Over 3,500 people quarantined on Diamond Princess cruise

[AquaDame]

This all is fair and true, but I certainly know people who’ve had to do online fundraisers for basic healthcare bills ($20,000 for childbirth, in one case). It’s that or lose your house. And I know someone whose toddler was killed in a car accident, the at fault driver was held liable and the family got a pain and suffering aware...which the insurance then sued them for. So they ended up still with the hospital bill for the dead child.
many people have insurance - more now with the exchanges - but the system has some major cracks. And people are absolutely afraid to seek treatment. Hospitals and the govt will need to come out clearly and vocally and say people won’t be bankrupted by this, or we will have people trying to treat at home.

This is my understanding as well.

Basically, if you have nothing, yes you will get care, and will not have to pay. The hospital will ultimately eat it and they will not turn you away from the ER. That means that you will not get care until it is SO BAD that you end up in the ER. Some things could have been prevented or taken care of when they were more minor, but because they do not have coverage that is the only way to get help. Or you can try your luck by camping out overnight if these guys or someone similar is in town: https://www.newsweek.com/remote-are...ricas-uninsured-go-through-health-care-287507

But if you DO have something, your life as you know it may be over as they will bill you, you will have to go to court if you do not pay, and that will affect your credit score etc etc. If you don't have a house to lose, and can afford the payment, then it's not as big a deal. It just sucks and you were "unlucky" for your body doing what bodies do. Most people have some kind of insurance, but what does it cover and how much? I know people who will be paying for medical bills the rest of their lives for relatively normal things like complications from diabetes, cancer, and a brain aneurism. Heck, I paid 2K out of pocket last week for orthodontics. My insurance only covers a lifetime maximum of $2,500 and its considered "good" insurance.

Our gov may step in and offer more assistance for this particular disease, but if they don't, a lot of people are going to be stuck choosing between the frying pan and the fire.

 

[QueenElinor]

Apparently an Italian cruises ship in the carribeans has just been pushed back.

https://www.foxnews.com/travel/cruise-ship-msc-meraviglia-coronavirus-concerns

It's the Meraviglia, which came from Miami. Apparently, two crew are ill, but at least one test + for Influenza A. However, this doesn't mean he can't have BOTH Influenza and SARS2-CoV- co-infection apparently is common (probably one makes a person more susceptible to the other).

If this is a ship that will return to Miami, the CDC needs to get on this right away. It's one thing if it's like the Westerdam, it's another thing entirely if it's like the DP.

This is why I would think twice about a big-ship cruise. IF anyone on board falls ill, even if it's not with COVID19, then port authorities will panic. As they are doing now.

 

[Dreams&wishes]

https://www.foxnews.com/travel/cruise-ship-msc-meraviglia-coronavirus-concerns

It's the Meraviglia, which came from Miami. Apparently, two crew are ill, but at least one test + for Influenza A. However, this doesn't mean he can't have BOTH Influenza and SARS2-CoV- co-infection seems common (probably one makes a person more susceptible to the other).

If this is a ship that will return to Miami, the CDC needs to get on this right away. It's one thing if it's like thee Westerdam, it's another thing entirely if it's like the DP

Wow I'm already having a super hard time trying to convince my husband to go on a cruise in May, but now this will put him off completely,

 

[QueenElinor]

Wow I'm already having a super hard time trying to convince my husband to go on a cruise in May, but now this will put him off completely,

My spouse and I are in agreement that the only ship we'd ever sail on is one small enough to jump off of if we had to.

The thing about this ship is the crew is from the Phillipines. There has been a lot of chatter online that COVID19 is more rampant there than the government is willing to acknowledge, so there is some cause for concern.

 

[smmco]

This is my understanding as well.

