Who kills, again? Fuck every one of these assholes.
They are all aiding and abetting murder by taking up ICU space with diseases that were easily preventable. Look at this example.
What first struck Nathaniel Osborn when he and his wife took their son, Seth, to the emergency room this summer was how packed the waiting room was for a Wednesday at 1 p.m.
The Florida hospital’s emergency room was so crowded there weren’t enough chairs for the family to all sit as they waited. And waited.
Hours passed and 12-year-old Seth’s condition worsened, his body quivering from the pain shooting across his lower belly. Osborn said his wife asked why it was taking so long to be seen. A nurse rolled her eyes and muttered, “COVID.”
Seth was finally diagnosed with appendicitis more than six hours after arriving at Cleveland Clinic Martin Health North Hospital in late July. Around midnight, he was taken by ambulance to a sister hospital about a half-hour away that was better equipped to perform pediatric emergency surgery, his father said.
But by the time the doctor operated in the early morning hours, Seth’s appendix had burst — a potentially fatal complication.
I take that personally. When I was a child, I almost died of appendicitis — the memory of the agony of that event still burns in my memory. I only had to wait 5 minutes after my dad carried me at a run into the hospital (my projectile vomiting probably motivated the staff), but if that thing had ruptured, if modern medicine hadn’t made appendectomies safe and routine, I wouldn’t be here today. I still remember the pain and drifting in and out of consciousness on that short and probably too fast drive to the hospital, and I can’t imagine what it would have been like to wait 6 hours for treatment.
Fortunately, in this case there was a relatively happy outcome.
Seth Osborn, the 12-year-old whose appendix burst after a long wait, spent five days and four nights in the hospital as doctors pumped his body full of antibiotics to stave off infection from the rupture. The typical hospitalization for a routine appendectomy is about 24 hours.
The initial hospital bill for the stay came to more than $48,000, Nathaniel Osborn said. Although insurance paid for most of it, he said the family still borrowed against its house to cover the more than $5,000 in out-of-pocket costs so far.
You know, there’s this process called triage, in which you rank the needs of the patients. I would not object if hospitals made a patient’s refusal to obtain a cheap, safe, easily obtainable vaccination part of the triage process. When Seth Osborn shows up in the emergency room, they should have looked at the list of people taking up ICU beds with COVID-19 who had not been vaccinated, and bumped one of them out to make room for the kid. It’s a hard decision, but medical personnel sometimes have to make those painful choices.
Imagine if Seth had died because some selfish asshole had neglected to do the minimally responsible thing, all because some Republican had told him not to.
The only part of your post I disagree with is that I don’t think it would be a hard decision. The doctors should write something like “COVID – no vax” is large, red letters an every one of those patients’ charts. If someone else comes in who needs an ICU bed for something else, boot the first “COVID – no vax” patient you see, change the sheets, and get to work on the new patient.
And your “imagine in Seth had dies” comment, we don’t have to imagine it. There have been cases in the news recently of patients dying of heart attack or other things because they couldn’t get into the ICU.
That the antivaxxers are murdering children is no surprise.
The antivaxxers are also producing orphans on a large scale. The estimate as of July, 2021 is 119,000 in the USA. It’s not that uncommon for both parents to get Covid-19 and die. The unit of infection most times is the family.
There are also large numbers of children in the USA being raised by single mothers or custodial grandparents. When they die, that is it.
This pandemic is going to leave a mark on our society for a generation.
There will be a Great Grief: masses of mourners going through PTSD. Intensity of the Grief will be inversely correlated to the number of degrees of separation to a covid death. This number is lower in Trump country; therefore the Grief will be greater there.
Anti-vax = pro-covid = pro-Grief.
I agree. Try as I may, I simply cannot drum up any sympathy for these terrified slobs who haven’t gotten vaccinated. So much needless death driven by political bull.
???
Maybe.
I know that I’m appalled and heartsick by what I’ve seen in this pandemic. Some people I know are dead, a larger number are maimed by Covid-19 long hauler syndromes. Lately, I’ve seen unvaccinated kooks spreading the Covid-19 virus to anyone they come across.
What I haven’t seen is that the people in the Red states and Red rural counties of the Blue states really much care if they get sick and die. Not enough to take simple precautions like wear a mask and get a vaccine. I’m baffled by them. Who knows, maybe there really are Zombies and we call them fundie xians.
I have recently seen up close unvaccinated kooks spreading the Covid-19 virus.
The health foods Yoga teacher of a class at the local gym had an immune system that could take care of anything. Except the Covid-19 virus as she found out.
And yeah, she spread it to a bunch of people including people not in her class. One of whom I know.
My friend was vaccinated and didn’t get very sick with the breakthrough infection but the whole event definitely spooked her.
In 2017 I had a “sneaky” appendicitis that wasn’t super painful before bursting. Thanks to very good public healthcare access, I got around to seeking treatment in time anyway.
First, I had mild fluctuating stomach pain over many days. On one Thursday night the pain was more severe, so in the morning I called to my neighborhood public health clinic and visited there around midday. By then the pain was mild again. They suspected appendicitis (blood test showed infection) and referred me to a hospital within the city. I didn’t hurry too much going there, but instead did some quick preparation for a possible hospital stay.
After I arrived at hospital around 4pm, it took me 2 or 3 hours to get examined and a total 8 hours to get the diagnosis. I needed a couple rounds with fancy modern imaging technology, because my appendix was difficult to find. I felt more hungry and bored than sick, complained mildly and once considered walking away. A nurse encouraged me to stay and wait. Turned out my appendix was fairly close to bursting, if I understood correctly.
After diagnosis, it took me about 40 hours to get operated (I’d have been instantly ready for non-emergency surgery thanks to empty stomach). I still don’t know for sure if it was an unusually busy weekend, or just a regular weekend (with lots of drunks injuring themselves and each other). I was pre-emptively kept on IV antibiotics and painkillers (the latter may have been unnecessary). I was in no pain, but hungry, anxious and frustrated.
