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Comment by lifeisstillgood | Hacker News Reader

Edit: It has been (correctly) pointed out downthread that I have helped hijacking a very personal post for political point scoring - which I think is fair. However we lack a decent history function in HN so I leave it here otherwise the thread will read strangely.

Thank you - as a Brit I read this too. I cycled through emotions - fear and sympathy for the diagnosis, hope as some of our best professionals consider new options, and then.

WTF describes it best.

Americas attitude toward health care is odd from our perspective - not mismatched socks odd but like a Collegue suddenly announcing that aliens are real, they look very talk and thin and one is living in his attic

That kind of odd

(I am glad that the OP has recovered, heartened by every success medicine has against this disease. Just ... It's odd how nearly this was a different story)

May you have a long and happy life.

View on HN

So long as you're not poor, health care in the US is good. If you live in a major city and are diligent about who takes care of you, it is great.

I've had three MRIs. All were scheduled the same day they were prescribed. I've routinely scheduled appointments with renown specialists and waited less than 2 days to get in. My double hernia surgery was performed by the same guy who treats the Chicago Bears. My old chiropractor/kinesiologist used to be Andre Agassi's.

To clarify: "not poor" != "rich". At the time of these expenses, I was making a good salary, but nothing unattainable by HN definitions.

However, if you're on Medicaid... you. are. fucked.

Really? Medicaid outcomes are actually pretty dam good considering the population that is being treated!

Wait time for an MRI can be months (at least that was the case back in 2008 when they compared Medicare/Medicaid to Canada's system).

"So long as you're not poor..."

I had a kidney stone a few weeks ago. All told, the bills for dealing with that hit $34,000.

For a kidney stone.

That's not about being poor or not, that's highway robbery.

Have you considered traveling abroad to get your surgery? For that kind of money, it seems it would have been cheaper to get the surgery in another country even after factoring in the cost of the trip.

I had a near miss with MS 8 years ago. Several MRIs, spinal taps, blood work, etc. Before insurance: about $25k. After insurance: $3k.

Double hernia surgery was a couple grand out of pocket.

Not all insurance is the same.$34k is robbery.

Let's put it this way:

34 k would pay for the original poster's trip to my country (Uruguay), the best treatment available, and he'd have money left over - heck, 34 k would probably pay the doctor's wages on that hospital for a year.

There are very dodgy and shady costs with US healthcare.

I have the very best healthcare available in my country (Hospital Británico). It costs U$ 150 per month. A kidney stone would probably run me in the hundreds of dollars. 3k would probably bankrupt me.

http://www.hospitalbritanico.org.uy

Some differences are that doctors in the U.S. are paid an order of magnitude more, and I've heard hospitals have legions of well-paid administrators doing paperwork for insurance companies, which will have legions of people doing paperwork on their side, and government doing its bit, and lawyers doing their thing. All that money is obviously not going directly into healthcare, it's basically bureaucracy friction. I suspect "real" healthcare costs, even factoring expensive U.S. doctors, would be shockingly cheap.

I don't disagree.

Tell me something: Suppose you go in to get your left kidney removed, but the doc removes the right one by accident. What are your options? Law suit? What would you expect to get in settlement?

I'd expect in most places you'd get damages, and most likely the costs for the ensuing transplant (after all, you were needing to remove the left kidney for a reason, so now you have no other option).

Your doctors only earn 34k a year?

That's per hospital, and for a non-surgeon, a doctor on average works on 3 or 4 hospitals, so he would make about 140k per year (among the highest paid in my country).

Surgeons and anesthetists are on a class of their own, they make upwards of 60k per hospital.

Have you been able to negotiate a reduction in your bills?

woo! fellow kidney stone sufferer here. I had a 9mm stone i had to have busted up ~18 months ago (and a few 5mm ones i didnt). Ended up owing a few grand on it even with insurance. still paying it down (owe only like $400 on it now, thank God).

yes. health reform (and lots of others) is/are needed.

I think you are far worse off if you make too much to be on Medicaid, but don't get health insurance through work and can't afford it. Everyone I know on Medicaid can go pretty much anywhere they want to receive treatment. I know very few doctors that don't accept Medicaid. (Dentistry is the exception, for those who are covered, it can be difficult to find a dentist.) (This is in Missouri- it may vary depending on your state). Even if you don't have insurance, you can still get a great deal of medical care- you will just be billed exorbitant amounts of money.

