5 ms·

Shit... my vet can do that. They saw my cat, estimated the surgery necessary, the length of care in an ideal and not-ideal situation, cost of potential extras b

by ajford 7y ago

Shit... my vet can do that. They saw my cat, estimated the surgery necessary, the length of care in an ideal and not-ideal situation, cost of potential extras based on possible complications or additional needs such as full sedation. I was given three estimated prices that ranged from $800 to almost $1800, with an expected final cost of $1000 being the most likely outcome. Surgery came out to $975. And this is with a non-communicative and uncooperative animal, not a human. Not to belittle what a doctor does, but I totally agree that a doctor should be able to estimate the most likely and most extreme situations and gauge the range.

ceejayoz 7y ago
The extremes are much wider in human medicine, though. No one's going to spend a million bucks on a severely premature puppy, but we will for a human, regularly. "This might be $500, or $250,000" isn't super helpful.
- bonzini 7y ago
  That's why private healthcare makes no sense. You just cannot attach a price tag to human life no matter if it's premature birth or a child with leukemia or routine surgery like an appendicitis. The only sensible way to run healthcare is by socializing it.
  - aesthesia 7y ago
    Socializing healthcare doesn't eliminate the cost calculus, it just shifts it to a different group of deciders. It feels icky to attach a price tag to human life, but in a world where resources are not infinite, and healthcare requires resources, those decisions have to be made somehow.
    - bonzini 7y ago
      Most countries with socialized healthcare and comparable (sometimes lower) GDP per capita to the US have higher life expectancy, lower expenditures for both the state and the citizens, and a better relationship between healthcare and the citizens. It's a fact. No, death panels aren't a thing. You die when your heart stops beating, period. Really, reading all the stories on this thread is insane when I think my wife and I could just walk into a hospital and get out three days later with a baby without having to worry about paying a buck. Same when my father went to the ER and came out over a month later after an emergency heart surgery, a week in the ICU and two weeks of physiotherapy.
      - unishark 7y ago
        If a govt decides to restrict the amount of MRI scanners hospitals can have in a region for budgetary reasons, forcing patients to wait longer or only get them when the risk is higher, an economic decision has been made regarding the value of your life. A well-known stat that was already true decades ago was that Orange county california has more MRI scanners than Canada (population difference about 10x). And it isn't just a gimmick, far more imaging is done in the US than other countries. The US probably puts a higher value on life than any other country, which is part of the cost problem. And considering that 90 percent of costs are borne in the last year of life by dying patients, it's naive to think there won't be something like death panels in some form, whether it's that explicit or not. Simple economics says price fixing creates shortages.
        ceejayoz 7y ago
        It’s naive to think the USA doesn’t already have death panels. People die after unsuccessfully fighting their insurers for coverage already. The USA doesn’t put more value on life. We put more costs on it, but our outcomes aren’t meaningfully better.
        unishark 7y ago
        I don't see that your case has been made. I see more willingness to perform costly interventions as a clear example of how more value is being placed on lives. As for outcomes, you can argue a CYA approach where they try everything they possibly can isn't necessarily more effective, but I disagree that you can dismiss it as proving less value has been placed on life. I also distrust stats about outcomes given how politically charged the topic is. The most obese country in the developed world comes in with a bias towards worse outcomes already. By the way the vast majority of people who die in the US are an a socialized medicine system at the time (e.g., medicare). Either way though, yes, of course there's "death panel" behavior or other cost-controls which effectively lead to the same result (e.g. doing harm through inaction rather than direct action), in any system.
- ajford 7y ago
  True, but it should be possible to say the average cost is $10,000 according to the last N similar operations. In the event of something abnormal occurring, you might require an extra $25,000 for this and that, and if the shit hits the fan, expect $250,000 for extreme lifesaving effort.
joquarky 7y ago
When one of my pets had surgery a few years ago, the surgeon's office actually sent us back a bit over $500 a few weeks afterward since it went smoother than expected.

by ajford 7y ago

ceejayoz 7y ago

The extremes are much wider in human medicine, though. No one's going to spend a million bucks on a severely premature puppy, but we will for a human, regularly. "This might be $500, or $250,000" isn't super helpful.

bonzini 7y ago
That's why private healthcare makes no sense. You just cannot attach a price tag to human life no matter if it's premature birth or a child with leukemia or routine surgery like an appendicitis. The only sensible way to run healthcare is by socializing it.
- aesthesia 7y ago
  Socializing healthcare doesn't eliminate the cost calculus, it just shifts it to a different group of deciders. It feels icky to attach a price tag to human life, but in a world where resources are not infinite, and healthcare requires resources, those decisions have to be made somehow.
  - bonzini 7y ago
    Most countries with socialized healthcare and comparable (sometimes lower) GDP per capita to the US have higher life expectancy, lower expenditures for both the state and the citizens, and a better relationship between healthcare and the citizens. It's a fact. No, death panels aren't a thing. You die when your heart stops beating, period. Really, reading all the stories on this thread is insane when I think my wife and I could just walk into a hospital and get out three days later with a baby without having to worry about paying a buck. Same when my father went to the ER and came out over a month later after an emergency heart surgery, a week in the ICU and two weeks of physiotherapy.
    - unishark 7y ago
      If a govt decides to restrict the amount of MRI scanners hospitals can have in a region for budgetary reasons, forcing patients to wait longer or only get them when the risk is higher, an economic decision has been made regarding the value of your life. A well-known stat that was already true decades ago was that Orange county california has more MRI scanners than Canada (population difference about 10x). And it isn't just a gimmick, far more imaging is done in the US than other countries. The US probably puts a higher value on life than any other country, which is part of the cost problem. And considering that 90 percent of costs are borne in the last year of life by dying patients, it's naive to think there won't be something like death panels in some form, whether it's that explicit or not. Simple economics says price fixing creates shortages.
      - ceejayoz 7y ago
        It’s naive to think the USA doesn’t already have death panels. People die after unsuccessfully fighting their insurers for coverage already. The USA doesn’t put more value on life. We put more costs on it, but our outcomes aren’t meaningfully better.
        unishark 7y ago
        I don't see that your case has been made. I see more willingness to perform costly interventions as a clear example of how more value is being placed on lives. As for outcomes, you can argue a CYA approach where they try everything they possibly can isn't necessarily more effective, but I disagree that you can dismiss it as proving less value has been placed on life. I also distrust stats about outcomes given how politically charged the topic is. The most obese country in the developed world comes in with a bias towards worse outcomes already. By the way the vast majority of people who die in the US are an a socialized medicine system at the time (e.g., medicare). Either way though, yes, of course there's "death panel" behavior or other cost-controls which effectively lead to the same result (e.g. doing harm through inaction rather than direct action), in any system.
ajford 7y ago
True, but it should be possible to say the average cost is $10,000 according to the last N similar operations. In the event of something abnormal occurring, you might require an extra $25,000 for this and that, and if the shit hits the fan, expect $250,000 for extreme lifesaving effort.

joquarky 7y ago

When one of my pets had surgery a few years ago, the surgeon's office actually sent us back a bit over $500 a few weeks afterward since it went smoother than expected.