Whats rustling your jimmies?

Hoss · Mar 26, 2024

Vuuxo said:
Update: The wife, Karen, yes I relentlessly make fun of her for her name.

Just got home from the gyno office and got a PAP done. Her gyno set her up for a vaginal ultrasound NEXT WEEK because her gyno said that CT scans aren't the best for a ovarian cancer diagnosis. I live in shithole Louisiana and yes, it's a terrible fucking state with terrible fucking people and THE most incompetent doctors I've ever had the displeasure of meeting. Had a doctor tell Karen a couple years back "It's all in your head" MOTHER FUCKER she's literally bleeding from her bellybutton!!! It's not in her fucking head.

Anyway, so now I'm thinking the "doctor" that did the CT scan is retarded and I'm also thinking we need to do this in another state that isn't full of lazy, incompetent fucking doctors. This shit is so fucking frustrating. I cannot stand the hurry up and wait shit.

I'm sorry man. I'm not saying this to troll, but pretty much all doctors are garbage tier these days. The doctors themselves can be good, but hospitals are run by MBAs instead of medical professionals. They traded "first do no harm" for "first lose no money" a long time ago. My only sincere advice is to look for concierge care or some type of private group that does not even take medicare. I'm not sure any of them can tackle something like cancer, but IMO it's the best hope of getting good medical care these days.

Vuuxo · Mar 26, 2024

Hoss said:
I'm sorry man. I'm not saying this to troll, but pretty much all doctors are garbage tier these days. The doctors themselves can be good, but hospitals are run by MBAs instead of medical professionals. They traded "first do no harm" for "first lose no money" a long time ago. My only sincere advice is to look for concierge care or some type of private group that does not even take medicare. I'm not sure any of them can tackle something like cancer, but IMO it's the best hope of getting good medical care these days.

All the states I've lived in (Prior Air Force) I never dealt with doctors like here in Louisiana. When I was in Florida, my doctor was awesome. When I was stationed in Utah, those doctors were amazing and several other places but here... I could be wrong on this but it seems like during covid the good doctors were fired or quit and now we're stuck with the "just collecting a paycheck" doctors.

Burren · Mar 26, 2024

Vuuxo said:
All the states I've lived in (Prior Air Force) I never dealt with doctors like here in Louisiana. When I was in Florida, my doctor was awesome. When I was stationed in Utah, those doctors were amazing and several other places but here... I could be wrong on this but it seems like during covid the good doctors were fired or quit and now we're stuck with the "just collecting a paycheck" doctors.

I know people from Louisiana. I’ve done business there. It’s not a state that’s good at anything.

joz123 · Mar 26, 2024

Vuuxo said:
All the states I've lived in (Prior Air Force) I never dealt with doctors like here in Louisiana. When I was in Florida, my doctor was awesome. When I was stationed in Utah, those doctors were amazing and several other places but here... I could be wrong on this but it seems like during covid the good doctors were fired or quit and now we're stuck with the "just collecting a paycheck" doctors.

Health care in Nevada is shit. Doctors/dentists are employees that literally just show up for a paycheck and everything goes through office managers. Coming from California it's a huge difference.

Hoss · Mar 27, 2024

Vuuxo said:
All the states I've lived in (Prior Air Force) I never dealt with doctors like here in Louisiana. When I was in Florida, my doctor was awesome. When I was stationed in Utah, those doctors were amazing and several other places but here... I could be wrong on this but it seems like during covid the good doctors were fired or quit and now we're stuck with the "just collecting a paycheck" doctors.

I think covid just exposed and accelerated the bullshit that had been slowly building. Once it was brought into the open, the good doctors were brought to heel. I can't say when it started. Maybe it was 0bamacare and all those predictions have come true. Or maybe it was already happening before that. I don't know enough about day to day hospital operations to say for sure. But I have been a believer in HSAs and High deductible plans since they first came out. I look my doctor in the eye and we make the decision on whether the treatment is worth the price. If he really thinks I need something that I think isn't worth it, we negotiate. No faceless burrowrats between us trying to justify their existence. Same goes with the type of treatment, because it's not always about money for me. I don't trust new medicines. Insurance companies tell doctors they need to do certain treatments for certain conditions. When we remove that bloat from the relationship, the Dr can say "you know for 50 years we treated it with THIS and it worked just fine for almost everyone" and we go with that option. That's why I suggested concierge care. As I understand it, that's how they work.

Vuuxo · Mar 27, 2024

Hoss said:
I think covid just exposed and accelerated the bullshit that had been slowly building. Once it was brought into the open, the good doctors were brought to heel. I can't say when it started. Maybe it was 0bamacare and all those predictions have come true. Or maybe it was already happening before that. I don't know enough about day to day hospital operations to say for sure. But I have been a believer in HSAs and High deductible plans since they first came out. I look my doctor in the eye and we make the decision on whether the treatment is worth the price. If he really thinks I need something that I think isn't worth it, we negotiate. No faceless burrowrats between us trying to justify their existence. Same goes with the type of treatment, because it's not always about money for me. I don't trust new medicines. Insurance companies tell doctors they need to do certain treatments for certain conditions. When we remove that bloat from the relationship, the Dr can say "you know for 50 years we treated it with THIS and it worked just fine for almost everyone" and we go with that option. That's why I suggested concierge care. As I understand it, that's how they work.

