Intake – American's largest psychiatric chain • Hacker News Board

Re: Intake – American's largest psychiatric chain

#91

Post by specialist » Sat, Dec 10, 2016, 2:05 PM UTC

maxerickson wrote: post #12

DashRattlesnake wrote: post #5

> Lauren Singer, who worked for six months at the front desk of Colorado’s Highlands Behavioral, said people who were waiting in the lobby for an assessment would ask her what it would entail. “I would frequently get yelled at for overstepping my bounds and telling them too much about the evaluation process,” Singer said. A button behind the receptionist’s desk controlled the lock to the front door of the facility, a…

There can be pernicious motives whether a facility is nominally for profit or not. (For instance, say there is a doctor who gets paid in proportion to the time they spend treating patients at a non profit facility)

I use the word "incentives".

Re: Intake – American's largest psychiatric chain

#92

Post by maxerickson » Sat, Dec 10, 2016, 2:14 PM UTC

omginternets wrote: post #83

maxerickson wrote: post #52

Earlier quoted context omitted.

Well, I don't agree with that. I see generous salaries as being exactly the same thing as profit (they are just taxed differently). I also have difficulty with the idea that only de facto agents of the state can deliver healthcare (care only available at fixed prices, etc). So my point is that you need external controls regardless of the motivations of the actors inside the institution.

This is completely beside the point. "For-profit healthcare" and "well-paid doctors" are distinct concepts. Doctors are still very well-paid in France, for instance. It's just that the hospital isn't expected to turn a profit.

I'm arguing that compensation and profit are actually the same thing.

They are both economic benefits from providing a valued product or service. Saying that the one is evil while ignoring the other doesn't make any sense at all. It's the opposite of being beside the point.

Take the case of 2 doctors that have the same price list. One is better at doctoring and sees more patients. Because there is only the other doctor, their faster appointments represent a higher income than the other doctor. The second doctor still manages to provide competent care to all the patients they see, but they are capturing less economic benefit than Dr. Speedy. Is Dr. Speedy evil for charging the going rate?

Re: Intake – American's largest psychiatric chain

#93

Post by maxerickson » Sat, Dec 10, 2016, 2:16 PM UTC

rounce wrote: post #81

maxerickson wrote: post #52

Earlier quoted context omitted.

Well, I don't agree with that. I see generous salaries as being exactly the same thing as profit (they are just taxed differently). I also have difficulty with the idea that only de facto agents of the state can deliver healthcare (care only available at fixed prices, etc). So my point is that you need external controls regardless of the motivations of the actors inside the institution.

> I also have difficulty with the idea that only de facto agents of the state can deliver healthcare (care only available at fixed prices, etc). It seems that they aren't the only difficulties you have. In a social health-care system, possession of a medical license doesn't entail one's employer. You're more than welcome to set up private practice, though you'll have less chance of the career defining cases, as the m…

It's implicit in the argument I replied to that the side practice better not deliver excess economic benefits (profits!) compared to working in the public facilities.

Re: Intake – American's largest psychiatric chain

#94

Post by Spooky23 » Sat, Dec 10, 2016, 2:29 PM UTC

nommm-nommm wrote: post #88

gumby wrote: post #34

Earlier quoted context omitted.

Because in the US (at least) if the victim won't press charges the police can't take action. And in a case like this the defence will attempt to attack the (alleged, at the time of the trial) victim's credibility, which can be devastating. It's the main reason why rapists so often get away with it. Also why gang members are hard to convict. Some crimes don't have a legal victim, e.g. murder (victim is dead) or so-cal…

This is not true. The only person with the choice/authority to prosecute is the prosecutor.

Prosecutors want trophys.

If a victim won't testify, unless there is alt of other evidence, good luck getting a conviction.

Re: Intake – American's largest psychiatric chain

#95

Post by throwanem » Sat, Dec 10, 2016, 2:34 PM UTC

gonmf wrote: post #85

There should be a special place in hell for people who abuse the most vulnerable of people.

There is.

