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Post by Tbone81 on Sept 10, 2021 20:06:09 GMT -6
But as for precedent, people already do deny treatment, all the time. They also die and suffer from mostly self caused harm (lung disease, heart disease etc). Insurance still pays. Insurance companies do everything they possibly can to avoid paying. If they have any legal ground for denying coverage for unvaccinated people they will do it in an instant. yes, they try all the time. But in this particular scenario I don’t see how they’d have any ground. You could literally cut your own arm off for fun and if you have insurance they’ll pay for it according to what your coverage is. It’s not rare, far from it. Most of healthcare is taking care of diseases directly caused by poor lifestyle choices. |
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Post by ehrenebbage on Sept 10, 2021 21:54:45 GMT -6
Insurance companies do everything they possibly can to avoid paying. If they have any legal ground for denying coverage for unvaccinated people they will do it in an instant. yes, they try all the time. But in this particular scenario I don’t see how they’d have any ground. You could literally cut your own arm off for fun and if you have insurance they’ll pay for it according to what your coverage is. It’s not rare, far from it. Most of healthcare is taking care of diseases directly caused by poor lifestyle choices. They may not have legal ground (thanks, ACA!), but they'll find a way to offset the cost. At the minimum they'll just spread it out across all of their customers. Whatever the case, the insurance companies know the odds better than anyone and won't be denied their fortune : ) The system in Idaho, one of the least-vaccinated states in the country, is so overwhelmed that they've authorized the rationing of medical care. Yikes. It's completely illogical and totally driven by some combination of fear and a narrowly-framed idea of freedom. That's really what we want for ourselves? The fear of a vaccine with a minuscule risk is creating an environment with far greater risk. How is that logical? |
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Post by seawell on Sept 10, 2021 23:13:30 GMT -6
yes, they try all the time. But in this particular scenario I don’t see how they’d have any ground. You could literally cut your own arm off for fun and if you have insurance they’ll pay for it according to what your coverage is. It’s not rare, far from it. Most of healthcare is taking care of diseases directly caused by poor lifestyle choices. They may not have legal ground (thanks, ACA!), but they'll find a way to offset the cost. At the minimum they'll just spread it out across all of their customers. Whatever the case, the insurance companies know the odds better than anyone and won't be denied their fortune : ) The system in Idaho, one of the least-vaccinated states in the country, is so overwhelmed that they've authorized the rationing of medical care. Yikes. It's completely illogical and totally driven by some combination of fear and a narrowly-framed idea of freedom. That's really what we want for ourselves? The fear of a vaccine with a minuscule risk is creating an environment with far greater risk. How is that logical? Is there a single person in the USA during all of covid that has gone without care? I keep hearing these kind of stories and I hate to be so jaded at this point but all I can think of are huge military ships and multiple multi-million dollar field hospitals that went completely unused. |
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Post by bgrotto on Sept 10, 2021 23:56:18 GMT -6
They may not have legal ground (thanks, ACA!), but they'll find a way to offset the cost. At the minimum they'll just spread it out across all of their customers. Whatever the case, the insurance companies know the odds better than anyone and won't be denied their fortune : ) The system in Idaho, one of the least-vaccinated states in the country, is so overwhelmed that they've authorized the rationing of medical care. Yikes. It's completely illogical and totally driven by some combination of fear and a narrowly-framed idea of freedom. That's really what we want for ourselves? The fear of a vaccine with a minuscule risk is creating an environment with far greater risk. How is that logical? Is there a single person in the USA during all of covid that has gone without care? I keep hearing these kind of stories and I hate to be so jaded at this point but all I can think of are huge military ships and multiple multi-million dollar field hospitals that went completely unused. I've had family and friends both with delayed surgeries (to say nothing of issues with more routine stuff). One particular case -- with an immediate family member -- involved something potentially life-threatening (luckily it turned out benign, and the added wait was only a week or so). So yeah, it can happen, particularly in non-urban areas where hospitals have limited space and staff. |
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Post by seawell on Sept 11, 2021 0:21:13 GMT -6
Is there a single person in the USA during all of covid that has gone without care? I keep hearing these kind of stories and I hate to be so jaded at this point but all I can think of are huge military ships and multiple multi-million dollar field hospitals that went completely unused. I've had family and friends both with delayed surgeries (to say nothing of issues with more routine stuff). One particular case -- with an immediate family member -- involved something potentially life-threatening (luckily it turned out benign, and the added wait was only a week or so). So yeah, it can happen, particularly in non-urban areas where hospitals have limited space and staff. Sorry to hear hear that! That’s not quite what I meant. Certain news channels would lead you to believe people are dying on the sidewalk with no beds to spare. I am just tired of the fear mongering. |
