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My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because th

by andutu 3y ago

My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off. Luckily through their job they have some of the best medical insurance in the state and have been getting treatment at UT Southwestern. They pay little, but there was an instance where one of their physicians had to appeal to insurance to get a scan done (thankfully the insurance acquiesced). It doesn't make sense and all this debate around single payer healthcare is just obfuscation and distraction from investigating actual solutions. The vast majority of doctors genuinely want to help people and are more I interested in practicing the skills they've honed for decades rather than deal with faceless automata at health insurance companies who deny claims upon a mere glance. As long as people like Rick Scott can not only get away with introducing inefficiencies in the system, but defraud people and get away with it with no consequences other than personal enrichment, we are doomed.

colechristensen 3y ago
Why with single payer would there not still be instances of treatment being denied? >rather than deal with faceless automata at health insurance companies Would this not be replaced with faceless automata in government? Just look at how the VA is run and complains about it. Looking at that I have exactly zero confidence in the government being able to run things better than the shit show at the insurance companies. Businesses do need to compete with and overthrow the current middlemen in the medical world. It's just difficult and a very slow process.
- visybuns 3y ago
  [flagged]
- justin66 3y ago
  What was your experience like with the VA?
  - colechristensen 3y ago
    Hearing first or second hand stories of veterans waiting months or years for important care or struggling to get something addressed at all.
    - justin66 3y ago
      No experience then. Okay.
- cyberax 3y ago
  > Why with single payer would there not still be instances of treatment being denied? The most common failure mode for single-payer is scarcity. You won't be denied, but you'll have to wait many months for an appointment. > Would this not be replaced with faceless automata in government? They are controlled by politicians, who are directly responsible to their electorate. Brexit is a good example, using money sent to EU for NHS was one of the more influential ads. Of course, the outcome turned out to be... different. With the current insurance system, you don't have ANY levers. You can't usually change your insurance company because it's provided by your employer. And even if you want to buy medical insurance yourself via the ACA, you can switch it only once a year. With no way to tell in advance if your new company is going to cover your treatment. You also can't even sue your insurance company if it denies you the treatment because _all_ insurance companies require binding arbitration. And arbitrators basically always side with the insurance company, because your contract says that the insurance company is always right. That's how UnitedHealthcare can get away with just randomly denying treatment.
  - colechristensen 3y ago
    >They are controlled by politicians, who are directly responsible to their electorate. Brexit is a good example, using money sent to EU for NHS was one of the more influential ads. Of course, the outcome turned out to be... different. Calling out Brexit is an... interesting way to argue here. If you're proposing my options for heath care are going to be taken away and given to the single option controlled by the electorate who are liable to do things like Brexit... no thank you, I'll take marketplace competition where I can "vote out" the idiots by making a different choice for myself. People here are like "isn't it awful that personal medical choices are being made by politicians and popular vote" with respect to abortion, gender-affirming care, etc... and those same folks are damn near excited to give away all of their health choices to a government entity. Do you want your health care options to be dictated by an executive order the first day a new president enters office?
    - cyberax 3y ago
      > Calling out Brexit is an... interesting way to argue here. Why? It's an example of directly affecting healthcare via political pressure. > If you're proposing my options for heath care are going to be taken away and given to the single option controlled by the electorate who are liable to do things like Brexit... no thank you That's the thing, it can also be fixed by the electorate. > I'll take marketplace competition where I can "vote out" the idiots by making a different choice for myself. Except you can't. Go on, read your insurance contract if you don't believe me. You're at the total whim of death panels, who can just tell you to go and die.
- cyberax 3y ago
  > Just look at how the VA is run and complains about it. The VA system has on average delivers better outcomes than private insurance: https://www.rand.org/news/press/2018/04/26.html https://www.rand.org/news/press/2018/04/26.html It's the usual "review effect", you only see negatives about the VA, not positives.
  - colechristensen 3y ago
    >when compared to commercial HMOs, Medicaid HMOs and Medicare HMOs. That's not all private insurance, just some of it. That's also talking about the average. >although there is high variation in quality across individual VA facilities ... >It's the usual "review effect", you only see negatives about the VA, not positives. You're saying in rebuttal to a negative review of private insurance, which isn't even what's at issue. Difficulties getting things covered and being buried in beurocratic nonsense isn't really connected to "health outcomes on average". Your source doesn't make the argument well.
    - cyberax 3y ago
      > That's not all private insurance, just some of it. There are other studies with similar results. Comparisons with HMOs is especially illuminating because of the similar models (vertically-integrated organizations). > Difficulties getting things covered and being buried in beurocratic nonsense isn't really connected to "health outcomes on average". Of fucking course it is! WTF you're even talking about? People absolutely get inferior care because they can't wade through bureaucracy.
