Jinger/Jeremy: Not as Interesting as Jingerbread

[singsingsing]

38 minutes ago, LilMissMetaphor said:

I certainly wasn't trying to speak for everyone's community or part of the country.  I just have always had the impression since I moved back to my hometown in 2009, that mental wellness or unwellness is no different from physical (based on social media, conversations I've had, posters/pamphlets/media visible all over the place from elementary schools to churches to daycares to the mall...)  Someone may want to discredit my personal experience, that's fine.  I can see how if they'd been on the receiving end of harassment/intolerance, they wouldn't think the stigma was gone at all. 

Then again, I was coming from a country where I was told I would have to leave my job the second my pregnancy started showing, so it's possible I viewed Canada (and its comparative disinclination to stigmatize) with rosier glasses given the eight years I'd spent away.

I think you're confusing awareness with lack of stigma. There's much more awareness about mental illness now, which is great. The stigma is slowly being addressed, and it's better now than it was a decade or two ago. Also great. But that doesn't mean the stigma doesn't remain in a very real way. Your personal experience is discredited by the personal experiences of everyone who has dealt with mental illness and come face to face with the stigma and its consequences.

[louisa05]

If Beau Biden got insurance through his employment, once he was no longer able to work it is likely that the family lost insurance. Even if his wife was employed (don't know if she was or not), it may have been more expensive to get insurance through her employer. If she was not employed, they would have had to purchase private insurance and very likely (based on the previous years taxable income) would not have been likely for ACA subsidies. 

Even if obtaining or keeping health insurance was not an issue, it does not pay everything and people greatly underestimate the costs of cancer. My dad was on Medicare with only basic coverage. Medicare paid 80% of medical expenses. Even with that much paid, in the average month they spent about $600 on cancer for  co-pays, prescription medications, OTC medications and supplements (to combat side effects and nutritional issues from chemo), equipment, etc...That number assumed no hospitalizations or scans. Those meant even more out of pocket costs. An ICU stay for sepsis was almost $11,000 in out of pocket costs. Scans cost an extra $700 out of pocket every 8-10 weeks. 

Most insurance policies do not pay as well as Medicare. For people who are of working age, everything is complicated by loss of income as well. If Beau's wife was employed during his illness, it is quite likely she had to use a lot of unpaid leave (FMLA leave is unpaid) to care for him, go to appointments and treatments, etc... Combined with the loss of the patient's income (especially if the patient had been the family's primary breadwinner) and the costs above insurance can become extremely burdensome or impossible to pay. 

[Rachel333]

1 hour ago, singsingsing said:

I think you're confusing awareness with lack of stigma. There's much more awareness about mental illness now, which is great. The stigma is slowly being addressed, and it's better now than it was a decade or two ago. Also great. But that doesn't mean the stigma doesn't remain in a very real way. Your personal experience is discredited by the personal experiences of everyone who has dealt with mental illness and come face to face with the stigma and its consequences.

Yes, there's a lot more awareness now than there used to be, but the stigma is still there. Plus, just because someone says they think mental illness is just like any other illness doesn't mean they actually believe that. I have a mental illness myself and I still find that stigma affects the way I think about mental illness.

[send*the*ferrets]

11 hours ago, VelociRapture said:

My husband and I talked about this. Neither of us would be shocked if the treatments referred to were classified as "experimental." Insurance likely wouldn't cover those at all, whereas a decent plan would likely cover a good deal if approved treatments. 

*Note I said "likely" a few times. Because insurance companies are the goddamn devil sometimes.

(And I honestly don't know what treatments Beau was seeking. This was just a thought my husband floated. Possibly because we don't want to consider that even an excellent plan wouldn't cover cancer treatments.)

