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Author Topic: PLAYPEN: Covid-19 Everything Political  (Read 73137 times)

LesPalenik

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5920 on: June 30, 2020, 08:40:54 pm »

Driving through America, I'm astounded at the sight of billboards advertising hospitals.  Really?  Is this an good way to spend healthcare dollars?  On advertising?

Advertising hospitals is indeed foolish and inefficient. Canadian hospitals do it exactly in the same way as Tesla does. No advertising, no marketing, no sales staff, just word of mouth. People are desperate to get in.

John Camp

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5921 on: June 30, 2020, 08:48:57 pm »

Blaming immigrants for the American healthcare failings is meaningless unless you have proof that they're the root cause of the dysfunction.  It reads well on an Internet forum, but, like many things here, it ain't necessarily true.




I have experienced American health care.  My wife dislocated her shoulder and we presented ourselves at the emergency department of a hospital in the Pacific Northwest.  She received excellent care.  It was the middle of the night and there were zero other patients present.  We were fortunate that the head of orthopedic surgery was on duty and he realigned her shoulder quickly and professionally.

Two hours she was discharged, to the tune of $10K.  Yup, ten thousand dollars.  One line item was for a cloth sling that billed out at $150.  Extortionate is the only word I can use to describe the cost of that event.

Driving through America, I'm astounded at the sight of billboards advertising hospitals.  Really?  Is this an good way to spend healthcare dollars?  On advertising?

What is your experience of the Canadian health care system?

I wasn't blaming immigrants, I said they're part of the reason that the numbers look bad -- that we have bad numbers on things like child births. Well, if somebody has trekked up from Central America, and makes an illegal crossing through the Sonoran desert into the US, hoping to have her baby here as a so-called "anchor baby," the baby may have problems. Those are folded into our overall stats. In other words, we're dealing with literally millions of people who have severe "pre-existing conditions." As a reporter, I spent several months over a period of two or three years covering hospitals, and generally, as you experienced, the care is excellent. The problem is cost, but that's a separate problem. Under Obamacare, everyone is supposed to have insurance. Some evade the requirement, which isn't a problem for them (under the Obamacare rules) as long as they don't need trauma care. (Under Obamacare rules, if you have no insurance, if you evaded the requirement, and get cancer, you can then sign up for insurance under the rule that eliminates rejection of people for pre-existing conditions.) The problem with your wife, apparently, was that you didn't have insurance to cover a trauma here.

American care, by and large, is excellent; the American payments system is screwed up. I have my own example. I have hearing aids with a nipple-like device that covers the microphone in my ear, while the hearing aid itself sits above my ear. The nipple thing came off one of my hearing aids and got stuck deep in my ear canal. I had to go to an ER to have it removed -- took fifteen minutes, the invoice was $600; the only disposable used was a kind of napkin and two vinyl gloves. With Medicare, I paid $0. I agree that that kind of thing is absurd. When people complain about care (as opposed to payment) I don't think they're experiencing bad care, they're usually looking at stats, with numbers skewed by comparison to nation with cradle-to-grave insurance and also, very few needy immigrants with pre-existing conditions. I'm really tired of hearing how wonderful things are in a place like Finland, which, in 2019, took in 891 quota refugees. We take in 18,000 legal refugees; and tens of thousands of illegals.

As for my experience with Canadian medical care, my daughter went through two very long, very technical operations at the Toronto Hospital for Sick Children back in the 90s. The work was excellent, the outcome as good as could have been expected. I think our total cost for the two operations was in the neighborhood of $45,000. The only other place in North America where the operations were done was in Texas, either Dallas or Houston (it was long enough ago that I can't remember which) and the out-of-pocket cost would have been close to triple. I spent a week in Toronto for each of the operations, and found it to be quite an interesting city. The only other situation in which I personally know about Canadian health care is that a friend went to a clinic in Northwest Ontario to have a musky hook taken out of his face. I have no idea what the charge was, but his private US insurance paid for it.

Which raises another question. Did your Canadian health insurance pay for your wife's trauma care?
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Peter McLennan

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5922 on: June 30, 2020, 08:56:29 pm »

I wasn't blaming immigrants, I said they're part of the reason that the numbers look bad -

Possibly.  But I posit that it's a vanishingly small part of the "reason the numbers look bad". 

I mean, three and a half trillion dollars a year?  And with worse outcomes than other jurisdictions?   Time for a little introspection, I'd say.

Quote
Which raises another question. Did your Canadian health insurance pay for your wife's trauma care?

