US doctor forgives $650k in medical bills for cancer patients • Hacker News Board

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

#141

Post by refurb » Wed, Jan 06, 2021, 10:15 AM UTC

arcticbull wrote: post #123

refurb wrote: post #109

Earlier quoted context omitted.

Here is a good example as to why you might want to go to the US for cancer care. "It's crazy that I live in Canada, but now I'm looking at having to sell my house for coverage of my medication." https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-...

That's one people out of 36 million, making national news. You'll trip over a stack of them on your way to the news stand in the US. "I'm looking at having to sell my house for coverage of my medication" is practically America's national anthem. Failures happen from time to time but they are the exception and not the norm. Numbers available here: [1] for the most part Canadians getting medical care in the US are "sno…

I'm just calling out that health care coverage in Canada isn't all peaches and cream. I've experienced both systems so I know what the pros/cons of each are.

Here is another examples: https://www.cbc.ca/news/canada/british-columbia/patients-liv...

People in pain (who can't work or even walk) waiting 2 or 3 years for hip replacement. A friend of my mom's in BC is 85, needs a new hip and the gov't said no. Not "no, maybe later" it was just "no, you're too old for it to be worthwhile".

Now don't get me wrong, this is why healthcare is Canada is way more affordable than the US. The Canadian system is just limited by budget - the provinces set the budget (based on support from the federal gov't) and then say "this is how many hip replacements we'll do this year". And if you're not a priority, you wait.

While in the US, if you're either poor (Medicaid), retired (Medicare) or have good insurance through your employer (majority), you'll get care pretty quickly. But that comes at a cost - a cost about double of healthcare costs in Canada.

Again, I'm not saying the US system is better. It's outrageously expensive system, leaves many without care and is unsustainable. But if you're a middle class person in the US, don't expect the Canadian system will give you the exact same care for free.

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

#142

Post by refurb » Wed, Jan 06, 2021, 10:17 AM UTC

arcticbull wrote: post #115

refurb wrote: post #104

Earlier quoted context omitted.

Disagree on private healthcare being abolished. If people want to spend their own money outside the single payer system, why not let them? It doesn't absolve them of contributing to the public system, so the public system benefits when they decide to go outside it. And in Canada, there isn't much private healthcare because of the way Medicare is set up. A doctor has to choose - practice in the public system or the pr…

It varies from province to province [0]. What you're saying is true in some provinces but not all. However, even in the provinces without material barriers, no private sector exists. The article actually provides some solid theories. Your information about MRI waiting times isn't accurate in general - or rather paints only part of the picture. Even with the COVID situation happening now, in Ontario... Patients who sh…

"For the 90th percentile wait times, the improvements are even more significant. Province-wide, wait times went from an average of 221 days to 161 days."

That's a success? Waiting half a year for an MRI?

Come on. I'm Canadian and know plenty of Canadians. Wait times are one of the major issues in Canada. Yes, if you don't need it right now, you wait - sometimes years. But sometimes you need it in the next few weeks and you wait months.

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

#143

Post by Aerroon » Wed, Jan 06, 2021, 10:18 AM UTC

arcticbull wrote: post #23

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…

> 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.) Not in a single-payer state, no. It's also not really a problem in and of itself. You'll find that if cancer treatments are actually cheaper an…

>Not in a single-payer state, no.

You can always go to another country or just pay someone personally to hear out your problems and help fix them. You can't avoid that.

>It's also not really a problem in and of itself. You'll find that if cancer treatments are actually cheaper and more effective than the status quo as demonstrated by a study that a single payer state will quickly take them up.

Some people report that doing a ketogenic diet helps them control some diseases (eg diabetes). It's been a decade since its surge in popularity. Keto doesn't seem to always work, but it seems to work for some. Is it considered a treatment yet? Because doing a keto diet is likely to incur a higher cost - carbs are cheaper compared to protein and fats.

>Healthcare isn't a pay-to-win game. Generally if you find a way to pay more to get better care you're just bumping someone else down the priority list.

What do you mean? Healthcare is not a fixed pie. It's constantly expanding in what can be treated, you can train and hire more doctors and nurses, you can make more and better equipment. If people are willing to pay enough extra for some treatment, then this can directly lead to the capacity of that treatment increasing.

>That may be acceptable in America but it's not in much of the rest of the world.

This is exactly how it works in many countries. You have your public healthcare and then private healthcare, where you can skip queues.

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

#144

Post by pembrook » Wed, Jan 06, 2021, 10:20 AM UTC

serial_dev wrote: post #99

Pfhreak wrote: post #16

This is a prime example of a feel good story that is papering over systemic problems. We're meant to read this and think this doctor is a good person (and they are, at least for this act) rather than, "how is it possible there was this much medical debt for cancer treatment to forgive?" Yes, debt forgiveness is great and something we can all do as mutual aid, but we also need to acknowledge that the deeply flawed ide…

Exactly. I feel the same way about GoFundMe campaigns for medical bills. On one hand, I'm happy that some of them can get outside help, on the other hand why is a GoFundMe campaign necessary to stay afloat?

What’s so ironic about GoFundMe is that it’s basically a diorama of how socialized medical care would work (minus the cost savings), and yet nobody has any political objections to socialized funding when it happens there.

