7 ms·

Do hospitals turn away people with the flu away if they are not vaccinated? Or is it only Covid that you would impose this rule for?

by h3cate 5y ago

ethbr0 5y ago
Fair question. It looks like flu (influenza) hospitalizations run at about 0.15% of total population, per year. SARS-CoV-2, at 1-5%? Although that might be vs confirmed cases (?), which would muddle the numbers. But suffice to say substantially higher. So I think there's an argument to be made for this being a COVID only measure (and probably measles, etc too). IMHO, people are entitled to freedom regarding their choice to vaccinate. But if they choose to exercise their freedom in ways that limit my freedom (via resulting lockdowns, mandatory masking, banned social gatherings, preventing businesses from operating normally, etc.), then that doesn't feel very fair. They're externalizing the consequences of their decisions onto me, and the rest of society. So yeah, IMHO, their decisions: their bill to pay. With their life, if necessary. (But I may be biased, as I have family working ICU, triaging unvaccinated coronavirus deniers who show up at the ER, begging to be saved, who are then sapping care from non-COVID patients...)
- luckylion 5y ago
  > But if they choose to exercise their freedom in ways that limit my freedom (via resulting lockdowns, mandatory masking, banned social gatherings, preventing businesses from operating normally, etc.), then that doesn't feel very fair. You can easily make that argument for plenty of things though. Didn't care for education and wanted to party instead? No welfare for you! Overweight? Sorry, you're limiting my freedom via increased healthcare costs. Broke your leg while skiing? Sorry, you knew the risk, now live with it, insurance is for real accidents only.
  - ethbr0 5y ago
    All of those other examples have additional characteristics that cast the argument differently. Education and obesity both have income and access issues. In that, if you are poor, you don't have access to the same options as those who are wealthy. Skiing is actually the best example (Alaska aside!), given that it's a purely personal decision to engage in or not. So hypothetical... If hospital ICUs were filling with ski accident victims, to the extent they were unable to provide normal care to non-ski patients, and the economy was being impacted (businesses unable to operate, jobs lost, etc.) due to this ski pandemic, then you would say "Skiing is a personal choice that everyone deserves to make, and I have no problem with my tax and insurance dollars paying for skiers"?
    - luckylion 5y ago
      > Education and obesity both have income and access issues. Some, but not primarily, so it still stands. I'm sure you can find similar reasons with vaccine-anxiety. People aren't choosing to be afraid of vaccines "just because", there's something going on that terrifies them. > then you would say "Skiing is a personal choice that everyone deserves to make, and I have no problem with my tax and insurance dollars paying for skiers"? Yes, because that's the principle the system is built on. I mean, I think lots of people somewhat consciously make lots of terrible decisions all the time, and the consequences of their decisions do cost giant sums of money that I have to pay lots of taxes for and that cannot be used for people who face truly accidental hardship (think extreme skiing vs walking and a suitcase dropping from a plane). But we've generally decided that that's totally fine, and I've accepted that and I pay taxes to make sure they don't have to face the consequences of their decisions. We cannot say "that's fine for everything, but not here" if we operate on a principle. It's either "you're on your own" or it's not, but it has to be consistent.
      - ethbr0 5y ago
        > We cannot say "that's fine for everything, but not here" if we operate on a principle We already say that, for smoking. And through mandatory school vaccinations (DTaP, varicella, polio, MMR, meningococcal). Which is a big part of my point. What we claim our system to be (Freedom! With guaranteed care! With equal rights to opt out!) and reality (We won't pay for certain dumb things you do. And we'll give you basic guaranteed care and probably not let you die) are two different things. Which is the main thing that's shredding our health care efficiency in terms of per capita GDP spending.
        luckylion 5y ago
        > We already say that, for smoking. "We" don't, but maybe you do. I'm from Germany, the only time smoking/alcoholism/substance abuse comes up in a relevant way is when you need a transplant and there are multiple recipients and too few donors. And it's not a punishment for what you previously did, it's because of a prediction of what you're going to do, e.g. an alcoholic who has shown no sign of compliance will probably not get the liver if there's a non-alcoholic who also needs it and does what it takes to get/stay healthy. Deaf people whose condition could be cured/massively improved with implants are free to choose not to, and won't lose their disability status, it doesn't turn into a choice/hobby just because there's a choice in fixing it. I'm not sure that's what makes healthcare in the US so expensive. Again, we do it and we spend significantly less than the US. The country is much more densely populated though, university is free and physicians' income is much closer to the average than in the US.
- h3cate 5y ago
  I don't think anybody that's unvaccinated wants any restrictions either. So if it was proposed there would be no more restrictions on society would you still turn away unvaccinated people from hospital? Going off your logic they are no longer impacting your freedoms.
pbourke 5y ago
Has there been a flu season in recent history that caused the hospital system to collapse?
- nradov 5y ago
  Hospitals in some areas were overwhelmed with influenza cases as recently as 2018. https://time.com/5107984/hospitals-handling-burden-flu-patients/ https://time.com/5107984/hospitals-handling-burden-flu-patie...
  - ethbr0 5y ago
    For reference, when I looked up the numbers, influenza hospitalizations (estimated, total annual US) vary from around 150,000 to 550,000, depending on the year and strain. So yes, year to year has a lot of variance.
gilbetron 5y ago
Health systems operate by prioritizing, via an imperfect system, patients based on need. If you run a red light and slam into another car, but you're more injured than the other person, you will be prioritized even though you were culpable. I think that is the appropriate, ethical, and practical approach. However, the calculus changes when the health system is at or over capacity. Now, if two people come in and both are critically ill, but you only have room for one, I'm ok with choosing the one that was vaccinated. Likewise with many other situations and illnesses. If you cause a car accident, and both you and the person you hit require the ICU, but there is only one spot open, I'm ok with the person that got hit getting the spot. Now, I'm assuming you are jaded like me and know that actual answer is probably the person with the most money tends to get the treatment, but that's another bitter, cynical discussion.
- ethbr0 5y ago
  Here's my current level of jade -- listening to repeated stories about hospital staff having to argue with a patient's family (all unvaccinated) about why they can't visit the patient (also unvaccinated) in the COVID ward, when care is being withdrawn due to organ failure. At some point, it's like, "Jesus. Just stop talking, and please let me help you not kill yourself."

