As a Type 1 Diabetic, I just want to say: the diabetes industry is a racket.
I have to repeatedly go to a doctor to get prescription refills for a drug that I have to self-manage. The doctor provides no input day-to-day, where a mis-dose is a death sentence (the first time I nearly put myself into a coma, doc was like "oh yeah that can happen: I can give you glucagon shots as a scrip". Thanks for the heads up!). But cool, to get the drugs that keep me alive, I have to talk to a doctor that will look at my Dexcom charts and mumble some things.
So no surprise that the ADA is a fully industry-captured organization, even though I'm certain that there are good people doing good work for the right reasons.
Having lived in France, Germany, and Australia I can report that there’s a lot less bureaucracy in those systems than in the US system. Like telecom, the participants in the medical system put up tollbooths because they can.
It would be one more layer of bureaucracy, I can tell this as an Italian, if you have a serious emergency you are better off paying out of pocket for a private clinic.
And this is for every aspect of society, I feel like all this burocracy is just made for people that liv e off the state, I get home at 6pm, offices are not even open, I have to take half a day off work to stand in a line every time...
It really is easier, and you can see how this works in any number of countries with universal healthcare. I don’t have diabetes but do have chronic health issues that need constant treatment. Here in the UK:
1. I can reorder prescriptions on the NHS app when I’m running out. They get delivered to my preferred pharmacy or if I was away from home I can specify a local pharmacy. The prescription will be delivered there.
2. Prescriptions normally cost 9.90GBP per “item” (where an item is one type of medicine so may be multiple physical boxes of pills for example). This is a fixed cost and is independent of the type of medicine or how much it costs to the NHS. But…
3. You can get a prepayment certificate for 114.50 GBP per year which means you don’t have to pay per item. I have this so every time I go to the pharmacy I check one box and sign the bottom of a form and my drugs are free. The cert is a simple online purchase and took me about 5 minutes to apply and get accepted for. Zero friction. I have never been asked to show the certificate just state that I have one check a box and sign and we’re done. If I did have to show it, the “certificate” is just an email with a number so not hard.
4. The same app I used in #1 has messages from my GP in it so if there was ever a thing when they needed to talk to me, arrange a blood test, deliver test results etc it’s all in there (and I don’t pay a penny for any of those things either). Everything that’s in the NHS app is also on the NHS website which has excellent accessibility etc so works just fine on Linux for me when I don’t have my mobile device.
5. If you want to go outside the NHS you can go to a private practicioner and get a private prescription. That’s delivered to the same pharmacy you just have to give them this number that gets texted to you with the prescription and pay (a bit) more money for it. I had to do this recently and it cost me 22GBP for an “item”. You can also have private health insurance (I do) which means seeing specialists is easier than on the NHS and there is generally no wait time for tests etc. Private health insurance in the UK is much cheaper than it is in the US.
Bottom line: At least here in the UK the NHS may have bureaucracy internally but that doesn’t affect me at all as a “customer”. My healthcare is super-easy and convenient and far, far less expensive than healthcare in the US. You guys have the worst of all worlds. Both my wife and I have had medical treatment in the US and it manages to be eye-wateringly expensive and simultaneously worse than what I get for free on the NHS.
> I can reorder prescriptions on the NHS app when I’m running out. They get delivered to my preferred pharmacy or if I was away from home I can specify a local pharmacy. The prescription will be delivered there.
We have that too. But that doesn't address the person's main complaint, that they have to consult with a doctor in the first place to get that prescription.
Why would it be bureaucracy? In places with universal healthcare, you go to the doctor, show your card, then go to your appointment. Go to the pharmacy with your script, show your card and pay whatever is left to pay, if any.
That's it. No open enrollment, no surprise bills, no trying to figure out which ppo or hmo works best, no wondering if it's in network or not or any of that BS.
The apparent fear of universal healthcare many Americans seen to have is incredible.
And to call it out in a thread where someone has literally shared that they're forced to attend a pointless appointment at an exorbitant cost like that isn't itself some form of wasteful bureaucracy. But if the time and money is going to a corporation instead of the government it's better :/
The US has managed to combine the worst aspects of universal/socialized health care with the worst aspects of an attempted free market system. It’s quite an achievement.
