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'The People's Hospital' treats uninsured and undocumented
- tetris11 4y agoA free alternative can only drag the prices down of the privatized sector. I wonder if they will go down kicking and screaming, and that this freer alternative will be allowed to thrive.
- maxerickson 4y agoIt's not a free hospital, it's a public hospital that treats people regardless of their ability to pay while still charging people that can pay.
- quickthrower2 4y agoThe same model as silicon valley!
- maxwell 4y agoZuck got the idea from some "books on finance and banking" he read in 2012: "The whole banking industry is based on charging people different rates." https://theguardian.com/technology/2018/dec/05/facebook-emails-analysis-user-data-parliament https://theguardian.com/technology/2018/dec/05/facebook-emai...
- deleted 4y ago[deleted]
- lostlogin 4y agoNo, a pure SV healthcare model would sell your healthcare records to advertisers.
- quickthrower2 4y agoThey would do an end run on HIPAA by serving it up to a machine learning model then sell access to the model.
- p0pcult 4y agoNo, the SV model would be to treat you for free until you have some chronic condition that locks you in, at which point, they pull the "free" rug, and take you for every spare penny (and sometimes more).
- chii 4y agoThis is the worst of both worlds - those who could pay would just go to a private hospital (and pay for the best they can get). This just leaves those who can't pay at the public hospital, incurring the cost and the burden onto the few existing payers.
- anovikov 4y ago[flagged]
- wongarsu 4y agoWhy would it be illegal? If it is where's the line? If I find myself in a first aid situation, do I have to ask for valid ID before initiating CPR?
- csomar 4y agoNot only that but you have to validate the ID too. You know these illegal immigrants use Fake IDs, so you better be sure. If they can't procure an ID, it's better to let a fellow citizen die than take the risk of rescuing an illegal immigrant. s/ of course.
- DoreenMichele 4y agoYou remind me of a comedian I saw years ago say something like "All those illegal immigrants here to take our jobs. I always wanted to be an underpaid farmhand but, no, the illegal immigrants took all those jobs."
- Nextgrid 4y agoThe "taking our jobs argument" is stupid. Since Brexit (and compounded by the pandemic), here in the UK a lot of industries turned to shit because it turns out that 1) the Brits don't actually want those low-paid jobs and 2) immigrants (whether outright illegal or "legal" under EU rules) were critical to a lot of those industries' proper functioning. I'm talking about hospitality, transportation (Uber/etc), basically anything that relies on unskilled labor.
- csomar 4y agoMost people do not understand that raising the prices of these "basic" workers will make these jobs higher paid (for sure) but will also reduce the opportunity (or the size) of the market. If you had 4.000 Uber eats bikers with illegals, then you'd only have 400 without. On the other hand, the 90% of the population (that used the remaining 3.600 bikers) no longer can afford the "Uber Eats" and will no longer have that luxury. Now imagine that for almost everything, and there you have inflation for basic goods.
- DoreenMichele 4y agoMany of the patients here are dealing with serious illnesses as a result of not being able to get access to basic preventive care. This is part of why it matters to make healthcare accessible: It's more expensive to not make it accessible. Ye olde "the horse was lost because the horseshoe was lost because a nail was lost" principle. It's not just that someone has an advanced illness, if they die and now their kid needs additional resources from the welfare system, the rest of us are paying for it. According to this piece, under EMTALA -- he Emergency Medical Treatment & Labor Act passed in the 1980s -- it's not illegal to treat undocumented immigrants.
- Retric 4y agoFrom what I have read preventative medicine has been tried as a cost saving measure and it only seems to reduce costs in dentistry, immunization, and a few other fairly narrow areas. “Prevention can reduce the incidence of disease, but savings may be partially offset by health care costs associated with increased longevity.” https://pubmed.ncbi.nlm.nih.gov/22052182/ https://pubmed.ncbi.nlm.nih.gov/22052182/
- arethuza 4y agoWhat counts as preventative medicine? A few years back I was hospitalised because of a bite on my arm from one of our cats (long story) and was given heavy doses of multiple antibiotics. If that hadn't been treated so promptly I might have required surgery or might even have lost my arm (a nurse told me about someone who lost a leg to a cat bite!). Edit: When I went to the hospital I had no idea how serious it was and turned up to the "Minor Injury Unit" - they had me in A&E and X-rayed within about 10 minutes! Edit: Of course, having been in the hospital for 3 days rather than the expected hour or so I was fretting about car parking charges - turns out they are free at the point of parking....
