Comment by js2 | Hacker News Reader

Comment by js2 | Hacker News Reader

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There's more detail on her wikipedia page:

https://en.wikipedia.org/wiki/Anna_Bågenholm

These are the tidbits I found most interesting:

> A team of more than a hundred doctors and nurses worked in shifts for nine hours to save her life. Bågenholm woke up ten days after the accident, paralyzed from the neck down and subsequently spent two months recovering in an intensive care unit. Although she has made an almost full recovery from the incident, late in 2009 she was still suffering from minor symptoms in hands and feet related to nerve injury.

> "Her body had time to cool down completely before the heart stopped. Her brain was so cold when the heart stopped that the brain cells needed very little oxygen, so the brain could survive for quite a prolonged time."

> "victims of very deep accidental hypothermia with circulatory arrest should be seen as potentially resuscitable with a prospect of full recovery. The key success factors of such marginal resuscitation efforts are early bystander actions with vigorous CPR and early warning of the emergency system, early dispatch of adequate rescue units (ground and air-ambulances) and good co-ordination between the resources outside and inside the hospital, aggressive rewarming and a spirit not to give up."

> Bågenholm [upon waking paralyzed] feared she would spend the rest of her life on her back, and was angry with her colleagues for saving her. Bågenholm soon recovered from the paralysis, however, and later apologized to her friends; "I was very irritated when I realized they had saved me. I feared a meaningless life, without any dignity. Now I am very happy to be alive and want to apologize."

As to the first point, the cost of this care had to be in the millions, or would be in the U.S. anyway. My MIL recently had extended care due to a fall and the bill was $500K. Fortunately after Medicare, cost to her was $1300.

In any case, it's still an extraordinary allocation of resources to save one life. According to https://en.wikipedia.org/wiki/Healthcare_in_Norway:

> Expenditure on healthcare is about 7,727 USD per person per year in 2020, among the highest in the world. While the availability of public healthcare is universal in Norway, there are certain payment stipulations. Children aged sixteen or younger, and several other groups (such as nursing women and retirees) are given free healthcare regardless of the coverage they may have had in previous situations. All other citizens are responsible for paying a certain amount in user fees. If they reach a certain amount of money paid out-of-pocket, they receive an exemption card (frikort for helsetjenester in Norwegian) for public health services, and they no longer have to pay user fees for the remainder of the calendar year. The amount is 2460 NOK in 2021, or about 264 USD. Everything above this amount is given for free for the rest of that year.

She went on to become a radiologist so probably pays a decent amount in taxes now. As well, as a radiologist, she now helps to care for others. But still, she'll never "pay back" what was expended on saving her life.

I'm not trying to make any point here, other than that humans are weird in how we allocate resources to each other.

Edit to add:

I didn't mean to spawn a whole conversation about U.S. vs European healthcare, and my point above is not well made.

I'm just lamenting how 100 humans will come together to save one life while we still allow over a half million people a year to die from malaria. You'll see a dozen humans rescue a dog during a flood while I don't even want to look up the number of dogs that are euthanized. How the world came together to save those kids from the Thai cave, but we can't collectively figure out how to deal compassionately with immigrants.

I know we're just doing the best we can as a species. But I can still be both amazed by a symphony orchestra and sad that we use those same brains to build F-22s.

Also, FWIW, as a U.S. citizen, my vote is for Medicare For All, or failing that, a price-regulated multi-payer system like Germany's.

Humans place a high priority on saving the lives of their countrymen/women, and IMO that makes a lot of sense. It’s not about “hopefully she pays that back in taxes in the future,” it’s “I want to live in a society where, if my life can be saved, we don’t let me die to save money” - or the same for you family, friends, coworkers, etc.

Also worth noting that American healthcare is exceptionally expensive, which may be biasing your view of medical costs. American healthcare costs about double other similar nations, per capita: https://www.cihi.ca/en/how-does-canadas-health-spending-comp...

Whatever it did cost in Norway, it was probably very roughly half what it would have cost in America.

