jdreyer wrote on Dec 12, 2024, 17:16:
Interesting how two Canadians (RP & Simon) have opposite views of the same system.

After being attacked for calling a murderer a murderer, nothing surprises me. Maybe RP has never had to deal with the healthcare system. Or maybe some rando on 4chanfaceredditbookinternet put it out there and he took it as gospel.

But do yourself a favor, or better yet don't, and read Palin's initial facebook statement (it's in the death panel wiki).
Truly beyond the pale.

RedEye9 wrote on Dec 12, 2024, 06:29:

FYI Rect. Prol is Canadian, Not that they're immune to facts, But we've seen another Canadian that has issues w/them.

Thanks. I thought I recalled that RP lived in FL.

Interesting how two Canadians (RP & Simon) have opposite views of the same system.

jdreyer wrote on Dec 12, 2024, 02:15:

Teddy wrote on Dec 11, 2024, 23:08:

Rectal Prolapse wrote on Dec 11, 2024, 15:17:

Mr. Tact wrote on Dec 11, 2024, 11:13:
I'm pretty sure we mostly agree on all of this. The slight difference being my willingness to acknowledge there is a cost factor in the equation. Even if the government was getting the bill, we can't afford to give every person the very best care. It sucks, but it is a financial reality.

In Canada (and each province has different rules/culture regarding health care), instead of a corpo-drone deciding your fate, it will be a government drone deciding it.

Why do people who know literally nothing about the Canadian Health Care system feel so confident posting absolute nonsense about it?

Because Fox News has told them it's socialized medicine where government death panels decide to put granny down when she breaks a hip.

FYI Rect. Prol is Canadian, Not that they're immune to facts, But we've seen another Canadian that has issues w/them.

Sarah Palin, former governor of Alaska and 2008 Republican vp candidate, coined the term when she charged that proposed legislation would create a "death panel" of bureaucrats who would carry out triage, i.e. decide whether Americans—such as her elderly parents, or children with Down syndrome—were "worthy of medical care".[2] Palin's claim has been referred to as the "death panel myth",[3
https://en.m.wikipedia.org/wiki/Death_panel

Fox, never one to tell the truth, and some Republicans in Congress latched on to it like a blood sucking tick to its host.

Result, 30% of low-information voters believed the lie.
The damage had been done.

Teddy wrote on Dec 11, 2024, 23:08:

Rectal Prolapse wrote on Dec 11, 2024, 15:17:

Mr. Tact wrote on Dec 11, 2024, 11:13:
I'm pretty sure we mostly agree on all of this. The slight difference being my willingness to acknowledge there is a cost factor in the equation. Even if the government was getting the bill, we can't afford to give every person the very best care. It sucks, but it is a financial reality.

In Canada (and each province has different rules/culture regarding health care), instead of a corpo-drone deciding your fate, it will be a government drone deciding it.

Why do people who know literally nothing about the Canadian Health Care system feel so confident posting absolute nonsense about it?

Because Fox News has told them it's socialized medicine where government death panels decide to put granny down when she breaks a hip.

Rectal Prolapse wrote on Dec 11, 2024, 15:17:

Mr. Tact wrote on Dec 11, 2024, 11:13:
I'm pretty sure we mostly agree on all of this. The slight difference being my willingness to acknowledge there is a cost factor in the equation. Even if the government was getting the bill, we can't afford to give every person the very best care. It sucks, but it is a financial reality.

In Canada (and each province has different rules/culture regarding health care), instead of a corpo-drone deciding your fate, it will be a government drone deciding it.

Why do people who know literally nothing about the Canadian Health Care system feel so confident posting absolute nonsense about it?

Rectal Prolapse wrote on Dec 11, 2024, 15:17:
In Canada (and each province has different rules/culture regarding health care), instead of a corpo-drone deciding your fate, it will be a government drone deciding it.

That's NOT how any of this works.

The doctors and specialists on your case decide each and every single time, no one else and they certainly aren't "gov drones".

Doctors and specialists command, nurses execute, there's no bean counter in the building or elsewhere that overrule them. And they will more often than not err on the side of caution even if the chances are remote if it is needed to arrive at a diagnostic to solve the underlying issue, "just in case".