The surgery was said to have been relatively difficult. They wanted me to stay in hospital for another two nights and a day, so I left around Tuesday midday. I barely got home before diaorrhea from antibiotics (and from eating again) kicked in, but there were no other complications. Eventually, I paid a co-payment amount that equals a few hundred dollars in total.
I guess I mean to say, If there had been a poorly managed pandemic clogging hospitals in my area, I’d have been more hesitant to go to hospital for a mild stomach pain. Honestly same, if I’d known beforehand that the processing would be so slow even in relatively normal (?) conditions.
I could probably look this up, but… what exactly is a “co-payment” and an “out-of-pocket-cost”? Are these part of the cost of buying private health insurance that you have to suffer, or something else?
@9
It’s what we pay out of our own pockets even though we have insurance that is supposed to pay for our healthcare expenses. Because… freedom, I guess.
A co-payment is a sum you have to pay to just go to the clinic. It’s intended to discourage you from looking for treatment. The co-pay at my local clinic is $35, for instance: I’m gonna get billed that just for the affront of going in the door.
If you get treated, the hospital will hand you a big bill. That bill will be divided into the sum your insurance covered (hooray, you can just put that out of mind), and the sum your insurance refuses to pay — that’s your out-of-pocket-cost. The base bill is already huge and over-inflated, so you’re gambling that the insurance will cover most of it. It’s always a shock to get the big bill you assumed would be covered by insurance, and discovering your insurance company had a handy excuse for not doing so. “You didn’t say ‘mother may I’ before submitting the bill,” that sort of thing.
No one wants to see a doctor for anything in this country. You could be gored by a bull with your intestines hanging out and some people will try to patch it up themselves to avoid the inevitable bill with unpredictable surprises.
Don’t even ask me about ambulance charges.
Cartomancer @9
Insurance companies, including those working with medicaid and medicare, are fond of deductibles and co pays (out of pocket cost) to discourage “unecessary” medical care, doctor visits, or prescription costs. I buy a medicare supplement policy to I don’t have to worry about paying, for example, $45 on each visit to see my primary care internist.
Okay, here’s a quick glossary of terms for American insurance:
Copay: The flat fee you have to pay for every visit to the hospital. Copays are there whether or not it’s major surgery or a check-up. It’s also a fee you pay for prescriptions. Sometimes you don’ t have to pay a copay. For instance, I get two free clinic (no urgent or emergency) visits per year without a copay. Sometimes the copay is higher than the prescription. If your copay is 50 bucks, but the medicine is 25, buying the medicine is the same whether or not you have insurance.
Deductible: The amount of medical expense you have to pay per year before the insurance will cover anything, not including the copay. So if your deductible is 2000 dollars, and a bill is 1,999 dollars, the insurance company will not pay a penny. It is yearly, though, not every time.
Out-of-pocket maximum. Not all plans have this, but normally most insurance plans say that you can’t pay more than X amount per year on medical care. Normally some ridiculously high number like 50k. These generally apply to in-network care, not out-of-network.
In-Network- the hospitals, and sometimes doctors that you can go to within your insurance plan. the out-of-network are the ones that your insurance doesn’t cover. For instance, say you need to see a dermatologist. Sometimes, you need to see a primary care doctor (pay your copay) and then they recommend a couple. (Not always; sometimes you can just look up “dermatologist” on the insurance terrible website.) Then you see if they’re taking new patience, and cross- reference them to what the insurance will cover. Neither the insurance nor the doctor will tell you up-front how much a visit will be, and who might be cheaper. If you go to an out-of-network place, because the insurance doesn’t cover it, or you called the doctor and they said they take your insurance, and later find out that they do take your insurance company, but not your particular plan, you’re on the hook for the whole visit and it doesn’t count towards your deductible or max out of pocket.
Premium- The amount paid each month to the insurance company. Fixed cost whether or not you use it. Normally, but not always, split between you and your employer.
Clear as mud?
@ 9 cartomancer
co-payment
Quaint US custom designed, apparently, to bankrupt you.
Our healthcare system in Ontario is not as comprehensive as yours but rather than PZ’s $35 I hand my health card to the receptionist at the clinic and that’s it.
The only thing I have against the “COVID- NO VAX” bit is if people do legit have conditions where they cannot get vaccines. Not “I’m a sucker” but immune deficiencies and allergies. They should get bumped higher in the triage.
I’m glad my dad didn’t live to see this day. He was a Navy medic in the Pacific during WW2, and lived for 50 years with undiagnosed and untreated PTSD as a result of his trauma. I’ve been thinking about him recently because one of the dirtiest words in his vocabulary was “triage.” I remember him being triggered by the word and the idea when I was a small child in the early 50s. No doubt docs, nurses, medics, EMTs of today will have PTSD for similar reasons.
And there was naieve little me thinking that the problem with the US health system was just that you had to pay high insurance costs to access it, because you don’t have a cheap, government-funded health insurance scheme like the French or the Japanese do. But as well as that there are apparently all these Kafkaesque loopholes that are expressly designed to make things worse? A fee explicitly designed to STOP people seeking medical treatment? What sort of nonsense is that?
How are you people not running round with torches and pitchforks burning the whole place to the ground right now?
Who do you burn down? The hospitals? The administrators who actually cause these problems are working from home. The insurance companies? Most of the people there don’t have any authority or ability to change these, the executives are behind bullet-proof glass. The government buildings? We do actually need to have those.
It’s a diffuse, and disperse problem. And the biggest part of it? Most Americans don’t know any better. Most believe the propaganda that it’s worse in other countries. Only 1/3 of Americans have a passport, much less than that actually use it. Most Americans have no idea how bad it is in the US because are plans and access are very, very different depending on where you are, and our neighboring countries only report on outliers. So you get the “Man waited for 5 years for hip surgery” stories coming out of Canada and “Multiple people infected from unsterile equipment in Juarez” coming out of Mexico and think “Man, it’s frustrating but it’s the cost of having the best healthcare in the world!”
