5 ms·

What happens when someone has an emergency like a stroke or heart attack? Not a lot of time to email all the local hospitals. What happens when the patient is u

What happens when someone has an emergency like a stroke or heart attack? Not a lot of time to email all the local hospitals. What happens when the patient is unconscious? What happens if their condition can only be treated by a certain facility or medication? But yes, surely people are only getting screwed over the healthcare system because they are lazy. /s

notyourday 8y ago
That's the only time when one cannot get quotes. Depending on a location ( ave/st in NYC and a time of day ) the ambulance would take one to a specific emergency room in a specific hospital chain. But again, that's not where most of medical services "waste" is occurring.
- dredmorbius 8y ago
  Most medical expense is care of chronic conditions and end-of-life care. Not elective procedures. https://www.qualityhealth.com/health-lifestyle-articles/10-most-expensive-medical-conditions https://www.qualityhealth.com/health-lifestyle-articles/10-m...
  - notyourday 8y ago
    So if it is chronic there's even more reason to ensure that one does not overpay for what one would be consuming all the time?
    - dredmorbius 8y ago
      It's both the duration and increasing severity that account for much of the cost, along with the systematic cost-inflating aspects of the US healthcare system. Individual actions play little role.
      - notyourday 8y ago
        That's just hand waving. If the duration increases it makes absolutely no sense not to attempt to get the cheapest way to manage the condition. People do it all the time if they are on a hook for payments -- that's why we have drugs being grey important from Canada, Europe and India, especially if those drugs are not covered by the US insurance. Suddenly saving $200/mo per type of a pill becomes important. As soon as it is covered by insurance it becomes "Whatever, insurance pays"
        dredmorbius 8y ago
        No, it is not. It's an argument for structural rather than individual change.
        notyourday 8y ago
        Yes, the structural change is "make individuals be on a hook for overpayments"
        dredmorbius 8y ago
        Actually, the best cost-containment strategy is to make the provider liable. That's the notion behind comprehensive HMO systems, with fixed capitated premiums, minimal copayments (a very low friction suffices against most frivolous use0, penalties for failed delivery (see also the Chinese doctor model: the patient pays when healthy), comprehensive monitoring and routinisation, a public health model, and som external oversight. Within the US, that model describes the Kaiser Permanente healthcare model. Or Medicare I'd add a Danish malpractice remedy to that (provision of care to correct or mitigate mis-delivery or errors), but it's remarkably effective. Pharmaceuticals remain outside the Kaiser and Medicare systems, a chief weakness. There's also the fact that virtually all improvements over pre-modern longevity come from public health rather than acute medical interventions. http://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAAAM/eyirotYDmXo/s1600/2004_01_healthstat.jpg http://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAAA...
notyourday 8y ago
> What happens when someone has an emergency like a stroke or heart attack? Not a lot of time to email all the local hospitals. What happens when the patient is unconscious? What happens if their condition can only be treated by a certain facility or medication? This is not a rocket science: when one sees a complex problem one does not attempt to solve the entire problem using an full rewrite -- instead one breaks out it into pieces and solves one piece at a time. If the piece is too big to solve that piece is broken down into pieces and those individual pieces are solved. It is debugging of the problem 101. > What happens when someone has an emergency like a stroke or heart attack? Call 911. Have a toothache? Don't call 911. Call a dentist. In fact, call several dentists. It is, of course, possible to call 911 and have an ambulance take one to an emergency room because of a toothache ( this was a case told to me by a friend who is currently doing an ER rotation. He swore he was not pulling my leg ). > What happens if their condition can only be treated by a certain facility or medication? It is unlikely that a common condition can be treated by a single facility. > or medication? If we are to optimize the costs of overspending by not selecting cheaper alternatives where we can there would be more money to spend on the expensive "it can be only done here" or "it can only be done using this medication".

notyourday 8y ago

That's the only time when one cannot get quotes. Depending on a location ( ave/st in NYC and a time of day ) the ambulance would take one to a specific emergency room in a specific hospital chain. But again, that's not where most of medical services "waste" is occurring.

dredmorbius 8y ago
Most medical expense is care of chronic conditions and end-of-life care. Not elective procedures. https://www.qualityhealth.com/health-lifestyle-articles/10-most-expensive-medical-conditions https://www.qualityhealth.com/health-lifestyle-articles/10-m...
- notyourday 8y ago
  So if it is chronic there's even more reason to ensure that one does not overpay for what one would be consuming all the time?
  - dredmorbius 8y ago
    It's both the duration and increasing severity that account for much of the cost, along with the systematic cost-inflating aspects of the US healthcare system. Individual actions play little role.
    - notyourday 8y ago
      That's just hand waving. If the duration increases it makes absolutely no sense not to attempt to get the cheapest way to manage the condition. People do it all the time if they are on a hook for payments -- that's why we have drugs being grey important from Canada, Europe and India, especially if those drugs are not covered by the US insurance. Suddenly saving $200/mo per type of a pill becomes important. As soon as it is covered by insurance it becomes "Whatever, insurance pays"
      - dredmorbius 8y ago
        No, it is not. It's an argument for structural rather than individual change.
        notyourday 8y ago
        Yes, the structural change is "make individuals be on a hook for overpayments"
        dredmorbius 8y ago
        Actually, the best cost-containment strategy is to make the provider liable. That's the notion behind comprehensive HMO systems, with fixed capitated premiums, minimal copayments (a very low friction suffices against most frivolous use0, penalties for failed delivery (see also the Chinese doctor model: the patient pays when healthy), comprehensive monitoring and routinisation, a public health model, and som external oversight. Within the US, that model describes the Kaiser Permanente healthcare model. Or Medicare I'd add a Danish malpractice remedy to that (provision of care to correct or mitigate mis-delivery or errors), but it's remarkably effective. Pharmaceuticals remain outside the Kaiser and Medicare systems, a chief weakness. There's also the fact that virtually all improvements over pre-modern longevity come from public health rather than acute medical interventions. http://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAAAM/eyirotYDmXo/s1600/2004_01_healthstat.jpg http://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAAA...

notyourday 8y ago

> What happens when someone has an emergency like a stroke or heart attack? Not a lot of time to email all the local hospitals. What happens when the patient is unconscious? What happens if their condition can only be treated by a certain facility or medication? This is not a rocket science: when one sees a complex problem one does not attempt to solve the entire problem using an full rewrite -- instead one breaks out it into pieces and solves one piece at a time. If the piece is too big to solve that piece is broken down into pieces and those individual pieces are solved. It is debugging of the problem 101. > What happens when someone has an emergency like a stroke or heart attack? Call 911. Have a toothache? Don't call 911. Call a dentist. In fact, call several dentists. It is, of course, possible to call 911 and have an ambulance take one to an emergency room because of a toothache ( this was a case told to me by a friend who is currently doing an ER rotation. He swore he was not pulling my leg ). > What happens if their condition can only be treated by a certain facility or medication? It is unlikely that a common condition can be treated by a single facility. > or medication? If we are to optimize the costs of overspending by not selecting cheaper alternatives where we can there would be more money to spend on the expensive "it can be only done here" or "it can only be done using this medication".