Healthcare USA #1

Yeah, it seems basically impossible to judge from the patient’s perspective how good your medical care was. It’s like 100% results oriented. If you got better and everyone was nice to you, then you got good care. If you didn’t get better or whatever outcome you were expecting, and you had a long waiting time, then it sucked. No thought is really given to whether the process was done correctly. And any attempts to do that are generally pretty poor, because how the fuck would you even know.

Obviously, I’m being a bit hyperbolic here, because there is some stuff that is pretty clear cut (e.g. amputating the wrong leg, and even less egregious stuff), but most evaluations of good/not good care are not as straightforward as that.

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Bu…but…but why do rich people come to America for healthcare then? Huh? Answer that you socialist! And wait times!

Let’s just do whatever Scandinavia does. Then if that’s still not good enough we can seize the means.

10 years ago, I had to wait 8 hours with a dislocated hip for the only orthopedic surgeon in the hospital to spend 2 minutes popping it back into place.

Worst physical pain I ever felt.

That’s a solid meme.

what the hell? Was this in the US? I’m guessing no?

uber, instacart etc.

this is also why extreme deplorables are so pissed at restaurant workers being “too lazy” or “living large on government handouts.” They’re furious that these underlings would have the termerity to say “nah I’m good” when their betters order them to dance.

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Well we’re kind of conflating capitalism with US military adventurism now. I’m not willing to concede that you can’t have a govt with highly regulated, strong social safety net capitalism, and still eschew military adventurism. I’ll also never be convinced that this [unclear but definitely not capitalism] brave new unknown world isn’t going to end up with much more military adventurism, if not outright war.

Do you think Bernie would say his ideal US is closer to a Scandinavian system, or closer to seizing the means, killing the landlords, and ending capitalism entirely?

I am writing about the scourge of colonialism, the USA’s evil foreign adventures, and the perils of globalization right now in my book. Believe me, I’m not ignoring anything. I knew the broad overlay, but reading the actual details has been incredibly eye-opening. But I’m also not convinced that the US turning into the Soviet Union is going to make things better for the rest of the world. Even a newer, better Soviet Union. Or any state-controlled system. Or anarchy on a scale of 350M people, which sounds like warlords and road warriors to me.

I’ve just read 6 books about the Nicaragua revolution - all of the authors were between neutral to very pro-Sandinista. There is no doubt that the US caused most of Nicaragua’s problems, and completely hamstrung the Sandinista’s to the point that we have no idea if they would have succeeded in what they were trying to do.

But it also seems some stuff like fixing prices and land reforms were extremely unpopular with the exact peasants they were supposed to help. And this was even before the Contras ratcheted up and made life hell. Even the most pro-Sandinista authors tend to argue that the Sandinistas were learning form their mistakes, and moving towards a more free market system in some areas where a state-controlled system didn’t seem to be working as planned. IE - huge black markets sprang up in the price-controlled items. Peasants refused to grow cotton, rice and wheat for the prices the govt was paying - resulting in all kinds of weird situations like young urban Sandinistas moving out to try to make a go of farming as a patriotic act.

The Sandinistas were actually pretty moderate by Marxist-adjacent revolutionary standards, and like most of those authors, I’d really like to have seen what would have happened without Reagan’s singular obsession with skull-fucking them at every turn. But even being moderate, a lot of their most Soviet Union style state policies seem to be have been very unpopular.

And of course - when the originally pure-hearted Sandinistas realized they were going to be out of power in the 90s, they stole everything they could get their hands on - privatizing all kinds of state-owned businesses. Something about a decade + in power and the scum rises to the top I guess. And now you basically have Ortega running a Putin-style sham democracy.

As fucked up of results as democracy can produce, if you can somehow preserve it, at least it seems to stave off dictatorships. In countries like Nicaragua or Russia without long histories of legitimate democracy, it seems a lot easier to corrupt into a sham democracy.