Basically, if you have nothing, yes you will get care, and will not have to pay. The hospital will ultimately eat it and they will not turn you away from the ER. That means that you will not get care until it is SO BAD that you end up in the ER. Some things could have been prevented or taken care of when they were more minor, but because they do not have coverage that is the only way to get help. Or you can try your luck by camping out overnight if these guys or someone similar is in town: https://www.newsweek.com/remote-are...ricas-uninsured-go-through-health-care-287507

But if you DO have something, your life as you know it may be over as they will bill you, you will have to go to court if you do not pay, and that will affect your credit score etc etc. If you don't have a house to lose, and can afford the payment, then it's not as big a deal. It just sucks and you were "unlucky" for your body doing what bodies do. Most people have some kind of insurance, but what does it cover and how much? I know people who will be paying for medical bills the rest of their lives for relatively normal things like complications from diabetes, cancer, and a brain aneurism. Heck, I paid 2K out of pocket last week for orthodontics. My insurance only covers a lifetime maximum of $2,500 and its considered "good" insurance.

Our gov may step in and offer more assistance for this particular disease, but if they don't, a lot of people are going to be stuck choosing between the frying pan and the fire.

The problems are endless, but a majority of our patients are non-compliant frequent fliers. They are drain on the whole system. We treat them. They leave go home eat, drink, smoke whatever they want and are back again a month later rinse and repeat. If you have COPD you shouldn’t smoke but they do. CHF, diabetes, Kidney disease you have to be on a strict diet and fluid restriction but they won’t adhere to it.
If you are on dialysis you need to go to you dialysis appointments, but they won’t. They’ll miss appoints and end up in the hospital for days. I could go on and on. Meth users, opiate overdoses etc etc.

These are the people that fill up our hospital beds and they are one of the big reasons your premiums are so high and they pay nothing.

 

[QueenElinor]

The problems are endless, but a majority of our patients are non-compliant frequent fliers. They are drain on the whole system. We treat them. They leave go home eat, drink, smoke whatever they want and are back again a month later rinse and repeat. If you have COPD you shouldn’t smoke but they do. CHF, diabetes, Kidney disease you have to be on a strict diet and fluid restriction but they won’t adhere to it.
If you are on dialysis you need to go to you dialysis appointments, but they won’t. They’ll miss appoints and end up in the hospital for days. I could go on and on. Meth users, opiate overdoses etc etc.

These are the people that fill up our hospital beds and they are one of the big reasons your premiums are so high and they pay nothing.

We had one guy with alcoholic liver disease regularly use up all the blood in our small city when his esophageal varices would bleed. But he wouldn't quit drinking. The case ended up before the Medical Ethics Committee who said, to no one's surprise, we had just better stock up on more blood.

 

[smmco]

We had one guy with alcoholic liver disease regularly use up all the blood in our small city when his esophageal varices would bleed. But he wouldn't quit drinking. The case ended up before the Medical Ethics Committee who said, to no one's surprise, we had just better stock up on more blood.

Unless you work in healthcare you can’t wrap your brain around it. I’ve been in it 20 years worked at multiple hospitals and it’s the same everywhere. Medicare doesn’t reimburse for readmissions within a certain time. I can’t remember if it’s 30 or 90 days. I see the same patients over and over again.
These chronically ill people that don’t take care of themselves are the one that will be the most effected by the virus.

 

[QueenElinor]

Unless you work in healthcare you can’t wrap your brain around it. I’ve been in it 20 years worked at multiple hospitals and it’s the same everywhere. Medicare doesn’t reimburse for readmissions within a certain time. I can’t remember if it’s 30 or 90 days. I see the same patients over and over again.
These chronically ill people that don’t take care of themselves are the one that will be the most effected by the virus.

Yes, that's true, and we will pull out all the stops for them when the time comes. In the US we do not ever ration care, the sky's the limit all the time for everyone.

Which, from an ethical standpoint, is okay for a rich country (how much of our GDP we should actually spend on health care is way above my pay grade), but now we're up against actual limited resources (staff and equipment), which in general has never happened to us before. It will be a shock to say "No, we can't do that."

