Health Care Thread

Vaclav

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If you're rich, you never go bankrupt! Why do we need the ACA, when the solution is so obvious?
Rich folks go bankrupt too - my amazing in-laws had pretty comfortable money but retired and lived the high life and frittered it away until they Chapter 7ed themselves.... Something like $500k just 5 years ago...
 

Siddar

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Here's a link for you to ignore...


http:// http://m.voices.yahoo.com/a-brief-look-five-best-hospitals-worldwide-6306104.html

Amongst others that are easy to find...
A link with five hospitals two from US and three non US but private hospitals. I don't think you proved the point you were trying to make. Mayo clinic is actually four separate hospitals so that tilts list to five US and three non US. The non US hospitals all appear to be large scale low cost medical tourism hospitals that provide services to people unable to receive the same services from there national health systems.

Seems like you proved Tad10s point for him.
 

Royal

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not sure about the quality. Mostly, it is cost effective measures.

But health care is cheaper in other countries. Medical devices are sold at fraction of the cost, including the drug itself. Why is this happening? I dunno. Too much restriction in patents and trade maybe?
The number of Americans traveling abroad for healthcare annually is now in the millions (estimated at6 million a few years ago) so if there were persistent problems with low quality of care, the horror stories would be plentiful at this point. Many of the places people go, like Costa Rica and Belgium, aren't exactly third world countries. Most of the problems associated with the practice are related to traveling long distances shortly after certain procedures.
 

Royal

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They cost roughly the same for the devices, just they're subsidized by the state largely. Drugs however are largely due to the "rigorous" drug testing we put them through, even though our net quality standards are below cheaper FDA equivalents in other nations because of how inefficient our total process is - universalized medical records being a big one that maybe we'll get around to by 2100 at the current rate.
Some countries also have limits on what can be charged for certain medical devices.

Surgical implants is one area where we in the states pay 200-300% more than others do abroad for similar quality. The reason, in a nutshell, isthe five US manufacturers are basically a cartel being assisted by the government.
 

Vaclav

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A link with five hospitals two from US and three non US but private hospitals. I don't think you proved the point you were trying to make. Mayo clinic is actually four separate hospitals so that tilts list to five US and three non US. The non US hospitals all appear to be large scale low cost medical tourism hospitals that provide services to people unable to receive the same services from there national health systems.

Seems like you proved Tad10s point for him.
He claimed as did the original person I disagreed with that the US had the absolute best healthcare in the world. I wasn't chsllenging a public/private assertion. Especially since private hospitals could potentially take public insurance internationally I'm honestly not sure if that means what you think it means... (In MD we call GBMC a public hospital and JHH a private one but that has entirely to do with who paid to found each - not anything about treatment just how they were established)

In fact it proves my point even BETTER that way really - since even in your 'worst case' - it proves both arguments presented as wrong on equal footing. The other argument being cost as well as quality - each of those hospitals charges a fraction of our costs, while ranking closely and still being 'private'.

You actually improved my argument, thanks!

(Also on Mayo only two make top 10s for cancer treatments - in specific categories each, Washington and one other - Washington for many cancers, the other for one or two. The others don't even place in a US only Top 10.)
 

Denamian

Night Janitor
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That's a single disease possibility out of many - and it like many of them would be a huge winner.

Even something relatively common like an appendix removal runs an average of $33k with the range being $1.5k at the lowend and $180k (seriously!?!?) on the high end if you're not insured.
I've been uninsured for the last 16 years and had to have an appendectomy last year and I was surprised at the huge difference in price for such a simple procedure when I looked it up. I was in the hospital for just over 12 hours and just the hospital bill was nearly 16k. The surgeon, anesthesia, scan and other stuff brought it up to nearly 20k total. NY mandates that hospitals have a sliding scale based on the patients income, so that knocked the hospital bill down to $1200 or so. The other bills I negotiated down and my total out of pocket expenses ended up being around 2k.

As far as Obamacare goes, I'm probably going to take the penalty for at least the first year. My employer offers insurance, but it's too expensive for me to afford. The numbers I keep hearing about what's being offered on the exchange makes it sound like the cheapest plan is more expensive than what my employer offers for worse coverage. I just wish they went with single payer instead of this half assed shit.
 

tad10

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Here's a link for you to ignore...
Yeah "voices" that's not a reputable cite. Anyway, it's just saying these are good hospitals in this area. It's not saying the best hospital in Thailand is better than Mass General.

So no sale.


So yes. US Healthcare is far and away #1.
 

Vaclav

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Next time I see my docs at Johns Hopkins, I'll get their list or take pics of it (they post it on a wall) which is by condition and Top 5 in each field. John's is #1-3 on most of the lists, but outside of John's you see Mayo on the Cancer ones (generally just one facility for each, facilities listed separately) and many of the other lists with few or even none in a case or two (I want to say it was a specific transplant type - heart transplant I know US dominates in) or just John's as the only one on the list (like my important one I go there for of genetics - if I move away from here, I'm either coming back or heading to Europe for genetics work).

