Jinger/Jeremy: Not as Interesting as Jingerbread

[SHERA]

On 3/27/2017 at 11:10 AM, singsingsing said:

Oh no! Jeremy's just as much of an asshole as the rest of them? But he only has two siblings, and he's hot!

Yes, Jeremy, I was definitely depressed because of the sin in my heart, not because I suffered through ~20 years of school with an undiagnosed learning disability. Getting help from a licensed psychologist was a total waste of time, and my doctor definitely didn't give me anything when she prescribed me iron pills and B12 shots to treat my pernicious anemia (a common symptom of which is depression). Nope, I just had to call 1-800-JESUS and order a same-day slavery-and-bondage removal. Then my sinful depression disappeared. Hallelujah!

I have three words for Jeremy Vuolo: Go fuck yourself.  

Is he really saying depression is a sin? Good Grief Charlie Brown! I don't remember depression being listed in the 10 commandments? 

[VelociRapture]

2 hours 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. 

Are you purposely being a judgemental asshole? Or does your stunning ignorance just make you come across that way? 

1 hour ago, CuttySark said:

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. 

Our total cost out of pocket for the birth was gas for our car and snacks while I was still in recovery. We lucked out that we hit our deductible ahead of time... and, oddly enough, that our daughter was premature. Had she arrived on her due date in January we would have had to pay 3-4,000 before the deductible was hit.

So despite the shitty situation we wound up being incredibly lucky in many ways.

I'd personally never argue our system is better. I'm incredibly grateful for the ACA because it forced insurance companies to cover things like maternity and prenatal care - which means more families are offered better protections from massive bills. But it's far from perfect and Republicans did a lot to try and undermine its effectiveness and affordability. I'd love to see Congress work to resolve those issues, but that won't happen anytime soon unfortunately. 

[SHERA]

10 hours ago, Rachel333 said:

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

Are you freaking kidding me! They charged for holding your own child!  No Way!!!!!!

[VelociRapture]

Just now, SHERA said:

Are you freaking kidding me! They charged for holding your own child!  No Way!!!!!!

I already responded on this. The mother had a C-Section and informed them ahead of time she wanted the skin-to-skin contact right after the baby was born. An additional nurse was needed because the mother was given medication prior to the surgery (so she wouldn't be in pain) - the Nurse was needed for safety reasons.

[VelociRapture]

3 hours ago, nvmbr02 said:

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, 

Just realized I never responded:

I'm really sorry they're experiencing that. It's tough enough dealing with an ill child or a NICU stay - worrying about expenses on top of that is even worse. I hope your niece is feeling better and they're able to figure everything out. 

[Palimpsest]

1 hour ago, VelociRapture said:

Are you purposely being a judgemental asshole? Or does your stunning ignorance just make you come across that way? 

That was almost Palimpsest-worthy in its straightforward disgust!  I agree, and I like it when you shoot from the hip.  Perhaps I just need company in sounding mean when I think it is absolutely necessary.  

@VeganCupcake, I'm erring on the side of you just being very young and ignorant at the moment.  I would advise rethinking and perhaps apologizing for sounding like such a judgemental asshole.

[melon]

 Maybe it was because of our lawyer or could it be possible,that because my son had health insurance,he was over-charged?Anyway,we received a refund from the hospital,a few years later...for being over-charged.

Mr.Melon and I can't afford not to have health insurance.He is a diabetic and takes insulin,as well as other medicine.I have arthritis,spinal stenosis,I had to have a spinal fusion last August,and have not worked since then.I have been on Medical Leave.I can no longer do the job I was trained to do.I have profound weakness in my right arm,which could be permanent.I have had physical therapy and slowly my arm seems to be improving.I was terminated by my employer.After 6 months,if an employee hasn't returned ,they are terminated.My dr says I can work,but only light  duty.I cannot be lifting boxes all day long,like I did ,before.I need to work.I want to work.

I get disability,but it goes to Cobra..so we do have health insurance...for 18 months.We looked into Mr.Melon's health insurance..outrageous...more expensive,less coverage....$5,000 deductible...to my $500 deductible...wow.

We are managing,but I do worry.Mr.Melon just turned 60.Who knows how much longer he will be able to work.I'm almost 57,his friend told him that because of my age,I may find it hard to even get another job...they aren't supposed to discriminate,but they do.