I think I stated in my post that the damage was covered by independently sourced insurance.  Canadian medical care would not have covered us.

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TechTalk

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5923 on: June 30, 2020, 11:01:03 pm »

You must have run out of cogent arguments

Sometimes people run out of other things, like patience for the obsessive need to label, categorize, and stuff into a box: people, thoughts, ideas, groups, etc.; or tolerance for the repeated painting of people, places, and things with an overly broad brush or having their motives mischaracterized; or the energy to continually unpack the complex realities from grossly oversimplified assertions often made without evidence.

Not aimed at anyone in particular. Just examples of other things that people run out of when they choose to disengage from further discussion.
« Last Edit: June 30, 2020, 11:04:28 pm by TechTalk »
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kers

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5924 on: July 01, 2020, 08:52:01 am »

...
I'm really tired of hearing how wonderful things are in a place like Finland, which, in 2019, took in 891 quota refugees. We take in 18,000 legal refugees; and tens of thousands of illegals.
...

Try Germany for an example: they have let hunderds of thousands immigrants in...
I have no knowledge of heathcare system in Germany; but in Holland it is simple:
A hybrid system of insurance companies that work within the rules of the government

You can choose a health insurance company. about ca 100-150 Euro a month for the employee... depending on the level of insurance. The employer also pays some. And you pay some more if you make more profit.

The basic insurance is set by the government and is quite good. _ it does not cover some things like simple dentist checks and new glasses. It does check most operations etc.
The basic insurance has a 350 euro treshold that you have to pay when you have to use specialized help.
In Holland we have a system of basic doctors and specialists. You first go to the basic doctor for simple problems and to diagnose your problem and then to find the right specialist that is needed.
Basic doctor care is free. In the case of your ear ; he would have done this for free. Most medicin are free, but the most used,like paracetamol.
The insurance companies together buy in medicin to make it cheaper. Sometimes they even produce medicin to reduce costs.
( btw  The Netherlands about 20.000 asylumseekers a year on a population of 17 million, if you think it is important)

PS i have forgotten to say: everybody in the Netherlands has the basic health insurance, even the jobless. It is obligated.
« Last Edit: July 01, 2020, 12:52:44 pm by kers »
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Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5925 on: July 01, 2020, 09:07:53 am »

Try Germany for an example: they have let hunderds of thousands immigrants in...
I have no knowledge of heathcare system in Germany; but in Holland it is simple:
A hybrid system of insurance companies that work within the rules of the government

You can choose a health insurance company. about ca 100-150 Euro a month for the employee... depending on the level of insurance. The employer also pays some. And you pay some more if you make more profit.

The basic insurance is set by the government and is quite good. _ it does not cover some things like simple dentist checks and new glasses. It does check most operations etc.
The basic insurance has a 350 euro treshold that you have to pay when you have to use specialized help.
In Holland we have a system of basic doctors and specialists. You first go to the basic doctor for simple problems and to diagnose your problem and then to find the right specialist that is needed.
Basic doctor care is free. In the case of your ear ; he would have done this for free. Most medicin are free, but the most used,like paracetamol.
The insurance companies together buy in medicin to make it cheaper. Sometimes they even produce medicin to reduce costs.
What a lot of people don't realize, is that America isn't some free market of medicine that's all private.  Actually, around half of all medical costs are paid by government: either Federal, state or local governments.  These include Medicare, Medicaid, Veteran's Administration, etc.  Plus, state and local as well as Federal government workers have their insurance paid for by the government. So medical costs are hugely effected by government already.  One of the reasons costs are so high in America is because the government already has its fingers in the pie. 

Most health insurance in the US doesn't cover dental either.  They also don't cover glasses and hearing aids for the most part, and there are huge partial payments at a minimum on prescription drugs. Plans vary depending on the cost of them. 

Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5926 on: July 01, 2020, 09:36:44 am »

I seems my state of New Jersey and the northeast in general are doing pretty well.

