ny_quant

kakoj Brighton? are you kidding? i never worked within 1,000 miles of Brighton - no, once, in Upstate NY, far north.

what do you think happens with an UNINSURED man who winds up in teh hospital with a catastrophic illness? teh man gets Medikaid. RETROSPECTIVELY it pays for his ED and onward. that's why there is a cadre od "caseworkers" on every floor. these are all RNs with 10-30 years of experience.

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I meant Brighton spiritually, as a Mecca of cheating.

// what do you think happens with an UNINSURED man who winds up in teh hospital with a catastrophic illness?

Let me understand. Say, the guy makes 30k but is not insured. You're saying the hospital would put him on Medicaid? I believe it would be illegal, there are income restrictions for eligibility.

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if it were illegal i would not see it all the time.

if he makes 30K but wound up on 5West with a GBM - his emergency surgery alone to decompress teh tumor was already over 30K, att 12L/day ICU stay, add 15-10 K/day ward per day, add teh cost of chemo and monthly MRIs, add teh cost of XRT and gamma knife, add teh cost... add the cost....

pretty obvious that he is an indigent already. so.. he gets disability and medicaid, YES. and given the diagnosis will not likely work again a lot. or at all.

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Maybe you see those who are poor enough to be eligible while the rest of them are filtered out around triage are and sent home?

I don't disagree that a someone making $30k/y and having a serious condition is indigent and should be helped. But I don't believe this is how the law is.

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people who need care - get it.

\an army of caseworkers try to make sure this is paid for. if not - it is not. but the patient still gets maximal care.

that is how it is . - NOW.

manana - ???

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Personal experience. When I got into grad school I had a fellowship, a whopping 13k and a bare bones insurance, no dental though. My wife had none so she tried to apply for Medicaid. She was rejected because we had too much money. You can also Google it yourself and find that you should be below 133% of poverty level or something.

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well, if either of you had a catastrophic illness, it would be different. for relatively healthy people, medicaid is not so available unless they are really poor.

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So you just agreed with my point that many people are not covered in this country.

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don't try demagoguery on me. i disagreed with you. teh word was not COVERED but "have access". ther is a difference. not all are covered. thre is access for everybody, and nobpdy goes untreated, with rare exceptions.

you don't know anything about health care. i don't think you are worth my time to explain how things work.

за передерг шулерам дают по морде канделябром. считайте что вам дали.

Edited Date: 2017-03-10 01:17 am (UTC)

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Hm.. If you have a _catastrophic illness_ you would be helped (your words, not mine). And if it is not catastrophic? Tough luck, I suppose.

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read this post. read my omment with 1 2 3 4.

you apparently have issues with reading comprehension.

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Apparently. I have no idea what you mean.

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i mean spmething simple. your initial statement was stupid and uninformed. everybody here in the US has access to care, and very few cases go untreated for lacking insurance or money.

period.
i speak as an insider.

go have a pee or a drink. or both. you won't have an "idea"..

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Thank you for the advice. I will definitely do both in due course.

Still I don't see how you conclude that few cases go untreated without analyzing the statistics. Intuitively it is obvious to me that poor people without insurance would postpone a visit to the doctor for as long as possible.

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Intuitively it is obvious to me """""""

gives away your thinking process.
and "statistics" as well. there are, as i show above, categories 1, 2, 3, 4, of "potential undertreatment".

idiots plus leftie politics dump them all together, when these are almost discrete and nonoverlapping cases with different rates and consequences for "undertreatmnt" in any circumstances.

categoiries 2 and 4 practically never 'go undertreated", and if they do, it was the patient's wish or the patient's neglect. undertreatment in category 1 is unlikely to have more consequencies than for those with full access to routine and preventive care - that has been discussed and debated for over 20 years, you would not know.

category 3, especially as 3 may become 4 with time - may get a delay in treatment or and insufficient attention, with conseqences. however no "statistics" exist as to that group. experienced MDs will tell you that the politicians' sob story "she stopped taking her HAART cocktail, which is life-saving, because she could not afford it" - are lies. she DID stop taking her HAART cocktail because she was busy shooting up and does not care if she lives or dies.

life= saving and life-maintaining therapies are delivered to all who need them and care to show up. borderline cases are so few and far between that I can remember only a couple - anf thousands of counterexamples.

but of COURSE a bleeding-heart ignoramus knowns better. TFU. protivno.

now, Quant, for you - all of that, which I said, is expensive. and you pay. that's why we need universal "socialist" health care, to take some of the expense out of your pocket and mine, before the whole thing implodes.

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I also suspect that being inside, you're looking at a biased sample. You will simply never see those who never found a way inside the hospital.
I respect the opinion and you may be right in the end. However I don't like socialist solutions. I prefer universal access via vouchers.

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I was just going to say something about the selection bias. In this case it is particularly strong as (it appears) tandem_bike is a specialist, not a general practitioner.

Another point is that many issues are not life-threatening and perhaps have no medical consequences at all. Still, not being able to see a doctor when you are not feeling well or having pain can be very stressful even if those pains later go away on their own.