In Finland we have these for various healthcare services under public insurance, but in public clinic/hospital system they are fairly small and have a reasonable annual accumulation maximum (that some people still struggle to pay, I hear) and there’s no paperwork or guessing what might be covered. I never saw the actual price of my treatment – presumably it was in tens of thousands.
If I visit a private dentist or buy certain insurance covered meds from pharmacy, the copayment is proportionally larger but the insurance covered portion is still automatically deducted from the bill I get. I don’t suppose there’s any serious healthcare service available that isn’t covered by public insurance, and the public system presumably doesn’t refer people to private services anyway.
Another basic definition:
“Health insurance” is a subscription service providing the user with a deeply satisfying experience of getting oversized bills which also show you other large numbers that must be paid by someone else.
cartomancer:
Well, not “a fee” but many fees.
You go to this nurse/doctor ($), then to that specialist ($), then to get tests/lab work ($), then there are the drugs ($), then you return to check on your progress ($), then fill up on more drugs ($), etc. ($) And yes, this entire time you’ve also been paying regular premiums ($), and none of this “coverage” you nominally get is actually covered until you’ve gone over the deductible ($), assuming you didn’t have go somewhere outside of their “network” ($). And if it’s not “covered” even in the bullshit sense above, you’re obviously paying for that too ($).
Of course, some do still get treatment anyway. Debt is sometimes preferable to immediate death or suffering horribly followed by death. This is what we mean by “freedom.”
It makes perfect sense — not for you, but for the insurers, pharmaceutical companies, hospitals, as well as a whole class of lobbyists, politicians, and so forth.
Found an interesting article that summarizes the attempts for universal health care in the the US.
The biggest take-away to me was various special interest groups opposing the implementation for various reasons. Like the AFL post WWI opposing it as union health care insurance was important to the labor movement.
This probably helped to solidify the concept of having health insurance only if one worked and earned the privilege. Many people in the US feel you shouldn’t get anything without working for it.
Hospitals run based on Capitalism means their primary goal is to make money, not treat sick folks.
When any argument reaches “think of the children” levels, it’s time to breathe in a paper bag for a while. Maybe take a walk outside.
Copays and out-of-pocket expenses are hardly the worst of it. Insurance companies also try to deny care if at all possible.
Three decades or so ago, one of my co-workers got cancer. Our company’s insurance provider (Allstate) told her that the physician-recommended chemotherapy was ‘elective’ (not medically necessary). She could not afford to get the chemo unless the insurance provider paid, and later died of the cancer. Most of the execs in the large insurance companies should go to the guillotine, as their greedy policies have killed many people (one of the few places where I think the death penalty is appropriate).
antigone10 @15, you’re absolutely right. You’d want to put the “COVID – NO VAX” sign only people who could have gotten the vaccine but didn’t. If you have a medical exemption, or it just wasn’t available for you in time, then you get to keep your ICU bed.
Way off-topic, but useful information about fighting insurance co. denial for a treatment or procedure:
https://www.carcinoid.org/for-patients/general-information/what-if-insurance-wont-pay/
My medical bills usually start with a large number that’s the nominal cost of the service. Then there’s the “negotiated” cost that the provider and insurance company have agreed to. Of that, there’s the amount of that the insurance company covers, and the rest I have to cover. Depending on the type service/treatment and where I am in my deductibles, my cost could be small…$35…or quite large.
A couple of years I was taken to a hospital by a fire department ambulance. Some months later I got a huge bill from the fire department for my 15 minute ride to the hospital with several of their chaps along. The fire department and the insurance company couldn’t agree on a negotiated price. Fortunately I work for a large company that is actually self-insured although the plan is administered by a major insurance provider. It only took only email to HR and the insurance company finally came around.
All of this is the best reason, in my mind, to completely rethink the way we cover health care costs.
Okay, I’ll bite…
“ambulance charges”?
Pretty good advice.
It’s ironic. The millions of voters who don’t support a plan like M4A are getting tons of people killed in this country (including children obviously). But that’s not a reason to sort those people lower during triage. It’s not a health condition, and it’s a good thing you’re not a doctor (PZ) since you can’t recognize that. It’s a political position, one which is terrifyingly bad.
That’s also the exact same position taken when it’s implied that healthcare is not a human right, because you think it should be denied to someone whenever you get angry enough with them (or some such bullshit). If it’s ever a weapon to be wielded or a means of coercion, or whatever the fuck you’re thinking it is instead of a right that everyone has which must be protected, you’re doing it all wrong.
So when do we get to deny you your rights, PZ?
Answer: we don’t.
Catomancer @28,
Most insurance covers the ambulance trip to the hospital. They don’t always cover the trip from the hospital to the rehab center, or the rehab center home if the patient is still bed-ridden.
Yes.
Here’s a puzzle: Something’s apparently wrong. How do you know, prior to seeing a doctor, whether it’s “medically necessary” to use an ambulance?
And as it says above, even if it is “covered” in some way, you often still have to pay for that in addition to everything else, depending on which bizarre neo-feudalist realm you happen to be in at the time.
Just don’t come here, cartomancer. It’s for your own good.
“How are you people not running round with torches and pitchforks burning the whole place to the ground right now?”
Step 1: Slaughter all Republicans.
Not many modern problems that aren’t solved or improved by that, it seems. There could be some, but they seem to be as rare as WMD’s in Iraq.
Seriously? Countless examples to talk about. But right now, three Dems are trying to block a provision which lets Medicare negotiate drug prices. They are from the very Dem-friendly states of California, New York, and Oregon. This also reduces spending, which is a thing such asshats are always squawking about, but of course they are just totally full of shit about everything.
If that’s supposed to represent any kind of “improvement” over the Republicans, alright, whatever…. I still hate it.
“Slaughter all Republicans ”
That is already being done to Republican voters by Republican politicians (who are themselves vaccinated). We need a more selective tool.
A virus with an enzyme that is activated by the metals in the American flag pins they are wearing?
