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

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

#211

Post by DangitBobby » Wed, Jan 06, 2021, 1:40 PM UTC

lotsofpulp wrote: post #176

ruined wrote: post #170

Earlier quoted context omitted.

> 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.

You seriously over-estimate how much people know about their rights and the time they are willing to spend exercising them. But you are right that they should.

https://www.npr.org/sections/health-shots/2014/04/14/3025478...

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

#212

Post by valenterry » Wed, Jan 06, 2021, 1:42 PM UTC

lotsofpulp wrote: post #121

hippich wrote: post #102

Earlier quoted context omitted.

And an insurance should be, well, an insurance. What is referred as "health insurance" is more like "health care plans" (insurers even call it "plans"). Just consider how comprehensive auto insurance is different from health insurance in practice.

Overall health is not insurable. It’s a misnomer. There is a 100% chance of everyone needing healthcare in the future. US health insurance does a few things: 1) premiums partially serve as a tax to transfer wealth from young and healthy to old an sick 2) insurers healthcare recipient from the big costs (over out of pocket maximum - $7k to $13k per year), subject to in network providers 3) Negotiates pricing and deter…

> There is a 100% chance of everyone needing healthcare in the future.

1) that's not true. One can die in an accident and not cause an future healthcare costs.

2) health care costs are of course insurable, why not? Just because everyone will create costs with a high chance does not mean that everyone will always create the same costs. The insurance is there for when you have some illness that causes more costs than you could afford.

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

#213

Post by FpUser » Wed, Jan 06, 2021, 1:50 PM UTC

simonh wrote: post #116

FpUser wrote: post #18

Earlier quoted context omitted.

>"It’s a racket, plain and simple. Medical care should never be tied to personal wealth, period." In agreement. Still Government covered medical care has their own methods of avoiding / delaying procedures. In the end it all comes down to money.

You may not have meant it to come across this way, but "The alternative isn't absolutely perfect in every way, therefore both options are equivalent" isn't a useful contribution.

I meant exactly what I said. Basically nothing is perfect. And while I completely support the idea of free universal healthcare I know on my own experience that Government is on a constant lookout to cut those expenses and does it at the first opportunity.

Bunch of warriors with the downvoting clubs is not going to change anything. Frankly I do not give a s..t about being downvoted. I am not here to accumulate karma. Just for the record: personally I have never downvoted even single post. I believe that all this voting system is very unhealthy.

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

#214

Post by lotsofpulp » Wed, Jan 06, 2021, 1:51 PM UTC

trey-jones wrote: post #206

lotsofpulp wrote: post #179

Earlier quoted context omitted.

> 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…

Regardless of any progress that has been made, I think anecdotal evidence is important here, and pretty much anybody who has actually used the system knows that it sucks. Nobody knows what to pay and what not to pay, for one thing. There isn't any trust - as many posters here describe, paying medical bills in the US is (feels like?) a constant struggle against being defrauded by both your insurance company and your d…

While the system may suck, it's leagues better than it was before ACA for most people. Even your example shows it, since before ACA, there was no out of pocket maximums, and hence you continued to receive bills. In fact, before ACA, there was a maximum benefit amount the insurers would pay up to, and then after that, the costs would fall on you.

And your GA state program is most certainly made possibly by the expanded Medicaid funding due to ACA.

>There isn't any trust - as many posters here describe, paying medical bills in the US is (feels like?) a constant struggle against being defrauded by both your insurance company and your doctor.

This is true, but it would help if healthcare providers would list the codes they will charge so that people can look up the cost with their insurer and aren't signing blank checks every time they enter a medical office.

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

#215

Post by ballenf » Wed, Jan 06, 2021, 1:52 PM UTC

if you’re wondering why doctors don’t do this regularly, they can actually get into trouble with insurance companies if they have a policy of not collecting or forgiving copays.

There have been a few very high profile lab companies that have been prosecuted for this exact practice. TrueHealth was a recent one.

The media coverage will characterize the company as fraudulent.

The whole insurance system is corrupt to the core. Maybe those lab companies weren’t perfect but their real sin was just shining light on the broken system.

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

#216

Post by ykevinator » Wed, Jan 06, 2021, 1:55 PM UTC

This paints him like a hero, but he has enjoyed this artificial pricing for his whole career that has surely made him rich beyond his wildest dreams. The supply curve for his services is artificially constrained by his union, the AMA, which keeps the supply to about a tenth of what it could be. This keeps salaries high and the docs happily pay their union dues. We have a system problem that no one wants to talk a out and it is the AMA which sets quotas for doctors based on salary goals not skills or willingness.