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Post by ehrenebbage on Sept 11, 2021 6:53:42 GMT -6
I've had family and friends both with delayed surgeries (to say nothing of issues with more routine stuff). One particular case -- with an immediate family member -- involved something potentially life-threatening (luckily it turned out benign, and the added wait was only a week or so). So yeah, it can happen, particularly in non-urban areas where hospitals have limited space and staff. Sorry to hear hear that! That’s not quite what I meant. Certain news channels would lead you to believe people are dying on the sidewalk with no beds to spare. I am just tired of the fear mongering. I'd say that the widespread vaccine hesitancy and the call to arms to protect 'freedom' is 100% fear mongering. The fact that Fox beats this drum while quietly instituting their own vaccine policy is ridiculous. The hospital situation may not be bad where you live but it's really rough in a lot of places. A person just died in the waiting room of a hospital down the road from me...no beds to spare. My next door neighbor is a nurse practitioner at an urgent care clinic. Her clinic has been swamped by covid-related care for many months. My mom in law is a veteran ICU nurse. She works a couple shifts a week at a surgery center...recently had a situation where they were understaffed on short notice because one nurse who refused to get the vaccine went down with covid. A patient was in to repair a shattered ankle and something went sideways during the procedure...they thought they may need to transfer to a hospital and were having trouble finding an open spot anywhere nearby. Luckily the patient turned around and didn't need to go. A dear friend is a nurse in a supervisory role at a hospital. She says they are tapped out. Nurses are regularly tasked with 3 or 4 times the number of patients they should normally take. Not only is it brutal for the hospital staff, it puts patients at much greater risk. Hospitals are risky enough as it is. A friend of the family is an OB here in town. One of her patients has been trying to start a family for 12 years. IVF finally worked and they got pregnant with twins. Our friend begged them to get vaccinated, but all of the fear mongering led the patient to believe that it was potentially dangerous. Tragically and somewhat predictably, the mother got covid, passed it along to the babies in utero, and both babies died. Just horribly heartbreaking for the mother, the family, our friend, and the staff who had to deliver two stillborn babies. Had a conversation with an ER nurse who just came here from Alabama. He decided to take a travel nurse assignment because the situation down there was even worse than it is here and he needed to take a 'break'. This is just a slice of what's happening in my little town in Oregon in the past few weeks. It goes on and on. I dunno. I understand that there are issues with messaging, etc., but the fact is that we have a very safe solution to bring the situation under control. To choose 'freedom' at the expense of the greater good of society is both selfish and a misevaluation of risk. |
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Post by ehrenebbage on Sept 11, 2021 7:19:39 GMT -6
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Post by Tbone81 on Sept 11, 2021 9:14:33 GMT -6
Well if you don’t understand my point so be it. |
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Post by Tbone81 on Sept 11, 2021 9:21:29 GMT -6
I've had family and friends both with delayed surgeries (to say nothing of issues with more routine stuff). One particular case -- with an immediate family member -- involved something potentially life-threatening (luckily it turned out benign, and the added wait was only a week or so). So yeah, it can happen, particularly in non-urban areas where hospitals have limited space and staff. Sorry to hear hear that! That’s not quite what I meant. Certain news channels would lead you to believe people are dying on the sidewalk with no beds to spare. I am just tired of the fear mongering. The fear mongering is over the top, but the strain in hospital resources is real. The strain isn’t spread evenly though, some hospitals can’t keep up, others are doing just fine. Depends on their location, capacity, population they serve etc etc. For my hospital, we receive Covid transfers from all our other area hospitals in the state. That’s about a half dozen hospitals that transfer their patients to us for a higher level of care. We’ve handled the pandemic pretty well comparatively but things get rough on a daily basis. It gets bad…make if that what you will. And this delta wave is probably the worst it’s been the entire pandemic |
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Post by dmo on Sept 11, 2021 9:28:42 GMT -6
Worked the last few days and missed the speech - from the comments posted doesn't sound like it was very positive. Agree with Josh that the messaging continues to miss the point - and at this point not sure if we can have rational conversations since the dialogue tends to be divisive. But if we want to return to "normal" we need everyone to understand how to accurately assess risk/benefits - both personal and societal/global - and the impact vaccination can have. So let's consider 2 hypothetical scenarios, realizing that all numbers are estimates based on data that is incomplete and that there are other variables we're ignoring for the moment to keep this simple.
