Matt Day Medical Care GoFundMe

[skopar steve]

Thanks for posting the link Skiff.

 

[Roger Hicks]

I am late to this discussion, but would like to add a few thoughts. I am a physician who practiced in US in a highly technical field for 30 years. I took care of many thousands of very ill patients and performed around 14,000 procedures while in practice. I am now working for a large national healthcare system to try to help improve, the quality of care for our patients and tracking measurable outcomes (mortality, infection rates, heart attack and stroke rates, need for hospital readmission, quality of life, patient satisfaction, etc.j. It is not necessary for me to speculate about these numbers, we carefully gather them from multiple sources both internal and external. I have access to them from my computer. Here is what those numbers, as well as other verified research has to say.

Most Americans are under the misconception that the main issue with healthcare outcomes and costs is those that have insurance versus those that don’t. As long as I have “excellent” healthcare coverage through my job or Medicare, I will receive the excellent care the American healthcare system has to offer—the “envy of the world”. While it is certainly true that being uninsured or underinsured in America is a huge barrier to receiving healthcare, and can lead to personal financial ruin, the converse is not true. Having good insurance in no way guarantees good care.

The data show that for any given diagnosis or procedure there is a huge variation in outcomes depending upon where you live, who your doctor is, which hospital you go to, and what economic incentives or disincentives exist there. These variations cannot be simply explained by socioeconomic factors. I can compare the mortality rates for heart attack or heart failure patients (or whatever) across our >90 hospital system and find a wide variation in how patients do, and the poor outcomes may well be at one our gleaming, high tech suburban medical centers and the low mortality may be at an inner city “safety net hospital”. Also, the cost per equivalent severity case may be lower at the place with low mortality (that does fewer procedures and tests), and higher at the place with high mortality (that does a lot). For a description of this phenomenon I refer you to Atul Gawande’s article in The New Yorker on “The Cost Conundrum”. The data from our national healthcare system confirms those described in his article. https://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

Why might this be? We Americans tend to have a bias towards aggressive highly technical solutions to our problems, and we demand that of our doctors (the “Moon Shot” mentality—“Just fix me, Doc!). These solutions often carry signicant short and long term risks and, when eventually rigorously tested against less agressive, more “conservative” options, prove to have no better and often worse results at hugely greater expense. This is also true of many drugs we use. We American doctors tend to also favor these types of treatments, we train many years in how to do them, and as they say “when you have a hammer everything looks like a nail”. We get to be heros like on TV. There is also still a strong profit motive here for doctors and hospitals, and if you happen to own a million dollar imaging machine or robot it tends to get used whether or not it has been proven to provide better outcomes. This may be conscious or unconscious, but the data have shown it over and over again (see Gawande article above).

There certainly are situations in which immediate, aggressive high tech approaches are absolutely life saving. These tend to be for emergencies like heart attack, stroke, trauma/gunshots, acute bleeding, appendicitis, and the like. I know, because I helped develop some of these techniques (met a lot of helicopters in my career) and they were proven to be better in large studies. But, outside of the emergency setting we spend nearly twice as much money as other countries but our patients frequently don’t do as well. We all, including me, pay for this either with our own health or our dollars, whether in premiums, tax dollars, out of pocket expense, or bankruptcy. This is not a liberal vs conservative issue—some very good work on this has come from conservatives. No matter who is in power, these facts will need to be addressed. Call it Romneycare, Obamacare, Trumpcare, whatever you want, the patient and financial data is there to see (except for the actual patients who have essentially no access to the information they need on quality or price). This is fixable. We need to insist that whenever possible, all patients receive the treatments that have been proven to work the best in clinical trials, every time, for every patient, in every place. We doctors all think that is what we do, but the data says otherwise. Facts are stubborn things, and they (still!) matter.

Dear Steve,

All very true, but unfortunately for many people ideologies (including what you call the Moon Shot Ideology) trump facts, logic and data. You are of course absolutely right about evidence-based medicine, but another problem is what Frances has always called the God Syndrome, which leads a distressing number of doctors to believe that they are omniscient, and that their personal prejudices and (possibly out-of-date) training and education set them above the common herd.