      - AnthonyMouse 3y ago
        > People absolutely get inferior care because they can't wade through bureaucracy. But those people don't get counted in the statistics because they failed to navigate the system so the bureaucracy doesn't even know they exist.
    - AnthonyMouse 3y ago
      > That's also talking about the average. It's worse than that. The VA can't be compared to the average insurer because all of their patients are people who could at some point in their adult life satisfy the military's physical fitness requirements, which is not the case for the population at large.
- light_hue_1 3y ago
  So you've never used VA healthcare. Compared to the insanity of the rest of the system it's pretty amazing. Some locations are better than others though.
- flatline 3y ago
  The government is mostly just there to manage contracts, the actual work would be done by the same doctors that are doing it today. You would just pare n profit-seeking entities down to one principally administrative entity. If you wish to pay for your own medical procedures out of pocket there will be nothing stopping you. That is not to say this does not have problems. Insurance is anti-competitive on top of that. You have a Sophie’s choice of who you want to pay to buy into this crazy system. There’s no transparency in how services are priced or provided. You as a consumer have no insight into how prices are negotiated between the insurer and providers, nor how providers are paid out. Good luck making an informed decision.
  - AnthonyMouse 3y ago
    > You would just pare n profit-seeking entities down to one principally administrative entity. If you wish to pay for your own medical procedures out of pocket there will be nothing stopping you. Nothing except that it creates a monopoly and a monoculture. There are many procedures you may not be able to afford out of pocket, so the only way to get them is to choose a provider that covers it. If there is only one provider and they don't cover it, you no longer have that option. And because nobody else does either, that medical procedure stops being offered because there aren't enough patients to justify it if they all have to pay out of pocket and most can't afford it, even if you were one of the few willing to scrape together the money. Which might not have happened if some insurers had covered it, even if many didn't. > You have a Sophie’s choice of who you want to pay to buy into this crazy system. There’s no transparency in how services are priced or provided. You as a consumer have no insight into how prices are negotiated between the insurer and providers, nor how providers are paid out. The existing system is a dumpster fire to be sure. So why not fix it? Eliminate even the concept of negotiating prices, as if medical pricing is something to be haggled over at a bazaar in Calcutta. Require every provider to publish their price, and then that's their price, and anyone can compare providers. Which gets rid of the concept of "in network" and all of that nonsense. The insurance pays e.g. 90% of the median price of that procedure within 100 miles of your home, the equivalent of a 10% copay. Then you can choose any provider you want, anywhere you want, and pay their published price. The difference comes out of your own pocket, so you have the incentive to be price sensitive -- but if you want to pay a little more to save yourself an hour drive, you can do that too. And if you pick one that charges less than 90% of the median price you can put the rest in your HSA. The thing about regulations is that the most important thing they can do is to ensure that markets are competitive. The existing healthcare regulations in the US not only don't do that, they do the opposite. But they don't have to.
- dukeyukey 3y ago
  > Why with single payer would there not still be instances of treatment being denied? Typically no - what treatment is used might be different, but that treatment is needed and will be supplied is not usually up for discussion. > Would this not be replaced with faceless automata in government? In 29 years living in a single-payer system I've never needed to do this. The government does not get involved in healthcare, they just fund it.
- op00to 3y ago
  The denials would not be based in a profit motive in a single payer solution.
2-718-281-828 3y ago
[flagged]
- whutsurnaym 3y ago
  Looks like they used both "he" and "they". My guess was that the boyfriend might use either set of pronouns.
  - 2-718-281-828 3y ago
    I understand they as a pronoun if the person identifies as neither male nor female. But if boyfriend is considered appropriate then why not also he? he: boyfriend / they: s/o, partner, friend, hckrfriend ...
    - spondylosaurus 3y ago
      Commented this earlier up the thread, in case you didn't see it: https://news.ycombinator.com/item?id=38765243 https://news.ycombinator.com/item?id=38765243 And it's a fair question; I'd guess you were met with downvotes because so much Pronoun Discussion is made in bad faith, but I don't get the sense you were. So I wish more people would use these moments as an opportunity to explain their points of view! Part of what I mentioned in that other comment is the sparse availability of good gender-neutral words in English ("spouse" is a good one I should have mentioned—great on its own but sadly not applicable to the unmarried!), and something I didn't mention but should have is that it's not uncommon for people to use they/them pronouns while still identifying as male or female to some extent, whether by choice or upbringing or simply to make things convenient when signing paperwork. You may have heard of the Kinsey scale for sexual preference; there's no widely accepted equivalent for gender identity, but in some cases it offers a similarly useful mental model. One person smack in the middle of "equally (or neither) male nor female" might swear off words like boyfriend and wife entirely, but another person who falls slightly off to the side into the "somewhat but not entirely /exclusively male" camp might use a mix of masculine and neutral terms, but probably not many feminine terms, if any. And then someone who falls into the "entirely and exclusively male" side of the chart would almost certainly object to being called someone's wife, lol.