I recall debating with a friend who was against socialized healthcare recently, and then seeing them promote a GoFundMe campaign for a mutual friend’s medical bills on Facebook a few days later.

The irony was lost on him. I think the key is that Americans love to dream of themselves as wealthy philanthropists (no matter how poor they actually are).

If there was a way to make paying taxes feel more like philanthropy, maybe we could solve this. Maybe it’s as simple as giving everybody a certificate with a list of anonymized names and what treatments they helped pay for, so they can brag about it on Facebook.

“I helped pay for a child’s chemotherapy” instead of “the government took my money”

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

#145

Post by dxdm » Wed, Jan 06, 2021, 10:20 AM UTC

roenxi wrote: post #134

Areading314 wrote: post #131

Earlier quoted context omitted.

> 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?

You seem to be assuming that "contribution to society" should be the only factor when portioning out health care, and that there should be only one "best" proxy to measure such a factor. Why?

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

#146

Post by sillysaurusx » Wed, Jan 06, 2021, 10:26 AM UTC

shakezula wrote: post #13

Areading314 wrote: post #11

One of the most unfair characteristics of US healthcare is that if the health insurance company does not cover a claim, then the patient is responsible for the payment. It is unrealistic in practice for a patient to know or understand the process by which claims are made (since they are made by an error prone and disinterested provider administrator, and are made in a non-transparent and highly complex way), and also…

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…

I'm so sorry to hear about your fiancee. We don't know each other, but I can only imagine what that'd be like. Wishing you both a good 2021!

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

#147

Post by uzakov » Wed, Jan 06, 2021, 10:29 AM UTC

vidarh wrote: post #86

arcticbull wrote: post #72

Earlier quoted context omitted.

Interestingly, private healthcare isn't banned in Canada but in in reality, there's virtually none of it. The system is designed so that the public sector doesn't subsidize a potential private sector, and without those subsidies, nobody's interested. Personally, I agree with you. Private healthcare should be abolished entirely.

In the UK, about 10 percent has private insurance, but nearly all private plans are 'top up' type plans where the assumption is that you usually rely on the NHS first, but ask for a private referral if you need a specialist or procedure there's a wait for. As a result they're generally pretty cheap. In effect you're paying to jump queues for a limited resource.

I don't know if you live in the UK but I can share my 2 cents: UK NHS systems isn't exactly what many Americans picture it.

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

#148

Post by [deleted] » Wed, Jan 06, 2021, 10:32 AM UTC

ant6n wrote: post #107

rangibaby wrote: post #55

Earlier quoted context omitted.

In rich countries outside of the US it’s called “the government”

Other countries are slipping, though. For example, Germany does not actually have a single-payer system, but instead a "system" of public and private health insurance companies. As an employee you`re usually in the public system, which can be more expensive for higher-earners because the fees are based on your income (although the health taxes are regressive, capped above like 65K income per year). Self-employed peop…

[deleted]

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

#149

Post by inter_netuser » Wed, Jan 06, 2021, 10:32 AM UTC

arcticbull wrote: post #115

refurb wrote: post #104

Earlier quoted context omitted.

Disagree on private healthcare being abolished. If people want to spend their own money outside the single payer system, why not let them? It doesn't absolve them of contributing to the public system, so the public system benefits when they decide to go outside it. And in Canada, there isn't much private healthcare because of the way Medicare is set up. A doctor has to choose - practice in the public system or the pr…

It varies from province to province [0]. What you're saying is true in some provinces but not all. However, even in the provinces without material barriers, no private sector exists. The article actually provides some solid theories. Your information about MRI waiting times isn't accurate in general - or rather paints only part of the picture. Even with the COVID situation happening now, in Ontario... Patients who sh…

Canadian healthcare is horrible.

"Out of 11 countries, Canada was ranked ninth for health care, placing just above France and the United States."

https://www.kelownanow.com/news/news/National_News/Canada_ra...

"217,500 Canadians left the country for health care in 2017, according to Statistics Canada. If those travelling with the patients are included in the count, the total rises to 369,700 people."

https://torontosun.com/news/national/canadians-continue-to-l...

In this thread, someone said people travel to the US even from Norway. (!!!)

The US has the absolute best system money can buy, period.

It's just that most people don't have much money, and that is the problem that needs fixing.

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

#150

Post by DanBC » Wed, Jan 06, 2021, 10:37 AM UTC

varjag wrote: post #81

grey-area wrote: post #49

Earlier quoted context omitted.

The majority of single payer systems don't outlaw private care. There are private hospitals in the UK for example. Single payer is about removing insurance companies from the process (saving money), standardising care (saving money, improving outcomes), collective bargaining for drugs (saving money), providing a base level of care to all (saving money and improving QOL). But it doesn't usually forbid spending money o…

Thing is a good public option decimates the market for advanced private care of the level you have in the US. Here in Norway the private health providers that do exist mostly deal with low-investment, low-asset, high-return cases. They will look into your psoriasis but ain't going to treat your cancer. Fortunately the advanced care in public system is great. Still it's not unheard for patients that can afford it to g…

> decimates the market for advanced private care of the level you have in the US.

> Still it's not unheard for patients that can afford it to go to the USA for specific treatments.

They're often getting very expensive, but not very good, treatment that do not lengthen life nor improve quality of life. Sometimes these treatments reduce length of life or quality of life.