I cannot believe that the #1 comment responding to his thanks is basically a political one to raise awareness of the "broken" U.S. healthcare system, so I'll respond in-kind.

What was broken in this case was described by his statement: "I had no medical insurance and the few benefits I had with the VA would take months of paperwork to get me in." You can blame that on Ted Kennedy, btw. He is the one that made health insurance an institution in the U.S. The best chance we have at good healthcare here has nothing to do with government or health insurance, it was to do with doctors that are willing to say F.U. to the system and provide healthcare directly to paitents without middlemen. So, that's the other side of the politics. Now back to what we really should be talking about...

I think it is wonderful that his cancer was treated and that people here helped. Cancer really fucking sucks. I hate Cancer with a deep passion that some of you out there understand. Others of you like to think of how great your resume looks and how you are going to land a fat house on the beach. I used to also.

The UK has notoriously poor cancer outcomes.

http://www.telegraph.co.uk/news/uknews/1560849/UK-cancer-sur...

You understand we've done a lot since 2007, right?

EDIT: specifically, "survival rate" is just "how many people lived for 5 years after diagnosis". Thus, you detect a lot of slow growing prostate cancer and your survival rates go up, even though nothing has been done to reduce the incidence of cancer, or stop any more people from dying of cancer.

When you look at US cancer mortality rates they look pretty good, until you restrict the numbers to the under-65s, when suddenly the numbers look pretty average. This might be because poor americans don't get access to treatment until they're 65 and qualify for some aid.

Dan I am not challenging your statement I am just curious if you have seen any figures about the new outcomes. I did a quick look at the UK Cancer research page and it does not look like many of the statistics have been updated recently.

That being said it would be nice if the disparity in survival percentages on this side of the pond looked more like the stats from your side:

http://www.cancerresearchuk.org/cancer-info/cancerstats/surv...

Can you provide a link to a study that shows UK cancer outcomes exceeding those of US outcomes in populations under 65?

http://jama.jamanetwork.com/article.aspx?articleID=1710486

This appears to say that incidence of cancer is worse in the US, but that outcomes are better.

OK, I'm starting to think you're right about that. Here's another source that agrees with you.

http://www.nap.edu/openbook.php?record_id=13497&page=3

I'd like to add to this that the US recommended screening PSA screeening for prostate cancer, whereas there's no screening program in the UK because the medical evidence suggests it does more harm than good. A huge proportion of older men have prostate cancer (30% of men over 50, apparently) but in most of them even without treatment it never progresses to the point of affecting them in any way before they die of something unrelated.

Similarly, the US screened women for breast cancer and cervical cancer earlier and more frequently than the UK, which again does more harm than good but improves the 5-year survival stats.

The US Preventative Screening Task Force has since recommended that screening should basically fall in line with what the UK's doing, but that happened well after that article was published.

From those top tens for females and males, five out of ten are countries with populations less than 12 million each. It would be interesting to see the US statistics by state.

Smaller networks (small population of a country, or by state) could be a factor here.

Could you find the original study?

Is it this one?

(http://www.ncbi.nlm.nih.gov/pubmed/18639491)

Hi, I believe that's wrong. I don't know why there is conflict in the technical literature, but I believe the consensus is that US healthcare outcomes lag behind most industrialized nations, including the UK. See e.g.

http://politix.topix.com/homepage/7019-us-is-27th-in-the-wor...

and the paper from which the figure is taken

http://jama.jamanetwork.com/article.aspx?articleID=1710486

Those data show that the USA ranks far below the UK on Years of Life Lost due to several cancers. I don't see how that's consistent with your claim. [Edit: actually, YLL is an incidence statistic, whereas parent's claim is that survival statistics are higher in the US, which the sources I've found agree with.]

The Telegraph is a right-leaning paper and is well known to be anti-NHS. Please; being economically laissez-faire as people are on HN are is not incompatible with supporting state provision of healthcare, along with the other things a state provides. It's sad to see libertarians / laissez-faire economics people bashing the NHS by quoting stories cherry-picked by right wing media sources. It's just not something we need disagree about.

I wondered for a moment, "why is this relevant?" until I saw that you're responding to the parent's nationality.

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