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Post-apocalyptic life in American health care

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Re: Post-apocalyptic life in American health care

#11

Post by nathanaldensr »

I love this article. I feel like it gets down to the real root of the problems with the complexity of Western culture. I feel like this perspective applies to a lot more than healthcare. It matches my own thoughts that technological complexity is getting so high that eventually it will be beyond our own understanding, both individually or in a group of any size. We as a species simply won't be able to make use of our own tools and systems because they are so complex.

Ah, the hubris of humanity...

Re: Post-apocalyptic life in American health care

#12

Post by jbob2000 »

I know this is going to be controversial, but at this point:

> My mother’s mild dementia began accelerating rapidly a year ago. I’ve been picking up pieces of her life as she drops them. That has grown from a part-time job to a full-time job. In the past month, as she’s developed unrelated serious medical issues, it’s become a way-more-than-full-time job.

I would have kept my mother out of the healthcare system and let her pass at home or in a hospice. You can't save someone from dementia and old age, don't even try, you are just prolonging their pain. Let her drop the pieces of her life and leave them there. Lymphedema treatment? She's 84 years old with dementia, she isn't going to get up a run a marathon, why would you treat this?

I say this having never have dealt with a dying parent, so this may be ignorant on my part. I am sure it is difficult standing by while a loved one fades. I think it would be better to spend a few stress-free, happy months in a hospice than years running around between the confusing, painful, stressful mess that is the healthcare system.

Re: Post-apocalyptic life in American health care

#14

Post by TheAdamAndChe »

dbpatterson wrote: post #8

It's amazing that someone can go through this and come to the conclusion, at the end, that the solution is that this is a business opportunity that would make a lot of money if someone could just make it more efficient. Trying to make money off of healthcare is exactly how we have gotten the absolute mess that is the American medical system. All the incredibly complex rules exist so that health insurance companies ca…

We can complain about capitalism all we want, but at the end of the day, in America, we still live in a capitalistic society. Good deeds that cannot happen profitably will not happen here en masse without subsidies, period.

Given that our government has proven incapable of subsidizing healthcare in a way that promotes a combination of efficiency and effectiveness, it makes total sense that people would try to make a profitable business that meets the needs of our citizens. That's just how capitalism works.

Edit: To those downvoting me, can you please explain? What flaw do I have in my logic?

Re: Post-apocalyptic life in American health care

#15

Post by frgtpsswrdlame »

I really can't agree with this paragraph:

Are the confused rules Anthem’s fault? I imagine that the 1600 pages try to reconcile federal, state, and local legislation, plus the rules of three federal regulatory agencies, nine state agencies, and fifteen local agencies. All those are vague and conflicting and constantly changing, but Anthem’s rule-writing department does their best. They call the agencies to try to find out what the regulations are supposed to mean, and they spend hours on hold, are transferred from one official to another and back, and eventually get directed to a .gov web site that says “program not implemented yet.” Then they make something up, and hope that when the government sues Anthem, they don’t get blamed for it personally.

Anthem doesn't do their best to help people navigate their insurance and get solid answers. Individuals within the company may do their best but the company itself chooses how to fund those departments, how to run them, etc. Healthcare is confusing because 'healthcare explainers' and 'insurance navigators' are cost centers and so our privatized system places no real emphasis on them.

Besides it's not like these rules emerge from the ether either, they exist as a response to shady tactics by insurance companies. Surely we're not so far removed to have forgotten all the abuses of pre-existing conditions by insurance companies?

I might be able to say this isn't the fault of healthcare and insurance companies only so far as it's the fault of government for not just ending the charade and making the whole thing public.

Re: Post-apocalyptic life in American health care

#16

Post by evgen »

conanbatt wrote: post #9
dbpatterson wrote: post #8

It's amazing that someone can go through this and come to the conclusion, at the end, that the solution is that this is a business opportunity that would make a lot of money if someone could just make it more efficient. Trying to make money off of healthcare is exactly how we have gotten the absolute mess that is the American medical system. All the incredibly complex rules exist so that health insurance companies ca…

It isn't profit-seeking what makes healthcare what it is. Its the incredibly burdensome regulation and restrictions. If profit-seeking destroyed markets for profit, we would all be starving.

