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My Sudden Trip to Hell

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Re: My Sudden Trip to Hell

#111

Post by AnIdiotOnTheNet »

jwr wrote: post #82
corry wrote: post #48

Earlier quoted context omitted.

Don't want to spark a healthcare debate, but want to mention that I bet NONE of the non-US readers on HN would have given a single thought about the costs involved if this was happening in their countries. It's wild to me that the potential financial impact of this was part of the picture for many of the US people reading it (especially the startup founders who are probably without insurance right now, and this would…

I am from Europe and I can confirm that nobody would even consider the "costs involved". It's just not something you think about. I am puzzled by why the richest nation in the world prefers to spend 3.1 billions of dollars on arming Israel, or spend $700 billion military budget (even though its territory isn't being threatened in any way), rather than provide universal healtcare and education to its citizens, who liv…

It's a cultural thing. Americans, by and large, hate other Americans. The idea that someone else is getting something "they didn't earn" induces rage in the American brain. This is why you see people willing to spend $10 to avoid accidentally giving $1 to a welfare recipient who "doesn't deserve it" in their eyes.

Re: My Sudden Trip to Hell

#112

Post by saalweachter »

arisAlexis wrote: post #76
Ididntdothis wrote: post #63

Earlier quoted context omitted.

In the US the cost must have been in the millions. I know people who ran up several million dollar bills during cancer treatment.

do they deny you treatment if you don't have that kind of money?

I don't know the current (post-ACA) situation, but the short answer about the US's emergency care laws is "sometimes".

For instance, suppose you trip and fall, and in catching yourself, shatter your shoulder joint.

The emergency room would be obligated to keep that from killing you -- making sure the bone fragments weren't going to sever an artery or anything, stitching up open wounds and the like.

The emergency room would not be obligated to restore you to (as much as possible) functioning. If you need an expensive 20-hour surgery with a team of specialists to put all the pieces of your shoulder back together, well, that's too bad. Sure, your shoulder will heal into an immobile lump without treatment, but it won't kill you, so not actually an emergency.

Re: My Sudden Trip to Hell

#113

Post by novaRom »

Ididntdothis wrote: post #63
udkl wrote: post #50

Earlier quoted context omitted.

Can anyone make a good guess on how much this would have cost here in the US and if it had happened in Canada ?

In the US the cost must have been in the millions. I know people who ran up several million dollar bills during cancer treatment.

But most will be covered by the insurance company, or not?

Re: My Sudden Trip to Hell

#114

Post by dragonwriter »

bitL wrote: post #39

A friend of mine had her young brother suddenly developing a narrow line on the skin, growing quickly; 24 hours later both his arms and legs were amputated to keep him alive. I am wondering if having allowed emergency wide-spectrum antibiotics freely for such cases would help? Time seems to be extremely critical in such cases.

> I am wondering if having allowed emergency wide-spectrum antibiotics freely for such cases would help?

The problem is you also need emergency physicians available equally freely and ubiquitously to identify the need. Unnecessary use of powerful, broad spectrum antibiotics has significant potential adverse personal and public health consequences, and the general public is not qualified to appropriately assess need for use.

Re: My Sudden Trip to Hell

#115

Post by stordoff »

gamblor956 wrote: post #70
corry wrote: post #48

Earlier quoted context omitted.

Don't want to spark a healthcare debate, but want to mention that I bet NONE of the non-US readers on HN would have given a single thought about the costs involved if this was happening in their countries. It's wild to me that the potential financial impact of this was part of the picture for many of the US people reading it (especially the startup founders who are probably without insurance right now, and this would…

Universal Healthcare is generally only a thing in Canada and the EU. It's great if you need to wait a few months to see a doctor, but I know plenty of Canadians and Europeans who come to the US for medical care so they don't have to wait.

If you need emergency care, you don't have to wait (UK). My grandfather had a fall recently where he hit his head, and had a brain CT within two hours (he fell about 1am; he was admitted, assessed, treated, and discharged by 6am). A family member had an urgent referral for a mammogram last Thursday, and was assessed and given the results today.