I'll have to look into that for sure. The insurance companies piss me off more than the incompetent doctors. The system for sure is bloated if not out right broken.

Morsakin · Mar 27, 2024

As someone who just recently started seeing a concierge doctor -- I believe I'm paying ~$2,200 out of pocket per year to be one of his clients that insurance doesn't cover. It was worth it for the preventative tests alone, honestly. Basically a full panel of everything from grip strength, lung inhale/exhale force, heart/liver/circulatory tests, vein ultrasounds etc.

I figure it's going to be the "you'd be fine if we had caught it in time, but it's now Stage X" sort of shit that's going to get me.

Deathwing · Mar 27, 2024

Sounds similar to a physical in terms of preventative maintenance. Why wouldn't insurance cover such things? Too new?

sleevedraw · Mar 27, 2024

Deathwing said:
Sounds similar to a physical in terms of preventative maintenance. Why wouldn't insurance cover such things? Too new?

Because there's no strong evidence that those tests will affect long-term health outcomes for the majority of people, and if he's ordering 20 of them, those costs quickly add up.

A physical costs maybe $150-$300. He's talking $2200 in terms of costs. There are some companies out there that are offering 100-200 gene panels to "assess cancer risk" despite the fact that 90% of the genes included in the panel only "may" be associated with a higher risk of cancer (unlike things like BRCA which cause a proven, substantial increased risk).

Might these tests theoretically detect cancer or a problem in 1 out of every hundred thousand people? Maybe. Does that mean that it's cost-effective for the majority of the population? No. In order for insurance to maintain a risk pool that can stay afloat, you have to contain cost.

Same reason why an expensive custom engine mod isn't going to be covered by your car insurance unless you have a rider on your policy.

Hoss · Mar 27, 2024

Morsakin said:
As someone who just recently started seeing a concierge doctor -- I believe I'm paying ~$2,200 out of pocket per year to be one of his clients that insurance doesn't cover. It was worth it for the preventative tests alone, honestly. Basically a full panel of everything from grip strength, lung inhale/exhale force, heart/liver/circulatory tests, vein ultrasounds etc.

I figure it's going to be the "you'd be fine if we had caught it in time, but it's now Stage X" sort of shit that's going to get me.

Interesting. Is it $2200 toal and everything else is free; $2200 base and everything else is an add on; or $2200 up front and everything up to $2200 worth of care is included, after which you're back to paying as needed?

Hoss · Mar 27, 2024

sleevedraw said:
Because there's no strong evidence that those tests will affect long-term health outcomes for the majority of people, and if he's ordering 20 of them, those costs quickly add up.

I think you misspelled "Because the money is in treating people, not curing them and there's even less money in preventing problems"

The tests he was talking about sounded more like baseline tests than the voodoo predictive tests you were talking about.

sleevedraw · Mar 27, 2024

Hoss said:
I think you misspelled "Because the money is in treating people, not curing them and there's even less money in preventing problems"

The tests he was talking about sounded more like baseline tests than the voodoo predictive tests you were talking about.

Why does a person without a history of breathing problems need a pulmonary function test? Why does a person without painful venous reflux need their veins ultrasounded? These are also voodoo.

Basic bloodwork like a CBC to get a baseline, yes, I agree.

All other kinds of insurance exist to cover people in case of catastrophic loss, and doing these tests is not covering catastrophic loss.

To be clear, if people want to spend money on a concierge doctor for peace of mind, more power to them. I'd equate it with hiring a personal trainer, which I have - you can work out without one, but if you want to delegate exercise and nutrition planning to someone else so that you don't have to think about it, sure, go ahead. But is it necessary or a nice to have?

I also think that having a concierge doctor included as part of a health plan would be a nice add-on option if people wanted to bundle that in as a rider (like some people bundle roadside assist with their car), but that unfortunately won't happen as long as insurance is tied to employers for most people. Employers want one-size-fits-all.

Void · Mar 27, 2024

Not trying to derail the medical talk, but my jimmies get rustled every time I go to Prime Video these days. Literally half the fucking movies they show aren't actually on Prime, they are on Freevee. Fuck that fucking service and all the fucking commercials. And even if they weren't riddled with commercials, does Freevee even broadcast in something higher than 1080p? I don't believe they do, so why would I want to watch something that is definitely available elsewhere in 4k?

It would be totally different if they separated the Freevee movies into their own section, like they do with shit you can buy or the Max movies, etc. But no, they are mixed in with the normal Prime offerings like they belong there. Newsflash, they don't!

I briefly looked if there was a way to filter them out and didn't find one, so if anyone found it please let me know. It is bad enough I get ads for Prime now, but to think, "Oh cool, they have this movie? Let's watch it! Oh fuck, fucking Freevee?? Fuck you cunt!" Those may or may not be pretty close to the exact words that I have uttered many times. Adding the Freevee bullshit just makes it look like they have an actually decent sized catalog, when they really don't. Not to mention, Freevee is actually free, so why is it being promoted on the fucking service I pay for?? If I want free shit, I'll load up an app of all free shit. Not half free, half paid, with no distinction between the two except a line in the description.

