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Post-apocalyptic life in American health care

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Re: Post-apocalyptic life in American health care

#141

Post by sixdimensional »

nathanaldensr wrote: post #11

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…

I really hope we are both wrong, but I agree with you. I worked in healthcare and health insurance, and I have a unique perspective on the mass of regulations from across the US. I see the same patterns in many areas, government, finance, manufacturing and more.

I think that as things have evolved more and more quickly (rate of technological change, complexity of systems, increasing amounts of information/data, amount of knowledge and requisite volume and velocity of learning required to keep up), it has surpassed our ability to absorb/reason effectively and it continues to get worse.

I think the reason humanity is struggling to try to get AI (to help us carry the load) is related.

I think that there is a trend here, at least in Western culture, we can see manifested by the size of industries. If you look at the biggest industries contribution to GDP, they are also some of the most complex industries[1]. It seems that, among other things, when you have many individual players and groups with competing agendas, money and complex systems, you have these issues.

Perhaps it is literally survival manifesting itself in the modern age.

Anecdotally, I also see people looking to the past for simpler techniques and "core" knowledge, trying to find more general, longer-term survival/coping skills that cut across time and technological change.

[1] https://www.worldatlas.com/articles/which-are-the-biggest-in...

Re: Post-apocalyptic life in American health care

#142

Post by conanbatt »

trowawee wrote: post #94
conanbatt wrote: post #77

Earlier quoted context omitted.

Medicare has more patients than the population of england, or spain, or many of the european first world countries. It is already visible that medicare is not efficient.

You still haven't actually laid out a metric showing that Medicare is inefficient; you just keep asserting it is not efficient in the face of evidence that single-payer systems are in fact pretty efficient. To add more evidence to the "you are incorrect and single-payer systems are in fact pretty efficient" pile, here's another potential efficiency metric we could compare: Medicare spends significantly less (approxim…

> You still haven't actually laid out a metric showing that Medicare is inefficient; you just keep asserting it is not efficient in the face of evidence that single-payer systems are in fact pretty efficient

Medicare is an example of a government run healthcare service in the US. Its way more relevant to compare to Medicare than to compare with foreign countries health results. Its also revelant because single payer proposals in the US are basically expanding Medicare. So even if every single single-payer system in the world were efficient, if Medicare isnt, it wouldn't matter.

> Medicare spends significantly less (approximate 1.4%) on overhead costs, compared to private insurers that average around 12.4%.[1]

Sure, thats because it doesn't do price-fighting like private providers have to with insurance companies. It has the basic incentive to cede at every corner as an institution. But lets look at other reasons why healthcare is spending and how medicare solves them. How about pharma costs, doctor salary costs and legal costs. Is medicare cheaper on these other predominant reasons why healthcare is expensive?

You will find that Bernie sanders understands well that pharma is expensive because government restricts its importation. So if as an organization the government is strained to even bring drugs from abroad, a problem it has unique power and responsibility to solve today and no-one else can do except for 'retail smuggling', and we are supposed to put our entire faith into the same hands that cant solve that?

If you just eliminated restriction of drug importation, you would drop healthcare costs enormously in 24 hours. The only thing you have to do as a government, is to stop doing a thing. How simpler can it be.

The core idea here is that the debate of public vs private is a red herring. Healthcare is not expensive in the us because of private vs public. Its expensive for its own particular policies, which economists have consensus on and are hard to take on due to lobbying, or lack of public interest, or mere gubernamental complexity. The topic is presented as two black bentos, where you can only see the results in the faces of people eating them. But they really aren't. You can see what each has and why.

Re: Post-apocalyptic life in American health care

#143

Post by lukeschlather »

pc86 wrote: post #19
gt_ wrote: post #6

Earlier quoted context omitted.

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.

The article gives a good example of why it's in the insurance companies' interest to pay people to give you advice. It was obvious to everyone on the ground that the insurer would save money if they just sent the author's mother to an out-of-network physical therapist rather than keeping her in the hospital. But the insurer didn't have anyone who could quickly make that cost-saving judgment call.

Really, the biggest problem in a lot of cases is not that insurers deny claims for life-saving procedures, it's that they prioritize expensive and ineffective treatments over inexpensive and effective treatments.

Re: Post-apocalyptic life in American health care

#144

Post by [deleted] »

riverstones wrote: post #125
grecy wrote: post #98

Earlier quoted context omitted.