How do I know this? I'm Canadian, I've been through the healthcare system numerous times since birth for a plethora of problems, it's exactly how it works. If it weren't for our humane-centric healthcare system I'd probably be dead right now.

Stop trying to gaslight people on topics you know nothing about.

This comment was edited on Dec 11, 2024, 19:14.

Mr. Tact wrote on Dec 11, 2024, 11:13:
I'm pretty sure we mostly agree on all of this. The slight difference being my willingness to acknowledge there is a cost factor in the equation. Even if the government was getting the bill, we can't afford to give every person the very best care. It sucks, but it is a financial reality.

In Canada (and each province has different rules/culture regarding health care), instead of a corpo-drone deciding your fate, it will be a government drone deciding it.

Burrito of Peace wrote on Dec 11, 2024, 10:27:

Mr. Tact wrote on Dec 11, 2024, 09:26:
There are limits. Sometimes doing nothing is the more humane thing.

There are and sometimes that is the most humane thing.

The problem is that such a choice is not some faceless, soulless corpodrone's choice to make. That choice is between the doctor(s) and the patient or whomever is responsible for the patient.

I'm pretty sure we mostly agree on all of this. The slight difference being my willingness to acknowledge there is a cost factor in the equation. Even if the government was getting the bill, we can't afford to give every person the very best care. It sucks, but it is a financial reality.

RedEye9 wrote on Dec 11, 2024, 09:49:
I watched that show’s spin-off, it stars punchy dad as a social media influencer who gained fame, stardom and worshippers for his actions that day.

I'm sure you saw that, but it doesn't fit the show I was referring to.

In the show I'm referencing, you don't see the father after the scene where he punches the doctor. As I said, the doctor is just an auxiliary character.

Mr. Tact wrote on Dec 11, 2024, 09:26:
There are limits. Sometimes doing nothing is the more humane thing.

There are and sometimes that is the most humane thing.

The problem is that such a choice is not some faceless, soulless corpodrone's choice to make. That choice is between the doctor(s) and the patient or whomever is responsible for the patient.

Mr. Tact wrote on Dec 11, 2024, 09:26:
The doctor says, "You should get one." and then without giving the doctor time to react the father surges from his seat and punches the doctor in the face. And starts screaming at him...

I watched that show’s spin-off, it stars punchy dad as a social media influencer who gained fame, stardom and worshippers for his actions that day.

Not unlike the tributes to Elliot Rodger’s. (https://en.wikipedia.org/wiki/Elliot_Rodger Skip down to the bottom of the page and read Legacy)
And in a similar vein, those who cheer the likes of Luigi Mangione.
If you don’t know who Luigi Mangione, he’s the murderer who shot an innocent man in the back.

Burrito of Peace wrote on Dec 11, 2024, 08:51:
Medical sense to whom? That is one of the greatest fundamental flaws in the system.

I think you know what I meant. Yes, life is sacred and everyone desires as much life as they can get. But there are limits...

I am reminded of something I saw in a TV show recently. One of the auxiliary characters is a doctor and as a side story he has a really bad day because he has to tell the parents of a seven year old girl that she has a tumor the size of a lemon in her head and she will not live for another year. When the parents, not surprisingly, ask what can be done. He pauses slightly and starts to explain how if they do surgery, they'll have to start with removing one of the girl's eyes. The parents ask if they do the surgery what will life be like for the girl. The doctor says something like, "Her life will be pain. Which we will help with, but there is only so much we can do." They ask what they should do. He suggests they do nothing significant medically and simply make the rest her life as pleasant as possible. To spend as much time as possible with her, to do the things the girl loves to do. The father gets upset and says something like, "You think we should do nothing? I want a second opinion!" The doctor says, "You should get one." and then without giving the doctor time to react the father surges from his seat and punches the doctor in the face. And starts screaming at him...

So, yeah a fictional and extreme case but one I am sure has happened. There are limits. Sometimes doing nothing is the more humane thing.

Mr. Tact wrote on Dec 11, 2024, 07:21:
...My point was that doesn't address the fact when they refuse services which don't make medical sense...

Medical sense to whom? That is one of the greatest fundamental flaws in the system. If my doctor says "Burrito, you need surgery to finally get that right shoulder taken care of and to make it stop hurting all the time", I am inclined to trust my doctor's assessment and ability to tell me what I medically need far more than some faceless corpodrone or algorithm. My doctor knows me. Knows my medical history. Knows what I do in life. They are highly trained to know what is medically necessary to treat me.