- Retric 4y agoPreventative medicine is that which is done before significant symptoms. The basic issue, people tend to heal from most things. So the worst case of losing an arm to a cat bite is extremely unlikely. Meanwhile your hospital trip had an cost. Suppose the odds work out to 1:100,000 lost arm vs 300$ hospital treatment. Now a lost arm is expensive but it’s not 30 million dollars expensive. Those numbers aren’t based on anything but that’s the kinds of calculations involved. And as I mentioned the winners seem to be extremely cheap options like vacations.
- itamarst 4y agoIn normal sufficently-rich countries they call this a "hospital".
- hammon 4y ago[dead]
- abujazar 4y agoThat’s how all hospitals work in developed countries.
- Mariehane 4y agoI read an absolutely heart-wrenching excerpt from this book (The People's Hospital) recently in the new yorker. See: https://www.newyorker.com/science/annals-of-medicine/the-assumptions-doctors-make https://www.newyorker.com/science/annals-of-medicine/the-ass... One interesting point it emphasises is just how important insurance coverage is for survival. And that government insurance processes can be rather arbitrary or even injust. I hope this book is successful and that it makes a change towards more equitable healthcare in the United States.
- rqtwteye 4y agoLeadership in the US should be deeply ashamed that such things even exist. Unfortunately there is nothing in sight that would change this anytime soon. Obamacare was screwed up, Medicare For All seems a no-go (Biden should be ashamed for not embracing it), and Congress probably will be busy in the next few years investigating and impeaching each other while not doing anything productive.
- giraffe_lady 4y agoWe didn't even get paid sick leave out of covid we're extremely dedicated to not ever improving this at all.
- rqtwteye 4y agoAnd Biden lost me when the train people were on strike. The whole concept of limited sick leave is already ridiculous but their situation was just crazy.
- pkaye 4y agoNot enough Republicans senators would agree (need 60) for a bill to mandate paid sick leave for the train workers.
- vkou 4y agoThen parade them as the boogieman, fire your friendly press machine on all cylinders, don't just roll over and take the L. ... Or, more likely, the bill went exactly the way he and his backers wanted.
- throwayyy479087 4y ago“We have political opposition” is not a good excuse in a representative system.
- klyrs 4y ago
- programmertote 4y ago> "My cap is 15 patients in one day," Nuila says. "That's compared to some of my colleagues in the private world, who I've heard admit up to 24 patients in one night, or don't carry a cap." Learning from my spouse who is a current medical resident -- some attendings admit and discharge more patients than the capacity because their bonuses are tied to that. That is a twisted incentive and it is in conflict with ACGME's guidelines of not letting residents handle more than 10 patients at a time. The attending/hospitalist at my wife's hospital makes $420K/year + bonus (it's near Miami, FL). They work 8-hours shift for 7 days and then rest 7 days. If one chooses to, s/he can moonlight at another place (a senior friend of my wife works for a hospital in Palmdale, CA and another one nearby for 7 days each; she easily bags $600K/year; she is raking in money when she can work this much while buying houses, and she plans to work half as much in a few years). I also wonder if hospitals like "The People's Hospital" make patients sign waiver to not sue them. At my wife's hospital, some of the patients (and/or their families) are obviously angling for lawsuit and are always looking for excuses to do that. That legal/liability burden (among may other things like doctor's salaries; bloated administration; etc.) is part of the reasons why hospital bills are exorbitant.
- vkou 4y agoTexas did tort reform, severely capping doctor liability and damages, and to the surprise of nobody, healthcare didn't get any cheaper there.
- aftbit 4y agoThat's actually a little bit surprising to me. I have some family friends who are doctors (one's a dermatologist, the other an internist). They each pay somewhere around $50k per year in malpractice insurance premiums. Now sure, in the grand scheme of things, the 50k extra your doctor demands is likely not transformative for health care costs, but I also wouldn't imagine it is nothing.
- vkou 4y agoIn a transparent market, the theory of 'reduce costs' -> 'cheaper healthcare' might hold, but the healthcare market is anything but transparent. If my doctor can save money on something, he's not going to pass in on to me in the form of lower costs. Why would he? I don't pay my doctor! Three months after I visit him, I get a bill from my insurer for some co-pay that's a tiny fraction of what the doctor billed them. I'm assuming the savings were happily eaten by doctors' wages/hospital shareholders/admins/insurers. Meanwhile, the patients got to deal with gems like this[1] doctor. Healthcare seems to be much like rent in a supply-constrained environment, in that it is doing its best to siphon up all surplus funds sloshing around the economy. [1] https://www.propublica.org/article/dr-death-christopher-duntsch-a-surgeon-so-bad-it-was-criminal https://www.propublica.org/article/dr-death-christopher-dunt... - the hospitals didn't care that he was butchering his patients, because they get money per surgery performed, not per successful surgery performed. The patients had no recourse, thanks to tort reform. The doctor himself didn't care. He shuffled around from hospital to hospital (who welcomed a rainmaker that brings more business in with open arms), maiming people, until his negligence reached criminal levels.
