COVID-19 & US healthcare system

[Labster]

The largest benefit offered by US insurance companies is the allowed charges: insurers negotiate a maximum cost for each service for the hospitals (et al) to be in the insurance network. Without health insurance you are expected to shop around for a cheap hospital before you need urgent medical care. If you don’t, well, prices are highly variable between hospitals. Under insurance, it wouldn’t be uncommon to see a bill being 50% not allowed, 40% insurance, 10% insured. Which means you might be paying $5000 on that other persons $40000 visit.

Some, but not very many hospitals, pursue unpaid claims in court. This can lead to lost work hours, lost jobs, and lost homes — and also about a 1% increase in income for the hospital. So in practice, a large hospital bill can be significantly more costly than the bill itself. Just the price of living in a free country.

[hazard]

Or you could be in most of Europe and pay either nothing or close to nothing for the same treatment. Bills for medically necessary treatments rarely exceed 1000 euros here in the Netherlands, and that would already be a rather extraordinary circumstance. I would expect that the charges for the same treatment even uninsured would not exceed 1000 dollars in the EU.

Not because it doesn't cost the hospital more than 1000 dollars either. But because the health care system is heavily subsidized to keep consumer prices low.

[SilverFang01]

And this is why assigning a motive, intent, or nationality to a virus is so damn wrong.
FBI warns of potential surge in hate crimes against Asian Americans amid coronavirus

The document detailed a March 14 incident in Midland, Texas, in which "three Asian American family members, including a 2-year-old and 6-year-old, were stabbed … The suspect indicated that he stabbed the family because he thought the family was Chinese, and infecting people with the coronavirus."

[SilverFang01]

In the US, receiving a bill for $40,000 would be on the low end, with supposedly good insurance plans. Adding a 40% increase in premiums on top? A lot of people--those who can actually get insurance-- are going to start considering going without.

I think you are conflating several things here.

First, I was talking about the cost of a single day use of a hospital bed, and only the hospital bed without anything more than the standard check ups.

Second, you aren't noting the cost of the insurance premiums. It'd be useful for comparison.

Third, wait, 40 000 dollars? That's 2/3rd of the median income IIRC, and for the lower economic strata at least one year of income, when you already are in the situation where you have month left at the end of your wages. You aren't going to be able to pay that bill.

Yes, you were right. I was conflating several things and for that I apologize. But the $40,000 dollar figure for treatment wasn’t that far off: Coronavirus hospital bills: A look at the costs for Americans

[Rajvik]

If Obama wanted to battle a public health crisis, then why did he suck so bad at H!N1 and then literally BRING EBOLA INTO THE COUNTRY TO TREAT IT

As far as I am able to determine, no politician or government official ever acted to "literally bring" Thomas Eric Duncan into the USA.

You have just claimed otherwise - either that Thomas Eric Duncan was not Patient Zero in the USA, or that he was brought to North America.

Present your evidence.

Here Robbelk, and USA Today of all people, not some "Right-wing conspiracy nuts" 

https://www.usatoday.com/story/news/nati.../13453997/

edit: Sorry i took so long to answer, but i have effectively been offline for the last week or so

[Norgarth]

ii love how he takes that "not responsible" line out of context, real non-bias here
critical but objective, yeah right
yes, pandemics can start in other countries and they damn well don't respect borders WHEN YOU LET EVERY ASSHOLE THOUGH THE DAMN THINGS WITHOUT ANY CHECKS!
If Obama wanted to battle a public health crisis, then why did he suck so bad at H!N1 and then literally BRING EBOLA INTO THE COUNTRY TO TREAT IT

Alright Silverfang, BA you guys wanna listen to this dressed up shithead hater go right ahead, i'm DONE

Okay, so if Obama was wrong to bring this guy with Ebola into the country for treatment, doesn't that mean Trump was wrong to bring the Americans with the Caronavirus back for treatment as well?

[robkelk]

If Obama wanted to battle a public health crisis, then why did he suck so bad at H!N1 and then literally BRING EBOLA INTO THE COUNTRY TO TREAT IT

As far as I am able to determine, no politician or government official ever acted to "literally bring" Thomas Eric Duncan into the USA.

You have just claimed otherwise - either that Thomas Eric Duncan was not Patient Zero in the USA, or that he was brought to North America.

Present your evidence.

