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This is the most absurd escalation I've read regarding the US healthcare system. What a laugh. Since it's this bad, it alludes to vast untapped potential for m

by MrLeap 7y ago

This is the most absurd escalation I've read regarding the US healthcare system. What a laugh. Since it's this bad, it alludes to vast untapped potential for more cost saving measures that are both funny and embarrassing. A quick google suggests prisoners have to pay 10-100$ copays in some states, but otherwise receive care. I wonder if there's a topology of illnesses where a financially optimal course of action to acquire treatment is to commit some petty crime and receiving treatment in prison? After lost wages, and earnings potential from your now tainted record, and all else. There might be! Here's a business idea that might already exist, vocational-technical elementary / pre-school for trying to lead your own children into and through medschool. Doctors are so expensive you might as well make your own! That one baby saving medicine that just got approved costs like 2 million dollars, right? For anything ~ 200k+ that isn't literally holding your baby hostage from imminent death, it's probably cheaper to get a degree in chemistry and some lab equipment. https://www.vice.com/en_us/article/43pngb/how-to-make-your-own-medicine-four-thieves-vinegar-collective https://www.vice.com/en_us/article/43pngb/how-to-make-your-o... It's crazy, but only in a crazy system can things like this approach rational. Here's another idea. What if patients could rent hospital administration as a service. Put payment for a procedure in escrow, sign all the malpractice waivers and try to attract a doctor like tinder. I'll sign all malpractice waivers if you'll just cut this cancer out of my gut. We can use my living room! It's this or death anyways so fuck it! America WOO