Re: Intake – American's largest psychiatric chain

#96

Post by jessaustin » Sat, Dec 10, 2016, 2:34 PM UTC

warfangle wrote: post #75

0xcde4c3db wrote: post #67

Based on my experience as a patient (not at a UHS facility, as far as I can tell) I'm pretty confident that the stuff reported in this article is just the tip of the iceberg. These facilities are structured in a way that makes people doubt their own memories and feel powerless, even before the neuroleptics come out. Treatment "progress" is predicated on -- if not synonymous with -- submission. I was put on suicide wa…

Heres one who hasn't spoken out. I'm glad that I was able to get appropriate treatment (15 years later) but how I was treated as a teenager in a mental health facility was atrocious. Misdiagnosis, over medication, and only keeping patients as long as their insurance held out was par for the course.

TIL, contrary to recent political claims, there are some situations in which it's better for one's health insurance not to cover mental health.

Re: Intake – American's largest psychiatric chain

#97

Post by jessaustin » Sat, Dec 10, 2016, 2:52 PM UTC

spitfire wrote: post #64

This would make two incredible movies. First a horror movie about false involuntary admittance. Second, a fantastic corporate drama ala michael clayton about the corporate hierarchy that built, runs and protects the machine. If anyone writes the screenplay for these, I want royalties.

"Changeling" is one movie that portrays involuntary psychiatric admittance, although in that case it wasn't motivated by profit.

Re: Intake – American's largest psychiatric chain

#98

Post by jackfrodo » Sat, Dec 10, 2016, 3:09 PM UTC

0xcde4c3db wrote: post #67

Based on my experience as a patient (not at a UHS facility, as far as I can tell) I'm pretty confident that the stuff reported in this article is just the tip of the iceberg. These facilities are structured in a way that makes people doubt their own memories and feel powerless, even before the neuroleptics come out. Treatment "progress" is predicated on -- if not synonymous with -- submission. I was put on suicide wa…

>Treatment "progress" is predicated on -- if not synonymous with -- submission.

This was my experience as well. When I was in holding, a sympathetic nurse told me that to get out of there as soon as possible, I needed to smile, go to all meetings, and do exactly as I'm told. There was a Bible study that I wasn't interested in going to, and another nurse heavily suggested that I attend, which I ended up doing. I felt very powerless throughout it.

Re: Intake – American's largest psychiatric chain

#99

Post by ethbro » Sat, Dec 10, 2016, 3:17 PM UTC

StanislavPetrov wrote: post #71

DashRattlesnake wrote: post #5

> Lauren Singer, who worked for six months at the front desk of Colorado’s Highlands Behavioral, said people who were waiting in the lobby for an assessment would ask her what it would entail. “I would frequently get yelled at for overstepping my bounds and telling them too much about the evaluation process,” Singer said. A button behind the receptionist’s desk controlled the lock to the front door of the facility, a…

This is kidnapping plain and simple. The fact that it is done under the guise of a corporate/medical structure should not be relevant. Those involved in these crimes should be arrested and prosecuted under RICO laws, from the top to the bottom.

Sadly, I can see the counter argument. "It's not kidnapping, because someone with mental health issues can't be trusted to make their own decisions." {Cue jury ignoring logic errors and nodding}

Maybe it's currently reading Larsson's books, but mental health issues seem to raise incredibly challenging ethical questions (under economically feasible settings).

Re: Intake – American's largest psychiatric chain

#100

Post by warfangle » Sat, Dec 10, 2016, 4:04 PM UTC

jessaustin wrote: post #96

warfangle wrote: post #75

Earlier quoted context omitted.

Heres one who hasn't spoken out. I'm glad that I was able to get appropriate treatment (15 years later) but how I was treated as a teenager in a mental health facility was atrocious. Misdiagnosis, over medication, and only keeping patients as long as their insurance held out was par for the course.

TIL, contrary to recent political claims, there are some situations in which it's better for one's health insurance not to cover mental health.

A product of misaligned incentives caused by profit-driven healthcare industry.