- saul_goodman 4y agoI think people completely miss the point that this further enables a caste system in the US. You have an entire class of people who have almost no rights who live and work in this country. Any politician that makes it easier for illegal immigrants to survive in this country is NOT doing it out of the goodness of their heart. It's a calculated move to further abuse a class of people who can be completely abused without recourse. Does no one stop to wonder why the government is actively hindering border states from enforcing their international borders after 20+ years of a war on terrorism? Why are these people coming to the US in such high numbers now full-well knowing they will be abused here? Look up the School of the Americas and who their list of graduates include. https://wikispooks.com/wiki/School_of_the_Americas https://wikispooks.com/wiki/School_of_the_Americas
- renewiltord 4y agoTake doctors out of the loop and let me prescribe with the Internet as my guide and I will save more lives in America than I will harm. Access is everything.
- shanty 4y agoSuper interesting idea. I can't seem to find out how they actually operate though. It seems like this would be prone to general abuse with if an individual electing little/no/catastrophic coverage while also using this resource...or do they ask for W2s to verify eligibility?
- interactivecode 4y agoAgain why do we need hospitals to make money? Aren't national expenses like healthcare a good place to use taxes for?
- luckylion 4y agoBecause we don't want them to be bureaucracies that grow and grow without providing increasingly good service. If you can solve the problem of state agencies becoming insanely inefficient (mostly due to lack of incentive to be efficient, I suppose), you'll make everyone happy.
- jonas21 4y agoWe don't need them to. 62% of hospitals in the US are non-profit, and an additional 20% are run by the government. Only 18% are for-profit. In some states, like New York and Minnesota, there are no for-profit hospitals.
- verall 4y agoTons of people getting rich as fuck at those non-profit hospitals though.
- twblalock 4y agoYes, if you want good people you have to pay market rates. Some people in the medical profession may be willing to work for less money for a charitable cause, but not enough to run entire hospital systems.
- burkaman 4y agoNon-profit doesn't mean you don't make a profit, and doesn't mean you behave more ethically than for-profit hospitals. Example: https://www.propublica.org/article/methodist-le-bonheur-healthcare-sues-poor-medical-debt https://www.propublica.org/article/methodist-le-bonheur-heal...
- dghughes 4y agoI'm not in the US and it is staggering to see how much one hospital take in just one single hospital. Tisch Hospital New York NY Net patient revenue 2022 $6,273,707,636
- esalman 4y agoOutside of the US this is pretty much how most hospitals operate. You get through the door, you get care.
- s1artibartfast 4y agoThis is not how it works in any country on the planet. You do not walk through the door and get unlimited care of all types and for all diseases. Different countries have different methods for deciding who gets what care, and when they are cut off. You can argue which are better than others, but nowhere is it an all you can consume Buffet
- noodlesUK 4y agoI think what you're trying to say is that there are always limits to what care is available, and that the best possible care is not always provided due to resource constraints. There are of course always methods for determining who gets care, but at least as far as the UK goes, anyone who is legally resident in the UK can walk into a hospital and get largely the same healthcare as anyone else. If you're not legally resident in the UK (i.e., you're a visitor or undocumented), you will receive emergency care and primary care without charge, and you will only be charged if you're admitted to hospital. Many countries (including the EU) have arrangements so that their citizens/residents won't be charged even in those circumstances. Almost every developed country on the planet other than the US has universal healthcare. The notion that you will be cut off because you can't pay is the exception not the rule.
- 908B64B197 4y ago> There are of course always methods for determining who gets care, but at least as far as the UK goes, anyone who is legally resident in the UK can walk into a hospital and get largely the same healthcare as anyone else. They are allowed the privilege of a multi-year waiting list for basic procedures (unless they happen to be high enough socially to rub elbows with doctors.)
- 4y ago
- 29athrowaway 4y agoRegular hospitals too. If there's an emergency they have to be admitted. They just won't pay later.
- aristofun 4y agoThis is so clickbait to not mention a city or at least a country in such a post. Shame on you
- blippies 4y ago[flagged]