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

jakeseliger.com

51–60 of 72 posts

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

#51

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 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 Ame…

I think trained consumerism is a big part of it. People are trained to think (usually erroneously) that the solution to every problem is a product or service.

X will make me happy, Im sad because I dont have Y. There are absolutely outside forces pushing this, but there is also a deficit of cultural forces and norms pushing back. Its not that people are being bombed by advertising for expensive burials, but that they have low experience with excellent and cheap alternatives. Human culture is slow to change, and usually does so on the order of decades or generations. Any impact from things like books will be at the margin, especially since most readers are already inclined to agree.

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

#52
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…

A doctor friend of mine put it succinctly: let old people die; that's what they do . End-of-life interventions are not for benefit of the old, they are going to die anyway. It is an entirely perverse financial incentive that aligns with a positive "life preserving" incentive that fails to adjust to the nuances of natural human mortality. I believe this applies to the terminally ill as well. This is why most doctors r…

> This is why most doctors refuse (non-palliative) treatment for terminal cancer diagnoses.

I saw this claim a while back and looked it up and it didn't seem true. Very few people actually refuse non-palliative treatment entirely for cancer. And the few who do refuse are usually not doctors but rather alternative medicine enthusiasts. Modern treatment can extend the lifespan of many of those with terminal cancers for a couple of years with good quality of life, and few say no to that; those years can be very meaningful for many.

What doctors do frequently decline is treatment near the end of life that's overwhelmingly likely to be futile or result in a low quality of life.

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

#53

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.n…

Illegal in the Philippines. After years of struggle developing a product that (1) really worked and (2) anybody wanted. There are 200+ other countries in the world.

It's approved in the U.S., Canada and other countries but they don't sell it. Given that they are politicizing it so much you think they might grow 10 tons of it somewhere and sell small quantities of it so people could try it out ("get a $20 bag of rice and support its development") but (a) it defeats the narrative they're being victimized by Greenpeace and (b) people may or may not like the sensory characteristics.

I don't know how the GR2 trait itself impacts other agronomic characteristics but there is a principle that if an organism is spending energy on one thing it is going to have less for other things. A more definitely problem is that a small number of GR2 seed lines compete with a very large number of other rice lines. Even if the GR2 trait is neutral in other respects, the GR2 rice that is actually developed could be "ok" but not competitive with other seeds you could get.

In the US there is a staggering variety of Bt corn or Roundup-Ready soybean seeds because the technology has been licensed to and picked up by most of the big seed vendors so farmers can get seeds that perform well for them. Farmers want these crops because they help their bottom line. If somebody tries to ban them, they'll fight back.

PRRI doesn't have a lot of resources to develop a variety of optimized seeds, it doesn't have the deep relationships with seed vendors that (say) Monsanto has, it doesn't have a lot of enthusiasm from possible customers in the Philippines. If local farmers, public health authorities and such had organized to support it there could have been a different outcome. As it is PRRI comes across as another out-of-touch NGO.

There are all kinds of little silly things such as the fact that they will start charging you if you grow more than $10,000 worth of it. If they really are out to save people from illness, change the world, and normalize the idea of transgenic crops, they should be giving it away for free.

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

#54
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…

Thank you for sharing that beautiful, insightful story about your grandmother's life and death.

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

#55
post #39

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…

> Keeping anybody alive is worth it.

This might be true on average. But if you need to spend $1 million keeping a death row inmate alive who tried to commit suicide, that money might be better spent on infants with heart defects. Money being finite (and being an abstraction of medical equipment/expertise/hours which are also finite), you ultimately have scenarios where you have to choose one or the other.

> This shows how destructive capitalism is: In its pursuit of maximizing the profits

If something costs more than you can afford, then it is unaffordable. This remains true even for those who despise capitalism. The great innovation of communism was the destruction of all the data that would allow one to have insight about whether or not something was unaffordable or not. In the United States, insurance companies are heavily regulated, and premiums must reflect how much it costs to pay out claims, plus some small percentage for overhead. Nor do the hospitals themselves strictly seek profit... their adversarial relationship with insurance companies compels them to overbill in the theory that if one claim fails, the next can succeed... so price it for both.

Profit-minimization isn't a very good strategy for long-term anything. If you want to be able to stay in business until next year so you can perform surgeries, you might have to, I dunno, at least break even.

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

#56
post #44

We humans really live for one another, and without other people and especially love, why bother? Reading the essay I couldn't help but think that there was something missing from the author's calculations, and this quote really brought it home. We do live for one another, and that brings not only personal benefits like the joy of loving and being loved, but societal benefits: it is part of what binds us together and…

What a lucid and well-expressed opinion. Kudos.

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

#57
post #15

Earlier quoted context omitted.

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...

Both of those are at the low end of cooking time * temperature. Mashed potatoes provide essentially zero vitamin C same with many potato soups. https://fdc.nal.usda.gov/fdc-app.html#/food-details/170699/n...

365 calories of raw potatoes have 155% of your daily vitamin C requirement. A 365 calories serving of French fries has ~9% of your daily vitamin C requirements. Of course the cooking oil is part of that difference, but few cooked foods have much vitamin C. Worse many things like rice, bread, or beer provide none.

So you need some aspect of your diet to be a plentiful supply or take a supplement.

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

#58
post #7

"The future, which distinctly though barely missing, is going to be brighter than the present." This one hit pretty hard. I am not a cancer patient who is missing a life saving treatment by 10 years, but it does feel like we are living in a sort of liminal space between religion and technology. Sure we have iphones and Netflix but we all still work 40-50 hour weeks. ChatGPT seems nifty but if I break my arm they will…

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

#59
post #7

"The future, which distinctly though barely missing, is going to be brighter than the present." This one hit pretty hard. I am not a cancer patient who is missing a life saving treatment by 10 years, but it does feel like we are living in a sort of liminal space between religion and technology. Sure we have iphones and Netflix but we all still work 40-50 hour weeks. ChatGPT seems nifty but if I break my arm they will…

[flagged]

Oh my god man rent free

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

#60

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.

Should we spend all expenditures on healthcare and keeping sick people alive? We could do that. And that would almost certainly keep more sick people alive.

Of course real trade-offs exist here. It's a finite world, with finite resources.

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