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

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

#171

Post by lotsofpulp »

seesawtron wrote: post #151

As noble as it sounds, I failed to comprehend from the title how could a doctor have the authority to forgive half a million dollars alone when most of the costs go to the hospital for services and infrastructure. But in this case, the doctor decided to close his entire treatment centre. That is certainly a relief for the patients who have huge debts but not so great for the future patients who could have been treate…

I have business partners who are doctors that regularly earn half a million a year. The ones that own (successful) practices earn even more.

See:

https://www.medscape.com/slideshow/2020-compensation-overvie...

https://www.kaptest.com/study/mcat/doctor-salaries-by-specia...

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

#172

Post by gnopgnip »

atmosx wrote: post #48

A good question would be what can be done to fix healthcare in the US ? My understanding is that most voters don't support universal healthcare. IIRC even Obamacare was labeled as controversial. Current model costs way more, the model is clearly broken, why there is no pressure to fix it? ps. I don't want to get political or anything by mentioning Obamacare. I'm genuinely curious because the problems of the current h…

Most voters do support universal healthcare, Medicare for all, and single payer, and since 2016 support has grown significantly. https://www.kff.org/slideshow/public-opinion-on-single-payer... More recent polls show slightly higher support.

But whether people would support a specific plan that has a new payroll tax(and greatly reduces premiums, deductibles and copays, and still saves the government hundreds of billions each year) and all but abolishes private insurers is less certain. This is part of the reason why Biden's plan is for a new government insurance plan, not single payer or "funded" through a payroll tax. But it does include some provisions of S.1129 - Medicare for All like the start of lowering the medicare age

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

#173

Post by kmos17 »

lotsofpulp wrote: post #137
k_sze wrote: post #136

Earlier quoted context omitted.

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 eve…

Where is your data to backup this claim? Maybe you are right that claims are approved most of the time but in my experience the problem with our health care system is not just denial of claims, but about the cost of medical services and medicine.

In my anecdotal experience I have had insurance deny claims on medicine prescribed by my doctors frequently, in one case they would not cover a medicine costing $50 over the counter, but instead had me switch to an alternative with a $10 copay which turned out to be billed at $170 to the insurance company once i got the detailed statement!! how does that even make sense?

It makes sense to them because the insurance company benefits from higher cost of delivering health benefits as it justifies higher premiums. Since they are by law limited to earn a capped percentage on premiums minus costs (at least in my state), the only way they can deliver increased returns to shareholders is by increasing our costs and hence our premiums.

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

#174

Post by guitarbill »

lotsofpulp wrote: post #163
faceplanted wrote: post #158

Earlier quoted context omitted.

> It’s also not the case in 99% of US claims. So is it just sampling bias that we hear constant stories outside the US of everything from broken legs to cancer patients being denied coverage or being covered but having life destroying out of pocket costs? Because it really is constant.

There’s 330M people in the US and 365 days in a year, so you can hear about one mistake every day and it’s still an extremely minute error rate. It would be nice if someone brought data to the discussion. And specifically about health insurers erroneously denying coverage. I have first hand knowledge from a doctor at an insurance company that audits other doctors’ work at the same insurance company to ensure they are…

There aren't 330M insured people, and many people don't need visit a doctor in a year. (Also, there are ~740M people in Europe, and yet...)

Even that link you provided doesn't really back up what you said: "denial rates ranged from 1% to more than 40% across insurers"

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

#175

Post by throwaway0a5e »

pembrook wrote: post #144
serial_dev wrote: post #99

Earlier quoted context omitted.

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…

>nobody has any political objections to socialized funding when it happens there.

Nobody in your filter bubble.

There's plenty of people who don't like "internet panhandling"

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

#176

Post by lotsofpulp »

ruined wrote: post #170
lotsofpulp wrote: post #137

Earlier quoted context omitted.

> 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 eve…

> It’s also not the case in 99% of US claims. [...] Surely, there are mistakes made, but there is no standard operating procedure at insurance companies to deny healthcare. This is so out of sync with the experience of everyone i know that i wonder if you've interacted with the healthcare system at all beyond checkups and occasional antibiotics.

If it was true that insurers are routinely erroneously denying care, then people would be taking advantage of the ACA law that mandates external review of all claims and subjects insurers to the external’s reviewers’ decision.

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

#177

Post by lotsofpulp »

guitarbill wrote: post #174
lotsofpulp wrote: post #163

Earlier quoted context omitted.

There’s 330M people in the US and 365 days in a year, so you can hear about one mistake every day and it’s still an extremely minute error rate. It would be nice if someone brought data to the discussion. And specifically about health insurers erroneously denying coverage. I have first hand knowledge from a doctor at an insurance company that audits other doctors’ work at the same insurance company to ensure they are…

There aren't 330M insured people, and many people don't need visit a doctor in a year. (Also, there are ~740M people in Europe, and yet...) Even that link you provided doesn't really back up what you said: "denial rates ranged from 1% to more than 40% across insurers"

The point was there’s a lot of people with a lot of transactions in healthcare happening, so “hearing” about it constantly doesn’t mean anything.

