
Simone Giertz – Back from brain surgery [video] - lentil_soup
https://www.youtube.com/watch?v=-INz4XVeyJ4
======
PuffinBlue
We live in a world of marvels.

Often we talk of the future and it's wonders waiting to be discovered, but the
here and now has become equally astonishing.

The breadth, depth and scale of human ingenuity and endeavour is jaw-dropping
and here Simone and her story is another example.

Maybe I'm being trite by looking for the good in the bad but pause for a
moment and think of all that has been learned, how we have built a society and
developed infrastructure such that at this particular confluence of time and
space we as a species are capable of performing this life saving surgery.

And half a world away I follow the story through yet more confluences of
knowledge and development.

It is astonishing. i know it's tempting to take it for granted but take a step
back and think about it for a moment. It's astonishing.

I'm 32. I can only imagine how much more marvels I'll witness in my life,
either remotely or in person.

~~~
goodells
The whole system is awe-inspiring. Have a medical emergency? We'll send a
several-ton box on wheels speeding your way within minutes. If you're in a
city, the traffic lights will turn red as the emergency vehicle approaches to
make passing safer. Paramedics trained in evidence-based pre-hospital medicine
will perform the interventions most likely to save you based on their field
impression.

And when you arrive at the hospital it gets really cool - at a level 1 trauma
center, they should be prepared to give you a CT scan and treat you in 10
minutes or less. That might involve snaking a tiny wire through your arteries
all the way from your leg to your head, or administering one of thousands of
drugs that has exactly the desired effect.

It's easy to take it all for granted but the technology and systems in place
to take care of us are amazing.

~~~
slg
And if you live in the US and don't have good medical insurance the entire
thing might leave you bankrupt and homeless. The ingenuity of humanity is
amazing, but we still seem to get in our own ways a lot.

~~~
outworlder
You are still alive though, if it's any consolation.

Now, many countries have this problem solved – for now. As the population
ages, the solutions may have to change everywhere.

What I find interesting is that the discussion is almost never framed to
address the actual issue: the medical industry in the US simply overcharges
with impunity. I was shocked to discover that labor (as in, doctors) isn't
even the biggest line item in many (most?) medical bills. Hospitals and
clinics will simply crank the bill sky high and then have you or the insurance
try to haggle it back down, sometimes at a 3 or 4 digits percentage
difference. It's insane. There's also zero transparency on pricing, so it is
difficult to shop around even if you have the time.

~~~
monetus
Your points summarize the thrust of the first in a series of propublica
articles.

[https://www.propublica.org/article/why-your-health-
insurer-d...](https://www.propublica.org/article/why-your-health-insurer-does-
not-care-about-your-big-bills)

------
tonysdg
So glad to see Simone back on her feet. The sh __y robot nation needs its
queen!

As for that bill -- I'm curious: is there any resource I can look up to see
how much of that the average Medicare/Medicaid/private insurance plan pays?

I ask because I just had two teeth repaired after a bike accident and it'll
cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be
looking at ~$38,000 bill.

~~~
viraptor
I remember someone on HN recommending to send a copy of the bill to some
health billing transparency project, but I can't find the right link. Google
comes up with
[https://www.fairhealthconsumer.org/](https://www.fairhealthconsumer.org/)
although I'm pretty sure it's a different service (they don't use the
submitted bills from what I understand)

~~~
HarryHirsch
What's with the strange wording, why do they call patients "healthcare
consumers" now?

~~~
penguat
If the patient is a dependent of someone, or a minor, or dies, does someone
else pay? Is the consumer the person paying, or the patient?

------
RRiccio
Having gone through all of this recently with my little brother, I can
definitely relate. Her account of the pre and post surgery are spot on, as
well as the worries around this operation (will he survive? will his
personality change? will the operation be a success? what will be the
consequences?).

And I'm glad she had insurance, even more so considering she lives in the US.
In our case he had it too, but where we live the top neurosurgeons
unfortunately don't accept it – you need to pay the operation yourself. It can
be incredibly expensive as she mentioned.

It's great to hear she's doing fine. I don't recall ever being so happy about
the health situation of someone I didn't know 10 minutes before. What a
beautiful video.

