为什么贵， 因为要谋财害命。 西雅图儿童医院经典作业就是把孩子搞残， 然后一辈子拿钱。 你普通看病200， 这种搞残的一次outpatient 四五千美元。 一年几十万没有问题。 搞你一辈子。。 比如很简单的用新生儿筛查可以做出诊断的， 它们却故意谋杀。 这是我们把新生儿报告给西雅图儿童医院后， 这个垃圾医生的狡辩。 美国医院有多危险， 我可以告诉你远远比战场危险。 战场至少你还有一边， 有同志。 医院出了事故， 或是你发现罪恶后周围都是要搞死你的人， 除了医生护士， 还有社工和警察， 可以当场击毙你，而且保证媒体会说你打伤医护。 下面就看看这个医生如何狡辩的， Date: 4/23/2014 Yong Xie and liying Chen 21743 105th PI NE Redmond, WA 98053 To Jianhua''''''''s parents: I am writing this letter today in response to your email to our biochemical genetics nurse, Sarah Allen, RN, on Friday, 4/18/2014. In that email, you forwarded information on Jianhua''''''''s Washington state newborn screen results with comparison to reference ranges from plasma acylcarnitines done in the Mayo Clinic Biochemical Genetics Laboratory. In there, you note concentrations of Jianhua''''''''s newborn screening test results of C18:1, C16, and C18 acylcarnitines comparing these to the plasma reference ranges from the Mayo Clinic lab. In the letter you mention that the newborn screening values are 3 or 4 times the normal maximum range of the plasma reference ranges at Mayo Clinic. Then you question that if together with the labs done here at Seattle Children''''''''s Hospital in 2013 and his chronic liver problems -- are they convincing enough to say that Jianhua has a fatty acid oxidation disorder? In reviewing these results of Jianhua''''''''s newborn screening information, as we previously discussed, it is important to interpret the concentrations of the acylcarnitines on his newborn screening appropriately in the appropriate medical context and with the correct reference ranges. In this circumstance, we have to consider the Washington State newborn screen is done with a specific protocol and acylcarnitines are extracted from the dried blood spot collected on filter paper from when Jianhua was born. In this particular case, the concentrations of these C18:1, C16, and C18 acylcarnitines that you reference are from his first newborn screen that was done at 1 day and 2 hours of age, which is also documented on the newborn screening test document that you also forwarded attached to your email. The reference ranges from the Mayo Clinic Biochemical Genetics Laboratories are from a plasma acylcarnitine sample, as also is noted in the information you forwarded from their website from Test 10: ACRN. These reference ranges have been established based on the measurement of acylcarnitines in the plasma sample - collected from any individual who had had their plasma sample sent in an EDT A tube to the Biochemical Genetics Laboratory of the Mayo Clinic. They have established their own reference ranges based on their testing methodology using tandem mass spectrometry. These reference ranges actually will change over different ages, which they also note in their information. We also know from experience that the reference ranges will differ between commercial laboratories, as they would between any laboratory given that every laboratory has its own specific testing methodology, and has to establish their own population normal reference ranges according to their normal official laboratory certification protocols. In this particular case, as you note in your email.referencerangesfortheplasmaacylcarnitinesC18:1islessthanO.25micromolar.C16 is less than 0.036 micromolar, and C18 is less than 0.1 micromolar for children ages 8 days to 7 years of age, which would have been Jianhua''''''''s age in April 2013. We cannot use the reference ranges for plasma acylcarnitines from the Mayo Clinic Biochemical Genetics Laboratories for plasma samples from children collected between 8 days and 7 years of life when interpreting newborn screening result from a dried blood spot performed from blood collected from filter paper on a Washington State newborn screening report. This is because the Washington State newborn screening protocol is using a different extraction technique for extracting the blood from the filter paper compared to the plasma sample at the Mayo Clinic. This involves a different technical process. While they both may use tandem mass spectrometry, the reference ranges are completely different, which is a known fact seen between different sample types (plasma vs. dried blood spot), between screening laboratories, and between confirmatory diagnostic labs. We know actually reference ranges for newborn screening samples from filter samples are often much different. The Washington State Newborn Screening Laboratory does not release newborn screening information, nor do they release information on normal population references or their cutoffs used for newborn screening. I know from my experience as a biochemical geneticist that in newborn screening the normal range up to the 99th percentile may reach as high as 2.5 micromolars for the normal population range for C18:1 acylcarnitines. For C16 acylcarnitines, it may reach as high as 5-6 and for C18 acylcarnitines may reach as high as 1.5-2. These would clearly place Jianhua''''''''s newborn screening test results for C18:1, C16 and C18 acylcarnitines well within the normal range for a newborn screening specimen from a child collected during the first week of life. I very much appreciate your sincere efforts to completely