To truly contain this virus we're going to need a level of immunity probably close to that for measles (95% population). This is a guess on my part as the percentage needed for herd immunity varies from virus to virus (polio only needed about 80%) - but given the high level of transmission/mutation I think we'll need to be pretty high. We need to look at the actual numbers that would involve given current infected/vaccinated status (US) to really appreciate the difference vaccination can make. The US is currently about 50% vaccinated. Total population is 328 million with about 41M covid infected (about 12% population). Total vaccinated overlaps by unknown amount but for simple math we'll say we need the other 40% (131M) to be infected with covid to obtain immunity in the US without further vaccinations. Current data remains about 20% hospitalized and around 1.6% fatality rate for covid infection - that means we would see another 26.2M hospitalizations and 2.6M deaths to get there. In comparison, current estimates for vaccinated are 29 times less likely to be hospitalized and 11 times less likely to die (would be easier if everything was reported in percentage similarly). SO if we get that 40% vaccinated we'd see about 760,500 hospitalizations and 260,000 deaths (for simple math I rounded to 30 and 10). Again, rough estimates based on available data and sure the actual numbers will be different - but gives the general idea. This current wave is already stretching US healthcare to the brink - imagine what that delta (25M!!) in hospitalizations is going to do.
The other issue is we can get folks vaccinated fairly quickly now and potentially reach that magic 95% threshold rapidly, it will take much longer for the virus to spread naturally. And as long as we are below that 95%, we will see pockets of disease that create waves of outbreaks and increase risk of further mutations. The only way covid with be "controlled" is when there are too few potential vectors to maintain extensive spread. Even then, I suspect this will be like the flu and we will likely see seasonal outbreaks - but that's just my opinion.
The only way to get to that level of immunity is via extensive vaccination - there really isn't another option (review the history on eradication of smallpox). But we have created so much mistrust that I don't see us getting there anytime soon. Stay safe out there
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Post by Tbone81 on Sept 11, 2021 9:35:19 GMT -6
yes, they try all the time. But in this particular scenario I don’t see how they’d have any ground. You could literally cut your own arm off for fun and if you have insurance they’ll pay for it according to what your coverage is. It’s not rare, far from it. Most of healthcare is taking care of diseases directly caused by poor lifestyle choices. They may not have legal ground (thanks, ACA!), but they'll find a way to offset the cost. At the minimum they'll just spread it out across all of their customers. Whatever the case, the insurance companies know the odds better than anyone and won't be denied their fortune : ) The system in Idaho, one of the least-vaccinated states in the country, is so overwhelmed that they've authorized the rationing of medical care. Yikes. It's completely illogical and totally driven by some combination of fear and a narrowly-framed idea of freedom. That's really what we want for ourselves? The fear of a vaccine with a minuscule risk is creating an environment with far greater risk. How is that logical? I agree with you on the insurance companies. It’s business as usually for them however, they’ll always make the customer pay for the risk of the group, that’s how it works and we all know that the whole insurance industry is filled with unethical practices. They’re not looking after anyone but their own pocket books. As for Idaho, it’s tragic. And no it doesn’t seem logical. People have the right to make bad decisions though. Where I differ from most is I’m personally willing to