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

#51

Post by pyre » Mon, Sep 14, 2009, 12:22 AM UTC

jimmybot wrote: post #16

gruseom wrote: post #15

Earlier quoted context omitted.

Although your comment looks like a vacuous redditesque one-liner, I'll respond: I've jumped from similar heights under similar circumstances, i.e. a spot favored by locals, surrounded by people happily jumping and swimming. It's only in hindsight that what she did was an obviously bad move, and even then it sounds like a slightly different angle would have made it harmless. This aspect is hardly "the ultimate lesson…

Three other people were injured that day from jumping, and the ambulance that was called wasn't even called for the heroine of our story. I don't know what the denominator is, but it doesn't sound good. I do agree though, that jumping or not wasn't the main issue here.

Seems like it was a 'hot spot' because people used it often. Sure she says that other people were injured, but how badly? It's possible that her injury was the worse injury anyone has ever sustained from jumping there. If that's the case, and parents still encourage/let their children jump from that bridge, I would say it's a problem. (Not that I would ever let my kids jump from a 50' bridge, at least not until they're old enough to make decisions on their own -- I'm not advocating 'babying' your children after they've left the nest.)

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

#52

Post by pyre » Mon, Sep 14, 2009, 12:27 AM 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.

Yea. I can see people on both sides saying crap about this.

Pro: This wouldn't happen with government healthcare because there would be standards in place (i.e. the 'mobility test' would be standard everywhere not just in 'cutting edge' facilities)

Con: In government-run healthcare, she would have been forced to stay in that hospital so as to minimize the costs of treating her (i.e. no expensive transport from PA to Boston). The government would be taking away her individual rights to take ownership of her situation.

The healthcare debate is a lot more nuanced than the 'Arg! Socialism!' or 'Arg! Health insurance is evil!' crowds make it out to be.

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

#53

Post by pyre » Mon, Sep 14, 2009, 12:32 AM UTC

davidw wrote: post #32

andreyf wrote: post #20

Oi, that sure was lengthy. Summary: Some hospital in Pennsylvania tries to make money by doing unnecessary procedures on patients with good health insurance and went to great lengths to keep this lady from seeking a second opinion regarding her injury. IMO, this is the incentive of nearly all doctors in America - the dentists I've had span the entire spectrum of opinions about my wisdom teeth. From "if we don't take…

About 15 years ago, the dentist I went to said dire things about the immense pain my wisdom teeth were going to cause in my immediate future. I told him I'd make an appointment right away when that happened, even though his advice was to intervene as soon as possible to 'avoid any future problems'. I still have all of them and aside from the occasional twinge, they are just fine.

It's not necessarily about money though. To my knowledge, most people have problems with their wisdom teeth coming in wrong and screwing up their other teeth. If this is the majority case, then going on the offensive and taking care of them early can make sense rather than waiting to have issues.

Sometimes these cases end up sounding to me like the people who try to decry the state laws requiring you to wear a seatbelt by pointing out the relatively few cases where not wearing a seatbelt did save (or could have saved) someone's life. They completely ignore the overwhelming number of cases where seatbelts do save people's lives. It's just a case of people trying to make the facts fit a conclusion that they've already come to and don't want to change.

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

#54

Post by yummyfajitas » Mon, Sep 14, 2009, 12:56 AM UTC

potatolicious wrote: post #38

gluejar wrote: post #3

According to the author, the story is being used as fodder by both sides of the healthcare debate. All I can see is the perverse economic incentives on display.

AFAIK Canada gets around this problem by capping the number of billable patients a doctor can see per day (adjusted by specialty of course). Any patients in excess of the cap is only paid by the government at a steeply discounted rate. This discourages doctors from overworking themselves and offering shoddy care (instead choosing to move patients through like a cattle farm), and also discourages the sort of unnecessa…

I suspect that the doctors at this hospital would be well under the quota you speak of. Remember, the author suggested the hospital might lose it's accredition for this type of surgery since they didn't do enough of them.

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

#55

Post by zargon » Mon, Sep 14, 2009, 1:00 AM UTC

pyre wrote: post #53

davidw wrote: post #32

Earlier quoted context omitted.

About 15 years ago, the dentist I went to said dire things about the immense pain my wisdom teeth were going to cause in my immediate future. I told him I'd make an appointment right away when that happened, even though his advice was to intervene as soon as possible to 'avoid any future problems'. I still have all of them and aside from the occasional twinge, they are just fine.

It's not necessarily about money though. To my knowledge, most people have problems with their wisdom teeth coming in wrong and screwing up their other teeth. If this is the majority case, then going on the offensive and taking care of them early can make sense rather than waiting to have issues. Sometimes these cases end up sounding to me like the people who try to decry the state laws requiring you to wear a seatbe…

That comparison is like saying that when someone gets diagnosed with diabetes, they should preemptively amputate their feet so as to avoid trouble with them later.