examine all of the possibilities that Jianhua may have a fatty acid oxidation disorder. His newborn screening results as you provided here from his first and second newborn screens are well within normal population ranges. Additionally, from the information that you have shared with me and from what I have been able to determine from his medical records, he had no symptoms that I am aware of, or that you have shared with me, that would be consistent with a fatty acid oxidation disorder prior to his presentation in the hospital in April 2013. Additionally, his initial presentation in the hospital in April 2013 with acute liver failure would be a very atypical presentation for a fatty oxidation disorder without other simultaneous presenting symptoms such as hypoglycemia at presentation. His hypoglycemia occurred later during his hospitalization and this could be explained by his acute liver failure itself and not due to a fatty acid oxidation disorder causing the hypoglycemia. The plasma acylcarnitines were not elevated to the levels we would expect if a fatty acid oxidation disorder was causing the hypoglycemia. The findings on his urine organic acids were inconsistent with a fatty acid oxidation disorder when interpreted in clinical context with his plasma acylcarnitines and his health state in the hospital at that time. The interpretation of all of his biochemical testing would not support a fatty acid oxidation disorder as causing his acute liver failure nor the hypoglycemia at that time. If we then were to further theoretically assume he still had a chance of having a fatty oxidation disorder based on his acylcarnitine measurements, then the next step would be then do DNA sequencing. Jianhua has had whole exome sequencing and a microarray looking for deletions and duplications in mitochondria-related genes including the fatty acid oxidation disorder genes. He was only found to have one sequence variant for ACAD9 and no other variants for any other type of fatty acid oxidation disorder. Fatty acid oxidation disorders are autosomal recessive conditions so in order to have a fatty acid oxidation disorder a person would have to have two DNA sequence changes believed to cause disease, one in each of the two gene alleles for that particular gene. Jianhua has been only been found to have one DNA sequence variant in ACAD9, and nothing else. There is no DNA sequence evidence to support a possibility of a fatty acid oxidation disorder in Jianhua at this time. Overall, we have demonstrated clear evidence, both biochemical and molecular, reassuring us that he does not have a fatty acid oxidation disorder. I would not recommend any additional testing for fatty acid oxidation disorders based on this evidence. His clinical improvements over that past year have truly been wonderful, but I do not believe that this is due to his dietary treatment for a fatty acid oxidation disorder that you have started at your own initiative. Dietary evaluation should continue to reassure us that he does not have nutritional deficiencies. Since we have not demonstrated that he has an inborn error of metabolism that would require a fat-restricted and MCT supplemented diet, I would support you if you chose to transition him to a more normal diet. As we have discussed previously, he may benefit from further evaluation for common variable immune deficiency and I would recommend further conSUltation for this. I appreciate your sending me this information. I would be happy to discuss this further in the future at a clinic visit if you so wish to do so. Sincerely, Electronically Authenticated by J Lawrence Merritt, II, MD 04/29/201410:44 A J Lawrence Merritt, II, MD , Attending Physician, Genetics
下面这个华人医生举报我们家， 要把孩子带走， 在医院， 医生想着法子往死里整。。 这是医院举报的信息： Today, I received a call from Evelyn Hsu, MD, Gastroenterology Transplant attending. She and her team have been concerned that Jianhua initially presented about 7 months ago with acute liver failure. On biopsy, he had micronodular cirrhosis. Extensive testing was done at that time for a cause, and none determined; however, subsequently the clinical evidence of his liver disease has improved. He was last seen last spring, with the plan that he would follow up this fall. During the course of his evaluations, his father developed concerns that he had a fatty acid oxidation defect. Extensive metabolic testing has been negative so far, yet dad has been unwilling to drop this diagnostic concern. Due to conflicts with the Gastroenterology Service, he also has indicated that he is seeking care elsewhere, including at Pittsburgh and Portland, Oregon. The Gastroenterology Service is concerned that it would be important to document that, whatever the cause of the liver failure was, it is no longer active. I discussed with Dr. Hsu that, since Jianhua has a very serious medical problem, that failure of his father to seek appropriate follow-up care would constitute medical neglect. I recommended that Gastroenterology connect with dad and set a date this fall by which he must provide documentation that Jianhua is receiving appropriate care elsewhere. Short of that documentation, a Protective Services referral for medical neglect should be made.