accept my own bad decisions and live with the consequences. I’m not a hypocrite and fully realize that freedom can create chaos. But that’s always the balance in society. And it’s a hard balance to get right. It’s always been a fight between chaos and order. Too much chaos and people suffer, too much order and people suffer. At the extremes you have anarchy vs totalitarianism. I think most us want neither. The trend that worries me the most is one of growing government control, a loss of free speech, and loss of personal autonomy. It’s really nothing new though. And I’ve lost my train of thought…had a greater point I can’t remember but I slept like shit and haven’t had my coffee  maybe I’ll come back to this later. |
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Post by dmo on Sept 11, 2021 9:55:39 GMT -6
They may not have legal ground (thanks, ACA!), but they'll find a way to offset the cost. At the minimum they'll just spread it out across all of their customers. Whatever the case, the insurance companies know the odds better than anyone and won't be denied their fortune : ) The system in Idaho, one of the least-vaccinated states in the country, is so overwhelmed that they've authorized the rationing of medical care. Yikes. It's completely illogical and totally driven by some combination of fear and a narrowly-framed idea of freedom. That's really what we want for ourselves? The fear of a vaccine with a minuscule risk is creating an environment with far greater risk. How is that logical? Is there a single person in the USA during all of covid that has gone without care? I keep hearing these kind of stories and I hate to be so jaded at this point but all I can think of are huge military ships and multiple multi-million dollar field hospitals that went completely unused. Josh The reason the hospital ships weren't used is because they have ZERO respiratory isolation - wrong tool for the job. The "capabilities" of the platforms is much less than what most people think, they were designed in the 50's to support small arms trauma warfare - 16 OR's, limited ICU and the wards have no oxygen or telemetry/monitoring capability. And 500 beds are overhead racks that you climb into or overhead lift field stretchers into. They are not staffed when in reduced operating status so you pull clinical staff from modern fixed facilities to man them - really not effective and they didn't take any covid positive patients. Activating them was a photo-op, nothing more (full disclosure - former XO/CO MERCY) The field hospitals again provide limited capability - they are fully dependant on portable O2 systems and can care for "milder" symptoms but again are less than ideal for critically ill patients. The staff for these when activated pull from either military hospitals or National Guard assets which means pulling staff from their civilian hospital "day job" - they can add local bed capacity but at the expense of pulling staff from somewhere else. Neither of these can actually increase total US bed capacity as the staff is always coming from somewhere else - it's a zero sum game.
Believe me - US healthcare is strained enormously right now. This is not hype - and there will be long term issues even when the pandemic is over. Stay safe out there
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Post by ehrenebbage on Sept 11, 2021 10:13:55 GMT -6
Well if you don’t understand my point so be it. I'll rephrase. I understand your point, but it seems to be based on an inaccurate record of how we've functioned as a society since immunizations were first developed. None of this is new. Some public officials and media figures would lead us to believe that this is an unprecedented step but they're flat out lying. That's a 'messaging' issue with truly dangerous consequences. |
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Post by seawell on Sept 11, 2021 10:31:03 GMT -6
Ehren, people have lost jobs before over vaccine status? I’m not following what you mean by none of this is new.
