Tag: Health Care

County General on Saturday Night

I put down her chart. He was right. A bullet through the abdomen wasn’t the worst case. It was nothing. Something that would wait till morning. There were people who were worse, people who had been run over by cars or stabbed in gang fights, people with multiple gunshot wounds, people who wouldn’t survive if they didn’t get immediate attention. And this was the judgment residents had to develop in a MASH unit like this.

As we walked away, he said, “You’ll get used to it. You’ll learn to do it.”

I thought, No, I won’t.

I was wrong. I very quickly saw more than I ever imagined, and came to realize that doctors are basically biological repairmen, especially in inner-city hospitals on violence-riddled Saturday nights. On my first night at County General, I treated a guy with a penis the size of a football. It turned out he’d been shot in the ass, and the bullet had exited through his penis. After a few Saturdays, though, I learned that two things could be predicted with 100 percent accuracy: If you asked anyone with a knife wound what happened, they’d say, “I don’t know.” And if a person had something stuck up their butt—which in my experience included lightbulbs, broomsticks, and grapefruits—they’d explain, “It was an accident. I sat on it.”

Pinsky, Drew. Cracked: Life on the Edge in a Rehab Clinic

50 Years of the War on Drugs

Hinton has lived his whole life under the drug war. He said Brownsville needed help coping with cocaine, heroin and drug-related crime that took root here in the 1970s and 1980s.

His own family was scarred by addiction.

“I’ve known my mom to be a drug user my whole entire life,” Hinton said. “She chose to run the streets and left me with my great-grandmother.”

Four years ago, his mom overdosed and died after taking prescription painkillers, part of the opioid epidemic that has killed hundreds of thousands of Americans.

Hinton said her death sealed his belief that tough drug war policies and aggressive police tactics would never make his family or his community safer.

Brian Mann
Morning Edition

Go Fund Me as Health Care Finance

 

‘Why Is It So Expensive?’
We Asked People From Around the
World What They Think of U.S. Health Care.
Video by Chai Dingari, Adam Westbrook and Brendan Miller

From the comments:

Nan
One day I had a serious hemorrhage and was taken to a nearby public trauma hospital via an ambulance. As the doctor was frantically trying to stop the bleeding in the emergency room, I kept rambling incoherently (under powerful anesthetic) to confirm that the hospital was “in network” – the healthcare workers reassured me “you are fine.”

Zezee
When my friend fell and couldn’t get up she insisted that no one call an ambulance. She called her brother and waited – in excruciating pain – but she was more afraid of the cost of the ambulance.

Jim
I worked for a major medical company (Think of big health insurer they are all the same) when Obama care came around. Did we worry? Nope, because their profit was built in. healthcare companies just wanted to “reject” preexisting conditions . We knew, all the health plans would go up…listening to our “elected officials”, us lemmings in the office KNEW IT WAS A LIE… everyone knew the cost of insurance would GO UP.

We had unpaid claims that sat in our database FOR YEARS, never paying them because in a decade…that 50k is cheaper to process and it would just stay in a “round robin” appeals process that goes on forever. (literally we had claims that SAT unpaid for a decade or more because paying a 50k or 1 million dollar claims/debt from 10 years ago is cheaper, we talked about it openly)… All our executives made huge paychecks, huge paydays….. Its ridiculous. Meanwhile the rules are made by companies to pay as little as possible…I loved working for an insurance company, I had the Cadillac of Cadillac of insurance…. Literally it was the only redeeming quality .

Goldman Sachs and Chris Rock on Health Care Profitability

Goldman Sachs analysts attempted to address a touchy subject for biotech companies, especially those involved in the pioneering “gene therapy” treatment: cures could be bad for business in the long run.

“Is curing patients a sustainable business model?” analysts ask in an April 10 report entitled “The Genome Revolution.”

“The potential to deliver ‘one shot cures’ is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies,” analyst Salveen Richter wrote in the note to clients Tuesday. “While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow.”

Goldman Sachs asks in biotech research report: ‘Is curing patients a sustainable business model?’
Tae Kim
PUBLISHED WED, APR 11 2018

Nothing’s been cured in my lifetime. Nothing. The last thing they cured was polio and that was during the first season of “I Love Lucy.”

At least they’re still working on AIDS. They won’t cure it, but they will figure out a way for you to live with it. They won’t fix it, they’ll just patch it up. Their hope is that one day someone will say, “How come you weren’t at work yesterday?”
“My AIDS is acting up. You know when the weather gets like this, my AIDS just pop up. But I got me some Robitussin and I’m fine now.”

They don’t want to cure anything because the money is in the medicine. It’s like anything else. You think Cadillac can’t make a car that lasts a lifetime? Sure they can. But there’s no money in that.

“We need people to come back. We’ll make a car that lasts seven years. After that, shit’s gonna fall off.”

Diseases are just piling up. People still get cancer, sickle cell, tuberculosis, Jerry’s kids still limping around.

Cure some shit. Get rid of it.

Rock This!
Chris Rock
April 19, 2000

The Algorithm Did It

Stanford Hospital staff protesting the decision by higher ups to give vaccines to admins at home from r/pics

lucynyu13
“There is an enormous demonstration going on at Stanford Hospital right now carried out by staff, who are protesting the decision by higher ups to give vaccines to some administrators and physicians who are at home and not in contact with patients INSTEAD of frontline workers.” Twitter

Only Seven of Stanford’s First 5,000 Vaccines Were Designated for Medical Residents. Stanford Medicine officials relied on a faulty algorithm to determine who should get vaccinated first, and it prioritized some high-ranking doctors over patient-facing medical residents.

tristanjones
Algorithm issue my ass.

You prioritized age, and in so seniority, and didn’t prioritize Frontline work, and depriotize those working from home.

It doesn’t matter if you asked a computer to then run the numbers, you set the rules.

The sentence should be “Hospital administration did not prioritize front line workers but instead accounted for seniority in distributing the vaccine. As a result only 7 of the first 5,000 vaccines for staff will go to Frontline workers. These results were accepted without further scrutiny or adjustments by the administrators incharge of doing so.”

neotropic9
“The algorithm did it” is increasingly an excuse used for shitty management decisions.

GreatBallsOfFIRE
Yup. Algorithms are created by people. The correct phrasing is “the algorithm was written to do it.”

Decision Making Software

She doesn’t remember exactly when she realized that some eligibility decisions were being made by algorithms. But when that transition first started happening, it was rarely obvious. Once, she was representing an elderly, disabled client who had inexplicably been cut off from her Medicaid-funded home health-care assistance. “We couldn’t find out why,” Gilman remembers. “She was getting sicker, and normally if you get sicker, you get more hours, not less.”

Not until they were standing in the courtroom in the middle of a hearing did the witness representing the state reveal that the government had just adopted a new algorithm. The witness, a nurse, couldn’t explain anything about it. “Of course not—they bought it off the shelf,” Gilman says. “She’s a nurse, not a computer scientist. She couldn’t answer what factors go into it. How is it weighted? What are the outcomes that you’re looking for? So there I am with my student attorney, who’s in my clinic with me, and it’s like, ‘Oh, am I going to cross-examine an algorithm?’”

The coming war on the hidden algorithms that trap people in poverty
A growing group of lawyers are uncovering, navigating, and fighting the automated systems that deny the poor housing, jobs, and basic services.
Karen Hao
MIT Technology Review