addicted 3y ago
> They pay little, but there was an instance where one of their physicians had to appeal to insurance to get a scan done (thankfully the insurance acquiesced). It doesn't make sense and all this debate around single payer healthcare is just obfuscation and distraction from investigating actual solutions. Single payer is literally a complete solution to the problem you’re mentioning before. So why is it obfuscation and distraction? Especially when single payer systems in Europe have proven to have better outcomes at a fraction of the cost? I find the thought process here fascinating. Single Payer, which is actually delivering results in nearly every other developed country is an “obfuscation” and we need to find “actual solutions”. Doing what every other country that doesn’t seem to have the problem in question is not an “actual solution”. No, we must invent one out of thin air or it doesn’t count. This seems like a Not Invented Here syndrome taken to its extreme.
- dsign 3y ago
  It’s an ideology issue. I’m writing from the future. Here in Swerway we have transitioned to a health system that makes people twenty-five years old forever. On the other side of the pond, the last few US administrations have gotten elected on the basis of convincing Americans that it is evil and morally corrupt to live forever, specially if you haven’t earned an ethical dispensation by becoming a billionaire first.
  - burnerburnito 3y ago
    Remove Swerway and this is just insane enough that I get the feeling this will really happen. Rip Van Winkle sleeps in a coma for 80 years, wakes up revived in Swerway
- ianburrell 3y ago
  Single payer is actually pretty rare in developed countries. Canada and UK are the main ones. Hybrid public/private models are more common. Universal healthcare, where everyone has coverage, is what people usually want.
  - aragilar 3y ago
deleted 3y ago
[deleted]
ufocia 3y ago
Not an ad hominem attack or a microaggression, but hopefully constructive criticism. Your use of the "them" pronoun makes the post confusing. Does it refer to "they," presumably the doctors, the employer (job), the insurance, UT Southwestern, or to the gendered "boyfriend." Since you already decided to use a gendered noun, perhaps use it instead of the "they/them" or use a matching gendered pronoun "he/him" to distinguish the particular person from the other "them." I'm glad that your boyfriend has a wonderful and caring person like you to lean on.
- Jcowell 3y ago
  It would make it more clear, but in this case each Use of They was used right after the subject was mentioned. it stole only be confusing if They was used after multiple subjects are mentioned at once. But all pronouns can suffer from this.
- specialist 3y ago
  https://en.wikipedia.org/wiki/Singular_they https://en.wikipedia.org/wiki/Singular_they
  - RoyalHenOil 3y ago
    People know what the singular "they" is. It has been a common feature of English for centuries. It's just difficult to parse a writing where the same pronoun is used throughout for multiple different entities. This exact same issue commonly crops up with "he", "she", and "it" as well. The solution in these instances is to limit usage of the pronoun altogether and just use the noun directly wherever there may be any ambiguity. For example, don't say, "Julia wrecked Sarah's car; she was pissed!" The "she" here should just be replaced with "Sarah" or "Julia", even if it sounds a little odd to use the same noun twice in short succession.
    - persolb 3y ago
      This is a good example of where they is extra confusing too. It would be better if English had separate singular/plural versions of they. If Sarah goes by ‘they’, “They was pissed” sounds wrong and most people would actually speak “they were pissed”… but now it is a three way ambiguity: Julia pissed, Sarah pissed, both pissed. This feels like an example of a bigger failure mode, but I can’t nail it down. Something like ‘groups are resistant to short term change even if it is a clear Pareto improvement’
spondylosaurus 3y ago
> The vast majority of doctors genuinely want to help people and are more I interested in practicing the skills they've honed for decades rather than deal with faceless automata at health insurance companies who deny claims upon a mere glance. Not only that, but doctors also have to fight tooth and nail to get reimbursed by insurance companies (some worse than others... I have doctors who won't even take UHC anymore because the reimbursement rates are too low to break even on practice costs). So we end up with this bizarre arrangement where patients get their wallets drained and doctors have to hunt down their paychecks for services provided... all while the middleman gets richer. I hope your boyfriend's doing okay. Dealing with a major medical issue like cancer is already hard enough on its own without the added financial nightmare in this country, but at least it sounds like they're in good hands between you and the doctors they're seeing.
- Projectiboga 3y ago
  Single payer would lower costs by greatly reducing liability insurance both for the doctors themselves but also for car insurance and business liability coverage. All those would still exist but not for the actual medical treatments. The estimates are it would start to save money nationally the first year, and once the medical industry reorganized around delivering care that plus savings from preventive care and less lags getting scans. It isn't just the insurance providers against single payer, all the big pharma and medical technology providers don't want that. The saving would come from having most every health care outcome in one place along with every treatment and medicine. We would start to really see what works and is worth the money. Second even the most affluent would benefit from less crowded emergency rooms that puts us all at risk.