The high cost difference part is remarkable but the “she’ll never pay it back” part seems to me like observing a mega millions lottery winner will never pay back the prize money with future ticket purchases. Isn’t that the whole point of the lottery or health insurance? Getting a benefit that society as a whole can afford but no reasonable individual can.

This, and furthermore the scientific value of proving that this can be done has value too. Imagine trying to compensate someone to undergo this experiment willingly...

It's amusing to realize that health insurance is a lottery that pays the unlucky.

Not just health insurance, effectively every insurance. Insurance is a safety against an unlikely but highly negative outcome afterall.

Why would it cost millions? The private US hospital might charge millions, but if you have a government healthcare system, the cost is basically paychecks + rent + equipment amortization + medicine + "other" (food, cleaning,...).

I'm not sure what exatly they did to the frozen woman, but for your MIL, that would probably take a few dedicated doctors hours, a few dedicated hours of nurse care (both spread out over the whole stay), some xrays and other scans, and all together would get up to a few thousands of euros max.... usually even less.

I guess the numbers are difficult to get exactly right but the cost per day at ICU seems to be about 50 000 2019-NOK in Norway [1] (70 000 the first day, half the next).

By comparison (in 2005 dollars), "Using data from 253 U.S. hospitals, Dasta and colleagues found that the average daily cost for ICU patients decreased from $7,728 to $3,872 to $3,436 on Days 1 to 3" [2].

$7 700 in 2005 is about $11 000 today, and 70 000 NOK is about $9 100 using exchange rate from 2019 and adjusted for inflation

[1] https://legemiddelverket.no/Documents/Offentlig%2520finansie...

[2] https://www.atsjournals.org/doi/10.1513/AnnalsATS.201506-366...

None of these costs are real. They are artificially induced by the severe supply restrictions from the AMA limiting medical school seats.

Think of this instead as the value of 100 professionals in another field for a month. High, but much less than another person can produce in an entire life time.

1. Healthcare costs in the US are artificially inflated. You can’t compare the two.

2. This is the whole point of insurance. The majority loses money overall, but the outliers win. The point is that the outlier might be you.

> Fortunately after Medicare, cost to her was $1300

I know what you mean here, but I can’t help but read this as:

> Unfortunately, despite Medicare, she still had to pay $1300.

? Why would having 100 people work day and night to labour over you costing $1300 be a problem. Even by a civic standard it could have been very expensive and that would have been 'fair'.

Because we as a society (Germany in my case) already are already paying them for their work. Why would anybody bill an unfortunate soul for their misfortune?

This outlier is why health insurance exists in most countries.

That reminds of this quote from Aneurin Bevan - founder of the UK NHS:

"Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community."

This is the kind of entitled attitude that destroys any hope of productive socialism.

As an extreme example - you don't 'pay taxes' so that the government will launch a $20 million dollar rescue operation to save your life from deadly illness while on an arctic operation. You're just going to die.

We do a form medial triage on everything (there's an unlimited demand for medical services) and it's largely resources based.

Ex: COVID antivirals - not everyone gets them. They are rationed.

Every service definitely has it's limits, costs get out of hand at the far end of the spectrum on pretty much everything you can imagine.

Which is why 'co pays' are entirely rational - and likely more fair - form of paying for services, in fact it's surprising they are not more common.

A $20K bill for having 'having a baby' is outrageous as it happens in the US, but for '100 medical professionals in attendance' at once isn't unreasonable at all.

Yes that's exactly what the government collects taxes for. That is what say the Bergrettung does. Or what the Coast guard does if there is somebody lost at sea.

Also if somebody on an Antarctic base gets sick and can be evacuated they get evacuated - that is also exactly what you describe.

OFC there is triage but in normal time we have no medical triage aside from a very soft form of it in that non-life threatening and non-urgent procedures are scheduled and delayed as needed.

Co pays for non-elective are only rational if the amounts are negligible even for the most impoverished patient and then its easier and cost effective just to not haver them at all.

From a country that doesn’t have copays, I’m happy with the service I get and I don’t wish for copays. My dad died of cancer last year - the treatments and service he received were excellent. He even got extra money along the way due to his illness and I’m glad my surviving mother is left with the entirety of his estate instead of bills to pay.

