4 ms·

This is the reason we need universal public healthcare.

luckylion 4y ago
That won't help you there. Germany's public healthcare system denies plenty of things too, and will only pay for treatment when you sue (or know someone who works there). Germany's private healthcare system on the other hand is usually better (I'm sure there are exceptions and some insurance company that sucks).
- hestefisk 4y ago
  You can have good public healthcare without the need of the notion of 'claims'. The Scandinavian healthcare system is a good example (https://en.wikipedia.org/wiki/Healthcare_in_Denmark https://en.wikipedia.org/wiki/Healthcare_in_Denmark).
  - firstlink 4y ago
    > The central government plays a relatively limited role in health care in Denmark. So the exact opposite of what people usually mean when they say they want public healthcare. Words mean something.
    - theossuary 4y ago
      Public healthcare means health care paid for via public funds, nothing more. Many public health care systems aren't entirely centralized, even though they use public funds. For example even the UK's NHS has regions with allocated budgets they manage based on the number of patients they see, which they then spend as they see fit. You're trying to attach your biases and assumptions onto an amorphous phrase, and then pretend others are using it wrong because they don't have the same expectations. That isn't reasonable.
    - hestefisk 4y ago
      I am of Danish origin and stating that the central government has a limited role in healthcare is just downright incorrect. The Ministry of Health (Sundhedsstyrelsen) sets the budget, determines national practices, manages the public health insurance scheme, and manages the list of approved medicines. Yes, execution of healthcare is with the regions, but there has been a significant increase in centralisation of healthcare since the “amter” were disbanded.
  - marginalia_nu 4y ago
    Eh, my experience with health care in Sweden last couple of years is that almost no matter what your issue is, they'll ask what meds you are on, take your blood pressure, and some token blood samples and send you home. This costs $20. This process obviously does nothing to alleviate any medical issue, so you come back a few weeks later. You pay your $20. New doctor this time, who asks what meds you are on, takes your blood pressure and orders the same tests. Obviously testing the same thing a second time didn't further the investigation. So you go back. You pay your $20. Yet another doctor this time, who asks what meds you are on, takes your blood pressure and orders the same goddamn tests. Rinse and repeat. I've had like five of these contacts the last few years. Starting to look like a heroin junkie from all the blood samples. I've never learned of any test results. Just keep taking the same tests over and over. There is just zero continuity.
    - colinmorelli 4y ago
      This anecdote may be true, but Sweden has significantly more favorable health outcomes across most dimensions compared to the US. Infant mortality, in-hospital mortality, etc. In fact, most developed nations do. But part of what makes it so difficult to have a productive conversation about healthcare is that everyone has experience with the system in every single country, and bad experiences get passed around. So we say X country is doing better, and someone chimes in explaining how that country has its flaws. They all have their flaws. But the US health system is measurably worse than most other developed nations across most axes that we care about. Though there are interesting questions about how much worse per-capita healthcare spend actually is given the comparatively higher R&D investment in the US.
      - refurb 4y ago
