5 ms·

Didn't read the article and don't know about what nefarious things may be going on, but we need to think broader about these issues. There's lots of articles he

by jmugan 4y ago

Didn't read the article and don't know about what nefarious things may be going on, but we need to think broader about these issues. There's lots of articles here on hacker news about how the vast majority of medical expenses come at the end of life and how we do too much to keep people alive against their wishes.

kerkeslager 4y ago
> Didn't read the article Then don't comment. It's not complicated. > There's lots of articles here on hacker news about how the vast majority of medical expenses come at the end of life and how we do too much to keep people alive against their wishes. Jesus Christ. Let me get this straight: you're saying the solution to medical expenses is "let old people die, they don't want to live anyway"? There are certainly cases where people are kept alive beyond what's compassionate, but that's a pretty separate cultural problem from the situation at hand, which is people who need basic care and can't get it because of capitalism being involved where it shouldn't be.
- jmugan 4y ago
  Come on, we can't be children. I'm saying we need a conversation as a society about how we are going to handle end of life. We can't lurch form unthinking outrage to unthinking outrage.
  - kerkeslager 4y ago
    True, but I'm not interested in hearing the opinion of companies in that conversation. When I and my loved ones are reaching end of life, what decisions we make should be a conversation between me, my loved ones, and my doctor. Whether it's humane to pursue life-extension should be a part of that conversation, sure, but I trust my doctor to present that viewpoint: people who profit from that viewpoint and don't know anything else about the situation (such as Medicare Advantage providers) are welcome to fuck right off. The reason our society keeps lurching from unthinking outrage to unthinking outrage is that people like you who can't be arsed to read an article and respond on topic keep proposing outrageous changes to our society. If you don't like unthinking outrage, maybe be more thoughtful and stop saying outrageous things.
    - jmugan 4y ago
      I agree that medical care should be run by the state. I would prefer that to our current system. I don't think its worth us talking any more since we don't seem to be learning from each other.
      - kerkeslager 4y ago
        > I agree that medical care should be run by the state. ...which is largely irrelevant, because the state should also not be involved in the conversation about whether pursuing life-extending care is humane. > I don't think its worth us talking any more since we don't seem to be learning from each other. Nobody involved in internet disagreements learns from each other typically. I approach internet disagreements with the idea that non-participants reading the disagreement can learn from it. That is, outrageous viewpoints like yours should not go unchallenged because that normalizes them. If you want to stop representing your viewpoint to readers, you're welcome to, but you can drop the smug superiority about it. If you want conversations to learn and educate, you might start by reading the articles you're responding to.
  - jewayne 4y ago
    Before we have this conversation, let's first agree on one thing. Let's all agree on the fact that health care is not actually exorbitantly expensive. That "health care costs" are not what's out of control in the US, what are out of control are health care PRICES. And that those prices lost virtually all relationship to the cost of providing services DECADES ago. Americans already use fewer health services than most other industrialized countries, but we still spend way more than anybody else. Will using fewer health services at end of life make a serious dent in health expenditures? Maybe temporarily, but rest assured the hospitals, big pharma, insurance companies and others will raise prices until all those savings are eaten away, and more. Make no mistake, I am totally for end of life planning, but I believe it is a completely separate question entirely.
    - jmugan 4y ago
      That's a useful distinction. I've never been able to understand where the prices come from, and my sister is an ER doctor. I'm surprised that these basic facts are so hard to come by. I read articles that say, well, healthcare prices aren't high because of X, where X is just about anything I can think of.
      - jewayne 4y ago
        This article is a good place to start: https://time.com/198/bitter-pill-why-medical-bills-are-killing-us/ https://time.com/198/bitter-pill-why-medical-bills-are-killi... When it came out 10 years ago, it answered questions that I'd had for the previous 15 years.
    - HDThoreaun 4y ago
      Don't agree. Americans recieve an absurd amount of end of life care. In many, many case outcomes would be improved by putting people in hospice instead of invasive surgery that increase their lifespan by maybe a year. Our medical system discourages preventative care which is much more cost effective, but in the end we need to say no to many more end of life procedures.
      - 4y ago
- cr1895 4y ago
  > Jesus Christ. Let me get this straight: you're saying the solution to medical expenses is "let old people die, they don't want to live anyway"? That’s quite an uncharitable take, and plainly not what they meant to express.
  - kerkeslager 4y ago
    Well, I don't hear you offering an alternative interpretation that sounds plausible. And critically, the person I was responding to, responded back to me, and didn't disagree with my interpretation, so... Startup culture's brand of charitable interpretation glosses over a lot of anarcho-capitalistic sociopathy and I'm not interested in participating in that. Perhaps if you were more interested in actual charitable action such as making sure seniors' medical expenses are paid rather than charitable interpretation, this place would be a bit less toxic.
    - jmugan 4y ago
      Your interpretation is too off the mark require an explicit response.
      - kerkeslager 4y ago
        If you don't want to participate in a discussion you don't have to respond. If you think my interprepation is wrong, feel free to explain, otherwise we can only conclude that it wasn't wrong, and you just don't want to have to defend your indefensible idea.
    - potatoman22 4y ago
      My take: many people spend $$$ at the end of their life to receive aggressive treatment that ultimately doesn't do much. Palliative care is underutilized -- it's lower cost and results in a higher quality of life [1]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610551/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610551/ Other interesting articles: https://www.nursing.upenn.edu/details/news.php?id=848 https://www.nursing.upenn.edu/details/news.php?id=848 https://med.stanford.edu/news/all-news/2014/05/most-physicians-would-forgo-aggressive-treatment-for-themselves-.html https://med.stanford.edu/news/all-news/2014/05/most-physicia...

