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

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

#261

Post by mindslight » Wed, Jan 06, 2021, 3:29 PM UTC

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.

I'll chime in with an opposing anecdote about managing the healthcare for my father with cancer. Dealing with a large insurer, we have no problems with being denied coverage, timely prior approvals, and while some of the copays are high, they are not unreasonable for the plan he chose. Whenever I call, the agents are pleasantly helpful. My main complaint is with providers' fraudulent billing ("cost": $500, "adjustment": $390, insurance: $65, copay: $45), and the worst thing I've had to do was sometimes wait after receiving a billing nastygram, for the claims to settle out.

Of course he is of Medicare age, so this is a Medicare Advantage plan that is still bound by many of the Medicare rules and copay schedules. I can't imagine going through the same thing with my own insurance.

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

#262

Post by leetcrew » Wed, Jan 06, 2021, 3:35 PM UTC

dusted wrote: post #188

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 here my "socialist" ass was thinking the most unfair characteristic of the US "healthcare system" was that not all citizens have the basic right to the same, best-effort treatment.

> same, best-effort treatment

no matter how enlightened the society is, you can still pick at most one of these.

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

#263

Post by frobozz » Wed, Jan 06, 2021, 3:49 PM UTC

Illness is neither an indulgence for which people have to pay nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community.

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

#264

Post by delecti » Wed, Jan 06, 2021, 3:50 PM UTC

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…

Agreed. I'm reminded of a tweet I saw:

> Every heartwarming human interest story in america is like "he raised $20,000 to keep 200 orphans from being crushed in the orphan-crushing machine" and then never asks why an orphan-crushing machine exists or why you'd need to pay to prevent it from being used.

https://twitter.com/pookleblinky/status/1309325764739858432

These heartwarming stories are like a bandaid on a gunshot wound. Not even making a dent in the problem.

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

#265

Post by duckfang » Wed, Jan 06, 2021, 3:53 PM UTC

baldeagle wrote: post #245

The really messed up thing about this is the tax implications. The doctor gets a write off for his 'losses'; his tax bill it lower. The patients are subject to paying tax on this as-if it were income (because they received $X of debt cancellation). Their tax bills will go up.

So, can I go around writing "Debt forgiveness bills", take that off my taxes, and report them as "debt reconciliation income"?

What allows them to make up magic numbers for a price?

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

#266

Post by Pfhreak » Wed, Jan 06, 2021, 3:56 PM UTC

unishark wrote: post #22

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…

It was for 200 people. Works out to about $3k per person on average.

Which is a fortune to many (most?) Americans. That's like 5% of the median income.

And these people just had cancer, so it's less likely they've been able to hold down steady work.

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

#267

Post by cultus » Wed, Jan 06, 2021, 3:58 PM UTC

whymauri wrote: post #35

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…

>My fiancée has cancer, and we regularly joke that dealing with insurance companies is worse than the actual stage 3 cancer she has. You know what's crazy? This isn't even the first time I've heard this. Literally had the same conversation with a close friend last year. Thankfully it wasn't Stage Three and their spouse is in remission, but the financial ordeal was more stressful than the diagnosis.

It's so heartbreaking to see people who are very sick or even dying have to stress about bills. It's just not something a moral society does. It's not just mental, cortisol really knocks down your immune system.

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

#268

Post by programmertote » Wed, Jan 06, 2021, 3:59 PM UTC

trynewideas wrote: post #162

Some context: the clinic (technically named the Arkansas Cancer Institute, not the Arkansas Cancer Clinic as in the story) faced lawsuits in 2018-19 after more than 50 patients tested positive for an undisclosed bacterial infection linked to saline flushes on infusion ports.[1][2] The results of the lawsuit weren't reported, but the clinic closed in February 2020, about a year after the firm behind the suit pursued c…

Glad to see someone pointing out the context.

Certainly this doctor and his family did a great thing by forgoing the debt owed by his patients. BUT, my wife worked and volunteered at a few private clinics around NY metro areas and I would wager that this doctor's clinic already makes a lot of money (2-3x that 650K) every year if not more.

As an example, one of the primary care physician's clinic that my wife (who is now in medical residency) used to work in NY Chinatown (a lot of patients there are on Medicaid/Medicare, etc.) still raked in at least $600K/year. The doctor sees ~40-50 patients a day. The doctor would write one or two bogus diagnoses to inflate the billing codes to make up for the 'loss in revenue' due to treating patients on Medicaid or simply making each patient encounter worth it.

Another example from a different clinic, where my wife used to volunteer, put on phone consultation fee in the bill when the patient called in to check about his appointment and asked a side question about one of his medication. It literally took that psychiatrist less than a minute to answer that call, but the patient is going to be footing ~$50-$100 from his/her co-pay.

In summary, some of these private clinics (not to mention the hospitals and we have read about their b.s. billing practices many times) are billing patients bogus stuff on almost every patient encounter. Some of them justify this by saying it's not the patient who pays the bill (but in fact, some patients with high deductibles/co-pay have to) or that they need to make up for their expected earning of running a private clinic (which is better than what a general physician would earn--$250K/year on average--at a hospital).

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

#269

Post by Pfhreak » Wed, Jan 06, 2021, 3:59 PM UTC

imgabe wrote: post #60

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…

It was for 200 people, that's an average of $3250 per person.

Posted this above, but that's a lot of money. The median household income in the states is about 60k. And these folks may be less likely to have held stable employment while they battled with cancer.

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

#270

Post by leetcrew » Wed, Jan 06, 2021, 4:00 PM UTC

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…

> 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).

I'm not sure I see the irony either. if I'm understanding correctly, your friends pooled their own money together to help someone they knew and cared about. how is this similar to socialized healthcare at scale?