Eugenics? Cost cutting?
Darwinism.
At first glance I read: “afforable deaths”…
Oh no we don’t have those in America. Dying is expensive, but don’t worry the government won’t get a penny of that as an estate tax
I have yacht payments and a mortgage on a third mansion to make. Don’t make me pay for you to stay alive.
I did too!
A penny saved…
Are they falling in China, Russia, Susan, Israel? only shit holes are our peers.
China yes, susan no. But susan is an outlier.
Sounds Sus.
Suddenly Susan
Leave Susan out of this.
You’re right. She’s really cleaned up her shit.
The name is Ginormica.
Can you please not use that term “Lazy Susan”? It’s got racist and sexist connotations, and I’d really prefer you just not call it that.
Who’s that racist towards? Susans? That’s crazy. Where’d you get that?
Okay. I would just like you to not use the term.
You’re right. You know what? It should be…
We should definitely start using the Ambitious Susan.
Yes, yes. Please spin the Indefatigable Susan.
Oh, can we have the Multifaceted Susan my way, please?
Yeah, spin the Industrious Susan.
Ooh, can you spin Ambidextrous Susan, please.
‘Shithole country’
https://www.worldometers.info/demographics/life-expectancy/
United states is ranked 48. And they claim to have th best healthcare in the world.
Obviously that’s not true, they may have one of the best for the very rich. But on average it’s VERY bad.Food standards are also bad, so again it’s only if you are doing well that you can afford healthy food.
The countries surrounding USA on this list have about a third the wealth per capita!!!
Ben Shapiro said years ago that the US Healthcare system is the best… but it’s only flaws were regulation. I think Ben Shapiro needs to have his ass examined and then given a diagnosis of colon cancer and told to fuck off.
Ben Shapiro
Imagine being that dimwitted! But maybe he is just a troll?
No he is a legit vile dipshit who wants police convicted of murder pardoned and probably reinstated as police. He WANTS the riots to ensue.
He WANTS the riots to ensue.
May he be the first victim.
Best health care = most profitable health care.
We can add time to your life by charging so much money and limiting access via networks that you avoid care until it’s too late. Or you just choose the cheapest insurance that’s actually useless if you need it. Now that you’ve collapsed from a heart attack and taken a $5k ride in a fancy ambulance to the out-of-network ER that has reduced coverage for non-preapproved procedures we can extend your life via stents and bypasses or other serious measures. You have severely reduced life expectancy, maybe lost your job if the attack disabled you, maybe lose your home, but look how great our medical care was in making sure you didn’t use it until you desperately needed it!
wealth per capita
If only that were how it actually got distributed
Well that’s kind of decided by the voters and population, and Americans voting Republican abs0olutely makes it worse.
Man, that table is wild. South Africa has a lower life expectancy than Afghanistan and in Russia women live 12 years longer than men? Bonkers.
I’m guessing women don’t get drafted for special operations in Ukraine
Yes I didn’t even notice the South Africa thing. I would have thought they did better?
Way above them are Uganda, Rwanda and Ethiopia, all countries that has had very serious problems and I though were way poorer?The average person in SA lives in a metal hut, is probably an alcoholic, might have HIV, could work in an illegal mine, etc. it makes great sense to me
It’s probably due to HIV rates.
Yes, that’s stated as reason #1:
https://www.iol.co.za/news/south-africa/western-cape/four-reasons-for-sas-low-life-expectancy-1798106
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That’s because we’re a regressing country
it’s SO weird to be someone who grew up in America and has now spent about 25 years back home. i cannot understate the powerful effect of the mindset of “being an American”.
I’m unfortunately still here and even I haven’t a fucking clue
here’s the thing. one might say something like, “well get one and move!” just like they’d say to a tesla owner, “if you don’t want your car defaced, then just get rid of it!”
i’m not defending tesla. nothing burns brighter than an T. as in “time to leave”.
but you can’t just up and swap countries or cars every four years, right? there’s a word for that, but half the country refuses to hear it… it’s unsustainable.
none of what i just wrote is directed at you personally. i personally have a spare bedroom in Canada that you’re welcome to inhabit (barring obvious vets).
