UHC CEO Gunned Down in Midtown Manhattan

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.

Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.

Yes. We spend millions keeping babies alive who will never leave the hospital, let alone live anything close to a normal life.

No we don’t

Yes, we do.

"On average, surviving infants approaching micro preemie status (of birthweight between 500 and 750 g) stay 103 days in the NICU costing $313,000 (in 2019 US dollars) per infant to the healthcare system [7]. Beyond the neonatal period, it is estimated that less than half of micro preemies will survive after their first year (45.9%) and most will have major morbidities that are likely to affect their long-term prognosis [[8], [9], [10]]."

https://www.sciencedirect.com/science/article/abs/pii/S1744165X22000154#:~:text=Across%20studies%2C%20the%20mean%20healthcare,first%20six%20months%20of%20life).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.

You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.

Old people are covered by Medicare. Their care isn't the reason why the United or BCBS plan you get through your employer is expensive.

It's part of their business, isn't it? If you have a line that isn't overly profitable, you seek higher profits from the other lines.

Medicare Advantage is where the real juice is!

Medicare Advantage is a horrible scam and quite a few doctors no longer take Advantage plans.

Cites or more info on this?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.

You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.

Well advocate for assisted suicide/euthanasia

More medical intervention? Why not just die of natural causes.

Because it can be extremely painful and debilitating without support.

And in the meantime you might be a terrible burden on your loved ones for years or even decades.

You realize most won't jump to assisted suicide instead.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.

You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.

Well advocate for assisted suicide/euthanasia

+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.

Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.

Yes. It's absurd how many resources and how much money is being allocated to fairly hopeless end of life situations for very elderly patients with dementia or Alzhemers. But I have no idea how you create rules or legislation to mitigate against absurd and hopeless interventions that raise the cost of health care for every other living person.

England made it legal, this month!

It's been legal in Oregon since 1997.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Say what you want about this killer but we have been talking about healthcare and it’s ethics for over a week now. He wanted to make a point and he certainly made it.

Yet oddly, we have not talked about Gun Control, with this cold-blooded m*rder. hmmm. Where are all those marches and protests?

See my 12/9 post.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:I suspect the apologist for the insurance industry who's been posting in this thread all day in fact is an employed wonk with the insurance industry. LOL.

Yeah, that poster seems to be worshipping soundbites.

workshopping

Well they aren’t working.

Honestly, healthcare IS a basic human right. As a society we’ve developed the science to treat disease and ease suffering. Why a big fat insurance CEO needs to get a big cash bonus before humans are treated is simply bizarre.

I think most people agree that healthcare is a human right but the rub is deciding how much healthcare and what kind of healthcare that is?

The question is, how do we make sure those decisions are made by people for whom health care is care, rather than those for whom it is first and foremost a financial investment whose value must by definition grow?

Well these are decisions that should not be made by people with a fiduciary duty to shareholders. No matter who is the CEO, they’re going to have conflicting legal duties to their investors and a moral duty (and contractual) to their customer.

Insurance company are using AI to approve and deny medical decisions

Evil.

[Anonymous]

Oh the Economist summed it well:

Sadly, changing health-care policy is easier to talk about than to do. And one irony of Mr Mangione’s writing is that, while it is true that American health care is expensive and often ineffective, that is not clearly linked to America’s lagging life expectancy. Indeed, one notable contributor to shorter lifespans has nothing to do with doctors. That is, the 20,000 or so murders committed each year with guns.

But I’m an American and know our government won’t do anything about either! They’re bought off by the gun and health insurance lobbyists. Congress is unwilling to serve the average American.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Say what you want about this killer but we have been talking about healthcare and it’s ethics for over a week now. He wanted to make a point and he certainly made it.

Yet oddly, we have not talked about Gun Control, with this cold-blooded m*rder. hmmm. Where are all those marches and protests?

Or how Brian was about to go to prison for his crimes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.

Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.

Or even back it up earlier to the super preemies. The reality is nobody wants to tell anyone else no, their care is not necessary or worth it. People want other people to make the hard decisions they would never make themselves.

People are able to make the hard decisions if they are given full information. But there is little training in the medical community for sharing hard cold facts with the parents of terminally ill children and/or dying elders. There was a great op-ed about this in the NYT recently, by the mother of a girl who died, lamenting that she spent the last months with her daughter focused on treatments instead of enjoying the remaining time they had together. Here are some letters to the editor that followed.
https://www.nytimes.com/2024/12/07/opinion/orli-wildman-halpern-death.html

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.

Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.

Or even back it up earlier to the super preemies. The reality is nobody wants to tell anyone else no, their care is not necessary or worth it. People want other people to make the hard decisions they would never make themselves.

People are able to make the hard decisions if they are given full information. But there is little training in the medical community for sharing hard cold facts with the parents of terminally ill children and/or dying elders. There was a great op-ed about this in the NYT recently, by the mother of a girl who died, lamenting that she spent the last months with her daughter focused on treatments instead of enjoying the remaining time they had together. Here are some letters to the editor that followed.
https://www.nytimes.com/2024/12/07/opinion/orli-wildman-halpern-death.html

THIS. It is very telling that medical professionals who work in these fields - oncologists, pulmonologists, palliative care doctors, hospice nurses - almost universally say that with most serious diagnoses late in life, they want less treatment rather than more.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.

Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.

Yes. We spend millions keeping babies alive who will never leave the hospital, let alone live anything close to a normal life.

No we don’t

Yes, we do.

"On average, surviving infants approaching micro preemie status (of birthweight between 500 and 750 g) stay 103 days in the NICU costing $313,000 (in 2019 US dollars) per infant to the healthcare system [7]. Beyond the neonatal period, it is estimated that less than half of micro preemies will survive after their first year (45.9%) and most will have major morbidities that are likely to affect their long-term prognosis [[8], [9], [10]]."

https://www.sciencedirect.com/science/article/abs/pii/S1744165X22000154#:~:text=Across%20studies%2C%20the%20mean%20healthcare,first%20six%20months%20of%20life).

What do other countries do with micro preemies with 50% survival rates and 100% devastating disabilities rates?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Say what you want about this killer but we have been talking about healthcare and it’s ethics for over a week now. He wanted to make a point and he certainly made it.

Yet oddly, we have not talked about Gun Control, with this cold-blooded m*rder. hmmm. Where are all those marches and protests?

Parts of it were 3d printed, gun control is about to die out soon once crazy people can make it at home.

That’s ok. Bulletproof backpacks and an armed schoolteacher will solve the problem.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Irrational family members and elderly patients at end-of-life care time are what drive the health costs off a cliff in America.

Should this apply to babies in ICU with a diagnosis of three to nine months to live as well.

Or even back it up earlier to the super preemies. The reality is nobody wants to tell anyone else no, their care is not necessary or worth it. People want other people to make the hard decisions they would never make themselves.

People are able to make the hard decisions if they are given full information. But there is little training in the medical community for sharing hard cold facts with the parents of terminally ill children and/or dying elders. There was a great op-ed about this in the NYT recently, by the mother of a girl who died, lamenting that she spent the last months with her daughter focused on treatments instead of enjoying the remaining time they had together. Here are some letters to the editor that followed.
https://www.nytimes.com/2024/12/07/opinion/orli-wildman-halpern-death.html

+1. When my mom was diagnosed with advanced cancer at 61, she straight up told the oncologist she only wanted treatment if it had a good chance of meaningfully extending her life. She was dead in 6 months, most of which she spent in treatment that maybe, MAYBE, extended her life a month or two. She would MUCH rather have had 4 months to spend with us than spending it at chemo and radiation. And she knew this in advance, wanted to be told, and the doctors still wouldn't tell her. A couple of days before my mom was released to hospice (and two weeks before she died) some AWFUL oncologist at the hospital looked at a beach town t-shirt I happened to be wearing and said, "Oh, you should take your mom there!" My mom at that point couldn't walk, or use the toilet alone, and barely knew who I was." I was I had the balls to have said, "ARE YOU EFFING SERIOUS RIGHT NOW?"

[Anonymous]

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Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

So you’re saying we should shoot him in the back?

No, you treat pain and discomfort. But we shouldn’t be subjecting those over 80 to colonoscopies, mammograms, dialysis, adv cancer treatment, etc.

What about premature infants in NUCU for months on end costing hundreds of thousands or even millions of dollars? Or, infants with severe brain damage kept alive for years?

Special taxes for prolife people.

[Anonymous]

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Anonymous wrote:

Anonymous wrote:Did anyone read the CNN article about health insurance denials? On a personal level, they are all terrible stories … but on an economic/policy level, I’m not so sure.