Maybe he talked about CA?
所以我觉得楼主的推理太发散，一个肠镜的费用就可以妖魔化整个系统。
我打疫苗还提供了医疗保险的信息，医疗保险出了40美元，不知道是两次疫苗还是一次疫苗的钱！因为第二针疫苗，在同一个地方打，没有要医疗保险信息。我查了医疗保险的账单，也没有看到账单上有第二针疫苗的钱。
因为没法反驳毒瘤这个事实，你说A他跟你讲B。
毒瘤是什么事实，肿瘤与毒瘤是一个意思？认为这里的医疗系统是毒瘤，还不赶快跑到健康的医疗系统去，在这里被毒死是为何？我是问你个人体会，不是传闻。
15年在国内用了次医院
血常规二十多块，x光胸片60块，这还是这还是没有医保的全自费rmb价，挂号五块就不提了
美国同年拍了个胸片，拍片好像没收钱保险出了，读片保险外自付了两百多美金
美国医院有多危险， 我可以告诉你远远比战场危险。 战场至少你还有一边， 有同志。 医院出了事故， 或是你发现罪恶后周围都是要搞死你的人， 除了医生护士， 还有社工和警察， 可以当场击毙你，而且保证媒体会说你打伤医护。
下面就看看这个医生如何狡辩的，
Date: 4/23/2014 Yong Xie and liying Chen 21743 105th PI NE Redmond, WA 98053
To Jianhua''''''''s parents:
I am writing this letter today in response to your email to our biochemical genetics nurse, Sarah Allen, RN, on Friday, 4/18/2014. In that email, you forwarded information on Jianhua''''''''s Washington state newborn screen results with comparison to reference ranges from plasma acylcarnitines done in the Mayo Clinic Biochemical Genetics Laboratory. In there, you note concentrations of Jianhua''''''''s newborn screening test results of C18:1, C16, and C18 acylcarnitines comparing these to the plasma reference ranges from the Mayo Clinic lab. In the letter you mention that the newborn screening values are 3 or 4 times the normal maximum range of the plasma reference ranges at Mayo Clinic. Then you question that if together with the labs done here at Seattle Children''''''''s Hospital in 2013 and his chronic liver problems -- are they convincing enough to say that Jianhua has a fatty acid oxidation disorder? In reviewing these results of Jianhua''''''''s newborn screening information, as we previously discussed, it is important to interpret the concentrations of the acylcarnitines on his newborn screening appropriately in the appropriate medical context and with the correct reference ranges. In this circumstance, we have to consider the Washington State newborn screen is done with a specific protocol and acylcarnitines are extracted from the dried blood spot collected on filter paper from when Jianhua was born. In this particular case, the concentrations of these C18:1, C16, and C18 acylcarnitines that you reference are from his first newborn screen that was done at 1 day and 2 hours of age, which is also documented on the newborn screening test document that you also forwarded attached to your email. The reference ranges from the Mayo Clinic Biochemical Genetics Laboratories are from a plasma acylcarnitine sample, as also is noted in the information you forwarded from their website from Test 10: ACRN. These reference ranges have been established based on the measurement of acylcarnitines in the plasma sample - collected from any individual who had had their plasma sample sent in an EDT A tube to the Biochemical Genetics Laboratory of the Mayo Clinic. They have established their own reference ranges based on their testing methodology using tandem mass spectrometry. These reference ranges actually will change over different ages, which they also note in their information. We also know from experience that the reference ranges will differ between commercial laboratories, as they would between any laboratory given that every laboratory has its own specific testing methodology, and has to establish their own population normal reference ranges according to their normal official laboratory certification