Easily spread and harmless, until that enzyme is activated…
the response to this pandemic is just hard to imagine actually happening. I have heard for years what we need is some external threat to bring us all together. Well that has so far proven to be wrong on all counts.
As exemplifed by our health care system and their response to the current crisis it is beginning to look like the ruling class as personified by the conservatives seems to be working themselves toward a snow covered field or a manure cart to the town square and a short flight of stairs. such a pity
Just came across one example to give the foreigners here a little taste of the fraudulent horseshit that we have to deal with in the US:
The patient was being charged $99, for a test which would normally only cost a fraction of that. This was in Wyoming, not an especially expensive place to live where you may expect better pay for medical staff. The mystery bill came over a year later. And if somehow you’re impressed by this level of so-called coverage (“hooray, what a huge discount!”), you’ve fallen for one of their many scams, which you also pay for in the form of high premiums and deductibles in addition to worse care.
For reference:
$10,715.94 = €9,139.20 = £7,798.80
$99.00 = €84.43 = £72.05
@consciousness razor:
You’ve kind of answered your own point there… ‘Democrats’ like this often come from highly Dem-friendly states for precisely that reason. Politically they actually align with the Republicans, but they know they could never actually get elected as Republicans, so they claim to be Democrats instead, and enough people only vote based on the ‘D’ or ‘R’ without paying attention to the actual issues reported that they get in that way.
They’re people who dishonestly seek access to power via claiming party affiliation rather than people who care even vaguely about the ideology the party supposedly stands for. (Without even getting into how much that has shifted.)
In states that aren’t so openly leaning towards the Democrats, these sorts of people would probably actually join the Republican party.
@unclefrogy
Heh. I actually made a comment like that in a story I’ve been working on. “They won’t work together unless they believe they’re faced with an existential threat. Actually being faced with an existential threat isn’t enough if they can continue to deny that it’s happening.”
@drew, spot on! Getting emotional and trying to make any decision frequently results in faulty decision making.
After all, we don’t approve of those who are antivax, so deny care. We don’t approve of people who eat highly processed foods, so deny care. We don’t approve of those who inhale smoke, so smokers and firefighters are denied care.
Sounds decidedly fascist to me.
When confronted with casualties that exceed one’s available resources, which in a hospital environment is always, one triages to sort those whose interventions lower their category, while stabilizing them. The less severe can in theory never be treated, but normally get treated after quite a prolonged wait, so that trauma and vascular cases get treated immediately and the dislocated finger gets delayed if circulation is still patent.
We augmented our 6 man treatment team to 8 men – to triage and treat 200 injured soldiers, with three evacuated from the scene to a hospital trauma center. Guess who did scene triage? Me, as senior medic on scene, I triaged and played traffic cop, treating only those in the greatest need of intervention with an eye toward stabilization and moving onward to our treatment center or trauma center.
And that was after a lightning strike on covered bleachers.
birgerjohansson @ 34,
But what if I wear the flag upside-down to signal distress? Or ironically?
@#18, antigone10:
In order: the insurance companies, the investors in insurance companies, the politicians who signed onto the ACA (which requires everybody to get terrible private health insurance, rather than actually fix the problem), the politicians who resisted single-payer so that the ACA actually seemed like an improvement, the AMA organization (which was the lobbying organization which tipped the scales against single-payer back under Nixon), and the voters who supported the politicians mentioned above.
“True cost of US healthcare shocks the British public.”
I know perfectly well that they are conservatives and “align” in that way, which doesn’t answer any question I had.
Look, they are real Democrats, without the scare quotes. The federal, state, and local levels of the party have supported that type of candidate for a very long time. And with that comes the campaigning and even collusion against actual left-leaning candidates (ones who ironically wouldn’t get scare quotes), in all sorts of different elections in all sorts of different places. Doesn’t matter when or where or who it is — they always come up with bullshit rationalizations for this.
Anyway, there is nothing even remotely atypical about the conservative Democratic politician, and that’s been the reality for the last several decades at least. It doesn’t do any good to sweep that under the rug, and the easy/obvious alternative is just to say “conservatives” or “the right” something like that, if that’s what you really mean.
But that’s not what a lot of people actually mean, and such people wouldn’t object when this is pointed out. Instead, some want to deflect responsibility away from the Democratic party, in an attempt to place it all on the Republican party. That’s pure fantasy, for one thing, but it’s also not helping the left in any way, as some of these people seem to think they’re doing by avoiding any hint of self-examination or self-criticism. It would be an incredible improvement if we just stopped providing cover for assholes like that. Also very easy to do. They’re grown adults, and I think they can take the heat, just like everyone else does.
Vicar, you left out the media conglomerates that live on all of that hospital/insurance/pharma money and push its propaganda.
(Not literal torches and pitchforks, if you ask me. Metaphorical ones are fine.)
“I suppose you’re wondering why you’re in hell.”
The Vicar is lying. The ACA does not require “everybody to get terrible private health insurance.” It’s a life-changing and -saving improvement over what previously existed (and still exists in many Republican-dominated states) for tens of millions of people, including me (I haven’t paid anything for visits, screening, or surgery since it came into effect, and have received outstanding care). Many Democrats who voted for it did so knowing it would end their career. The insurance companies, the billionaires bankrolling opposition to any socialized medicine, and the Republicans who’ve spent decades working to block, weaken, or repeal any such legislation are the reactionary opposition. When the Vicar specifies “the politicians who signed onto the ACA” as those who should be fought, it serves their rightwing interests. You have to be a privileged, oblivious douchebag to claim that the ACA is responsible for US healthcare problems.
The ACA does not require “everybody to get terrible private health insurance.”
To be completely clear: I don’t have private health insurance. I don’t have terrible health insurance. I don’t have terrible private health insurance. This is simply a lie. It’s the sort of lie that works against any leftwing healthcare projects, including those people like this claim to support. The Vicar might as well be paid by the Kochs.