And yes, I know the link doesn’t have statistics in erroneous denials of coverage (I couldn’t find it anywhere quickly), but it did note that the law requires insurers to abide by an external reviewer’s decision.

Surely if there were that many erroneous denials of coverage, there would be lots of people clamoring to get it overturned via the external reviews.

It’s probably just the case that most denials are justified (in the legal sense) that the requested healthcare lacked sufficient documentation, did not have efficacy data, was using brand name medicine instead of generic, etc.

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

#178

Post by jmiserez »

roenxi wrote: post #157
dxdm wrote: post #145

Earlier quoted context omitted.

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?

I'm assuming that while people don't like rationing things based on wealth, their objection is to the rationing more than the wealth. There are alternatives to rationing things by wealth. All the ones I can think of are arbitrary, unfair, or unworkable (raising interesting and difficult questions too, eg, a fun example would be should highly contentious politicians be first in line for the best healthcare due to thei…

There is no need for magical thinking, but you do need to take a step back and look at the bigger picture.

Many countries view it as a much simpler problem of optimizing their society as a whole:

1. There are N doctors & medical supplies.

2. There are M people that have an illness.

3. How can we as a society make sure that these M people don't die?

Then, you (as a society) make up a set of rules and incentives and economic structures so that longterm you are able provide treatment to M people and define what "adequate" means based on your resources. If someone wants more than "adequate" treatment, you add some way to pay for things. Ideally in wealthy countries these are never actual medical necessities.

Once you're there, you just solved 80% of the problem and nobody dies just because they weren't rich.

Of course life is messy, so you need to have some resources to spare for edge cases and exceptions to the rules out of compassion, where there are e.g. experimental treatments, etc. It is true that there will be limits as to what you can provide, as treatments will cost money and disability-adjusted life years gained will go towards zero the older you are.

But that is also the case when you have a "pay money, get service" system, even if you are extremely rich you will not be able to extend your life forever.

The rationing happens either way, and in most countries you would need to be extremely rich to be able to come out on top. Actually you would need to already be born rich in order to be able to pay for anything that comes up in your childhood. That is extremely cruel, but unfortunately a reality in some places in the world.

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

#179

Post by lotsofpulp »

kmos17 wrote: post #173
lotsofpulp wrote: post #137

Earlier quoted context omitted.

> 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 eve…

Where is your data to backup this claim? Maybe you are right that claims are approved most of the time but in my experience the problem with our health care system is not just denial of claims, but about the cost of medical services and medicine. In my anecdotal experience I have had insurance deny claims on medicine prescribed by my doctors frequently, in one case they would not cover a medicine costing $50 over the…

> Where is your data to backup this claim?

I’m claiming that insurers do not erroneously deny claims in the hopes that people give up. I don’t have data for it, but I’ve also never seen data that shows insurers deny coverage just to dissuade people (post ACA).

> experience the problem with our health care system is not just denial of claims, but about the cost of medical services and medicine.

Yes, I agree here about the cost of healthcare, but that is a separate issue from insurance companies erroneously denying coverage.

> how does that even make sense?

Prices for medications are extremely obfuscated, and you will never know the true price paid due to various rebates and fees on the backend between manufacturers, insurance companies, and retailers. There are various reimbursement rules from CMS (centers for Medicare and Medicare services), state Medicaid, various employers, and it’s a very, very inefficient method of price discrimination.

> Since they are by law limited to earn a capped percentage on premiums minus costs (at least in my state),

ACA caps health insurer profit margins federally, so it applies to all states. Assuming there are multiple competing health insurers, then unless they collided, they would not be able to arbitrarily raise prices to increase the absolute value of their profit margin.

The problem was the political compromise that had to be made in order to pass ACA, which is that it allowed employers to maintain their silo’d group of employees. So you have a whole bunch of healthy white collar lives taken out of the healthcare.gov market, which leaves it with all the sick and poorer lives, making it less viable for multiple health insurers to exist. If everyone had been forced onto healthcare.gov, then it’s feasible for multiple health insurance companies to exist and compete. Also, there should be no state boundaries, since some states’ populations are so small that they can’t afford to spread around the healthcare costs.

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

#180

Post by beagle3 »

arcticbull wrote: post #98
beagle3 wrote: post #90

Earlier quoted context omitted.

> In Canada, while in general private cover is not illegal, for covered health services, it roughly speaking does not exist and my statement that you "have nowhere else to go" holds. The key is “covered health services”. E.g. a friend who broke his arm in Israel (which has an NHS like medical system) needed to have it cast; a standard plaster cast was covered, but for an extra $150 or so, he was able to pay and get a…

> The key is “covered health services”. Covered health services in Canada is substantially all health services. This is addressed in the link I provided.

It is the same in Israel. And yet, there’s room for some private health services.

In the public system, you usually have a room mate after an operation.

If you use the private system, you get a private room and get to request specific food. You don’t get treatment that is any better from a health perspective. But you do get a nicer stay.

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