5 ms·

> Lack of access to basic health care the number of Americans with health insurance is at a historic high, Biden bragged about it on Twitter last week it does

by newaccount2021 4y ago

> Lack of access to basic health care the number of Americans with health insurance is at a historic high, Biden bragged about it on Twitter last week it doesn't matter if you go to the doctor...if you don't take the doctor's advice and eat better + exercise...

malauxyeux 4y ago
> advice I was under the impression that doctors were getting sheepish about giving such advice in the US. Patients don't like to hear it. And overweight patients require more and more expensive treatments over the course of their lives, creating a perverse incentive in a for-profit healthcare system.
- throwaway0a5e 4y ago
  >I was under the impression that doctors were getting sheepish about giving such advice in the US. Patients don't like to hear it. Seems like doctors either tell people to lose weight to cure an ear infection or they don't say anything about weight ever because the outcomes are poor so why bother. >creating a perverse incentive in a for-profit healthcare system. Normally private insurers would dump these kinds of people (perhaps leaving them for some government insurer to deal with if such exists). But in a world where insurers' profit margin is regulated to a fixed percentage of the money that flows through insurers they are valuable people to have around.
  - bobthepanda 4y ago
    Medical staff now get personal satisfaction scores from patients at some hospitals, so now there is also a huge tension about telling patients things they don’t like. Anecdotally, this was a big reason many of my friends left medicine and nursing.
  - watwut 4y ago
    > Seems like doctors either tell people to lose weight to cure an ear infection or they don't say anything about weight ever because the outcomes are poor so why bother. Pretty much. But larger thing is that ... doctors are not nutritionists nor lifestyle experts. They do know their own specialization very well, but they are not able to make people loose weight. They do not have evidence based well know strategies of the "we know that this program/advice makes x% of people to make loose weight long term" sort. Usually, what patient gets is general advice of "eating less" followed by some unsustainable diet that is necessary going to fail and just lead to yoyo cycle. By unsustainable I mean the sort if diet that leads to malnutrition of some sort due to missing stuff your body needs or the one that is too low in calories making the person following it unable to function normally.
bastawhiz 4y ago
> the number of Americans with health insurance is at a historic high, Biden bragged about it on Twitter last week I have "good" insurance through my employer. Over the summer I had appendicitis. The cost of the surgery and hospital stay after insurance would have bankrupted my brother and put any of my cousins in substantive medical debt. It would have been nearly a fifth of my retired mother's net worth. Having insurance is great because it makes lots of care attainable, but it's a vast overstatement to say that having it gives you access to basic care. A majority of Americans have less than $1000 in savings—that's not even an ambulance ride.
- lotsofpulp 4y ago
  FYI, out of pocket maximum in the US is $8,400 for an individual for a calendar year. If the appendicitis happened Dec 31, and treatment was received across 2 calendar years, then two years worth of oop max would apply, so $16,800. https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...
  - deleted 4y ago
    [deleted]
  - BigRedDog1669 4y ago
    I used to be me worried until I realized about the out of pocket maximum. But I'm still not sure how it works in practice. Are there ways that hospitals could charge for things that are considered separate from that number, like out of network or not covered things in the insurance plan? There always seem to be extra charges from what the health plans advertise, so I hesitate to trust their out of pocket maximum too.
    - lotsofpulp 4y ago
      The big risk used to be getting billed by an out of network provider while you are at an in network facility. Such as getting a surprise bill for $10k from an anesthesiologist that you had no idea was out of network since you thought your hospital was in network and there was no need or ability to check. But as of Jan 1, 2022 that is no longer a concern: https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bills https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bill... The other concern was getting out of network care due to an emergency where you cannot choose in network care, but that is also no longer a concern per above link. I have had two child births in the past 6 years, and both years we hit our family oop max (~$5k), and after that, we did not have to pay a cent. We took the opportunity to get a whole bunch of healthcare like seeing an ENT, dermatologist, vasectomy, physical therapy to recover from childbirth, etc and all were fully paid for. I always use the insurer’s website to find in network providers, and I can even get a procedure/diagnosis code and get estimated costs before a visit.
baby 4y ago
These health insurances you get in the US are horrible because you can easily pay hundreds of dollars if you go to the doctor depending on your plan. There’s a minimum you need to spend from your own pocket before the insurance starts covering you. For this reason many (most?) people who are insured still do not visit their doctor.
gadders 4y ago
As (I think) the comedian Jimmy Carr said - "Life is like a box of chocolates. Neither last long if you are obese."

