Comment by schneems | Hacker News Reader

Comment by schneems | Hacker News Reader

My S/O used to work at a company AuntBertha. They're a "search engine for social services" but they are a for-profit company (a B-Corp).

Their biggest clients are hospitals and insurers. There are people called "frequent flyers" who come to the emergency room frequently and while they might only be 2% of clients they account for a huge share of costs. It's actually cheaper to hire social workers to provide these people with the things they actually need (i.e. treating the causes) instead of the symptoms.

Here's an example. Guy is low income. Cannot afford food & insulin for diabetes. So he chooses to not buy insulin and the food he does buy is high in sugar (think cheap whitebread). Goes into diabetic shock and gets sent to the emergency room. Instead it's much cheaper for everyone involved if a social worker finds out the problem, helps him research some foodbanks to cover his nutritional needs or gets him on a discount insulin program. It's not free, but it's much cheaper than trying to clean up a mess after the fact.

I often wish we in the US would separate out long-term medicine from insurance. It really violates any rational for insurance to have a continuous, known cost be part of that. Also, it ups the insurance cost for everyone else.

I wish we had a separate drug assistance program. Something like if you are making less than 200 or 300% poverty[1] the government will pay the full cost[2] and then just pro-rate it from there. Since we are talking long term drugs, its by definition something that would be applicable to preexisting conditions. I worry that it will not take the steps necessary to control fraud or run out of money like IHS.

1) http://familiesusa.org/product/federal-poverty-guidelines

2) obviously some upper limits apply https://www.medicaid.gov/medicaid/prescription-drugs/pharmac...

> wish we had a separate drug assistance program.

Already exists.

https://www.medicaid.gov/medicaid/prescription-drugs/index.h...

I mean for everyone in the US not just those on Medicaid. Replacing insurance but still able to use Medical Savings Accounts to purchase my share of the drugs.

This isn't even a good faith argument. You're well aware that most people aren't eligible for medicaid.

Let's just say if you live in a country where you cannot get insulin if you need it, that is a pretty fucked up country.

Let's not forget insulin formulations are ancient yet generics don't exist for "reasons". It's as corrupt as it gets.

The old formulations are available for $25.

http://insulinnation.com/treatment/why-walmart-insulins-aren...

These also happen to be the most difficult to use in terms of dosing frequency and rate of blood glucose control.

In the US of all places, there isn't a good argument for the very, very slightly modified newer insulins to cost so much more.

(these points are alluded to in the article, just want to mention them here, as well)

Yeah, it's shocking how inhumane this is. And how casually the op mentions it, like it's not a big deal.

Am I "op" here? I live in America so it's all I've ever known.

Another example involving insulin: The client got free insulin but did not pick it up. It was only after a social worker dug into the issue found out the client did not have a fridge and so when picking up the insulin the pharmacist said "do you have a fridge", they said "no" and walked away. The social worker found a program with home depot to get a free mini fridge.

The op was stating a fact. I didn't take it as "no big deal"

Insulin is covered by a few different social programs in the US

> if you live in a country where you cannot get insulin if you need it, that is a pretty fucked up country.

Welcome to America. Land of the free.

This is a large problem in Canada as well. A relative is an ER nurse and she has endless amounts to say about the number of people who come in for these kinds of reasons, or less. The hospital she works at is in a town that was economically decimated in the late 80's and only just started to recover. The number of people who go into emergency because of alcoholism, self-neglect, loneliness, and of course (probably encompassing the rest) mental illness is staggering. She says it's one thing to know their names, but it's bad when you know how their [grand-/]children are doing in school, and who visited or did not visit last week. She is not shy about how much she thinks that social programs need to be expanded in accessibility. I agree.

From what I understand, much of the medical world feels the same way. That's one thing I would certainly add to Canadian health care -- some kind of minimum of public mental health and social work. There are a lot of programs already that don't attach a fee for the patient/subject, but they're not necessarily common knowledge or accessible to people as a "walk in and book" sort of service.

edit: To wit, I think the reasons social programs don't work is inaccessibility to those who really need them, lack of familiarity with them, and taboo (but this last one is probably another discussion). I think right now we need more of them, and they need to have access to proper resources and that their end benefit to society would be substantial. I'd be interested in seeing some projections surrounding that to be sure.

Why don't we increase taxes on the food that make us sick?

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