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> 1. The ICU is filled with old people... Pretty much all these patients are on Medicare, which means your taxpayers dollars are making this happen. This ignor
by fernly 4y ago
> 1. The ICU is filled with old people... Pretty much all these patients are on Medicare, which means your taxpayers dollars are making this happen.
This ignores the (I think) very strong possibility that the old people are preferentially selected by the system because, thanks to Medicare, they can _afford_ the ICU. Many people aged less than 65 cannot. Consider the idea that if we had something like "Medicare for all", the population of the ICU would better reflect normal demographics.
That said, as a beneficiary of Medicare I can only be grateful. I had several days in a top-quality hospital and a procedure by a top-quality surgeon, and after all the EOBs had come in, I ended paying out of pocket... nothing at all.
- ericmcer 4y agoOld people having more health issues is not really a crazy observation to make. I would be blown away if medical care needed was equal across all ages.
- fernly 4y agoIt wouldn't be. Clearly age brings medical problems. However, I'm saying that the cheap access to hospital care afforded by Medicare, could be skewing the distribution of ICU patients. If we had universal medical insurance comparable to Medicare, the ICU population might be closer to the demographic norm.
- ghufran_syed 4y agoability to afford the ICU is not relevant at all when the docs decide to put someone there or not, based on my 14 years practicing in the US. Do you have any experience to the contrary? I’m pretty sure that would be illegal in the US
- fernly 4y agoA very quick DDG search turns up stories from reputable outlets: "Americans dying because they can't afford medical care"[1], "66% of Americans fear they won’t be able to afford health care this year"[2], "Nearly 46m Americans would be unable to afford quality healthcare in an emergency"[3], "Nearly 1 in 4 Americans are skipping medical care because of the cost"[4], and more are easily found. If this doesn't reflect people avoiding hospitals, or leaving early AMA, and thus reducing the number of pre-Medicare patients by some amount, I'd be very surprised. [1] https://www.theguardian.com/us-news/2020/jan/07/americans-healthcare-medical-costs https://www.theguardian.com/us-news/2020/jan/07/americans-he... [2] https://www.cnbc.com/2021/01/05/americans-fear-they-wont-be-able-to-pay-for-health-care-this-year.html https://www.cnbc.com/2021/01/05/americans-fear-they-wont-be-... [3] https://www.theguardian.com/us-news/2021/mar/31/us-affordable-healthcare-uninsured-underinsured https://www.theguardian.com/us-news/2021/mar/31/us-affordabl... [4] https://www.cnbc.com/2020/03/11/nearly-1-in-4-americans-are-skipping-medical-care-because-of-the-cost.html https://www.cnbc.com/2020/03/11/nearly-1-in-4-americans-are-...
- ghufran_syed 4y agoThat’s the patient choosing not to go to the doctor - how is that the ICU doctor’s responsibility? Are they meant to scour the streets looking for people who need intensive care?
- halper 4y agoHaving experience from emergency departments in two different countries with "Medicare for all", it seems pretty much the same everywhere. There are two cohorts that make up the frequent flyers: the old and the drunk/addicts. The former get sick often and when they get sick they don't recover well; the latter end up in problematic situations like falling asleep outside in winter, getting in fights, overdosing or similar.