[VelociRapture]

1 minute ago, Palimpsest said:

That was almost Palimpsest-worthy in its straightforward disgust!  I agree, and I like it when you shoot from the hip.  Perhaps I just need company in sounding mean when I think it is absolutely necessary.  

@VeganCupcake, I'm erring on the side of you just being very young and ignorant at the moment.  I would advise rethinking and perhaps apologizing for sounding like such a judgemental asshole.

I was going to suggest a wellness check on you. I feel like I'm channeling your spirit a lot lately. 

It's actually because I'm a new mom. Momma has no time to suffer fools right now.

[laPapessaGiovanna]

7 hours ago, VeganCupcake said:

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

I think either you are a trumpster troll or you have some problem comprehending the English language. 

You know that evidence based doesn't mean symptom-based, right? Preventative care (tests and visits to prevent illnesses) IS evidence based, meaning that there's evidence that it works!

[nvmbr02]

6 hours 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. 

Wanting to have 2 children is hardly irresponsibly having a ton of children. And while they don't have a ton of cash readily available they aren't "broke" either. They are a mid thirties, college educated couple who are both employed full time, own their home and 2 cars outright.  Neither has a huge salary but they also live in a low cost of living area. They don't have to think about the "what ifs" because they are now living it. 

3 hours ago, VelociRapture said:

Just realized I never responded:

I'm really sorry they're experiencing that. It's tough enough dealing with an ill child or a NICU stay - worrying about expenses on top of that is even worse. I hope your niece is feeling better and they're able to figure everything out. 

Thank you, my niece is doing well! She is still in the NICU but should be home soon. She had surgery a few days ago and is healing nicely, Just waiting on pathology results to come in, hopefully soon. 

[VelociRapture]

4 minutes ago, nvmbr02 said:

Thank you, my niece is doing well! She is still in the NICU but should be home soon. She had surgery a few days ago and is healing nicely, Just waiting on pathology results to come in, hopefully soon. 

Regardless of who her parents may have supported, she's an innocent child and no parent should have to deal with the things they are. It's wonderful she's doing better already - NICU babies are born fighters.  

Hopefully your little love gets a clean bill of health and can come home soon. I'll keep them all in my thoughts. 

[Rachel333]

On the topic of evidence-based care, some scientists who were frustrated with an over-reliance on evidence-based medicine (which does have its problems) wrote a paper about how using parachutes isn't good evidence-based care. It concludes

Quote

As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.

[Feminist_Defrauder91]

On ‎3‎/‎30‎/‎2017 at 2:26 PM, danni9242 said:

When Trump et al go on about being pro-life the cut off for that is after they can't control a woman's body any more. Personally I would 100% prefer zero abortions, but in the world we live in people end up with pregnancies they don't want for a variety of reasons. You can't stop abortion, you can only stop safe abortion, and if you want people to have the children you have to be willing and able to say to them you will give them the support they need for housing, healthcare, food and education so they won't be killing themselves with several jobs or sinking into a black hole of debt.

But that would make too much sense!!  *Sarcasm*

[mpheels]

28 minutes ago, Rachel333 said:

On the topic of evidence-based care, some scientists who were frustrated with an over-reliance on evidence-based medicine (which does have its problems) wrote a paper about how using parachutes isn't good evidence-based care. It concludes

That reads like it was written by scientists who don't actually understand evidence based practice or observational research. I am a research methodologist, and I specialize in observational studies using clinical and administrative data. Randomized control trials are definitely the gold standard, but they aren't always feasible or ethical. It takes a lot of work, but it is possible to draw reasonably sound causal conclusions through observations research. The evidence from multiple observational studies taken together can be as compelling as an RCT. Observational studies are frequently more meaningful than RCTs because observational studies can see how well a practice or policy works in the real world, while RCTs can really only tell you if the practice works in 100% perfect/controlled settings. Contrary to what those authors wrote, parachutes are evidence based - if you look at data from people who jumped out of planes with and without working parachutes, and the odds of death for a person without a parachute are huge compared to a person with a parachute. Lack of an RCT does not equal lack of evidence.

Honestly, the biggest problems with evidence based practice (in the US, at least) are an appalling lack of scientific literacy in the general population, and terrible numeracy among most clinical providers. The evidence is never definitive, and science is never settled. We do the best we can with the information we have on any given day. Members of general public see a headline that something is good/bad for their health, and they run with it without actually understanding the process or limitations of the research. There is also a tendency to reject science when it contradicts "common sense" and to dismiss the importance of science confirming "common sense." Common sense if frequently wrong, and we need science to test our assumptions before we make life or death decisions based on those assumptions.

