapps1.healthcare.uiowa.edu/tiniestbabies/

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#124

Earlier quoted context omitted.

> one-and-a-half-pound globs This is a human being we are talking about. A child. I like to think of myself as someone who can usually empathize with folks who hold a different point of view, but I have never been able to understand someone who looks at a human life in terms of a "cost-benefit" analysis.

> This is a human being we are talking about. A child. This glob we're talking about has less in common with a (prototypical) human being than does a 29-week fetus still implanted in the womb. You're taking a strong stand here in the abortion debate; is that intentional?

No, I'm very pro-choice. But a 1 lb baby is still a baby. If we were talking about an actual clump of cells, I'd have agreed with you.

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#125
post #22

This guy is a walking disaster. How is it anyone is willing to work for him?

Well, if you work for him, you apparently get Compensation, including salary, 401(k) matching, and a health plan that'll cover your infant's medical expenses even if they run to like a million dollars. For someone or another, that's probably the best deal they were offered.

401k benefit is dropping, that's what this story was about before the baby gossip blogging buried the point.

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#126
post #30

My daughter had a similar birth and hospital stay, which also produced a million dollar insurance bill. It costs about $10,000/day to stay in the NICU. I was never able work out why it costs so much, except that this is a major profit center for hospitals, and they use the money to cover other, money losing, departments. Fortunately Google is run by good people, and they were never anything other than supportive. I'm…

> I do think our medical system needs some rethinking though. You probaby don't want to hear it, but if I were running a medical system I'd decree that gestating one-and-a-half-pound globs (from the article: "One doctor, visibly shaken, described [the fetus's skin] as 'gelatinous'") outside the womb is a waste of resources. To me, if miscarriages aren't the end of the world, neither are "babies" that die of natural c…

It is impossible to do a cost-benefit analysis on something like that. It is worth any amount of money if the child can be saved. I'd go to the ends of the earth for my children.

Who knows what these children could end up being or doing as adults? Who knows what value they could end up bringing the world? What they might invent? What health issues they could solve? What priceless works of art they may create?

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#127
post #30

My daughter had a similar birth and hospital stay, which also produced a million dollar insurance bill. It costs about $10,000/day to stay in the NICU. I was never able work out why it costs so much, except that this is a major profit center for hospitals, and they use the money to cover other, money losing, departments. Fortunately Google is run by good people, and they were never anything other than supportive. I'm…

"... except that this is a major profit center for hospitals, and they use the money to cover other, money losing, departments ..."

I think you, like many people, misunderstand the reimbursement regime as it works in American hospitals currently. A patient in an ICU will typically have a DRG associated with him/her. This DRG relates to the acuity, and these in turn, impact the reimbursement level. This is because the complexity of care, as indicated by the acuity level, implies higher resource utilization. For instance, the patient-nurse ratio in a typical hospital room is somewhere right around 4:1. In ICUs this ratio is, more often, 1:1. The ICU also needs an array of techs for a patient... highly specialized techs capable of analyzing and acting on information coming off of the monitor that the tech is responsible for.

So hospitals are not saying, "Hey... we have these people here who we can get a lot of money out of!" The system, as it currently stands, is "volume based", so money comes in for ICU care regardless of what the hospital wants. One of the issues with being volume based in this fashion, is that money does NOT come in for things like data analytics, nutrition departments and occupational therapy for instance. Now here's the rub... how do you offer comprehensive ICU care without due consideration of nutrition? Without the ability and expertise to analyze the data coming off of what could very well be an extensive array of monitoring equipment?

It actually goes further than that... Most hospitals MUST have a clinical equipment department for which they are not reimbursed at all. Of course, the creation of an ICU withOUT a clinical equipment department is out of the question.

So while there do exist cross subsidies in any given hospital, it misses the mark to view the departments on the receiving end of the subsidies as "money losing". This sort of thinking has led the industry to all of the issues we see presently. A good example is the poor reimbursement of primary care... and so primary care becomes "money losing" when viewed in that manner. Instead, I think these departments would better be viewed in the fashion that they are viewed in the "value based" reimbursement regime that the industry is currently transitioning to.

Not only will care delivery facilities be in a better position to provide care to families like your own and others, but the quality of care will increase across that enterprise. Your family was given high quality care because the hospital took money from a "volume based" reimbursement system, and distributed those monies based on the judgement of what were probably some very clever "value based" administrators. I can pretty much guarantee you that they did not view Clinical Equipment, Data Analytics or Nutrition as "money losing" departments.

One of the things that has been missing in the discussion about the health care system is the education of the typical citizen about the tradeoffs and compromises that, for example, hospitals are making internally to deliver the quality of care that they do. I think if the citizenry had a more full understanding of the nuances of things like the reimbursement system, we could have a more productive debate on the issue of healthcare.

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#129
post #92
post #31

I'm delighted to hear that this child is doing well, and I'm utterly appalled at Tim Armstrong's attitudes towards the lives of his employee's children. Apparently it's possible to pay a programmer $100K/year, but spending ten times that to save the life of one of his employee's children is absolutely unacceptable. I'll be sure to keep that in mind the next time I hear from an AOL recruiter. The whole point of insura…

"I'm utterly appalled at Tim Armstrong's attitudes towards the lives of his employee's children. Apparently it's possible to pay a programmer $100K/year, but spending ten times that to save the life of one of his employee's children is absolutely unacceptable." Did he say that?

Sometimes it's not about what you say but about what people infer about what you think from what they've heard.

Re: That “distressed baby" Tim Armstrong blamed for benefit cuts? She’s my daughter

#130

Earlier quoted context omitted.

Just curious, do you have kids? I might have agreed with you before I held my preemie (only 5 weeks, nothing like the baby we are talking about) in my hand: http://www.mcvoy.com/lm/photos/1999/04/16.html It's easier to make the calls before you have a kid, they are calls in theory. After you have a kid you are changed, what was an obvious call becomes much much more complex. If you can make that call after holding yo…

For your reference: I don't have children of my own. When I was 16, my mother gave birth to twins, so I have more parenting experience than the typical childless American, including that of holding closely-related infants. > It's easier to make the calls before you have a kid, they are calls in theory. After you have a kid you are changed Very true, but I don't see myself reversing on this.

There's no comparison. I don't think it's possible to understand parenting without actually being a parent. I certainly wasn't able to understand it before, and I thought more as you do now.
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