Do hospitals turn away people with the flu away if they are not vaccinated? Or is it only Covid that you would impose this rule for?

by h3cate 5y ago

Do hospitals turn away people with the flu away if they are not vaccinated? Or is it only Covid that you would impose this rule for?

ethbr0 5y ago

Fair question. It looks like flu (influenza) hospitalizations run at about 0.15% of total population, per year. SARS-CoV-2, at 1-5%? Although that might be vs confirmed cases (?), which would muddle the numbers. But suffice to say substantially higher. So I think there's an argument to be made for this being a COVID only measure (and probably measles, etc too). IMHO, people are entitled to freedom regarding their choice to vaccinate. But if they choose to exercise their freedom in ways that limit my freedom (via resulting lockdowns, mandatory masking, banned social gatherings, preventing businesses from operating normally, etc.), then that doesn't feel very fair. They're externalizing the consequences of their decisions onto me, and the rest of society. So yeah, IMHO, their decisions: their bill to pay. With their life, if necessary. (But I may be biased, as I have family working ICU, triaging unvaccinated coronavirus deniers who show up at the ER, begging to be saved, who are then sapping care from non-COVID patients...)

luckylion 5y ago
> But if they choose to exercise their freedom in ways that limit my freedom (via resulting lockdowns, mandatory masking, banned social gatherings, preventing businesses from operating normally, etc.), then that doesn't feel very fair. You can easily make that argument for plenty of things though. Didn't care for education and wanted to party instead? No welfare for you! Overweight? Sorry, you're limiting my freedom via increased healthcare costs. Broke your leg while skiing? Sorry, you knew the risk, now live with it, insurance is for real accidents only.
- ethbr0 5y ago
  All of those other examples have additional characteristics that cast the argument differently. Education and obesity both have income and access issues. In that, if you are poor, you don't have access to the same options as those who are wealthy. Skiing is actually the best example (Alaska aside!), given that it's a purely personal decision to engage in or not. So hypothetical... If hospital ICUs were filling with ski accident victims, to the extent they were unable to provide normal care to non-ski patients, and the economy was being impacted (businesses unable to operate, jobs lost, etc.) due to this ski pandemic, then you would say "Skiing is a personal choice that everyone deserves to make, and I have no problem with my tax and insurance dollars paying for skiers"?
  - luckylion 5y ago
    > Education and obesity both have income and access issues. Some, but not primarily, so it still stands. I'm sure you can find similar reasons with vaccine-anxiety. People aren't choosing to be afraid of vaccines "just because", there's something going on that terrifies them. > then you would say "Skiing is a personal choice that everyone deserves to make, and I have no problem with my tax and insurance dollars paying for skiers"? Yes, because that's the principle the system is built on. I mean, I think lots of people somewhat consciously make lots of terrible decisions all the time, and the consequences of their decisions do cost giant sums of money that I have to pay lots of taxes for and that cannot be used for people who face truly accidental hardship (think extreme skiing vs walking and a suitcase dropping from a plane). But we've generally decided that that's totally fine, and I've accepted that and I pay taxes to make sure they don't have to face the consequences of their decisions. We cannot say "that's fine for everything, but not here" if we operate on a principle. It's either "you're on your own" or it's not, but it has to be consistent.