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

#217

Post by A4ET8a8uTh0 » Wed, Jan 06, 2021, 1:55 PM UTC

lotsofpulp wrote: post #201

iguy wrote: post #198

Earlier quoted context omitted.

I agree that there would be plenty of horror stories to fill the news, even if such events were extremely rare, but multiplied by 300 million. However, many people's "hearing" is a slightly less biased sample than that. It's that every American they have personally talked to about any visit to a hospital seems to have a horror story about (at very least) crazy bills, hours on the phone with insurers for months to yea…

Just to re-iterate, my original comment scrolling up was specifically responding to this claim: > We don't get this nonsense where the insurer tries to deny us and hope that we don't dispute. Restated, this is claiming that health insurers in the US erroneously deny coverage as a policy. And that is the specific statement I am saying is untrue. The crazy bills are true, you should of course budget to be able to affor…

"Restated, this is claiming that health insurers in the US erroneously deny coverage as a policy. And that is the specific statement I am saying is untrue."

The policy may not be explicitly stated, but having dealt ( and likely having have to deal with both this year ) with medical issues ( and related bills ) in US, to me it is clear that everything is stacked against the recipient of healthcare benefits. In other words, actions speak louder than words. The moment I have to spend multiple hours a day, faxing stuff, confirming receipt, complaining, contacting various overseeing bodies, I think the unstated policy is pretty simple. Deny and delay is a tactic. And it works. Not everyone can devote time and energy to this. It is exhausting.

"The problem that I have in US healthcare is that no healthcare provider is willing to give me a code, even for simple checkups or X-rays or what have you, where everything is known in advance. The healthcare providers don't want to risk"

I am willing to agree here. There is a fair amount of issues that are created for a patient by the providers ( coding, communication with insurer or lack thereof, now standard 'you are responsible for everything insurance doesn't pay' clause and my current favorite 'some of the providers in our hospital may bill you separately' ). It usually takes some yelling to get some of the charges to 'reasonable' level and I have the feeling the only reason I got away with it is, because the election was in full swing and no one wanted another crazy hospital story.

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

#218

Post by hshshs2 » Wed, Jan 06, 2021, 2:00 PM UTC

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…

I have valid claims denied multiple times a year (3 out of 8 total claims last year). If it’s not standard practice they’re really bad at their jobs. They also won’t fix it for you, I end up having to call billing departments for billing codes and look up state laws on coverage, etc...

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

#219

Post by lotsofpulp » Wed, Jan 06, 2021, 2:00 PM UTC

DangitBobby wrote: post #211

lotsofpulp wrote: post #176

Earlier quoted context omitted.

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.

You seriously over-estimate how much people know about their rights and the time they are willing to spend exercising them. But you are right that they should. https://www.npr.org/sections/health-shots/2014/04/14/3025478...

That's actually very interesting. Although the article is from Apr 2014, it has some statistics that may be relevant to insurers erroneously denying coverage:

https://www.capradio.org/articles/2014/04/01/patients-win-ab...

>Insurers say only about three percent of claims are denied.

>California data show about half the time a patient challenges a denied health care service through a third party, the patient wins and gets the health service.

If we assume that denied claims that were overturned were erroneously denied coverage by the insurance company, then half is a huge error proportion, one that would make me think the insurance company is doing it intentionally, or at least intentionally not doing it right.

But maybe the ones that got appealed are closer to being decisions that could go either way and the ones that don't get appealed are black and white cases that were clearly covered or not covered.

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

#220

Post by oauea » Wed, Jan 06, 2021, 2:01 PM UTC

lotsofpulp wrote: post #166

gambiting wrote: post #164

Earlier quoted context omitted.

Not OP, but when my dad had cancer in Poland, the national health fund covered his entire treatment over 8 years. Few operations, monthly dose of Glivec(google the cost of Glivec treatment in the US to see how insane that is), hospital stays, and like OP said - he would get reimbursed for travelling to the hospital and back. And this treatment was never tied to his employment, he never had to prove to anyone that he…

The Gleevec was probably an order of magnitude cheaper or more for the Polish government than in the US: https://www.statista.com/statistics/312011/prices-of-gleevec... And doctors in Poland are probably not earning a few hundred thousand USD per year, and similar for nurses wages and all the other people in the healthcare chain. Quick googling shows wages might be an order of magnitude cheaper also. I assume healthc…

> but bottom line is healthcare costs more in the US because everyone earns more top to bottom in the US

So there's more taxes available to absorb this cost. It's a self solving problem, in countries that have their shit together.