Frustration with American Medical System
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RJOberg wrote:
WHY is a hospital ...
Money. They probably don't have a replacement, as long as the person is there, I guess someone pays for it. If another person comes along who needs "life saving machines" they will probably decide it is time. X|
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When a person is old, ready to move on, has requested no heroic measures, has a living will stating no machines keeping them alive, is no longer coherent enough to make sound decisions, power of attorney activated and that person saying that the patient would not want the current situation. Terminal illness plus an infection that cannot be cleared, only pushed back with antibiotics. Which the hospital won't stop since the infection will return if they discontinue them. WHY is a hospital allowed to continue the use of a machine that makes sure there is enough oxygen in the patient's blood to not pass away and have enough pressure to force the air into the lungs? Not eating, not drinking, but they won't discharge because the patient isn't well enough. It is like they are telling us, "I'm sorry, they aren't healthy enough to die in peace." Why does the hospital insist on treating the patient, getting them as healthy as they can be... SO THEY CAN DIE!?!?! Suffering once isn't enough apparently. :mad: Why is this country so terrified of death that they can't let people die in peace with their dignity? Some pain killers to keep the edge off and then let nature take its course. Who cares if they develop a morphine addiction? Not like it will matter long. One of the doctors even said that if it weren't for the breathing assistance, it would likely be a matter of hours or days at the most before the exhaustion from breathing was to much to continue. However, because there isn't a tube in throat take is handling the act of breathing... it isn't considered a life saving machine. Even when the person is pulling off all the wires, IV, and everything else the hospital has placed and begging to keep it off, they put it back on and use restraints? I'm so frustrated and there isn't anything we can do. :mad: X| A good person, who led a dignified life and had one simple wish. And we can't honor it. Needed to scream anonymously at the wind in a public setting. :rose:
Just a quick update for everyone who replied... First of all and most importantly, thank you for the thoughts and kind words. :rose: Secondly, two of the treating doctors spoke with a palliative care physician and all three sat down with the family. They discussed everything and had a bit of back and forth. They have removed everything, moved to a quieter part of the hospital with more comfortable beds. They also did a lot of the legwork with the hospice to get care set up so a nursing home will never be a possibility. Round the clock monitoring to make sure that pain is managed and comfort is maintained as best they can. The reviews I have read about the place say they have done a great job doing just that while being minimally invasive so the family has time alone. Plus they provide bereavement services for the entire family for 18 months for no additional fee, which includes referral to private therapists if that is requested. All in all, those two doctors were amazing and their staff were equally dedicated. A few weeks ago when the first problems came up, they did everything they could to return health and happiness. Even had a prognosis of at least a year of happy and healthy life. Unfortunately there were other problems that they didn't know about which caused a return trip. Then there was all that frustration and high emotions. And now finally dignity is being restored. So in the end, wishes are being honored and they are helping us do just that. Things turned out as best they could given the circumstances. Overall, some new people on my Christmas card list and a thank you note or six to write. I know their job isn't easy and they did it as best they could. Now to get some :java: since I still haven't had much :zzz:
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jschell wrote:
RJOberg wrote:
but they won't discharge because the patient isn't well enough
Definitely illegal. Excluding some highly infectious diseases one is allowed to leave when one wants.
Poor wording on my part made in a moment of frustration. After stepping back and actually thinking for a moment, maybe the hospital doesn't want to discharge because they might actually be trying to help. If they feel like there is a lack of a good support plan to make sure that comfort and care is provided, they might be trying to help buy time to get one in place. Less refusal, more of strongly suggesting against it with a hint of omission that it is even an option. Of course if they said that, it would be helpful. Although then they might get in trouble for not discharging right away. Who knows... all frustrating. That on top of a week without much sleep, poor quality for what little has been available, and stress being careful not to upset anyone. When things gets to a certain point, clear and rational thought is difficult.
RJOberg wrote:
maybe the hospital doesn't want to discharge because they might actually be trying to help
Doesn't matter. The hospital doesn't get to make the decision regardless of why the patient\caregiver made the decision (excluding some rare circumstances.)
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RJOberg wrote:
WHY is a hospital ...
Money. They probably don't have a replacement, as long as the person is there, I guess someone pays for it. If another person comes along who needs "life saving machines" they will probably decide it is time. X|
V. wrote:
Money. They probably don't have a replacement, as long as the person is there, I guess someone pays for it. If another person comes along who needs "life saving machines" they will probably decide it is time
I seriously doubt that. There are basically much less self-serving reasons (plural) which hospitals and/or doctors do resist early discharges. You scenario is an unlikely and perhaps very unlikely edge case. And the most recent post by the OP would demonstrate that there are in fact individuals who are not self serving.