Routine GPs appointments can generally be gotten within a week, and emergency[1] appointments (where we wait until the GP is done at the end of the surgery, and are then seen) if the triage nurse determines you need to be seen sooner can be gotten on the day. You also have the option of speaking to your local pharmacist, many of whom can prescribe medication for certain conditions if appropriate, or otherwise point you at suitable over-the-counter primary care.

A number of places also have walk-in centres for minor ailments where you don't need an appointment, and they generally have long opening hours (8am-10pm, 365 days a year for my local one). Urgent dental care is also available 24/7 in many places.

You may have to wait longer for non-emergency / non-priority / time-insensitive treatments - my routine MRIs have a lead time of about 8 weeks, and a specialist referral can be something in the region of 6-12 weeks (sometimes longer) - but I think that's a fair trade off. You do of course also have the option of paying for private care as well if you don't want to wait (often NHS doctors / semi-retired doctors working evenings in my limited experience).

[1] bit of a misnomer really - urgent but not critical is more accurate

Re: My Sudden Trip to Hell

#116

Post by dragonwriter »

majewsky wrote: post #81
bitL wrote: post #61

Earlier quoted context omitted.

Your points are valid, people are irresponsible with antibiotics, however consider that e.g. 1 hour drive to emergency would cost you an arm, literally, whereas quickly eating 5 pills of wide-spectrum antibiotics would keep the infection at bay and give you time to drive to ER without any adversarial effects on your future life. What would be your choice?

The dichotomy is wrong. If you allow people to have antibiotics at home, enough of them are gonna chew them like vitamins to spread antibiotics resistance even faster. Then when you have your emergency, sure you can eat your pills, but it's not gonna do shit. The only remotely viable solution is improving access to ERs.

> The only remotely viable solution is improving access to ERs.

Telemedicine plus improving 24-hour pharmacy distribution and equipping them for rapid door-to-door delivery of critical meds (possibly by drone) might work, and might soon be more viable than ERs for the particular use case.

ER access addresses a lot more problems and probably wins aggregate cost/benefit analysis for the foreseeable future.

Re: My Sudden Trip to Hell

#117

Post by raincom »

AnIdiotOnTheNet wrote: post #111
jwr wrote: post #82

Earlier quoted context omitted.

I am from Europe and I can confirm that nobody would even consider the "costs involved". It's just not something you think about. I am puzzled by why the richest nation in the world prefers to spend 3.1 billions of dollars on arming Israel, or spend $700 billion military budget (even though its territory isn't being threatened in any way), rather than provide universal healtcare and education to its citizens, who liv…

It's a cultural thing. Americans, by and large, hate other Americans. The idea that someone else is getting something "they didn't earn" induces rage in the American brain. This is why you see people willing to spend $10 to avoid accidentally giving $1 to a welfare recipient who "doesn't deserve it" in their eyes.

Was this attitude common even before the civil rights act of 1964, despite the confederation?

Re: My Sudden Trip to Hell

#118

Post by dragonwriter »

PhasmaFelis wrote: post #95
bitL wrote: post #61

Earlier quoted context omitted.

Your points are valid, people are irresponsible with antibiotics, however consider that e.g. 1 hour drive to emergency would cost you an arm, literally, whereas quickly eating 5 pills of wide-spectrum antibiotics would keep the infection at bay and give you time to drive to ER without any adversarial effects on your future life. What would be your choice?

If that was allowed, it might save hundreds in the short term and doom millions in the long term. Of course I'd do whatever it took to save myself or my loved ones. Anyone would. That's not a good basis for government policy. (Also, being honest, the number of situations where powerful antibiotics now vs. at the hospital would make a difference and the people involve realize that and administer them has got to be tin…

> If that was allowed, it might save hundreds in the short term and doom millions in the long term.