How severe is the pandemic where you live? (in the USA by state and county)
https://globalepidemics.org/key-metrics-for-covid-suppression/
https://www.npr.org/sections/health-shots/2020/07/01/885263658/green-yellow-orange-or-red-this-new-tool-shows-covid-19-risk-in-your-county

Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5927 on: July 02, 2020, 10:36:13 am »

Numbers of Non-COVID-19 Deaths Up During Pandemic
"But a third possibility, the one we're quite concerned about, is indirect mortality -- deaths caused by the response to the pandemic," he said. "People who never had the virus may have died from other causes because of the spillover effects of the pandemic, such as delayed medical care, economic hardship or emotional distress."
https://www.usnews.com/news/health-news/articles/2020-07-01/numbers-of-non-covid-19-deaths-up-during-pandemic

LesPalenik

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5928 on: July 02, 2020, 10:44:45 am »

Numbers of Non-COVID-19 Deaths Up During Pandemic
"But a third possibility, the one we're quite concerned about, is indirect mortality -- deaths caused by the response to the pandemic," he said. "People who never had the virus may have died from other causes because of the spillover effects of the pandemic, such as delayed medical care, economic hardship or emotional distress."
https://www.usnews.com/news/health-news/articles/2020-07-01/numbers-of-non-covid-19-deaths-up-during-pandemic
Also, 3 people in New Jersey were injured when a deer ran into the crowd of demonstrators.

Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5929 on: July 02, 2020, 10:47:07 am »

Also, 3 people in New Jersey were injured when a deer ran into the crowd of demonstrators.
Must have been a Republican deer.

In any case, we get even.  We run them over all the time on the roads around here.  The Turkey Vulture population is doing just fine. 

PeterAit

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5930 on: July 02, 2020, 11:50:24 am »

I have hearing aids with a nipple-like device that covers the microphone in my ear, while the hearing aid itself sits above my ear. The nipple thing came off one of my hearing aids and got stuck deep in my ear canal. I had to go to an ER to have it removed -- took fifteen minutes, the invoice was $600;

With all due respect, this is part of the issue with medical care in America. Going to the ER for a hearing aid nipple stuck in your ear?? Seriously? That happens to me now and then, and a minute with tweezers gets it out. Leave the ERs for actual emergencies. I am amazed that you were charged only $600.
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John Camp

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5931 on: July 02, 2020, 02:34:40 pm »

With all due respect, this is part of the issue with medical care in America. Going to the ER for a hearing aid nipple stuck in your ear?? Seriously? That happens to me now and then, and a minute with tweezers gets it out. Leave the ERs for actual emergencies. I am amazed that you were charged only $600.

Believe me, this was not something you'd fish out with a pair of tweezers (which I've done a few times with my wife's help.) The nipple was out of sight. I first went to my hearing aid place, and they took a look and suggested I go to the ER, since they didn't think they could remove it. What happened (I think) was that I took my hearing aid out, didn't notice the nipple was missing. But it itched in my ear, and I kept trying to scratch the itch with a finger, and managed to jam it almost down to the ear drum. When we got it out, there was actually a bit of blood involved.
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hogloff

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5932 on: July 02, 2020, 06:44:28 pm »

My wife had a mishap on a bike on Kauai and broke her arm up high near the shoulder. Took her into emergency, they took an x-Ray, said it was broken but that break isn't fixable by operating, just a sling and it basically heals itself in a month or two. Basically was in emergency for maybe 1 hour, got an x-Ray, sling and a pain killer. Total bill was nearly $4,500. Our travel medical insurance covered it after the $1,000 deductible.

In Canada we would have walked into emergency, gave them our medical card and that would be that.
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Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5933 on: July 03, 2020, 12:45:02 am »

My wife had a mishap on a bike on Kauai and broke her arm up high near the shoulder. Took her into emergency, they took an x-Ray, said it was broken but that break isn't fixable by operating, just a sling and it basically heals itself in a month or two. Basically was in emergency for maybe 1 hour, got an x-Ray, sling and a pain killer. Total bill was nearly $4,500. Our travel medical insurance covered it after the $1,000 deductible.

In Canada we would have walked into emergency, gave them our medical card and that would be that.
Why would you expect Hawaii to give you free medical care? You planned smartly and had travel insurance that covered it. 

Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5934 on: July 03, 2020, 01:07:09 am »

$600 federal unemployment benefits to expire by the end of July.  So NJ will extend their normal 39 month unemployment benefit 20 weeks to 59 weeks for laid off employees.  Most states will do extensions of their own.  As an ex-business owner, I recall my unemployment premiums were based on how many people I laid off.  The more layoffs, the higher the premiums. So next year, all these small business will have huge premiums.  Another very costly addition to running a business at a time when you're getting squeezed from shutdowns and regulations that prevent full business operation.   What a disaster. 

The current situation with Federal payments is as follows by comparison.  NJ unemployment insurance pays 60% of your weekly salary up to $713.  So if you made  let's say $500 a week, you'd get $300 a week from NJ plus the Federal payment of $600 for four months or a total of $900 a week or $400 more a week than if you were working.  No wonder no one wants to go back to work.