protocols. In this particular case, as you note in your email.referencerangesfortheplasmaacylcarnitinesC18:1islessthanO.25micromolar.C16 is less than 0.036 micromolar, and C18 is less than 0.1 micromolar for children ages 8 days to 7 years of age, which would have been Jianhua''''''''s age in April 2013. We cannot use the reference ranges for plasma acylcarnitines from the Mayo Clinic Biochemical Genetics Laboratories for plasma samples from children collected between 8 days and 7 years of life when interpreting newborn screening result from a dried blood spot performed from blood collected from filter paper on a Washington State newborn screening report. This is because the Washington State newborn screening protocol is using a different extraction technique for extracting the blood from the filter paper compared to the plasma sample at the Mayo Clinic. This involves a different technical process. While they both may use tandem mass spectrometry, the reference ranges are completely different, which is a known fact seen between different sample types (plasma vs. dried blood spot), between screening laboratories, and between confirmatory diagnostic labs. We know actually reference ranges for newborn screening samples from filter samples are often much different. The Washington State Newborn Screening Laboratory does not release newborn screening information, nor do they release information on normal population references or their cutoffs used for newborn screening. I know from my experience as a biochemical geneticist that in newborn screening the normal range up to the 99th percentile may reach as high as 2.5 micromolars for the normal population range for C18:1 acylcarnitines. For C16 acylcarnitines, it may reach as high as 5-6 and for C18 acylcarnitines may reach as high as 1.5-2. These would clearly place Jianhua''''''''s newborn screening test results for C18:1, C16 and C18 acylcarnitines well within the normal range for a newborn screening specimen from a child collected during the first week of life. I very much appreciate your sincere efforts to completely examine all of the possibilities that Jianhua may have a fatty acid oxidation disorder. His newborn screening results as you provided here from his first and second newborn screens are well within normal population ranges. Additionally, from the information that you have shared with me and from what I have been able to determine from his medical records, he had no symptoms that I am aware of, or that you have shared with me, that would be consistent with a fatty acid oxidation disorder prior to his presentation in the hospital in April 2013. Additionally, his initial presentation in the hospital in April 2013 with acute liver failure would be a very atypical presentation for a fatty oxidation disorder without other simultaneous presenting symptoms such as hypoglycemia at presentation. His hypoglycemia occurred later during his hospitalization and this could be explained by his acute liver failure itself and not due to a fatty acid oxidation disorder causing the hypoglycemia. The plasma acylcarnitines were not elevated to the levels we would expect if a fatty acid oxidation disorder was causing the hypoglycemia. The findings on his urine organic acids were inconsistent with a fatty acid