I didn't scroll all the way to see if this got answered, so I may be redundant, but I know a little about this subject. The problem (preACA, which I believe Beau passed away before the law had been enacted) is the lifetime max. Chemo is *extremely* expensive- literally 50k for one treatment. Then most people will receive a nulasta (possibly spelling that wrong) shot the next day- it boosts white blood cell production- that shot alone is 10k. One "round" of chemo is usually 8-12 treatments- that's over half a million for one round of chemo. It's not uncommon for people to go through 3-4 rounds of chemo, sometimes they even do multiple chemo cocktails at the same time. Plus add in pain medicine, anxiety medicine, antidepressants, diagnostic tests, possible surgeries... and a lot of policies would have a lifetime maximum of 2 million. A person with cancer can hot that lifetime maximum in under a year. Easily. My sister is a nicu nurse and preACA they would frequently have babies who reached their lifetime insurance maximum before they *even left the hospital* 

now, there are options once that max has been reached- but you have to basically be below the poverty level- which is possibly why Biden was going to sell his house, because he was trying to prevent his son leaving his wife and kids with nothing. I know in my state, you can't have over 999.99 before accessing the state insurance. 

[Rachel333]

On the topic of healthcare costs, I just saw this image of a hospital bill for someone being treated for rape.

And here's a hospital bill for a birth. Apparently it costs $39.35 to hold your own baby.

[PainfullyAware]

Reading all these stories has made the debate over healthcare in the US so much more real to me. I'm a Canadian and I've known generally about the US insurance system and the ACA but not so much about the human cost.

I've been so frustrated with our public healthcare system because of my own health issues...I waited 8 months for surgery that would be scheduled in a matter of weeks in the US (if you have insurance!). But I'm so grateful I never have to worry about paying for all the specialists and consults. I have drug coverage through my husband's employer, which I guess would be similar to the US system, although as far as I know there are no limits on drug coverage on our plan.

The crazy part is we spend less per GDP than the US does on health. I think in Canada it's 11% and the US is 18% of GDP on healthcare. I think the relative efficiency of tax dollar spending - audits find it is efficient and not wasteful on the whole -are why many conservative Canadians support public health care.

I don't think the argument about Freedom in healthcare makes any sense to most Canadians. Like "we don't want a single payer system because we will lose our freedom to choose". Choose to die and go bankrupt from lack of coverage? Some freedom. Everyone agrees to follow traffic laws instead of driving wherever and whenever they want and consider that loss in freedom made up for by the safety that communal traffic laws ensure over chaos. I think in Canada the compromise is seen the same way. Sure, there are limits on choice and options in our system, but knowing that you or someone you love will always have access to lifesaving care no matter what seems to more than compensate for that.

[laPapessaGiovanna]

Whoever thinks that health care costs so much in the US because you are funding the research for the whole world should read this

truecostofhealthcare.net/the_pharmaceutical_industry/ 

Some excerpts

Quote

The pharmaceutical companies tell us that they turn these high prices into research toward new cures for diseases. It’s true, we in the US seem to be picking up most of the research tab for the rest of the world, but if we’re curing diseases, maybe it’s worth it.

In other words, let’s see if the pharmaceutical companies are really delivering on their side of the bargain, and then we’ll go back and decide how much we should be paying them.

So next we’ll examine the research question: does pharmaceutical research really cost so much that, even with the prices they charge, they barely have any money left over at the end of each year? A good way to find out is to look at their annual financial statements. Each year every publicly traded company has to file an annual financial report with the SEC which lists annual revenues, itemizes costs, profits, etc…

I examined the annual financial reports of 12 major pharmaceutical companies over 13 years (2003-2015). These were among the world’s largest pharmaceutical companies and were responsible for a combined total of 42% of all of the world’s pharmaceutical sales from 2010-2013.

...

On page 17 you’ll find the above table which is an analysis of the consolidated statements of income for Pfizer. You can see from the first line that Pfizer reported just over $67 billion in revenue in 2011. A few lines down you can see that they spent just over $9 billion on research and development that same year. OK, $9 billion is a lot of money. It was nearly 14% of their total revenue.