It works as intended. It's a part of cutthroat capitalism. The goal here is to make sure that basic service is unevenly distributed so that people who don't have it are motivated to work extra hard and get it.
There’s no “cutthroat” about it. The system intentionally removes as much competition as possible. It’s cushy, taxpayer-funded socialism for the rich. (Also known as corporatism.)
At this point, China is doing capitalism better than us in its consumer industries. They actually have real competition, so fierce at times that the government worries about what it calls “involution”, or destructive competition (which Marx predicted as the end state of capitalism). Of course, its healthcare system is not run through capitalist competition like its consumer industries; it is fully state managed.
Some real competition might actually help if we’re going to keep pretending to be capitalists. Or we could move from socialism for the rich to socialism for the people. I don’t really care which as long as we move on from the current dysfunctional system.
> In places with universal healthcare, you go to the doctor
NHS experience: you might have to wait two weeks to see the doctor, and it will be a ten minute appointment. (Which in this case might be fine.) If you can use a nurse things tend to be much easier.
The NHS relies on heavy triaging - so, for primary care, emergency cases will be seen immediately (either at a hospital or at the nearest GP surgery with an available slot), urgent will be seen same day (at your usual GP surgery), and non-urgent medical problems (eg. back pain that isn't getting worse) might take 2-3 days.
But everything else (eg. discussing blood test results, medication reviews, mental health issues) will get dumped into the "routine" appointment bucket and, yes, will often take 1-2 weeks.
You do hear occasional horror stories about the triage process, but my experience has been pretty reasonable. For example, I lost my voice last year but had no other symptoms - so I expected to have to wait a few days to be seen. But I was treated as an urgent case since it affected my ability to work, and got an appointment that afternoon.
I've had a checkup with the NHS once or maybe twice in my life, and it was not with a doctor. (I'm not saying that it should be, maybe a nurse and a blood pressure check is all you need?)
There's actually less bureaucracy involved for the patient. In Germany, you normally don't do anything at all, just let the doctor's assistants read your card, then go to the pharmacy, let them read your card and get your medicine. Sometimes you have some copay of around 5 Bucks.
From what I read, healthcare had always been super complicated and bureaucratic in the US. Nobody here knows what "network" or "deductibles" even mean.
Going to the doctor or calling an ambulance is similar to calling the police in some sense. You don't think about "network" or cost when calling the police, right? We do neither for health care related things.
Btw. getting down voted for an honest question is a bad thing in my opinion. People should talk to each other and ask questions.
Insulin being expensive is the most weird and disturbing thing. It's just crazy. Don't they have Canada just in front of them to learn from their neighbors just how ridiculous this is?
“ So no surprise that the ADA is a fully industry-captured organization,”
I am always imagining the doctors working together with the food industry that pours sugar into everything and the insulin producers. It’s a perfectly symbiotic relationship.
Fascinating claim that the scientists were removed for being "Partisan" in distributing information that disagreed with their opening speaker, but of course the opening speaker was somehow completely non-partisan in disagreeing with the banned scientists.
I don't really see how you can possibly have it both ways.
"Apolitical is when I agree with you. Political is when I disagree with you. And this is not a political space, stop bringing politics into everything or you're out!"
> Ryder added that he and his colleagues were never told what part of the code of conduct that they violated, adding that the meeting organizers did not communicate with them directly before or during the incident.
Unsurprising that the development of the "CoC Violation" tool as a non-contestable device to shut down discussion turned out to be a brazen bull. It reminds me of the fact that sex crimes auto-convict people as far as the public is concerned. These make them effective devices to alter opinion in the public sphere.
As a Type 1 Diabetic, I just want to say: the diabetes industry is a racket.
I have to repeatedly go to a doctor to get prescription refills for a drug that I have to self-manage. The doctor provides no input day-to-day, where a mis-dose is a death sentence (the first time I nearly put myself into a coma, doc was like "oh yeah that can happen: I can give you glucagon shots as a scrip". Thanks for the heads up!). But cool, to get the drugs that keep me alive, I have to talk to a doctor that will look at my Dexcom charts and mumble some things.
So no surprise that the ADA is a fully industry-captured organization, even though I'm certain that there are good people doing good work for the right reasons.
Yeah. I have a running joke with my Endo.