~~~
sp332
Even if the surgeon doesn't deal with the insurance company directly, you
should at least be able to submit the bill to them yourself?

~~~
RRiccio
The way it works in Brazil – maybe in other similar countries as well – is
that insurance only covers specific doctors which have partnerships with the
insurer. A common question when you're talking about a doctor or call his
office is "which insurance plans does she accept?". Usually it's 2 or 3 plans,
and thus you end up maintaining in your life a network of doctors that work
with your specific insurance – so that whenever you have a problem you know
where you can get treatment without spending extra.

This creates a relationship where doctors get paid much less than they would
normally charge (e.g. $20 for an insurance-paid appointment vs. $100 for a
customer-paid appointment). But this way they end up receiving a steady number
of clients from the insurer. And in most cases doctors have to accept this
deal because they don't have enough demand on their own.

Naturally, that's not the case for top neurosurgeons. They have way too much
demand and can make only a few surgeries per week. So virtually none of the
top ones agree to being "accredited". They make an order of magnitude more
money by charging the customer directly.

If you decide to use a "non-accredited" doctor you have to pay out of your own
pocket. Typical insurers won't reimburse you in this case, and even the high
end ones will give you back only up to 10 or 15%. They do cover for hospital
expenses (room, nurses, meals, etc.), but these are a small fraction of the
cost of brain surgery.

There are some different insurance plans that will reimburse your customer-
paid appointments/procedures, but – since the cost for these visits is way
higher – these are plans that only multi-millionaires can afford.

------
tomclive
That's put a smile on my face to see her looking well but ouch, that's quite a
bill. I had a transnasal craniotomy (surgery through the nose) back in 2012 to
remove a pituitary tumour. Not technically brain surgery, but they did need to
cut a hole in my skull to get to it. I spent a week or so in ICU to recover.

Luckily being UK based I didn't have a bill of any kind to pay afterwards and
was paid in full while I recovered.

------
goshx
I’ve never worried so much about someone I never actually met. The time after
her surgery without updates on her twitter account was hard and it’s funny to
see that a lot of people felt that way (if you read the tweets from that time
you’ll see what I am talking about).

It is great to see her doing so well. Medicine has come a long way... the
bills not so much.

~~~
throwaway5752
It's really sobering to think about how often this happens per day, to less
charismatic/attractive people without social media presences or worse/no
insurance. Very happy for Simone (and felt the same way as you following the
story) but also trying to take the opportune to empathize with a wider group
of people.

~~~
dv_dt
It's an odd thought experiment to follow through that in the US we're
supplying evolutionary selection for well networked extroverts via our
healthcare + media and GoFundMe type mechanisms.

------
mosselman
Yikes, what a bill. My mother had brain surgery a few years ago and didn’t
have to pay for anything besides the insurance she always pay for which
amounts to a few hundred euros a year.

~~~
ryanmercer
>Yikes, what a bill.

Yeah, cancer-related bills can add up fast. Worse, they'll send you bills for
years after the fact... my father had been dead almost a decade from his
cancer and the occasional bill would still come and my mom would have to spend
hours arguing with them on the phone "uh yeah, he's dead, he's been dead, this
happened a decade ago, get your shit together" and they'd usually be all 'oops
our bad' almost like they were trying to double dip.

We need some serious healthcare reform in the US.

~~~
jandrese
The worst thing about this is that it teaches patients to ignore bills from
hospitals, because so much of the time the bill is bullshit. They're just
fishing for rubes that will pay it without realizing that the insurance is
already paying for it.

Then when a real bill comes they get angry at you for ignoring it, even though
it was mostly indistinguishable from their bullshit bills.

------
zachruss92
This video literally made my morning. If anyone deserves a successful recovery
it's Simone. I admire her authenticity and humor, even in the face of
something as terrifying as brain surgery. Hopefully when she's feeling up to
it we'll be entertained again by shitty robots again :)

------
bootloop
So this country doesn't make enough money to be able to keep some unlucky
people alive without throwing them or their family into poverty? Or is it
simply that nobody cares for anybody else as long as you are better off then
them?

~~~
WhompingWindows
I believe it is highly American to believe in self-sufficiency and to minimize
the role of luck in success or failure. Whether we go back to the Protestant
work ethic, the Puritan sensibility, gold rushes, unfettered capitalism, the
Gilded Age, and our current second gilded age, to me it is clear that caring
for others is a secondary concern for many Americans. Just look at the
"makers/takers" model of our populace put forward by the top current
lawmakers. In this framework, sick people are takers and capitalists are
makers.

~~~
NegativeK
This is never how it's framed when you actually discuss these problems with
people who believe in small government. Every time I've pressed the issue,
it's a two pronged response:

A) Healthcare costs are too high, and it's due to
malpractice/overregulation/other government influences. B) In the event that
an individual can't afford healthcare, the community will pick up the tab --
and have the money to do it, since the government isn't taxing it away from
them.

~~~
plassma
Ya I have never once heard of someone's neighbor or whoever picking up their
medical tab for them.

------
ArtWomb
Get well, Simone! Truly amazing that you were able to get your vision fully
restored.

Real life on YouTube is better than any other content out there ;)

------
cwkoss
She is so funny, I love the pun story with Dr. Reddy.

Great human being, glad things went well for her.

------
xupybd
Glad to see she's doing alright.

I played the brain tumour game a few years back. Healing can really take the
wind out of your sails so I'm glad to see she still seems to have a lot of
energy.

