When Medical Debt Collectors Decide Who Gets Arrested • Hacker News Board

Re: When Medical Debt Collectors Decide Who Gets Arrested

#191

Post by dragonwriter » Sun, Oct 20, 2019, 2:40 PM UTC

black_puppydog wrote: post #190

WillPostForFood wrote: post #112

Earlier quoted context omitted.

Pretty much anyone homeless is going be eligible for Medicaid. Problem for them is navigating the system to get care.

The administrational/bureaucracy seems to generally be a problem with the US healthcare system, even for more affluent people. But for homeless people it needs to be close to zero. For moral reasons (it would and does effectively prevent them from being treated like the humans they are) but also for efficiency reasons. If there's clearly no money to be had from someone, minimize your handling losses by giving them wh…

> minimize your handling losses by giving them what they legally deserve without making it a lot of work for everyone.

The problem necessitating bureaucracy in a separate system for the poor on top of the US’s mostly-private-pay health care system is identifying who is eligible and what they legally deserve.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#192

Post by mattkrause » Sun, Oct 20, 2019, 3:03 PM UTC

tehlike wrote: post #152

jliptzin wrote: post #115

Earlier quoted context omitted.

> They need to compete for our business. No, they don't. When you're out of breath with pain running down your left arm and are about to collapse, you're going to try to get to the nearest hospital, not first shop around to see which one has the most competitive rates like you're buying a new car or something.

Emergency is one thing. For others you could have time to shop.

Have you ever actually tried to do this? It is hard.

A family friend, a very smart guy himself, was recently diagnosed with Parkinson’s Disease. Since I’m a neuroscientist, he asked me for advice. I work on brain stimulation, one of the better treatments for Parkinson’s Disease. My institute is a Parkinson’s Centre of Excellence, and I collaborate with movement disorders specialists. I have easy access to experts and tons of relevant training and literature. Nevertheless, I found it very hard to make a recommendation, even between the options his doctor had laid out—-and I wasn’t even considering price, since he has excellent insurance. This decision was smack in the middle of my wheelhouse too; helping with, say, a decision about kidneys would have been even worse.

There’s no way people, especially people in vulnerable situations, can reasonably be expected to catch up with experts that have a decade of advanced training and then second-guess them.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#193

Post by Keverw » Sun, Oct 20, 2019, 3:56 PM UTC

knolax wrote: post #160

smelendez wrote: post #131

Earlier quoted context omitted.

There was an issue a few years ago in Tulsa where the sheriff was deputizing political cronies with minimal training, and one of them,a man in his 70s, fatally shot someone. https://nyti.ms/1aPwG91

"The reserve sheriff’s deputy in Tulsa, Okla., who killed an unarmed suspect, apparently after mistaking his pistol for a Taser" It'd be funny if it wasn't something that actually happened.

There was a story where someone was filming police and they mistaked someones phone for a gun.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#194

Post by shantly » Sun, Oct 20, 2019, 4:58 PM UTC

bhupy wrote: post #137

shantly wrote: post #68

Earlier quoted context omitted.

More important is that states can’t control immigration and cross-border trade, making a variety of policies infeasible or much more expensive, compared with the same implemented nationwide.

Immigration and cross-border trade is free in the EU, and yet healthcare is a member-state level issue. In India, healthcare is explicitly a state issue, not a Union issue.

At a glance, it looks like both have mandates of some sort that keep states/countries from going full-on free rider, which is what I expected.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#195

Post by lotsofpulp » Sun, Oct 20, 2019, 5:50 PM UTC

Animats wrote: post #148

lotsofpulp wrote: post #75

Earlier quoted context omitted.

No health insurance can deny insurance coverage for pre existing conditions since ACA was passed.

No. No US health insurance sold via the ACA marketplace can deny coverage for pre-existing conditions. There are new "short term" insurance policies which are not ACA compliant, and do not cover pre-existing conditions. [1] https://www.commonwealthfund.org/blog/2019/short-term-plans-...

Thanks for that info. I don’t understand why those are allowed to exist, and more importantly, why people buy them.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#196

Post by wglb » Sun, Oct 20, 2019, 5:53 PM UTC

tracker1 wrote: post #73

tracker1 wrote: post #41

I'm reminded of some lines from "A Christmas Carol." "Are there no workhouses? Are there no prisons?" ... It's wild how many changes to embolden debt collections happens in so many places, often snuck in by a few legislators that just don't think they'll get called out and generally don't. I'm lucky to live in a state that to my knowledge has a lot of protections in place and makes it harder to charge interest or sue…

I'm not sure I understand the downvotes... unless those downvoting likes how things are and feel the medical industries should just run roughshod over the population.

