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

Re: When Medical Debt Collectors Decide Who Gets Arrested

#221

Post by ceejayoz » Mon, Oct 21, 2019, 1:07 PM UTC

TheDong wrote: post #155

AnthonyMouse wrote: post #138

Earlier quoted context omitted.

> Because for a lot of people, there is no real choice involved. If there's one hospital around for hundreds of miles, they realistically don't have the option to go to one further out when their job expects them to be available for work every single day. Federal law requires employers to provide at least unpaid sick leave. That caps the premium a local hospital can charge over competitors at the loss of the day's wa…

> Federal law requires employers to provide at least unpaid sick leave. That caps the premium a local hospital... Not really. The law you're referring to is the Family and Medical Leave Act (FMLA), which only applies for childbirth and "serious health conditions". Most things you can shop around for also aren't serious enough to qualify, so you're not entitled to such unpaid sick leave. But also, it's kinda a moot po…

FMLA has an even bigger gaping loophole - it only applies to employers with 50+ employees. That excludes an enormous number of people.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#222

Post by ceejayoz » Mon, Oct 21, 2019, 1:10 PM UTC

snagglegaggle wrote: post #57

77pt77 wrote: post #34

> Judges don’t need a law degree in Kansas, or many other states, to preside over cases like these You can't make this up!

I think this is completely fine. You'd rather be ruled by a credentialed class that could have opinions completely divorced from reality? The law is supposed to be human and obvious. Any case that "requires" a JD and ten years experience is likely full of trash.

> You'd rather be ruled by a credentialed class that could have opinions completely divorced from reality?

There's a great New Yorker cartoon about this. https://www.newyorker.com/cartoon/a20630

Re: When Medical Debt Collectors Decide Who Gets Arrested

#223

Post by ceejayoz » Mon, Oct 21, 2019, 1:12 PM UTC

lotsofpulp wrote: post #195

Animats wrote: post #148

Earlier quoted context omitted.

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.

People buy them because 90% of the customers are happy evangelists. "I pay next to nothing for my health insurance!"

The other 10% actually wound up having to use it, and discovered why the ACA said they don't count as insurance.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#224

Post by dragonwriter » Mon, Oct 21, 2019, 1:14 PM UTC

black_puppydog wrote: post #215

dragonwriter wrote: post #191

Earlier quoted context omitted.

> 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"...

The part that requires bureaucracy for Medicaid is making sure the recipient is legally entitled to Medicaid at all (and, if they are, that they still don't have other insurance which should be paying ahead of Medicaid.)

That’s where having a separate system for the medically indigent in a mostly prvate-pay system becomes much more burdensome, per covered person, than a universal coverage system without private insurance.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#225

Post by flexblue » Mon, Oct 21, 2019, 1:57 PM UTC

Nosewelder wrote: post #218

flexblue wrote: post #161

Earlier quoted context omitted.

> 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…

> It is used in Germany, the Nederlands, and Switzerland I think.

Germany today has a public/private mixture, Switzerland and Netherlands is fully private. I'm making this distinction because private profits do exist in these system, while the original comment I replied to lamented them.

> 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.

Are you sure about this? Last time I looked it up, I came to a different conclusion: Administrative overhead (~8%) is neither a huge part of costs, nor is it massively different than in Europe. Drugs prices also only account for 10%.

Salaries for workers on the other hand are a significant chunk, and those are easily double than those in Germany in most cases. Note that I'm talking about all salaries, doctors, nurses, clerks, cleaners...

I agree with the overprovisioning being much costlier, but those are due to legal liabilities being more expensive in the US in general. In Germany, even if you win a malpractice suit, you get a pittance.

> There are about 1 million doctors working in the US. So thats 100 billion. US overspending is about 1 500 - 1 800 billion.

Again, this disregards the vast majority of worker salaries involved.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#226

Post by mcv » Mon, Oct 21, 2019, 3:47 PM UTC

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…

> "things I did not consent to be sent away or billed externally."

This may be the thing that most baffles me about this: how can you be held responsible for costs you never agreed to?

Mysterious medical costs popping up that you were never aware of and never agreed to, sounds like a recipe for fraud and extortion.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#227

Post by mcv » Mon, Oct 21, 2019, 3:51 PM UTC

xhgdvjky wrote: post #119

mars4rp wrote: post #80

Earlier quoted context omitted.

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.

Why Medicare for all vs other reforms

Which other reforms exactly?

Both the situation before ACA and the reaction to it have shown that privatised health insurance is never going to work in the US. Medicare for All looks like the only practical way forward, and it's been gaining a lot of momentum as a result. Medicare itself also still needs some fixes; at the moment the government isn't even allowed to negotiate prices. That's a law that clearly needs to be repealed. But other than that, Medicare for All sounds pretty good, and I'm not aware of any other credible proposal that looks anywhere near as good.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#228

Post by mcv » Mon, Oct 21, 2019, 3:54 PM UTC

flexblue wrote: post #225

Nosewelder wrote: post #218

Earlier quoted context omitted.

"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…

> It is used in Germany, the Nederlands, and Switzerland I think. Germany today has a public/private mixture, Switzerland and Netherlands is fully private. I'm making this distinction because private profits do exist in these system, while the original comment I replied to lamented them. > The difference in payment between US and European health care workers isn't large enough to make much of a dent in US healthcare…

> "Switzerland and Netherlands is fully private."

Private insurance in those countries works because those markets are highly regulated, and they don't have a corporate culture of trying to rip off people as much as they can.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#229

Post by tracker1 » Mon, Oct 21, 2019, 5:00 PM UTC

wglb wrote: post #196

tracker1 wrote: post #73

Earlier quoted context omitted.

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.

There was a bit there... and without an actual reply, it's hard to know what part or parts someone took offense to or disagreement with. I'm fine with being down-voted, but would prefer to have at least some insight into the why. As it is, there was no furthering any discussion which is less than productive.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#230

Post by dillondoyle » Wed, Oct 23, 2019, 5:44 AM UTC

dunnevens wrote: post #170

dillondoyle wrote: post #98

Earlier quoted context omitted.

I'd love to hear what you think of KS-Sen race if you have been keeping up?

I have kept up a little. The GOP establishment is scrambling to keep Kris Kobach out of the race, but he's popular with the sort of voter who shows up in droves to the Republican primaries. So, he's the front runner. Considering his loss in the 2018 gubernatorial race, KS Democrats are hoping he'll win the primary. He's as unpopular with general election voters as Brownback now is. Democratic side is full of candidat…

Glad you like Boller - or minimally think she is interesting / courageous ;)

I think there's a struggle to motivate national $$ with a moderate message/candidate. But I think we all might be surprised that the truth, the honest personal story, (and the insider electability politics) might be even more valuable than some liberal issue crusader.