The healthcare system seems to be optimized towards extracting as much money from older people as possible. I just hope we can move the ball forward and try to make it good at healthcare instead by the time I get old.
The healthcare system is biased towards doing something . Patients want there to always be some action taken, and actions are found. Doing nothing seems like giving up.
I think the healthcare provider incentive is a more important factor since there is such a power imbalance. I’ve had numerous elective surgical procedures recommended. When I asked for non-surgical therapies I was told there are none. When I researched I found them and found other healthcare providers.
I’m pretty young and healthy so the bias for surgeons to recommend surgery seems really strong. Maybe it’s not sinister and it’s just a coincidence that a surgery costs $10-30k and physical therapy costs $1k to someone other than the person who is recommending.
I had a life...I had a future
Yes, but now you have a cause.
Ever thought about attending law school? Or some other related course of action? You can stand up for the other people like you. You could be for them, what wasn't there for you.
I can't comment on what happened before but there may be ways out of your pain. Have you explored all options in terms of pain management.
Spinal cord stimulators? Baclofen pumps?
There are several options for treating 'neurogenic' pain including MR guided focused ultrasound (for which there is a clinical trial going on now at the University of Maryland). Where are you based?
But my living situation now is very unstable and hostile and stress worsens pain and hopelessness. You can't solve that with pills and procedures. On top of that it's not as simple as "solving pain". I have lost all forms of security, have no family or social reliability, have obviously severe depression and anxiety because of all of this, keep taking more hits in all regards, and you can't just plug one hole while there are 7 others in the boat and an 8th about to blow etc. I will never have a full and good life, but a survivable one is possible just not accessible. I don't want to disclose my location online since I have been very candid about my situation as all I need is someone calling the authorities and causing me more loss of agency and massive medical debt. They won't help with what I really need but will 100% "help" by locking me up and feeling good about themselves.
I don't want more surgery or devices or procedures. I don't need more doctors. I have (actual not dramatized) PTSD about doctors and hospitals now. I don't trust them with the exception of two in Europe who actually helped me. Here the have never helped and have literally ruined my life. I need my basic needs secured and a peaceful and stable environment away from hostile people, in a place where I am not one emergency or major problem away from complete and permanent debt losing the tiny bit I have left.
I don't mean to sound rude toward you and I know you mean well. Thank you for that. I have just crossed that line from despair into rage because I know I COULD live...but that I will not because it's not profitable for anyone for me to do so. That would enrage anyone but people deny this can happen to them while ignoring the actual solutions for those it does happen to. I have fought, begged, and raged about it for ages now and I will still be gone and it won't even register. I have learned I simply do not matter. Most people are terrible and most people are who make the rules of the game.
(I admit I don't know if that price is for indica or sativa)
I don't know your whole story, and I haven't suffered as you, but at least some states in the country are trying [1]. I hope you've explored the possibility of relocating within the country.
[1] https://coloradosun.com/2019/10/07/colorado-public-health-in...
- Do you have no way to travel/move? Do you have any money saved/access to money? Perhaps move to a friendlier state (as someone else suggested) or back to Europe as you mentioned?
- If you're completely stuck for funds, can you use crowdsourcing or go_fund_me? - I'm sure many people would want to help if they heard your story.
- If you're being poorly treated by family etc. can you not seek refuge with organizations such as the the salvation army?
- I don't really know much about dealing with homelessness but a quick search suggested: https://endhomelessness.org/how-to-get-help-experiencing-hom...
- Also try to do all the basics: get enough sleep, take in good nutrition, if you're able to exercise (even basic exercise) do it, try to find an environment with less stress (as above), try meditating if you haven't already.
- Hang in there, at least try the suggestions above. Let us know how you get on.
