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Insured, but Still Owing $109K for a Heart Attack

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Re: Insured, but Still Owing $109K for a Heart Attack

#221

Post by acomar »

lotsofpulp wrote: post #105
acomar wrote: post #91

Earlier quoted context omitted.

> Why the fuck isn't there a law against this kind of shit? There's a pretty clear answer to this question almost every single time it's asked... the people who benefit are wealthy and the people hurt are poor. The latter structurally lack the ability to fight it or lobby their congresspeople to change the law to help them. Until a mass movement steps forward to say "no, we will not tolerate this", nothing can possib…

Based on voting demographics, the poorest are the ones who are voting for politicians who hate the government and are opposed to any kind of subsidized healthcare.

There's a lot to unpack here. First, neither party has the trust of the working class, whatever the rhetoric. Second, the candidate that talked about fixing the system, including healthcare, won -- that he was actually talking about breaking it further gets lost in the discourse around both candidates. There's a longer discussion to be had about how to build trust and what can be done about broken political systems, but it's not the parties that can act on that at this moment.

It will take something like the union/wildcat teachers' strikes, that forced Republican majorities with unified control of state governments to raise wages and increase funding, to do anything about healthcare or the many other structural challenges we face as a nation.

Re: Insured, but Still Owing $109K for a Heart Attack

#222

Post by wang_li »

DanBC wrote: post #181
wang_li wrote: post #135

Earlier quoted context omitted.

Unless the NHS has no approved treatment, in which case you die instead of being able to go abroad for care.

If the NHS has no approved treatment you can go abroad or you can pay privately in the UK. What conditions are you thinking of that don't have "approved" treatments?

Within the NHS specifically, there was the recent case of Alfie Evans[0], where the medical practitioners said there was no hope for him and the family wanted to take him abroad for care. The NHS and the UK legal system decided that his best interests were to die in the UK. His family was not allowed to take him for additional care.

0. https://en.wikipedia.org/wiki/Alfie_Evans_case

Re: Insured, but Still Owing $109K for a Heart Attack

#223

Post by alphabettsy »

krupan wrote: post #209

Here's the deal. Insurance is a simple concept. Take house fires. They are fairly rare, but they do happen. We could all just save up enough money to cover a house fire ourselves, or, since we know that house fires are rare, we can pool our money together as friends and neighbors and when one of us in that pool gets unlucky and has their house burn down, it can be covered by insurance. A lot of us pay a little money…

I completely disagree. The reason insurance pays for the small things is to encourage people to seek treatment early because it’s cheaper in the long run. Almost nobody would pay hundreds for a cancer screening like mammogram or colonoscopy that they don’t believe they need, but catching these things early is orders of magnitude better both for health and financial outcomes.

Insurance covering a minor infection prevents needing to handle a major infection. Your system assumes humans are rational and a good judge of risk, something that has proven to be untrue countless times.

Re: Insured, but Still Owing $109K for a Heart Attack

#224

Post by csomar »

jhayward wrote: post #148
csomar wrote: post #146

Looking at the bill, here is some ridiculous: NaCl (basically salted water) costing around $300/liter. That's outrageous. These guys are protected by your politicians and make use of mercenary tactics. Villains in doctors clothing. I'm for free markets but we are kinda going over the limit here. Maybe have fixed rates for emergency where you can't get the approval of the patient. Maybe give the patient the possibilit…

Retail cost for Lactated Ringer's solution, injectable (basic saline fluid for IV) was over $40/liter in qty 12 liters about 3 years ago. I can imagine it has gone up since then. The use of the health care system to extract every single excess dollar from the middle class extends to many, many layers of the supply and service chain. It may be that the saline was "merely" marked up by a factor of 2x.

Seems like the problem is broadly in the medical sector (including pharmacological). There is 0 reasons why it would cost over $1. Maybe $2. $40 is still way ridiculous. I mean in a competitive market.

Re: Insured, but Still Owing $109K for a Heart Attack

#225

Post by s73v3r_ »

scarejunba wrote: post #72
xyzzyz wrote: post #28

Earlier quoted context omitted.

I'm not sure if our patient here was quite in a mood for price shopping, with the whole ongoing heart attack thing.

When there's enough competition, all hospitals will be cheap. He won't price shop at illness time. He'll know which hospitals close by he can afford. There'll be three or four equivalently accessible ones and he'll already know which one he's going to go to. Surgery outcomes in Indian top cardiology hospitals are better than in America. And they're cheaper. And more available. And perform more surgeries per week. Com…

Competition isn't likely everywhere, though. Rural areas, for instance, probably could not support more than one hospital.

Re: Insured, but Still Owing $109K for a Heart Attack

#226

Post by burkaman »

krupan wrote: post #216
burkaman wrote: post #212

Earlier quoted context omitted.