The "expensive toys" syndrome is also very dangerous. It turned out, unfortunately, that the local physiotherapist largely eschews hands-on massage in favour of the ripple massage bed, the "deep heat" collar and other bits of technology.

Fortunately we hope to be off to the baths at St. Thomas next week: 10€ ($11) each for an all-day visit, and a lot more use. Highly medicalized and (worse still) artificial spas tend to be very expensive and often useless, but a long soak in a proper spa -- essentially, a warm swimming pool fed by a thermal spring -- is another matter. We have visited them in France, Hungary, Germany, Romania, Greece...

Medical care is not a political issue. It's a public health issue. But again, ideology raises its head.

Cheers,

R.

 

[RObert Budding]

Answer is: NO, thanks to Obamacare (aka Mitt Romney’s health care reform in Massachusetts).

LOL! So do you believe that things were better before the ACA? Do you look back fondly on the days when 55 million Americans had no insurance coverage?

The ACA is far from perfect, but it has been an improvement. The only sensible alternative is to provide universal coverage, as almost every other developed nation has done.

 

[Roger Hicks]

LOL! So do you believe that things were better before the ACA? Do you look back fondly on the days when 55 million Americans had no insurance coverage? . . .

Sure! Who cares if poor people die horribly, or from cheaply avoidable causes? They're just poor people.

What are you, some kinda commie?

Cheers,

R.

 

[FujiLove]

Dear Bob,

No, I'm just wondering why. Don't you ever wonder why things are the way they are? Especially when one country does things one way, and everyone else does them another. There's not necessarily any "should" in it. But there's a lot of "wondering why". You seem exceptionally unwilling to address this.

Cheers,

R.

"You see, if only they didn't speak English in America, then we'd treat it as a foreign country–and probably understand it a lot better"

— Jon Sopel, from his book 'If only they didn't speak English'

I think he's onto something there.

 

[Roger Hicks]

"You see, if only they didn't speak English in America, then we'd treat it as a foreign country–and probably understand it a lot better"

— Jon Sopel, from his book 'If only they didn't speak English'

I think he's onto something there.

Brilliant! Thanks!

Quite honestly, Frances and I have more in common with most of our Tibetan refugee friends than we do with some of our American and even English relatives. The Anglophone popular press and economic world picture can be pretty corrosive.

Cheers,

R.

 

[ChipMcD]

I find it very interesting how so many people here know the exact details of someone's financial well-being and what kind of situation he is currently in to be able to make such judgements about someone. Maybe his insurance wouldn't cover it because it required a specialist doctor or surgery that regular insurance wouldn't cover? There's an endless amount of reasons that they need help. The GoFundMe wasn't set up by Matt or his wife. It was set up by someone else with their family as the beneficiaries without them even knowing about it. I donated because Matt is a good friend, not because he's got a little bit of e-fame. I would have donated more if I could. Life gets hard sometimes and sometimes you're fortunate enough to have a community to help you out, even when you don't ask for it. To those of you saying things like, "He should have sold his stuff, he should have done this or that," you can **** right off. Ban me if you want.

These are good points. Recently Matt put up a YouTube video explaining that he contracted a very rare tick-borne illness in the course of his occupation of engraving gravestones in cemeteries. In this country, that type of business is typically a small business for which good medical insurance is very expensive because of the small number of employees constituting the risk pool. Matt explained that he suffered serious nerve damage in his arms, for which the rehabilitation period is lengthy. He cannot work during this time, and I believe that the Go Fund Me fund is partially to help out with the loss of income. Although he does not say so, given the nature of the nerve damage, it seems possible that he may not be able to continue in this line of work, and if he owns his own business, he may lose it.

If you watch the video (https://www.youtube.com/watch?v=9UEQSOSJH8A), you will see that he is extremely humble and grateful for the help he has received, which was orchestrated by a fellow photographer. I'm sure that there are abusive Go Fund Me campaigns, but it seems unlikely that this is one of them. It is disappointing that some posters here seem to jump to an adverse conclusion.