One of the biggest troubles of being a US citizen is the conservatives will happily tell you “If you don’t like it, leave!”
Not being a conservative, I know my associates degree self is not gonna be terribly welcome to vast majority of the countries.
It’s not hard at all. -If one has a PhD in the hard-sciences and at least $500,000.00 in savings prior to turning 30yo
/s
*civilization
Bollocks
We have one habitat we’re terraforming against ourselves. As much as I’d be willing to lay more blame at the feet of this shithole called the US, the same doom is coming for all of us, accelerating beyond models of years past, and none of the global superpowers are going to use their power to stop it.
Our global crops are already feeling the squeeze.
*county
Civilization isn’t regressing. This is just one shithole country getting shittier.
Have more babies though.
Your owners need your kids to be exploited into an early, miserable grave to run up their nepo kid’s ego scores. The doting ones at least, the owners toss kids that don’t become little nepo clones of themselves as bad investments.
Luxury climate bunkers are boring, are you really going to deprive a future billionaire child that matters the joy of watching line go up powered by your worthless peasant offspring’s life force, you monster?
Maybe stop being so selfish and think about what you can do to further enrich your betters. Priorities, my fellow batteries, priorities!
The batteries analogy in the Matrix was bad and originally it was that the machines used humans as bio-computers, which makes a lot more sense.
I’m aware, that’s my Fandom, I know the lore intimately.
Being a “battery” is in the vernacular though, and most understand what a capital battery means.
I even see the Architects nod to the supposed answer requiring a “lesser mind” albeit a more human curious mind in the oracle was a nod to that original idea the studio mandated the Wachowskis change, from bioprocessors to batteries. Would have worked on so many levels, even with the machines falling victim to repetition loop breakdowns without processing from imperfect minds, but that was on the Studio, the writers were vocal they didn’t like the change, which makes it easy for me to look beyond.
“When the researchers examined the causes of avoidable deaths (including road traffic accidents, illnesses preventable by vaccines, treatable conditions like sepsis or appendicitis, and conditions preventable by early detection and treatment like cervical cancer, ischemic heart disease and tuberculosis), they found that deaths from a variety of different causes are rising in every U.S.”
“There’s been a lot of discussion about preventable deaths in the U.S. such as drug-related deaths or suicides, which do account for a big proportion of this trend,” Papanicolas said. “However, we found that deaths from nearly all major categories are increasing.”
People just aren’t going to the doctor cause it costs too much…thanks, free market!
There’s also a severe shortage of medical professionals ever since covid in all fields all over the country (but especially in rural and rapidly-growing areas). Good luck actually getting a medical appointment, and even if you can swing one standards have been weakened so that what would normally be a visit with a doctor (or the field’s equivalent) is now a nurse practitioner or other less-educated title. If you want a “real” medical professional you need a referral, and again, good luck getting that appointment scheduled. Everyone working in medicine is overworked and burned out. Unless you’re actively bleeding out, seeking medical attention, especially routine checkups and preventative screening, doesn’t feel worth it anymore.
I’m not too surprised to see cancer deaths being one rare area that’s decreasing; besides strides in treatment, most cancer sufferers are older and thus wealthier and also have Medicare, plus they also probably already have a primary care physician from pre-shortage. The hardest-hit in the medical care shortage are the young and people who have recently moved, and find themselves running into the wall of “no one is taking new patients.”
There was a case of a self employed carpenter in Queens, NY. He won the lottery and splurged on getting a checkup.
He had cancer. If he’d lived in a place that had better healthcare he’d have been able to get treated earlier.
I’m curious, how much is a typical doctor’s visit in the U.S. without insurance of any kind? Just a straight out of pocket sort of expense. $50, $100, $250, $500, $1000? I assume that it scales based on more complicated procedures or longer visits, but what about the basics, like going in for what you think is a bad cold or the flue, maybe a rash or something along those lines?
A couple years ago I didn’t have a job or health insurance and the flu shot cost $37.