oxidation disorder when interpreted in clinical context with his plasma acylcarnitines and his health state in the hospital at that time. The interpretation of all of his biochemical testing would not support a fatty acid oxidation disorder as causing his acute liver failure nor the hypoglycemia at that time. If we then were to further theoretically assume he still had a chance of having a fatty oxidation disorder based on his acylcarnitine measurements, then the next step would be then do DNA sequencing. Jianhua has had whole exome sequencing and a microarray looking for deletions and duplications in mitochondria-related genes including the fatty acid oxidation disorder genes. He was only found to have one sequence variant for ACAD9 and no other variants for any other type of fatty acid oxidation disorder. Fatty acid oxidation disorders are autosomal recessive conditions so in order to have a fatty acid oxidation disorder a person would have to have two DNA sequence changes believed to cause disease, one in each of the two gene alleles for that particular gene. Jianhua has been only been found to have one DNA sequence variant in ACAD9, and nothing else. There is no DNA sequence evidence to support a possibility of a fatty acid oxidation disorder in Jianhua at this time. Overall, we have demonstrated clear evidence, both biochemical and molecular, reassuring us that he does not have a fatty acid oxidation disorder. I would not recommend any additional testing for fatty acid oxidation disorders based on this evidence. His clinical improvements over that past year have truly been wonderful, but I do not believe that this is due to his dietary treatment for a fatty acid oxidation disorder that you have started at your own initiative. Dietary evaluation should continue to reassure us that he does not have nutritional deficiencies. Since we have not demonstrated that he has an inborn error of metabolism that would require a fat-restricted and MCT supplemented diet, I would support you if you chose to transition him to a more normal diet. As we have discussed previously, he may benefit from further evaluation for common variable immune deficiency and I would recommend further conSUltation for this. I appreciate your sending me this information. I would be happy to discuss this further in the future at a clinic visit if you so wish to do so. Sincerely, Electronically Authenticated by J Lawrence Merritt, II, MD 04/29/201410:44 A J Lawrence Merritt, II, MD , Attending Physician, Genetics
这个医生和PICU director故意杀害病人。。 后来接手的不比前面的手软。。 当然最牛逼的是picu director， 不留下一点点痕迹， 杀人杀熟练了。。 西雅图儿童医院这么杀人， 在这类病已知如何诊断治疗的情况下， 至少应该从七十年代就开始了。到现在五十年罪恶累累了。 我跟华盛顿州举报了， 根本不查。。。 州还派人到家里威胁我们要把孩子抢走。。
没有比美国更邪恶的国家了。
这是医院举报的信息：
Today, I received a call from Evelyn Hsu, MD, Gastroenterology Transplant attending. She and her team have been concerned that Jianhua initially presented about 7 months ago with acute liver failure. On biopsy, he had micronodular cirrhosis. Extensive testing was done at that time for a cause, and none determined; however, subsequently the clinical evidence of his liver disease has improved. He was last seen last spring, with the plan that he would follow up this fall.
