Public Health

Aims

To describe and compare OUD treatment policies across nine international jurisdictions, and to understand how they are situated within their primary care and health systems.

Methods

Using policy documents, we collected data on health systems, drug use epidemiology, drug policies, and OUD treatment from Australia, Canada, France, Germany, Ireland, Portugal, Sweden, Switzerland, and Taiwan. We used the health system dynamics framework and adapted definitions of low- and high-threshold treatment to describe and compare OUD treatment policies, and to understand how they may be shaped by their health systems context.

I have one tattoo that flares up occasionally, especially when I have other allergies. I use it like a litmus test now for when to take a pill lol.

In March 2021, Geert Vanden Bossche (Virologist and Vaccine Developer) warned of the dangers of mass vaccination during a pandemic to drive viral evolution.

Recent further unusual patterns in viral evolution have indicated to him that the virus is now making more changes which will allow it to evade all vaccines.

Three clinicians will reflect on his assumptions and analyse disease presentation in the general public.

• Dr Shankara Chetty (South Africa)
• Dr Robert Rennebohm (USA)
• Dr Philip McMillan (UK)

Channel url: https://odysee.com/@GeertVandenBosscheVideos:9

Hospitals will often give patients an IV as an automatic procedure and then use it for just one blood draw or injection, or even not use it at all. Then charge ≥$~~60~~ 600¹ for it (in the US)!

I went to the ER in Europe and got an automatic IV. They only used it to take blood and nothing else. So I took notes and prepared for a dispute. When the invoice finally came, I found no charge for the IV. But had to probe because I’m the type that will fight over a nickel on principle. I asked for details on some of the doctor’s fees, since it was not itemized separately. After my investigation, it turns out the IV was bundled in but only €6. LOL. So insignificant indeed.

Not sure if it’s fair to call it a swindle in the US. Is it typically a deliberate money-grab when the IV is not really needed? Staff are (generally rightfully) unaware of pricing and just focused on giving the best care for the patient independent of cost. And for insured people that’s ideal. But I often steer the staff, saying I’m an uninsured cash payer and need price quotes and to asses the degree of need on various things. It’s a burden on them but it’s important to me. I have gotten discharged a day early on a couple occasions (which generally saves me ~$/€ 1k each day I avoid).

Funny side story: a doc who I steered well toward budget treatment pulls out his smartphone with a gadget that does an echo. He said this is free but unofficial… maybe we can get out of the pricey proper echo imaging. And indeed the pics were good enough.

Anyway - to the question:

Whether to give an IV involves guesswork on whether more things will need to be injected. Do docs have any criteria to follow when ordering an IV, or is it their full discretion and they just order it for convenience without much thought?

1. ~~$60~~ was the price ~15-20 years ago.. probably even more today. CORRECTION: the ER nurse in my family apparently tells patients who possibly don’t need an IV that the cost on the bill will be $600 (as a good samaritan warning). I don’t have direct contact with this family member.. heard it through someone else. Can any other ER nurses in the US confirm whether that’s accurate? I am really struggling to believe this price and wonder if someone’s memory failed. I think if I were quoted that price I would surely say for that price I do not need it.. feel free to stick me 10-20 times if needed. (update 2: seems realistic)