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Immediate skin-to-skin contact with unstable newborns improves survival chances

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Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#211

Post by pedroma »

acuozzo wrote: post #205
gambiting wrote: post #202

Earlier quoted context omitted.

>>Why should I pay for someone's crimes? It's such a stupid system. If they are murderers they should just receive the capital punishment. And if the crime is not murder, they can be put into factories where they are able produce something of value -- farming or whatever. If their business is not profitable it should at least reduce the taxpayer burden. God, I would hate to live in the system you're describing. And a…

People like this always imagine that they'll be on the "good" side of such a system— That the private prisons wouldn't lobby to make all speeding illegal in order to increase the labor pool for profit. That they'll hear about the law change in time. That they'll never have to drive 5mph above the speed limit because they're running late. That they'll never be one of the slaves in the cyberpunk dystopia they're longin…

What's your suggestion for changes to our god awful prison system then? Or might you even be okay with it?

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#212

Post by lolinder »

ghufran_syed wrote: post #197
lolinder wrote: post #169

Earlier quoted context omitted.

My understanding is that that is often because doctors fail to educate them sufficiently on the cons. The recovery from a C-section is worse, the outcomes are worse for both mother and child, future children are likely to be more difficult. There's not much reason to recommend an elect C-section in most cases (certainly not 33% of cases) except that the doctors get to bill for it.

The case linked below started off with an attempt at a normal vaginal delivery. Based on your comment, you might think it admirable that the doctors didn't consider doing a c-section and continued to try vaginal deliver for around 60 hours - but then had to do a c-section and the baby had severe brain injury. "Specifically, the family alleged the hospital did not properly estimate the weight of the fetus, even though…

Uh, nope, that's exactly a situation where a C section is warranted. That's not what I was referring to by an "elect" C section.

The WHO has long emphasized that the expected rate of necessary C sections is 10-15%. The US is sitting at around 30%, 2-3x the desirable rate. Some of that is doctors trying to avoid malpractice suits (it's harder to get sued for doing too much), but some of that is convenience for doctors or moms.[0] Those are the cases I'm concerned about.

[0] https://www.usnews.com/news/healthiest-communities/articles/...

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#213

Post by gambiting »

pedroma wrote: post #210
gambiting wrote: post #202

Earlier quoted context omitted.

>>Why should I pay for someone's crimes? It's such a stupid system. If they are murderers they should just receive the capital punishment. And if the crime is not murder, they can be put into factories where they are able produce something of value -- farming or whatever. If their business is not profitable it should at least reduce the taxpayer burden. God, I would hate to live in the system you're describing. And a…

>As for forcing people to work so they are not a burden on society - that's just slavery with extra steps. But oh wait, I forgot that US still does that. Nevermind then. This is just a difference in our morality I guess. I don't think prison should be a great place to live. They should be incentivized to leave prison. And they aren't treated as slaves, they are learning a trade and applying those skills. They should…

>>This is just a difference in our morality I guess. I don't think prison should be a great place to live. They should be incentivized to leave prison

No one said prisons should be nice. Just that we have empirical data which prison systems support rehabilitation and reintegration into society and which ones don't. American prisons aren't on the first list. They are disproportionately about revenge and retribution, which leads to low rehabilitation rates.

>>They should be incentivized to leave prison

Let me get this straight - you think current prison system doesn't incentivize leaving prison enough?

>>I don't understand why prisons should not make money. Why does there be distinctions for things that should or shouldn't make money?

Because it creates a whole lot of perverse incentives that simply shouldn't exist around the prison system. Incentives to both keep people longer than necessary in prisons as well as put them in prisons in the first place if they are places to make money. And it's not just a made up fear - there have been judges in the US found to be doing exactly this, taking cash bribes to send people to for-profit prisons. That profit making incentives shouldn't exist. Just like schools shouldn't be making profit, just like hospitals shouldn't be making profits - they are utilities for the society, not profit centres. Or at least in a well adjusted society they shouldn't be. As soon as you introduce profit the incentives shift where they shouldn't.