But what’s really interesting is that you can see that Pfizer spent more than twice as much on Marketing (selling, informational and administrative expenses) as they spent on research; over $19 billion! And look at their profit for that year. They made just over $10 billion in net income (after taxes) which, by the way, is more than they spent on their research for that year.

So the cost of research wasn’t exactly eating all of Pfizer’s income pie in 2011. But that’s one pharmaceutical company’s financial statement for one year. How about the rest of them?

As I said before, I went over 13 years of financial reports for 12 major pharmaceutical companies and here is some of what I found:

-The combined total revenue for all 12 companies over 13 years was about $5.35 Trillion.

-The Combined total profits for these companies was about $1.05 Trillion.

-All 12 pharmaceutical companies spent a total of $887 Billion on research.

-The total amount they spent on marketing was nearly twice what they spent on research: $1.59 Trillion.

...

As you can see, the pharmaceutical companies do spend a lot on research but their research budgets are dwarfed by their marketing budgets. They also made more in profits each year, on average, than they spent on research.

So let’s do some estimates. Just as an example, we’ll take that dose of Effient that we get for $12.60 and the Canadians for less than $3. The pill most likely costs just a few cents to manufacture (we know that from the cost of the generics), so the $12.60 is mostly profit. But they charge (us in the U.S.) $12.60, they say, to cover the cost of discovering it.

Yet from their own statements, only about $2.14 of the $8 (17%) goes into research. Another $2.50 is pure, after-tax profit, and a whopping 30%, or about $3.80 of that $12.60 pill goes, not to the scientists at the pharmaceutical companies, but toward buying all of those medication ads you love so much. So most of what we “buy,” when we pay the highest drug prices in the world, is high corporate profits and lots of television commercials of middle-aged men with very pretty wives.

...

Now that we’ve taken a closer look at how the money is spent after the pharmaceutical companies get it, let’s go back to the bargain—the one where we in the US agreed to pay far more for the same drugs than anyone else in the world—and ask “how did we end up making this bargain, anyway?”

In any market, an actual bargain can only occur when each party has the option to walk away. If you think the hamburger is too expensive in one store, you can shop in a different store. Or you decide to buy chicken instead. If the rancher can’t make money selling you beef, he’ll sell it to someone else. Or maybe he’ll decide to raise chickens. Somewhere in there, the two of you agree what the product is worth, and that’s what you pay.

But can you really “bargain” when buying prescription drugs? Think about it, when a doctor writes a prescription that’s the only drug you can legally buy. Your only other choice is to get no medication at all and remain sick. And, if the disease you have could kill you then the choice you have is literally “your money or your life”. Most people won’t choose to die in order to save money, even if it’s most of their money. So, since the patient really can’t just walk away she has no real ability to bargain at all.

But then why does the rest of the world pay so much less than we do? The answer is that, while individual patients have practically no bargaining power when buying prescription drugs that’s not at all true of governments. Virtually every other government in the world finds that pharmaceutical companies would rather lower prices significantly than simply not to sell in a particular country. So other governments bargain with the pharmaceutical companies on behalf of their citizens, and this type of bargaining significantly lowers the price of brand name medications in these countries.

The one exception is the US government. As the single largest market for medications in the developed world, you can imagine our government is in the best possible position to bargain on our behalf. And, even though this strategy works for all the other governments, our government won’t do it. US law prohibits our government from taking any active role in negotiating the prices charged by pharmaceutical companies. And for practical purposes, that fact is the reason that we pay more (much more) than anyone else in the world for drugs. That is the “bargain” we (or really our Congress) made.