malauxyeux 4y ago

> advice I was under the impression that doctors were getting sheepish about giving such advice in the US. Patients don't like to hear it. And overweight patients require more and more expensive treatments over the course of their lives, creating a perverse incentive in a for-profit healthcare system.

throwaway0a5e 4y ago
>I was under the impression that doctors were getting sheepish about giving such advice in the US. Patients don't like to hear it. Seems like doctors either tell people to lose weight to cure an ear infection or they don't say anything about weight ever because the outcomes are poor so why bother. >creating a perverse incentive in a for-profit healthcare system. Normally private insurers would dump these kinds of people (perhaps leaving them for some government insurer to deal with if such exists). But in a world where insurers' profit margin is regulated to a fixed percentage of the money that flows through insurers they are valuable people to have around.
- bobthepanda 4y ago
  Medical staff now get personal satisfaction scores from patients at some hospitals, so now there is also a huge tension about telling patients things they don’t like. Anecdotally, this was a big reason many of my friends left medicine and nursing.
- watwut 4y ago
  > Seems like doctors either tell people to lose weight to cure an ear infection or they don't say anything about weight ever because the outcomes are poor so why bother. Pretty much. But larger thing is that ... doctors are not nutritionists nor lifestyle experts. They do know their own specialization very well, but they are not able to make people loose weight. They do not have evidence based well know strategies of the "we know that this program/advice makes x% of people to make loose weight long term" sort. Usually, what patient gets is general advice of "eating less" followed by some unsustainable diet that is necessary going to fail and just lead to yoyo cycle. By unsustainable I mean the sort if diet that leads to malnutrition of some sort due to missing stuff your body needs or the one that is too low in calories making the person following it unable to function normally.

bastawhiz 4y ago

> the number of Americans with health insurance is at a historic high, Biden bragged about it on Twitter last week I have "good" insurance through my employer. Over the summer I had appendicitis. The cost of the surgery and hospital stay after insurance would have bankrupted my brother and put any of my cousins in substantive medical debt. It would have been nearly a fifth of my retired mother's net worth. Having insurance is great because it makes lots of care attainable, but it's a vast overstatement to say that having it gives you access to basic care. A majority of Americans have less than $1000 in savings—that's not even an ambulance ride.

lotsofpulp 4y ago
FYI, out of pocket maximum in the US is $8,400 for an individual for a calendar year. If the appendicitis happened Dec 31, and treatment was received across 2 calendar years, then two years worth of oop max would apply, so $16,800. https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...
- deleted 4y ago
  [deleted]
- BigRedDog1669 4y ago
  I used to be me worried until I realized about the out of pocket maximum. But I'm still not sure how it works in practice. Are there ways that hospitals could charge for things that are considered separate from that number, like out of network or not covered things in the insurance plan? There always seem to be extra charges from what the health plans advertise, so I hesitate to trust their out of pocket maximum too.
  - lotsofpulp 4y ago
    The big risk used to be getting billed by an out of network provider while you are at an in network facility. Such as getting a surprise bill for $10k from an anesthesiologist that you had no idea was out of network since you thought your hospital was in network and there was no need or ability to check. But as of Jan 1, 2022 that is no longer a concern: https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bills https://www.cms.gov/nosurprises/Ending-Surprise-Medical-Bill... The other concern was getting out of network care due to an emergency where you cannot choose in network care, but that is also no longer a concern per above link. I have had two child births in the past 6 years, and both years we hit our family oop max (~$5k), and after that, we did not have to pay a cent. We took the opportunity to get a whole bunch of healthcare like seeing an ENT, dermatologist, vasectomy, physical therapy to recover from childbirth, etc and all were fully paid for. I always use the insurer’s website to find in network providers, and I can even get a procedure/diagnosis code and get estimated costs before a visit.

baby 4y ago

These health insurances you get in the US are horrible because you can easily pay hundreds of dollars if you go to the doctor depending on your plan. There’s a minimum you need to spend from your own pocket before the insurance starts covering you. For this reason many (most?) people who are insured still do not visit their doctor.

gadders 4y ago

As (I think) the comedian Jimmy Carr said - "Life is like a box of chocolates. Neither last long if you are obese."