>>Okay, then I guess we live in different realities if you think black kids are doing well in inner city public schools.

That wasn't your question though. You asked if public schools are doing black kids in inner cities any good. To which my answer is still the same - of course they do. If you'd like to ask your question again I'll answer it again.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#214

Post by pedroma »

gambiting wrote: post #201
pedroma wrote: post #174

Earlier quoted context omitted.

Why should I pay for other people's kids if I'm never going to have kids? The only people that should have to pay for those services are the people who actually use those services. For things that are unplanned like injuries (or even unplanned pregnancies), payment can be deferred if necessary and wages deducted straight from the paycheck to pay back for those services. Ideally, roads are that way too. People license…

>>Why should I pay for other people's kids if I'm never going to have kids? Hmmmm. I think the issue here is that you're looking at it from an individualism perspective. Why should I be paying for something that I'm not using. You're obviously completely entitled to such an opinion, and I'm not going to change it with one HN comment, but imho that's the wrong way to build a society. Society should be paying to suppor…

You're right that this is a matter of personal philosophy.

I view it as an optimization problem. Given a set number of tax dollars collected, everyone wants a piece of it. I don't trust people to allocate these correctly. The alternative is to give less of these dollars so less corruption and mistakes can occur, which is what I view is better.

As for using the next generation to support the older generation through taxation, this does not seem to work very well in practice. As societies reach higher quality of life, like in the US, Japan, some Euro countries, there tends to be a drop in birth rates. There are other factors in play (career opportunities, culture), as in some of these countries giving birth is highly encouraged (e.g. Japan pays families to give birth). I just view it as risky to expect there to be enough children to support all the old folks. They might even vote those benefits out and you'll be left hanging.

For example, if we're going to mandate something, rather than Social Security a mandatory 401k-style plan seems better. That account is yours, it's your own money, and the government just asks you to deposit 5-10% of every paycheck into that account and you can withdraw a fraction of that account with some interval once you're 50. Maybe it can used to pay for health care before 50.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#215

Post by pedroma »

mjbeswick wrote: post #203
pedroma wrote: post #174

Earlier quoted context omitted.

Why should I pay for other people's kids if I'm never going to have kids? The only people that should have to pay for those services are the people who actually use those services. For things that are unplanned like injuries (or even unplanned pregnancies), payment can be deferred if necessary and wages deducted straight from the paycheck to pay back for those services. Ideally, roads are that way too. People license…

I can only guess you are against universal healthcare also? In countries that have universal healthcare, that care is substantially cheaper; so you pay much less overall. I live in the UK, which has quite a generous benefits system. Although such a system is open to abuse, it's much cheaper than imprisoning people that have resorted to crime to get by (they they do in the US).

This narrative is overblown and parroted by the uninformed. We do have Medicaid for low income families, and Medicare for seniors.

The problem is you have to apply for it. Maybe people should be automatically enrolled.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#216

Post by pedroma »

gambiting wrote: post #213
pedroma wrote: post #210

Earlier quoted context omitted.

>As for forcing people to work so they are not a burden on society - that's just slavery with extra steps. But oh wait, I forgot that US still does that. Nevermind then. This is just a difference in our morality I guess. I don't think prison should be a great place to live. They should be incentivized to leave prison. And they aren't treated as slaves, they are learning a trade and applying those skills. They should…

>>This is just a difference in our morality I guess. I don't think prison should be a great place to live. They should be incentivized to leave prison No one said prisons should be nice. Just that we have empirical data which prison systems support rehabilitation and reintegration into society and which ones don't. American prisons aren't on the first list. They are disproportionately about revenge and retribution, w…

>Let me get this straight - you think current prison system doesn't incentivize leaving prison enough?

Yes, it doesn't. Many have nothing to look forward to outside of prison. I hate to use a movie as an example, but take a look at Shawshank Redemption. They should leave having gained something, maybe prisons can help inmates find employment for the skills they gained as they reach the end of their sentence.

>Because it creates a whole lot of perverse incentives that simply shouldn't exist around the prison system.

