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Healthcare:: WTF goes to hospital

Am I the only one who does not get this obsession with healthcare/hospitals.

Has the world really become that unhealthy?

Here's me
29 Male
Last visit to hospital:: March 17, 2006
I got mugged and only went because the cops said it should be documented in case they ever caught the chaps who did it. Bandage for cut above eye.

Visit before that:: October 1995
Had a climbing accident. Was airlifted off the mountain, and heli took me to hospital. Stiches on upper lip, and plaster for broken ankle.

Not sure about the time before that. Might ahve been after a hockey accident in high school.

Am I unusual in not becoming "oh my god, I need to go to the doctor!" ill in over ten years?
Permalink Send private email Tapiwa 
September 7th, 2006 10:50am
Let me paraphrase your post:

"My limited and highly specific experience does not mesh with the average experience, therefore the average experience is clearly fantasy."
Permalink Send private email muppet 
September 7th, 2006 10:55am
"Am I unusual in not becoming "oh my god, I need to go to the doctor!" ill in over ten years?"

Yes. You've been blessed by being born an unusually healthy person. Even then you will need more and more healthcare in the future.
Permalink Send private email Flasher T 
September 7th, 2006 10:55am
Not totally unusual. I did not seek medical treatment for any kind of illness between 1985 and this year.
Permalink Send private email bon vivant 
September 7th, 2006 10:56am
I could count the times on one hand...

We do have quite a bit of hypochondria in this country. It's probably getting worse as a direct result of pharmaceutical marketing.
Permalink Send private email JoC 
September 7th, 2006 10:58am
I used to think I was a hypochondriac but then I almost died of pancreatitis and I don't think that anymore.
Permalink Send private email muppet 
September 7th, 2006 10:59am
I suspect that a single male in his early 30's, of all age groups, is statistically to not have gone to the doctor's the longest.

We go when we're young and vulnerable. We go when we've become middle aged and the life insurance company makes us go. (Women tend to go once a year no matter what age.)

There was a commercial campaign on TV here (by Spike TV channel I think) to offer men some sort of incentive for going to the doctor.
Permalink Send private email just me 
September 7th, 2006 11:09am
Last "real" doctor visit was when I was discharged from the military in 1987. I've been to the Doc-in-a-box places a couple of times for some minor injuries since then, but not very often.

Now that I'm over 40, I probably need to start scheduling regular visits.  :-(

What I want in a doctor is someone who is curious about medical stuff.  I don't want someone who is complaicent (sp?) and is just going to push pills at me.  I want someone who, for lack of a better term, is a medical geek.
Permalink xampl 
September 7th, 2006 11:10am
Muppet,

Just sharing my experience, and wondering what it is I am missing. I drink and smoke for chrissakes!
Permalink Send private email Tapiwa 
September 7th, 2006 11:12am
My kidneys have a tendency to act up in very nasty and painfull ways. I thank God both my country and my line of work allow me to pay for regular visits to the doctor.
Permalink Lustiges Häschen 
September 7th, 2006 11:12am
If it wasn't for a robust healthcare system, my mother-in-law would've been dead twenty years ago, my sister-in-law would've died at 25, and my dad would've died six years ago.

So YMMV.
Permalink Send private email Philo 
September 7th, 2006 11:14am
xampl, most of them now just dish out antibiotics
Permalink Send private email Tapiwa 
September 7th, 2006 11:17am
But antibiotics don't do squat against a viral infection.  In fact, they make things worse because they breed stronger bugs (BTW: how do the I.D. people explain this?)

I want a doc who is willing to say to me: "You have a virus.  There's nothing we can do.  Go home & drink plenty of fluids and get some rest."  Not someone who will say "Here, take these drug company samples, and get this prescription filled. Next patient please."
Permalink xampl 
September 7th, 2006 11:22am
The issue with healthcare is this.

You can spend the rest of your working life, from 29 to age 65, earning money and trying to put some aside for your retirement.

Then, you can easily spend all the money you've saved in your life on a heart-bypass, a cancer treatment, or long-term care in a year or two.  Maybe less.

So no, you 29 year old perfectly healthy person, YOU don't need any f'ing health care.  NOW, anyway.  But if you don't keep your eyes open, by the time you DO need it for yourself, your wife, your children, or your parents, you won't be able to afford it.

