Nine Inch Nails raises $260,000 in less than one day to help heart patient

May 21, 2009 11:53 AM

Eric de la Cruz needs a heart transplant. He has a pre-existing medical condition (over and above that), which prevents him from having medical insurance. His sister, former CNN.com reporter Veronica de la Cruz wrote to Trent Reznor of Nine Inch Nails, asking for his help. Last night, Trent posted a plea for donations and an offer to fans to attend a show, hang out with the band, backstage, etc. As of a few minutes ago, over $260,000 in donations have been accepted by NIN on Eric's behalf since last night.
posted by Bluecoat93 (94 comments total)

Wow. just wow. This is incredibly amazing.
posted by majikstreet at 11:57 AM on May 21, 2009

Great story. Not a fan of NIN but a HUGE fan of Trent's kind soul.
posted by KevinSkomsvold at 11:57 AM on May 21, 2009 [1 favorite]

So there you have it, the answer to Americas healthcare problems: Have celebrity friends.
posted by Artw at 11:58 AM on May 21, 2009 [62 favorites]

See? He's getting help! No need to destroy our way of life with socialism.
posted by Tomorrowful at 12:00 PM on May 21, 2009 [22 favorites]

Heartwarming.
posted by bz at 12:00 PM on May 21, 2009

Artw, I'm not going to begrudge him for being lucky enough that his sister was able to get Trent's interest. He still needs over $500,000 more to pay for the actual operation (estimated at $780,000 total). He needed at least $150,000 as a "down payment" just to get on the transplant list. This is what happens in this country when you don't have insurance.
posted by Bluecoat93 at 12:01 PM on May 21, 2009 [1 favorite]

Artw, I'm not going to begrudge him for being lucky enough that his sister was able to get Trent's interest. He still needs over $500,000 more to pay for the actual operation (estimated at $780,000 total). He needed at least $150,000 as a "down payment" just to get on the transplant list. This is what happens in this country when you don't have insurance.

Don't other countries really kick you up a notch in their immigration policies if you're able to bring in over $10,000 or so? With $260K, maybe he should try to move to a country with decent healthcare and get on one of their transplant lists.

Half kidding
posted by barnacles at 12:12 PM on May 21, 2009 [6 favorites]

In Canada, everyone has a pseudo-celebrity sister with a rock star pen-pal.
(and still your saviour Obama won't support single-payer)
posted by rocket88 at 12:12 PM on May 21, 2009

It's unfair of me, I know, but whenever I hear of stories like this, I get a mental image of a surgeon standing outside of an operating room door with his arms crossed, occasionally looking down at his watch and breathing out impatiently, irritated that the money is not forth coming.
posted by IndigoJones at 12:13 PM on May 21, 2009 [2 favorites]

This is what happens in this country when you don't have insurance.

I think that was the point. It's nice what they're doing and all, but you really shouldn't need to have a famous sister who's buddies with a rock star in order to get health care.
posted by kittens for breakfast at 12:15 PM on May 21, 2009

I'm also disapointed at the lack of a lyric based pun title.
posted by Artw at 12:16 PM on May 21, 2009 [4 favorites]

Rachel Sklar wrote about this the other day. She said he had insurance but it wouldn't let him seek treatment outside of Nevada, which I guess is the same thing. The twitter campaign is #eric.
posted by Stephen Elliott at 12:18 PM on May 21, 2009 [1 favorite]

What happens when he discovers that his new heart rhythmically ejects bursts of steam?
posted by idiopath at 12:18 PM on May 21, 2009 [1 favorite]

Suggested lyric-based alternate title: "...there's IV holes where my compassion used to be, and there's inflammation in my heart..."
posted by rusty at 12:22 PM on May 21, 2009

Or: "I got my heart but my heart's no good..."
posted by rusty at 12:25 PM on May 21, 2009 [2 favorites]

I don't understand why I should care. His semi-celebrity sister got celebrity Trent Reznor to make an appeal to his fanbase that resulted in lots of donations. Uh...yay, I guess?