During the course of his evaluations, his father developed concerns that he had a fatty acid oxidation defect. Extensive metabolic testing has been negative so far, yet dad has been unwilling to drop this diagnostic concern. Due to conflicts with the Gastroenterology Service, he also has indicated that he is seeking care elsewhere, including at Pittsburgh and Portland, Oregon.
The Gastroenterology Service is concerned that it would be important to document that, whatever the cause of the liver failure was, it is no longer active. I discussed with Dr. Hsu that, since Jianhua has a very serious medical problem, that failure of his father to seek appropriate follow-up care would constitute medical neglect. I recommended that Gastroenterology connect with dad and set a date this fall by which he must provide documentation that Jianhua is receiving appropriate care elsewhere. Short of that documentation, a Protective Services referral for medical neglect should be made.
合理分配医疗资源，且没有refer保险公司可能会拒保。
主要是这样比较方便漫天要价，坐地还钱
是，不明白为啥非要家庭医生refer，即使是PPO，打电话到专科都要找家庭医生refer.
没错，我当时拿的国内offer中最低的是90%报销，最高的是100%。 100%就自己出个挂号费中不在保险内的那几块钱。如果是专家，大概几十块。
中国各种核算隔离 都不需要疫苗
长时间在美国慢慢习惯相信医生，结果搬家后就悲剧了，被医生误导测了好几个保险不cover的，医生office就把大砍刀使劲往病人身上招呼，TMD，都想让他们搁到追债公司随便了，反正也没有身份问题，暂时没有买房的念头，爱咋咋地。
我生完孩子都几个月了，还在不停收到各种生产账单。每次收到保险邮件的EOB就开始焦虑了。好多bill 都是想都没想过的。然后还有几个被denied
看不惯别人有批评的自由的人才适合回国呆着。
很少有老人抱怨，， 尤其是很少有亚洲老人抱怨。
基本都死了。。。看一个笑脸就完蛋。。 亚裔平均据说87
可是就算是南加州， 我来了几年没有遇到亚裔年长的。。
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医院靠法院把孩子判决活活饿死。。。
假话。出了6000，还有coinsurance很多项目20%自付，还有out of network需要更多的自付，或者保险一分不付。
那粪便不是你自己的粪便吗？医生不恶心你怎么恶心了😂
老太太脑癌昏迷 被医生说几个月生命 都被新药治好了 但是另外一个亚马逊的脑癌男码农 一年就死了
如果是老人年纪大，孩子家人不在身边的怎么办？他们的药是怎么拿到的？
在美国我是知道医生直接把处方发到药店，药店网上付费，现在都是免费寄到家里。
不行，有滞纳金的，这可不像在国内谁会闹谁划算，在美帝除非你是无产阶级有的是法子治你
人家说东,你非要说西。 车子坏了，保险公司指定的修车铺修就不给钱，你非要说要去隔壁那家没有指定的修车铺，非要再交钱。 谁还敢跟你继续讨论啊
你估计太久没回去看病了
真心请教2022现在是怎么解决的吧，我2018年回去给家人看病就是如此折腾的
如果需打rabies immune globulin 只能在ER打。urgent care 没有这个药
挂号都是提前网上预约有大致时段，等待时间不长。walk in的就在一楼自助机约，不用排队，但等医生要排。
所有的缴费都是自助机上刷卡完成，非常快。
拿药也没等过，因为缴费好再到一楼的几分钟内基本就好了。
抱怨等待的都没想过美国拿药要开车去药店，一般最快也要两小时之后才ready。做检查也要预约等待，更别说还要开车跑过去。环境是舒适了，但时间都花出去了。 要是多做两个检查就更久了。。。
Check这个想起一个经历。PPO，有一天找了一个医院的医生去看病。到了那里突然想到他是in还是out of network。问前台，他们说是in network。然后打电话问保险公司的客服，居然说不是！又打了一遍换个人还是说不是。既然已经来了最后还是去看了，过了好几个星期出账单最后发现前台居然说对了，是属于in network的。 也就是说连保险公司的客服可能都不知道你去的到底是不是in network的。
还有一次年检，医生问了一个你在吃什么药的问题。回答了一下，他又说了几句。根本没有主动征询他什么建议，因为前一次看病的医生已经注意事项全说过了。结果就被bill成Office visit收了四五百刀，因为“讨论了病情”！难不成医生问问题的时候都要问他我如果回答你的问题要不要收钱？ 后来跟医生打电话问，他愿意改code，结果！医院不愿意改说你就是讨论病情就是Office visit，懒得扯皮了还是付了钱。
不是。客服只能根据网站上列出来的，其实跟你上网看是一样的。但是如果网站不能及时更新，或者你去的facility 是网站列的子公司，名字有点不一样，客服也不能做判别，只能照本宣科。 做胃镜就碰到这样的情况，查来查去就算了，至少医生是in network。后来证明医生/facility/麻醉都是in network， 样本检验是out network。这个最后一项实在是无法控制的
医生不厚道
你说的我全部都用了，提前网上预约，到时候还是要提前过去排队你错过一分钟你的位置就没了，缴费在自助机器上完成，但是缴费机前也要排队。拿药的队伍都排到九霄云外了，全是窗口，全是人。上次回国时间长，亲身经历了至少10几次。如果是小医院没啥人看的也许是，3甲医院都是人山人海。
在美国都是医生把处方发到药店cvs，药店message我ready了，我直接用app付费， 1-2天药店免费寄到家里信箱。自从Pandemic以来再也没有去过药店。
现在很多保险肠镜45岁以上就是免费了。
是的，说APP方便不排队的就是没有亲身体验过的。随便找一个新闻吧，去年（2021年）11月的。
https://www.163.com/dy/article/GNKRKTN905148JTU.html
【在武汉协和看病有多难：号难挂，车难停，队难排】湖北省最好的三甲医院，武汉协和医院早上7:30的盛况，请容许我用盛况来形容现在的场面。早就听说协和很难看病，凌晨4.30出发，5:20到协和，看到排队进地下室的车辆，感觉心累。
好不容易排了1个小时的队，到分诊台再一次眼前一黑，人山人海。我在想大家都是凌晨2、3点来排队吗？
刚才有一个老年患者和护士吵架，老人让陪护的一起进去，护士不让，结果老人爆发，说：我这么大岁数，记忆力不好，你们就这么为人民服务？护士就是坚决不让陪护进，其实两方都挺难，不好办！
刚才看了一下号，看专家起码等到11点，再做检查，再复诊，一天耗在医院了。
看病难其实是排队难，医疗资源差距太大，好医院都在热闹，人多的区域，半夜去排队，偏远的区域没有好医院，也没规划。