Before that I read a bunch of books about Honduras, the original Banana Republic and one of the countries getting most hosed right now by globalism. It’s completely fucked up that poor Hondurans are subject to the race to the bottom system where capital is free to chase profits around the globe, while the people who produce the goods and services are bound to the country they were born in.

But unlike what the US did with the Sandinistas - they give tons of aid to Honduras and have NGOs trying all kinds of things like setting campesinos up with coffee farms. But then coffee prices crash so they all try to sneak into the US for work.

My argument is for now just give migrants work visas like we do with Mexico. We give out 250k H2A and H2B unskilled labor visas to Mexico, and we give hardly any to Honduras. Just in the last few years they’ve allotted 10k work visas, but Hondurans don’t even know they’re available and the system is hard to navigate. So they still are paying coyotes $2-$5k and all that money goes to organized crime - instead of say a plane ticket to Houston and a lot more to get set up in the US.

Almost all of the men who leave from rural villages return to Honduras at some point, and most of the women. They don’t want to spend their lives in the US - they just want to save up enough to build a house and come back set up. Ideally things would get better in their own country so they wouldn’t need to migrate. But for now we should just let them in imo.

Obviously the people fleeing gang violence (which the US helped cause of course) are a different story. They deserve asylum.

So anyway I feel like this is something concrete we can advocate for. But if your only answer to every problem is always just “abolish capitalism”, that to me doesn’t seem that practical or useful. I don’t see how the US abolishing capitalism is going to help anyone in Honduras in the short term, and I’m not sure about long term.

I dunno, I guess I’m just the bourgeoisie and I’m old. If things get so bad that the youth in the US overturn the whole system, so be it. But I also think there’s a path that doesn’t have to end in bloody revolution, and doesn’t oppress the rest of the world.

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It was in the US

The nurses refused to give me any pain relief beyond NSAIDs. Had to yell at them until I got something stronger. Morphine didn’t do much when I got it either. :frowning:

Doc said that a hip replacement is a real possibility in the distant future due to avascular necrosis from the lack of blood flow to the area for so long. But thankfully my hip fully recovered.

You have to possess an unusually high level of knowledge and/or experience of the thing you’re being treated for which obviously isn’t going to happen often. However, it’s not that uncommon among rare disease patients / parents given the amount of persistence, advocacy, travel, testing, specialized treatment, and cost that can be associated with those disorders.

For example, I saw this yesterday. His case is particularly wild because it’s paraganglioma and MCAS, but I can’t imagine anyone watching this and thinking he’s not considerably more knowledgeable than the average patient. It’s obvious he was suffering for years but kept learning and researching while fighting for help. Pheos can recur, so this dude is obviously gonna know if he’s being bullshitted if there’s ever a Round 2.

that’s bullshit, would have popped that in as soon as possible. Not going for it is not right.

Euro ER docs aren’t really specialized in EM a lot of the time (it varies country to country), which is why i thought it might be in europe.

Well that’s rural New York state for ya.

I actually checked the hospital I stayed at and it’s clear that they saw their Google star rating because a bunch of fake 5 star reviews have gone up in the last year or two. Way too obvious that the people either work there or patients were paid to give 5 star reviews.

Hospitals faking google reviews is seriously some very dystopian circa 2021 America shit.

“people love their private insurance”

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Americans think everything is supposed to be a consumer experience. They will actually prefer bad medical outcomes as long as they get to speak with the manager and wring some kind of concession out of them, however trivial.

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god this is 100% right on and super incisive

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i mean just look at any discussion about restaurant service

literally you can go into any chili’s in this country and just act like a fucking psycho and they will comp your whole meal

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I hate this part of our culture so much it’s unreal. But yeah direct hit. Absolutely accurate.

The thing about Karens that love their private insurance and get those frozen steaks comped is that they haven’t been hit with any real shit yet. When it happens, they invariably resurface on GoFundMe begging like peasants.