That initial cost to get on the list is ridiculous.
posted by graventy at 12:25 PM on May 21, 2009

There's one more possibility, but it's from With Teeth, and even I have some standards.
posted by rusty at 12:27 PM on May 21, 2009

I’m getting nowhere with “Head like a Hole” – Heart like a hole, black [is not the colour of ink in financial statements of some type], I’d sooner [be alive rather than not have access to a large amount of money].

I guess "Heart like a (financial) hole" could work...
posted by Artw at 12:27 PM on May 21, 2009

Anyone who's seen the video for Happiness in Slavery would think twice before asking Reznor for assistance with surgery.
posted by lekvar at 12:29 PM on May 21, 2009 [6 favorites]

What is the Veronica-Trent connection? Are they friends or she just randomly picked his name and got lucky or what? The world of celebrity is murky and alien to me.
posted by m0nm0n at 12:30 PM on May 21, 2009

He had insurance but it wouldn't let him seek treatment outside of Nevada

It's actually that he's on Nevada Medicaid, which can only be used at treatment facilities in Nevada, but there are on transplant centers in Nevada. He needs to get accepted to Medicare so that he can be transported to California to one of their transplant centers. More detail on that here from a Las Vegas news station.
posted by Bluecoat93 at 12:35 PM on May 21, 2009 [2 favorites]

In Canada, everyone has a pseudo-celebrity sister with a rock star pen-pal.

I had a goiter once, my sister made a couple of phone calls and before I knew it Gowan was at the door with a penknife, Maglite and 500 mL of Crown Royal to serve as both antiseptic and anesthetic. He said I could call him "Doctor Larry" and still sends me a card every June 24 for St-Jean-Baptiste. What a guy.
posted by Shepherd at 12:36 PM on May 21, 2009 [3 favorites]

I want to transplant you with an animal.
posted by Paid In Full at 12:38 PM on May 21, 2009

Gray would be the color, if I had a heart.
posted by biggity at 12:43 PM on May 21, 2009 [2 favorites]

Stent Reznor.
posted by fire&wings at 12:43 PM on May 21, 2009 [6 favorites]

Or a birthson who's a network head with lots of celebrity friends: Kidney Now!
posted by wfitzgerald at 12:45 PM on May 21, 2009 [1 favorite]

I'm actually huge NIN fan [ previously ], though light years from Trent's politics. Good for Eric in having connections that will help fund his surgery. This may partially illustrate the "brokenness" of our healthcare system--Medicaid being a state-run program, it fails poor people living in rural areas who are in need of higher level acute care found only outside that state (are there really no transplant centers in Nevada?? Surprising). But Eric's advocates would be wise to not use this as fodder to push a nationalized healthcare program. The only way to make such programs work is to ration everyone's care. IANAD and I don't understand Eric's co-morbidities, but is any patient with multiple health issues really going to rank high on the priority list for treatment of any kind when the provision of care is so restricted?

Again, I'm kinda thrilled and awed at the power certain online communities have. And pleased that my personal Rock God ;> has made a difference for this one patient. But can it be said that--in this case--the competitive (read "Capitalist") healthcare system has worked?
posted by njbradburn at 12:50 PM on May 21, 2009 [1 favorite]

Rachel Sklar wrote about this the other day. She said he had insurance but it wouldn't let him seek treatment outside of Nevada, which I guess is the same thing. The twitter campaign is #eric.

He can't get treatment outside of NV and there are no facilities to do it inside NV. Now that's fucked up.
posted by delmoi at 12:53 PM on May 21, 2009

The only way to make such programs work is to ration everyone's care.

Um, hello? Right now some people get healthcare and others do not? In what way is that not "rationing"?
posted by delmoi at 12:54 PM on May 21, 2009 [8 favorites]

But can it be said that--in this case--the competitive (read "Capitalist") healthcare system has worked?

Also how can you say that? he still needs a half million dollars! He's only raised one third of the money needed. Pay attention.
posted by delmoi at 12:55 PM on May 21, 2009 [1 favorite]

I wonder if hanging out backstage with NIN and Janes Addiction is the same as it would have been when both of these performers were at their creative and youthful self-destruction peaks?

