How twitter helped a technology consultant escape from an evil hospital • Hacker News Board

Re: How twitter helped a technology consultant escape from an evil hospital

#41

Post by DougBTX » Sun, Sep 13, 2009, 10:14 PM UTC

windsurfer wrote: post #35

gruseom wrote: post #9

Earlier quoted context omitted.

We very well could be spending a lot less money for the same amount of health care. ... not to mention greater actual health. When health care was the leading issue in Canada a few years ago and every politician was going around promising to expand it, I remember wondering if I was the only one thinking we need less of it, not more. It might be helpful if we used a more accurate label than "health care" (perhaps "dis…

Hey, as a Canadian, if you feel you don't want as much health care, just use it less. The system is designed so that people take as much as they need, but not more.

Rational appraisal of risks, especially about your own healthcare and as a non-expert, is difficult.

Re: How twitter helped a technology consultant escape from an evil hospital

#42

Post by SarahCortes » Sun, Sep 13, 2009, 10:15 PM UTC

DEinspanjer wrote: post #36

I wonder if the treatment was really all about the "really great health insurance" and not just the doctors at the hospital deciding that they knew better than another doctor many hours away that had not seen the patient or the pictures of her spine. Upon reading the description of how the accident took place, my first thought was, "Really, is her insurance going to pay for that!?" And according to the last comment o…

Ah,is that really a question? My comment on my blog that my health insurance decided it was best to leave me on the ledge to die of exposure was-need I say-tongue in cheek.You must be under the impression the insurance companies are in possession of that awesome perfect blame calculator - parsing an infinite number of scenarios to detemine blame for accidents and disease, then confirm or deny coverage based on their magic box. That is your insurance company, not mine. Please reply quickly, unless you are tied up arguing with them about whether they should cover your AIDS since everyone knows sharing needles is unsafe.

Re: How twitter helped a technology consultant escape from an evil hospital

#43

Post by SarahCortes » Sun, Sep 13, 2009, 10:17 PM UTC

benatkin wrote: post #33

Since that time, people on both sides of the health care debate have listened to my story and pointed out it supports their views, both pro and con. Unsurprising. I think this is more about patients' rights than healthcare funding, though.

True, but clearly that some have too little and others, relatively, too much- i think that was a major issue in my situation.

Re: How twitter helped a technology consultant escape from an evil hospital

#44

Post by SarahCortes » Sun, Sep 13, 2009, 10:18 PM UTC

fnid wrote: post #6

It never occurred to me that carrying high-level heath insurance would mark me as a candidate for unnecessary surgery. Perhaps this is exactly why health care costs have gone up so dramatically. We have insurance, so the doctors take advantage of it -- needlessly. We very well could be spending a lot less money for the same amount of health care. I think the solution to the health care problem is for someone to start…

I agree, and I said, No! Less was way more, for me.

Re: How twitter helped a technology consultant escape from an evil hospital

#45

Post by rdouble » Sun, Sep 13, 2009, 10:37 PM UTC

My dad's a doctor in a rural environment, and I had a bad back injury including ruptured discs and cracked vertebrae when I was in high school. I can offer some insight on the psychology of the doctors and even a little bit of information on this particular injury.

A rural surgeon is going to be professionally offended if their patient calls up an egghead at Harvard from their pre-op hospital bed and then tells him she doesn't trust his judgement and instead wants to be medivac airlifted back to Boston. It's like when you watch a detective show when the FBI takes over and the local cops are all bent out of shape. The hospital staff may have been thinking about health insurance and losing their accreditation but I doubt it was a sinister plot to meet their spinal surgery quotas. It was probably more along these lines: "a crazy lady from Boston just broke her back jumping off a bridge with some 13 year olds. Now she's telling us to schedule a chopper to Boston because she's Facebook buddies with some prick neurology prof at Harvard. Quick, give her some morphine and get her under the knife before her spinal column collapses and she's paralyzed and we get slapped with a half billion dollar malpractice suit... "

Note that I'm not defending that sort of attitude. That's just what I think they would be thinking, rather than some nefarious conspiracy to maximize insurance profits, which is what the article and most commenters on this post seem to be suggesting.

The other thing is that I don't think the doctors were necessarily wrong in their diagnosis. The higher you go up in the spine, there's a lot more danger of paralysis or other severe spinal cord problem. If you're over 30 and shatter your T12, there's a 50% chance you're going to end up with a serious neurological problem. The odds for recovery are far better the sooner you have surgery, if the surgery is necessary.

Timing of surgery is also an important issue in the treatment of thoracic spine fractures. ... Some studies suggest that patients with thoracic spine fractures treated within 72 hours, irrespective of concomitant injuries, do much better physiologically postoperatively than those in whom stabilization is delayed.

http://emedicine.medscape.com/article/1267029-treatment

Lastly, I don't think a patient requested 370 mile helicopter flight for a treatment which could be performed locally could possibly be covered under any insurance plan, no matter how good the coverage is.