“A1c is good. Charts are good. No changes.”
“And that’ll be 700 dollars?”
“Yup. See you soon.”
Of course it doesn’t actually cost that much (copay wise at least), but the point stands. I manage my disease super well. I don’t need the middle men.
I’m becoming much more radical on universal healthcare the longer I’m on my own.
> I manage my disease super well.
"If it tastes good, spit it out." - Jack LaLanne
Why do you think universal healthcare will make it easier to get the drugs you need? I’d imagine the opposite with additional bureaucracy.
Having lived in France, Germany, and Australia I can report that there’s a lot less bureaucracy in those systems than in the US system. Like telecom, the participants in the medical system put up tollbooths because they can.
Presumably by removing the existing bureaucracy which is much worse than the new bureaucracy.
It would be one more layer of bureaucracy, I can tell this as an Italian, if you have a serious emergency you are better off paying out of pocket for a private clinic.
And this is for every aspect of society, I feel like all this burocracy is just made for people that liv e off the state, I get home at 6pm, offices are not even open, I have to take half a day off work to stand in a line every time...
It really is easier, and you can see how this works in any number of countries with universal healthcare. I don’t have diabetes but do have chronic health issues that need constant treatment. Here in the UK:
1. I can reorder prescriptions on the NHS app when I’m running out. They get delivered to my preferred pharmacy or if I was away from home I can specify a local pharmacy. The prescription will be delivered there.
2. Prescriptions normally cost 9.90GBP per “item” (where an item is one type of medicine so may be multiple physical boxes of pills for example). This is a fixed cost and is independent of the type of medicine or how much it costs to the NHS. But…
3. You can get a prepayment certificate for 114.50 GBP per year which means you don’t have to pay per item. I have this so every time I go to the pharmacy I check one box and sign the bottom of a form and my drugs are free. The cert is a simple online purchase and took me about 5 minutes to apply and get accepted for. Zero friction. I have never been asked to show the certificate just state that I have one check a box and sign and we’re done. If I did have to show it, the “certificate” is just an email with a number so not hard.
4. The same app I used in #1 has messages from my GP in it so if there was ever a thing when they needed to talk to me, arrange a blood test, deliver test results etc it’s all in there (and I don’t pay a penny for any of those things either). Everything that’s in the NHS app is also on the NHS website which has excellent accessibility etc so works just fine on Linux for me when I don’t have my mobile device.
5. If you want to go outside the NHS you can go to a private practicioner and get a private prescription. That’s delivered to the same pharmacy you just have to give them this number that gets texted to you with the prescription and pay (a bit) more money for it. I had to do this recently and it cost me 22GBP for an “item”. You can also have private health insurance (I do) which means seeing specialists is easier than on the NHS and there is generally no wait time for tests etc. Private health insurance in the UK is much cheaper than it is in the US.
Bottom line: At least here in the UK the NHS may have bureaucracy internally but that doesn’t affect me at all as a “customer”. My healthcare is super-easy and convenient and far, far less expensive than healthcare in the US. You guys have the worst of all worlds. Both my wife and I have had medical treatment in the US and it manages to be eye-wateringly expensive and simultaneously worse than what I get for free on the NHS.
> I can reorder prescriptions on the NHS app when I’m running out. They get delivered to my preferred pharmacy or if I was away from home I can specify a local pharmacy. The prescription will be delivered there.
We have that too. But that doesn't address the person's main complaint, that they have to consult with a doctor in the first place to get that prescription.
I looked up the US price for the private prescription I paid 22GBP for. On drugs.com it would have cost me 239 USD.
Why would it be bureaucracy? In places with universal healthcare, you go to the doctor, show your card, then go to your appointment. Go to the pharmacy with your script, show your card and pay whatever is left to pay, if any.
That's it. No open enrollment, no surprise bills, no trying to figure out which ppo or hmo works best, no wondering if it's in network or not or any of that BS.
The apparent fear of universal healthcare many Americans seen to have is incredible.
And to call it out in a thread where someone has literally shared that they're forced to attend a pointless appointment at an exorbitant cost like that isn't itself some form of wasteful bureaucracy. But if the time and money is going to a corporation instead of the government it's better :/
The US has managed to combine the worst aspects of universal/socialized health care with the worst aspects of an attempted free market system. It’s quite an achievement.