I mean "eat dinner with us?" Wouldn't "bust a few rails with us" be a little more enticing?
posted by M.C. Lo-Carb! at 12:59 PM on May 21, 2009 [2 favorites]

Okay sorry about making four comments in a row, but I do want to address this "rationing" thing. First of all, we already have rationing, it's just done by insurance companies (if you have insurance) The companies place all kinds of restrictions on what kinds of procedures you can get, based on how much those things cost. Deductibles and co-pays are designed to make sure that you minimize the medical care you get (even if it could lead to long term problems)

And waiting lists? We have those too, already. And in fact the wait times in the U.S. are higher then they are in countries like France, the UK, Australia and Germany, which have universal health care. The wait times are lower then in Canada, but Canada is Unusually slow. No one is proposing to make it illegal to pay for your own medical care if you have the money.

All anyone is proposing is replacing private, for-profit bureaucrats with government ones (or giving people the option of a private or government bureaucrats). Rich people will still be able to get all the liposuction and face lifts they want.
posted by delmoi at 1:01 PM on May 21, 2009 [9 favorites]

Um, hello? Right now some people get healthcare and others do not? In what way is that not "rationing"?
Certainly access is arbitrarily and shamefully limited to huge portions of our population, but it isn't called "rationing," it's called "inequity." "Rationing" is an organized, deliberate restriction of goods/services by the controlling party for the purposes of conserving a minimum standard for the many (think WWII). Rationing is entirely different than the barbaric whims of Capitalism.
posted by njbradburn at 1:02 PM on May 21, 2009

Also how can you say that? he still needs a half million dollars! He's only raised one third of the money needed. Pay attention.

Oh, I'm certain he'll get what he needs! I say that because we have a system that grants some people extreme wealth and voices that move followers to action. Having access to that is in many ways the bedrock of the Capitalist system.
posted by njbradburn at 1:06 PM on May 21, 2009

Certainly access is arbitrarily and shamefully limited to huge portions of our population, but it isn't called "rationing," it's called "inequity." "Rationing" is an organized, deliberate restriction of goods/services by the controlling party for the purposes of conserving a minimum standard for the many (think WWII). Rationing is entirely different than the barbaric whims of Capitalism.

Your comment is confusing, and difficult to logically follow. Are you saying that people dying because of economic inequality is better than a minimum standard of healthcare for all humans?
posted by Sova at 1:10 PM on May 21, 2009

But can it be said that--in this case--the competitive (read "Capitalist") healthcare system has worked?

My take: No.
posted by Artw at 1:18 PM on May 21, 2009

But can it be said that--in this case--the competitive (read "Capitalist") healthcare system has worked?

Yes. If you're fucking crazy.
posted by xmutex at 1:20 PM on May 21, 2009 [1 favorite]

Gotta go with Art on this one. This does not meet my operational definition of "working". If I get sick, all I have is the bassist from Foghat! I'll be fucked!
posted by Mister_A at 1:22 PM on May 21, 2009 [10 favorites]

But can it be said that--in this case--the competitive (read "Capitalist") healthcare system has worked?

No. It can be said that this is a really shameful, horrifying example of competitive (read "Capitalist) healthcare not working at all, in that the guy a) still doesn't have enough money, b) had to publicly beg for money to receive healthcare that he hasn't gotten yet and c) why the fuck is the US the only semi 1st world nation in the world where you have to have become a professional fundraiser to go to the doctor?
posted by mygothlaundry at 1:24 PM on May 21, 2009 [4 favorites]

He still needs over $500,000 more to pay for the actual operation (estimated at $780,000 total). He needed at least $150,000 as a "down payment" just to get on the transplant list. This is what happens in this country when you don't have insurance.

The best part is that about half of that fee, on average, will be used to pay for shuffling paper around.
posted by Blazecock Pileon at 1:28 PM on May 21, 2009

Are you saying that people dying because of economic inequality is better than a minimum standard of healthcare for all humans?
Comment was just to put a finer point on my use of the word "rationing." No, I'm not making so dramatic a statement. Our system is deeply fucked up, I just don't believe that a nstionalized system will be significantly better. And it could make some aspects much worse. Single-payor is not a panacea, that's all.
posted by njbradburn at 1:35 PM on May 21, 2009

If I get sick, all I have is the bassist from Foghat! I'll be fucked!