Here Robbelk, and USA Today of all people, not some "Right-wing conspiracy nuts" 

https://www.usatoday.com/story/news/nati.../13453997/

edit: Sorry i took so long to answer, but i have effectively been offline for the last week or so

Quoting from that story:
"The State Department did not name the two individuals,"

I asked for evidence, not innuendo.

EDIT: By the way, Obama was no President during the H1N1 epidemic. Woodrow Wilson was President then.

[robkelk]

Canada's next-door neighbour is now the epicentre of global pandemic. Here's what that U.S. surge means

The United States had approximately 20 times more reported cases than Canada and 25 times more deaths, as of Monday evening.

The U.S. population (330 million) is about nine times higher than Canada's (37 million).

James Blanchard of the University of Manitoba pegged the U.S. rate at 43 infected per 100,000, compared with 15 per 100,000 in Canada.

"Seeing almost a three-fold higher number of cases in the U.S. than in Canada suggests the current burden is higher than in Canada," said Blanchard, who was trained at Johns Hopkins University in the U.S. and who researches how individuals and communities spread illness.

"We test more than anybody else," Trump told Fox News on Monday. "So we will show [more]."

Blanchard said there's no evidence the U.S. has tested more people — at least not per capita. Canada said Monday it had tested more than 221,000 people, while Trump said Monday that the U.S. had tested over 1 million people.

Doing the math there: the USA is testing approximately half as many people per capita as Canada is. Pick up the pace, USA - you're falling behind.

One border town is starting to suffer a heavy humanitarian toll: Detroit, where cases are surging. And Canadian medical workers are getting a gut-wrenchingly close view.

"My district relies on 1,000 Canadian nurses," Rashida Tlaib, a member of Congress from Detroit, told a U.S. House hearing this month, urging that essential workers be allowed to keep flowing across the border.

They still are.

[nocarename]

If Obama wanted to battle a public health crisis, then why did he suck so bad at H!N1 and then literally BRING EBOLA INTO THE COUNTRY TO TREAT IT

As far as I am able to determine, no politician or government official ever acted to "literally bring" Thomas Eric Duncan into the USA.

You have just claimed otherwise - either that Thomas Eric Duncan was not Patient Zero in the USA, or that he was brought to North America.

Present your evidence.

Here Robbelk, and USA Today of all people, not some "Right-wing conspiracy nuts" 

https://www.usatoday.com/story/news/nati.../13453997/

edit: Sorry i took so long to answer, but i have effectively been offline for the last week or so

Quoting from that story:
"The State Department did not name the two individuals,"

I asked for evidence, not innuendo.

Wikipedia appears to name the individuals in question, with their repatriation being before Mr. Duncan's arrival.
https://en.wikipedia.org/wiki/Ebola_viru...y_Writebol

Wikipedia, at least, classes these as 'medically evacuated' which is treated differently from local transmission or people who were found wandering around outside with the disease but happened to get it somewhere else. Which makes sense, as when you bring infected people home I surely hope you are paying much closer attention to exposure than a regular commercial flight.

[SilverFang01]

This is bad.

Captain of Theodore Roosevelt pens letter pleading for resources:
Exclusive: Captain of aircraft carrier with growing coronavirus outbreak pleads for help from Navy

[hazard]

He's not getting that support, and his career is dead.

Pity, he seems to be a good man.

[Inquisitive Raven]

EDIT: By the way, Obama was no President during the H1N1 epidemic. Woodrow Wilson was President then.

Wilson was president for H1N1 1918. Obama was president for H1N1 2009 which wasn't nearly as nasty.

[Rajvik]

Not the argument i expected Rob, but i'll bite

Arguably, no and here is why. The two missionary doctors that were evacuated were where there was already facilities set up to treat Ebola patients, The US citizens on that cruise ship, did not have that.

nocarename: as the article states at least one, probably both, were flown in on small jets that had been specially set up for infectious diseases, the problem is that to be absolutely certain that no virus was accidentally left behind they would then have had to strip the entire inside of the aircraft down to bare metal and incinerate the contents while treating the bare metal with damn near pure chlorine to ensure nothing was left there. Because this is not cost effective i HIGHLY DOUBT the CDC did such with that aircraft.

as for the US citizens from the cruise ship, the numbers precluded anything BUT a commercial airliner, or else treating them in Japan, which the Japanese were not going to do

[nocarename]

nocarename: as the article states at least one, probably both, were flown in on small jets that had been specially set up for infectious diseases, the problem is that to be absolutely certain that no virus was accidentally left behind they would then have had to strip the entire inside of the aircraft down to bare metal and incinerate the contents while treating the bare metal with damn near pure chlorine to ensure nothing was left there. Because this is not cost effective i HIGHLY DOUBT the CDC did such with that aircraft.

