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The absurdity is painful. That in a wealthy nation people can be unable to access medicine because the system for deciding who will pay how much for it is unava
by Blahah 3y ago
The absurdity is painful. That in a wealthy nation people can be unable to access medicine because the system for deciding who will pay how much for it is unavailable. Absolutely grotesque.
The hack isn't the problem. The system that privileges access to medicine is.
- easyas124 3y agoI mean, even on a good day, the people who need drugs can't necessarily access them. Can't wait for the system to come back up so I can find out another important medication isn't covered.
- roenxi 3y agoThat sounds like it is still part of the system that privileges access. In a sane world, you have the option of paying the seller for the thing you want, then they give it to you. That is a big part of what makes this crazy. People are in an insane system where they can't pay for drugs. Then the system goes down and they really get into trouble.
- easyas124 3y ago[flagged]
- Blahah 3y agoRight, equitable access to medicine means everyone pays a zero, or trivially affordable price, that's the same regardless of who they are and regardless of what the medicine is. In the UK that is £9 maximum - free for many. P.S. vouched your gp comment back to life.
- caturopath 3y agoI'm not sure this is the message of this story. There are tons of computer systems involved under single-payer systems.
- fragmede 3y agoI agree that the hack is the problem, but a single-payer system would mean the moving parts of the distributed system are less complex which means it's easier to manage. Just having fewer corporations involved means fewer boundaries between systems which means it's less likely to break.
- Blahah 3y agoBut none relating to payment or ability to pay. In the UK, medications are dispensed without checking whether a person is eligible for free prescriptions. Anyone can collect a prescription medication without paying by claiming an exemption (e.g. being on low income, pregnant, etc.) without proof. The pharmacist can also waive the £9 fee for a prescription. There's never a situation where not being able to figure out the paperwork prevents medicine being available. The prescription system itself could be compromised, in which case everyone in society would face the same issue (which would be mediated by the fact that paper prescriptions are still produced, and a pharmacist can telephone a prescribing surgery). Only a supply chain attack would really cripple the system.
- BHSPitMonkey 3y agoPresumably even in a single-payer system, you still need just as good of an accounting of costs and care provided. The data needs are all still there, just fewer parties are transacting.
- Blahah 3y agoAbsolutely. But in the UK, Ireland, Germany, New Zealand, etc... nobody would be refused their medicine because the payment system didn't work. Even if the computers didn't work. In the USA, people can and do die because there's a financial barrier to accessing medicine. Not so in countries that care about people.
- culturestate 3y ago> But in …Germany…etc... nobody would be refused their medicine because the payment system didn't work. Even if the computers didn't work. If the computers didn’t work, it would be incredibly painful in Germany because most pharmacies don’t regularly stock most prescription drugs. They’re often ordered from central warehouses on demand - i.e. if you walk in with a prescription for Xanax in the morning, you’ll typically need to come back in the afternoon to pick it up. That ordering process is entirely digital. If you suddenly switched to paper forms, phone calls, and faxes, it’d be a nightmare.
- mindslight 3y agoPerhaps it's possible for the public to outbid the parasite's owners and pay the ransomware group to just shred the entire operation. As companies become ever more virtual, the corporate death penalty ala Fight Club or Mr. Robot seems ever more plausible.
- rainbowzootsuit 3y agoSomething between John Oliver burning $15M in medical debt and Tyler Durden with vans full of nitroglycerin.
- bluGill 3y agoThey will be pack if you pay. The only safe payment is in fbi tracked money. then track the guilty down and put them in prison (or what ever reform program). If the country they live in won't give them up that is an act of war and send NATO in.
- waihtis 3y agoIn practice, cyber attacks dont seem to trigger even discussion of article 5. It will be interesting to see if we reach a state where they do
- Geisterde 3y agoYou might think about geopolitics a bit too much if you reach for article 5 because of cyber crime, maybe a bit too much wargaming in your head, things are kind of tense these days and I dont think invading a country would be an appropriate or mature response.
- refurb 3y agoEvery nation does this? When I lived in a universal healthcare system I had to show my healthcare card to get medicine. Prescriptions were transmitted electronically. None of this is unique to the US.
- Blahah 3y agoHaving to show identity documentation doesn't rely on a payment processor. Prescriptions in the UK (and other places - Germany for example) are electronic by default but can be made out on paper and verified without a computer.
- raffraffraff 3y agoSame in Ireland. My doctor can send it electronically to a pharmacy but I can take my paperwork to any pharmacy to get it filled.
- refurb 3y agoIt's not showing an identity document, it's "our systems aren't up so I can't fill your prescription".
- raffraffraff 3y agoHow many countries allow a single company to monopolise it?
- refurb 3y agoAre you suggesting that single payer systems have multiple, redundant IT systems in place with different vendors?
- lionkor 3y agoIn germany I get a piece of paper and bring it to a pharmacy most of the time... It has worked when my phone was out of charge, when the pharmacy had Internet problems, etc.
- Kalium 3y agoOne the primary goals of any - and indeed every - medical system is to ration resources. Which is to say to privilege access to medicine. When we talk about medical care access, we tend to talk around this, but it's a needed part of any system. Any system that doesn't do this quickly learns, institutionally, that without some limiting mechanisms in place the system will be overwhelmed and its resources exhausted. Obviously some approaches and systems work better than others and are more tolerant to some kinds of faults. Unfortunately, none of this gets away from the absurd, insulting, and grotesque reality that care has to rationed somehow.
- throwaway118899 3y ago> One the primary goals of any - and indeed every - medical system is to ration resources. We can fix this. Essentially, every smoker, every alcoholic, and every obese human immediately goes to the back of the line. No need for this convoluted bullshit of a system.
- roenxi 3y agoFirstly, that is still a convoluted bullshit system for rationing healthcare. Logically you'd have to assign some sort of worthiness score to every activity that matters then track everyone to figure out their score and stop them lying to get to the front of the queue. Even if you literally only mean these 3 things, you'd have to track smoking and alcohol consumption. I doubt that'd be enough to effectively ration healthcare though, since the resource demand is practically infinite. Secondly, you're inviting some really complex moral and political arguments. There have been worse ideas than linking healthcare to a political assessment of lifestyle, but I suspect it'd be up there in the same orbit as communism, genocide and slavery. It is hard to see it ending well once the politicians start to disagree on the healthiness of people's lifestyles. I dunno, in some ghoulish sense it might be the next logical thing for the US to try. Why stop at merely bad ideas?
- nradov 3y agoThe Affordable Care Act (Obamacare) does allow health plans to charge higher premiums to smokers. Implementation varies by state. I'm sure that a lot of plan members just lie to avoid the surcharge. https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/can-i-be-charged-higher-premiums-in-the-marketplace-if-i-smoke/ https://www.kff.org/faqs/faqs-health-insurance-marketplace-a...