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US doctor forgives $650k in medical bills for cancer patients

bbc.com

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Re: US doctor forgives $650k in medical bills for cancer patients

#131

Post by Areading314 »

roenxi wrote: post #127
shakezula wrote: post #13

Earlier quoted context omitted.

And even if you can contest the denial, it can take days to months to get it back, meanwhile you’re shouldered with the burden of paying full price for your treatment with the _hope_ that they’ll reimburse you later. My fiancée has cancer, and we regularly joke that dealing with insurance companies is worse than the actual stage 3 cancer she has. They constantly deny her coverage for medications she’s been on for yea…

> Medical care should never be tied to personal wealth, period. There is literally no limit to how much effort society can put into one person's healthcare. In the absurd extreme, we could reshape society into doctors, farmers and medical manufacturers in a mad quest for best possible medical care. At some point we have to ration healthcare and decide when to put more resources towards something else. If not personal…

> Unless there is some really amazing alternative, money is one of the best proxies available for for contribution to society

This is an absolutely ridiculous assertion. Many people inherit, luck out, or get wealthy by other means. Personal wealth is a terrible way to determine "societal value". It is deeply disturbing to me that there are people with these types of views. I hate to assume but my impression is that you have not had to personally experience much hardship, would you say that is accurate?

Re: US doctor forgives $650k in medical bills for cancer patients

#132

Post by 29athrowaway »

lotsofpulp wrote: post #122
29athrowaway wrote: post #120

This episode of "Adam ruins everything" covers healthcare insurance providers: https://www.youtube.com/watch?v=CeDOQpfaUc8 My takeaway is that the system is calibrated to aggresively punish people without insurance.

The system was calibrated to create as much friction to receiving healthcare if you are poorer (usually meant you didn’t have insurance pre ACA). Medicaid is the “insurance” for poor people, which pays healthcare providers on the low end and a as a result is not accepted as much. The more friction that it creates for poorer people, the less healthcare they will use, and that helps keep taxes low.

Interesting perspective. Although preventive care is usually cheaper for society than the alternatives IMO.

I've heard in some countries, e.g.: the UK, you get summoned by your doctor for preventive care, and this approach helps reducing the overall cost of healthcare.

Re: US doctor forgives $650k in medical bills for cancer patients

#133

Post by Aerroon »

wvenable wrote: post #45
Aerroon wrote: post #20

Earlier quoted context omitted.

It's inevitable that medical care in some way is tied to personal wealth. Some treatments are so expensive and/or niche that public programs likely wouldn't cover them. Such treatments will probably always exist. (And if they didn't, then that could he a problem by itself.) But at least basic modern healthcare (things that existed ~20 years ago) should be provided as (mostly) free to the patient. We need people to no…

> Some treatments are so expensive and/or niche that public programs likely wouldn't cover them. I have co-worker with a very unique disease with a very niche and very expensive treatment and here in Canada it's free. The whole point of public health care is that the cost is spread among everyone -- the young, the healthy, the old, the very sick.

You can sink virtually infinite resources into healthcare. There are always going to be more things to research and develop treatments for. At some point you have to draw a line, because the cost to the system can become enormous.

Take some of the gene therapies as an example.[0] Zolgensma costs over $2 million per treatment or Zynteglo[1] that costs $1.8 million per treatment. Maybe US healthcare can afford this, but poorer countries can't. The hope is that the existence of these treatments means that they will eventually come down in price. 20-50 years from now I expect these treatments to be part of basic healthcare in most countries. On the other hand, if we limit the existence of treatments like these right now, then maybe 20-50 years from now these treatments simply wouldn't exist.

Healthcare systems always play with limited resources. We should first start covering dental care, glasses and eyesight surgeries as an example of something that's missing in a lot of countries.

Furthermore, regardless whether the system had the money or not, some 'treatments' will still be niche and not considered 'healthcare'. Traditional medicine can help with some problems, but it might not fall under healthcare. Most things related to diet are basically a pseudo science, but some of them work for some people. You'll never cover all of this.

[0] https://www.reuters.com/article/us-novartis-genetherapy-idUS...

[1] https://www.wsj.com/articles/new-gene-therapy-priced-at-1-8-...

Re: US doctor forgives $650k in medical bills for cancer patients

#134

Post by roenxi »

Areading314 wrote: post #131
roenxi wrote: post #127

Earlier quoted context omitted.

> Medical care should never be tied to personal wealth, period. There is literally no limit to how much effort society can put into one person's healthcare. In the absurd extreme, we could reshape society into doctors, farmers and medical manufacturers in a mad quest for best possible medical care. At some point we have to ration healthcare and decide when to put more resources towards something else. If not personal…

> Unless there is some really amazing alternative, money is one of the best proxies available for for contribution to society This is an absolutely ridiculous assertion. Many people inherit, luck out, or get wealthy by other means. Personal wealth is a terrible way to determine "societal value". It is deeply disturbing to me that there are people with these types of views. I hate to assume but my impression is that y…

> This is an absolutely ridiculous assertion.

What do you think is a better proxy?

Re: US doctor forgives $650k in medical bills for cancer patients

#135

Post by lotsofpulp »

29athrowaway wrote: post #132
lotsofpulp wrote: post #122

Earlier quoted context omitted.

The system was calibrated to create as much friction to receiving healthcare if you are poorer (usually meant you didn’t have insurance pre ACA). Medicaid is the “insurance” for poor people, which pays healthcare providers on the low end and a as a result is not accepted as much. The more friction that it creates for poorer people, the less healthcare they will use, and that helps keep taxes low.

Interesting perspective. Although preventive care is usually cheaper for society than the alternatives IMO. I've heard in some countries, e.g.: the UK, you get summoned by your doctor for preventive care, and this approach helps reducing the overall cost of healthcare.