Are you serious? You think every American should be required to write a living will for them and their children listing every conceivable illness and injury by individually researching all the medical options in their area? And what, update it weekly as they follow the markets? Should they keep up with the latest medical research so they know what the newest drugs and treatments will cost? What about vacation, do you…

"listing every conceivable illness and injury" No. Just the ones that are true emergencies where you won't have time to do any shopping around ahead of time. Why is this such a hard concept? Think of all the times you've seen a doctor in your life. How many of those were super time critical? Big accidents and heart attacks are. Having a cold or flu isn't. Heck, even cancer isn't super time critical, you could take a…

Ok, here's one list, I'm sure it isn't comprehensive: http://ourmed.org/wiki/List_of_medical_emergencies

So for each item on this list you'll need to find out every possible treatment and drug and what they cost at every hospital within ~50 miles. Make sure you look up allergies and any side effects when combined with medication you regularly take, you don't want to be in a situation where you listed Hospital X for meningitis, but their cheap drug can't be combined with your asthma medication, or whatever.

And again, how often do you update this will? And what about travel?

Is there anything else in your life that you shop around for in case of emergency?

Re: Insured, but Still Owing $109K for a Heart Attack

#227

Post by alphabettsy »

krupan wrote: post #219
DennisP wrote: post #214

Earlier quoted context omitted.

One reason they do it that way is that if you don't pay for screenings and small problems, people tend to skip going to the doctor for them, and you end up paying for more big, expensive problems.

Yes, and is that line of reasoning working? Are we as a society saving money doing it that way? It seems what people really need is just a savings account and some incentive to actually save money for future expenses (because knowing that someday you are going to get an illness that 100% of people get apparently isn't enough motivation).

HSA’s are available and most people don’t effectively use them, part of the problem is most people don’t/can’t save anyway. You’re not all wrong, but you’re talking about changing behavior which is much harder than just making the system work for how people actually behave.

Re: Insured, but Still Owing $109K for a Heart Attack

#228

Post by krupan »

alphabettsy wrote: post #223
krupan wrote: post #209

Here's the deal. Insurance is a simple concept. Take house fires. They are fairly rare, but they do happen. We could all just save up enough money to cover a house fire ourselves, or, since we know that house fires are rare, we can pool our money together as friends and neighbors and when one of us in that pool gets unlucky and has their house burn down, it can be covered by insurance. A lot of us pay a little money…

I completely disagree. The reason insurance pays for the small things is to encourage people to seek treatment early because it’s cheaper in the long run. Almost nobody would pay hundreds for a cancer screening like mammogram or colonoscopy that they don’t believe they need, but catching these things early is orders of magnitude better both for health and financial outcomes. Insurance covering a minor infection preve…

Yes, humans are shortsighted and stupid. That's why we need state-sponsored medical care. Run by humans.

Re: Insured, but Still Owing $109K for a Heart Attack

#229

Post by h4b4n3r0 »

TomVDB wrote: post #217
h4b4n3r0 wrote: post #139

Earlier quoted context omitted.

>> I'd switch immediately a well I doubt it. Someone needs to pay for it, so this switch would have to imply a 20% tax increase. Unless you’re paid peanuts, it’s not worth the tradeoff.

> Someone needs to pay for it Or you could pay less for it. There are many studies that show how the US system has incredibly high overhead that simply isn't needed. Just an example: in the US, a primary care physician usually has a nurse and somebody who handles paperwork, insurance BS, and what not. Most European countries simply don't have this, mostly because there is no insurance BS to deal with. There is insura…

Once again, US share of taxes in GDP is 26%. Denmark: 50.8, Sweden 49.8, Germany 44.5, France 47.9, UK 34.4. So weighted by GDP it does cost quite a bit.

Re: Insured, but Still Owing $109K for a Heart Attack

#230

Post by swebs »

DesiLurker wrote: post #143
swebs wrote: post #73

Earlier quoted context omitted.

And here's a handy list of all representatives and how much they took from healthcare lobbyists. https://www.opensecrets.org/industries/summary.php?ind=H&cyc...

whats amazing to me is how little money it takes to sway a politicians vote. yes there are big numbers in the list but most of them are 10s of thousands. its just amazing that they are willing to put their conscience aside and condemn people to bankruptcy or worse for that little. for the worshipers of free market they sure are selling themselves off cheap.

I'm amazed by just how high the donations can go. What the hell did senator Sherrod Brown do to get $1.4M from the healthcare industry? A quick Google search doesn't reveal anything out of the ordinary, except for maybe the most ironic tweet of all time:

https://twitter.com/sensherrodbrown/status/89082321753065062...

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