THAT'S the issue with health care.
Permalink Somebody 
September 7th, 2006 11:23am
Hey somebody

Sounds like it is a bit of a ponzi scheme then.

Either that, or your argument is predicated on some people putting in far more than they take out.

Both parents dead, and no kids, so I will probably take my chances with savings, and the occasional medical holiday to Thailand or India when the time comes.
Permalink Send private email Tapiwa 
September 7th, 2006 11:56am
"and the occasional medical holiday to Thailand or India when the time comes."

The world revolves far too quickly for you to plan like that. And yes, public health is a scheme: the healthy people, the ones who work, subsidize the care of the elders, who can't afford it. When its their turn to be old, they will be subsidized by the working generation.
Permalink Lustiges Häschen 
September 7th, 2006 12:09pm
till shit hits the fan, and governments start worrying about aging populations.

Rubbish I say. Rubbish.
Permalink Send private email Tapiwa 
September 7th, 2006 12:18pm
No, it's not a ponzi scheme.  A ponzi scheme keeps paying out to 'early' investors, because it keeps getting in 'later' investors.

Health insurance is "insurance".

"Insurance" is where a group of people gather resources.  The few to whom "bad things happen" get supported by the many to whom "nothing bad happens".

This doesn't make sense, right?  Why should the many support the few?

Because you don't know, going in, who is who.  It's hedging
your bets.  It's expensive when 'something bad happens'.  If you can average out the cost, then it's affordable for everybody.

So -- scenario 1.  You think you don't need insurance, because right now you're healthy.  You live your life to an old age, never need any major medical, and die in your sleep.  You never needed any insurance.  Good on ya.

Scenario 2.  You think you don't need insurance, but in 5 years you're going to be involved in a major traffic accident (or have a fall) which impairs your ability to work, and leaves you in major pain.  Since you don't have insurance, you have to come up with the $30,000 per year for meds and hospital stays.  Don't have it?  Sorry.  Go die somewhere, you've voted that Insurance and Hospitals for the indigent aren't important.  Oh, it's immoral for society to let you die?  Ok, then, society does maintain a low-level medical system for the poor.  That's now you.  Go there.

Scenario 3.  You think you need health insurance.  You get it through your employer.  When the accident happens, the insurance company pays for your health care.  You don't lose your house.

Scenario 4.  You think you need health insurance.  You get it through your employer.  Nothing happens to you your entire life.  Your premiums help those in category 3.  It's not "ponzi", because THEIR premiums would help you if YOU wound up in category 3.

What's missing in your analysis is an acknowledgement of risk, and an awareness that paying for insurance is one way of covering some of your risk. 

Scenario 1 is not a problem, and is the cheapest approach, BUT you can't guarantee you ARE Scenario 1.  So there's a risk.

Scenario 2 is a huge problem, and is the most expensive approach.

Now, if you pay for insurance you CAN guarantee that Scenario 2 Will Not Happen.  Sure, you also guarantee that Scenario 1 won't happen.  So the question is, what cost is resonable?

Anyway, that's the Insurance Equation. It's up to each person to look at it, and decide.  I only put it up here because it seems you're ignoring Scenario 2, through innocence or wishful thinking.  You're thinking the choice is between Scenario 1, or Scenario 4.  But that's not a choice YOU get to have.  LIFE chooses between scenario 1 and 2, or scenario 3 and 4.  That's why people buy insurance, to GUARANTEE whatever life chooses, they get scenario 3 or 4.

All of this makes a LOT more difference when you have children, by the way.
Permalink Somebody 
September 7th, 2006 12:18pm
My youngest (8) that's who.  In the last year he has broken his thumb, had a lymph glands in his abdomen mimic appendicitis, split his chin to the bone needing 4 stitches and last night put an inch long gash into the back of his head when he fell onto the edge of a brick wall.

I've no complaints about the treatment he received for 3 of those from the NHS and was extremely impressed by the French Hospital who treated the other one.
Permalink Send private email a cynic writes... 
September 7th, 2006 12:23pm
I changed my mind; I'm with Tapiwa. I'll bet there aren't any 29 year old males in any hospital anywhere.