That’s not bad, I guess, but probably more than anyone would want to pay if they were out of work.
Pretty much, yeah
I recently had a routine visit with my doctor. About ten minutes. The office sent me a bill. $179.00 Luckily for me it was sent to me in error and my ‘cadillac’ health insurance covered everything.
Well, that’s something at least. How much does a “Cadillac” health plan’s coverage cost you though?
I got it through my job/union. I pay about $20.00 for a doctor’s visit out of pocket. Pretty much everything else is covered.
I wish everyone had coverage like mine.
if any blood tests are involved then that alone can send it into the 1000’s. -I’ve had firsthand experience with that.
That’s insane, I can’t even begin to estimate the markup on those tests.
A bad cold or flu you probably wouldn’t go to a doctor, just an urgent care clinic for some antibiotics or whatever. Probably run $100-$150 + cost of meds (hopefully generic).
If urgent care can’t help, an out of pocket visit to primary care provider will be closer to $300 just to step in the door. Hospitals will put you on a payment plan if you can’t front it.
My experience is that urgent care is significantly more expensive than primary care.
Ah, yes I’ve heard that about stateside hospitals. Apparently there’s an entire department alongside accounting that deals with remediation of accounts payable. Less than ideal, but it sounds as though it costs a lot less that I’d been assuming this whole time.
I’ll stress that’s just to get in the door. Usually if you’re going to the doctor they’ll want to run xrays, CT scans, MRIs, blood tests, whatever diagnostics and it starts escalating fast.
But this is stuff people can plan for. Emergency visits are much worse in my experience, suffering from appendicitis would have put us $40k in the hole overnight without insurance.
Holy shit, that’s daunting. I think that I might try cutting it out myself rather than go bankrupt.
You can do it!!!
https://www.bbc.com/news/magazine-32481442
"Rogozov had intended to use a mirror to help him operate but he found its inverted view too much of a hindrance so he ended up working by touch, without gloves.
As he reached the final and hardest part of the operation, he almost lost consciousness. He began to fear he would fail at the final hurdle.
‘The bleeding is quite heavy, but I take my time… Opening the peritoneum, I injured the blind gut and had to sew it up,’ Rogozov wrote. ‘I grow weaker and weaker, my head starts to spin. Every four to five minutes I rest for 20 - 25 seconds.’
‘Finally here it is, the cursed appendage! With horror I notice the dark stain at its base. That means just a day longer and it would have burst… My heart seized up and noticeably slowed, my hands felt like rubber. Well, I thought, it’s going to end badly and all that was left was removing the appendix.’
But he didn’t fail. After nearly two hours he had completed the operation, down to the final stitch."
That story about Dr. Rogozov always struck me as something superhuman. I’ve only ever managed to perform very minor surgeries on myself, I just can’t imagine a major operation on internal organs - with or without the mirror for extra complication.
"That story about Dr. Rogozov always struck me as something superhuman. "
It actually says near the end of the article that Rogozov and Gagarin (who flew 16 days later) both served as models for the Soviet superhumans mentioned in propoganda. It’s also probably why some countries now make appendectomies compulsory prior to visiting Antarctica.
Oh, I quite agree. Reading through it (again) I had many mental pauses saying to myself, “That’s where I’d die.” An incredible feat for sure.
If you have to go to the Emergency Department, $1000 is you won the lottery.
Holy shit, yeah, that’s not good. With so many just barely squeaking by month to month, even that could be ruinous…
If we wait until an injury or condition is imminently life-threatening then the hospital is legally obliged to treat regardless of an ability to pay and that’s one reason people wait. Also, insurance often penalizes (by paying less) for ER visits that turn out not to be emergencies. The thinking is that you should have gone to your doctor who’s booked-up six weeks out instead.
That tracks with a lot of what I’m hearing. Risking adverse outcomes by waiting until a condition becomes life threatening is a bit like playing Russian roulette, and with acute conditions it’s even worse. It’s maybe a bad analogy, but dentistry comes to mind - waiting until a cavity or tooth infection becomes severe can kill, even if it’s solved with surgery. It’s serious as serious can be, as much as people can’t afford the treatment, they can’t afford to walk a tightrope line where falling kills them.