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Post by ehrenebbage on Sept 11, 2021 10:36:45 GMT -6
They may not have legal ground (thanks, ACA!), but they'll find a way to offset the cost. At the minimum they'll just spread it out across all of their customers. Whatever the case, the insurance companies know the odds better than anyone and won't be denied their fortune : ) The system in Idaho, one of the least-vaccinated states in the country, is so overwhelmed that they've authorized the rationing of medical care. Yikes. It's completely illogical and totally driven by some combination of fear and a narrowly-framed idea of freedom. That's really what we want for ourselves? The fear of a vaccine with a minuscule risk is creating an environment with far greater risk. How is that logical? People have the right to make bad decisions though. Where I differ from most is I’m personally willing to accept my own bad decisions and live with the consequences. I generally tend to agree when the consequences of decisions are mostly limited to the person making them, but where do we draw the line when an individual's bad decisions affect lots of people and impact their life, liberty, and pursuit of happiness? I guess that's the point of debate. Individuals have the right to smoke. Society has the right to create non-smoking spaces. |
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Post by Tbone81 on Sept 11, 2021 10:55:03 GMT -6
Well if you don’t understand my point so be it. I'll rephrase. I understand your point, but it seems to be based on an inaccurate record of how we've functioned as a society since immunizations were first developed. None of this is new. Some public officials and media figures would lead us to believe that this is an unprecedented step but they're flat out lying. That's a 'messaging' issue with truly dangerous consequences. The scope isn’t the same. In certain spheres vaccines have been required for a long time now but what’s happening now is that the vax is required for just about everything, or at least that’s where it’s headed. For hospital workers we’ve already been required to 1) have certain vaccines OR 2) show a titer that we’ve already had XYZ infection and are immune OR 3) sign a declination OR 4) get a medical or religious exemption These mandates aren’t being rolled out in that manner. And they are more widespread. It’s about far more than just healthcare workers, or kids going to k-12 school and the exemptions are few and in many cases non existent. Some companies are granting religious exemptions, for example, but then not allowing those people to work. They’re not technically “fired” just not allowed to earn money, or collect unemployment. And just wait till they require vaccines for air travel. Most countries already have some type of Covid vax requirement for entering the country. When was the last time you couldn’t cross the border (in a western country) without a polio vax or TB shot? When was the last time you couldn’t enter a music venue or restaurant without showing proof of MMR vax? This is just the start of the mandates not the end of them. That’s the problem. We haven’t struck a balance between personal liberty and public health. We’re not even trying to really. Much like everything else this issue is being dissected into its extremes. On one side people are being irresponsible and claiming their freedom to buck even common sense, minimally intrusive interventions. And on the other side there’s an authoritarian, top down approach that ignores natural immunity and disregards personal freedom. Those two sides don’t represent most people, in my estimation. And both those sides are making things worse |
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Post by ehrenebbage on Sept 11, 2021 10:55:23 GMT -6
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Post by Tbone81 on Sept 11, 2021 10:58:05 GMT -6
People have the right to make bad decisions though. Where I differ from most is I’m personally willing to accept my own bad decisions and live with the consequences. I generally tend to agree when the consequences of decisions are mostly limited to the person making them, but where do we draw the line when an individual's bad decisions affect lots of people and impact their life, liberty, and pursuit of happiness? I guess that's the point of debate. Individuals have the right to smoke. Society has the right to create non-smoking spaces. Agreed, it’s difficult and nuanced and the devil is in the details. And as easy as it is for me to point out the wrong way of doing it, it’s very hard for me to point out the right way to do it. And you’re right, the debate needs to happen. There’s just a tragic shortage of good faith people making good faith arguments. |
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Post by ehrenebbage on Sept 11, 2021 11:06:32 GMT -6
I'll rephrase. I understand your point, but it seems to be based on an inaccurate record of how we've functioned as a society since immunizations were first developed. None of this is new. Some public officials and media figures would lead us to believe that this is an unprecedented step but they're flat out lying. That's a 'messaging' issue with truly dangerous consequences. The scope isn’t the same. When was the last time you couldn’t cross the border (in a western country) without a polio vax or TB shot? When was the last time you couldn’t enter a music venue or restaurant without showing proof of MMR vax? When was the last time we were in a global pandemic? Why would we require proof of polio, tb, or mmr shots in a restaurant when A) we're not in a pandemic, and B) almost every American citizen has been required to be immunized at some point already? Here's a list of immunizations required for travel to/from certain places in the world. Again, none of this is new. www.who.int/ith/2016-ith-county-list.pdf |