Regarding the idea that the rest of the world is leeching away research funded by US citizens, I'd like to underline that it's true that a lot of the research happens in the US and when it gets published the whole world can read it, but if you don't have drugs and equipments to enact it, said research stays on the paper. And you know what the rest of the world buys the drugs and the equipments bargaining the best price. Now do you really think that pharma companies suddenly become not for profits and sell their technologies for less than what they cost, research included? Who can't afford the drugs even after bargaining the price goes without, that's it. In the rest of the world it's whole nations, in the US it's many citizens. For example my country doesn't find an agreement with the company that produces the latest miracle drug against HCV, this means that my fellow countrymen (rich or poor it doesn't matter) don't get it. In the US this doesn't happen because the "freedom" for rich people to buy the bestest of the best at whatever price prevents the state from having bargaining power to grant everybody's right to access affordable care. In this way lower income people are "free" to go without healthcare. Now I wonder why your insurance companies don't do the bargaining part, probably because you can't really shop around for better companies nor exert pressure on your company to obtain better options as we can do on our state (ie citizens are mobilising to obtain the drug I referred to above).

Sorry but saying that the US pays so much for health care because other countries don't pay enough simply isn't true. ETA to make a comparison it's as if you bought let's say a new mattress, you shopped for the best price of the model wanted and when your neighbour finds out that he paid a lot more for the very same mattress he alleges that he paid for yours too. It is a ridiculous claim, in a normal market siruation (pharma companies aren't on the brinck of bankruptcy and the demand is generally high) a producer doesn't sell without a profit, even minimal, whoever the buyer is. Clearly the bigger the buyer the bigger the bargaining power.

[VeganCupcake]

11 hours ago, Georgiana said:

I believe in Universal Healthcare......[snip].......... Until profits/insurance companies/medical costs are REGULATED so that companies are FORCED to provide actually affordable options, I don't support a healthcare mandate.  

The problem with that is, we can't force anyone to be a doctor. What happens when med school is no longer viewed as a guaranteed path to profit? Med school is already prohibitively expensive to most students. The government can't just pay every doctor, if there aren't even enough doctors to go around. 

"Universal Healthcare" countries don't have enough doctors either. Yeah their healthcare is free, but it's rationed. For example, Pap smears aren't routinely done in the U.K. until age 25. Well I had an abnormal one at age 21. So I'm glad I was able to receive care for it. 

I certainly believe that everyone deserves healthcare, but it isn't a national budget issue. It's a RESOURCES issue. We can't buy something that isn't there. 

 

[bal maiden]

1 hour ago, VeganCupcake said:

The problem with that is, we can't force anyone to be a doctor. What happens when med school is no longer viewed as a guaranteed path to profit? Med school is already prohibitively expensive to most students. The government can't just pay every doctor, if there aren't even enough doctors to go around. 

"Universal Healthcare" countries don't have enough doctors either. Yeah their healthcare is free, but it's rationed. For example, Pap smears aren't routinely done in the U.K. until age 25. Well I had an abnormal one at age 21. So I'm glad I was able to receive care for it. 

I certainly believe that everyone deserves healthcare, but it isn't a national budget issue. It's a RESOURCES issue. We can't buy something that isn't there. 

 

It's rationed in the US as well though, just by the so-called 'invisible hand'. How many women don't have insurance that would have covered that pap smear you had at age 21? At least in the UK, the rationing is evidence-based (i.e. high risk vs low risk groups), rather than based solely on a lottery of what your/your parents' job is.

[singsingsing]

Everything I've read on the subject recently indicates that most women don't need pap smears until at least 25, unless there's reason to believe something might be wrong. ECGs and mammograms aren't routinely performed on young women either, even though it's possible for a young woman to have an abnormal one, even in the U.S.

I live in a country with universal healthcare and nothing has ever seemed 'rationed' to me? This isn't a commentary on what I think the U.S. should do to fix its system because I honestly don't know. I don't know what it's like in the UK or other countries with universal healthcare, but I've received a very high standard of care in Canada.

[laPapessaGiovanna]

3 hours ago, VeganCupcake said:

The problem with that is, we can't force anyone to be a doctor. What happens when med school is no longer viewed as a guaranteed path to profit? Med school is already prohibitively expensive to most students. The government can't just pay every doctor, if there aren't even enough doctors to go around. 