Pretty much the fastest way to be penniless in the US medical bills. Hence why we have such shit outcomes, we tend to wait until the last damn second for anything medical.
And frankly, the $1000 winning the lottery is with insurance as well.
Christ, not a good state of affairs. I’d say that the U.S. healthcare system should have been overhauled decades ago, but the resistance to improving it seems almost insurmountable when the way that money affects the setup is taken into account. It might not change for the better for a long time yet.
As someone with insurance, it’s complicated? So I pay per paycheck on the plan I want. I’m allowed to change this plan once a year or change electives, which will higher what I pay per paycheck or lower based on the plan. I have a wife and 2 kids, and for the plan just under the top it costs me about $600 a month just to be covered (and this is considered really good, I think). If any of us go to our doctors, there is a copay of $30. This copay is based on the plan I picked and have access to. It could be less if I wanted a higher plan or more if I wanted a lower one. This also applies to “urgent care” which is just a quick way to see a doctor if you’re sick and can’t get to your doctor. On top of this, normally you’re allowed a few wellness visits per year with your doctor without copay since they are necessary. If you want to see a specialist the copay can be the same or slightly higher, all depends on your plan. The other kicker, you also need to make sure your doctor or the specialist is in network and takes your insurance. Otherwise, you pay more. Is this crazy yet or make sense?
Other things, hospital or emergency visits, will normally be $100 or way more because they don’t want you to just go to the ER all the time unless absolutely needed. Wildcards, sometimes you need to see people and have no idea what you will pay in the end since sometimes they will do work or use something that isn’t fully covered so you then get a bill a month later telling you insurance only covered this you owe the difference. It’s up to you to figure out if that’s correct or not then go down the path of fighting it. Normally, it’s like the visit is 1k but insurance only covered $950, so you’re now paying another $50 on top of the copay. This happens a lot and is frustrating because you really never know what you will pay in the end. If your married you both can have insurance and submit the remaining cost to the 2nd plan to see what they cover. On top of this, prescriptions have copays as well and have rates based on what the drug is. If you get generic brand it’s normally less, if they don’t have a generic brand you may be lucky and can get the name brand for the generic pricing because they don’t have it.
This is just scratching the surface, I guess to answer your question it’s $30 per visit, but that can change based off above. Also, is it really $30 if I’m also paying $600 per month? Another thing, you can’t just not have insurance. If you don’t, you will have to pay a penalty on your taxes for the time not covered. If you don’t have a job your still required to get a plan and from what I’ve heard those plans can be 1k or more a month for someone who doesn’t even have a job which makes total sense!
Wildcards, sometimes you need to see people and have no idea what you will pay in the end since sometimes they will do work or use something that isn’t fully covered so you then get a bill a month later telling you insurance only covered this you owe the difference.
You can request preauthorizations for an estimate. I always try to request those. Not always practical, however, especially when it’s urgent.
It’s up to you to figure out if that’s correct or not then go down the path of fighting it.
Fighting it is the worst. It’s a 3-body problem—you, the insurance, the provider—and you’re caught in the middle. You can’t just tell anyone in plain language “my insurance covers preventative care cost-free, so why am I being charged for this?” They force you to do the detective work, and they don’t make it easy. You basically have to know billing codes better than the billers and tell everyone to use correct ones. The billing codes aren’t necessarily printed on billing statements or claims (mine didn’t have them). Their meanings & provisions are unexplained. The patient has no reason to understand them or know they exist. Infuriating system.
This is just scratching the surface
You didn’t mention deductibles. Before copay or coinsurance kicks in, your policy may require paying a deductible. Cost sharing provisions vary by policy.
High deductible insurance plans come with a health savings account, which is completely tax-free (no taxes on contributions, their earnings, or eligible distributions) for health expenses including any type of cost share (deductible, copay, coinsurance). As long as you pay health expenses with other funds & retain the receipts, it functions in practice as a smaller investment retirement account with less taxes than IRAs. Somewhat interesting.