It might save hundreds and but also kill thousands in the short-term, too: powerful broad spectrum antibiotics aren't without adverse effects, perhaps especially if taken in a genuine emergency that just isn't the kind of emergency the user thinks it is.

Re: My Sudden Trip to Hell

#119

Post by kerkeslager »

marcinzm wrote: post #78
kerkeslager wrote: post #47

It's a sign of what it's like to be an American that the following stood out to me: The timing of his illness is rather unfortunate, as it caught him in New York, rather than Toronto, which probably cost him a lot of money.

If I'm an American visiting Canada then I would also be charged for any medical services I get in Canada as I do not pay taxes there nor have insurance in Canada. edit: And the fees aren't trivial. https://www.qch.on.ca/uploads/Finance/Fees%20for%20Cdns%20wi...

Why are you assuming the author was uninsured in NY? Lots of Candadians buy travel health insurance when visiting the US.

Even with your unfair comparison: if you have health insurance in the US, it's quite easy to pay higher fees than you would uninsured in Canada. For example, compare Fidelis Care Silver[1] ambulance charge ($150 after deductible) with Canadian ambulance charge ($240 CAD -> $180.75 USD). The completely uninsured Canadian pays only $30 more than the insured American, and that's if the American has already paid their $1700 deductible, and has paid their premiums (which are more than the taxes Canadians pay toward their healthcare). And that's literally just grabbing the first US plan I looked at: I'm sure that there are worse insurance plans out there which people are forced to take.

[1] https://www.fideliscare.org/Portals/0/Members/ComparisonChar...

Re: My Sudden Trip to Hell

#120

Post by hestipod »

merpnderp wrote: post #72
corry wrote: post #48

Earlier quoted context omitted.

Don't want to spark a healthcare debate, but want to mention that I bet NONE of the non-US readers on HN would have given a single thought about the costs involved if this was happening in their countries. It's wild to me that the potential financial impact of this was part of the picture for many of the US people reading it (especially the startup founders who are probably without insurance right now, and this would…

Before the ACA, I contracted, and only carried catastrophic coverage on myself. I had no coverage until my yearly bills reached $5k, but that was also my max out of pocket. My insurance ran $63/month - which was ridiculously cheap and the worst I could ever be "ruined" was $5k. Keep in mind I live in the backwoods of a small state in the US and could have a catscan in an hour, an MRI tomorrow, would likely only wait…

I have told my story over and over so anyone truly interested can look in my history as I won't write it all again, but I lost my life due to America's system and have sunk further as an ironic consequence of only having access to it. Every time these topics come up I see people defending it or making claims that are simply false.

ACA was a horrible compromise because the right would not allow proper Universal Healthcare. In my state, as in many, there is a gap where you can be denied a subsidized ACA plan and Medicaid. I fall in that gap and get nothing but the privilege of buying a full priced ACA, poor coverage, plan for something like 7-800usd a month plus something like 6000usd yearly deductible plus the multi thousand coverage floor you mentioned. All of which is impossible for me. I did things right. I had a significant savings when this happened, spent most all of it on this stuff, I have a few hundred a month pension I was lucky to have, it doesn't cover my needs, I have no insurance or benefits. I was denied disability. This is America.

Someone else below also brought out the "I know lots of people from Europe who come to the USA for superior healthcare" line as well. I lived in Europe and never met or heard of a single person who did this. It surely happens. But its not "lots" nor proof of some superiority.

I recently got another diagnosis after having to really fight and spend a lot because the system is so broken. The 3-5min you get and insane costs for everything hinders care. I was already on the edge as my history points to...and have been trying desperately to move back to Europe where its not perfect, but even in the paid, private system I would have access to for the first years I can get far superior care to here for less. But the hits just keep coming and I don't see making it anywhere now. I wish people would care about others and how this system hurts them, rather than their politics. I will lose my life because of politics I never chose to be born into and that have continually reduced my quality of life. I just cannot understand why people continually deny this is the case and fight against that which helps all of us. I have mostly passed anger and am in intense disappointment on the issue. I just want to live. I am not allowed to.

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