    - ethbr0 5y ago
      > We cannot say "that's fine for everything, but not here" if we operate on a principle We already say that, for smoking. And through mandatory school vaccinations (DTaP, varicella, polio, MMR, meningococcal). Which is a big part of my point. What we claim our system to be (Freedom! With guaranteed care! With equal rights to opt out!) and reality (We won't pay for certain dumb things you do. And we'll give you basic guaranteed care and probably not let you die) are two different things. Which is the main thing that's shredding our health care efficiency in terms of per capita GDP spending.
      - luckylion 5y ago
        > We already say that, for smoking. "We" don't, but maybe you do. I'm from Germany, the only time smoking/alcoholism/substance abuse comes up in a relevant way is when you need a transplant and there are multiple recipients and too few donors. And it's not a punishment for what you previously did, it's because of a prediction of what you're going to do, e.g. an alcoholic who has shown no sign of compliance will probably not get the liver if there's a non-alcoholic who also needs it and does what it takes to get/stay healthy. Deaf people whose condition could be cured/massively improved with implants are free to choose not to, and won't lose their disability status, it doesn't turn into a choice/hobby just because there's a choice in fixing it. I'm not sure that's what makes healthcare in the US so expensive. Again, we do it and we spend significantly less than the US. The country is much more densely populated though, university is free and physicians' income is much closer to the average than in the US.
h3cate 5y ago
I don't think anybody that's unvaccinated wants any restrictions either. So if it was proposed there would be no more restrictions on society would you still turn away unvaccinated people from hospital? Going off your logic they are no longer impacting your freedoms.

pbourke 5y ago

Has there been a flu season in recent history that caused the hospital system to collapse?

nradov 5y ago
Hospitals in some areas were overwhelmed with influenza cases as recently as 2018. https://time.com/5107984/hospitals-handling-burden-flu-patients/ https://time.com/5107984/hospitals-handling-burden-flu-patie...
- ethbr0 5y ago
  For reference, when I looked up the numbers, influenza hospitalizations (estimated, total annual US) vary from around 150,000 to 550,000, depending on the year and strain. So yes, year to year has a lot of variance.

gilbetron 5y ago

Health systems operate by prioritizing, via an imperfect system, patients based on need. If you run a red light and slam into another car, but you're more injured than the other person, you will be prioritized even though you were culpable. I think that is the appropriate, ethical, and practical approach. However, the calculus changes when the health system is at or over capacity. Now, if two people come in and both are critically ill, but you only have room for one, I'm ok with choosing the one that was vaccinated. Likewise with many other situations and illnesses. If you cause a car accident, and both you and the person you hit require the ICU, but there is only one spot open, I'm ok with the person that got hit getting the spot. Now, I'm assuming you are jaded like me and know that actual answer is probably the person with the most money tends to get the treatment, but that's another bitter, cynical discussion.

ethbr0 5y ago
Here's my current level of jade -- listening to repeated stories about hospital staff having to argue with a patient's family (all unvaccinated) about why they can't visit the patient (also unvaccinated) in the COVID ward, when care is being withdrawn due to organ failure. At some point, it's like, "Jesus. Just stop talking, and please let me help you not kill yourself."