
23andMe Anne Wojcicki Berates Stanford and Valley Med on Behalf of Sick Friend - hhhust
https://www.mercurynews.com/2018/04/05/dying-friend-of-anne-wojcicki-gets-help-from-stanford-after-the-23andme-founder-shamed-the-medical-center/
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darawk
Um, you're a millionaire. Why don't you put up the money? _Someone_ is paying
for it. This is literally an ultra-wealthy person complaining that someone
else won't pay for her friend's million dollar medical treatment.

It's fine if you want to argue for single payer healthcare. But where do you
get off berating a non-charitable institution about covering their costs? They
have their longevity to think about. If they simply gave everyone infinite
treatment for free they wouldn't exist anymore.

~~~
bsder
You are defending the position that we should let someone die because they
don't have enough money to pay for medical treatment.

Are you really sure you want to go there?

Now, if you want to argue I would argue that why is this CEO letting a
"friend" go without healthcare when CoveredCA has platinum plans at about
$7000/year for an individual?

~~~
darawk
> You are defending the position that we should let someone die because they
> don't have enough money to pay for medical treatment.

> Are you really sure you want to go there?

Yes, I absolutely am. Grown-ups in the adult world have to make choices. We
have limited resources and time, and yes, sometimes that means that we can't
give life saving treatments to every person that needs it.

~~~
grk
This sounds extremely weird when you read it in Europe.

~~~
icebraining
We in Europe have the same choices to face. For example,

 _" In June, Nice said the £48,000 per year price tag of the drug, which could
benefit 450 women a year, could not be justified."_

[https://www.telegraph.co.uk/news/health/11785840/NICE-
refuse...](https://www.telegraph.co.uk/news/health/11785840/NICE-refuses-to-
fund-ovarian-cancer-drug.html)

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cncrnd
The larger point of this article is about the need to advocate for your own
medical care. It really hit me hard, due to my own and family experiences with
hospitals and doctors who simply didn't care or recognize the effect of their
everyday behaviors on the lives of others.

The example given in the article is Valley Med requiring 5-10 days to serve
patient medical records. These 5-10 days can be the the difference between
LIFE and DEATH when it comes to medical care. There exists an inefficiency,
which can lead to wrongful death, and there is a clear path to remove the
inefficiency. Why is nothing done and why does society accept it, despite
paying ridiculous amounts for healthcare?

The fact is that doctors are perfectly adept at handling 95% of cases which
they see often, but outside of that they seem to lack the drive to 'connect
the dots.'

When I go to the doctor, I do my research before I step foot into the office
and I tell them what I am thinking. Sometimes I am wrong and cede to the
doctor's explanation, other times it results in different tests
taken/treatment paths.

~~~
sjg007
There's one problem with this.. for emergent care, the records can be faxed
over immediately. At least PAMF does that. They can also get the doctor on the
phone. Always remember your doctor's name. It's on the discharge sheet.

~~~
cncrnd
Requests for medical records should not take 5-10 business days period. When
someone requests medical records it is for some purpose related to health. A
hospital taking 5-10 business days to make medical records available can only
hurt patients.

~~~
sjg007
I agree. Nothing I said disagrees with that. His care was emergent. and I also
agree that medical records should be ready the same day.

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lopmotr
Perhaps the problem is more that there exists expensive treatments. As long as
they exist, people will be upset at not getting them. When they don't exist,
people won't blame anyone for their death. Imagine if some miracle cancer cure
is discovered but it genuinely costs a million dollars (not just due to
patents). There'll be no option but to let uninsured poor people die. There
might not be enough money in the country to actually save them all.

~~~
eigenvector
Considering that the USA spent $1.9 trillion on the Iraq war, something that
was quite literally not needed by anyone, I wouldn't be so sure that money
couldn't be found to provide lifesaving treatment and research technological
advancements to bring its cost down in the long term.

~~~
CobrastanJorji
In this scenario, that $2 trillion would prevent about a quarter of the deaths
from cancer in one year, except that spending was over a decade, so assuming
that we could spend at that same rate perpetually, replacing Iraq War spending
with million dollar cancer cures would prevent about 2% of cancer deaths.

~~~
ShorsHammer
Do you have a source for that $2 trillion/ quarter of all deaths figure? I
understand healthcare in the US costs far more than in the rest of the
developed world, but those calculations seem quite wrong.

[http://ascopubs.org/doi/abs/10.1200/JCO.2016.34.15_suppl.661...](http://ascopubs.org/doi/abs/10.1200/JCO.2016.34.15_suppl.6618)

> In the EU in 2012 the estimated cancer incidence was 2.6 million cases. The
> estimated cancer mortality was 1.3 million deaths, accounting for 26% of all
> deaths. DHCC (direct health cost of cancer) in the whole EU increased from
> €79 to €86 billion during 2005-2014 (in 2014 prices)

The population of the EU is over 500 million people. The annual taxation
needed to afford this level of care ranges from 50-270 euros per person across
the region.