So what can I do? I can't squeeze blood from a stone. You can't plead with me to rescue myself from a riptide in a hurricane. You can't expect me to make desperate advice that never really works, or works one time out of 100,000,000 to somehow work THIS time. I don't have that power. I am sorry it worries you but even that's about your feelings...doesn't do anything practical for me but make me. I am sorry it upsets you but how someone else feeling bad about my betrayal and end isn't something I can do anything about. Should I pretend its all ok so nobody has to feel bad and die quietly Nobody REALLY cares...proof is in the pudding. People act in their own self interests nearly every time and my life doesn't further anyone's own self interests. I was a naive idiot to believe most others thought like I did...like the handful of rare souls I have met in life like my grandfather...altruistic and quietly helping. Doing the right thing and not blaming victims/ The distress anyone may feel momentarily reading this...like they do when they see any tragedy...will pass and they will go back to their Starbucks. 99% of people simply DO NOT CARE about others and the proof is there every minute of every day. They have far more important things to worry about like egos and profits. They will be far more angry about me in my last breaths criticizing them than they will be about my life collapsing entirely. I have seen it happen to people all my life...nothing changes.
When I needed a leg up to get back a sustainable life everyone who could help and every system ignored me and failed me. When it got worse and I could still manage partially but would need some help long term everyone who could help and every system ignored me and failed me. Now that it's in a state that will require long term support for me to even survive at all everyone who could and every system ignores me. I have done all I can...nobody does it alone but I am expected to as I hurtle toward the bottom. Gravity will win and I can't do a thing about it.
Of course after enough trauma and hard knocks - and an impersonal system - you are worn out. I think that is why the poster above suggested basics like sleep and nutrition, if you can get them - not a global solution I know but it does help. (Small lever points).
Situations can change in really weird ways - that no one ever could have predicted - even when it has been tough for years, even when things seem really hopeless.
I'm not in the business of depressing you more, or taxing you emotionally. Your life does matter.
The doctors I know claim that they are good people and will treat anyone regardless of means, but they have also sent many patients into bankruptcy and suicide with five, six figure debts for minor procedures. That's not ethical. That is doing harm. It's either bad faith or sociopathy to ignore the fact that our life expectancy is going down every year, I'm not sure which.
>This assumes widespread bad faith, when I think the situation is much different.
There is really widespread bad faith and there is widespread incompetence. A near complete lack of integrity. ( there are always the physician/practitioner who is the exception, but they are rare.)
>Doing nothing seems like giving up.
This point to the competence aspect. In many situations doing nothing is precisely what is needed. In many types of cancer this is what is to be done. (I cannot be certain but this seems to be the case). Aggressive early treatment appears to endanger the patient more than inaction. No treatment is also 'doing something' and not to be confused with 'we-do-not-care' type of inaction.
Reward outcomes rather than fee-for-service?
Less stress and less risk for the doctor.
-For example, a bit of searching shows an appendectomy takes about an hour. Lets add 1/2 hour onto that for prep & cleanup.
-Searching indicated about $900 to $1200 is the typical insurance payment to the surgeon. That's $600 to $800 an hour.
-Based on my own insurance claims, specialist visits are reimbursed from $200-$300. Average 10 minutes per visit and that works out to $1200 to $1800 and hour. (Non specialist annual "wellness" checkup/physical was reimbursed around $180 for $1080 an hour)
Certainly not all surgeries are necessarily the same, so rates may vary and there could be more or less $/hour, although the same goes for office visits. As such, doctors already are paid roughly similar, or close enough that concerns of pushing surgeries for the $$$ probably don't need to be a huge worry.
https://www.vox.com/science-and-health/2017/11/3/16599072/st...
"Spending during the last twelve months of life made up a modest share of aggregate spending, ranging from 8.5 percent in the United States to 11.2 percent in Taiwan, but spending in the last three calendar years of life reached 24.5 percent in Taiwan"
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017....
Or you could wait until you start to get sick, but how would you know it's not just short-term? You could have a case of pneumonia but recover in a month, and again go on for another 10 years. I've seen a fair number of elderly be sick for most of a year and still come out of it: A relative recently passed at 94, but around 86 she had some serious health issues, and her fate was very uncertain. But she beat them, and had another 8 years where she took great joy in seeing multiple great-grand nieces & nephews born, swim in her pool, listen to her read them stories, etc. They were some of her happiest times, but would have never happened if she'd been trying to beat the 18-month decline.
Since many don’t succeed those costs pile up and count in your stat. But many do succeed do people’s lives are extended.