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PaperclipPerfector  1yr ago (text post)   3363 thread views

Friday Fun Thread for May 12, 2023

Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.

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This will probably get buried but it's outrageous that you can be bankrupted by medical debt if you get sick in the US! In Europe this doesn't happen.

I run a cancer forum on reddit https://old.reddit.com/r/coloncancer In the 6+ years moderating the community, I have encountered exactly zero Americans being bankrupted or made destitute due to medical debt, or being denied treatments or long delays owing to unaffordability. Everyone gets good, timely, high-quality treatments regardless of socioeconomic status, including costly surgeries and the latest chemo even if there is low likelihood of the procedures working. High medical bills are either negotiated lower, covered by various insurance programs (like Medicaid), covered by charity care, etc. Medical debt can be easily discharged, unlike other types of debt.

Fascinating!

One thought: is the group of people that doesn't have insurance and therefore doesn't get annual physicals and therefore doesn't have their colon cancer detected before it's way too late (a) a real cohort and (b) very well represented here? That would be a case of people having worsened outcomes because of poor access to care, no?

From what I have read, Canadians who have above average risk factors, such as family history, seem to have the hardest time getting timely colonoscopies, which would detect the cancer sooner.

Probably don't tell stories about their good treatment so we only hear from people with bad treatment or that have mental illness (i.e. half of Reddit).

So here's another +1.

I had a serious form of cancer about 10 years ago. My treatment was wonderful. My doctors were excellent. Treatment started very quickly after I first went to primary care doctor with a mysterious lump. Furthermore, my cheap insurance paid for most of it. There were no surprise bills. I was out less than 10k out of pocket. I am lucky to be living in a major city in the US.

My step-kid has been on Medicaid for most of his life and he has some kind of non-metastatic cancer that grows and regrows in his throat. It's fatal for some kids and I think it's Make A Wish eligible (not really sure what that is but it sounds grim). In his case he merely had to have throat surgery under general anaesthesia on a near-monthly basis when he was a toddler to keep cutting them out.

Fortunately as he aged they stopped regrowing so aggressively and now he only needs surgery about every 12-18 months.

The surgeon who sees him is some kind of leading expert in this surgery and he's seen at this hospital that I didn't even know could be so shiny and nice.

Anyway, we never once had to pay out of pocket to treat it while he was on Medicaid. Now that we're on a private insurer it's about 10-20% co-insurance, so it's a few grand out of pocket every time we take him in; seems like a great fucking deal all things considered.

The surgeon did make a... funny?... remark once when he was finally switched to a private insurer from Medicaid that now the reimbursement will be enough that he can celebrate after each surgery with a mid-range IPA instead of PBR. Not sure how much to read into that; given how health care reimbursements work I could imagine the dude has a garage full of exotic cars or he really could mean he all-in nets beer money on each surgery. They both seem equally possible. I do hope he has a lot of exotic cars though.

Wow, that sucks. I can't even imagine how stressful that would be. Having a good doctor makes a world of difference.

The system seems to rely upon the good nature of some doctors. There are lots of doctors working for not much (compared to the stress of the job and compared to something like a Google engineer). On the other hand, there are profit-maximizing doctors pulling down 7 figures who are probably responsible for a large percentage of the cost inflation.

It's tough to get rich seeing patients. But if you own an MRI machine or other diagnostic equipment you can really make bank. I'm pretty sure it's been shown that doctors prescribe more unnecessary tests when they are financially rewarded for doing so.

But if you own an MRI machine or other diagnostic equipment you can really make bank. I'm pretty sure it's been shown that doctors prescribe more unnecessary tests when they are financially rewarded for doing so.

Owning a medical practice where you have your own MRI machine and write prescriptions to use it does sound like it would be pretty lucrative.

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