I view nothing as immune to corruption. It's just a matter of better alternatives. Ideally inmates are allocated more to prisons with high rates of success after serving their sentence, which gives prisons an incentive to get their inmates out and with marketable skills.

>taking cash bribes to send people to for-profit prisons

This is not exclusive to for-profit prisons. Prisons that have higher number of inmates can make an argument for a higher allocation of tax dollars.

>Just like schools shouldn't be making profit, just like hospitals shouldn't be making profits - they are utilities for the society, not profit centres

You've said this more than once, but I still don't see why they shouldn't be. All I hear is "they just shouldn't make money". Why? They're just going to play games to get more tax dollars if they're forced not to make any money themselves. Bad schools are allocated more funds, take the LA Unified School District for example -- some of the worse performing schools in the nation, yet some of the best funded public schools! If I'm pessimistic enough, I would even imagine the teachers and administration are not doing their job on purpose.

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#217

Post by acuozzo »

pedroma wrote: post #211
acuozzo wrote: post #205

Earlier quoted context omitted.

People like this always imagine that they'll be on the "good" side of such a system— That the private prisons wouldn't lobby to make all speeding illegal in order to increase the labor pool for profit. That they'll hear about the law change in time. That they'll never have to drive 5mph above the speed limit because they're running late. That they'll never be one of the slaves in the cyberpunk dystopia they're longin…

What's your suggestion for changes to our god awful prison system then? Or might you even be okay with it?

I am in favor of the way the prison system is run in Sweden; more broadly, the so-called "Nordic Model".

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#219

Post by ghufran_syed »

lolinder wrote: post #212
ghufran_syed wrote: post #197

Earlier quoted context omitted.

The case linked below started off with an attempt at a normal vaginal delivery. Based on your comment, you might think it admirable that the doctors didn't consider doing a c-section and continued to try vaginal deliver for around 60 hours - but then had to do a c-section and the baby had severe brain injury. "Specifically, the family alleged the hospital did not properly estimate the weight of the fetus, even though…

Uh, nope, that's exactly a situation where a C section is warranted. That's not what I was referring to by an "elect" C section. The WHO has long emphasized that the expected rate of necessary C sections is 10-15%. The US is sitting at around 30%, 2-3x the desirable rate. Some of that is doctors trying to avoid malpractice suits (it's harder to get sued for doing too much), but some of that is convenience for doctors…

Thats fair, I didn’t pick up on your use of the word “elective”. But vaginal births have twice the incidence of urinary stress incontinence, overactive bladder and pelvic organ prolapse. There is also a risk of tearing of the vagina, and even tears that extend into the anus [2]. If I could choose a surgery that would prevent tearing of my genitalia, at the cost of money pain and possibly other complications somewhere away from my genitalia, I might well choose that - one might even say that a woman should have the right to choose.

It seems weird that we think that the WHO, an organization run mostly by men [3] would somehow know the “correct” rate at which women should risk urinary incontinence and genital injuries - why wouldn’t we let the patients decide with the assistance of their doctors?

[1] https://jamanetwork.com/journals/jama/fullarticle/2718794 [2] https://www.mayoclinic.org/healthy-lifestyle/labor-and-deliv... [3] https://apps.who.int/gb/gov/en/composition-of-the-board_en.h...

Re: Immediate skin-to-skin contact with unstable newborns improves survival chances

#220

Post by souprock »

pmiller2 wrote: post #199
Thorentis wrote: post #177

Earlier quoted context omitted.

Providing poor service and still making money isn't capitalism. That's a lack of competition. Plenty of countries have poor government run services and there's no alternative. Same deal - no competition.

Charging for things just because you can is a capitalist mindset, however. Besides, hospitals will never be more competitive than an oligopoly in most cases, simply because only so many are built in any given geographic area, and most people can only travel so far for medical care. There are some services the “free market” simply can’t deliver efficiently.

The reason why "only so many are built in any given geographic area" is because we aren't being very capitalist or free market. One must obtain a "certificate of need" before opening a new facility, and that will be opposed in court by all possible competitors.

We could give capitalism and free market a try.

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