Re: How twitter helped a technology consultant escape from an evil hospital

#46

Post by mhb » Sun, Sep 13, 2009, 11:02 PM UTC

po wrote: post #26

fnid wrote: post #6

It never occurred to me that carrying high-level heath insurance would mark me as a candidate for unnecessary surgery. Perhaps this is exactly why health care costs have gone up so dramatically. We have insurance, so the doctors take advantage of it -- needlessly. We very well could be spending a lot less money for the same amount of health care. I think the solution to the health care problem is for someone to start…

Another good article which I don't think is getting as much press as the New Yorker article: http://www.theatlantic.com/doc/200909/health-care

http://news.ycombinator.com/item?id=760477

Re: How twitter helped a technology consultant escape from an evil hospital

#47

Post by ryanwaggoner » Sun, Sep 13, 2009, 11:04 PM UTC

po wrote: post #26

fnid wrote: post #6

It never occurred to me that carrying high-level heath insurance would mark me as a candidate for unnecessary surgery. Perhaps this is exactly why health care costs have gone up so dramatically. We have insurance, so the doctors take advantage of it -- needlessly. We very well could be spending a lot less money for the same amount of health care. I think the solution to the health care problem is for someone to start…

Another good article which I don't think is getting as much press as the New Yorker article: http://www.theatlantic.com/doc/200909/health-care

Fantastic article, but it was on the front page about a month ago:

http://news.ycombinator.com/item?id=760477

Re: How twitter helped a technology consultant escape from an evil hospital

#48

Post by Retric » Sun, Sep 13, 2009, 11:11 PM UTC

kmavm wrote: post #12

fnid wrote: post #6

It never occurred to me that carrying high-level heath insurance would mark me as a candidate for unnecessary surgery. Perhaps this is exactly why health care costs have gone up so dramatically. We have insurance, so the doctors take advantage of it -- needlessly. We very well could be spending a lot less money for the same amount of health care. I think the solution to the health care problem is for someone to start…

This is essentially the thesis of Arnold Kling's "Crisis of Abundance": http://www.amazon.com/Crisis-Abundance-Rethinking-Health-Car... Except for a few blockbuster interventions (antibiotics for bacterial infection, orthopedics, reading glasses), the expected return of many health care interventions is negative; they cost so much, and have the potential to do so much harm, for such uncertain good, that we're better…

The problem with that philosophy is there are thousands of "blockbuster" treatments, everything from a simple filling, to a Tylenol would be miraculous if you steeped back a few hundred years.

Finding the right balance between cost and heath is hard, but blaming everything but the blockbusters is the wrong place to start. Two years ago my father went from fine to dead in one week in part because the doctor failed to ask for a single test. He had health inshurance, went to a doctor who liked to avoid extra tests and died. A hundred years ago, dieing at 62, could have been seen as living a long life, but today a simple test and a quick surgery and he could have lived another 20 years in good heath.

PS: If you really want to look for waste in heath care figure out where the money goes. Starting with the payments to your heath insurgence company and how little get's back to actual treatments.

Re: How twitter helped a technology consultant escape from an evil hospital

#49

Post by marze » Sun, Sep 13, 2009, 11:19 PM UTC

This seems like a situation where knowing a certain phrase might help. I don't know what that phrase might, but a lawyer or someone else familiar with the medical industry might.

Something like "I will not authorize you to perform this procedure and have notified my physician and lawyer of this, if you perform anything that I have not authorized will result in an expensive lawsuit" or something.

Anyone know what the right terms to use are? It seems in other situations there are magic words that can be used to produce immediate results.

Re: How twitter helped a technology consultant escape from an evil hospital

#50

Post by pyre » Mon, Sep 14, 2009, 12:19 AM UTC

windsurfer wrote: post #35

gruseom wrote: post #9

Earlier quoted context omitted.

We very well could be spending a lot less money for the same amount of health care. ... not to mention greater actual health. When health care was the leading issue in Canada a few years ago and every politician was going around promising to expand it, I remember wondering if I was the only one thinking we need less of it, not more. It might be helpful if we used a more accurate label than "health care" (perhaps "dis…

Hey, as a Canadian, if you feel you don't want as much health care, just use it less. The system is designed so that people take as much as they need, but not more.

One of the problems in Canada (at least Ontario -- because healthcare is run by the province not the federal government) is people using the emergency room as a doctor's office. This is because regular practice doctor's are regulated on the number of patients they can see (this is an attempt to prevent doctors from seriously overbooking themselves with patients in an attempt act like a 'health factory' where patients are just pushed down an assembly-line) so people have a hard time getting an actual physician.

There are a couple of solutions to this, but no one really talks about them. (1) There are plenty of people that are qualified to be doctors, but because they did their medical school in India or China before immigrating to Canada, they aren't allowed to be certified as doctors. (2) Lots of doctors 'jump ship' to more profitable countries like the USA because they can just charge insurance and they aren't regulated from creating a 'factory practice' where no patient ever gets more than 5 minutes of the doctor's time.