And since the Vicar and consciousness razor might well respond with lengthy screeds for which which I have no patience, I’ll sign off now. But for those who aren’t familiar with the history of efforts to get socialized healthcare in the US, I urge you to investigate the history. And to look at the actual provisions and effects of the ACA.
that”s our boy on this subject
kind of reminds me of politician by cream
Sean Boyd @ 40
An obvious bug to whose solution I am dedicating 80% of the computing power of my hollowed-out volcano lair.
@ 1 cartomancer
Kafka could not describe the US health morass.
An old friend and her husband from the US had rented a cottage here in Ontario. He injured his back while out in a boat. My sister organized a quick rescue—which included the village barber—and we had him in a top-notch hospital 75km away in about an hour or so. Then the second wave of panic hit.
He is a very senior local authority administrator in a large city in New York state and presumably has excellent health insurance. However as my panicking friend discovered it only applied in a radius about 100km from the city centre if he was not on official business.
Next move was a quick evacuation to the USA!
He would have been liable for costs in Canada though they would have been minuscule compared to the US costs. Actually I believe that in more rural, non-touristy areas of Canada minor healthcare charges are often ignored as nobody wants to bother trying to figure out how to charge. Where I live we have enough international visitors we are willing to put up with the hassle especially for serious long term care.
I remember something similar from years ago which involved US & Canadian ambulances meeting in the middle of an international bridge and transferring a patient on a stretcher. A bit like a spy exchange.
“ambulance charges”?
Yes, you pay for getting to the hospital. Happens here too. After a serious accident I got a bill for CDN$45 for the 2km ambulance ride to the hospital. Weird, as the 7 weeks in hospital, half a dozen doctors, various therapists plus after hospital care cost nothing. I even got a taxi chit home.
@ 21 Nerd of Redhead
This probably helped to solidify the concept of having health insurance only if one worked and earned the privilege.
A US cousin seemed really uncomfortable about universal healthcare for that reason.
?
cartomancer:
The cost of the ride to the hospital, which is often billed separately.
A few years ago, my wife had sudden-onset unilateral pain in her head. Excruciating – maxing out her pain scale, and her pain scale was calibrated by giving birth twice. She called me and asked what she should do. Fearing that she was having a stroke, and knowing about the “golden hour”, where medication received quickly can mean the difference between full recovery and lifelong disability or death, I told her “call 911 and get to the hospital as soon as possible”.
She ended up being fine. They couldn’t figure out what it was, at the hospital, but it turned out to be nerve compression, possibly trigeminal neuralgia, which we were able to treat with stress reduction and certain massage and self-massage techniques for her temporalis and masseter muscles.
We got a bill from the ambulance company, despite the fact that we had employer-provided health insurance which is quite good. I was in a bad way for other reasons, and did not reply immediately; I saw the bill and said, “We’re covered. They’ll figure it out.”
They sent it to collections. It was up to me to phone everyone involved and find out that someone had left the last letter of my wife’s insurance number off of the ambulance form, which caused the insurance company to deny insurance without bothering to inquire what the final letter was, which caused the ambulance company to bill us directly. It got sorted out in the end.
The cost to us for that 10-minute ambulance ride would have been about $1000.
The problem is diffuse. This was not the ambulance company’s fault (except for the transcription error); it wasn’t the insurance company’s fault (except for asking a simple effing question to resolve a transcription error, since they could have looked her up by name and seen that the ambulance company had everything but the last digit); it wasn’t anybody’s fault.
I could go on at length. I’m fighting my insurance company over a denial right now (and daulnay THANK YOU for that link!). The whole system needs to be torn down completely and rebuilt as a single-payer entitlement which we can argue about by electing representatives, the way they do it in civilized countries.
Grace
?
@#48, SC (Salty Current):
Typical Obama/Clinton apologist. Post outright lies, and then announce in advance that anybody who disagrees must be a Republican and that it is unrealistic to actually want to fix any problems. What next, another outcry over “purity tests”?
It’s absolutely hilarious that when Obama negotiated in advance with private insurance companies and promised them that there would be neither single-payer nor a Public Option, and then personally called Congress members who were trying to push for those things to make them stop, and this was admitted by his administration immediately after the damned thing passed, and he himself admitted that single-payer was the only long-term viable solution, imbecile party-over-country loyalists like SC here are still trying to pretend it was something other than a way to prop up the profits of private insurers instead of solving the problem. Every problem with the ACA — such as skyrocketing premiums and featureless “disaster-only” offerings — was entirely visible in Massachusetts, where the bill the ACA was based on was passed under Governor Mitt Romney. And even though SC works entirely in the service of people who are in the same pockets as the Republicans, they are the first to claim that, no, it’s their opponents who are right wing.
(And incidentally, in case anybody was wondering: it’s blatantly obvious that SC pays nothing because SC is on Medicaid, which could have been expanded to its present state, or even beyond it, without passing an individual mandate to force people into buying private health insurance.)
Vicar, quit lying.
@ cartomancer, #17
We’re all too sick and tired to do much of anything about it. Well, not ALL of us, but the healthy folks who don’t have to deal with the shit insurance companies pull day in and day out have the luxury of not thinking about how terrible our system is, and thus most don’t care. I, for one, am always exhausted because my asthma isn’t well-managed.
If you want a more detailed breakdown of what healthcare can cost in the US, I offer my story:
There’s a medicine I can use once a day that treats it perfectly… but it costs $350 (or possibly $450) a month, and insurance refuses to pay for it. Why? Because they can.
I can’t afford $350 or $450 a month, especially since my “good” insurance costs about $750 a month. That doesn’t include co-pays for my other medications (minimum $15 per medication) and doctors visits ($35 for primary physician/$60 for specialist, in either case I also have to pay 20% of the cost of the visits). That doesn’t apply to my psychiatrist, however, as mental health is something my insurance simply refuses to pay anything for. If I go to the emergency room, I’m $500 up front, and if my insurance company decides the visit wasn’t necessary, they’ll refuse to pay any bills related to an emergency room visit.
Then there’s my $2800 deductibles. There are two deductibles: one for medication, and one for everything else. In practice, this means my deductible is actually $5600. Fortunately, I seldom meet the “everything else” deductible, but I usually meet my medication deductible within the first three months of the year.