So Ebola is a horrific disease, but it actually doesn't jump form person to to chair to person so easily apparently. It is not measles or even chicken pox for infectiousness.

In general, the virus survived on surfaces for a longer time when in the climate-controlled conditions than in the West African environment, the study found. Under hospital-like conditions, the virus lived for 11 days on Tyvek, eight days on plastic and four days on stainless steel. The longest the virus was able to survive in the tropical conditions of the West African environment was three days, on Tyvek.
...
The study also found that the Ebola virus could survive in water for up to six days. The potential for the virus to be spread through wastewater remains unknown, but the new finding "warrants further investigation into the persistence of the virus in aqueous environments, such as in wastewater or sewage canals," the researchers said.

Finally, the study found that the virus could survive in dried blood for up to five days, and in liquid blood (outside the body) for as long as 14 days.

Source: https://www.livescience.com/50758-ebola-...faces.html
(Emphasis mine)

So a good cleaning with bleach, maybe some quality time with a high concentration of ozone and two weeks of no touching once the patient was out and all the evidence we have says that the plane should be safe. I'm not trying to make light of the work that would actually need to be done with care and attention to detail, but I am saying that the level of effort you are describing would actually be overkill when the best evidence we have is that parking the plane for a month and scrubbing it down two or three times would apparently do the job very well and with a safety factor.

That said, I hope the plane was light on tricky to clean parts like carpeted floors. There's no point in making the work harder than it needs to be and burnable, disposable covers over everything probably wouldn't hurt, but I've never seen one of the planes in question and I'm not in a hurry to either.

Respect disease, investigate it, be cautious, but give it no ground that it does not actually hold.

[robkelk]

CBC Analysis: 'Wartime president' Trump isn't calling all the shots in U.S. battle against COVID-19

tl;dr: No one person gets all the credit or blame for how the USA is handling the pandemic response.

"No, the president cannot simply order state and local governments to change their policies," says University of Texas law professor Robert Chesney, writing in the Lawfare blog.

Constitutionally legitimate federal laws do supersede state and local laws, he says, but there isn't a federal law that fits these circumstances. Without one, "it does not follow that President Trump can therefore override state and local rules on matters like shelter-in-place."

Still, Trump does bring some unique powers to the fight against COVID-19. At the end of January, for instance, Trump barred entry by foreign nationals travelling from China — the original epicentre of the outbreak — to the US. Only a president has the authority to do that.

[SilverFang01]

This is why conspiracy theories are dangerous:

[nocarename]

And for those of us outside where CBS wants that to be seen.
https://www.pbs.org/newshour/health/man-...p-feds-say

At least I hope that's the same one. Two would be two too many.

[Black Aeronaut]

This is why conspiracy theories are dangerous:

*Somewhere in Texas, there is a small thermonuclear explosion...*

THAT FUCKING IDIOT!!!!

He's lucky he was caught by the police at first.  If he got anywhere even close to the ship, he'd have the Hospital Corpsmen to deal with before the cops ever got to lay a finger on him.

They don't take the same oath the doctors do.  They are very much allowed to use deadly force, especially if it means the protection of their patients.

https://www.uso.org/stories/2378-7-thing...ital-corps

[Matrix Dragon]

Asshole derailed a train. There's no way the corpsmen would have let him pass. Fucking lunatic.

[Labster]

"Moreno says he acted alone, and didn't plot this out ahead of time."

You don't say.

It's now official: America's response to the coronavirus is a train wreck.

Meanwhile, in Wisconsin, citizens are ordered to shelter in place, and not go outside.  Except to the elections happening next Tuesday -- get out and vote!  Don't just stay at home, do something!  Except totally stay at home because it's dangerous outside.

Census day was April 1.  But this year they mailed people a code to do it online instead of doing a form.  Response rates have been well, somewhat abysmal, about 15% lower than a decade ago.  Apparently Trinity County, California, had about 2% of households responding to the census before the day itself.  Which means we need to send out an army of workers to visit lots of houses, or we could lose billions in funding, and representation.  Except, hey, we're not going to do that, because there's a virus out there.