"Universal Healthcare" countries don't have enough doctors either. Yeah their healthcare is free, but it's rationed. For example, Pap smears aren't routinely done in the U.K. until age 25. Well I had an abnormal one at age 21. So I'm glad I was able to receive care for it. 

I certainly believe that everyone deserves healthcare, but it isn't a national budget issue. It's a RESOURCES issue. We can't buy something that isn't there. 

 

The average salary for a doctor with a ten years experience in a public hospital in my country is 2400 € (taxes already paid). There are specialised blue collar workers that earn more, yet somehow there isn't any shortage of students who want to study medicine. Probably because they won't find themselves deep in debt after six years (in case you wonder, the public expense for educating one doctor in my country is estimated around 150-160 000 €). And there's the promise for a great career for those who excel or of a honest even if less brilliant career for those who don't aspire to win Nobel Prizes.

BTW a pap smear before 25yo, privately done with no state funds, cost me 18 € some years ago. And the private ob/gyn visit cost me from 85 €. How much does it cost in the US?

I know that there are places with higher and lower COL, but no amount of COL difference can explain how it is possible that the very same test that cost an American woman 2500 $  would cost me here a bit more than 40 € (I don't remember what test it was, we discussed it in the Pregnant and parenting FJ thread).

[VelociRapture]

7 hours ago, send*the*ferrets said:

I didn't scroll all the way to see if this got answered, so I may be redundant, but I know a little about this subject. The problem (preACA, which I believe Beau passed away before the law had been enacted) is the lifetime max. Chemo is *extremely* expensive- literally 50k for one treatment. Then most people will receive a nulasta (possibly spelling that wrong) shot the next day- it boosts white blood cell production- that shot alone is 10k. One "round" of chemo is usually 8-12 treatments- that's over half a million for one round of chemo. It's not uncommon for people to go through 3-4 rounds of chemo, sometimes they even do multiple chemo cocktails at the same time. Plus add in pain medicine, anxiety medicine, antidepressants, diagnostic tests, possible surgeries... and a lot of policies would have a lifetime maximum of 2 million. A person with cancer can hot that lifetime maximum in under a year. Easily. My sister is a nicu nurse and preACA they would frequently have babies who reached their lifetime insurance maximum before they *even left the hospital* 

now, there are options once that max has been reached- but you have to basically be below the poverty level- which is possibly why Biden was going to sell his house, because he was trying to prevent his son leaving his wife and kids with nothing. I know in my state, you can't have over 999.99 before accessing the state insurance. 

Thank you and @louisa05for explaining! I just want to note that Beau passed away in the spring of 2015, well after the ACA was implemented. His death was one of the biggest reasons Joe Biden decided not to run for President in 2016.

6 hours ago, Rachel333 said:

On the topic of healthcare costs, I just saw this image of a hospital bill for someone being treated for rape.

And here's a hospital bill for a birth. Apparently it costs $39.35 to hold your own baby.

The couple uploaded that because they found it funny. The charge was included because the mother had a C-Section. Due to the medicine she was on and liability issues, an extra Nurse had to be present to make sure the baby was safe while mom was holding them. That was why there was a charge.

As for the rape bill... it's really sad that she would have received a bill like that after such a traumatic experience.  

[Rachel333]

5 minutes ago, VelociRapture said:

The couple uploaded that because they found it funny. The charge was included because the mother had a C-Section. Due to the medicine she was on and liability issues, an extra Nurse had to be present to make sure the baby was safe while mom was holding them. That was why there was a charge.

Yeah, I thought the bill was funny too, but it's also just interesting to see how much a birth costs in general. $13000 is a lot! It's good they had insurance, not that $1600 is cheap for most people either.

[VelociRapture]

15 minutes ago, Rachel333 said:

Yeah, I thought the bill was funny too, but it's also just interesting to see how much a birth costs in general. $13000 is a lot! It's good they had insurance, not that $1600 is cheap for most people either.

The bill total wasn't surprising to me, but I've recently had a baby. Mine was actually $6,000 higher - not counting the epidural ( a separate bill of $3500) or my baby's NICU stay (around $65,000) - and I didn't even need a C-Section. 

