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Why Did My Patient Leave Me?

cancer.nautil.us

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Re: Why Did My Patient Leave Me?

#101

Post by alphonsegaston »

ThomPete wrote: post #92
alphonsegaston wrote: post #88

Earlier quoted context omitted.

There's no question about it morality - it's immoral. Creating a system where whether you live or die is premised on your income is immoral. Even more so when single-payer systems demonstrably achieve better health outcomes at lower prices. The reality is that that so many people in this country have bought into some kind of Capitalist Calvinism, where the suffering is not only pre-ordained by "market forces," but co…

It's not that simple. Single payer systems also decide who to treat and for what sicknesses, what machines to buy etc. The reason why the US system is so expensive is because of perverse incentives given to the industry. As long as you can afford it I would rather be treated in the US system than the French or Danish system.

>It's not that simple. Single payer systems also decide who to treat and for what sicknesses, what machines to buy etc.

So does the US, they just use one's wealth as a proxy to arrive at demonstrably worse results for everyone overall.

If you want to have a system where one's income determines their ability to survive because you have enough money and that works for you right now, go ahead. But at least drop the pretense that it's in any way just or moral.

Re: Why Did My Patient Leave Me?

#102

Post by pdkl95 »

dragonwriter wrote: post #95
ThomPete wrote: post #86

Earlier quoted context omitted.

Most people in the west aren't poor just like most people aren't wealthy. Most people are in the middle. There is a large number of people who can't afford to buy a washing machine but it's not most people.

> Most people in the west aren't poor just like most people aren't wealthy. Most people are in the middle. Wrong, income distribution isn't normal, it's bottom-heavy, and most people are well below the mean.

https://www.ssa.gov/cgi-bin/netcomp.cgi?year=2015

Exactly. In 2015, most (50.08666%) wage earners earned less that $30,000/year.

While it isn't a majority, the fact that 3-in-10 (29.72726%) earn less than $15,000/year is a travesty.

Re: Why Did My Patient Leave Me?

#103

Post by giardini »

jacquesm wrote: post #26
ThomPete wrote: post #24

Earlier quoted context omitted.

I do question the sustainability of the french system though and that of many other european systems. Its important to remember that in a state economy where healthcare is free or semi free it's operated as a cost center and thus has budgets that are politically mandated not determined by market demand at least not directly. This leads to a number of limitations on what kind of care patients can get what machines the…

Good point. I'm not too worried about France, they seem to have their priorities straight there, other countries are less stable. Especially in former Eastern European countries there are disasters happening right now, and many Western countries will have to come to terms with the cost of health care and attempting to take commerce out of it. NL had a very good system which got replaced by something much less efficie…

I'm not so sure about "have their priorities straight there". Using the state to manage healthcare brings up strange priorities: "Should we cover kidney transplants or should our soldiers have real bullets in their guns this year?", "Should we build the new transit line or increase coverage to include penile transplants?", etc.

I don't want people voting based on their appendix, their bad knee surgery, or a skin rash. Involving government in healthcare inevitably leads to possible futures wherein a country is brought to it's knees by colonoscopies. One's enemies can only laugh.

Re: Why Did My Patient Leave Me?

#104

Post by dleslie »

ziikutv wrote: post #97

It ain't perfect in Canada either. I remember losing my hairs and getting patches of super smooth bald spots. Super embarrassing for a kid in a bad neighbourhood and bad school. Went to the doctor she looked at my charts and said I was super low on iron so low that I might even die if it continues to lower. I was given iron pills. Two months after I went to the doctor again and said my hair patches are not fixed. She…

Bureaucratic mishaps and mediocre care providers are bound to occur in any sufficiently complex system.

Re: Why Did My Patient Leave Me?

#105

Post by uiri »

foldr wrote: post #93
muninn_ wrote: post #58

Earlier quoted context omitted.

I hear you. Previous office I went to I had to wait more than 30 minutes past my appointment time before being seen by the nurse (before being seen by the doctor) which didn't include "arrive 10 minutes before your appointment". Obviously this is annoying. The third time I showed up to the same office I was 10 minutes late to my appointment, and they told me I would have to reschedule or wait about 45 minutes to an h…

What you appear to want is contradictory. Tolerance for people arriving late is incompatible with having appointments start on time, as everything gets backed up.