At least it'll be a Slow Ride.
posted by inigo2 at 1:41 PM on May 21, 2009 [1 favorite]

This is retarded. I don't see how anyone can be either happy or proud of this stupid shit. How about member of the US armed forces takes a half-second without pay to cover this guy's operation?

Also, this:

before I knew it Gowan was at the door with a penknife

YES. MetaFilter needs more Gowan. I'm going be humming "Strange Animal" all afternoon.
posted by GuyZero at 1:45 PM on May 21, 2009

"member" == "every member". edit fn, pls, thx.
posted by GuyZero at 1:45 PM on May 21, 2009

Eric has been turned down for a heart transplant list because he is on Nevada Medicaid, and there are no transplanet centers in Nevada. [H]e needs to go to California under the Medicare Disability program. He has been rejected twice and the next appeals hearing is one year from today. We cannot wait one year!

What's going on with the multiple rejections? Would the rejections be related to his condition or just Tuttle/Buttle nonsense?
posted by FuManchu at 1:46 PM on May 21, 2009 [1 favorite]

Um, hello? Right now some people get healthcare and others do not? In what way is that not "rationing"? Certainly access is arbitrarily and shamefully limited to huge portions of our population, but it isn't called "rationing," it's called "inequity." "Rationing" is an organized, deliberate restriction of goods/services by the controlling party for the purposes of conserving a minimum standard for the many (think WWII). Rationing is entirely different than the barbaric whims of Capitalism.
...
Comment was just to put a finer point on my use of the word "rationing." No, I'm not making so dramatic a statement. Our system is deeply fucked up, I just don't believe that a nstionalized system will be significantly better. And it could make some aspects much worse. Single-payor is not a panacea, that's all.

What? This is the definition of ration as a verb:

4. to supply, apportion, or distribute as rations (often fol. by out): to ration out food to an army.
5. to supply or provide with rations: to ration an army with food.
6. to restrict the consumption of (a commodity, food, etc.): to ration meat during war.
7. to restrict the consumption of (a consumer): The civilian population was rationed while the war lasted.

6 and 7 are what we're talking. It just says restrict, it doesn't say by whom. Whether the choices are made by the government or private companies, the results are the same: Rationing of health care.
posted by delmoi at 1:49 PM on May 21, 2009 [1 favorite]

My Industrial Metal Medical Sponsor is Richard 23 of Front 242.
posted by Artw at 1:49 PM on May 21, 2009 [2 favorites]

Ah, the answer:

We also wanted to know why Eric couldn't find the help he needed.

We contacted the State Department of Health and Human Services. They tell us, its primarily about cost. A heart transplant is just too expensive.

So Eric has to get Medicare or pay for the surgery himself.

"There's a serious cost component within the healthcare system at this point, unfortunately that does lead to situations where people can't get the care they require," Ben Kieckhefer, with the Dept. of Health and Human Services says.
posted by FuManchu at 1:49 PM on May 21, 2009

He still needs over $500,000 more to pay for the actual operation (estimated at $780,000 total).

What the fucking fucking fuck is going on here? How can ANY rational person not see how absolutely fucking fucked we all are? Seven HUNDRED AND EIGHTY THOUSAND DOLLARS? We should not be sitting here typing away on some community web log but out in the streets drinking sweet red wine from the hollowed out skulls of these cocksucking health insurance company CEOs.

Defend that, you anti-single payer fucks.
posted by KevinSkomsvold at 1:50 PM on May 21, 2009 [17 favorites]

but that's only Nevada's answer... that still doesn't cover Medicare's refusals
posted by FuManchu at 1:51 PM on May 21, 2009

KevinSkomsvold -- that's the cost of the operation. You should be directed that anger at the hospital and doctors.
posted by FuManchu at 1:55 PM on May 21, 2009

Rationing" is an organized, deliberate restriction of goods/services by the controlling party

I would rather have the controlling party be my government, in which I have some input as to policy, (especially as part of a larger group, like a political party or interest group), than a random corporation which does not have to give the smallest amount of fuck about my painful death due to lack of treatment.

