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When Medical Debt Collectors Decide Who Gets Arrested

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Re: When Medical Debt Collectors Decide Who Gets Arrested

#211

Post by flexblue »

Faark wrote: post #199
flexblue wrote: post #178

Earlier quoted context omitted.

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 shoo…

> The difference is GKV being the default, and opting out of that kind of hard.

It's not hard at all, just go self-employed and you have the option.

> And the step is intentionally hard to reverse.

Yes, so that people towards the end of their lives don't profit from a system they never paid into. You're stuck with expensive private insurance for the rest of your life. In the US however, you would qualify for Medicaid.

> At that point people have to actively shoot them self in the foot, and I've little pity for those.

It's actually not that uncommon for people to fall into the trap of working self-employed for most of their lives, then retiring poor because they never paid into the pension system and their private insurance costs them over 500€/month.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#212

Post by hestipod »

logicbombr wrote: post #125
hestipod wrote: post #36

Earlier quoted context omitted.

I've been trying to move back abroad since I returned to the USA. It's not as easy as people think in the best of times to immigrate, let alone when you are in such bad shape all around. No place takes broken and relatively broke people. Believe me I'd have been gone years ago if I could have managed it. I've thought about extreme ideas like asylum but my research shows it's never granted to people from such countrie…

If you are a software engineer just came to brazil and you will live as a king here. There more than 400,000 jobs opening related to computer science. And I’m sure you will have access to universal health system and private ones.

I am not a sw engineer and cannot work consistently or enough to earn like a normal person. That's the entire problem. My health was ruined and my finances decimated. Since without social aid your health is required to work and buy a life that puts me in an unsurvivable situation.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#213

Post by flexblue »

hannasanarion wrote: post #200
flexblue wrote: post #178

Earlier quoted context omitted.

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.

Then it's not a compulsory purchase, it's a tax. The money doesn't go to the insurer. Even before the penalty was $0, it was too low to be effective.

In Switzerland, it is compulsory to purchase insurance, there's a basic plan that all insurers must offer, and if cost exceeds a certain fraction of the income, the state chips in.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#214

Post by tehlike »

mattkrause wrote: post #192
tehlike wrote: post #152

Earlier quoted context omitted.

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 an…

i was mostly saying "it should be possible", not that it is possible/easy today.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#215

Post by black_puppydog »

dragonwriter wrote: post #191
black_puppydog wrote: post #190

Earlier quoted context omitted.

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.

Other countries define "what they legally deserve" that pretty much as "what makes sense, medically"...

Re: When Medical Debt Collectors Decide Who Gets Arrested

#216

Post by FDSGSG »

yardie wrote: post #204
FDSGSG wrote: post #168

Earlier quoted context omitted.

If you're moving because you're probably going to die if you don't, does it really matter whether or not you're doing so legally or not? It's really easy to remain in EU forever as an illegal immigrant, in some places your immigration status will have no effect on your access to free healthcare.

I've met many illegal aliens in the EU. It's not an easy life. Yes, you could move to one of the EU countries, clandestine. You would give up up a lot to do so. Access to work would be "on the black." Access to housing would be restricted to sublets with multiple roommates, who are also in the same illegal immigrants. A good friend of mine, without papers, was living 10+ people in a 2 bedroom flat. Everything he owne…

> Access to housing would be restricted to sublets with multiple roommates, who are also in the same illegal immigrants.

Nobody has ever checked my immigration status while renting in the EU, nobody has ever cared about the fact that I work for an US company owned by me that pays my salary to my US account.

Sure, maybe you'll have a bad time renting in France. Don't go live in France unless you want to have a hard time while renting.

> A good friend of mine, without papers, was living 10+ people in a 2 bedroom flat

A good friend of mine, is here illegally and lives in a nice central 2 bedroom flat in Barcelona all by himself. He had zero trouble finding an apartment, the landlords just don't give a shit.

Many illegal immigrants are completely broke, but that's by no means a requirement.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#217

Post by FDSGSG »

hestipod wrote: post #209
FDSGSG wrote: post #168

Earlier quoted context omitted.

If you're moving because you're probably going to die if you don't, does it really matter whether or not you're doing so legally or not? It's really easy to remain in EU forever as an illegal immigrant, in some places your immigration status will have no effect on your access to free healthcare.