 Thank God for insurance because they covered all of it after we hit our deductible last fall or summer. Having a kid is fucking expensive!

(Their bill was kinda funny though. Who expects to see that on their bill?! )

[VeganCupcake]

2 hours ago, bal maiden said:

It's rationed in the US as well though, just by the so-called 'invisible hand'. How many women don't have insurance that would have covered that pap smear you had at age 21? At least in the UK, the rationing is evidence-based (i.e. high risk vs low risk groups), rather than based solely on a lottery of what your/your parents' job is.

Yes I am still on my parents' insurance; my mom doesn't work and my dad is a middle school teacher.  Meanwhile people with the EXACT same job in the U.K. and elsewhere have less access to care. There are also upper age cutoffs for certain procedures and surgeries, like heart surgery,  which don't exist in the US. I don't think anybody has a perfect system yet, so I don't want to idealize any certain country.  

Oh and "EVIDENCE-BASED" healthcare is utter bullshit! By the time you see evidence of cancer, it's usually far too late! 

[nvmbr02]

9 minutes ago, VelociRapture said:

The bill total wasn't surprising to me, but I've recently had a baby. Mine was actually $6,000 higher - not counting the epidural ( a separate bill of $3500) or my baby's NICU stay (around $65,000) - and I didn't even need a C-Section. 

 Thank God for insurance because they covered all of it after we hit our deductible last fall or summer. Having a kid is fucking expensive!

(Their bill was kinda funny though. Who expects to see that on their bill?! )

My births were fairly inexpensive (hospital birth, but uncomplicated and med free) but my sister just gave birth to a little girl last week and her little girl had an undiagnosed medical problem that required surgery and a NICU stay of about a week. Plus follow on care with specialists. Neither my sister or her SO have great insurance, or a big savings so this is a major financial hit for them. I know they would love to have anther child in the relatively near future but who knows if they can afford it. 

Of course the SO is a die hard Trump supporter and while my sister hasn't been vocal about it she probably is too, 

[VeganCupcake]

12 minutes ago, nvmbr02 said:

My births were fairly inexpensive (hospital birth, but uncomplicated and med free) but my sister just gave birth…… this is a major financial hit for them. I know they would love to have anther child in the relatively near future but who knows if they can afford it.  

Wow. Unbelievable. Have they thought about how they will even afford to raise the first child, when they are already in the hole from the birth alone? And what would they do if their baby came down with leukemia, or autism, or some other super expensive condition?? I say this with no judgment. My own broke parents irresponsibly had a ton of children, and it's a huge stroke of luck that all of us have been healthy so far. 

[CuttySark]

53 minutes ago, VelociRapture said:

The bill total wasn't surprising to me, but I've recently had a baby. Mine was actually $6,000 higher - not counting the epidural ( a separate bill of $3500) or my baby's NICU stay (around $65,000) - and I didn't even need a C-Section. 

 Thank God for insurance because they covered all of it after we hit our deductible last fall or summer. Having a kid is fucking expensive!

(Their bill was kinda funny though. Who expects to see that on their bill?! )

This all blows my mind (Canadian), no matter how often I hear about it. My total bill for each of my births (both with complications, but b"h no NICU time) was $100. Because provincial health care covered a semi-private room and I upgraded to private ($50 / night). And the physiotherapy / lactation consultants / all prenatal care was completely free. 

I've had every procedure I've ever needed taken care of within very acceptable time frames. My partner was being seen for angina, went in for a dye test at the end of November and was in getting four stents placed in seven days (literally, 'this needs to be done, come in this time next week.') And the tests, hospital stay, stents, follow-up appointments and care clinics have all been completely covered. The only thing we've ever been on the hook for is medication, and that's where the Blue Cross and employer drug plans come in, because we're not in the protected classes that get drug plan help. 