In practice, I’m out around $12,000-$15,000 on healthcare/insurance each year, assuming I have no real emergencies. For that price, I receive insufficient healthcare to live a normal life. I’m not really in that bad a way, but without adequate mental health services I’m unable to get and keep a job.
Those costs don’t go into the tremendous hassle I have to go through just to get my insurance to pay for the things they are explicitly obligated to pay for. They deny coverage routinely just because they can, as they know that a lot of people don’t have the time to spend hours jumping through all the bullshit hurdles they throw up. In my case, I’m certain they deny so many things (and do other sleazy shit) because they have my full psych profile, and thus know I’m not good at navigating the particular bureaucratic mazes they’ve crafted. Everything I just mentioned in this paragraph is, ostensibly, illegal. But, like I said, they know very well that I’m terrified of dealing with authority, and they’re careful not to be too overt.
Insurance execs are mass murderers, period. As for why we haven’t dealt appropriately with them, well, that’s why we have police. To make sure that the worst murderers never face justice.
I am indeed on Medicaid, as are, again, tens of millions of USians. I would like it to be expanded to everyone, but it’s being blocked by the right (and their useful idiots like the Vicar). These are the states refusing Medicaid expansion: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, Texas, and Wisconsin. (You might sense a theme.)
So you’re going to stop lying when?
Note that the Vicar refuses to acknowledge the lie about the ACA requiring everyone to “get terrible private health insurance.” It’s all lies. No accountability, no responsibility, no interest in the common good. No political debate can be had unless you STOP LYING.
(And as an aside, there are lives on the line in your crusade. Pause and think about them.)
Seems kinda disgusting to look forward to triage as a method of settling political scores with the unvaccinated. I don’t want sociopaths making those kinds of decisions.
The Vicar is right about the history of the Heritage Foundation’s health care plan that forms the basis of the ACA. I don’t expect partisan hacks to accept it, but there’s a reason there are deep rifts in the Democratic party right now, and why more and more leftists think it’s well past time to treat the Democratic party as the adversary it is instead of a partner in an abusive relationship.
Oh, STFU.
A technical point about Medicaid:
So, it’s funded by the federal government and (for no good reason) state governments. That money then goes to those private MCOs (including big insurers like UnitedHealthcare, Aetna, etc.) in a contract with the state agencies. A big confusing clusterfuck of different systems, because … why not?
Of course, that’s pretty “normal” for this country. The federal civilian workforce has remained stagnant or in decline since WWII, even though the population requiring its services has gotten much larger. And obviously there are also newer agencies now, which are thus expected to do much more with much less.
The approach is generally to pay some other private entity to do the government’s work, because those rich owners can also donate to campaigns for the politicians who give them these nice big contracts. I can’t explain it, but many have become almost completely desensitized to the fact that much of our system (even the “good” or at least “okay” stuff) is fueled constantly by bribery and nepotism and collusion. If it doesn’t have the stench of a corrupt corporatist good old boys’ club, you’re probably just in the wrong place. It’s very hard for me to understand how anybody can be okay with it, but that’s what we’ve got.
beholder #59
Several people have said something similar, so I think it important to clarify: This has nothing to do with “settling political scores” with or “disapproving” of anti-vaxers. This has to do with the fact that they’re endangering their fellow citizens. They’re causing a huge burden on an already struggling health care system, at a time of a deadly pandemic that has already cost close to 700,000 lives in the US alone (I expect we’ll pass 700k sometime in October). There’s a direct causal line from people not getting vaccinated to other people dying.
We’re now into triage territory. That’s not a decision, it’s a fact: Somebody is going to die, we’re just debating who.
I wonder why we should prioritize saving the people who caused the problem in the first place, rather than those who did their best to avoid it.
Questions for The Vicar, consciousness razor, beholder: did passing the ACA make things better, worse or neither for Americans needing medical care? If the Republican Party andor the packed courts destroy it, will that make things better, worse or neither for Americans needing medical care? A simple “better”/”worse”/”neither”, with accompanying justification and without any further screeds about how much better it could have been (I already know that, living in the UK) would be appreciated, but also, given prior experience, unexpected.
As long as the US uses a “first past the post” voting system, it’s going to have a 2-party system, cuz there’s no percentage in coming in 2nd. Personally, I’d rather like the US to abandon “first past the post”; there are a number of viable alternative voting systems which are already in use in various nations, after all.
But until such time as the US does switch over from “first past the post” to a voting system which doesn’t incentivize 2 parties… well, we’re stuck with 2 parties.
Vicar, among other people, affects to believe that there is no real difference between the two major US political parties. But…
Donald Trump ran as a Republican.
AOC ran as a Democrat.
Any questions?
KG: you didn’t ask for it, but here’s my opinion. It depends on your situation.
For me, ACA did nothing. I’ve got good insurance through my employer, and I don’t have major worries right now about personally coping with potential medical crises. I still see the bills, though, and medical and drug costs are still through the roof. There has been no cleanup of the medical system, it’s still a mill for enriching biomedical corporations and insurance companies. So much inefficiency and grift…
However, I know it did benefit people who are in less cushy positions than I am. To some degree. It’s a leaky, sloppily stitched together safety net, but it’s still a net, sorta, an incremental improvement over the situation before.
Where I do worry, though, is that I can’t retire, mainly because I can’t afford to lose the health care I’ve got. I’m going to have to die in my traces, because ACA is not adequate, and health care is still a rickety, clumsy mess for the majority of Americans. We have to keep improving things, and I don’t believe that taking one step back, losing ACA, will be followed by two steps forward.
PZ Myers @ 65
It may be worth doing a deep dive on your retirement options.
My insurance costs have actually gone down compared to the first few years after I retired from my job. That happened when I finally applied for social security and got Medicare along with the Medicare supplemental plan offered by our state retirement system.
I think some of the drop may have been due to pressure from the ACA at the time. And I’d have to check, but I may even be paying less than I did when I was employed and having payments deducted from my paycheck.