        Infant mortality rates aren't calculated the same in every country. I have no idea if Sweden does it differently than the US, but Cuba's low infant mortality compared to other Central American countries disappears when you calculate them all the same way. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681443/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681443/
  - speedgoose 4y ago
    The Norwegian public healthcare is great. The default recommendation to most health issue is to do more sport. Being very physically active usually helps, so it’s not a bad recommendation. You may experience more pain compared to some other healthcare systems. Like France from my experience and probably USA from what I read. I had some unforgettable experiences in Norway, such as a colonoscopy without sedation or anaesthesia in case I can tolerate the pain. I didn’t after a while. Or some little operation that according to the English Wikipedia is done under general anaesthesia in USA. The doctor in my local small emergency room simply told me that the needle for a local anesthesia would be as painful as the operation so it’s unnecessary. She then asked a large nurse to hold me and I was given instructions about how to breathe. I think the doctor may have lied about the pain. But I pay between $20 and $40 per visit and I don’t have to pay if it accumulates more than $300 per year. It’s also not connected to my work, I can be fired and still have the same healthcare benefits, forever.
    - kwhitefoot 4y ago
      > I had some unforgettable experiences in Norway, such as a colonoscopy without sedation or anaesthesia in case I can tolerate the pain. What pain? I have had a colonoscopy without any sedation, also in Norway. It was uncomfortable, occasionally very, but I wouldn't have called it painful. I think you must have encountered an incompetent doctor. Can't imagine why you would want general anaesthesia unless it was strictly necessary as it gives an additional risk of dying.
      - cameronh90 4y ago
        Arguing over whether something is painful or merely very uncomfortable seems like splitting hairs. That said, I had a colonoscopy with alprazolam and fentanyl, and it was, if anything, a moderately enjoyable experience. There was the odd slightly painful moment as they went round corners, but the drugs made me feel great throughout and I walked home afterwards with a mild afterglow. However, while I personally certainly wouldn't have requested general anaesthesia, I think it should be down to patient choice. I'm from the UK, and we often take a clench your teeth and bear it attitude to patient suffering, which I think can often be borderline inhumane. Ultimately if a patient wants to accept a 0.001% chance of dying to avoid experiencing pain or discomfort, mental or physical, that is up to them. You also have to consider the second order effects of people avoiding treatment due to fear of pain, as well as people who may have been raped or otherwise have very valid reasons to not want to experience having something inserted into their rectum.
  - refurb 4y ago
    Every system has a list of approved and unapproved medicines. Every system. The one benefit (I guess) of universal coverage is that doctors already know the unapproved medicines won't get paid for, so they never try. So you avoid the whole issue of rejections. They just go with whatever the system says it will pay for.
- p_l 4y ago
  Having worked tangentially on AI that approved payments for outpatient ops for one of the companies involved in handling German health system... The very basic design goal was that the AI system could only approve, not reject. The goal was that obvious cases should be auto-approved, and anything where the AI returned below a certain confidence value was booted back to human to make a decision (same as pre-AI). So at least you get that.
ourmandave 4y ago
[flagged]