More importantly, this would hold true for everyone in the country, from the homeless kid on the street in Van, to the poorest seasonal fisherman in bumfuck nowhere Newfoundland, through to the highest-paid oil baron in Alberta. Because we take care of each other. 

And people still argue that the US health care system is better?? I can't even fathom. 

[Palimpsest]

1 hour ago, VeganCupcake said:

Yes I am still on my parents' insurance; my mom doesn't work and my dad is a middle school teacher.  Meanwhile people with the EXACT same job in the U.K. and elsewhere have less access to care. There are also upper age cutoffs for certain procedures and surgeries, like heart surgery,  which don't exist in the US. I don't think anybody has a perfect system yet, so I don't want to idealize any certain country.  

Oh and "EVIDENCE-BASED" healthcare is utter bullshit! By the time you see evidence of cancer, it's usually far too late! 

You really do not know what you are talking about.  At best you are just repeating uninformed anti- universal heath care propaganda.  There is a lot of it about. The Daily Fail gets mileage out of it.

A sensible article talking about concerns about denial of healthcare to older people  in the UK here:

https://www.theguardian.com/society/2012/oct/15/nhs-cancer-joints-surgery-age-discrimination

Quote

Such practices [age discrimination] are now illegal. In June, the government said denying drugs or treatments on the grounds of age would be outlawed from this month, meaning older people may be able to sue the NHS to challenge decisions they feel are discriminatory because of their age.

"A new legal framework to outlaw age discrimination in the NHS cements our moral duty of care to older patients and sends a clear signal to the NHS to deliver the best care and support to every patient in line with his or her needs," the report notes.

The Department of Health said the NHS should not deny patients treatment because of their age. "There should be absolutely no place in the NHS for assumptions about entitlement to treatment that are based on age or any other form of unjustified discrimination," said Dan Poulter, the health minister. "All patients should be treated as individuals, with dignity and respect, and receive care that meets their healthcare needs irrespective of their age.

"The government is committed to providing dignity in elderly care, and at the beginning of October we introduced an age discrimination ban, which means that all patients will receive a more personalised care service, based on their individual needs, not their age."

You also don't seem to know what evidence-based practice is, and that is rather sad.  Here you go: https://en.wikipedia.org/wiki/Evidence-based_practice

Evidence-based clinical practice is also used in the USA.   https://www.nlm.nih.gov/hsrinfo/evidence_based_practice.html

[QuiverFullofBooks]

1 hour ago, VelociRapture said:

The bill total wasn't surprising to me, but I've recently had a baby. Mine was actually $6,000 higher - not counting the epidural ( a separate bill of $3500) or my baby's NICU stay (around $65,000) - and I didn't even need a C-Section. 

 Thank God for insurance because they covered all of it after we hit our deductible last fall or summer. Having a kid is fucking expensive!

(Their bill was kinda funny though. Who expects to see that on their bill?! )

To return briefly to our ostensible topic, the Duggars were once billed hundreds of dollars for soap. JB recommends strongly that everyone should insist on itemized bills.

[Carm_88]

1 hour ago, VeganCupcake said:

Yes I am still on my parents' insurance; my mom doesn't work and my dad is a middle school teacher.  Meanwhile people with the EXACT same job in the U.K. and elsewhere have less access to care. There are also upper age cutoffs for certain procedures and surgeries, like heart surgery,  which don't exist in the US. I don't think anybody has a perfect system yet, so I don't want to idealize any certain country.  

Oh and "EVIDENCE-BASED" healthcare is utter bullshit! By the time you see evidence of cancer, it's usually far too late! 

Well, let's see at 21 I had two emergency surgeries back to back. 3 months after the second emergency surgery, I had another scheduled surgery. You know what I paid? Absolutely nothing. Since that day in 2010, I have x-rays every 2-3 months, I see an orthopedic surgeon every 6 months, on top of general doctors visits. I don't want to think about what that would cost in the US. It costs me nothing but time. Sometimes my ortho visits do get put off but seeing that I was once the reason that someone else got pushed back, I don't ever complain.