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Still, not being able to see a doctor when you are not feeling well or having pain can be very stressful even if those pains later go away on their own. """"""""

this is worth posting as a separate entry. i will.

it is a perfect example of 1. idiocy, and 2. entitlement, and 3. an important therapeutic effect which is related to placebo but is beyond it.

so e=despite 1. and 2., where mishab reveals himself again, he is eerily right if you consider 3. more later.

mishab, thank you for the discussion, i no longer am as involved in medical student teaching, but your opinions are priceless and worth preserving for future lectures - as the view of the electorate ( not dzhigurda, but close).

meaning - most of the time, you are maddeningly stupid. but once in a while you strike a note that totally defeats the opponent. that's what you had done with this little comment.

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Perhaps you should first decide on whether it is a "perfect example of idiocy" or an "important therapeutic effect".

But I forget, they don't teach logic in medical schools. So it's ok.

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i don't think you knlw what THEY do teach or do not teach.

it is actually both - an idiocy and an important therapeutic effect. can happen.

your condescension does not work - my PHD in applied math can probably fight yours and win.

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believe me i had enough relevant education to be aware of bias.

but you are forgetting that i am 55 and have a huge circle of acquaintances, friends, family and... patient stories, outside of my own practice. so i am not speaking as a narrow fourth-level specialist - BTYW in canada access to "me" would have taken a year, Quant.

i am speaking as everything i am, including xabalka Molly. :-) and i do believe i have a better view than the people who insist on "people without insurance don't get care". it really is baloney. i gave you the 1. 2 3 4 cases, and i posted in my blog as well.

out of those, there is only one group , 3, the "chronics", that are not invalids.. yet - who are potentially undertreated - but not for lack of access.

this misha, prostigospody, confuses ACCESS which is AVAILABILITY of care, with PROHIBITIVE COST of care. to group 3, this may somewhat apply in some cases. but to none of others.

io hate talking to people who are convinced of soimehtign - based on nothing. as he freely admits, but it is discouraging anyway, he is probably educated, but not caring to see how flawed his logic is.

i AM right in the end, dear, and i am also right about the socialist solution.

as much as i hate it, i had come around full circle, and believe that without FREE UNIVERSAL MEDICAL PLAN FOR ALL CITIZENS - we will rapidly descend into bancruptcy, chaos and increasingly horrible medical care.

believe me, i tried all views.

"vouchers" are a joke, mostly for two reasons. do you want me to continue?

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Nobody disputes that you’re better positioned than the rest of us but it doesn’t necessarily mean that you’re right*. To wit, you were just as well positioned when you had opposite opinions. Being in the same position, you made a full circle and, conceivably, you’ll make another one or two.

I’m guilty of the same “error” as I speak of access and unaffordability interchangeably. I appreciate the distinction but I’ll laugh if you tell me that Manhattan townhouses are available to me and other members of my economic strata. If I can never afford it, they are as good as unavailable.

My daughter’s BF probably has not seen a doctor in his adult life. If something serious happens he goes straight to bankruptcy, no doubt. Ditto my uninsured friend. You can continue claiming that they have access but I’ll say it’s a rather technical point. Maybe it’s better be alive and bankrupt rather than the other way around but I don’t think this argument supports your view. My view is that they should drink less and buy insurance but they have other preferences, nothing can be done about it. Your solution is for the nanny-state to step in and administer a dose of socialism to compensate for individual responsibility. I’m against it philosophically and (I suspect, pending sound cost estimates) fiscally as well.

Vouchers may be a joke although I don’t see why. It’s not my original idea. Milton Friedman suggested it (maybe he wasn’t the first as well) and he’s not known to be an idiot.

* If you look at ongoing global warming debate, nobody (and I mean it literally) is concerned that the opponent is better positioned and thus may have sounder judgment. I suppose you can just as well get used to it.

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not quite touche.

i changed my mind not about access or availability of care, but about how to make this care less expensive and universal.

i am not sure the manhattan touwnhouse analogy stands, either. please consider 1.2.3.4. again, 1. probably does not need any care, though if a funny-looking mole appears on his back and nobody picks up on it , not so good. the percentage of such cases is unknown to me or anyone else, really. 2. NOBODY ever went with pneumonia untreated or a broken leg unfixed because of money. do they face, in some cases, unpleasant bills and have to argue them down? yes. but this is not a townhouse.... 3. a SOMEWHAT shady group, some members of which probably go without proper care. i can elaborate on them. 4. ALWAYS get standard of care. no matter what.

so, your friend mishab is indeed .. well, let me not kick him anymore. but he is annoying.

as to your boys who won't get ACA or quasi-ACA - i don't call them irresponsible. it is their decision. they made a choice and i respect it.

it would make more sense if they had a "nanny-state" minimal program to fall back on, to avoid the fate of 2. who might need to go into debt, or 3. who might be in bad shape unless cared for adequately.

but you have NO IDEA - you and the milton friedman, for whom i cannot have much respect despite, i am sorry, i have trouble respecting someone because others respect them and nothing else - about the actual daily expenditures.

what VOUCHERS? the care of truly irresponsible people is what is chokiong the system. "vouchers" may help0 a few good citizens, maybe 10 million, okay 20, but there are 335 million of us here, and the most expensive customers won't reach for a voucher.

arbart and his dezhurnye mandavoshki would say "their problem, let them die" - but they are idiots. WE CAN'T LET THEM DIE.

so we need a nanny state and a nanny program.

re poteplenie - what do you mean? i did not get it. there are so many special interests there that it is better not to venture an UNINFORMED opinion. so i don't.

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