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The $200K lesson I learned from getting shot

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Re: The $200K lesson I learned from getting shot

#31

Post by nknighthb »

dnautics wrote: post #23
dbpatterson wrote: post #15

Earlier quoted context omitted.

Universal health care has _nothing_ to do with treating all people alike. It just means treating them all.

Fine. But government is required to treat all people alike. I think this is a reasonable requirement, given that you cannot 'opt out' of government. If you want to set up a private universal health care charity fund, I would happily cut a recurring check to help your cause, assuming some basic transparency and accountability. At least, if you mess up your charity and start, say, embezzling funds, I can opt out. http:…

Your misunderstanding of the equal protection clause has no basis in reality. The government is absolutely allowed to treat different situations differently. There is no legally recognized interpretation of the constitution -- none -- that would require the government to give person A a treatment inappropriate for A just because it gave person B the same treatment which was appropriate for B.

Re: The $200K lesson I learned from getting shot

#32

Post by taylodl »

dnautics wrote: post #28
robbiep wrote: post #25

Earlier quoted context omitted.

No, if you need lifesaving surgery, you get it. And you don't get a bill that ends up costing a second mortgage. Elective procedures - that's a different story. But it is location specific, and in many countries with mixed public/private systems you can pay through your nose if you like anyway

who gets to decide what is lifesaving and what is elective?

Currently the insurance company does, and since they were most likely selected by your employer whose objective was to hold down costs, what do you think that insurer's priorities are going to be? Plus, who's the customer in this situation? For whose business is the insurance company really working for?

Re: The $200K lesson I learned from getting shot

#33

Post by sliverstorm »

dnautics wrote: post #28
robbiep wrote: post #25

Earlier quoted context omitted.

No, if you need lifesaving surgery, you get it. And you don't get a bill that ends up costing a second mortgage. Elective procedures - that's a different story. But it is location specific, and in many countries with mixed public/private systems you can pay through your nose if you like anyway

who gets to decide what is lifesaving and what is elective?

It's like the line between "cosmetic" and "reconstructive". You would think it was a pretty clear line, and then discover it isn't.

Re: The $200K lesson I learned from getting shot

#34

Post by robomartin »

restlessmike wrote: post #27

I'm sure this has been pointed out many times when these posts pop up, but what is shocking to me is that we tolerate $200k medical bills for this sort of emergency care, as long as we aren't the ones paying for them ourselves. The healthcare industry needs a lot more transparency. Every hospital should be required (if they choose to accept Medicare/Medicaid patients) to publish prices in an easily comparable format…

> The healthcare industry needs a lot more transparency.

OK, yes. What it really needs is to be an open market both for care and insurance. Competition has amazing ways to both improve quality and affordability. This has been proven time and time again across a myriad of fields both within and well outside of medicine. Nothing beats open market competition. When providers and insurance companies truly have to compete for your business things change.

The ACA (Obamacare) is a disaster full of typical government-driven unintended consequences. We are just starting to see the tip of the iceberg. Funny that the very people who passed it will not have to live within this monstrous framework. And now the very unions who helped push it forward had an "oh-shit!" moment. They learned just how fucked it's going to be and want out.

I say, we are all on the same boat or shred the damn thing. If we are going to have socialized medicine the only equitable approach is that everyone, without exceptions, has to use it. All exceptions granted by POTUS need to be rescinded.

Re: The $200K lesson I learned from getting shot

#35

Post by dnautics »

taylodl wrote: post #32
dnautics wrote: post #28

Earlier quoted context omitted.

who gets to decide what is lifesaving and what is elective?

Currently the insurance company does, and since they were most likely selected by your employer whose objective was to hold down costs, what do you think that insurer's priorities are going to be? Plus, who's the customer in this situation? For whose business is the insurance company really working for?

no doubt having your employment being tied to your insurance is a really, really bad idea, but may I remind that state of affairs is because of a government incentive put into place by FDR.

Re: The $200K lesson I learned from getting shot

#36

Post by sliverstorm »

dnautics wrote: post #30
dnautics wrote: post #21

Earlier quoted context omitted.

Oh, it reduces his cholesterol level[0]. But he has at least one allele that increases the risk of myopathy when taking simvastatin (Assuming there were no milkmen - I do look quite a bit like him - I'm homozygous, and this allele is not terribly rare). The part about being asian is that asians tend not to catabolize statins as effectively, so his plasma levels are probably higher, since I found out he was taking a f…

ah, I found it, after all these years: http://www.ncbi.nlm.nih.gov/pubmed/21160131 as a bonus, here is the review on why asians should take less statins (hepatic enzyme clearance, probably a cyp450): http://www.ncbi.nlm.nih.gov/pubmed/17261409

That's not a consequence of being non-white so much as it is a consequence of your doctor being uninformed, which impacts people of all races.

I'm not saying it doesn't suck, I just take issue with your narrative of how race is the issue at hand, and how the medical system is bigoted towards minorities.