 

[Dreams&wishes]

Well, we now have thw president of the Lombardy Region in quarantine, together with all the other members of the council as a close colleague has been diagnosed with the virus!Seriously shocking news for us.

 

[StarSeven7]

This is my understanding as well.

Basically, if you have nothing, yes you will get care, and will not have to pay. The hospital will ultimately eat it and they will not turn you away from the ER. That means that you will not get care until it is SO BAD that you end up in the ER. Some things could have been prevented or taken care of when they were more minor, but because they do not have coverage that is the only way to get help. Or you can try your luck by camping out overnight if these guys or someone similar is in town: https://www.newsweek.com/remote-are...ricas-uninsured-go-through-health-care-287507

But if you DO have something, your life as you know it may be over as they will bill you, you will have to go to court if you do not pay, and that will affect your credit score etc etc. If you don't have a house to lose, and can afford the payment, then it's not as big a deal. It just sucks and you were "unlucky" for your body doing what bodies do. Most people have some kind of insurance, but what does it cover and how much? I know people who will be paying for medical bills the rest of their lives for relatively normal things like complications from diabetes, cancer, and a brain aneurism. Heck, I paid 2K out of pocket last week for orthodontics. My insurance only covers a lifetime maximum of $2,500 and its considered "good" insurance.

Our gov may step in and offer more assistance for this particular disease, but if they don't, a lot of people are going to be stuck choosing between the frying pan and the fire.

I totally agree with this! I don't want to dive too deep into healthcare in the US, but as an American citizen who has been living in Canada for the past 14 years, it's been pretty eye-opening for me. All of my family is in the US still and they all have insurance but the amount they have to pay still out of pocket is insane. One of my sisters has a son with Type 1 diabetes and they've really struggled financially since he was diagnosed. Another one of my sisters has a son with many health complications - Hirschsprung's disease, he had a heart condition at birth, and he has Down Syndrome so their medical bills have gone over $1 million for many years (the total bill, not their portion). The fact that they absolutely needed to have medical insurance for him at all times made it difficult for my BIL to switch jobs and they were just finally able to save up enough money to purchase a house. Both of my sisters rarely can afford a vacation partly because all their medical bills are so high. It's pretty sad.

 

[QueenElinor]

I totally agree with this! I don't want to dive too deep into healthcare in the US, but as an American citizen who has been living in Canada for the past 14 years, it's been pretty eye-opening for me. All of my family is in the US still and they all have insurance but the amount they have to pay still out of pocket is insane. One of my sisters has a son with Type 1 diabetes and they've really struggled financially since he was diagnosed. Another one of my sisters has a son with many health complications - Hirschsprung's disease, he had a heart condition at birth, and he has Down Syndrome so their medical bills have gone over $1 million for many years (the total bill, not their portion). The fact that they absolutely needed to have medical insurance for him at all times made it difficult for my BIL to switch jobs and they were just finally able to save up enough money to purchase a house. Both of my sisters rarely can afford a vacation partly because all their medical bills are so high. It's pretty sad.

Health care in the US is undeniably expensive. But when Danny Williams, the Premier of Newfoundland had a heart attack, he came to the US for surgery, he did not stay in Canada. I have colleagues who have package deals set up with local hotels to do quick turnaround knee replacements for Canadians (who pay out of pocket) because we're close to the border and they can't get their knees done.

Each country has problems with their healthcare system- I know, I spent 10 days in London learning about the NHS, brainstorming problems with them, and met with health care people from all over the world. All countries struggle to pay for it one way or the other- with taxes, or out of patient's or their employer's pockets, or with rationing. Part of it is that we're blessed with technology and treatment that we never had before. I personally am alive and kicking due to dreadfully expensive drugs most non-US countries health plans would never pay for.