Or I suppose you could go emeritus…
The ACA has been a huge advance for several marganalized and vulnerable segments of our country. The Medicaid expansion alone would make it worth it.
What it also did is save a whole lot of hospitals in rural areas from closing down, an ongoing problem for decades now. This matters a lot in the West where the nearest next hospital can be 50 or 100 miles away.
I saw one hospital in a Red rural area that was on the edge of closing down. It’s a heavily GOP area and also has a lot of poor people. They were being overrrun by patients that couldn’t pay their bills. The Federal government picks up some of that uncompensated care but it wasn’t enough.
Then the ACA passed. All of a sudden their cash flow improved. Patients were paying their bills or rather the ACA made it so the bills were being paid.
They are still there, still operating. And these days, are full of Covid-19 patients and have a refrigerated truck parked next to them.
The eligibility requirements for medicare.
You can buy into both parts A and B if you didn’t have medicare deducted from your paycheck.
I much prefer medicare with good supplement insurance compared to my prior work health insurance plan.
Amid COVID surge, states that cut benefits still see no hiring boost
The rethugs won’t learn from their cruelty.
More at the link.
Sorry, meant to post my #68 in the infinite thread, now cross posted.
KG:
Generally better than it was. Significant improvements for many. No question about that.
At the same time, the political situation may be worse. (Some days, I feel a little more optimistic, and other days not. So I don’t know.) We’re still relying primarily on employers/employment, as well as private insurance, private hospitals, private drug companies, etc. It’s not all about the ACA itself, of course. It’s partly a question of how people are discouraged from expressing any view about “how much better it could have been,” because they are expected to accept the status quo and not advocate for change. But to the extent that the ACA is stalling or preventing a socialized system, possibly for decades to come, that’s not good. The sooner we have a system that’s something like the one you enjoy in your country, the better.
Thanks PZ, raven.
BTW, I shouldn’t leave the impression that there’s nothing wrong with the UK’s health system. the NHS has been both grossly underfunded, and subjected to successive “reforms”, notably introducing an “internal market” which simply added layers of useless bureaucracy and pointless competition – probably a deliberate attempt at sabotage. Even from the start, though, it was never the fully socialised system that was needed: GPs (first-line medical practices) are independent contractors, while hospital consultants can and do moonlight in the private sector (Aneurin Bevan, the post-WWII Labour politician who took the lead in bringing it in overcame their opposition by in effect bribing them, and is reported to have said: “I stuffed their mouths with gold”). But the Tories hate the very idea of state provision of services, free at the point of delivery, and would love to destroy it if only they dared risk the political backlash – and when I hear tales of the American system, I realise how lucky we are that public support for the NHS is so solid that they never have – yet.
@ 52 SC (Salty Current)
first “?”
US translation ~ senior manager in city gov’t.
second “?”
OHIP Billing Codes: Ontario Schedule of Benefits 2021
Presumably what would form the basis for billing an uninsured person in the province.
BTW, an average citizen would know nothing about these OHIP codes.
Do you have any evidence for that claim? Because I’m not seeing any here – see comments by jrkrideau, SC, PZ, vucodlak…
Triage – it isn’t just for wartime anymore!
Oh FFS, Albanian Broadcasters Happy to Host Antivaxxer Conspiracy Theorists:
Previously in this series of poopyhead threads, that nonsense has been dealt with. In brief: Whilst biologically possible, Anjezë Bojaxhiu is not known to have been in the States prior to the 1950s(?), making it impossible teh horrible superstitionalist theocrat was Dr Fauci’s mother.
The CDC says Covid-19 vaccinates are delivered by a gauge 22–25 needle, which are less than 1 mm in diameter. It’s possible Albanian millimetres are different than ISO’s, but only in a suitable modified space-time reality (possibly the same one hair furor imagines he inhabits?).
The mildly deranged penguin says teh lluminati confirms they aren’t interested in the vaccine’s microchips, already having full control of all Wifi, 5G, GPS, and SoC manufacturing… they not only know where you are, were, and will be, but you have, are, and will think, as well as the most important thing of all, what you’ll eat for breakfast tomorrow. Bill Gates, she says they say, is yet again so far behind the curve he thinks digital watches are yet to be invented (apologies to Douglas Adams).
Apologies, me@76 was intended for poopyhead’s current Infinite [Pandemic and Political Madness] Thread.
KG:
Many (even some here) have been defending the ACA to the hilt and have opposed plans like M4A. I just don’t know where you’ve been for the last several years, if you’re under the impression that there’s been no significant resistance to things like M4A (including from numerous Democrats), and that nobody loses their shit as soon as a bad thing is said about the ACA. To put it very mildly, the atmosphere is not one that I would describe as being open to change or welcoming of criticism.
Have you really not noticed? I mean, you’re in the UK, so I could understand if someone there hasn’t been following things closely. But I think you have, so it’s surprising that you think you need any more evidence than you already have.
For some, I don’t think it’s opposition to “socialism,” although there is a lot of that in Dem circles too. It’s also a point of pride that they got anything significant done, and this must be a selling point that is communicated to voters, in order to win more elections for the party. Some maybe just don’t see it (yet) as “the status quo” that it has become, but rather as some sort of radical new change that needs constant vigilance from ardent defenders. Many worry about what Republicans might do with the knowledge that Dems are divided over this, so the strategic idea is to present a unified front and somehow hide such things (or shut down discussions before they can get anywhere). No doubt many people are also personally/financially invested in it, because they see their careers as being threatened (even though they often wouldn’t be, although it could cut into profits for many).
Obviously, I can’t read anyone’s mind, but many would fit into one of these patterns. There are probably some other psychological and sociological factors at play too, but to keep this somewhat short and to the point, that’s basically the impression that I’ve gotten.
Anyway, I thought you were saying in #63 that you didn’t want “any further screeds.” That is more immediately what I was responding to in my comment. Admittedly, I can’t be sure what you would count as a “screed,” but I suppose it’s effective enough due to the vagueness. Should I have interpreted that differently?