gambiting 7y ago
Americans need to raze their healthcare system down to the ground. None of the bandaid fixes like getting the government to pay but still having private companies dictating the prices. The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, but it's past the financial absurdity at this point, reading about insurance companies literally deciding whether cancer treatment is "strictly necessary" for weeks without approving it is not a healthcare system, it's hell, it's barbarism.
- rsyring 7y ago
  > The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, How involved are you with other US government organizations? Do they usually strike you as highly competent and efficient? Are you sure that if we did what you suggest we wouldn't have a whole different set of monstrous absurdities?
  - rootusrootus 7y ago
    We could choose to staff them with competent people instead of deliberately sabotaging it. There are viable alternatives to the GOP strategy.
    - b_tterc_p 7y ago
      If only someone had thought of that before
    - deleted 7y ago
      [deleted]
  - mikeash 7y ago
    Maybe we could run it similarly to the government-run air traffic control system, which is superb. “Government” doesn’t have to mean “incompetent and inefficient.”
    - AnimalMuppet 7y ago
      Maybe we could. Or maybe we'd run it like the VA. [Edit: enraged_camel said that the VA is pretty good. Is that accurate? I've heard otherwise, but I don't know firsthand. If the VA example isn't accurate, though, replace it with "California high speed rail" or "Amtrak" or "the Department of Education".] It doesn't have to mean incompetent and inefficient, but it seems that it often does.
      - 7y ago
namibj 7y ago
Not if. It's a question of how contrieved the scenario would need to be.
howard941 7y ago
> A quick google suggests prisoners have to pay 10-100$ copays in some states, but otherwise receive care. Dude I know you're going for the absurdum but if your search term was "prison health care" and you'd wish for that level of treatment - the actual level provided, not the one the law promises - then one of us needs to check our search engine or treatment expectations. A felony conviction's not going to land you in the Cleveland clinic. You'll be lucky to get antibiotics and sewn up if you survive having the shiv pulled out of your stomach.
- MrLeap 7y ago
  I promise you I am not trying to be absurd. Absurdum is flying you and your doctor 3000 miles away because the _ancillary_ cost savings make it a rational, no brainer decision. I'm trying to look at the factors that build up this reality and see other ways to zag through it. My hypotheticals, properly evaluated, would take into consideration the expected quality of inmate care. You might notice by tone that I grabbed onto it as an idea more gingerly than enticing a doctor with waivers and cookies to cut me open in my living room. Lawyers are the only thing that might possibly make that one not a winner in my way of grading. Prison requires a whole new calculus. The situation is BAD. I have a vested interest in this. My consulting career was great for the people that live with me. Unfortunately, my abjectly poor father in-law needs a heart transplant, insulin, and much else. Taking the system for granted, It's a shame I like him so much. Now I need to find a full time salaried position that's remote or in my area. My stochastic income can't be relied upon anymore, a life is on the line. I'm doing my best, but it makes me pretty angry to be in this position. A remote position specifically would be great, then I could make sure this guy gets to spend his final years (months?) without financial stress living next to his daughter... I'll take any interview, I'm pretty good at most software engineering... React/Nodejs/C#/WPF/ASP/PHP/Python/Unity/GLSL/HSL/C++. Fuck the U.S. healthcare system.
  - howard941 7y ago
    I understand (really!) You have every right to be angry. If we all were angry maybe we could get traction out of the shit for brains in office that keep the system the way it is. You shouldn't have to pick a job for health benefits, those should be a given whether or not you have a job, for you, for your in law too. WTF is wrong with this country that we have to put up with this horseshit? Peace
bb88 7y ago
> I wonder if there's a topology of illnesses where a financially optimal course of action to acquire treatment is to commit some petty crime and receiving treatment in prison? YES! https://www.theatlantic.com/health/archive/2013/02/on-purposely-getting-arrested-to-get-life-saving-surgery/273282/ https://www.theatlantic.com/health/archive/2013/02/on-purpos... "The next week, he went to a department store and, making sure a security guard saw him, pocketed some moisturizing cream. He looked up at the guard, smiled, and walked out. "After he was arrested, he wrote a note to the judge saying that he needed to get back into prison for a year, to get an operation. He told me the judge said "I'll give you 14 months, go get your surgery."
- romwell 7y ago
  This was a great read. >Any patient with end stage liver disease who does not have insurance (and is not eligible for Medicare) has the option of trying to qualify for state-funded Medicaid (which includes demonstrating both poverty and disability), stealing moisturizing cream from a department store, or dying. >I have personally taken care of a number of patients who did not want to put their family through the formidable weight of bankruptcy and opted for number three.
Swizec 7y ago
America is the only country where a TV show about a chemistry teacher who started selling meth to afford cancer treatment makes sense.
- shadowbanme 7y ago
  It’s worth noting that Walter White could have had cancer treatment under his insurance, he just wasn’t happy with the quality of it. (This was an important plot point — all along the road it was demonstrated that Walter did have other options, but due to his pride and greed he didn’t take them.) In countries with fully socialised medicine, if you’re not happy with the level of care provided you don’t even have the option of paying for better care.
  - rdm_blackhole 7y ago
    That is simply false. In most countries with socialised healthcare, you can buy extra private health insurance that allows you to be transferred to a private hospital, for example, to receive better care if that is what you wish. In this type of scenario, the government would still pay what it deems is the price of the service, then your health insurance will pay some % on top of that and the rest of will be from your own pocket. Finally, even if you can somewhat argue for some potential benefits of private health insurance, in Australia I can buy the very best health insurance for me and my wife for the price of $AUD125 per week with no deductible and very small waiting periods. In the USA I would probably have to pay triple that amount and have a 10k deductible on top of that. Finally, not having to think twice before to go to the doctor is amazing. My wife has a lot of health issues and even though I would love one day to emigrate to the USA for potential career opportunities, I know that not having a proper healthcare system is a deal-breaker because I want my family to be treated properly when they are sick no matter what kind of income we have.
    - refurb 7y ago
      Private care is de facto banned in Canada.
MaysonL 7y ago
> For anything ~ 200k+ that isn't literally holding your baby hostage from imminent death, it's probably cheaper to get a degree in chemistry and some lab equipment. Or find a chemist who was tempted by Breaking Bad but found the ethical problems and risk profile unsatisfactory, who would jump at the chance for a little profitable humanitarian patent infringement. Which leads to an interesting HN startup idea (or at least a Cory Doctorow novel): SciHub, but for drugs…
yholio 7y ago
> Put payment for a procedure in escrow, sign all the malpractice waivers and try to attract a doctor like tinder. I'll sign all malpractice waivers if you'll just cut this cancer out of my gut. We can use my living room! It's this or death anyways so fuck it! America WOO Nice try, buster. The medical profession is one of the most intensely regulated that exists. There is simply no opportunity to sell "best effort gallbladder removal by a student who took some years of medicine in Guatemala". You would be instantly jailed for a very long time. Even if, overall, the availability of such a service would save much more lifes than the current situation. Americans painted themselves into a corner: they asked the state to guarantee the quality of medical services while allowing providers to run for profit. What you get is an out of control lobby spiral that optimizes for more regulation that makes it even harder to compete, pushing competitors out of the market and the prices and profits of the incumbents soaring.
briandear 7y ago
However in other counties you can be denied care completely for experimental or even low percentage treatment. That little boy in the UK that had an Italian hospital willing to treat him was denied the right to leave the UK. Freedom has its upsides too.