Health insurance typically doesn’t cover dental or vision: those need separate plans.
Another thing, you can’t just not have insurance. If you don’t, you will have to pay a penalty on your taxes for the time not covered.
Federally as of 2019 that was set to $0, so the amount ends up varying by state & could be $0.
“Wildcards, sometimes you need to see people and have no idea what you will pay in the end since sometimes they will do work or use something that isn’t fully covered so you then get a bill a month later telling you insurance only covered this you owe the difference. It’s up to you to figure out if that’s correct or not then go down the path of fighting it.”
This alone would get my hackles up, let alone paying $600+/month for uncertain coverage of treatments and prescriptions. Moreso, it would rub me the wrong way to have someone in my life who was unable to pay in and left up the creek with no paddle. The bit about a tax penalty for absence of coverage is a bit much, does the government really need to kick someone when they’re down? Best of luck to you, it sounds as though you have it well in hand, but I don’t envy you the task.
The bit about a tax penalty for absence of coverage is a bit much, does the government really need to kick someone when they’re down?
This was struck down in court years ago.
The “stick” was to encourage people to get coverage ahead of time or face the penalty. If they decided not to, the extra tax could help cover unpaid ER visits where they must be treated whether or not they can pay.
The “carrot” At the same time was reduced price insurance based on your income and expanded Medicaid coverage for people who couldn’t afford anything. This was paid for by the federal government but Medicaid is administered by the state: several Repugnancan states refused the money because their politicians were so set against providing free medical care
After the tax “stick” was struck down, coverage dropped without that penalty, and states where they refused the money left millions of lesser paid people without coverage . So yeah, we needed it
I’ll be damned, it was almost addressed by legislation in a similar way as car insurance then, if I’m understanding the broad strokes (penalty for non possession)? That being the case, was the penalty via taxes not routed in much the same way as simply paying taxes overall, except only as a means to cover some of the cost for those least able to afford it?
People are generally pissed about paying sales taxes which achieve much the same outcome minus the carrot-stick approach and penalties, how much more or less pissed were Americans about getting ‘nudged’ in the right direction with income tax penalties by comparison?
I hope you realize what he is talking about every single American deals with and I think you missed the part where he is fortunate and this is literally the best case scenario (outside of being rich enough to not give af.)
I do, yes. I’ve read reams and reams of accounts, comments, and articles about the hardships experienced under the current healthcare model in America over the past few decades. The exact costing metric was never addressed though, which is why I asked about it specifically. The whole enterprise of for-profit medicine as carried out under the current insurance model is criminal and immoral by any measure.
You can make sure your doctor is in network, but if someone bills you for other services like an anaesthetists, radiologist or labwork, they may not be and you could get a surprise bill for thousands of dollars.
Oh, absolutely. When we had our kids both times we were hit with out of network anaesthesiologist bills. We fought it and won because we didn’t have a choice and when you have no choice it’s supposed to be covered. It took a few months to get an answer and is incredibly stressful and absolutely not something we should be worrying about after child birth, but welcome to America I guess… you hear about countries where the mother gets monthly care packages and at home wellness checkups on top of like 12 months off and I just get the extra stress of a 3k bill I may be held accountable for if I can’t complain hard enough on top of my wife having to go back to work in 1 month because you either don’t get paid or the few states that do takes over a month to get the first payment and it’s basically half of what you normally get. And that 1 month seems to be luckier than most since I’ve heard stories of people only allowed 1 to 2 weeks tops.
Honestly, if I wasn’t so established with life, career, friends, and also had financial freedom I really think if I had the ability to start over I would 100% be out of here… I know nowhere is perfect, but at least most don’t want to kick you when you’re down either.
What kind of Doctor? What kind of Visit?
Let’s say the family type, and a checkup for any of the more mundane things above.
Well, that’s the problem, due to changes passed with the Affordable Care Act (aka Obamacare), annual routine screenings are free including women wellness. A lot of people do not know this.
The problem is when they find something wrong. Going to a specialist can easily push from hundreds to thousands.