Re: The $200K lesson I learned from getting shot

#37

Post by robbiep »

dnautics wrote: post #14
adambard wrote: post #3

Can I be the first non-US citizen in this thread express my incredulity that anything less than universal health care is tolerated? "Barbaric" is the term that seems to strike me whenever I hear of it, hyperbolic though it may be.

you don't understand what it means to be a minority. We don't get anywhere near equal quality coverage and are basically forced to subsidize better medical care for white folk. For years, my father was prescribed a drug (simvastatin) that actually did damage to his body because it's nearly universally assumed to be good for him (it is for most white people), and strongly subsidized by the government (he's a military…

>>As we move into an era of personalized medicine, we'll be subsidizing better healthcare and better outcomes for some ethnic groups over others.

I think you miss the point of universal healthcare. It is not that one group has a higher utilisation of the healthcare system and therefore should pay more - the principle is that everyone is guaranteed the same provisions for healthcare, regardless of their risk factors.

Personalised medicine contributes nothing to the concept of universal healthcare; except for the noble aim of enabling better treatment of people through understanding individual responses. ' The idea that someone should be restricted in their level of healthcare utilisation under a universal system is absurd; As is the notion that someone should be forced to contribute extra (apart from the incremental addition of a high income earner through increased taxation) due to a perceived increase in risk.

>>The faulty assumption behind universal healthcare is that a one-size-fits-all prescription is good for everyone,

Again, I feel like you are trying to talk about personalised medicine inside of the concept of universal healthcare. Forget about personalised medicine. What the US needs first is access that won't bankrupt. The fact is we don't know enough about personalised medicine to give people different treatments based on genetic characteristics. And we won't for years. Sure, you can look at 1 or 2 isolated instances at the moment (ACE-inhibitors and ARBs in Black people for instance) - but none of this matters when it comes to life-saving care, for which the treatment is going to be the same for everyone anyway, unless you happen to have some rare blood disorder in which case racial profiling and blood tests at the time of intervention will dictate management.

>> so in a way, it's a subsidy for rich white people.

How so? Because they live longer anyway? Because they are less likely to indulge in the risk factors that result in early mortality? Again, Universal healthcare doesnt discriminate. But since rich black/brown/yellow/white/green people pay a higher proportion of taxes anyway, shouldn't your argument here be that Universal healthcare is a tax on rich people?

Additionally, just because you are on a high dose of a Statin, in a high risk population, doesn't mean you are developing myopathy. CK levels should usually be checked after a month or 2 of Statin therapy in line with followup for new lipid levels, and in the absence of symptoms it can be fairly safely ruled that you aren't experiencing a complication of a statin drug. But you probably already know this.

Re: The $200K lesson I learned from getting shot

#38

Post by dnautics »

robbiep wrote: post #37
dnautics wrote: post #14

Earlier quoted context omitted.

you don't understand what it means to be a minority. We don't get anywhere near equal quality coverage and are basically forced to subsidize better medical care for white folk. For years, my father was prescribed a drug (simvastatin) that actually did damage to his body because it's nearly universally assumed to be good for him (it is for most white people), and strongly subsidized by the government (he's a military…

>> As we move into an era of personalized medicine, we'll be subsidizing better healthcare and better outcomes for some ethnic groups over others. I think you miss the point of universal healthcare. It is not that one group has a higher utilisation of the healthcare system and therefore should pay more - the principle is that everyone is guaranteed the same provisions for healthcare, regardless of their risk factors…

>is that everyone is guaranteed the same provisions for healthcare

You're missing my point. If those provisions are the same, that's exactly the problem. It's only worse if they aren't the same (because who chooses?)

CK levels warnings are only triggered when you are having a serious complication from the statin. When you have a lesser complication, like, "going to the gym sucks instead of making you feel good", and you aren't aware of what's happening, and it's making you fatter, and your quality of life is going down, then what?

Re: The $200K lesson I learned from getting shot

#39

Post by pvarangot »

dnautics wrote: post #28
robbiep wrote: post #25

Earlier quoted context omitted.

No, if you need lifesaving surgery, you get it. And you don't get a bill that ends up costing a second mortgage. Elective procedures - that's a different story. But it is location specific, and in many countries with mixed public/private systems you can pay through your nose if you like anyway

who gets to decide what is lifesaving and what is elective?

In most systems, doctors.

Re: The $200K lesson I learned from getting shot

#40

Post by mason55 »

LekkoscPiwa wrote: post #24
purplelobster wrote: post #18

Earlier quoted context omitted.

Ironically, you're close enough to the truth. The only thing that stands in the way of dignified living for everybody is people like you. There is enough resources in this world (especially the US). Why should kids everywhere live in poverty, starve and not be given the same opportunity under the same conditions as more fortunate kids (well fed, good schools) because their parents couldn't find or hold down a job? In…

because we all know that then all kids would be hungry and not educated not only the poor ones. Somehow socialism always ends up making everyone equally poor and not equally rich. I read recently that in Canada waiting time for some surgeries are 6 months. For everyone. People who can afford and people who can't afford. Everybody screwed over. But of course that's what socialism is all about - making all people equal…

There's a huge difference between socialism and a minimum living standard
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