[1] If you're going to try to say that what is "unforeseen" is relative it's not that relative, you can get an independent committee of doctors and provide a percentage based on their experience how much often that event is expected in that situation

Software development is inherently nonrepetitive and therefore unpredictable.

Healthcare is much closer to auto repair than software development.

Sure, on a car that's running that you can't turn off, with parts you can't replace, a maintenance history you can't see, and an ECU that actively misrepresents what's going on.

That is a dangerously naive view of software. Even apps that look like simple CRUD end up riddled with specialized business logic. Apps which truly are a few screens of simple CRUD end up as spreadsheets or Microsoft Access. We've gotten pretty good at not reinventing wheels.

Say what you will about the challenge of it, doctoring is fundamentally procedural and repetitive. Patients don't really show up with whole new undiscovered diseases anymore.

O'boy. What doctor do you go to?

  Rolled ankle
    100% [of patients get charged]: Office visit: $50
    58%: X-rays: $55 - $95
    22%: boot/cast: $240
    3%: surgery: ??
    <1%: other: ??

""" When you are estimating tasks that are done over and over, you can look to your historical execution time for insights. We average chopping X logs per hour.

If I hand you a Rubik's Cube and ask you to tell me how long it will take you to solve it...what is your answer going to be? If you've done it before you might have an idea. Maybe you just kept plugging away until you finally solved it? Maybe you've watched one of those videos about how to solve a Rubik's Cube, have practiced it and are confident that you could do it in 3 minutes flat? Maybe you have no idea?

Complexity and experience will dictate your answers, but then those estimates still only reflect your perception of the task...not everyone else on your team.

At best those numbers are a guess.

Every step in a software project is solving problems. You don't know how long it will take to solve the problem. You don't know how many new problems you might run into along the way. Can the new problems be solved by you or do they need to be solved by other people? """

[1]: https://www.brightball.com/articles/reality-driven-developme...

>Vox's database shows that patients are especially vulnerable to these surprise bills when out-of-network doctors work at in-network hospitals.

“It does happen quite a lot in the emergency room,” says Christopher Garmon, an assistant professor at the University of Missouri Kansas City.

Garmon published a study last year that found as many as one in five emergency room visits led to a surprise bill from an out-of-network provider involved in the care.

https://www.vox.com/2018/5/23/17353284/emergency-room-doctor...

Insurance is through her work, so I had to coax her through logging in to her account so that I could try to find an in-network ER list.

After spending ~30 minutes grumbling at the website over the complete lack of anything resembling clarity, I had a list of 3 hospitals that appeared to be in-network (and a sinking feeling that this could easily cost thousands of dollars). Set off around 2am. Arrived at first. 5+hour wait. Went to the next, no wait. They didn't manage to do much aside from giving a few tests that came up negative, administered fluids, gave her a steroid shot, and did a blood panel.

Her blood panel had one abnormal result that the doctor was willing to admit her for observation over (and had admitted people in the pass for less), but the doctor also noted that the parameter can vary a lot person to person; some people would be fine at that level. I had a sinking feeling in my stomach and decided it would be better to take her home to keep an eye on her than risk financial ruin. I think we were there 2-3 hours.

When the bill came months later, it was $2600 because the doctor was out of network.

For all technological advancements in US, the healthcare system is quite backwards. It’s not a new problem. Tons of countries do it well “Canada, Australia, Sweden ...”

The US political and healthcare system refused to accept other models since there is sooooo much money to be made at the expense of “some-other” people dying and going bankrupt.

House insurance, car insurance, all other forms of insurance are transparent, US healthcare is the most “mafia-like money extortion” system.

Right, as soon as the patient is admitted, it's a cardiothoracic surgery issue, or an oncology issue, or a high-risk obstetrics issue, or a critical care issue, or a neurosurgery issue, or a nephrology issue, or a general surgery issue, or an in-patient psych issue, or an ENT issue, or an opthalmology issue, or a geriatrics issue, etc.

Too expensive to fix healthcare issue. You’ll probably die or make it worse if you don’t fix it. “How much is your life worth to you?”

You can get a ton more random money by holding people’s lives over them. That is in summary the US healthcare system. Full of middlemen squeezing every penny they can out of you because they can.

Whoever campaigns for a transparent healthcare system, I’m voting for them.

Our broken healthcare system kills more people than all terrorist attacks and natural disasters combined because people can’t afford to pay the bill mafia.

That’s just a very sad state of affairs.

How does that contrast with "care provided by emergency departments?"

That is true, but emergency care disproportionately results in bankruptcies compared to other forms of care.

Moderate sarcasm.

But really that’s a deeper issue with insurance causing most of that. If you don’t have insurance, most hospitals will severely discount the costs that you are originally charged if you just work with them. It shows those prices are bullshit to begin with.

My locality has a ballot initiative up this year that would put a % cap on what hospitals can charge over their costs, and boy oh boy are the industry mouthpieces out in force to oppose it! They are having a field day with patients’ wallets, they know it, and they don’t want it to end.

Edit: since we only just warned you about this, I've banned your account until we get some indication that you intend to follow the rules from now on. You're welcome to email [email protected] if that's the case.

It might take a day. It may take a decade. It may take you the customer to change your entire approach.

This is not feasible. You can not disregard hidden defects and the cost of fixing them unless you do not really want reliabilty. If you do not want it, then don't complain.

In IT this requested lack of reliability is accepted. In healthcare and auto repair it is barred by law.

EDIT: i hate autocorrection.

This idea that medicine is different than other fields is crazy.