Bottom line is every country has problems, it all costs a horrific amount, and the solutions differ from place to place, depending on their populations. There is no way an American would ever put up with the NHS, heck we won't even share a room. Canadians are shocked at what health cares costs here, but we can give our patients practically any technology available on the face of the planet. And so it goes. If there is a perfect system, I've yet to see it.

 

[StarSeven7]

Health care in the US is undeniably expensive. But when Danny Williams, the Premier of Newfoundland had a heart attack, he came to the US for surgery, he did not stay in Canada. I have colleagues who have package deals set up with local hotels to do quick turnaround knee replacements for Canadians (who pay out of pocket) because we're close to the border and they can't get their knees done.

Each country has problems with their healthcare system- I know, I spent 10 days in London learning about the NHS, brainstorming problems with them, and met with health care people from all over the world. All countries struggle to pay for it one way or the other- with taxes, or out of patient's pockets, or with rationing. Part of it is that we're blessed with technology and treatment that we never had before. I personally am alive and kicking due to dreadfully expensive drugs most non-US countries health plans would never pay for.

Bottom line is every country has problems, it all costs a horrific amount, and the solutions differ from place to place, depending on their populations. There is no way an American would ever put up with the NHS, heck we won't even share a room. Canadians are shocked at what health cares costs here, but we can give our patients practically any technology available on the face of the planet. And so it goes. If there is a perfect system, I've yet to see it.

I agree, there's no perfect solution. What works in Canada wouldn't necessarily work the same in the US because the population is so much larger. I will say though that I have been very impressed with healthcare in Canada. My daughter had to have major surgery when she was a baby and not only was the care she received excellent, but I also never even saw a bill for it. Heck, I just had a laser procedure done on my eye last month and I only went in for a consult but the doctor told me he could fix it right then and I didn't have to pay anything because it would be covered by OHIP since it was medically necessary. Um, ok! I do hear a lot of stories about people going to the US to get procedures/surgeries done quicker (it's not that they can't be done in Canada, they just might not be done immediately) but I live in a border city and have never met anyone who has gone to the US for medical treatment!

 

[tidefan]

I worked for many years doing data analysis on Medicare. In fact, in the US, the government already pays close to 1/2 of the medical payments already (through Medicare, Medicaid, etc.). I have always thought that people were focusing on the wrong side of the equation, the payment side. No one ever seems to want to focus on how much healthcare services actually cost...

I do have a funny story related to the last few posters. We had friends from the UK and would talk/skype with them a lot. I mentioned one morning that I had noticed a mole that I thought might be changing and said I need to go see my dermatologist. This was morning-time here and I called into the dermatologist and got an appointment at 1pm that afternoon. Our friends were in shock! ... This is just an example of what I think one of the biggest issues in the US will be is that the vast majority of people have gotten used to "real-time" medical care. Well, that comes at a cost...

 

[QueenElinor]

Oh, this is not good. First case of possible community transmission in the US in Solano County, CA. This is the county where Travis AFB is, and there are/were quarantined people from the DP and Wuhan on the base:

https://boingboing.net/2020/02/26/coronavirus-first-possible-pe.html

 

[o&smom]

Wow, crazy

Oh, this is not good. First case of possible community transmission in the US in Solano County, CA. This is the county where Travis AFB is, and there are/were quarantined people from the DP and Wuhan on the base:

https://boingboing.net/2020/02/26/coronavirus-first-possible-pe.html

Wow, crazy! I wonder where that came from?

 

[smmco]

I remember doing a tour in Jamaica. Outside the local hospital, there was a sign that said: "You are responsible for your health" I thought Geez what a concept why don't we teach accountability in the US! If people took better care of themselves we could really cut down on health care costs. We're so hung up on fat-shaming that it's become OK to be overweight. I know a lot of things are genetic, but living an unhealthy lifestyle doesn't help matters.

 

[DLgal]

Oh, this is not good. First case of possible community transmission in the US in Solano County, CA. This is the county where Travis AFB is, and there are/were quarantined people from the DP and Wuhan on the base:

https://boingboing.net/2020/02/26/coronavirus-first-possible-pe.html

The person has been sick since the 19th. When did the cruise passengers even arrive?

