riceart

Insurance exists to cover losses from unexpected events. Medical complications are unexpected events.

Your hungover surgeon is a bullshit strawman - most complications have nothing to do with provider malice or incompetence. Again since that seems to be the angle you are starting with you clearly have no interest in a grown up discussion or too ignorant and also full of hubris to understand any of this (which fits in perfectly well on this site).

If you throw a massive clot after a surgery and stroke out who’s fault was that if all the standard protocols for clot prevention were followed. Maybe you’re a smoker (or not) and 5 years later that unknown cancer will finally declare itself.

> more or less exists for each procedure

This is extremely misleading as it does not exist in any meaningful level of risk across the entire patient population.

> Like I shouldn't be billed extra if my surgeon is hungover and things don't go smoothly.

That’s what you think is the common root cause of complications?

You clearly are not interested in a productive discussion.

As for a fee for unpredictable occurrences - that’s what insurance is.

> The service seems to be by a company called Epic (www.epic.com), based in Wisconsin.

Lol, that mom and pop shop.

That’s the largest EMR vendor in North America and second in the world.

They’re the provider of the patient portal frontend amongst other things but there’s a lot more behind the scenes that must be done (with varying levels of quality) that is institution specific. Just using Epic does not make this work.

Without cryptographic techniques that is all easily forged.

Have you ever had to enter codes as a provider in Epic for instance? The UX is fucking terrible. Incentives are completely misaligned for accurate coding in academic institutions. Finally the ontology of ICD codes are trash on their face.

Right from the about page:

> Our clinical vignettes serve multiple purposes. They provide a distinctive, engaging learning tool for medical students and healthcare professionals looking to familiarize themselves with the ICD-10-CM system.

> X-rays confirmed a sprain in Gus's wrist

Eh, ok.

Yet more of the laziest cynical AI generated garbage. AI winter can’t come soon enough.

Seriously I see nothing here of interest to a healthcare professional.

> The ICD-10-CM coding system is a remarkable catalogue of every imaginable medical condition, injury, disease, and even the seemingly improbable events that can befall a human being.

The thing with ICD is while it has an odd array of oddly specific and absurd codes it misses sufficient detail for some very basic common diagnoses.

> I'm confused why you don't believe me that internet penetration in the salt lake valley was very limited in 1994

I do believe you. Really have no dispute with any details you’re putting down.

I suppose the distinction I’m making is about the cohort of early adopters that had special (usually U access) from those using commercial ISPs or BBSes. That earliest cohort no matter how small it was a good bit earlier than 1994 and eternal September. I’ll grant my wording inadvertently exaggerating the penetration of availability in 1994, just saying the first households were probably getting dialup some years prior.

For me an EE prof managed get me a shell account in 1990 while in middle school. Even in rust belt US many friends just used AOL into 1994 and uptake of dialup ISPs was still slow, but that 1994 cohort was distinct.

Ok not “way” after - really splitting hairs here. Point still stands public commercial dialup internet was available pretty much everywhere. Call them early adopters or whatever - but the internet already had established communities well before 1994.

> 50,000 people in a metro area of a few million.

We’ll just have to agree to disagree on the interpretation of what “first families”. In the context I read that post it sounded like someone saying they were among literally the first few, not 50k to 100k when anyone with a credit card could order service. First families in my interpretation would be those that probably had access from their parent’s university shell account. This follows with the claim 15 minutes to load a single webpage - but unless you were on a shitty rural phone line running 2400bps it’s not like everyone’s dialup internet access at the time was that limited. Some had to put up with that but the tech in 1994 was not that primitive.

> The internet was still the land of the nerds until the early 2000's

The first dot com boom, sort of the genesis of fortunes that make this site exist was prior to the early 2000s.

The early 2000s was the bust period.

> This is not correct for access open to the general public. The first commercial ISP in Utah, Xmission, was founded in 1993. Yes, many of us had internet access through the University of Utah before that (Pete Ashdown, the founder, had worked at Evans & Sutherland, which had quite good internet connectivity).

> The commercial Internet really only started taking off in 1993.

1993 is before 1994.

I am very much scratching my head by how this contradicts anything I stated in a way that makes it not correct.

If a commercial ISP existed in 1993, then by 1994 plenty of regular people would have been getting internet access - without any special affiliation other than a credit card - ie mainstream. (Per your own comment “many had internet access before that”) - those affiliated were among the first to have internet access is a pretty reasonable interpretation and that was well before 1994 in all of the continental US.