There should not be the equivalent of a hall monitor standing in the way between my doctor and myself.

/---\
To add fuel to this fire, Goldman Sachs asked in a biotech report "Is curing patients a sustainable business model?" You can read more about it here.

Maybe I'm just overdosing on crazy pills but, in my mind, there should not be a profit motive in curative and restorative medicine.

Yes as I said, I assume they were refusing services they shouldn't. My point was that doesn't address the fact when they refuse services which don't make medical sense, those involved are going to be just as upset as the first group. So, even if they had made only reasonable decisions, there would still be people upset with them.

The US healthcare system is mess. It doesn't help that capitalism has both made it better and made it worse. Profit was the main driver behind the research and discovery of so many drugs and treatment methods which make most of the medical "miracles" that happen in hospitals possible. But then that same system turns around and allows patents of drugs to be renewed even after the companies have recouped their costs and made millions. Meaning cheaper generic versions aren't allowed to be made. Anyone who thinks they have a solution to the US healthcare problems, doesn't fully understand the problem.

Mr. Tact wrote on Dec 10, 2024, 21:22:

jdreyer wrote on Dec 10, 2024, 16:56:
Who knows, maybe he's estranged from his family and their money?

Everything I've seen indicates all was good until he "recently" (I want to say, this year, but can't remember for sure) stopped contacting and responding to most everyone in his life. I'm guessing it is less of a personal gripe with UHC than it is an "awakening" of how evil they are and how much pain, suffering, and death they are causing all in pursuit of the almighty dollar. Just the fact that he bothered to read and make a commentary on Kaczynski's manifesto tells me he doesn't like where society has gotten to.

As for the lack of empathy for the murdered man, I find that unsurprising. I won't say it is deserved, but I understand why someone might feel that way.

I'm not going to try to defend UHC practices, I don't know a lot about them. But I'll assume they have refused services they probably shouldn't have. That said, I'll bet there are services they refused, which medically made sense to refuse, and the people involved are just as upset at the refusal as the people who actually should not have been refused. It isn't reasonable or possible to spend millions of dollars on each and every patient. The line does have to be drawn somewhere. And wherever that is, someone is going to be unhappy. I'm glad I'm not involved in having to decide where that line is drawn.

Sure, they reject claims not covered by the contract. That's normal and expected. But they do so much more.

One company I worked for had UHC. It was the only option. I was told that they used UHC bc they were the cheapest, and the employer has to pay 70% of the employee healthcare as a benefit. So from a cost perspective, it made sense for that company.

However, they only had one doctor in network in my state. And even when I used that doctor, some of my claims were rejected and I had to fight for them to be covered, which took months. The slower they pay out claims, the longer they get to use premiums to generate investment profit. One claim never got resolved despite the best effort of myself, my doctor, and my company's "fixer," and I was out $300. UHC rejects 33% of claims, the highest among HICs.

UHC had the lowest cost plans, but it's also the most profitable HIC. So they're doing something different, more extreme than other HICs. That thing is rejecting claims they're obligated to cover. There's no downside. There's no fine for doing so. Sick people can't afford to sue. Make people force you to pay them. Stretch it out for months. Deny to authorize care you're supposed to authorize like cancer treatment. Make the cancer patient fight for it. If they die first, well you just saved $100,000.

Some examples off Reddit:

- During the pandemic they called to schedule an assessment for home care for a patient who'd been previously denied and had been trying to schedule a reassessment. Great, only the patient had passed away several weeks prior. After being denied home care they were admitted to the hospital, got COVID and died.

- Had to pay 60k for my ex-wife’s 5 month stint in a rehab facility. It was covered in our policy, but they said she didn’t need it.

- Example: John Doe has a funny mole they notice late October. Get it checked first week of November, their PCP refers them to an Oncologist late Nov., they do a biopsy early Dec. It's cancerous, they've met their deductible and maximum out of pocket early in the year, there's a spot they can do the surgery late Dec. Everyone's like Let's do this thing! No, UHC denies the surgery for a bullshit reason that they immediately walk back on as soon as the new year starts and the patient has to pay for it out of pocket because their deductible reset.