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I believe this is to do with the US medical system whose sole purpose is to get as much money as possible out of the insurance industry. Having worked with US, UK and European clinical data - I can tell you that the US medical system is hugely bloated purely because of the greed of those running it. Having seen my mother die in a European hospital where, thankfully, she was left to slip away with some dignity without all the tubes and machines that you talk about - I sympathise with your difficult position:rose:
“That which can be asserted without evidence, can be dismissed without evidence.”
― Christopher Hitchens
GuyThiebaut wrote:
I believe this is to do with the US medical system whose sole purpose is to get as much money as possible out of the insurance industry.
That isn't true. Most doctors, nurses and patient support personal are, on average, mostly interested in providing patient care. And all of those are part of the medical industry. There are many other individuals such as janitors and bookkeepers whose jobs are either not impacted at all nor little but getting "as much money as possible" from insurance. But they too are part of the medical industry. There are many companies not involved directly in patient care yet providing patient products whose income is not tied directly to insurance payments but rather, like many companies, to sales. Yet they too are part of the medical industry. In general the only people specifically concerned are share holders, executive officers and other high ranking officials whose income is tied that. They form a small minority.
GuyThiebaut wrote:
I can tell you that the US medical system is hugely bloated purely because of the greed of those running it.
Then perhaps you should publish that information and\or do a whistle blower expose because the absolute proof that you suggest that you have would be of interest to many people. And it would certainly contradict the vast array of studies for many years done by many different groups with many different roles and objectives who have found a very wide array of reasons for costs.
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GuyThiebaut wrote:
I believe this is to do with the US medical system whose sole purpose is to get as much money as possible out of the insurance industry.
That isn't true. Most doctors, nurses and patient support personal are, on average, mostly interested in providing patient care. And all of those are part of the medical industry. There are many other individuals such as janitors and bookkeepers whose jobs are either not impacted at all nor little but getting "as much money as possible" from insurance. But they too are part of the medical industry. There are many companies not involved directly in patient care yet providing patient products whose income is not tied directly to insurance payments but rather, like many companies, to sales. Yet they too are part of the medical industry. In general the only people specifically concerned are share holders, executive officers and other high ranking officials whose income is tied that. They form a small minority.
GuyThiebaut wrote:
I can tell you that the US medical system is hugely bloated purely because of the greed of those running it.
Then perhaps you should publish that information and\or do a whistle blower expose because the absolute proof that you suggest that you have would be of interest to many people. And it would certainly contradict the vast array of studies for many years done by many different groups with many different roles and objectives who have found a very wide array of reasons for costs.
Much of the US medical system is funded by the medical insurance that people have. Because of this much of the clinical sector in the US see the insurance companies as an endless purse from which they can help themselves - consequently medical insurance in the US can be very high and full of exclusions. Did you read my post? - I have worked within the medical insurance industry and it is quite clear that the cost of medical interventions in the US are way higher than in the UK. It is actually quite easy to reduce medical costs in the US because there is so much over-prescription and over charging whereas in the UK it is a lot harder to save money - as the NHS, on the whole and from a clinical perspective, is excellent value for money.
“That which can be asserted without evidence, can be dismissed without evidence.”
― Christopher Hitchens
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V. wrote:
Money. They probably don't have a replacement, as long as the person is there, I guess someone pays for it. If another person comes along who needs "life saving machines" they will probably decide it is time
I seriously doubt that. There are basically much less self-serving reasons (plural) which hospitals and/or doctors do resist early discharges. You scenario is an unlikely and perhaps very unlikely edge case. And the most recent post by the OP would demonstrate that there are in fact individuals who are not self serving.
Perhaps my example is a little "on the edge", but trust me when I´m saying hospitals will keep their beds occuppied and will try to keep their machines running (scanners and other examination machines) as much as possible. (That means keeping you longer then necessary, ordering expensive eximanations when not called for, etc...) Hospitals used to be institutions of care (often run by nuns or so), but nowadays they´re more and more run by managers as a real company with money as the primary driving factor.