In any event, they make it clear that there is no known contact with anyone who had the virus or traveled overseas.

Also not a good sign that the first potential community acquired case arrived to UC Davis medical center already intubated and on a ventilator. Scary.

 

[QueenElinor]

The person has been sick since the 19th. When did the cruise passengers even arrive?

In any event, they make it clear that there is no known contact with anyone who had the virus or traveled overseas.

Also not a good sign that the first potential community acquired case arrived to UC Davis medical center already intubated and on a ventilator. Scary.

I believe the cruise passengers arrived on the 16th. but there were hundreds of evacuees from Wuhan there much earlier. I know three Wuhan evacuees tested positive; I don't know if there was one at Travis. One was at Lackland in TX, one in San Diego, at Miramar. It's possible there was an undiagnosed case among them, too.

But if there is a chain of transmission between the AFB and this person, they are right in that this isn't strictly anyone who had contact with a person known have the virus or traveled overseas. There's an intermediary, and that's also very scary. The fact that the person is already quite sick means the virus has not been contained for a while- 10 days at a minimum.

But something tipped off the local doctor. I wonder what it was.

Regardless, I bet they are testing everyone at the AFB as we speak.

It's possible that it's just coincidence, but they're going to have to prove that, and I don't know that they can. Occam's Razor and all that.

 

[Karin1984]

I just read an article about a Dutch couple who were on the Dream Princess (inside cabin). When they got back to Amsterdam, they were brought to our CDC, they got coffee, were asked questions, got checked. No one was wearing gloves or protective clothing, and then they could go home.

BUT...
They just live just across the border in Germany, and they were told the German CDC were informed. The following day, 3 man in protective outfits head to toe were coming by and they have to be quarantined again. This time at home, and they can go into their garden, but the neighbours have to do their shopping. Daily they get calls with questions how they feel from the German CDC. The man said he is feeling terrible, not because of being sick, but the amount of stress being imprisoned brings with it. He has trouble sleeping and nightmares.

 

[Dreams&wishes]

I just want to be a bit more clear about the health system in European countries and Australia given my experience living there. There is a public system, but there is ALSO a private system, so if I want to do something "elective" or see a specialist for no urgent matters, that indeed could take few months in the public system, I can always opt to do it privately and if you have an insurance be covered by it and if you don't you just pay out of pocket. BUT if you do have something serious/urgent maybe stroke, heart issues, cancer or whatever then you get immediate care and don't have to pay anything. So you always have the choice and every member of the community would receive cover. You can even be a private patient in a public hospital, which to me it's the best of both worlds, as pubblic hospitals are generally better equipped in case of emergency. In saying this, although they are all great health systems, for my experience the best system I found among Australia, UK and Italy, it's undoubtedly the Italian one. In Australia a big problem is the fact that due to population issues they don't actually have enough specialised doctors, really niche speciality doctors might not even be present in the whole country. To this I add that imaging services, if not urgently done in hospital have to be paid and the rebate of these from the government is very low and private health insurances don't cover it either. This is also true for specialist visits, unless it's through the hospital the out of pocket expense can be quite high. You find yourself not being really covered by the government and having to pay for private health insurance, but not being really covered by that either. The UK it's the OPPOSITE, everything is" free" sometimes even medicines. The problem with this though, is that because running a system like this it's very expensive there are shortcuts and prioritisations that have to be made that are not always in the best interest of the patients. Italy instead, and in this case I'm speaking specifically about LOMBARDY, as in Italy the health system is regional. Has a system where for diagnostics and specialist visits you just give a small contribution based on your income something like €16/€30. This is also the case for ER unless you are a red or orange case. This way it's not a burden for the citizen and it helps the government expenditure. I have attached a copy of WHO best world heath systems for you to give a look if aren't already familiar with it.