[SilverFang01]

Between this and pardoning convicted war criminals, morale and discipline in our military must be sky high:
Navy relieves captain who raised alarm about coronavirus outbreak on aircraft carrier

[SilverFang01]

A Major Medical Staffing Company Just Slashed Benefits for Doctors and Nurses Fighting Coronavirus

The memo announced that the company would be reducing hours for clinicians, cutting pay for administrative employees by 20%, and suspending 401(k) matches, bonuses and paid time off. Holtzclaw indicated that the measures were temporary but didn’t know how long they would last.

In a follow-up memo sent to salaried physicians on Tuesday night, Alteon said it would convert them to an hourly rate, implying that they would start earning less money since the company had already said it would reduce their hours. The memo asked employees to accept the change or else contact the human resources department within five days “to discuss alternatives,” without saying what those might be. The memo said Alteon was trying to avoid laying anyone off.

According to The Hill article about same:

These companies received benefits in the $2 trillion stimulus bill passed last week, including deferring payroll taxes, suspending reimbursement cuts and receiving advance Medicare payments.

[hazard]

"Moreno says he acted alone, and didn't plot this out ahead of time."

You don't say.

It's now official: America's response to the coronavirus is a train wreck.

Meanwhile, in Wisconsin, citizens are ordered to shelter in place, and not go outside.  Except to the elections happening next Tuesday -- get out and vote!  Don't just stay at home, do something!  Except totally stay at home because it's dangerous outside.

Census day was April 1.  But this year they mailed people a code to do it online instead of doing a form.  Response rates have been well, somewhat abysmal, about 15% lower than a decade ago.  Apparently Trinity County, California, had about 2% of households responding to the census before the day itself.  Which means we need to send out an army of workers to visit lots of houses, or we could lose billions in funding, and representation.  Except, hey, we're not going to do that, because there's a virus out there.

I know it's the law that the census is done every decade, and I wouldn't be surprised if the law says on the decade every decade no exceptions and by this date.

But maybe either postpone the due date until after the crisis or done, or consider setting up a rolling update that tracks the registries of birth, death, marriage and residence?

Between this and pardoning convicted war criminals, morale and discipline in our military must be sky high:
Navy relieves captain who raised alarm about coronavirus outbreak on aircraft carrier

As I predicted, the captain's now out of a job. I wouldn't be surprised if the Roosevelt will be ordered to set sail again soon and that in a couple of months everybody in the administration will pretend to be very surprised about the number of corona virus cases and deaths that happened on board due to this mismanagement.

A Major Medical Staffing Company Just Slashed Benefits for Doctors and Nurses Fighting Coronavirus

The memo announced that the company would be reducing hours for clinicians, cutting pay for administrative employees by 20%, and suspending 401(k) matches, bonuses and paid time off. Holtzclaw indicated that the measures were temporary but didn’t know how long they would last.

In a follow-up memo sent to salaried physicians on Tuesday night, Alteon said it would convert them to an hourly rate, implying that they would start earning less money since the company had already said it would reduce their hours. The memo asked employees to accept the change or else contact the human resources department within five days “to discuss alternatives,” without saying what those might be. The memo said Alteon was trying to avoid laying anyone off.

According to The Hill article about same:

These companies received benefits in the $2 trillion stimulus bill passed last week, including deferring payroll taxes, suspending reimbursement cuts and receiving advance Medicare payments.

Temporary meaning here 'for as long as we can get away with it'. They sure as hell are hoping indefinitely. And of course they're trying to avoid laying anyone off, that'd look terrible in a crisis like this and they know their employees most likely would have a new job in days.

But frankly? This would be one of those times where a sensible government goes 'well, clearly you don't need our stimulus package if you can afford to let your workforce work less'.

[SilverFang01]

Bwha?
So Germany Just Accused Us of Piracy
&
'Modern-day piracy': German official says US swooped on masks at airport

There is really no pretense that the USA is an ally of Germany any more, is there.

[robkelk]

3M faces pressure from Trump order to stop exporting N95 masks to Canada

Looks like Trump thinks that the free-trade agreement that he pushed for and signed less than a year ago isn't worth the paper his signature is on. Shows what his solemn word is worth.