by MrLeap 7y ago

gambiting 7y ago

Americans need to raze their healthcare system down to the ground. None of the bandaid fixes like getting the government to pay but still having private companies dictating the prices. The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, but it's past the financial absurdity at this point, reading about insurance companies literally deciding whether cancer treatment is "strictly necessary" for weeks without approving it is not a healthcare system, it's hell, it's barbarism.

rsyring 7y ago
> The whole system has to be torn down and rebuilt from scratch, with the state the main owner of hospitals and provider of healthcare. The kind of things that you read about the current system are just absurd, How involved are you with other US government organizations? Do they usually strike you as highly competent and efficient? Are you sure that if we did what you suggest we wouldn't have a whole different set of monstrous absurdities?
- rootusrootus 7y ago
  We could choose to staff them with competent people instead of deliberately sabotaging it. There are viable alternatives to the GOP strategy.
  - b_tterc_p 7y ago
    If only someone had thought of that before
  - deleted 7y ago
    [deleted]
- mikeash 7y ago
  Maybe we could run it similarly to the government-run air traffic control system, which is superb. “Government” doesn’t have to mean “incompetent and inefficient.”
  - AnimalMuppet 7y ago
    Maybe we could. Or maybe we'd run it like the VA. [Edit: enraged_camel said that the VA is pretty good. Is that accurate? I've heard otherwise, but I don't know firsthand. If the VA example isn't accurate, though, replace it with "California high speed rail" or "Amtrak" or "the Department of Education".] It doesn't have to mean incompetent and inefficient, but it seems that it often does.
    - 7y ago

namibj 7y ago

Not if. It's a question of how contrieved the scenario would need to be.

howard941 7y ago

> A quick google suggests prisoners have to pay 10-100$ copays in some states, but otherwise receive care. Dude I know you're going for the absurdum but if your search term was "prison health care" and you'd wish for that level of treatment - the actual level provided, not the one the law promises - then one of us needs to check our search engine or treatment expectations. A felony conviction's not going to land you in the Cleveland clinic. You'll be lucky to get antibiotics and sewn up if you survive having the shiv pulled out of your stomach.

MrLeap 7y ago
I promise you I am not trying to be absurd. Absurdum is flying you and your doctor 3000 miles away because the _ancillary_ cost savings make it a rational, no brainer decision. I'm trying to look at the factors that build up this reality and see other ways to zag through it. My hypotheticals, properly evaluated, would take into consideration the expected quality of inmate care. You might notice by tone that I grabbed onto it as an idea more gingerly than enticing a doctor with waivers and cookies to cut me open in my living room. Lawyers are the only thing that might possibly make that one not a winner in my way of grading. Prison requires a whole new calculus. The situation is BAD. I have a vested interest in this. My consulting career was great for the people that live with me. Unfortunately, my abjectly poor father in-law needs a heart transplant, insulin, and much else. Taking the system for granted, It's a shame I like him so much. Now I need to find a full time salaried position that's remote or in my area. My stochastic income can't be relied upon anymore, a life is on the line. I'm doing my best, but it makes me pretty angry to be in this position. A remote position specifically would be great, then I could make sure this guy gets to spend his final years (months?) without financial stress living next to his daughter... I'll take any interview, I'm pretty good at most software engineering... React/Nodejs/C#/WPF/ASP/PHP/Python/Unity/GLSL/HSL/C++. Fuck the U.S. healthcare system.
- howard941 7y ago
  I understand (really!) You have every right to be angry. If we all were angry maybe we could get traction out of the shit for brains in office that keep the system the way it is. You shouldn't have to pick a job for health benefits, those should be a given whether or not you have a job, for you, for your in law too. WTF is wrong with this country that we have to put up with this horseshit? Peace