It works as intended. It's a part of cutthroat capitalism. The goal here is to make sure that basic service is unevenly distributed so that people who don't have it are motivated to work extra hard and get it.
There’s no “cutthroat” about it. The system intentionally removes as much competition as possible. It’s cushy, taxpayer-funded socialism for the rich. (Also known as corporatism.)
At this point, China is doing capitalism better than us in its consumer industries. They actually have real competition, so fierce at times that the government worries about what it calls “involution”, or destructive competition (which Marx predicted as the end state of capitalism). Of course, its healthcare system is not run through capitalist competition like its consumer industries; it is fully state managed.
Some real competition might actually help if we’re going to keep pretending to be capitalists. Or we could move from socialism for the rich to socialism for the people. I don’t really care which as long as we move on from the current dysfunctional system.
> In places with universal healthcare, you go to the doctor
NHS experience: you might have to wait two weeks to see the doctor, and it will be a ten minute appointment. (Which in this case might be fine.) If you can use a nurse things tend to be much easier.
For a checkup? Or if you are sick?
The NHS relies on heavy triaging - so, for primary care, emergency cases will be seen immediately (either at a hospital or at the nearest GP surgery with an available slot), urgent will be seen same day (at your usual GP surgery), and non-urgent medical problems (eg. back pain that isn't getting worse) might take 2-3 days.
But everything else (eg. discussing blood test results, medication reviews, mental health issues) will get dumped into the "routine" appointment bucket and, yes, will often take 1-2 weeks.
You do hear occasional horror stories about the triage process, but my experience has been pretty reasonable. For example, I lost my voice last year but had no other symptoms - so I expected to have to wait a few days to be seen. But I was treated as an urgent case since it affected my ability to work, and got an appointment that afternoon.
I've had a checkup with the NHS once or maybe twice in my life, and it was not with a doctor. (I'm not saying that it should be, maybe a nurse and a blood pressure check is all you need?)
There's actually less bureaucracy involved for the patient. In Germany, you normally don't do anything at all, just let the doctor's assistants read your card, then go to the pharmacy, let them read your card and get your medicine. Sometimes you have some copay of around 5 Bucks.
From what I read, healthcare had always been super complicated and bureaucratic in the US. Nobody here knows what "network" or "deductibles" even mean.
Going to the doctor or calling an ambulance is similar to calling the police in some sense. You don't think about "network" or cost when calling the police, right? We do neither for health care related things.
Btw. getting down voted for an honest question is a bad thing in my opinion. People should talk to each other and ask questions.
You can just check you don’t have to imagine anything
Well, it’ll make it not cost $700
Insulin being expensive is the most weird and disturbing thing. It's just crazy. Don't they have Canada just in front of them to learn from their neighbors just how ridiculous this is?
[dead]
“ So no surprise that the ADA is a fully industry-captured organization,”
I am always imagining the doctors working together with the food industry that pours sugar into everything and the insulin producers. It’s a perfectly symbiotic relationship.
Fascinating claim that the scientists were removed for being "Partisan" in distributing information that disagreed with their opening speaker, but of course the opening speaker was somehow completely non-partisan in disagreeing with the banned scientists.
I don't really see how you can possibly have it both ways.
"Apolitical is when I agree with you. Political is when I disagree with you. And this is not a political space, stop bringing politics into everything or you're out!"
"Let's compromise - if we agree we'll do it your way, if not we'll do it my way."
Landry and the erstwhile NOCVB want to continue to guzzle corporate cash.
Not saying that's what happened here, but the reasoning makes sense in general.
Partisans strongly dislike non-partisan positions, because they are even more dangerous to them than the partisan counterpart.
> Ryder added that he and his colleagues were never told what part of the code of conduct that they violated, adding that the meeting organizers did not communicate with them directly before or during the incident.
Probably the average CoC enforcement.
Unsurprising that the development of the "CoC Violation" tool as a non-contestable device to shut down discussion turned out to be a brazen bull. It reminds me of the fact that sex crimes auto-convict people as far as the public is concerned. These make them effective devices to alter opinion in the public sphere.
surprised no one else walked out when that happened
News from early June OP;
Some discussion then: https://news.ycombinator.com/item?id=48433410