Hoss · Mar 27, 2024

sleevedraw said:
Why does a person without a history of breathing problems need a pulmonary function test? Why does a person without painful venous reflux need their veins ultrasounded? These are also voodoo.

As i understand it, the point of a "baseline" is to test a thing while a person is still healthy. That way if they start having trouble with it later you have something meaningful to use as line. of base.

But I'm no ~~doctor~~ insurance agent. I'm just someone who knows english pretty good.

sleevedraw · Mar 27, 2024

Hoss said:
As i understand it, the point of a "baseline" is to test a thing while a person is still healthy. That way if they start having trouble with it later you have something meaningful to use as line. of base.

But I'm no ~~doctor~~ insurance agent. I'm just someone who knows english pretty good.

Just because a baseline is obtained does not mean that said baseline is a clinically useful number.

A genetics company can make the exact argument that you are making ("we're just obtaining a map or baseline of the patient's genetics"). Okay, and how does this affect the management of the patient (and/or 99.99% of people?)

The health care system may be largely treatment focused, but there's very good money to be made for holistic providers with so-called "preventive" services, too, because the system is largely fee-for-service. I very much am in support of preventing people from getting sick in the first place (that means my company needs to pay out less), but there needs to be hard data that obtaining the baseline for a specific value will benefit the lion's share of people.

Fucker · Mar 27, 2024

Vuuxo said:
All the states I've lived in (Prior Air Force) I never dealt with doctors like here in Louisiana. When I was in Florida, my doctor was awesome. When I was stationed in Utah, those doctors were amazing and several other places but here... I could be wrong on this but it seems like during covid the good doctors were fired or quit and now we're stuck with the "just collecting a paycheck" doctors.

It is only going to get worse. New doctors are lazy and don't work very hard. Diversity hires clog up the system even more. All the md's I know will only see a male doctor of one of two races only.

popsicledeath · Mar 27, 2024

Deathwing said:
Sounds similar to a physical in terms of preventative maintenance. Why wouldn't insurance cover such things? Too new?

I have good public employment insurance (I've been told). My insurance covers a free checkup per year, where my doctor will ask if I have any complaints. If I say no, I'm out the door. If I want tests or labs or even longer than a 20 minute appointment I pay the normal price and the word "preemptive" is never used because it doesn't matter.

Insurance used to want to keep people healthy. They now get enough in gov-bucks and increasing premiums your health isn't that much of a concern anymore. In many cases they make more the worse health you have.

There's a reason medical groups got together to outline how profitable trans patients would be. Like 7 million per. And just like that trans cases are on the rise.

I mean, they're now pushing for weight loss drugs to be covered by government "affordable" healthcare as a "preventative" measure. Can anyone think of other ways to prevent obesity? They wouldn't be pushing those drugs if everyone is involved wouldn't make money from it, insurance company included.

I tou can afford a private, pay out of pocket doctor, consider it. Just like anything the government or proxies control and fund, including school, housing, transportation. Unless you're involved directly, including financially, you'll just end up a loot pinyata.

Fucker · Mar 27, 2024

popsicledeath said:
I have good public employment insurance (I've been told). My insurance covers a free checkup per year, where my doctor will ask if I have any complaints. If I say no, I'm out the door. If I want tests or labs or even longer than a 20 minute appointment I pay the normal price and the word "preemptive" is never used because it doesn't matter.

Insurance used to want to keep people healthy. They now get enough in gov-bucks and increasing premiums your health isn't that much of a concern anymore. In many cases they make more the worse health you have.

There's a reason medical groups got together to outline how profitable trans patients would be. Like 7 million per. And just like that trans cases are on the rise.

I mean, they're now pushing for weight loss drugs to be covered by government "affordable" healthcare as a "preventative" measure. Can anyone think of other ways to prevent obesity? They wouldn't be pushing those drugs if everyone is involved wouldn't make money from it, insurance company included.

I tou can afford a private, pay out of pocket doctor, consider it. Just like anything the government or proxies control and fund, including school, housing, transportation. Unless you're involved directly, including financially, you'll just end up a loot pinyata.

Little woman had appt at big hospital last year. Masks required. Cafeteria was packed, people eating a few feet away from each other. No masks. I guess the act of mastication obviates the spread of disease.

Palum · Mar 27, 2024

Our dog has lost his favorite toy that he's had for almost a decade now and carried everywhere around the house. We've looked everywhere, under every piece of furniture and behind all the appliances.

He spends about 30 minutes every day searching for it.

Only thing we can think of is he hid it in a box or something we were going to throw out. Sucks.

Burren · Mar 27, 2024

Palum said:
Our dog has lost his favorite toy that he's had for almost a decade now and carried everywhere around the house. We've looked everywhere, under every piece of furniture and behind all the appliances.

He spends about 30 minutes every day searching for it.

Only thing we can think of is he hid it in a box or something we were going to throw out. Sucks.

Outside? In the car? At the park?

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