The financial costs of healthcare costs, or, is keeping me alive worth it? • Hacker News Board

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#31

Post by s1artibartfast » Fri, May 17, 2024, 3:16 PM UTC

foobarian wrote: post #26

s1artibartfast wrote: post #23

Earlier quoted context omitted.

I think a huge part of it isnt even corporatism, but social and cultural avoidance and fear of death. US culture, the only one I claim to speak for, is in denial about death. We hide it away, pretend it wont happen, and then when it does, we lie to the children and try to suppress it ourselves. We drag death out medically, and then have no time to be with the dying. Doing this leads to not only neurotic choices from…

I have every intention to do the same. The only thing that gives me nightmares is to lose mental capacity, which it seems your grandmother was lucky to keep to the end. My aging friend circle keeps throwing around ideas of various dead man switches to cut short any kind of mental decline.

Me too. She didnt have mental capacity all the way to the end, but her proactivity in confronting death allowed her to take actions and make her wishes clear before she mentally deteriorated.

That said, deterioration from dementia is a whole different beast. Fentanyl seems like a quick way to go, but it would be hard deciding when to pull the plug, and how long you have before you lose the option.

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#32

Post by jncfhnb » Fri, May 17, 2024, 3:32 PM UTC

antisthenes wrote: post #11

One thing about keeping sick people alive that financials don't cover - keeping up the social contract. A society must take care of its weak and old, unless you want these people to reneg on the contract and start being destructive. Marginalizing and neglecting a social group is step 1 towards fostering terrorism.

Can you point to a single example of this occurring I history?

Because I can think of none, at the individual level or societal level, excluding explicit mental illnesses which feel like a cop out.

Aside from Jigsaw, that is.

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#33

Post by Aunche » Fri, May 17, 2024, 3:41 PM UTC

PaulHoule wrote: post #3

That bit about Golden Rice is a crock. I'm not saying it couldn't play a positive role or that I think it is dangerous, but there are (1) many ways to get Vitamin A, (2) many problems in global nutrition other than Vitamin A. Trying to picture the developers like Prometheus getting their liver torn out every day just isn't helpful. The fact that they got 100 Nobel Prize winners to sign their petition is bunk because…

I think there is plenty of reason to be skeptical of do-gooder foreigners who think they know better than the locals, but IMO that describes Greenpeace here more than the golden rice project. They are banning it completely, taking agency away from local farmers and consumers. Also, most of their objections seem to stem from GM fearmongering disguised as environmental and nutritional concerns. I doubt that they would fight golden rice if it were a hybrid crop instead.

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#34

Post by ToValueFunfetti » Fri, May 17, 2024, 3:52 PM UTC

PaulHoule wrote: post #3

That bit about Golden Rice is a crock. I'm not saying it couldn't play a positive role or that I think it is dangerous, but there are (1) many ways to get Vitamin A, (2) many problems in global nutrition other than Vitamin A. Trying to picture the developers like Prometheus getting their liver torn out every day just isn't helpful. The fact that they got 100 Nobel Prize winners to sign their petition is bunk because…

Greenpeace sued successfully to make it illegal. It's hard to imagine how anything can be a greater obstacle, regardless of whether there are additional obstacles- it's a brick wall.

The additional obstacles you've listed all do seem less significant and more surmountable than not being allowed to grow the crop at all. And I can't find any evidence of the yield or drought tolerance actually being worse.

https://www.nature.com/articles/s41598-021-82001-0

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#35

Post by mlhpdx » Fri, May 17, 2024, 3:53 PM UTC

I’m so grateful for the author having written and shared this piece. I have similar thoughts - at what point is money to extend my life better applied to others? I don’t know how to decide that, but I know it’s a decision that is being made irrationally.

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#36

Post by hypeatei » Fri, May 17, 2024, 3:57 PM UTC

bdcravens wrote: post #29

antisthenes wrote: post #11

One thing about keeping sick people alive that financials don't cover - keeping up the social contract. A society must take care of its weak and old, unless you want these people to reneg on the contract and start being destructive. Marginalizing and neglecting a social group is step 1 towards fostering terrorism.

Correct, but this is why we need living wills, and for those without them, we need sane and humane defaults. There is a point where being alive is its own form of suffering.

Life is inherently suffering, close to death or not.