@ 63 KG
For states that passed Medicaid expansion, incrementally better. For states that did not, neither at best, worse for those who were hit with penalties for not buying terrible private insurance.
Go fuck yourself. I don’t have to make excuses for bad laws.
Incremental improvement isn’t the best option available with a democratic society. It’s not even among the good options. The Democrats were able to pass whatever laws they wanted to in 2009-2010 and for most of 2021 so far; it’s fair to assume the ACA is what they wanted, or, less generously, the clearest expression of their anti-populist contempt they thought they could get away with.
@ 64 cubist
As long as the US uses a “first past the post” voting system, it’s going to have a 2-party system
This just-so excuse for propping up the two capitalist ruling parties is tiresome. Yes, Democrats and Republicans crafted several mutually-reinforcing laws in all fifty states that entrench their electoral advantage over third parties. No, it’s not as fundamental as the way our ballots are counted; other countries manage to do just fine with multiple parties and first-past-the-post. Some countries only have one party, which is largely what our situation resembles. Interesting how first-past-the-post doesn’t help them magically spawn an opposition.
The ACA is good, to a point. The problem is that I am someone who does not make enough money to qualify for it. Thus, I am stuck paying full price. One of my sisters is helping me out. I do hate taking money from people, but I’m out of options. Yes, I am unemployed, but looking…and looking…and looking. I finished graduate school almost 20 years ago, and I’m getting burnt out on job applications. It would be nice if potential employers got back to me, but they frequently don’t. I also happen o be a visibly disabled person in a Republican state, where the last I heard, a little less than half of the people in the state who are disabled and can work are employed. I’d happily do a job washing dishes, but the last time I worked in that sector, dishes seemed to be the last thing to be attended to. Besides, my sister is immunocompromised, and the vast majority of the state is unvaccinated. It seems like working fast food is just tempting fate. (She was in the hospital with multi-organ failure several years ago, before COVID came on the scene. She’d be a breakthrough infection that ended up in the ICU.) So yes, the ACa has been great for some people I know, but for me, it hasn’t made a difference.
Ah ,American style heath care business ,for that is what it is ,coming to the UK ,thanks to the dickheads voting for the tories .
They have wanted to get rid of the NHS for 80 odd years. They are very patient ,all they had to do was wait for the thickest generation
of english people ever .
@ 74 KG
see comments by jrkrideau,….
I am horrified by the US health
systemwhatever but I am Canadian. I don’t know vucodlak’s nationality.Our system could stand a lot of improvement but we have a system. Well, 13 but they are all basically the same. My Ontario health card is valid anywhere in Canada.
The ADA sounds like an improvement but the entire healthcare deliver system sounds like something from hell.
OT 1
Bart D Ehrman a secular Bible scholar has just published a piece at Youtube unpacking the book of revelations and what it really was about.
OT 2
Apostate Prophet has posted an except at Youtube from a recent debate between ex-muslim Harris Sultan and a western islamic scholar (whose name I never get right) that is not ‘using a filter’, giving an insight into the mind of salafist muslim scholars.
Be warned, it is not pretty.
BTW
Norway has a rock-solid economy in case you are thinking about where to go in case the corruption/traitor party climbs back in power. And their public health insurance system is second to none.
My native Sweden is fine, but not as scenic. Denmark is fine if you like very flat landscapes.
Germany has a weird language with gendered nouns, will require lots of language training.
@ jrkrideau, #82
Hmm… perhaps there’s some subtle clue buried deep within the text? Here’s a hint: the first letter of each line gives my location in relation to the position of Aldebaran on Walpurgisnacht in the dead tongue of the rat-bat-spider people of the miffed mauve planet.
Alternatively, there’s this obscure bit of text from ages long past (by which I mean my #57):
Truly, it is an enigma.
Sorry. Well, sorry-ish. I could have resisted, but where would be the fun in that?
Unlike the Vicar and the other lofty lefties, I don’t live in a world where perfect choices are available. So, I tend to judge things in terms of whether they make things better or worse. The ACA increased the number of people with health insurance. It mandated that many common-sense preventative procedures and drugs be free at no cost to the patient. It reduced healthcare related bankruptcies. It improved health outcomes for many of the most vulnerable Americans.
It is far from perfect. It is far from good enough. But only a blinkered fool would deny that it is an improvement on what existed before.
consciousness razor@78,
What I said @63 was:
so your #71 was appreciated, but raised a new point, which I queried@74. I’m not really convinced by #78 that:
but I accept it (who are these “discouraged” people?) as a reasonable response
And the same to you – with brass knobs on! I wasn’t asking you to make excuses for anything, as you’d know if your reading comprehension was up to scratch, and you weren’t filled with a sense of your own ineffable superiority.
great thought experiment: imagine the world is sims like computer game and you create the society and healthcare system to make your productive outcome best possible.
How would you do that?
I can imagine having co-pays at some small amounts to discourage some people who go to doctors when they are bored (we have such situation here) but I can’t imagine deductibles, out-of-pocket costs or insurance companies for that matter to be a thing.
Not only that, you would be paying fines/increased rates of taxes for not going to the doctor for regular checkups as they lower the final cost of healthcare. You would be forbidden to work with the sniffles (and getting sick pay is the crucial part of that) because spreading the cold to other workers is harmful in the long run.
When you look at healthcare system from the perspective does this specific solution increase or decrease total effort (in human time, resources and pollution) then you see how dysfunctional the system is and when you look at all the solutions that harms society the most, they are mostly designed to extract the money from people.
There are 3 general types of corrupted states – banana republic (almost everyone can be bribed by almost everyone, corruption is normal), cleptocracy (look at Putin’s Russia, where ruling elite highjacked the state to fill up their own pockets) and corporate corruption. known as crony capitalism (crapitalism), where corporations bought the politicians so state fills up their coffers.
If 2nd amendment was really meant to oppose tyrannical government, US would be already in an open war between CEOs lobbyists and politicians versus people.