by jmugan 4y ago

kerkeslager 4y ago

> Didn't read the article Then don't comment. It's not complicated. > There's lots of articles here on hacker news about how the vast majority of medical expenses come at the end of life and how we do too much to keep people alive against their wishes. Jesus Christ. Let me get this straight: you're saying the solution to medical expenses is "let old people die, they don't want to live anyway"? There are certainly cases where people are kept alive beyond what's compassionate, but that's a pretty separate cultural problem from the situation at hand, which is people who need basic care and can't get it because of capitalism being involved where it shouldn't be.

jmugan 4y ago
Come on, we can't be children. I'm saying we need a conversation as a society about how we are going to handle end of life. We can't lurch form unthinking outrage to unthinking outrage.
- kerkeslager 4y ago
  True, but I'm not interested in hearing the opinion of companies in that conversation. When I and my loved ones are reaching end of life, what decisions we make should be a conversation between me, my loved ones, and my doctor. Whether it's humane to pursue life-extension should be a part of that conversation, sure, but I trust my doctor to present that viewpoint: people who profit from that viewpoint and don't know anything else about the situation (such as Medicare Advantage providers) are welcome to fuck right off. The reason our society keeps lurching from unthinking outrage to unthinking outrage is that people like you who can't be arsed to read an article and respond on topic keep proposing outrageous changes to our society. If you don't like unthinking outrage, maybe be more thoughtful and stop saying outrageous things.
  - jmugan 4y ago
    I agree that medical care should be run by the state. I would prefer that to our current system. I don't think its worth us talking any more since we don't seem to be learning from each other.
    - kerkeslager 4y ago
      > I agree that medical care should be run by the state. ...which is largely irrelevant, because the state should also not be involved in the conversation about whether pursuing life-extending care is humane. > I don't think its worth us talking any more since we don't seem to be learning from each other. Nobody involved in internet disagreements learns from each other typically. I approach internet disagreements with the idea that non-participants reading the disagreement can learn from it. That is, outrageous viewpoints like yours should not go unchallenged because that normalizes them. If you want to stop representing your viewpoint to readers, you're welcome to, but you can drop the smug superiority about it. If you want conversations to learn and educate, you might start by reading the articles you're responding to.
- jewayne 4y ago
  Before we have this conversation, let's first agree on one thing. Let's all agree on the fact that health care is not actually exorbitantly expensive. That "health care costs" are not what's out of control in the US, what are out of control are health care PRICES. And that those prices lost virtually all relationship to the cost of providing services DECADES ago. Americans already use fewer health services than most other industrialized countries, but we still spend way more than anybody else. Will using fewer health services at end of life make a serious dent in health expenditures? Maybe temporarily, but rest assured the hospitals, big pharma, insurance companies and others will raise prices until all those savings are eaten away, and more. Make no mistake, I am totally for end of life planning, but I believe it is a completely separate question entirely.
  - jmugan 4y ago
    That's a useful distinction. I've never been able to understand where the prices come from, and my sister is an ER doctor. I'm surprised that these basic facts are so hard to come by. I read articles that say, well, healthcare prices aren't high because of X, where X is just about anything I can think of.
    - jewayne 4y ago
      This article is a good place to start: https://time.com/198/bitter-pill-why-medical-bills-are-killing-us/ https://time.com/198/bitter-pill-why-medical-bills-are-killi... When it came out 10 years ago, it answered questions that I'd had for the previous 15 years.
  - HDThoreaun 4y ago
    Don't agree. Americans recieve an absurd amount of end of life care. In many, many case outcomes would be improved by putting people in hospice instead of invasive surgery that increase their lifespan by maybe a year. Our medical system discourages preventative care which is much more cost effective, but in the end we need to say no to many more end of life procedures.
    - 4y ago
cr1895 4y ago
> Jesus Christ. Let me get this straight: you're saying the solution to medical expenses is "let old people die, they don't want to live anyway"? That’s quite an uncharitable take, and plainly not what they meant to express.
- kerkeslager 4y ago
  Well, I don't hear you offering an alternative interpretation that sounds plausible. And critically, the person I was responding to, responded back to me, and didn't disagree with my interpretation, so... Startup culture's brand of charitable interpretation glosses over a lot of anarcho-capitalistic sociopathy and I'm not interested in participating in that. Perhaps if you were more interested in actual charitable action such as making sure seniors' medical expenses are paid rather than charitable interpretation, this place would be a bit less toxic.
  - jmugan 4y ago
    Your interpretation is too off the mark require an explicit response.
    - kerkeslager 4y ago
      If you don't want to participate in a discussion you don't have to respond. If you think my interprepation is wrong, feel free to explain, otherwise we can only conclude that it wasn't wrong, and you just don't want to have to defend your indefensible idea.
  - potatoman22 4y ago
    My take: many people spend $$$ at the end of their life to receive aggressive treatment that ultimately doesn't do much. Palliative care is underutilized -- it's lower cost and results in a higher quality of life [1]. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610551/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610551/ Other interesting articles: https://www.nursing.upenn.edu/details/news.php?id=848 https://www.nursing.upenn.edu/details/news.php?id=848 https://med.stanford.edu/news/all-news/2014/05/most-physicians-would-forgo-aggressive-treatment-for-themselves-.html https://med.stanford.edu/news/all-news/2014/05/most-physicia...