by andutu 3y ago

colechristensen 3y ago

Why with single payer would there not still be instances of treatment being denied? >rather than deal with faceless automata at health insurance companies Would this not be replaced with faceless automata in government? Just look at how the VA is run and complains about it. Looking at that I have exactly zero confidence in the government being able to run things better than the shit show at the insurance companies. Businesses do need to compete with and overthrow the current middlemen in the medical world. It's just difficult and a very slow process.

visybuns 3y ago
[flagged]
justin66 3y ago
What was your experience like with the VA?
- colechristensen 3y ago
  Hearing first or second hand stories of veterans waiting months or years for important care or struggling to get something addressed at all.
  - justin66 3y ago
    No experience then. Okay.
cyberax 3y ago
> Why with single payer would there not still be instances of treatment being denied? The most common failure mode for single-payer is scarcity. You won't be denied, but you'll have to wait many months for an appointment. > Would this not be replaced with faceless automata in government? They are controlled by politicians, who are directly responsible to their electorate. Brexit is a good example, using money sent to EU for NHS was one of the more influential ads. Of course, the outcome turned out to be... different. With the current insurance system, you don't have ANY levers. You can't usually change your insurance company because it's provided by your employer. And even if you want to buy medical insurance yourself via the ACA, you can switch it only once a year. With no way to tell in advance if your new company is going to cover your treatment. You also can't even sue your insurance company if it denies you the treatment because _all_ insurance companies require binding arbitration. And arbitrators basically always side with the insurance company, because your contract says that the insurance company is always right. That's how UnitedHealthcare can get away with just randomly denying treatment.
- colechristensen 3y ago
  >They are controlled by politicians, who are directly responsible to their electorate. Brexit is a good example, using money sent to EU for NHS was one of the more influential ads. Of course, the outcome turned out to be... different. Calling out Brexit is an... interesting way to argue here. If you're proposing my options for heath care are going to be taken away and given to the single option controlled by the electorate who are liable to do things like Brexit... no thank you, I'll take marketplace competition where I can "vote out" the idiots by making a different choice for myself. People here are like "isn't it awful that personal medical choices are being made by politicians and popular vote" with respect to abortion, gender-affirming care, etc... and those same folks are damn near excited to give away all of their health choices to a government entity. Do you want your health care options to be dictated by an executive order the first day a new president enters office?
  - cyberax 3y ago
    > Calling out Brexit is an... interesting way to argue here. Why? It's an example of directly affecting healthcare via political pressure. > If you're proposing my options for heath care are going to be taken away and given to the single option controlled by the electorate who are liable to do things like Brexit... no thank you That's the thing, it can also be fixed by the electorate. > I'll take marketplace competition where I can "vote out" the idiots by making a different choice for myself. Except you can't. Go on, read your insurance contract if you don't believe me. You're at the total whim of death panels, who can just tell you to go and die.
cyberax 3y ago
> Just look at how the VA is run and complains about it. The VA system has on average delivers better outcomes than private insurance: https://www.rand.org/news/press/2018/04/26.html https://www.rand.org/news/press/2018/04/26.html It's the usual "review effect", you only see negatives about the VA, not positives.
- colechristensen 3y ago
  >when compared to commercial HMOs, Medicaid HMOs and Medicare HMOs. That's not all private insurance, just some of it. That's also talking about the average. >although there is high variation in quality across individual VA facilities ... >It's the usual "review effect", you only see negatives about the VA, not positives. You're saying in rebuttal to a negative review of private insurance, which isn't even what's at issue. Difficulties getting things covered and being buried in beurocratic nonsense isn't really connected to "health outcomes on average". Your source doesn't make the argument well.
  - cyberax 3y ago