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Perhaps my example is a little "on the edge", but trust me when I´m saying hospitals will keep their beds occuppied and will try to keep their machines running (scanners and other examination machines) as much as possible. (That means keeping you longer then necessary, ordering expensive eximanations when not called for, etc...) Hospitals used to be institutions of care (often run by nuns or so), but nowadays they´re more and more run by managers as a real company with money as the primary driving factor.
V. wrote:
I´m saying hospitals will keep their beds occuppied and will try to keep their machines running (scanners and other examination machines) as much as possible. (That means keeping you longer then necessary, ordering expensive eximanations when not called for, etc...)
First hospitals don't order tests - doctors do. Second some of that comes from self-preservation. Because doctors need to back up their opinions with more tests to avoid the cases where malpractice come up. Third although there probably is test inflation to inflate bills that isn't to keep beds full nor does it necessarily lead to beds being full. And very much is an edge case that they would attempt to deny a patient request to leave based on that.
V. wrote:
Hospitals used to be institutions of care (often run by nuns or so)
Hospitals still are run by nuns - probably about 10% of all hospitals in the US.
V. wrote:
they´re more and more run by managers as a real company with money as the primary
All hospitals profit and non-profit must have a non-negative income flow to stay open. But REGARDLESS administrators do not administer health care - doctors do.
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Much of the US medical system is funded by the medical insurance that people have. Because of this much of the clinical sector in the US see the insurance companies as an endless purse from which they can help themselves - consequently medical insurance in the US can be very high and full of exclusions. Did you read my post? - I have worked within the medical insurance industry and it is quite clear that the cost of medical interventions in the US are way higher than in the UK. It is actually quite easy to reduce medical costs in the US because there is so much over-prescription and over charging whereas in the UK it is a lot harder to save money - as the NHS, on the whole and from a clinical perspective, is excellent value for money.
“That which can be asserted without evidence, can be dismissed without evidence.”
― Christopher Hitchens
GuyThiebaut wrote:
Much of the US medical system is funded by the medical insurance that people have.
Not sure what you mean by "medical insurance" but since the vast majority of people do not pay themselves because either they are covered by some plan or they don't pay at all this point is hardly news. However private insurance pays less that %50.
GuyThiebaut wrote:
Because of this much of the clinical sector in the US see the insurance companies as an endless purse
It is the ONLY purse. There is no other in the most liberal term of "insurance". Where exactly do you think that they would get their money otherwise?
GuyThiebaut wrote:
and it is quite clear that the cost of medical interventions in the US are way higher than in the UK.
You however made a conclusion from that and decided that the only possible reason was basic intent of malfeasance on the entire medical industry. And that does NOT follow. And as I already pointed out it isn't even logical because there is no direct correlation.
GuyThiebaut wrote:
It is actually quite easy to reduce medical costs in the US...
Anyone that thinks anything is "easy" in terms of very large organizational structures needs to get out more and/or do quite a bit of reading.
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V. wrote:
I´m saying hospitals will keep their beds occuppied and will try to keep their machines running (scanners and other examination machines) as much as possible. (That means keeping you longer then necessary, ordering expensive eximanations when not called for, etc...)
First hospitals don't order tests - doctors do. Second some of that comes from self-preservation. Because doctors need to back up their opinions with more tests to avoid the cases where malpractice come up. Third although there probably is test inflation to inflate bills that isn't to keep beds full nor does it necessarily lead to beds being full. And very much is an edge case that they would attempt to deny a patient request to leave based on that.
V. wrote:
Hospitals used to be institutions of care (often run by nuns or so)
Hospitals still are run by nuns - probably about 10% of all hospitals in the US.
V. wrote:
they´re more and more run by managers as a real company with money as the primary
All hospitals profit and non-profit must have a non-negative income flow to stay open. But REGARDLESS administrators do not administer health care - doctors do.
Perhaps US hospitals are different... here it is NOT as you say...
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Perhaps US hospitals are different... here it is NOT as you say...
V. wrote:
Perhaps US hospitals are different...
here it is NOT as you say...The OP however is in the US and it seems likely that the comments in that post were directed to the US medical system. One can be sure medical systems in other places vary quite a bit from the US and from each other.
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V. wrote:
Perhaps US hospitals are different...
here it is NOT as you say...The OP however is in the US and it seems likely that the comments in that post were directed to the US medical system. One can be sure medical systems in other places vary quite a bit from the US and from each other.
it is not a win-lose situation, you´re perfectly entitled on your own opinion.
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it is not a win-lose situation, you´re perfectly entitled on your own opinion.