Tapiwa, you should also live somewhere where you don't have to pay car insurance, since you've never had a car accident.
Permalink Send private email Philo 
September 7th, 2006 12:23pm
I studied Actuarial Science at university.

I fully understand the technical machinations of the insurance industry.

Ergo, I think with the inefficiencies in the marketplace, one cannot underestimate the potential benefits of self insuring.

A lot of big fleet operators will not insure with third party firms. It makes more sense to self insure.
Permalink Send private email Tapiwa 
September 7th, 2006 12:27pm
"A lot of big fleet operators will not insure with third party firms. It makes more sense to self insure."

What does that mean?
Permalink Lustiges Häschen 
September 7th, 2006 12:29pm
Then I think you phrased your question very badly.  "Who the hell goes to hospital" is an ambiguous question.  What it seems, now, that you were asking is something like "why do people go to the hospital all the time, instead of doing something else"?

In fact, it seems like you've got a conclusion you'd like to see -- "People go way the hell more to the hospital than they should" -- but there's so much left unsaid it's hard to determine even that.
Permalink Somebody 
September 7th, 2006 12:36pm
"Somebody" (with all the nick changes, I forget who he/she is/was) has been the most sensible poster in this thread.

Tapiwa is coming across like one of Heinleins cardboard "competent man" protagonists.  Maybe Hugh Farnham (from Farnham's Freehold)? You're a Libertarian (or a fellow traveller), right?
Permalink possibly maybe 
September 7th, 2006 12:38pm
Farnham's Freehold:

http://en.wikipedia.org/wiki/Farnham%27s_Freehold
Permalink possibly maybe 
September 7th, 2006 12:40pm
What the OP said was that by and large 29 year old males don't go to the hospital. Which is true.

But if they or their employers didn't pay health insurance all the people who do go would be fucked.

Personally I don't see why national health insurance should cover 'rock climbing' incidents. Cause there's no necessity in engaging in such behavior. Pay for those just deserts out of your own damn wallet.
Permalink victim of my own victimhood 
September 7th, 2006 12:55pm
"Visit before that:: October 1995
Had a climbing accident. Was airlifted off the mountain, and heli took me to hospital. Stiches on upper lip, and plaster for broken ankle. "

I'm insatiably curious to know just how much the helicopter airlift off the mountain cost.  Not to YOU, of course, but total.
Permalink Somebody 
September 7th, 2006 1:01pm
And who paid for it.
Permalink Lustiges Häschen 
September 7th, 2006 1:03pm
What about smoking-related illnesses?  Sickness caused by obesity?  STDs?

How to tease out the genetic components (if any) of illnesses vs. how much can be traced directly to deliberate actions?  The environmental component?

Do you have cancer because you ate too much char-broiled steak?  Because your groundwater was contaminated?  Because you're predisposed to having cancer due to your mother's/father's genes?

Etc. etc.

Let's just have health coverage and try to educate/cajole people into making healthier/saner life choices but bite the bullet and care for them like a civilized society even if they behave foolishly.  Obvious self-destructive behavior would still get you a psych exam or held for observation.
Permalink possibly maybe 
September 7th, 2006 1:06pm
re:fleet insurance
It is cheaper for a company with 1000 cars to take the hit when one of their cars gets nicked than to pay theft insurance for every single car in the fleet.

Somebody:
The question was phrased badly I agree. I suppose all I am suggesting is that healthcare benefits at this juncture of my life are not a primary consideration when evaluatng job offers. Show me the money ... but then again, I do not live in the US

Possibly:
Yup, I am a libertarian.

Climbing accident:
I did pay for my hospital costs. Actually, my parents did. I was at university at the time. Can't recall the exact numbers, but they would be quite low in US$ ... it was in Cape Town, South Africa.

Moral Hazard:
One of the first things you learn in actual sciences, is the concept of moral hazard. People who can go to hospital for free will do more of it than those who pay per use. Given that 'free' means I have already paid, why not use it, it kinda defeats the purpose of 'insurance' (collectively pooling the costs).

Say insurance premium is calculated on assumption of 1 in 100 cars being stolen. Suddenly, the 100 people with car insurance do not fit anti-theft devices. Numbers rise to 3 in 100 cars being stolen. Car insurance now more expensive for everyone ... Repeat.