To add on: it has to be coded correctly for insurance. A “yearly physical” is its own special thing which does not require a copay, and if coded correctly covers like a basic metabolic panel, lipid panel, maybe something less common if family history suggests it. It has to be billed as a “preventative service” for something on this list of what falls under the “free” stuff, if you don’t want a nasty bill. I know a full lab workup for me is billed at around $1600 before insurance, and a primary care visit would be around $300.
Interesting, it’s no wonder that so many Americans have a difficult time with medical bills. I was also under the impression that the Affordable Care Act had been dismantled, it’s a bit tough to catch all of the headlines with so much going on all the time.
Affordable Care Act is mostly still there, but
- the tax penalty for choosing no coverage was struck down in court, so more people are making this choice
- several states refused federal money to cover lower income
- republicans re-opened the door to junk policies that don’t provide meaningful coverage
Also the current administration is trying to
- replace support for state Medicaid programs with block grants that can be used to squeeze the state’s, who will reduce coverage
- repeal important features of ACA, like no refusal of treatment for pre-existing conditions, 100% coverage of routine care including immunizations
It’s still counter-intuitive to me, the thought that any country/state would try to save money by rolling back coverage for immunizations. The total loss to GDP from chronic and acute health problems is nothing to shake a stick at, denying coverage for immunization is like a country shooting itself in the foot (assuming that they can cover the cost to begin with).
Have you met Republicans? They like shooting themselves in the foot. They love guns.
And it is mostly the red states doing these counterintuitive measures. Unintended consequences going to catch up real fast.
A lot of people think that it was gutted, but it’s actually the reason we have a health insurance marketplace and why you can no longer get denied for preexisting conditions. Before it existed, you were just SOL.
https://en.m.wikipedia.org/wiki/Affordable_Care_Act
Not that it’s cheap, but my employer charges about the same rate for a high deductible plan. If you are low income, you can get cheaper plans.
Healthcare in America isn’t that BAD if you are relatively healthy, but it is nearly impossible to navigate… by design. Now, if you are actually sick, YMMV.
Damn, good to know that the bit about pre-existing conditions hasn’t been struck down yet. I had to look up YMMV :(
Typically, out of pocket no insurance cost for primary care physician visit is around $200-300.
If you know the doctor, maybe $100 if he or she does a sliding scale.
That’s encouraging, at least. It’s not cheap per se, but definitely not as exorbitant as I assumed.
For most lower income Americans that can be cost prohibitive.
There are some lower cost options:
CVS and some other retailers have mini clinics where you see a nurse practitioner. Out of pocket these visits can be $50-100 out of pocket.
Some hospitals and health departments offer free clinics but they are often busy.
Online options have become more popular but they often are limited to very simple issues (e.g. sinus infections, allergies, etc).
This assumes you don’t need a prescription or labs.
From a prescription standpoint, Walmart still offers $4 prescriptions for very common drugs. Again out of pocket.
Labs your sort of SOL.
That does make sense, and although I guess it’s good that there are ultra low-cost options available, there’s that old adage about “getting what you pay for” to a certain extent.
That is exorbitant for most people for a basic doctor’s visit. Federal minimum wage is $7.25/hr. Takes an entire work week for a minimum wage worker to afford a doctor’s visit.
As other’s have explained to you, that is just a visit. It covers nothing else. No medication, no tests, no referrals. Just to talk to the Nurse Practitioner for 15 minutes. You will not be talking to the doctor.
Just brutal, I can’t imagine losing my job and home because I got sick. It’s been the case for many thousands of years typically, but it just seems so arbitrarily cruel to know that there’s a better system that’s been adapted (matter of opinion, I know), but strike it from consideration altogether because of the business model surrounding American healthcare. Paying higher taxes kind of sucks, but at least I’ve never had to remortgage for serious injuries.
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Well yeah, that’s to be expected when healthcare has a paywall.
Yeah, about that reporter…
He fell down an elevator shaft. Onto some bullets.
Was it the same one the first Bowler fell down?
I seem to remember there was some suspicion surrounding his death…