- I’ve been getting Botox for migraines for about 10 years. It’s life changing for me. Prior to receiving it I had a migraine nearly every day of my life now I get a few a year. They sent me a letter a month or so ago that they are no longer covering it. No explanation or reason.

- UHC required a new Prior Auth EVERY 6 MONTHS for dialysis. (Most insurance carriers will approve them for 12 months, which is understandable.) And they would not backdate the PAs. At the time, the majority of the patients my office handled were doing dialysis in a clinic 3x/week. UHC was/is a very popular insurance company, both commercial and Medicare Advantage plans. It was impossible to keep up with all the PAs that were due to expire, and they weren't the only insurance provider we dealt with. I cannot tell you how many dialysis sessions where we had to write off the costs on because they weren't authorized.

- I was taking birth control pills, but I needed to be on an expensive one because of an unrelated health condition. When the ACA went into effect, I thought my prescription would be free in accordance with the new law. I gave it six months and contacted United Healthcare. The customer service person couldn't explain why I was still being charged nearly $50 a month. A week later, I received a letter in the mail from UHC. It said that they were only covering new hormonal birth control prescriptions as it would be financially prohibitive to grandfather in prescriptions from before the ACA. I paid $48 a month for those pills every month for the next five+ years. Nearly $3000. I later found out that what UHC did was illegal. They actually were required to provide me my prescription at no cost to me. I never did get my money back.

Mr. Tact wrote on Dec 10, 2024, 21:22:
The line does have to be drawn somewhere.

And therein lies the problem of the antiquated US healthdoesn'tcare system.

In every other modern healthcare system, the doctor of the patient ( or a specialist tasked with the patient's case ), the one best placed to make that judgement, makes the judgement. Not some bureaucrat out for his own personal interests when those personal interests are in direct conflict with the doctor's/specialist's best judgement.

Mr. Tact wrote on Dec 10, 2024, 21:22:
I'm glad I'm not involved in having to decide where that line is drawn.

Me neither, best leave that decision to those who are the best placed to make it, the doctors and specialists who studied almost a decade and have decades more of practice.

Burrito of Peace wrote on Dec 10, 2024, 17:28:
RedEye stated that Luigi Mangione committed cold blooded murder. How is that functionally different from Brian Thompson's company letting thousands die via cold blooded decisions to deny life saving care?

Functionally? The results are the same. Structural violence, physical violence, same results. It's only the process and legality that are different. And whether it's legal or not has no intrinsic value in isolation in and of itself ( context is most of it ). Slavery was legal. For profit prisons with slave labor are still legal. Even wars to some extent are legal. Homelessness amid plenty of vacant housing is legal. Hoarding insane amounts of wealth when a billion is chronically underfed and among them 500 millions are chronically starving while 3.2 billions are overweight or obese on a 8 billions pop world where enough food is produced to feed 12 billions, this is also legal.

Structural violence of this nature in other forms, like withholding medical treatment, is also legal.

Structural violence also kills an insane amount of people each year, estimates range from 10 to 20 millions. That's a billion easily avoidable deaths in 100 to 50 years. Not because there's not enough food, water, clothing, housing or medication, but because some people have decided that the distribution of those needs, even in a context of surplus, should be for profit.

A lot less people die because some people decided that healthcare in the US should be for profit and it's only a tiny fraction of the structural violence deaths, but they're still easily avoidable deaths nonetheless that happen because of inaction, ignorance, apathy, avarice, indoctrination and many other factors.

If you let someone starve on your land when you have 50% surplus food for everyone, is it murder? If you let someone bleed out or die from sickness on your land when their wounds or illness could easily be attended for, is it murder? If you let someone die of exposure on your land when you have vacant shelter, is it murder?

I would never let that happen on my land, ever. Yet... It happens all over the world on someone's land tens of thousands of times ( ~27k to ~54k ), every single day.

Is it murder?

I think, like BoP, that it is indeed murder.

This comment was edited on Dec 10, 2024, 22:52.

jdreyer wrote on Dec 10, 2024, 16:56:
Who knows, maybe he's estranged from his family and their money?