The 70 year old woman from Worcester complains that she pays hundreds of dollars a month but her insurer would not cover more than 6 weeks in a post-acute rehab center after her surgery, although it appears that center cost about 5K a week…..the economics just don’t add up. Most elderly people will have multiple health issues and surgeries are not uncommon. If the insurer is charging hundreds in premiums, yet paying out tens of thousands in provider charges, how can this make sense? It used to be that these large costs were rare so the premiums paid by healthy people covered the costs of the unlucky, but now it seems like almost everyone has some health condition or needs a surgery to improve quality of life. Post-acute in patient care is great but that wasn’t even really a thing 20-30 years ago—you just had to have family that would stay with you to help you post-surgery.

And the young girl with cancer probably picked a cheaper plan with a higher co-pay, figuring she was young and healthy. Should insurance companies not be permitted to offer those types of plans? I really don’t know. The problem is that most health care consumers don’t really adequately assess their potential risks and everyone is operating with insufficient information about what their health needs might be, and what things actually cost.

As far as the paramedic and his MRI….that seems ridiculous and he probably has a good appeal.


https://www.cnn.com/2024/12/12/business/us-health-care-insurance-frustrations/index.html

5% of the population accounts for 50% of healthcare spending. There are a lot of people like me who rarely visit doctors and have no prescriptions. I do screenings, blood work, etc., as recommended, but I'm a healthy 47 yo F who pays about $5K a year in premiums.

Are we talking about the same 5% of people year after year? If not, I'm not sure this is particularly helpful information; it just means that in a given year, 5% of the population gets really sick.

It seems like a small share of the US population have long-term illnesses that require expensive treatment, and those people should definitely get all the help they need. But a good chunk of the expensive patients are just people who like to get the latest tests and treatments for every small health issue, expecting miracles and without doing any of the hard work it takes to stay healthy. For example, for most (not all) people, exercise will resolve back pain, but some people refuse to exercise and just want $$$ surgeries and painkillers. I know someone who goes to the ER (or takes her kids there) many times each year, because she has untreated anxiety and refuses to see a therapist or take anxiety meds. And before you tell me I'm lucky that I'm not seriously ill -- I have a chronic condition that I manage cheaply with drastic changes in diet and exercise, while I know some people spending tens of thousands on medication that allows them to live symptom-free without any adjustment to their diet or exercise. I'm not immortal and I'm sure some day I'll need some expensive round of cancer treatment, but getting expensive treatments when absolutely necessary in old age is not the same as expecting them as a routine matter starting in childhood.

Why should one group "definitely" get expensive on going treatment and another be denied some tests?

In order to ensure a baseline of health for the whole population. If you want every headache test to be paid for, at the expense of not having money left for cancer treatments, you will end up with a society where minor conditions are over treated and life-threatening ones are fatal.

Tell us which age group sucks up most of the resources and how that benefits the whole population.

Oh I agree 100%, the ridiculous life-extending care for the oldest cohorts are out of control in this country. Paying $30,000 a month for intensive nursing care for a very sick 90-year old so he can live to 91, all by himself strapped into a bed with a feeding tube.

I fail to see how that person "definitely" needs their care but a younger able bodied person should be shamed and denied for seeking out answers or tests for an issue they are having. Since apparently we have to pick and choose what benefits society as a whole, according to that PP.

You're not reading right. Extending life for the oldest people who are not able to sustain themselves is a waste of money and makes it harder for younger, healthier people to get the care that can actually help them go back to living a normal life.

Well advocate for assisted suicide/euthanasia

+1 I have zero desire to be over 80 and be sick to the point where I’m sitting around waiting to die and all of my family has to sit and watch me whither away and having to tolerate pain. Let the elderly decide after the age of 80 and let people over 65 decide if they have something terminal.

Nurse here. And this is why Advanced Directives and having the conversation with loved ones are so important. We see so much intervention at the end of life that honestly sometimes just looks like torture. And often it is family driven.
I can understand when it’s a young person and there is a hope that person will pull through and make it. But 80-something year old nana with dementia and no quality of life? It happens more often than people realize.

Yes. It's absurd how many resources and how much money is being allocated to fairly hopeless end of life situations for very elderly patients with dementia or Alzhemers. But I have no idea how you create rules or legislation to mitigate against absurd and hopeless interventions that raise the cost of health care for every other living person.

You don't. You give insurance companies the flexibility to establish and enforce their own policies, and you hope that market pressures from employers purchasing group plans, as well as public perception, generally keep things from getting too unreasonable. Obviously that has problems, but I'm not sure there are better alternatives.

I wish (reasonable) health care was a guaranteed right provided through a socialized health care system, but I don't have a lot of confidence in the American public to accept that reasonable cost-benefit tradeoffs need to be made to make it practical.