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saagarjha
It's nice that she was able to help out, but think about how many people
aren't in a situation where they can call up the CEO of 23andMe to help.

~~~
clay_the_ripper
I think this situation shows how ludicrous our current situation is. You
shouldn’t need to know the CEO of a billion dollar company to get healthcare.

And good for her fiend, when your life is on the line no one shoood feel bad
about using every option available to them.

~~~
pebers
You obviously don't need to know the CEO just "to get healthcare" \- her
friend was already being treated. It only seems to be necessary as a means of
getting access to expensive private treatments that were otherwise
unaffordable.

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jonhendry18
"Such assertiveness came in handy when Wojcicki was visiting her grandmother
in a Palm Springs care home several years ago and couldn’t find a doctor in
the building."

The nursing homes I'm familiar with have nurses and a doctor who comes in one
day a week, and takes calls from staff. If anything significant comes up the
resident is taken to the ER.

A care home with a doctor on staff full time (let alone 24 hours) would likely
be significantly more expensive.

I suspect Wojcicki's grandmother couldn't afford that. And it's probably
overkill.

~~~
sjg007
It's standard of care to send a patient to the ER from the nursing home... We
may not "know" this but it's also fine to call 911 and get an ambulance
especially if the staff on hand is not cooperative. Some nursing homes have a
clinic attached to them for daily and urgent care but even if you had a
hospital next door they would still have to be wheeled or taken by ambulance.
So this specific part of the article is overly sensational.

~~~
jonhendry18
If the issue was really urgent enough for an ambulance, then "a doctor"
probably wasn't what was needed. The doctor would just call for an ambulance -
they probably wouldn't have much in the way of emergency treatment equipment
on hand anyway.

If the issue wasn't urgent enough for an ambulance, and she just wanted to
escalate the issue because she didn't trust the nurses or wasn't happy with
the quality of service she felt she was getting, then it would be
irresponsible to call 911. 911 is not for the use of impatient rich people.

She could have just called her grandmother's doctor.

~~~
sjg007
You basically rehashed everything I just said without offering anything new or
substantially different.

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writimov
Glad Anne Wojcicki, CoveredCA and Legal Aid were able to step in and help.
There are some specific problems highlighted in the article that could be
fixed by software startups:

1) Problem: Difficulty to identify a Doctor for a second opinion. a) Possible
solution: software that allows you to input the medical term (or possibly the
medicare code for a disease or combos of diseases?) and find all the second
opinion doctors located near you. The software needs things like sort by
reputation or reviews, price estimates, speed to get second opinion, time
window (with a button to click for life-threatening emergency). Also, why be
local? Through telemedicine you could video chat with your second opinion
after digitally transferring records.

2) Problem: Too long to transfer medical records 5-10 days instead of 10mins.
a) Possible solution: HIPAA and GDPR compliant digital medical health platform
that works with all hospitals. (Very difficult to solve this because of non-
standardization.) b) Secondary solution: Biometric authorization (fingerprint
and voiceprint ID or DNA scan) and quick digital download of medical record in
plain text. Must complete in less than 10mins even with slower bandwidth.

3) Problem: Didn't have health insurance. Hospital was looking at a
potentially very large unpaid bill. a) Single payer government health
insurance is the best solution. b) SW Tech company solution is quick instant
insurance signup with government or charity guarantee for some percentage of
bill. The rest of the bill is dumped into CoveredCA or something else. And the
patient is enrolled for 1 year after the fact and must pay premiums. ? There
are probably better solutions.

4) Problem: Must rely on humans. a) IBM Watson for disease diagnosis and
treatment recommendations combined with additional neural net or machine
learning technologies could be used to created automated second opinions. Feed
all the raw data into the system to determine the outcomes and probability of
recovery for all treatment options.

~~~
michaelpinto
The problem is that when you have a hammer (a software startup), everything
looks like a nail:

1\. There may be a shortage of Doctors to provide a 2nd opinion. The cost of a
medical education is quite high, and the pay has been going down these past
few years. This can't be solved by a software startup.

2\. Hospitals have less funding than ever, and are trying to do more with
less. So there may already be software out there, but they can't afford it (or
the staff to to maintain it, never mind the staff to distribute it). This
can't be solved by a software startup.

3\. This is really a political problem, and again that can't be solved by a
software startup.

4\. A medical opinion may not be a binary option, and it could be a moving
target where data changes by the day, and it could be a suggestion to collect
more data, or even to talk to someone else. Opinions by definition are
arbitrary, as where something like IBM Watson may just give you options based
on probability (but that probability is only as good as the data you collect,
which may not be all inclusive, and may be a moving target). So a startup
might even make things worse as people base their options on incomplete data
or dated options.

The depressing reality is that there is a great deal of economic inequality in
our society, and that's reflected in the quality of healthcare that many
people receive. It should also be noted that poverty can prevent access to
preventative healthcare strategies which include everything from diet to
access to basic medication.

