America's healthcare insanity

Can we buy it from CA here in MI?

Pre-pandemic, when border crossing was simple, I just went up to Canada to buy my insulin. It’s otc there, so you don’t need a prescription and it’s pennies on the dollar compared to the U.S.

A lot of these for-profit collection agencies are owned and run by the hospitals.

That, and no administrator ever gets fired for staying with the same system. But they do get fired if they try something new (like trying to figure out how to manage debt payoff like this) and it goes haywire somehow.

Inertia is a huge thing in business. It’s very hard to get them to change.

Yep and debt doesn’t “go to collections”, its sold to collection agencies. Then uncollectible debt gets written off by both companies. The Health Care organization that owns the hospital and the agency makes money on both ends. This is likely why they are opposed to the RIP Medical Debt idea. Playing with debt the way they do is probably better than getting it paid off, especially since I am guessing RIP MD probably looks for the “settled in full” option on these debts. Welcome to America where frikkin debt is an actual commodity!

PS: full disclosure, I was a manager at a medical collections agency for years. Worst job ever.

This isn’t necessarily an “American health care” problem, but this particular company is American. It’s the old cyberpunk story about people who get bionic eyes, then the prosthetics company goes out of business, leaving the implanted in the dark as far as updates, repairs, or emergency removals.

On the Twitter thread where I saw this story, some people were calling for laws that would provide for medical device continuity. At first glance, that sounds like a good idea to me.

At first glance

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I’d say “no pun intended”, but some of the patients interviewed in the story made some of those same remarks.

There are a ton of other cool, non-ocular, exotic implantable medical devices out there, and some of those implant recipients would be up shit creek if the manufacturer failed and ghosted.

I’m trying to decide if laws requiring medical device software to be open sourced would be a good idea, or the absolute worst idea.

Sunlight is the best disinfectant!

More seriously, the biggest potential issue with OSS that I can see is the whole dependency web vulnerability issue (aka the leftPad.js problem). That can be mitigated with good process, but the burden still falls on the maintainers and it’s hard/impossible to automate away.

But that risk plane is probably less bad ultimately than closed-source abandonment that is clearly already an issue.

June 2021

A drug derived from this research caused the single largest year-to-year increase in Medicare premiums. The drug was so ineffective that several FDA employees quit in protest when the agency approved it.

Why would we wanna live longer? Have you seen America?

All that freedom isn’t free.

Srsly just let me die before I run out of retirement money. Which should be about age 68, the year after I retire.

My grandmother lived to 99, and in her later years was pretty vocal in her irritation about her continued good health. She didn’t plan on living that long, and didn’t really want to.

Your grandmother was AWESOME.

She was. Drank a bottle of red wine a night, hated vegetables, smoked for 60 years, and stayed sharp as a tack until the end. And for as long as I’d been alive, had a big “BEWARE OF ATTACK DEMOCRAT” sign posted in her front window. I’m just glad she didn’t live to see the 2016 election.