There are some things government* does better than corporations--roads, education, armies, and healthcare are among them. We have a crushing load of evidence for this in the experience of other nations and in our own sad mortality statistics, and hell, in stories like this one.

*not perfectly, but better, and with at least the possibility of redress for grievances.
posted by emjaybee at 1:56 PM on May 21, 2009 [2 favorites]

you give capitalism a reason.
you give capitalism control.
i gave my savings for rent and food
my life savings the hospial stole
do you think i wouldn't recognize
this compromise
am i just to damn stupid to realize
that the health care debate is lies, lies, lies.
posted by the aloha at 2:01 PM on May 21, 2009 [3 favorites]

seriously, it is awesome that trent stepped up to the plate with a colletion plate for whatever reason he has done.
posted by the aloha at 2:03 PM on May 21, 2009

Also, how the hell is the cost so high? According to this site ca 2004, the cost of a heart transplant is $50,000 - $287,000.
posted by FuManchu at 2:04 PM on May 21, 2009

Artw, did I ever tell you about the time I went to the Nitzer Ebb clinic for a cardiology consult? I was like, what's wrong with my heart, doc? And they were all, "MUSCLE!"

So I said yeah, I know it is a muscle, and they're like "FORCE IS MACHINE!"

So I walked out. Fuckin' socialist medicine.
posted by Mister_A at 2:05 PM on May 21, 2009 [5 favorites]

The Front 242 clinics methods for securing heart donors have been criticized by some, but seem straightforwards enough to me. First they lock the target, then they bait the line, then they spread the net, and then they catch the man.
posted by Artw at 2:11 PM on May 21, 2009 [6 favorites]

Well, it's really great how money and support are pouring in thanks to the awareness Trent brought, but it's just so horribly depressing just how much red tape there is and how many hoops need to be jumped through in this country.

Here's to a universal healthcare system and soon.
posted by cmgonzalez at 2:33 PM on May 21, 2009

I want to help you like an animal.
posted by basicchannel at 2:42 PM on May 21, 2009 [4 favorites]

See, this is working out much better than the time I asked Oderous Urungus for some minor surgical assistance... he says I won't get the rest of my limbs back unless I can ante up a crack rock the size of a bowling ball.
posted by FatherDagon at 2:57 PM on May 21, 2009 [1 favorite]

I would rather have the controlling party be my government, in which I have some input as to policy, (especially as part of a larger group, like a political party or interest group), than a random corporation which does not have to give the smallest amount of fuck about my painful death due to lack of treatment.

In my mind, this is one of the most salient arguments for universal healthcare, and a robust democratic process (of which this kind of back-and-forth is, obviously, a part) could result in a program that provides better access to higher quality care than we now have. But sometimes (especially recently) the media paints a picture of the Federal government being the better steward of healthcare because "It" has a heart or something.
posted by njbradburn at 2:58 PM on May 21, 2009

re njbradburn: "are there really no transplant centers in Nevada??"

Nevada has a history of being kind of a deserty...desert where you don't really want to live. Back in the first half of this decade, there were almost no OBs there due to the malpractice problems they were having. (A little searching shows that there still aren't many, especially given the sheer size of the state.)

When I first read this a few days ago on the twitter-feed, I was a teensy bit skeptical. Of course, we don't know the whole story, and we don't need to - that's his personal health information and it's up to him to deal with it as he sees fit. But I'm still skeptical. At no point is the condition itself named, only his symptoms and a few drugs - not very specific ones, either. For some reason it bothers me; maybe it's working in health care and when our pleas regarding lung transplants go out we usually discuss the disease itself, not just the symptoms. Maybe it would be nice if she had some doctors advocating for him, which possibly might be his key problem.

I've dealt with insurance problems relating to lung transplants as per my job, but I'm lucky - while we don't do them in CT, there are centers for that in the neighboring states and we've managed to get an override for the one time we had to send someone to PA. It requires a lot of phone calling and a dedicated provider to write really good letters about why the patient needs care at a certain place. It also needs the right person to read that letter.