NJ extends unemployment insurance by 20 weeks for those who exhausted benefits
https://www.njherald.com/news/20200701/nj-extends-unemployment-insurance-by-20-weeks-for-those-who-exhausted-benefits

Robert Roaldi

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5935 on: July 03, 2020, 08:04:13 am »

Why would you expect Hawaii to give you free medical care? You planned smartly and had travel insurance that covered it.

Did he say he expected free medical care from Hawaii? I'm pretty sure he was alluding the ridiculously high fees for service. Why are you changing the subject.

By your logic, maybe the hospital should have charged $45,000 then. How about $450,000? It's the free market after all. Caveat emptor. They should have shopped around for a cheaper hospital, maybe read those billboards more carefully. Maybe he should have contracted with a "concierge service" that he could phone, while his wife ached with pain, to find the cheapest alternative in the area. An injury broker, maybe? Like an insurance adjustor, get a pre-estimate on the shoulder before deciding on which hospital to go to. Or maybe get on the phone with the nearby hospitals and get a quote first, you know, shop around first like a good consumer.

Maybe he should have bought legal insurance before travelling so to have a lawyer on standby that he could call who could enter into negotiations with the hospitals on his behalf, add that extra legal weight.

There are all kinds of solutions, just have to be creative.
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hogloff

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5936 on: July 03, 2020, 08:12:59 am »

Why would you expect Hawaii to give you free medical care? You planned smartly and had travel insurance that covered it.

I wouldn't expect it to be free...but $4,500 for an x-Ray, sling and a tylonal seems a bit extreme.
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Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5937 on: July 03, 2020, 08:35:40 am »

Did he say he expected free medical care from Hawaii? I'm pretty sure he was alluding the ridiculously high fees for service. Why are you changing the subject.

By your logic, maybe the hospital should have charged $45,000 then. How about $450,000? It's the free market after all. Caveat emptor. They should have shopped around for a cheaper hospital, maybe read those billboards more carefully. Maybe he should have contracted with a "concierge service" that he could phone, while his wife ached with pain, to find the cheapest alternative in the area. An injury broker, maybe? Like an insurance adjustor, get a pre-estimate on the shoulder before deciding on which hospital to go to. Or maybe get on the phone with the nearby hospitals and get a quote first, you know, shop around first like a good consumer.

Maybe he should have bought legal insurance before travelling so to have a lawyer on standby that he could call who could enter into negotiations with the hospitals on his behalf, add that extra legal weight.

There are all kinds of solutions, just have to be creative.

ER's in America are expensive if you have no insurance.  I agree it's a big problem.  That's why I commended him for buying health coverage for his trip.  If he doesn't want to face problems like that and doesn't want to buy the insurance, than don't come to America.  Vacation in Tahiti.  No one twisted his arm.  Or don't pay the bill or negotiate it. 

Alan Klein

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5938 on: July 03, 2020, 08:46:00 am »

I wouldn't expect it to be free...but $4,500 for an x-Ray, sling and a tylonal seems a bit extreme.
They are very expensive.  Apparently, hospitals try to make up for the low payments they get from government mandated programs like Medicare.  Because half of medical care in the US is paid by the government, controls on pricing forces hospitals and doctors to charge more to those who aren't covered by insurance to make up for their loses.  The government is causing the problem.  If we had real free markets and competition, and the government stopped perverting the market, things would be a lot better and prices lower.   

By the way, I'm curious if you know what the insurance company finally paid on the bill after your deductible?

Robert Roaldi

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Re: PLAYPEN: Covid-19 Everything Political
« Reply #5939 on: July 03, 2020, 09:14:48 am »

ER's in America are expensive if you have no insurance.  I agree it's a big problem.  That's why I commended him for buying health coverage for his trip.  If he doesn't want to face problems like that and doesn't want to buy the insurance, than don't come to America.  Vacation in Tahiti.  No one twisted his arm.  Or don't pay the bill or negotiate it.

How do you square that with your often stated belief that "competition" in medicine creates efficiencies and reduces cost for the consumer? Because all the evidence that's ever brought forward in discussions like this one points to exactly the opposite, that costs are totally out of control and out of whack with services rendered. As described, it most often resembles a criminal racket, at least as far as hospital fees are concerned. The very fact that insurance companies or people in the know are able to negotiate large discounts off the invoices, far from being a balm, is just another example of how unfair the racket is.

Medical care is not the same thing as buying hammers or restaurant meals. I don't know what could be more obvious.
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