godzillabacter @ godzillabacter @lemmy.world

Posts

1

Comments

74

Joined

2 yr. ago

I'm aware that those costs do not magically disappear and are absorbed into other billing/passed on to society. However that is not why healthcare is so ludicrously expensive in the United States. It is the substantial and unnecessary administrative costs, predominantly driven by for-profit insurance companies, for-profit hospital systems, and pharmacy benefits managers. The continued exploitation of the ill for shareholder benefit is a uniquely American take on health care, and coupled with our incredibly individualistic tendencies bring about a huge fraction of the poor health outcomes we have in comparison to other developed nations, despite spending generally more than double per person.

Some of this is certainly driven by system inefficiencies such as forcing people into a situation where they have to use the ER for primary care. Or where they cannot afford their blood pressure or cholesterol medicine, and instead of our society helping provide these very affordable interventions, we pass the buck. So when those individuals inevitably have a heart attack, we then pay many times more for care that they may not have needed had they simply gotten good preventative care.

I will happily stand up and bash the current US healthcare system. I despise its insistence that human lives and suffering are secondary to wealth-extraction. But as much as I hate it I can't change it, and while I will advocate for policy to change things, for now all I can do is continue to provide care to the patients presenting as a symptom of an ill society.

I hope others can see that these patients presenting to the ER are simply doing the best they can to take care of themselves and their families, and that the real blame and consternation should be placed on the government, hospital, insurance, and pharmaceutical officials and lobbyists who continue to exploit their illness for profits.

Let's see if I can add something to this conversation. I'm a fourth year medical student in the United States, who in a few short months will hopefully begin training to be an emergency medicine physician. You are absolutely correct, that the government subsidizes health insurance, and that in a decent number of cases, individuals without insurance or the means to pay for healthcare are eligible for Medicaid. You are also correct that the ideal use of the emergency room is to evaluate for medical emergencies, I say this as someone soon to be an emergency room doctor. Lastly, there are certainly physician groups which are capable of providing cash pay based care.

However, the process to apply for Medicaid can be quite complicated, particularly amongst those with low medical or even just general literacy levels. This disproportionately impacts individuals for whom English is a second language. As I said above, in a perfect world, the emergency department is only for true medical emergencies. However, patients as a whole are notoriously bad at knowing if their symptoms are from an actual emergency or not. Secondarily, in many communities, the emergency department is the only reliable access some individuals have to the health system due to difficult difficulties with transportation and scheduling. With regards to your last point, while there are certainly clinics that can provide cash based care, the majority of individuals who cannot afford insurance are also likely the patient who cannot afford a cash pay clinic.

The fact is also that a large number of uninsured patients will simply have their ER bills written off by the hospital, and/or social workers within the ED will help sign the patients up for Medicaid if they qualify so they become insured can then have the visit billed for, as opposed to the individuals giving fake names.

Unfortunately, the current state of the US Healthcare system is that for many disadvantaged populations, the ER is their primary care physician. This is not ideal, but I will not admonish my patients for doing what they can to seek care in a system that otherwise leaves them abandoned and uncared for

IIRC I've never given Valve/Steam payment info. Everything is processed through PayPal. But even then, you should be able to gift his account a purchase without him putting in payment methods if you can convince him to use steam at all

I self host a lot of shit, but after almost a year of using Obsidian I finally paid for their sync feature for one reason: iCloud sync to iOS is painfully slow.

I was sometimes waiting 30-45 seconds to jot down a note just waiting on the app to open with iCloud sync as my backend. Now, with Obsidian sync, the app is ready-to-go in seconds.

Now if you're only going to be using on desktop, I would definitely consider a git-repository based sync, but if you're gonna use mobile I'd recommend you at least consider Obsidian Sync

There is an OTF version, it's just not bundled w/ anything by default as far as I'm aware.

Available here: https://ctan.org/pkg/kpfonts-otf?lang=en

Personally I'm a huge fan of the Kepler Project font. I got hooked on it when I started writing papers in LaTeX.

http://luc.devroye.org/fonts-47327.html

If you were somewhere else you could use MakeMKV to break the region lock/DRM on the disc and give you playable files. Unfortunately, within the USA (depending on who you ask) cracking DRM is illegal. Though I am not aware of anyone ever being prosecuted for breaking DRM on discs for personal use copies of media they legally own. IANAL

Yes, but most DRM has been circumvented in one way or another. DRM primarily continues to keep law-abiding citizens from easily acquiring a copy of media they rightfully own as opposed to preventing piracy.