No, it is profit-seeking that created this cluster-fuck. It only seems to be a problem in third-world nations like the US; the rest of the world seems to be blissfully free of broken profit-seeking institutions that cannot talk to other profit-seeking institutions so that they can collectively figure out the least amount of healthcare they can provide to the patient (so that both can maintain their profit.)

Re: Post-apocalyptic life in American health care

#17

Post by frgtpsswrdlame »

conanbatt wrote: post #9
dbpatterson wrote: post #8

It's amazing that someone can go through this and come to the conclusion, at the end, that the solution is that this is a business opportunity that would make a lot of money if someone could just make it more efficient. Trying to make money off of healthcare is exactly how we have gotten the absolute mess that is the American medical system. All the incredibly complex rules exist so that health insurance companies ca…

It isn't profit-seeking what makes healthcare what it is. Its the incredibly burdensome regulation and restrictions. If profit-seeking destroyed markets for profit, we would all be starving.

You know those regulations are there for a reason right? Would you like to go back to the days where people are kicked off insurance for extremely dubious pre-existing conditions?

>If profit-seeking destroyed markets for profit, we would all be starving.

It depends on what you mean by 'destroy markets.' The market is functioning well in the sense that healthcare stocks keep going up. It's functioning poorly in the sense that it's the ill who have to die or go bankrupt to support it.

Re: Post-apocalyptic life in American health care

#18

Post by dragonwriter »

conanbatt wrote: post #9
dbpatterson wrote: post #8

It's amazing that someone can go through this and come to the conclusion, at the end, that the solution is that this is a business opportunity that would make a lot of money if someone could just make it more efficient. Trying to make money off of healthcare is exactly how we have gotten the absolute mess that is the American medical system. All the incredibly complex rules exist so that health insurance companies ca…

It isn't profit-seeking what makes healthcare what it is. Its the incredibly burdensome regulation and restrictions. If profit-seeking destroyed markets for profit, we would all be starving.

Profit seeking destroys markets with large externalities or where utility isn't readily discernable at low relative cost, and where for either or both of those reasons the rational choice model doesn't reasonably approximate actual behavior in the market.

Lots of real goods don't face that problem, but healthcare definitely does.

Re: Post-apocalyptic life in American health care

#19

Post by pc86 »

gt_ wrote: post #6
toomuchtodo wrote: post #2

> For complex health care problems, I recommend hiring a consultant to provide administrative (not medical!) guidance. This is called a patient advocate. Think of them as your healthcare guardian. Sometimes you hire one, sometimes one will be assigned to you in more progressive healthcare systems. If you are fighting a chronic or potentially lethal disease, I highly recommend one. Edit: Your patient advocate is usual…

Does American insurance cover this? I have inquired about something like this before when I was getting conflicting diagnoses and treatment plans. Everyone I asked (at my insurance company) acted like they didn’t know what I was talking about. I did not size the phrase “patient advocate” but if one were available, I think my need for them would have been clear.

If insurance denies claims for life-saving medical procedures because they happened out of network, I have a hard time believing they'd pay for someone to give you advice.

Re: Post-apocalyptic life in American health care

#20

Post by rdtsc »

yborg wrote: post #10
maxxxxx wrote: post #3

"There is, in fact, no system. There are systems, but mostly they don’t talk to each other. I have to do that." That's something I have noticed too. My girlfriend had to visit several doctors for a problem. One was confused about the notes of the other doctor so I proposed to call and figure it out together. The doctor seemed really perplexed about this suggestion and instead ordered the same series of tests again.

Because ordering a redundant set of tests generates revenue. Just consulting another doctor wastes both of their time better spent ordering up redundant tests and quickly moving on to the next victim that can have tests ordered.

Yap that's what I realized as well. It is a complicated beast in that some things happen because there is a profit attached to it, some happen because there is regulation requiring it.

Unnecessary tests are not even the worst, unnecessary face and nose surgery as suggested by one of the doctors for a family members was really terrifying. Good thing we decided to spend more money an time to get second opinions.

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