Preventative care is not subject to deductibles (i.e. free for people with insurance) after ACA, such as annual wellness exams, vaccinations, etc.

People just don’t want to do it, or if they do, they don’t want to give up their sugar/carbs/alcohol/sat fats/sedentary lifestyle habits. Which is probably the cause for the majority of chronic healthcare spending.

Re: US doctor forgives $650k in medical bills for cancer patients

#136

Post by k_sze »

alphabettsy wrote: post #28
shakezula wrote: post #13

Earlier quoted context omitted.

And even if you can contest the denial, it can take days to months to get it back, meanwhile you’re shouldered with the burden of paying full price for your treatment with the _hope_ that they’ll reimburse you later. My fiancée has cancer, and we regularly joke that dealing with insurance companies is worse than the actual stage 3 cancer she has. They constantly deny her coverage for medications she’s been on for yea…

It’s intentional. They save billions using this practice because some people don’t have the time, knowledge or resources to dispute.

I don't even understand how the "health care" system and the insurance industry can be both so messed up in the US.

It may be just anecdata, but In Hong Kong, my family has an insurance agent whom we work very close with. We're just middle class. E.g. only my dad has a car; my sister is 42 and I'm 38, and we still don't have our own car. Whenever something related to making use of the insurance plan comes up, the insurance agent would be very helpful and ensure we get our money's worth. She would teach us what to do in order to not miss out on benefits. The claims process is also easy. We don't get this nonsense where the insurer tries to deny us and hope that we don't dispute.

Re: US doctor forgives $650k in medical bills for cancer patients

#137

Post by lotsofpulp »

k_sze wrote: post #136
alphabettsy wrote: post #28

Earlier quoted context omitted.

It’s intentional. They save billions using this practice because some people don’t have the time, knowledge or resources to dispute.

I don't even understand how the "health care" system and the insurance industry can be both so messed up in the US. It may be just anecdata, but In Hong Kong, my family has an insurance agent whom we work very close with. We're just middle class. E.g. only my dad has a car; my sister is 42 and I'm 38, and we still don't have our own car. Whenever something related to making use of the insurance plan comes up, the ins…

> We don't get this nonsense where the insurer tries to deny us and hope that we don't dispute.

It’s also not the case in 99% of US claims. The ones you hear about are typically due to healthcare providers not providing sufficient justification for the healthcare or medications they are prescribing, which can easily cost tens of thousands, if not hundreds of thousands of dollars.

The “insurers” are many times not even the payer. In many cases, the government hires insurers to adjudicate healthcare according to the government’s rules, which will specify under what scenario and documentation they will pay for certain treatments.

Surely, there are mistakes made, but there is no standard operating procedure at insurance companies to deny healthcare. They employ teams of doctors and pharmacists to review cases and determine what is evidence based medicine and what conforms to the payers’ guidelines.

Re: US doctor forgives $650k in medical bills for cancer patients

#138

Post by beachy »

roenxi wrote: post #127
shakezula wrote: post #13

Earlier quoted context omitted.

And even if you can contest the denial, it can take days to months to get it back, meanwhile you’re shouldered with the burden of paying full price for your treatment with the _hope_ that they’ll reimburse you later. My fiancée has cancer, and we regularly joke that dealing with insurance companies is worse than the actual stage 3 cancer she has. They constantly deny her coverage for medications she’s been on for yea…

> Medical care should never be tied to personal wealth, period. There is literally no limit to how much effort society can put into one person's healthcare. In the absurd extreme, we could reshape society into doctors, farmers and medical manufacturers in a mad quest for best possible medical care. At some point we have to ration healthcare and decide when to put more resources towards something else. If not personal…

All good questions, but irrelevant to the point you are refuting.

With a public health system, medical care is tied to the country's wealth - not to any individual.

In my country, a government body negotiates with the drug companies on behalf of the entire country.

That does indeed mean that some drugs are not funded - e.g new cancer drugs can take some time, or maybe never be publicly provided.

But what will (should) never happen under the public system is that a poor person is denied equivalent medical treatment to a wealthy person.

For people who want access to a higher level of care - there's private health insurance. Many have it, and use it, but anyone without it is provided the same base level of care, including free hospital treatment, available to everyone else.

Re: US doctor forgives $650k in medical bills for cancer patients

#139

Post by snakeboy »

Areading314 wrote: post #131
roenxi wrote: post #127

Earlier quoted context omitted.

> Medical care should never be tied to personal wealth, period. There is literally no limit to how much effort society can put into one person's healthcare. In the absurd extreme, we could reshape society into doctors, farmers and medical manufacturers in a mad quest for best possible medical care. At some point we have to ration healthcare and decide when to put more resources towards something else. If not personal…

> Unless there is some really amazing alternative, money is one of the best proxies available for for contribution to society This is an absolutely ridiculous assertion. Many people inherit, luck out, or get wealthy by other means. Personal wealth is a terrible way to determine "societal value". It is deeply disturbing to me that there are people with these types of views. I hate to assume but my impression is that y…

> It is deeply disturbing to me that there are people with these types of views.

Just friendly advice: you're never going to have a meaningful discussion or a productive debate if that's how you treat a differing opinion.

Re: US doctor forgives $650k in medical bills for cancer patients

#140

Post by KSteffensen »

chordalkeyboard wrote: post #97
tomaskafka wrote: post #92

$650k gets you something like measuring of temperature and prescription of Paralen in the US, right? (I am always amazed how an act or treatment that costs around $20 in Europe costs thousands of dollars in the US and no one seems to mind.)

> no one seems to mind Oh we mind alright, we just don't have effective means of changing the system.

Not as long as the US citizenry as as afraid of taxes and 'socialism' as they are.
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