That won't help you there. Germany's public healthcare system denies plenty of things too, and will only pay for treatment when you sue (or know someone who works there). Germany's private healthcare system on the other hand is usually better (I'm sure there are exceptions and some insurance company that sucks).

hestefisk 4y ago
You can have good public healthcare without the need of the notion of 'claims'. The Scandinavian healthcare system is a good example (https://en.wikipedia.org/wiki/Healthcare_in_Denmark https://en.wikipedia.org/wiki/Healthcare_in_Denmark).
- firstlink 4y ago
  > The central government plays a relatively limited role in health care in Denmark. So the exact opposite of what people usually mean when they say they want public healthcare. Words mean something.
  - theossuary 4y ago
    Public healthcare means health care paid for via public funds, nothing more. Many public health care systems aren't entirely centralized, even though they use public funds. For example even the UK's NHS has regions with allocated budgets they manage based on the number of patients they see, which they then spend as they see fit. You're trying to attach your biases and assumptions onto an amorphous phrase, and then pretend others are using it wrong because they don't have the same expectations. That isn't reasonable.
  - hestefisk 4y ago
    I am of Danish origin and stating that the central government has a limited role in healthcare is just downright incorrect. The Ministry of Health (Sundhedsstyrelsen) sets the budget, determines national practices, manages the public health insurance scheme, and manages the list of approved medicines. Yes, execution of healthcare is with the regions, but there has been a significant increase in centralisation of healthcare since the “amter” were disbanded.
- marginalia_nu 4y ago
  Eh, my experience with health care in Sweden last couple of years is that almost no matter what your issue is, they'll ask what meds you are on, take your blood pressure, and some token blood samples and send you home. This costs $20. This process obviously does nothing to alleviate any medical issue, so you come back a few weeks later. You pay your $20. New doctor this time, who asks what meds you are on, takes your blood pressure and orders the same tests. Obviously testing the same thing a second time didn't further the investigation. So you go back. You pay your $20. Yet another doctor this time, who asks what meds you are on, takes your blood pressure and orders the same goddamn tests. Rinse and repeat. I've had like five of these contacts the last few years. Starting to look like a heroin junkie from all the blood samples. I've never learned of any test results. Just keep taking the same tests over and over. There is just zero continuity.
  - colinmorelli 4y ago
    This anecdote may be true, but Sweden has significantly more favorable health outcomes across most dimensions compared to the US. Infant mortality, in-hospital mortality, etc. In fact, most developed nations do. But part of what makes it so difficult to have a productive conversation about healthcare is that everyone has experience with the system in every single country, and bad experiences get passed around. So we say X country is doing better, and someone chimes in explaining how that country has its flaws. They all have their flaws. But the US health system is measurably worse than most other developed nations across most axes that we care about. Though there are interesting questions about how much worse per-capita healthcare spend actually is given the comparatively higher R&D investment in the US.
    - refurb 4y ago
      Infant mortality rates aren't calculated the same in every country. I have no idea if Sweden does it differently than the US, but Cuba's low infant mortality compared to other Central American countries disappears when you calculate them all the same way. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681443/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681443/
- speedgoose 4y ago
  The Norwegian public healthcare is great. The default recommendation to most health issue is to do more sport. Being very physically active usually helps, so it’s not a bad recommendation. You may experience more pain compared to some other healthcare systems. Like France from my experience and probably USA from what I read. I had some unforgettable experiences in Norway, such as a colonoscopy without sedation or anaesthesia in case I can tolerate the pain. I didn’t after a while. Or some little operation that according to the English Wikipedia is done under general anaesthesia in USA. The doctor in my local small emergency room simply told me that the needle for a local anesthesia would be as painful as the operation so it’s unnecessary. She then asked a large nurse to hold me and I was given instructions about how to breathe. I think the doctor may have lied about the pain. But I pay between $20 and $40 per visit and I don’t have to pay if it accumulates more than $300 per year. It’s also not connected to my work, I can be fired and still have the same healthcare benefits, forever.
  - kwhitefoot 4y ago
    > I had some unforgettable experiences in Norway, such as a colonoscopy without sedation or anaesthesia in case I can tolerate the pain. What pain? I have had a colonoscopy without any sedation, also in Norway. It was uncomfortable, occasionally very, but I wouldn't have called it painful. I think you must have encountered an incompetent doctor. Can't imagine why you would want general anaesthesia unless it was strictly necessary as it gives an additional risk of dying.
    - cameronh90 4y ago
      Arguing over whether something is painful or merely very uncomfortable seems like splitting hairs. That said, I had a colonoscopy with alprazolam and fentanyl, and it was, if anything, a moderately enjoyable experience. There was the odd slightly painful moment as they went round corners, but the drugs made me feel great throughout and I walked home afterwards with a mild afterglow. However, while I personally certainly wouldn't have requested general anaesthesia, I think it should be down to patient choice. I'm from the UK, and we often take a clench your teeth and bear it attitude to patient suffering, which I think can often be borderline inhumane. Ultimately if a patient wants to accept a 0.001% chance of dying to avoid experiencing pain or discomfort, mental or physical, that is up to them. You also have to consider the second order effects of people avoiding treatment due to fear of pain, as well as people who may have been raped or otherwise have very valid reasons to not want to experience having something inserted into their rectum.
- refurb 4y ago
  Every system has a list of approved and unapproved medicines. Every system. The one benefit (I guess) of universal coverage is that doctors already know the unapproved medicines won't get paid for, so they never try. So you avoid the whole issue of rejections. They just go with whatever the system says it will pay for.
p_l 4y ago
Having worked tangentially on AI that approved payments for outpatient ops for one of the companies involved in handling German health system... The very basic design goal was that the AI system could only approve, not reject. The goal was that obvious cases should be auto-approved, and anything where the AI returned below a certain confidence value was booted back to human to make a decision (same as pre-AI). So at least you get that.

ourmandave 4y ago

[flagged]