This guy's case seems like someone should have stepped up much earlier to get him onto Medicare to begin with; someone botched some paperwork once - or, possibly, at the time it was filed his condition wasn't classed as seriously enough - and now it's going to be harder as time goes by.

On further looking around the site she's set up (god please fix the spelling of digoxin at the very least) I see that one article in a LV paper says it's all up to a judge. All right, hopefully the judge gets all the information, since we can't. And I hope that judge makes the right choice.
posted by cobaltnine at 3:00 PM on May 21, 2009 [2 favorites]

Thanks, cobaltine. LV was (still is?) the fastest-growing city in the country and there are some strong health systems there. Guess I assumed they provided those services.

This guy's case seems like someone should have stepped up much earlier to get him onto Medicare to begin with; Sadly, this happens a lot, and it takes the feats of heroism you described to overcome. And will the need for hospital staff to take care of these administrative details disappear with a bigger Federal program? Not (entirely) sarcastic in asking.
posted by njbradburn at 3:09 PM on May 21, 2009

Sadly, my healthcare celebrity solicitor for donations was the bassist of a defunct band from Kalamazoo... Oh, Screwtape, where are you when I need you?
posted by Ghidorah at 3:23 PM on May 21, 2009

One of my best friends, in Canada, had a heart transplant in August 2008, after being admitted to the hospital for shortness of breath about a few months prior - rapid heart failure caused by an unknown virus.

I'm still in awe that the surgery costs were close to $1million, yet at the time his only out of pocket expenses (other than missing work, of course) was the TV rental in his hospital room.

Reznor did a great thing here - the added stress of the financials would hinder anyones recovery.
posted by jeffmik at 3:27 PM on May 21, 2009

After carefully reading this whole thread it has moved me to donate $100.00












To my local Harry Chapin food bank.
posted by notreally at 3:40 PM on May 21, 2009 [1 favorite]

nj: I have no idea; there are more and less efficient ways of dealing with the 'medical necessities' issues surrounding health care. There's also the ethics of it; doctors take an ethical oath and come from a different background, mentally, than Tina B. who is on the other line of the phone somewhere in the Carolinas, working for a company that works for an insurance company, who is, instructed by a flow sheet, denying a PET scan to a cancer patient.

It's really broken. I don't trust anyone who says they know how to fix it currently. I'm not entirely sure it is fixable. But razing the whole setup, private and public, won't be pretty either.
posted by cobaltnine at 4:01 PM on May 21, 2009 [1 favorite]

Interesting tidbit: This report [PDF] from the Canadian Organ Replacement Register compares (on p71) heart transplants per million population in Canada, US, and France. The US consistently has 2 more heart transplants pmp per year than either. Anyone known what the difference is there? Are more rich old men allowed onto the US waitlists? More lax donor requirements?
posted by FuManchu at 4:07 PM on May 21, 2009

Could be a higher availability of donor organs due to lax motorcycle helmet laws or something.
posted by GuyZero at 4:27 PM on May 21, 2009

barnacles: "With $260K, maybe he should try to move to a country with decent healthcare and get on one of their transplant lists"

That's what I'd be doing! Worth a shot anyway.

I don't understand the majority US attitude that universal healthcare = communism. Since when is helping sick people communism? The fact is some things are best done by the state. Commercial interests - especially in a poorly regulated sector - are not necessarily in alignment with the best interests of the country and its people. This is one of those situations.

Many other countries have sensibly decided that healthcare is about having a compassionate society. And a healthy population is a productive one, just like having an educated population benefits the whole society.

When people are dying because they have no insurance, that's a pretty big sign that the debate should be framed in terms of people, instead of political ideologies.
posted by joz at 4:33 PM on May 21, 2009

SWEDEN
posted by tarvuz at 4:52 PM on May 21, 2009

I see lots of sound and furry here, but very few people are discussing the real point : It doesn't need to cost $800k, but the insurance companies spend incredible amounts figuring out what coverage to exclude, make the doctors fight for, etc., and doctors spend incredible amounts fighting insurance companies, going to school, etc.