[Rachel333]

9 minutes ago, mpheels said:

That reads like it was written by scientists who don't actually understand evidence based practice or observational research. I am a research methodologist, and I specialize in observational studies using clinical and administrative data. Randomized control trials are definitely the gold standard, but they aren't always feasible or ethical. It takes a lot of work, but it is possible to draw reasonably sound causal conclusions through observations research. The evidence from multiple observational studies taken together can be as compelling as an RCT. Observational studies are frequently more meaningful than RCTs because observational studies can see how well a practice or policy works in the real world, while RCTs can really only tell you if the practice works in 100% perfect/controlled settings. Contrary to what those authors wrote, parachutes are evidence based - if you look at data from people who jumped out of planes with and without working parachutes, and the odds of death for a person without a parachute are huge compared to a person with a parachute. Lack of an RCT does not equal lack of evidence.

Honestly, the biggest problems with evidence based practice (in the US, at least) are an appalling lack of scientific literacy in the general population, and terrible numeracy among most clinical providers. The evidence is never definitive, and science is never settled. We do the best we can with the information we have on any given day. Members of general public see a headline that something is good/bad for their health, and they run with it without actually understanding the process or limitations of the research. There is also a tendency to reject science when it contradicts "common sense" and to dismiss the importance of science confirming "common sense." Common sense if frequently wrong, and we need science to test our assumptions before we make life or death decisions based on those assumptions.

They're not saying there's no evidence for parachutes working, they're pointing out that no one has gone through all the hoops of having double blind studies with placebos. They're not against evidence-based medicine altogether, it's just that a lot of doctors feel like researchers don't always understand what it's like to actually treat patients. In the case of parachutes, it would actually be unethical to do a proper study when they already know what works. EBM is good (I'm pretty sure no one is advocating that scientists don't do studies at all!), it just has its limitations when people try to apply it. Part of the problem is what you mentioned, where when a study comes out people, unfortunately including some doctors, just believe it without understanding how could be flawed.

[MayMay1123]

Just to throw this out there...if you *know that you're having an issue that needs antibiotics and you can't afford to get them, or afford a doctor's visit, get yourself some "fishmox". It's amoxicillin for fish, same as for humans. We just got insurance in January after not having it for almost a year. I missed 3 doctors appointments because I couldn't afford it, luckily my doctor kept up my scrips. Now I'm really afraid I'm going to lose this new insurance or that it's going to be too expensive to keep. 

[closetcagebaby]

6 hours ago, Palimpsest said:

snip

@VeganCupcake, I'm erring on the side of you just being very young and ignorant at the moment.  I would advise rethinking and perhaps apologizing for sounding like such a judgemental asshole.

I'm leaning more towards troll than ignorant young person. I'm 22 and I would hate to count this person in my generation. 

[Palimpsest]

9 minutes ago, closetcagebaby said:

I'm leaning more towards troll than ignorant young person. I'm 22 and I would hate to count this person in my generation. 

Yes.  I agree that she is absolutely not representative of your generation. 

She needs to redeem herself with a sincere apology and much better behavior in the future to ensure that we all don't see her as a troll.

[louisa05]

40 minutes ago, MayMay1123 said:

Just to throw this out there...if you *know that you're having an issue that needs antibiotics and you can't afford to get them, or afford a doctor's visit, get yourself some "fishmox". It's amoxicillin for fish, same as for humans. We just got insurance in January after not having it for almost a year. I missed 3 doctors appointments because I couldn't afford it, luckily my doctor kept up my scrips. Now I'm really afraid I'm going to lose this new insurance or that it's going to be too expensive to keep. 

Probably not a good idea for many reasons. Just a few off the top of my head: Dosage issues. Interaction issues. Amoxicillin not being the best antibiotic to treat every illness. People who are allergic might not know especially if they have reacted to a related drug rather than to amoxicillin. And thinking you need an antibiotic doesn't mean you do. 

[just_ordinary]

@louisa05 I wish I could like that post more than once. I am astonished about the amount of antibiotics that are still subscribed. So many people scream for them and so many doctors throw them out like candy even if they won't work because your health problem is not caused by bacteria. And then there is the ridiculous amount of antibiotics for animals (factory farming has so many ugly faces). The resistance rates might become our biggest problem at one point. We still got some good stuff in the drawers but they are likely to cause serious side effects (because they are quite strong). In my country some of them won't get subscribed to you. 