Also women with family histories of breast and ovarian cancer have no problems getting mammograms and pap smears. Not perfect? No, there are issues but I'll take universal health care any day. 

[2manyKidzzz]

I know I heard Joe Biden say in an interview that he was discussing Beau's care and while talking to Obama said that they would sell their house if necessary. Obama said he would give him money. Obama had money from books and such and I guess Biden did not have that level of money. 

Glad people aren't forced to live in the US I guess. 

[Ali]

1 hour ago, VeganCupcake said:

Wow. Unbelievable. Have they thought about how they will even afford to raise the first child, when they are already in the hole from the birth alone? And what would they do if their baby came down with leukemia, or autism, or some other super expensive condition?? I say this with no judgment. My own broke parents irresponsibly had a ton of children, and it's a huge stroke of luck that all of us have been healthy so far. 

This is an extremely judgmental comment. How dare you judge someone for wanting a second child and when they are still trying to pay off the first child's medical bills.

Are you unaware that many insurance plans have high deductibles? Are you unaware that people have to come up with thousands of dollars just to pay for the out of pocket costs? Do you have $13,000 sitting in a bank account right now? If everyone waited to save $13,000 before having a child, only the rich would have children. Perhaps that is what you think should happen?

[singsingsing]

1 hour ago, VeganCupcake said:

Yes I am still on my parents' insurance; my mom doesn't work and my dad is a middle school teacher.  Meanwhile people with the EXACT same job in the U.K. and elsewhere have less access to care. There are also upper age cutoffs for certain procedures and surgeries, like heart surgery,  which don't exist in the US. I don't think anybody has a perfect system yet, so I don't want to idealize any certain country.  

Oh and "EVIDENCE-BASED" healthcare is utter bullshit! By the time you see evidence of cancer, it's usually far too late! 

So you're having mammograms, colonoscopies, MRIs and ultrasounds on various body parts every time you go for your annual physical, right? Since evidence-based healthcare is utter bullshit and by the time you're showing symptoms it's far too late?

1 hour ago, VeganCupcake said:

Wow. Unbelievable. Have they thought about how they will even afford to raise the first child, when they are already in the hole from the birth alone? And what would they do if their baby came down with leukemia, or autism, or some other super expensive condition?? I say this with no judgment. My own broke parents irresponsibly had a ton of children, and it's a huge stroke of luck that all of us have been healthy so far. 

Hey, still using the pull-out method as your only form of birth control? 

[evolutionbaby]

I'm a lower middle class Canadian (I've made between $20-35K/annually throughout my working years) and other than my monthly medical premiums, I have never paid a dime for healthcare. The most I've ever paid for premiums was $52 and the least I've paid is $12/month. I have no idea what the actual cost for medical services I've received are, but I've seen a doctor whenever I need to, have gone to the emergency room when it's required, and also had specialist appointments as required too. 

I lived in the states for two years on a work visa, but the first year I was down there I did not have medical insurance and I learned first hand just how third-world the medical system is down there. Four months into my stay down there I got a UTI and I had no money. It was $100 just to walk into a clinic, nevermind prescriptions. I finally found a doctor who served low-income patients and was able to see him for just $40 and he gave me a weeks worth of sample antibiotics and said "that should probably do"; a typical round of antibiotics is usually two weeks. He was a kind doctor and did the best he could.

A few months later I got mono, although when I first got sick I thought I just had the flu, but what worried me was when my fever didn't subside by the fourth day. I called the same Dr. again, and he was kind enough to counsel me on the phone and suggest the diagnosis of mono. He gave me some advice and things I should be wary of in case I needed to go to emergency. I know ethically he should not have given me a phone diagnosis, but he understood that I had no money and would not go to emergency unless it was absolutely necessary. Morally he did the right thing.

Many people in the US die every year because they don't want to go to Emergency and get a bill.

I've had friends and colleagues who have had their entire live savings wiped out or had to declare bankruptcy due to medical bills. That is just so barbaric to me.