We don't tolerate this behavior for subjects even tangentially related to national security : scientists & engineers are usually paid for going to school, after the bachelors anyway. no company is build on avoiding paying the scientists or engineers. etc.

Finally, you can have single payer without having fully socialized "rationed" care, just replace medicare with a flat reimbursement for each drug, operation, etc. together with mandatory copay, but (a) let doctors charge more too,and (b) open it to all age & income groups. So suddenly everyone benefits by improving medicare, especially the old people who vote more.
posted by jeffburdges at 5:54 PM on May 21, 2009

Update from Veronica's twitter: the judge in Nevada has ruled in favor of Eric, meaning he can get on Medicare Disability and be transported legally to UCLA to begin the transplant evaluation procedures. She still has no idea what Medicare will cover and what they'll be on the hook for. The finance people at UCLA, when told what they'd raised so far, said "keep fundraising."

http://twitter.com/VeronicaDLCruz

On a side note, Tom Morello (of Rage Against the Machine and AudioSlave fame), has now added his new band, Street Sweeper Social Club, to the soundcheck and meet-and-greet festivities for NIN fans who donate.
posted by Bluecoat93 at 5:56 PM on May 21, 2009 [1 favorite]

Just a final cautionary point on nationalized healthcare: the United States is, um, a little larger and more complex than Sweden.
posted by njbradburn at 7:29 PM on May 21, 2009

Like, TOTALLY different diseases.
posted by Artw at 7:49 PM on May 21, 2009 [1 favorite]

"It's really broken. I don't trust anyone who says they know how to fix it currently. I'm not entirely sure it is fixable."

Sure it is. All we have to do is look at the evidence of what works elsewhere. We have a great deal of good information to draw on, and some of the socialized systems work very well. The transition won't be all that easy, but we already have plenty of good resources and information from working examples. The political issues are probably the most difficult, as the vested interests have a lot of money and donate a lot of it to almost all US politicians, from the insurance industry to hospitals, medical schools and doctors, to pharmaceutical companies and all the side industries.

But avoiding the problem because the opposition is well funded is not going to work, not for us, and not so much for the existing industries, as they are pricing themselves out of the range of customers. The price trajectories don't support gaining market share, but where can you go? So, some people are going to India or other countries for major surgeries, because it's cheaper and often the same or better quality care - people from the US are paying for international flights to countries where we outsource jobs to get medical care which is far out of their reach in their own country. In the end, the citizens of this country have to come before the businesses which have become entrenched in an untenable and unsustainable situation. But, really, we know how to make it work. The idea that we don't is part of a marketing campaign by the industries which have created this problem and which are now trying to hold our public health hostage, and who are literally destroying the health and lives of millions of people by their opposition to meaningful reform.
posted by krinklyfig at 9:06 PM on May 21, 2009

"Just a final cautionary point on nationalized healthcare: the United States is, um, a little larger and more complex than Sweden."

Specifically, could you give some examples how the US can't do nationalized care because of its size or "complexity?"
posted by krinklyfig at 9:08 PM on May 21, 2009

"We don't tolerate this behavior for subjects even tangentially related to national security : scientists & engineers are usually paid for going to school, after the bachelors anyway. no company is build on avoiding paying the scientists or engineers. etc."

Insurance is a financial arrangement with a profit motive, which is not a sound basis for health care. But even as a private financial arrangement, it's organized as a pooled resource, because the individual burden is too great. IOW, you don't pay into an account which accrues interest, but the insurance company itself calculates risk and uses it to create a pool of money which is paid out in small amounts to individuals under the terms of the arrangement, and of course the company uses the pool for (purportedly) conservative investments. I don't see why this arrangement doesn't sound like something government does all the time, which is utilizing and distributing our shared resources to manage the burdens of society. If we do it right, then the priority is the health of the citizenry, which is better than the priority of the insurance industry, which is to make a profit and minimize costs by avoiding paying out claims whenever possible.
posted by krinklyfig at 9:22 PM on May 21, 2009

Specifically, could you give some examples how the US can't do nationalized care because of its size or "complexity?"