Downvotes (which you shouldn't complain about) often mean disagreement.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#197

Post by tehlike » Sun, Oct 20, 2019, 6:28 PM UTC

TheOtherHobbes wrote: post #187

kgantchev wrote: post #177

Earlier quoted context omitted.

In all of those cases you can: 1. Take 30 mins to find the most affordable option. 2. Ask for a lower price.

1. The most affordable option may be a complete waste of money, and you have no way to tell ahead of time. 2. Ditto. You also could just live in a country with a good single payer health service, and know that you'll be treated without any bullshit. The fact that anyone would seriously suggest shopping around for treatment, as if there is a convincing and credible reason why anyone should even have to consider this,…

I think this is the part where i use "could". This is simply not possible today. Doctors dont really know or care how much "you" will be charged vs how much they get paid. If there was more transparency, you could imagine doctors and patients working their way out. People would see the inefficiency, and yake counter measures, both as care giver and care taker.

I have heard multiple stories now whete independent practices now just want cash, without insurance, payments for much cheaper, and they get paid more in the end.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#198

Post by tehlike » Sun, Oct 20, 2019, 6:37 PM UTC

kgantchev wrote: post #177

Broken_Hippo wrote: post #171

Earlier quoted context omitted.

Ok. So when you have flu complications? Gall bladder issues? When you fell and twisted your ankle but don't need emergency services even though you can't really walk? When you need a stint put in? Or how about when you've been diagnosed with an autoimmune disorder? Sure, you technically have time to shop, but it seems to me that this is just an excuse and makes sick people suffer more.

In all of those cases you can: 1. Take 30 mins to find the most affordable option. 2. Ask for a lower price.

2 is interesting.

We are expecting a baby, and one of the tests we had to get done early in the pregnancy was NIPT. There was 2-3 companies we could go with, and when we asked for the price they responded some number between >2.7K - I don't really recall - it could even be 8K. When asked for the cash price, they said 250$.

Crazy.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#199

Post by Faark » Sun, Oct 20, 2019, 7:07 PM UTC

flexblue wrote: post #178

dthul wrote: post #174

Earlier quoted context omitted.

I guess the point is: No matter whether you are privately or publicly insured in Germany, a transport in an ambulance, an emergency helicopter ride, a long-winded illness like cancer, or any other medical treatment won't ruin you financially. The same goes for most (all?) of Europe.

Doesn't insurance in the US cover these cases? I think it ultimately comes down to whether people can afford healthcare or not. For instance, healthcare costs are covered with unemployment benefits in Germany. If you don't have insurance in Germany you'll have to pay for that yourself as well. That's rare, but it happens especially with the precariously self-employed. The issue with the US system is that you can't ha…

> If you don't have insurance in Germany you'll have to pay for that yourself as well. That's rare, but it happens especially with the precariously self-employed.

The difference is GKV being the default, and opting out of that kind of hard. You have to earn €5,062+ per month, for a start [0]. And the step is intentionally hard to reverse. I consider that a decent compromise. At that point people have to actively shoot them self in the foot, and I've little pity for those.

If you didn't opt out, thus are still under the GKV, the system will cover emergency services. Even if you haven't payed (yet).

[0] https://www.bundesaerztekammer.de/weitere-sprachen/english/h...

Re: When Medical Debt Collectors Decide Who Gets Arrested

#200

Post by hannasanarion » Sun, Oct 20, 2019, 7:13 PM UTC

flexblue wrote: post #178

dthul wrote: post #174

Earlier quoted context omitted.

I guess the point is: No matter whether you are privately or publicly insured in Germany, a transport in an ambulance, an emergency helicopter ride, a long-winded illness like cancer, or any other medical treatment won't ruin you financially. The same goes for most (all?) of Europe.

Doesn't insurance in the US cover these cases? I think it ultimately comes down to whether people can afford healthcare or not. For instance, healthcare costs are covered with unemployment benefits in Germany. If you don't have insurance in Germany you'll have to pay for that yourself as well. That's rare, but it happens especially with the precariously self-employed. The issue with the US system is that you can't ha…

Compulsory purchases are constitutional, as long as Congress can reasonably invoke its taxation power in application of the penalty. Americans are already compelled to buy health insurance, but as of the 2017 Republican tax bill, the penalty for not doing so is $0.