A few years ago my brother broke his leg horribly. The Ambulance drivers said it was the worst break they had ever seen. Multiple surgeries, months in hospital, rehab, got addicted to morphine in the process etc. etc. At the end of it all was a handshake and "get well soon". There was no bill. Australia.

I grew up in England. Same deal. In and out, no bill. The Americans who decry "socialist" medicine have never used it. There has to be a way to divorce health care and profit. English, Aussie, and Kiwi doctors all make about the same pay as American doctors, but they work in a non-profit system. Go figure... Americans are largely opposed to a system where there is no profit. The Americans are the Ferengi of medicine,…

[deleted]

Re: Post-apocalyptic life in American health care

#145

Post by mnm1 »

yodsanklai wrote: post #130

I'm wondering, is the American health care bad for (upper) middle-class too? let say you have a good job in a big corporation, do you have to worry about healthcare? can you go to a decent hospital for any problem you may have and get appropriate care without spending any dime?

Yes, it's horrifically terrible. The hospitals/doctors you can go to are dictated by your insurance. Having a good job does not equal having good insurance. It's hit or miss. Having a good job does not guarantee you have someone to help you out with the paperwork and the stress from that can and will kill you even if you survive the actual hell that is the healthcare itself (topic of the article).

If you get injured on the job, you have to go through the worker's compensation system which can take months to years just to be seen for certain conditions like RSI. And if you change states, you're fucked because there's literally no one who knows how the systems should work together. The more history you have, the worse. Sometimes you have to lie and omit medical history just to get your foot in the door.

I worry about healthcare and whether I will be able to do my job (writing software) next year, let alone ten or thirty years from now because I simply cannot get the care I need for a problem that's 100% caused by work. This is supposed to be covered 100%. Now imagine how bad people without insurance or people who have otherwise not-covered conditions have it. It's a fucking nightmare for everyone who is not part of the upper class and can afford good insurance and the ability to hire assistants to actually make the insurance work for them, so much so that certain companies have contracted out for such services for their employees. It's a perk of employment that very few employers offer. I'm sorry, but horrific doesn't even begin to describe the situation ... I'm actually at a loss for words in describing how bad healthcare is in the US.

Re: Post-apocalyptic life in American health care

#146

Post by i_feel_great »

EvanAnderson wrote: post #101
shrike wrote: post #25

About 8 years ago I broke my leg and eventually developed a methicillin-resistant infection where screws had been inserted. Fighting this type of infection in the bone is difficult. I spent 11 months in a hospital bed plus some time in a SNF. A total of 7 surgeries in the first 18 months and another 2 after that, the most recent 3 years ago. I can second the experience of the author. All in I had contact with over 40…

More and more I am becoming convinced "killing people" is an intended "feature" rather than a bug. I'm sure it's not an explicit goal of any but a tiny fraction of participants in the "system", but, cynically, I am becoming convinced it is somebody's goal.

I feel it is due to its complexity. The complexity is caused by rent seeking behaviour. I see shades of it here in Clay Shirky's essay: http://www.shirky.com/weblog/2010/04/the-collapse-of-complex...

Re: Post-apocalyptic life in American health care

#147

Post by tinymollusk »

EliRivers wrote: post #67

It appears that 73% of the labor cost of a health care organization is spent on trying to communicate with other health care organizations that have no defined interface. So if it worked properly, US healthcare would cost one quarter if what it does. Less, once the people engaged in trying to talk to each other are no longer required. That's quite a statement.

"The number 73% is my dazed estimate based on informal observation and analysis conducted in doctors’ examination rooms."

from the footnote

Re: Post-apocalyptic life in American health care

#148

Post by conanbatt »

frgtpsswrdlame wrote: post #15

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 fin…

No matter how much money in lobbying anthem might have spent, the ultimate responsiblity for the law as written is of government.

Government should fix the current problems it has before asking for more responsibility.

Re: Post-apocalyptic life in American health care

#150

Post by frgtpsswrdlame »

conanbatt wrote: post #148
frgtpsswrdlame wrote: post #15

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 fin…

No matter how much money in lobbying anthem might have spent, the ultimate responsiblity for the law as written is of government. Government should fix the current problems it has before asking for more responsibility.

I don't understand how your comment relates to mine. Care to elucidate?
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