> This is the kind of entitled attitude that destroys any hope of productive socialism.

Since his attitude is based on how the systems successfully work in other (more "socialist") countries, I don't think that's a fair argument to make.

You pay for Medicare out of your paycheck your entire career, and you continue to pay for supplementary insurance after that.

There’s an argument for paying a token user fee to discourage overuse of the medical system, but that isn’t the case here.

Because some people regard attempting to literally quantify the value of someones life into a dollar amount to be a "problem"

If she wasn’t using those resources, would the country have saved all that much? These folks were all employed and working, ready for less extraordinary situations, and thus available for a situation like this.

Norwegian doctors spring into existence at the moment of need and cease to exist once the need is over.

The accounting for things like this is the same that results in saying space craft toilets cost fifty billion dollars.

In reality there is some costs associated with consumables, overtime, etc that could be avoided but it’s hard to account for the costs that would have been spent “anyway”.

Perhaps you could argue that there was care neglected in other aspects of the facility, but given the strangeness of the situation it’s likely that many involved were involved only peripherally and/or would have been doing research anyway.

elastic norwegian doctor service

There's almost unlimited demand for Healthcare services in modern countries. That said, some uses are better than others.

>> to become a radiologist so probably pays a decent amount in taxes now.

Specialist doctors are one of those jobs that is on the cusp of tax planning/avoidance technology. Once you are touching 1mil per year you have enough money to engage proper tax professionals to take care of your money. In the US they will run their practice as a business rather be any sort of employee. Offshore trusts, spendthrifts, deferals ... I wouldn't assume that every doctor suffers a huge tax bill each year.

Do you seriously think that doctors get 1mil per year anywhere outside of the US?

I fear that most americans aren’t aware how vastly different wages are in europe and for what reasons

In Australia it’s not uncommon but that’s also exceptional.

Doing some quick googling tells me that the median radiologist wage is at about 1 million NOK a year, which is 103k EUR/ 111k USD. This will be taxted at about 31,3% without any deductions. The median wage in Norway was 635 000 NOK in 2021.

> But still, she'll never "pay back" what was expended on saving her life.

I’m not so sure. In direct taxes, maybe not. But she earns a wage and and spends that too. The shops she spends at pay tax, and that money goes around. Unless she burns her money, her contribution to society in money alone is a lot greater than just her own tax bill.

Morbid curiosity or mean comment maybe, but what's the price tag on a Sea King ambulance helicopter rescue in the U.S.?

But in most countries that kind of service is just not available. It is highly available in Norway due to the oil industry needs, the many islands and mountains making it useful, and generally very high standard of living.

For reference, the operating cost of such rescue helicopter (including crew) is about 100 000 NOK per hour in Norway [1] or ~$11 000.

[1] https://ambulanseforum.no/artikler/redningsaksjonen-kostet-r...

But still, she'll never "pay back" what was expended on saving her life.

You don't know that. Let me suggest the movie It's a wonderful life in place of trying to debate this with you.

But I appreciate you trying to say something meaningful. Please don't interpret this as combative.

But it's also these extreme cases that most expand the limits of our medical understanding and ability, such advancement being analogous to dividends that will pay out for all eternity.

The Wikipedia page does mention Bågenholm's case becoming a literal textbook example (and links to a paywalled case study).

Thanks, the temperatures in the article means nothing for those who don't speak Fahrenheit...

Because 12C ~ 21F there are some convenient temperatures to interpolate between.

of course 0C = 32F and -40C = -40F but also (within a degree F):

  04C =  40F
  16C =  61F
  28C =  82F
  40C = 104F

note that the last two digits are always reversed.

below 0C they get less useful

  -08C =  18F
  -19C =-1.9F
  -31C = -23F

Interesting strategy. I long ago memorized 20C = 68F and then adjust in increments of 5/9, which works well enough for the range of temperatures I consider habitable. I've gotten so good at this I once translated on the fly between some fellow American and European runners during a marathon. :-)

"When it's springtime in Alaska, it's forty below". That's all I have managed to memorize about temperature conversion so far in my life.

56.7F = 13.7C

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