    > That's not all private insurance, just some of it. There are other studies with similar results. Comparisons with HMOs is especially illuminating because of the similar models (vertically-integrated organizations). > Difficulties getting things covered and being buried in beurocratic nonsense isn't really connected to "health outcomes on average". Of fucking course it is! WTF you're even talking about? People absolutely get inferior care because they can't wade through bureaucracy.
    - AnthonyMouse 3y ago
      > People absolutely get inferior care because they can't wade through bureaucracy. But those people don't get counted in the statistics because they failed to navigate the system so the bureaucracy doesn't even know they exist.
  - AnthonyMouse 3y ago
    > That's also talking about the average. It's worse than that. The VA can't be compared to the average insurer because all of their patients are people who could at some point in their adult life satisfy the military's physical fitness requirements, which is not the case for the population at large.
light_hue_1 3y ago
So you've never used VA healthcare. Compared to the insanity of the rest of the system it's pretty amazing. Some locations are better than others though.
flatline 3y ago
The government is mostly just there to manage contracts, the actual work would be done by the same doctors that are doing it today. You would just pare n profit-seeking entities down to one principally administrative entity. If you wish to pay for your own medical procedures out of pocket there will be nothing stopping you. That is not to say this does not have problems. Insurance is anti-competitive on top of that. You have a Sophie’s choice of who you want to pay to buy into this crazy system. There’s no transparency in how services are priced or provided. You as a consumer have no insight into how prices are negotiated between the insurer and providers, nor how providers are paid out. Good luck making an informed decision.
- AnthonyMouse 3y ago
  > You would just pare n profit-seeking entities down to one principally administrative entity. If you wish to pay for your own medical procedures out of pocket there will be nothing stopping you. Nothing except that it creates a monopoly and a monoculture. There are many procedures you may not be able to afford out of pocket, so the only way to get them is to choose a provider that covers it. If there is only one provider and they don't cover it, you no longer have that option. And because nobody else does either, that medical procedure stops being offered because there aren't enough patients to justify it if they all have to pay out of pocket and most can't afford it, even if you were one of the few willing to scrape together the money. Which might not have happened if some insurers had covered it, even if many didn't. > You have a Sophie’s choice of who you want to pay to buy into this crazy system. There’s no transparency in how services are priced or provided. You as a consumer have no insight into how prices are negotiated between the insurer and providers, nor how providers are paid out. The existing system is a dumpster fire to be sure. So why not fix it? Eliminate even the concept of negotiating prices, as if medical pricing is something to be haggled over at a bazaar in Calcutta. Require every provider to publish their price, and then that's their price, and anyone can compare providers. Which gets rid of the concept of "in network" and all of that nonsense. The insurance pays e.g. 90% of the median price of that procedure within 100 miles of your home, the equivalent of a 10% copay. Then you can choose any provider you want, anywhere you want, and pay their published price. The difference comes out of your own pocket, so you have the incentive to be price sensitive -- but if you want to pay a little more to save yourself an hour drive, you can do that too. And if you pick one that charges less than 90% of the median price you can put the rest in your HSA. The thing about regulations is that the most important thing they can do is to ensure that markets are competitive. The existing healthcare regulations in the US not only don't do that, they do the opposite. But they don't have to.
dukeyukey 3y ago
> Why with single payer would there not still be instances of treatment being denied? Typically no - what treatment is used might be different, but that treatment is needed and will be supplied is not usually up for discussion. > Would this not be replaced with faceless automata in government? In 29 years living in a single-payer system I've never needed to do this. The government does not get involved in healthcare, they just fund it.
op00to 3y ago
The denials would not be based in a profit motive in a single payer solution.