Ponzi:
I suggested it was a Ponzi, as a lot of people seem to not mind terribly that a lot of these funds are technically insolvent. "nevermind, the kids joining in the next few years will ensure that there is still money in the kitty to pay for our medicare"

I suppose the question was aimed at figuring if my non hospital visiting was normal; if people with healthcare went more often; if not, why continue to 'buy' a product we don't use?

ps. I am in the UK where NHS is free (you get what you pay for).
Permalink Send private email Tapiwa 
September 7th, 2006 1:19pm
It's not ponzi scheme, but not completely insurance either.

If 1 in 3 people will have cancer in their lifetime, then basically it's ... communism :)
Permalink Rick Zeng/Tseng 
September 7th, 2006 1:32pm
Current income tax/benefits laws mean most of us live in communist states.

From each according to his ability (progressive tax)
To each according to his need (means testing for benefits)

Try telling that to most of the idiots I am surrrounded by.
Permalink Send private email Tapiwa 
September 7th, 2006 1:39pm
"Personally I don't see why national health insurance should cover 'rock climbing' incidents. Cause there's no necessity in engaging in such behavior."

Probably not a large number of those to worry about.
Permalink Send private email Philo 
September 7th, 2006 1:40pm
Tapiwa gets the advantage back by pointing out that he paid for the airlift himself and raising the moral hazard issue. Ie, with no direct feedback people have no reason to limit behavior - either by going to the doc too frequently, or doing risky/unhealthy things. And costs sky rocket.

I guess in some countries what's expensive about the health care system is not the out of pocket costs but having to wait around forevah to see a doctor. That counteracts the moral hazard right there.
Permalink Send private email just me 
September 7th, 2006 1:42pm
No, Tapiwa reveals his hypocrisy because his PARENTS paid the bill, he doesn't know HOW they paid the bill,  he doesn't know what the bill WAS, and despite all of that he feels free to criticize it.

AND, he lives in a country with a National Health Service.  So he has the luxury of complaining about something that he's not actually experienced himself.

I agree there's an issue to discuss here, regarding the affect a co-pay has on Emergency Room visits.  Anybody want to start a new thread?
Permalink Somebody 
September 7th, 2006 1:46pm
I do not recall what the bill was, a couple of thousand rands in 1995 money.

My parents paid the bill with THEIR money.

How does that make me a hypocrite?

I might now live in a country with a free NHS, but I do not use it. The waiting time means most people who can do go private (pay themselve or private insurance). Again, was wondering if my non use, was normal.
Permalink Send private email Tapiwa 
September 7th, 2006 1:50pm
There is no reason why we can't have both public and private clinics.
Permalink Rick Zeng/Tseng 
September 7th, 2006 2:00pm
Oh!  Is THAT what you were asking?

Yes, that's normal.  I belong to Tri-Care (US Military Retiree Medical service), and the wait for service (call 30 days in advance) has certainly made me reluctant to call for service.
Permalink Somebody 
September 7th, 2006 3:30pm
In my limited experience, no. Until yesterday, it's been years since I sought medical help and I'm roughly twice your age. Not that this was wise, as I'm now waiting on some tests to see whether it was a kidney stone or back trouble or whatever that floored me.

Possibly I should have had more checkups along the way, but there's better things to do in life than read old magazines.

Occasionally I've taken one of my kids to base hospital Cas(ualty) and it's generally full of unfortunates. Some are there simply because it's warm, some because they may be able to get some attention for their disorientation, some with trivial complaints, some with more serious.  The triage nurse sorts them out. Sometimes the tedium is broken as an ambulance arrives with the real deal.
Permalink trollop 
September 7th, 2006 9:51pm
----"One of the first things you learn in actual sciences, is the concept of moral hazard. People who can go to hospital for free will do more of it than those who pay per use. Given that 'free' means I have already paid, why not use it, it kinda defeats the purpose of 'insurance' (collectively pooling the costs)."------

If you only provide emergency care for free it often works out more expensive than providing everything for free as people don't get to see the doctor until the disease is well-established and more difficult to prevent.
Permalink Send private email Stephen Jones 
September 8th, 2006 6:05am

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