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

#56

Post by btilly » Mon, Sep 14, 2009, 1:08 AM UTC

Retric wrote: post #48

kmavm wrote: post #12

Earlier quoted context omitted.

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…

Whether or not you like that philosophy in general, and despite your father's tragedy, it is extremely appropriate for spinal surgery. Spinal surgery costs a lot of money, frequently goes very badly, and even "successes" tend to be temporary and are followed in a few years by being worse off.

This is why in the mid-90s the Agency for Health Care Policy Research (AHCPR) looked at the subject and concluded that back surgery was inadvisable if any other options were available. Unfortunately for the AHCPR back surgeons are a fairly well off group, got the AMA on their side, and the result was that Congress nearly destroyed the AHCPR. The remnants have learned not to issue politically controversial opinions, no matter how well-founded in fact they may be. Thus a well-meaning attempt to actually evaluate expensive medical treatments for effectiveness ended.

Incidentally experts claim that the vast majority of the gains in life expectancy over the last 150 years have been due to improvements in public health, not medicine. Each of vaccination, sanitation and clean water supplies has done more to contribute to longevity than any medical advance you care to name, including antibiotics. Yet people are unaware of the contribution of public health. I find this odd.

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

#57

Post by btilly » Mon, Sep 14, 2009, 1:08 AM UTC

Retric wrote: post #48

kmavm wrote: post #12

Earlier quoted context omitted.

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…

Whether or not you like that philosophy in general, and despite your father's tragedy, it is extremely appropriate for spinal surgery. Spinal surgery costs a lot of money, frequently goes very badly, and even "successes" tend to be temporary and are followed in a few years by being worse off.

This is why in the mid-90s the Agency for Health Care Policy Research (AHCPR) looked at the subject and concluded that back surgery was inadvisable if any other options were available. Unfortunately for the AHCPR back surgeons are a fairly well off group, got the AMA on their side, and the result was that Congress nearly destroyed the AHCPR. The remnants have learned not to issue politically controversial opinions, no matter how well-founded in fact they may be. Thus a well-meaning attempt to actually evaluate expensive medical treatments for effectiveness ended.

Incidentally experts claim that the vast majority of the gains in life expectancy over the last 150 years have been due to improvements in public health, not medicine. Each of vaccination, sanitation and clean water supplies has done more to contribute to longevity than any medical advance you care to name, including antibiotics. Yet people are unaware of the contribution of public health. I find this odd.

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

#58

Post by zaphar » Mon, Sep 14, 2009, 1:28 AM UTC

radu_floricica wrote: post #39

andreyf wrote: post #19

Earlier quoted context omitted.

No accreditation means no funding, means no hospital, means no job. So by your definition, the only way doctors can remain doctors at said hospital is by being evil. Hence, I would blame the short-sighedness of whoever created and approved for the rules of accreditation for hospitals, not the people at the whims of those rules.

Don't downmod this, it has a valid point. It's by far better if the rules of the game don't give incentives to being evil. If they do it's as good as guaranteed that sometime somewhere you will get this kind of incident. Whether you choose to also blame the individuals involved is up to you, but it's the rule-makers who created this.

Every rule system ever designed has the potential to be misinterpreted, misused, and create incentives that were never intended.

Rule systems and rule makers can't be held responsible for idiotic/selfish/malicious behavior by individuals. Yes rules and systems can be refined to improve them but ultimately it will always be up to the individual to exercise judgement and moral character. So I'm afraid I have to disagree with you. If you blame the system for being misused you miss the point.

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

#59

Post by pyre » Mon, Sep 14, 2009, 1:49 AM UTC

zargon wrote: post #55

pyre wrote: post #53

Earlier quoted context omitted.

It's not necessarily about money though. To my knowledge, most people have problems with their wisdom teeth coming in wrong and screwing up their other teeth. If this is the majority case, then going on the offensive and taking care of them early can make sense rather than waiting to have issues. Sometimes these cases end up sounding to me like the people who try to decry the state laws requiring you to wear a seatbe…

That comparison is like saying that when someone gets diagnosed with diabetes, they should preemptively amputate their feet so as to avoid trouble with them later.

So you are saying that removal of wisdom teeth gives you a disability similar to removal of feet?

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

#60

Post by joe_the_user » Mon, Sep 14, 2009, 2:03 AM UTC

pyre wrote: post #50

windsurfer wrote: post #35

Earlier quoted context omitted.

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…

Uh,

In the US, a large number of people use the emergency room as a doctor's office because they have no other choice.

So, Canada: problematic. US: fail

But if Canada keeps using US logic, it might wind-up in our boat. Good luck to you...