bb88 7y ago

> I wonder if there's a topology of illnesses where a financially optimal course of action to acquire treatment is to commit some petty crime and receiving treatment in prison? YES! https://www.theatlantic.com/health/archive/2013/02/on-purposely-getting-arrested-to-get-life-saving-surgery/273282/ https://www.theatlantic.com/health/archive/2013/02/on-purpos... "The next week, he went to a department store and, making sure a security guard saw him, pocketed some moisturizing cream. He looked up at the guard, smiled, and walked out. "After he was arrested, he wrote a note to the judge saying that he needed to get back into prison for a year, to get an operation. He told me the judge said "I'll give you 14 months, go get your surgery."

romwell 7y ago
This was a great read. >Any patient with end stage liver disease who does not have insurance (and is not eligible for Medicare) has the option of trying to qualify for state-funded Medicaid (which includes demonstrating both poverty and disability), stealing moisturizing cream from a department store, or dying. >I have personally taken care of a number of patients who did not want to put their family through the formidable weight of bankruptcy and opted for number three.

Swizec 7y ago

America is the only country where a TV show about a chemistry teacher who started selling meth to afford cancer treatment makes sense.

shadowbanme 7y ago
It’s worth noting that Walter White could have had cancer treatment under his insurance, he just wasn’t happy with the quality of it. (This was an important plot point — all along the road it was demonstrated that Walter did have other options, but due to his pride and greed he didn’t take them.) In countries with fully socialised medicine, if you’re not happy with the level of care provided you don’t even have the option of paying for better care.
- rdm_blackhole 7y ago
  That is simply false. In most countries with socialised healthcare, you can buy extra private health insurance that allows you to be transferred to a private hospital, for example, to receive better care if that is what you wish. In this type of scenario, the government would still pay what it deems is the price of the service, then your health insurance will pay some % on top of that and the rest of will be from your own pocket. Finally, even if you can somewhat argue for some potential benefits of private health insurance, in Australia I can buy the very best health insurance for me and my wife for the price of $AUD125 per week with no deductible and very small waiting periods. In the USA I would probably have to pay triple that amount and have a 10k deductible on top of that. Finally, not having to think twice before to go to the doctor is amazing. My wife has a lot of health issues and even though I would love one day to emigrate to the USA for potential career opportunities, I know that not having a proper healthcare system is a deal-breaker because I want my family to be treated properly when they are sick no matter what kind of income we have.
  - refurb 7y ago
    Private care is de facto banned in Canada.

MaysonL 7y ago

> For anything ~ 200k+ that isn't literally holding your baby hostage from imminent death, it's probably cheaper to get a degree in chemistry and some lab equipment. Or find a chemist who was tempted by Breaking Bad but found the ethical problems and risk profile unsatisfactory, who would jump at the chance for a little profitable humanitarian patent infringement. Which leads to an interesting HN startup idea (or at least a Cory Doctorow novel): SciHub, but for drugs…

yholio 7y ago

> Put payment for a procedure in escrow, sign all the malpractice waivers and try to attract a doctor like tinder. I'll sign all malpractice waivers if you'll just cut this cancer out of my gut. We can use my living room! It's this or death anyways so fuck it! America WOO Nice try, buster. The medical profession is one of the most intensely regulated that exists. There is simply no opportunity to sell "best effort gallbladder removal by a student who took some years of medicine in Guatemala". You would be instantly jailed for a very long time. Even if, overall, the availability of such a service would save much more lifes than the current situation. Americans painted themselves into a corner: they asked the state to guarantee the quality of medical services while allowing providers to run for profit. What you get is an out of control lobby spiral that optimizes for more regulation that makes it even harder to compete, pushing competitors out of the market and the prices and profits of the incumbents soaring.

briandear 7y ago

However in other counties you can be denied care completely for experimental or even low percentage treatment. That little boy in the UK that had an Italian hospital willing to treat him was denied the right to leave the UK. Freedom has its upsides too.