Because as someone said below it's not going to fix things just by being in another place I like better. Being illegal is a hard life with constant risk and lack of access to many things. It's not "really easy" at all and I don't know why anyone would think that. I need MORE stability than I have...not less. I said I am going to move because I refuse to die in this miserable country after what it's done to me. The on…

> Being illegal is a hard life with constant risk and lack of access to many things

It's a hard life in the US, often with access to even less things than illegal immigrants have here. Not sure what this "constant risk" is, unless you engage in violent crime you'll find it very difficult to get yourself deported.

By far the biggest thing you lose is the ability to fly around easily, but it remains (and will remain) easy to sneak out after overstaying your visa waiver.

> It's not "really easy" at all and I don't know why anyone would think that

Because I know multiple illegal immigrants who vastly improved their lives by moving. A good friend of mine spent 4 years going in and out of KS state prisons, after a while he decided that he needed a change of scenery and hopped on a plane to Spain.

There's little chance he could get a visa without lying, but that hasn't really affected his life. He makes a living freelancing online, gets paid to his US account and pays the IRS. Here he enjoys access to excellent healthcare without risking bankruptcy.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#218

Post by Nosewelder »

flexblue wrote: post #161
hannasanarion wrote: post #122

Earlier quoted context omitted.

Because for-profit healthcare is immoral, wasteful, and inevitably results in scenarios like the above. A Bismarck system (nonprofit govt sponsored insurance companies that all charge the same and are taken by all doctors) would be fine too, but that's not on the table in the US

> Because for-profit healthcare is immoral, wasteful, and inevitably results in scenarios like the above. There's no such thing as a healthcare system where nobody profits in some way. Lots of people working in "non-profit" organizations are still lining their pockets. > A Bismarck system (nonprofit govt sponsored insurance companies that all charge the same and are taken by all doctors) would be fine too, but that's…

"Bismarck" is a class of healthcare systems, referring to employer/employee financed insurance-based healthcare. It is used in Germany, the Nederlands, and Switzerland I think. Other models are Beveridge (like the UK) and National Insurance like Canada.

The difference in payment between US and European health care workers isn't large enough to make much of a dent in US healthcare expenses. The big sources of costs is the US massive bureaucracy dealing with bills, insurance and negotiation, as well as the medical inefficiency and overprovision inherent in the system. Also high drug prices.

For example, a US medical doctor makes about 100 000 $ more than the European average, although a few countries pays doctors more. There are about 1 million doctors working in the US. So thats 100 billion. US overspending is about 1 500 - 1 800 billion.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#219

Post by ceejayoz »

kgantchev wrote: post #175
hannasanarion wrote: post #122

Earlier quoted context omitted.

Because for-profit healthcare is immoral, wasteful, and inevitably results in scenarios like the above. A Bismarck system (nonprofit govt sponsored insurance companies that all charge the same and are taken by all doctors) would be fine too, but that's not on the table in the US

> Because for-profit healthcare is immoral The [majority of hospitals in the US are non-for-profit]( https://www.aha.org/statistics/fast-facts-us-hospitals ). Needless to say, they are not able to provide a cheaper service than the for-profit hospitals. So there is some factor, unrelated to profit, which makes healthcare expensive. If profit was causing healthcare expenses to rise, then non-for-profit hospitals shoul…

The "not for profit" thing is a bit of a fiddle.

Sure, there aren't shareholders getting dividends. There are plenty of other motives that push non-profit hospital systems to want to make money. New buildings, fancy robotic surgery machines, cushy patient amenities to compete with the other system in town, expensive administrators and staff...

Re: When Medical Debt Collectors Decide Who Gets Arrested

#220

Post by Nosewelder »

mars4rp wrote: post #80
hestipod wrote: post #3

My life was ruined by badly done, and even worse ultimately unneeded surgery. That privilege initially cost me many thousands, along with career and insurance going away, and the subsequent struggle to survive since has cost multiples of that. My entire future billed away. For a time I was able to avoid collectors because of a significant savings a frugal life had left me, but as time goes on you have to choose betwe…

I know people in HN hate to talk about politics, but this is a political problem. People, please vote for medicare for all candidates, it might not affect your life now, but you don't know what the future holds for you.

About the "free market" approach: Medical care has what in economics is known as "zero price elasticity". That means that people have zero ability to refuse the product if the price is too high. In economics, its associated with market failure, because low price elasticity means providers make more money by raising prices than by competing with each other.

Some subsets of the health care industry have price elasticity and seem to work fine in the free market, such as Lasik and liposuction etc. But stuff that gets called medically necessary don't work in a market, there is an entire branch of economics dedicated to it: Health Care Economics. Ironically pioneered by an American, Kenneth Arrow. Won him a Nobel Prize.

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