'Cause we ain't communists...
posted by Huck500 at 9:22 PM on May 21, 2009 [1 favorite]

"The US consistently has 2 more heart transplants pmp per year than either."

Does that indicate that the US is more successful at providing heart transplants, or that the citizens of the US need more heart transplants?
posted by krinklyfig at 9:25 PM on May 21, 2009

Well, that's where the unique size of Americans comes in.
posted by Artw at 10:27 PM on May 21, 2009

The rhyme's a bit off, but "Bow down before celebrities, you're going to get what you deserve" ..?
posted by dickasso at 11:28 PM on May 21, 2009 [1 favorite]

Just a final cautionary point on nationalized healthcare

How sage. Aren't we lucky that you're here to warn us about how the United States is larger and more complex than Sweden.
posted by Kutsuwamushi at 12:47 AM on May 22, 2009 [1 favorite]

My question: Why does this procedure cost $780,000?

Yes, yes, it's an involved operation, healthy hearts are rare, etc. But can someone point me to an itemized list of why it costs so much?
posted by moonbiter at 1:42 AM on May 22, 2009

[i]My question: Why does this procedure cost $780,000?[/i]

Replacing heart with new one: $1,000
Knowing HOW to replace heart with new one: $779,000
posted by Bluecoat93 at 5:24 AM on May 22, 2009 [1 favorite]

I have always been a fan of NIN but Trent has stepped up even more in the good books for me.
posted by boomcha76 at 7:40 AM on May 22, 2009

You'll be on immunsuppressive drugs forever, there's a whole squadron of cardiologists, transplant surgeons, anesthesiologists, nurses, etc that need to take care of you, including pre- and post-surgical care, there's the guy who schlepps the new heart from somewhere else to put it in you, there's probably some sort of fees associated with typing you for the transplant and getting you in the database, there's a lot of expensive stuff happening with heart transplants beyond the complex, demanding, labor-intensive hours of the surgery itself.

So I understand why it's costly... still don't understand why this kid has to pay it out of pocket.
posted by Mister_A at 8:51 AM on May 22, 2009

Well, the latest updates aren't especially good. Veronica says that UCLA now won't accept Eric into the transplant program because he doesn't have secondary insurance. When told that they'd already raised nearly $500k, they told apparently her "well, that still isn't enough for a transplant."

This country's health care system isn't just broken, it's bagged up and sitting by the bins waiting for the trash man.
posted by Bluecoat93 at 3:04 PM on May 22, 2009

Just a final cautionary point on nationalized healthcare: the United States is, um, a little larger and more complex than Sweden.
posted by njbradburn at 7:29 PM on May 21 [+] [!]

I don't understand the swipes at this comment?

As a Sicko fan, for what it's worth, I thought it a perfectly sensible capsule reminder of Sweden's different attitudes to tax and government control, not amazingly comparable demographics - sort of stuff that can't possibly be adequately addressed in a few words?
posted by Jody Tresidder at 3:19 PM on May 22, 2009

Gee, thanks Jody! I was thinking I was going to have to launch off on some tedious 10th ammendment lecture... ;>
posted by njbradburn at 4:55 PM on May 22, 2009

Replacing heart with new one: $1,000
Knowing HOW to replace heart with new one: $779,000

If that is the actual answer then heart surgeons are very, very avaricious people.
posted by moonbiter at 12:53 AM on May 24, 2009

"Replacing heart with new one: $1,000
Knowing HOW to replace heart with new one: $779,000"

Or:

Replacing heart with new one: $1,000
Knowing HOW to replace heart with new one: $155,000
Paying malpractice insurance premium for the single procedure: $622,000
posted by bz at 11:35 AM on June 20, 2009

Cite?
Seriously, I have no idea what those numbers are like, and it's a common argument people make (that malpractice premiums are x times the cost of procedures). So...is this true, or just a strawman?
posted by inigo2 at 4:06 PM on June 20, 2009

Sorry, no, I just made them up. I do know a friend of ours who is an ob/gyn pays a bit over $500K/yr for malpractice insurance premiums. Yep, about $10K a week.
posted by bz at 5:58 PM on June 20, 2009