Diabetes and Heart I do recall us dominating in, the rest was definitely a fight or a rout - but it'll be a while till I'm back at JH. (Besides their Wilmer Eye - but that's not in their downtown main hospital where I saw the report posted)
 

tad10

Elisha Dushku
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Next time I see my docs at Johns Hopkins
Yes, I want to see this list putting non-American hospitals at the top of any specialty. :)

Vaclav, I agree with you MMO preferences but not with your healthcare choices ;-)
 

Sebudai

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Yeah, totes. Other than minor shit like healthcare outcomes and healthcare costs, the US is far and away #1. :) :) :)


8=======D
 

Vaclav

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Not sure how many were #1 - I do recall alot of #1's even within the lists that had the Top 5 filled with international ones.

Oh and remembered one we sucked even worse than genetics in - Gastroenterology was all international, two in the UK, one in EU, Singapore and Hong Kong from the list I'd jotted down. Found my (handwritten though - not great as "evidence" I can photo it though, as worthless as that would be) note from when I was there since I've got some chronic GI issues that have never been solved. With a big ole star I added next to Singapore, since I'd love to visit and frankly would love a firsthand account of their system - since to me, their system looks to be the best one we could adapt ours into.

Don't get me wrong though, I like US healthcare as a Maryland resident - it scares the shit out of me to think about moving out of this state though if I'm not going to Washington, California or Boston though - since it seems like there's enormous wastelands of shitty hospitals. The idea of getting sick and having to fly someplace I'd feel comfortable being treated seems.... unfun.

Stuff like death rates on some hospitals are frankly terrifying - there's plenty of states where a 20-22% chance of death with heart attack treatment is the NORM! (Harford County General is on there, if you ever consider getting taken to a MD hospital somewhat close to you at 18.6% chance of mortality on a heart attack call) International average is 14%, whereas our best gets to the 10-11% range... with 20-22% being a much larger band for us.
[Hospital death rates unveiled for first-time comparison - USATODAY.comhas a link to the tool I was playing with inside it to quote the national numbers - international was from WHO]

Don't get me wrong though, I think the ACA was only a tiny improvement in things could even potentially thanks to some of the bullshit loopholes be even worse in the longrun - and would ideally prefer to see a Singapore model which no one really has pitched over here (if you're not familiar they basically do a mandatory HSA that once you go past you get your coverage taken care of by the state - personal responsibility with a safety net - and it includes dental apparently!) although single payer would be a form of improvement as well.

Either way, I want to see the health insurance industry gone though as it stands - secondary policies perhaps, but never primary policies as it stands today - I've felt that way since I was a kid at my first real job doing records for my mother's doctor's office (she was the lead RN, not doc) when I realized I was putting together records to send to the same insurance company for the same claim from Dr. Ruz's office for literally from one of my first days until I left when college started about 18-24 months later because the insurance company wanted to refuse to pay Dr. Ruz the money that it owed him for treatment of their patient on some stupid contingency they were claiming or misfiled paperwork or whatever else, that kept being a moving goalpost for Dr. Ruz to get reimbursed the ~$400 he was owed for the procedure.

Something like that should NEVER happen - much less multiple times (although that was the worst example I saw in his ~40 patient a day practice there were a few that finally got paid after 12-15 months, Medicare in comparison paid consistently at the 2 month point + however many days till next day on the payment schedule at that point... [Medicare only pays on set days - so could add 2 weeks sometimes, a day others]... and Medicaid here was generally 1-4 weeks - but they are privately run, but they wouldn't play the same games, I guess since they've got the State baking the plans they don't bother or something...) - and then later dealing with COBRA and my PEC that cropped up - I got to see a $500/mo plan balloon to $931/mo then to $2000/mo when there was no way I would ever use anywhere near that amount of services, literally became cheaper for me to pay for MRIs and shit out of pocket every TWO MONTHS than it was to keep the plan.

The insurance industry is and remains pretty damn fucked up - it either needs tons of regulations (which I'm not a huge fan of) or needs a reset button where it's only a side benefit.

Their current method of running the industry like a casino while using a stacked deck is a terrible thing when it's an item with inelastic demand that everyone needs at some point to varying degrees.
 

Blakkheim

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Obama Administration Uses Pirated Code on Healthcare.gov
http://torrentfreak.com/obama-admini...re-gov-131019/


I'm not a copyright lawyer but hopefully the company who's software is being ripped off will seek an immediate injunction and have the whole fucking Healthcare.gov website shut down. The lulz from that might be so epic it disrupts the entire space time continuum.
 

Burnem Wizfyre

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Obama Administration Uses Pirated Code on Healthcare.gov
http://torrentfreak.com/obama-admini...re-gov-131019/


I'm not a copyright lawyer but hopefully the company who's software is being ripped off will seek an immediate injunction and have the whole fucking Healthcare.gov website shut down. The lulz from that might be so epic it disrupts the entire space time continuum.
If my code had been stolen and used for the ACA websites, I would claim that wasn't my code.
 

Erronius

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If my code had been stolen and used for the ACA websites, I would claim that wasn't my code.
Maybe you could make a few dollars selling that code to a conservative so that they could stir the pot, and you could go buy an island somewhere instead.