Though if institutions insist on utilizing DRM for prevention of privacy, I do think that DRM should be built to fail after a meaningful timeframe, at worst the expiry of the copyright for the material. Unfortunately many pieces of media, particularly video games, are abandoned and unsupported long before their copywriter expires. Abandonware in general is not well handled by modern copywrite law.

I think the point is more so why are digital purchased DRM'ed and prohibited from local storage in so many ways. The historical argument is "well you're not buying it, you're buying a license to use it for as long as we wish to provide it", but why does it necessarily need to be that way. And more generally, from the standpoint of artistic/media preservation, as BluRay releases continue to decrease and console video game releases become continually more digital-only, these non-archivable or locked-without-server-license-validation media results in IP that at some point in time, this media could be permanently lost.

Personally, I feel this is unacceptable. The media we consume forms a huge portion of our culture, and is just as much an example of artistic expression as painting. While I thoroughly believe artists/companies should be able to charge for these properties, I do not believe that when it is no longer profitable for them to support the system, that these pieces of media should simply be discarded with no method for future recovery and preservation.

Could you elaborate on what you mean?

4th year medical student. AI is not ready to be making any diagnostic or therapeutic decisions. What I do think we're just about ready for is simply making notes faster to write. Discharge summaries especially, could be the first real step AI takes into healthcare. For those unaware, a discharge summary is a chronological description of all the major events in a patient's hospitalization that explain why they presented, how they were diagnosed, any complications that arose, and how they were treated. They are just summaries of all of the previous daily notes that were written by the patient's doctors. An AI could feasibly only pull data from these notes, rephrasing for clarity and succinctness, and save doctors 10-20 minutes of writing on every discharge they do.

Works for PhD's, but try doing oral exams for 1000 Bio101 students.

AI, especially as it relates to completing daily tasks. I cannot wait until an AI can efficiently sort, delete, and categorize my email so I don't have to deal with all the junk and FYI emails.

Pharmacist and 4th year medical student here. Medical tests are ordered based upon their statistical ability to alter your likelihood of a diagnosis. No test is perfect in either direction (negative result meaning you don't have disease or positive result indicating you have disease). Tests cost money, take resources of the healthcare system, and have the potential to be wrong. When a test is wrong, it can result in financial, emotional, and physical harm to an individual.

Example: you're an otherwise healthy 34 year old and you feel a little under the weather and are coughing. It's only been going on a few days, mild fever, but you're worried and you go to the doctor. Your doctor thinks this is most likely a viral infection, recommends Tylenol and ibuprofen and sends you home. You imply to the doctor you'll sue if you don't get antibiotics and a chest x-ray just to be safe. The doctor, rather than argue with you when they have a dozen other patients to see, just orders the stuff and moves on. The chest X ray doesn't explain your cough, but there's a small lesion of undetermined significance on the X-ray. Now you need a CT. The CT says "probably a self-limited granuloma from a fungal infection, can't rule out cancer, correlate with biopsy". Then you have to go get sedated, put a camera down your throat, and have a pulmonologist take a sample of your lung to see if you have cancer. Maybe you end up with a complication from the sedation or a pneumothorax. Meanwhile the antibiotics you took didn't really improve your cough but now you have this uncomfortable itchy rash. Are you allergic to the amoxicillin? Or did you just develop the typical rash seen in people who have mononucleosis that also take amoxicillin? Will you get allergy testing for the amoxicillin? Just avoid amoxicillin, an awesome antibiotic, for the rest of your life?

We are restrictive in our prescribing of medications and tests not because we don't care about you, not because we want to save the hospital or the insurance company money (in fact the hospital prefers we order more things because they make money on testing). We are restrictive because we want to maximize benefit while minimizing risk, and everything we do has risks and benefits.

Awesome! Let me know if you have any questions about DM'ing. I highly recommend Matt Colville's Running the Game series. You absolutely don't have to watch it all. If you watch the first three real episodes (Your first adventure, Your first session, and Running your first dungeon) you'll be set!

You mentioned trying board games, any interest in TTRPGs like Dungeons and Dragons and the like? The game is basically designed to forge friendships. If you or your partner is willing to learn to be the Dungeon Master, you'll have no trouble finding players, in fact you may have so many interested individuals you have to do brief interviews lol.