If you routinely have to wait 30+ minutes when you arrive to your appointment on time, and then have to wait even longer if you show up a little late then the office is already backed up on a regular basis.

Re: Why Did My Patient Leave Me?

#106

Post by nicky0 »

ThomPete wrote: post #24
jacquesm wrote: post #18

Earlier quoted context omitted.

France has some of the best healthcare in the world. A family member was involved in a horrific truck/passenger bus accident in France near Metz and I spent the better part of a week in and out of their intensive care department visiting. I've never seen a hospital that I liked better. Everybody was so unbelievably nice and caring it was a huge improvement over what I'd seen elsewhere. http://krant.telegraaf.nl/krant…

I do question the sustainability of the french system though and that of many other european systems. Its important to remember that in a state economy where healthcare is free or semi free it's operated as a cost center and thus has budgets that are politically mandated not determined by market demand at least not directly. This leads to a number of limitations on what kind of care patients can get what machines the…

The way I see it is as long as the state provides effective and accessible healthcare, things like hospital choice over equipment or drug supplier is a "nice to have". Prioritizing these things seems like freedom for freedom's sake.

Re: Why Did My Patient Leave Me?

#107

Post by maxerickson »

ThomPete wrote: post #96
maxerickson wrote: post #85

Earlier quoted context omitted.

I was implying that the US doesn't really have a market.

Compared to Europe it does though. I.e. the us healthcare system does't get most of it's payment through taxation. Thats an important distinctions.

I guess.

Medicaid and Medicare are more than a third of spending and don't necessarily cover the total costs of the care provided under the programs (any unmet costs are a hidden tax). The VA is not nearly as expansive as those programs but is another couple whole percentage points of US health spending.

And you've also got Tri Care and some BIA stuff, and state expenditures that are outside of Medicaid.

Re: Why Did My Patient Leave Me?

#109

Post by delecti »

foldr wrote: post #93
muninn_ wrote: post #58

Earlier quoted context omitted.

I hear you. Previous office I went to I had to wait more than 30 minutes past my appointment time before being seen by the nurse (before being seen by the doctor) which didn't include "arrive 10 minutes before your appointment". Obviously this is annoying. The third time I showed up to the same office I was 10 minutes late to my appointment, and they told me I would have to reschedule or wait about 45 minutes to an h…

What you appear to want is contradictory. Tolerance for people arriving late is incompatible with having appointments start on time, as everything gets backed up.

The logic seems to be "if it's not going to start on time anyway then my being late shouldn't affect anything". That seems reasonable to me, or at the very least, if a doctor's office is chronically quite behind anyway, then your being late is only contributing to the problem, not causing it.

Re: Why Did My Patient Leave Me?

#110

Post by mistersquid »

ThomPete wrote: post #69
ido wrote: post #63

Earlier quoted context omitted.

The problem is that people then tend to forgo preventive care & routine checkups if they don't have to (especially poor people), and in the long term end up costing a lot more when they do get treatment once their situation is far worse.

No thats actually not true which Denmark has lots of data to show. It's 100% free to go to the doctor yet a lot of people don't go for checkups it's not a common thing to do. Furthermore the situation is even worse for men over 50. So access to healthcare has very little to do with that.

Earlier you write:

  > Its important to remember that in a state economy where
  > healthcare is free or semi free it's operated as a cost
  > center and thus has budgets that are politically mandated
  > not determined by market demand at least not directly.
and later write:

  > My personal suggestion for a good balanced system is that
  > most people pay most of the cost for normal healthcare costs
  > like going to the doctor for a checkup, most of the cost for
  > one of things like a broken leg but that society pays for
  > more serious and longer term situations like cancer, heart
  > surgeries where you are supposed to stay at the hospital for
  > a longer time.
But here

  > It's 100% free to go to the doctor yet a lot of people don't go for checkups it's not a common thing to do.
you allude to Danish data that show prospective patients do not take advantage of healthcare even if that cost is 100% subsidized.

So which is it? Does healthcare that is 100% subsidized distort demand so that people seek unnecessary care, or is demand so inelastic that people and populations who would benefit from it decline to use it?

EDIT: add third in situ quotation. Add comma in last sentence/question. Change pronoun to conjunction in last sentence; pluralize noun.

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