Clarifying: Of course people who need antibiotics should get them.

[bal maiden]

@VeganCupcake as others have already mentioned, I think perhaps you are misunderstanding the concept of evidence-based medicine, especially in regards to defensive medicine as often practiced in the USA. You are a student, so I shan't patronise you with links, as I'm sure your burgeoning research skills will help you look into these concepts  

FWIW, I have lived in both the UK and USA (with 'good' insurance), and both systems have their pros and cons. The thing that struck me most about the US healthcare system was how much the standard of care varied between localities e.g. the care I got living up in Silicon Valley was far superior, and far less disjointed, than the care when I lived down in Lori Alexander-ville. Both areas are wealthy coastal California, and our insurance coverage was excellent, so I can only imagine the variations between regions and insurance levels across the USA. The UK healthcare system is often frustrating, as you have to justify your need for treatment at times, BUT when you have a need, it is amazing to walk into a hospital and get everything you need without having to fill out any forms or hand over a penny. Too bad that successive governments have been systematically running the NHS into the ground in order that the population no longer sees the value of what we have/had, so will no longer see it as something worth saving. Anyway, I would much rather be treated by an NHS doctor than the average US doctor, because I like my healthcare evidence based rather than defensive. But I'd like my NHS doctors to have the resources that were available to me in the States... It's a question both of healthcare philosophies are well as organisational systems. 

[seraaa]

Agreed with the above about the NHS - it can be (is!) fantastic, but that is wholly dependent on it being properly resourced.

pray for the nhs, basically.

[jozina]

10 hours ago, louisa05 said:

Probably not a good idea for many reasons. Just a few off the top of my head: Dosage issues. Interaction issues. Amoxicillin not being the best antibiotic to treat every illness. People who are allergic might not know especially if they have reacted to a related drug rather than to amoxicillin. And thinking you need an antibiotic doesn't mean you do. 

Yes!!  Urinary tract infections are often caused by bacteria resistant to amoxicillin for instance.  Very few respiratory infections need antibiotics and amoxicillin isn't the best bet for most.  Antibiotic resistance is a monster of a thing and it will only get worse.

A huge component of my medical degree and the postgraduate training I've done was in evidence based medicine, including the methodology, levels of evidence and how it should be applied.  I find Australian doctors within the public hospital system very literate in it and most expect other doctors to have a very high knowledge of it.  Some general practitioners in the community (especially older ones) who I've spoken to make me scared for their patients given their disinterest in evidence based medicine and applying it in their practice, same with some private specialists.  There are plenty who are good or outstanding in this regard too of course.

Addressing all of that with patients can be challenging.  If I see someone who has an expectation they'll get antibiotics I'll start with "I'm going to find out some more information about what's wrong with you and then do an exam to see if they're necessary, or if they won't help".  "Magazine/TV show/Blog X had a story about how we should all be on/avoid aspirin/fish oil/statins" is never a fun start to a consultation but I usually try to do a 5 minute explanation of how a study works and pull up something like Medline to find some examples of how complicated things can be. I wish schools spent more time in science class on working out whether or not something is rubbish. 

[Glasgowghirl]

On 01/04/2017 at 8:27 AM, 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 only in England and Wales that you have 25 to get a smear test the rest of the UK is still 21. The UK healthcare system varies from country to country. People still have the option to go private if the want to. The UK system isn't perfect by any means but people are not dying because they can't afford basic treatments.

[nastyhobbitses]

31 minutes ago, Glasgowghirl said:

It's only in England and Wales that you have 25 to get a smear test the rest of the UK is still 21. The UK healthcare system varies from country to country. People still have the option to go private if the want to. The UK system isn't perfect by any means but people are not dying because they can't afford basic treatments.

When I lived in London, I remember being so shocked/pleasantly surprised when I had to go to the doctor because I got a kinda gnarly infection in one of my ear piercings. The whole affair (consultation, cleaning up the piercing, prescription, and recommendation for a disinfectant to put on for a few days) was 8 pounds. I couldn't believe it; in the US, just seeing my primary care doctor is $25, and that's without any special stuff added on. Yeah, I had to wait like an hour and a half, but I had a book and I wasn't dying, so whatever.