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#37

Post by triceratops » Fri, May 17, 2024, 4:05 PM UTC

Retric wrote: post #15

giantg2 wrote: post #9

Earlier quoted context omitted.

The thing that I haven't been able to really understand, is why aren't these areas able to grow other vitamin A rich crops? The climate and environment is usually fine for growing something - yams, mangos, cantaloupe, carrots, etc. I can see that sometimes it's a cost thing as those sell for higher prices or are more expensive to preserve than rice. But it seems that farmers stick with regular rice because that's wha…

People most in need of vitamin A don’t realize or can’t pay a premium for something else. Ignorance is a big part of why foods get fortified. Scurvy is making something of a comeback among wealthy kids eating an unhealthy diet because high temperatures destroys Vitamin C so you need to eat un/minimally cooked foods or have it added back in. https://www.timesofisrael.com/scurvy-makes-a-shocking-comeba...

I think the unhealthy diet is the fundamental reason, not cooking food at high temps.

"The amount of vitamin C retained from raw potatoes varied according to the method of cooking, e.g. about 80% for potatoes boiled in skin and about 30% for hash-browned potatoes."

Source: https://www.sciencedirect.com/science/article/abs/pii/S03155...

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#38

Post by pessimizer » Fri, May 17, 2024, 4:06 PM UTC

s1artibartfast wrote: post #23

paxys wrote: post #4

I recommend anyone who is interested in this area read "Being Mortal: Medicine and What Matters in the End" by Atul Gawande. Not just for the financial aspects, but an overall deconstruction of the broken end-of-life care system in the country. By making "extend one's life for a few days/weeks by any means necessary" as the gold standard for good medical care, we have lost sight of what healthcare should actually be…

I think a huge part of it isnt even corporatism, but social and cultural avoidance and fear of death. US culture, the only one I claim to speak for, is in denial about death. We hide it away, pretend it wont happen, and then when it does, we lie to the children and try to suppress it ourselves. We drag death out medically, and then have no time to be with the dying. Doing this leads to not only neurotic choices from…

> I think a huge part of it isnt even corporatism, but social and cultural avoidance and fear of death.

These aren't mutually exclusive. It's like saying "I think a huge part of the desire for fashionable clothing isn't even fashion, but the fear of being ostracized or left behind by one's social circle." A natural source of fear and uncertainty is stoked by people who find opportunity to make a buck off it.

"The American Way of Death" is a good book to read in that vein, although it's about the pointless, blindingly expensive ostentation of US burial rituals. The book was very successful and well-regarded; didn't change a thing.

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#39

Post by zrn900 » Fri, May 17, 2024, 4:07 PM UTC

Keeping anybody alive is worth it. The human species became a civilization only because it kept its then-unproductive weaker members alive - which allowed it to develop learning, technology, and all the things that revolve around them.

Even before that, it was able to survive and exist as a physically weaker species by taking care of and keeping alive its sick and wounded.

This shows how destructive capitalism is: In its pursuit of maximizing the profits to increase the hoards of imaginary wealth, it even destroys the most fundamental tenets that made humans a successful civilization.

Re: The financial costs of healthcare costs, or, is keeping me alive worth it?

#40

Post by s1artibartfast » Fri, May 17, 2024, 4:09 PM UTC

derbOac wrote: post #16

giantg2 wrote: post #5

Earlier quoted context omitted.

It seems people are disagreeing with you, maybe because your statement is short and seen as political. However, you do have a valid point. Even in socially funded systems there has to be a cutoff on what care will be funded and what will not based on the views of society and the potential costs vs benefits (including probability of sucess). A very interesting example on how social views influence healthcare decisions…

> there has to be a cutoff on what care will be funded and what will not based on the views of society and the potential costs vs benefits (including probability of success). It goes even further than that though, when you start to allow for the full force of real-world economics. These types of discussions (end-of-life economics, life value) tend to make these idealistic assumptions, that actors (providers, payers)…

in the US, almost nobody has your financial interests in mind.

Individuals want the most expensive care when they are sick, because costs are distributed over their insurance pool. Insurance companies want the most expensive care, because profits are capped as a % of expenses. PBMs make money on the difference between list price and rebates. Lastly, manufacturers obviously want to sell for the highest price.

I honestly think that if you asked most people with 6 months to live if they would prefer care or to give their children 500k, they would choose the latter. When it is saving other people 500k, they dont.