2-718-281-828 3y ago

[flagged]

whutsurnaym 3y ago
Looks like they used both "he" and "they". My guess was that the boyfriend might use either set of pronouns.
- 2-718-281-828 3y ago
  I understand they as a pronoun if the person identifies as neither male nor female. But if boyfriend is considered appropriate then why not also he? he: boyfriend / they: s/o, partner, friend, hckrfriend ...
  - spondylosaurus 3y ago
    Commented this earlier up the thread, in case you didn't see it: https://news.ycombinator.com/item?id=38765243 https://news.ycombinator.com/item?id=38765243 And it's a fair question; I'd guess you were met with downvotes because so much Pronoun Discussion is made in bad faith, but I don't get the sense you were. So I wish more people would use these moments as an opportunity to explain their points of view! Part of what I mentioned in that other comment is the sparse availability of good gender-neutral words in English ("spouse" is a good one I should have mentioned—great on its own but sadly not applicable to the unmarried!), and something I didn't mention but should have is that it's not uncommon for people to use they/them pronouns while still identifying as male or female to some extent, whether by choice or upbringing or simply to make things convenient when signing paperwork. You may have heard of the Kinsey scale for sexual preference; there's no widely accepted equivalent for gender identity, but in some cases it offers a similarly useful mental model. One person smack in the middle of "equally (or neither) male nor female" might swear off words like boyfriend and wife entirely, but another person who falls slightly off to the side into the "somewhat but not entirely /exclusively male" camp might use a mix of masculine and neutral terms, but probably not many feminine terms, if any. And then someone who falls into the "entirely and exclusively male" side of the chart would almost certainly object to being called someone's wife, lol.

addicted 3y ago

> They pay little, but there was an instance where one of their physicians had to appeal to insurance to get a scan done (thankfully the insurance acquiesced). It doesn't make sense and all this debate around single payer healthcare is just obfuscation and distraction from investigating actual solutions. Single payer is literally a complete solution to the problem you’re mentioning before. So why is it obfuscation and distraction? Especially when single payer systems in Europe have proven to have better outcomes at a fraction of the cost? I find the thought process here fascinating. Single Payer, which is actually delivering results in nearly every other developed country is an “obfuscation” and we need to find “actual solutions”. Doing what every other country that doesn’t seem to have the problem in question is not an “actual solution”. No, we must invent one out of thin air or it doesn’t count. This seems like a Not Invented Here syndrome taken to its extreme.