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Post by seawell on Sept 11, 2021 11:13:52 GMT -6
I'm aware of all that, I thought you had found precedent in history for something similar to what we're dealing with now. Those are not 1:1 examples. |
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Post by ehrenebbage on Sept 11, 2021 11:18:18 GMT -6
I generally tend to agree when the consequences of decisions are mostly limited to the person making them, but where do we draw the line when an individual's bad decisions affect lots of people and impact their life, liberty, and pursuit of happiness? I guess that's the point of debate. Individuals have the right to smoke. Society has the right to create non-smoking spaces. Agreed, it’s difficult and nuanced and the devil is in the details. And as easy as it is for me to point out the wrong way of doing it, it’s very hard for me to point out the right way to do it. And you’re right, the debate needs to happen. There’s just a tragic shortage of good faith people making good faith arguments. I agree 100% that most of what we hear are knee jerk reactions on both sides. Media is incentivized to be dramatic. Social media is intentionally designed to encourage emotional and often negative communication. It's bad. Your point about the right way/wrong way is a good one. I'm sure that you've had experiences with patients where you have to make quick decisions to save a life and there isn't a lot of time to figure out the most ideal, error free, all-sides-considered path. You just have to identify the most urgent need and act on it. Imagine someone standing at the side criticizing every little move, getting in the way, and/or flat out denying that the patient is dying on the table. If we're going to be mad at someone... I think that we are there as a society. The safest and most effective course of action is undeniably clear. Some folks are being forceful in how they communicate that message which may be working against them, but that doesn't mean they're wrong. |
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Post by ehrenebbage on Sept 11, 2021 11:22:30 GMT -6
I'm aware of all that, I thought you had found precedent in history for something similar to what we're dealing with now. Those are not 1:1 examples. I'm not sure there is a perfect 1:1 example. When in the course of history has the world faced the rapid spread of a deadly disease and flat out refused the opportunity for free, safe and effective treatment? |
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Post by ehrenebbage on Sept 11, 2021 11:27:13 GMT -6
I'm aware of all that, I thought you had found precedent in history for something similar to what we're dealing with now. Those are not 1:1 examples. I'm not sure there is a perfect 1:1 example. When in the course of history has the world faced the rapid spread of a deadly disease and flat out refused the opportunity for free, safe and effective treatment? Well, here's a story about how the government dealt with people refusing the smallpox vaccine...they raided their homes and held them down, sometimes at gunpoint : ) www.npr.org/2011/04/05/135121451/how-the-pox-epidemic-changed-vaccination-rules |
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Post by Tbone81 on Sept 11, 2021 11:28:03 GMT -6
The scope isn’t the same. When was the last time you couldn’t cross the border (in a western country) without a polio vax or TB shot? When was the last time you couldn’t enter a music venue or restaurant without showing proof of MMR vax? When was the last time we were in a global pandemic? Why would we require proof of polio, tb, or mmr shots in a restaurant when A) we're not in a pandemic, and B) almost every American citizen has been required to be immunized at some point already? Here's a list of immunizations required for travel to/from certain places in the world. Again, none of this is new. www.who.int/ith/2016-ith-county-list.pdfThe scope of this is indeed new. You say as much by asking “when was the last time we were in a global pandemic”. The scale at which things happen matters. You’re free to disagree, clearly you do. When was the last time a titer wasn’t acceptable as proof of immunity?when was the last time your entire lively hood could be stripped away from you for not getting vaccinated against a disease you already have immunity to? You may see these things as reasonable, and as “nothing new”. I don’t. Regarding that WHO list, I just breezed through it but can you point me to the page where it says you can’t travel to a western country without a MMR, TB vax or etc? Because I’ve traveled to Europe in the past and I never had to show vax status to anyone. And to keep things in context, that list was specific to Yellow Fever and Malaria which are regional diseases. So it’s similar but not the same. |
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Post by seawell on Sept 11, 2021 11:33:03 GMT -6
Even for smallpox, previous infection/natural immunity was accepted…that’s the key difference you’re missing here in my opinion. If they would include natural immunity in the current mandates, 90% of this storm would go away.
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maybe I’ll come back to this later.