Everything I've seen indicates all was good until he "recently" (I want to say, this year, but can't remember for sure) stopped contacting and responding to most everyone in his life. I'm guessing it is less of a personal gripe with UHC than it is an "awakening" of how evil they are and how much pain, suffering, and death they are causing all in pursuit of the almighty dollar. Just the fact that he bothered to read and make a commentary on Kaczynski's manifesto tells me he doesn't like where society has gotten to.

As for the lack of empathy for the murdered man, I find that unsurprising. I won't say it is deserved, but I understand why someone might feel that way.

I'm not going to try to defend UHC practices, I don't know a lot about them. But I'll assume they have refused services they probably shouldn't have. That said, I'll bet there are services they refused, which medically made sense to refuse, and the people involved are just as upset at the refusal as the people who actually should not have been refused. It isn't reasonable or possible to spend millions of dollars on each and every patient. The line does have to be drawn somewhere. And wherever that is, someone is going to be unhappy. I'm glad I'm not involved in having to decide where that line is drawn.

Burrito of Peace wrote on Dec 10, 2024, 17:28:

jdreyer wrote on Dec 10, 2024, 16:56:
Just looking at the statistics and reading the UHC horror stories online, you can see how someone might be radicalized. I saw this quote in one of the stories:

When legal options to blatant injustice are exhausted or made unavailable, one must assume that a society will reach for extra-legal ones.

Two wrongs don't make a right, but you can see how someone might be driven to take such an action.

OK, I'll bite. When you have functionally no legal redress to injurious action or indifference, when is it ethically wrong to seek justice? Not the perverted sense of justice that the US legal system currently has, where whomever has the most money wins, but actual justice. Or, as Aristotle described it, justice as a virtue where conduct and law are centered around the good of others and the fair mean is equally applied to all.

Because, honestly, I foresee this happening more and more. Especially with generations that grew up getting royally fucked from before birth. Generations that will never have the opportunities provided to Boomers and, to a lesser extent, Gen X. Generations that have little hope for any real, meaningful change as money continually puts old, predominantly white, men in to power who are just puppets for corporate interests. Those generations have nothing to lose by taking out CEOs and other icons of greed, inequality, and hubris. They might go to jail? For some, the idea of three meals, shelter, and a fixed routine that costs them nothing might be quite alluring. They're probably not getting that now.

RedEye stated that Luigi Mangione committed cold blooded murder. How is that functionally different from Brian Thompson's company letting thousands die via cold blooded decisions to deny life saving care?

I think that my biggest frustration is that while portraying Magione as a "murderer" and "assassin," politicians and the press describe the UHC side as a "policy difference" or "broken system," when nothing is further from the truth. I suppose I should expect nothing less from multi-millionaire journalists and politicians, but as you say UHC is engaging in deliberate behavior that results in 1000s of deaths per year in order to increase profits, and those directives and strategies come from the top. I'm sure it's partly the case that these people depend on conglomerate healthcare companies like UHC, Cigna, Humana, Aetna, and the like for ad dollars and political donations. But also telling the truth might expose them to libel lawsuits from deep-pocketed insurance companies, however tenuous the charge.

Reddit has a great set of stories about how UHC's policies resulted in great suffering and premature deaths.

jdreyer wrote on Dec 10, 2024, 16:49:
Factorio vs Satisfactory vs DSP

Which is best?

I don't think there is an objective answer. For me personally, I would rank them from the top: DSP, Factorio, Satisfactory.

However, more than anything that's probably because I had over 2,000 hours in Factorio before the other two came along. If they all had appeared simultaneously I suspect Factorio and Satisfactory would swap places. To me, the biggest down side for Satisfactory is when you get to the end game grind (which all three games have) it is much harder in Satisfactory due to their blueprint system being so limited in comparison to the other two. Additionally, although the hand crafted world Satisfactory provides is very well done, it just doesn't provide the replay value you get from the ability to increase, decrease, and/or randomize the resources like you do in the other two.

All that said, some people just hands down prefer the 1st person perspective you get in Satisfactory. All three are great games. And if you aren't playing all three you better not be calling yourself a "factory game guy".

Cutter wrote on Dec 10, 2024, 18:02:
I didn't realize the mods here were in the pockets of the elite.

[Snickers]

Given the comments of one of them in this very thread, that is extremely unlikely to the point of ridiculous.