dsign 3y ago
It’s an ideology issue. I’m writing from the future. Here in Swerway we have transitioned to a health system that makes people twenty-five years old forever. On the other side of the pond, the last few US administrations have gotten elected on the basis of convincing Americans that it is evil and morally corrupt to live forever, specially if you haven’t earned an ethical dispensation by becoming a billionaire first.
- burnerburnito 3y ago
  Remove Swerway and this is just insane enough that I get the feeling this will really happen. Rip Van Winkle sleeps in a coma for 80 years, wakes up revived in Swerway
ianburrell 3y ago
Single payer is actually pretty rare in developed countries. Canada and UK are the main ones. Hybrid public/private models are more common. Universal healthcare, where everyone has coverage, is what people usually want.
- aragilar 3y ago

deleted 3y ago

[deleted]

ufocia 3y ago

Not an ad hominem attack or a microaggression, but hopefully constructive criticism. Your use of the "them" pronoun makes the post confusing. Does it refer to "they," presumably the doctors, the employer (job), the insurance, UT Southwestern, or to the gendered "boyfriend." Since you already decided to use a gendered noun, perhaps use it instead of the "they/them" or use a matching gendered pronoun "he/him" to distinguish the particular person from the other "them." I'm glad that your boyfriend has a wonderful and caring person like you to lean on.

Jcowell 3y ago
It would make it more clear, but in this case each Use of They was used right after the subject was mentioned. it stole only be confusing if They was used after multiple subjects are mentioned at once. But all pronouns can suffer from this.
specialist 3y ago
https://en.wikipedia.org/wiki/Singular_they https://en.wikipedia.org/wiki/Singular_they
- RoyalHenOil 3y ago
  People know what the singular "they" is. It has been a common feature of English for centuries. It's just difficult to parse a writing where the same pronoun is used throughout for multiple different entities. This exact same issue commonly crops up with "he", "she", and "it" as well. The solution in these instances is to limit usage of the pronoun altogether and just use the noun directly wherever there may be any ambiguity. For example, don't say, "Julia wrecked Sarah's car; she was pissed!" The "she" here should just be replaced with "Sarah" or "Julia", even if it sounds a little odd to use the same noun twice in short succession.
  - persolb 3y ago
    This is a good example of where they is extra confusing too. It would be better if English had separate singular/plural versions of they. If Sarah goes by ‘they’, “They was pissed” sounds wrong and most people would actually speak “they were pissed”… but now it is a three way ambiguity: Julia pissed, Sarah pissed, both pissed. This feels like an example of a bigger failure mode, but I can’t nail it down. Something like ‘groups are resistant to short term change even if it is a clear Pareto improvement’

spondylosaurus 3y ago

> The vast majority of doctors genuinely want to help people and are more I interested in practicing the skills they've honed for decades rather than deal with faceless automata at health insurance companies who deny claims upon a mere glance. Not only that, but doctors also have to fight tooth and nail to get reimbursed by insurance companies (some worse than others... I have doctors who won't even take UHC anymore because the reimbursement rates are too low to break even on practice costs). So we end up with this bizarre arrangement where patients get their wallets drained and doctors have to hunt down their paychecks for services provided... all while the middleman gets richer. I hope your boyfriend's doing okay. Dealing with a major medical issue like cancer is already hard enough on its own without the added financial nightmare in this country, but at least it sounds like they're in good hands between you and the doctors they're seeing.

Projectiboga 3y ago
Single payer would lower costs by greatly reducing liability insurance both for the doctors themselves but also for car insurance and business liability coverage. All those would still exist but not for the actual medical treatments. The estimates are it would start to save money nationally the first year, and once the medical industry reorganized around delivering care that plus savings from preventive care and less lags getting scans. It isn't just the insurance providers against single payer, all the big pharma and medical technology providers don't want that. The saving would come from having most every health care outcome in one place along with every treatment and medicine. We would start to really see what works and is worth the money. Second even the most affluent would benefit from less crowded emergency rooms that puts us all at risk.