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

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

#271

Post by cultus » Wed, Jan 06, 2021, 4:01 PM UTC

TrackerFF wrote: post #251

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…

US healthcare culture is very different from that of many countries with "free" universal healthcare. In many such countries, there's no such thing as a yearly / annual checkup. People go to the doctor when they feel sick - or if they actually get checkups, it's in the light of some illness like cancer. Usually, there's nor any "full" check, meaning that doctors will run every test known to man on you, just to be sur…

The incentives are all wrong. Tests are money spinners, so hospitals and clinics push them hard. Over-testing is usually associated with worse health outcomes. For example, nearly anyone who gets a full body scan has a few suspicious looking blobs. It's almost always nothing, but it results in unnecessary treatment or exploratory surgery while not actually saving many lives.

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

#272

Post by programmertote » Wed, Jan 06, 2021, 4:02 PM UTC

Railsify wrote: post #199

I think there is an important point to be highlighted: We often blame the system for being expensive but in this case an individual doctor was able to say we will not collect. These decisions to charge patients a literal fortune for treatment probably always falls to an individual or small group of individuals. We should highlight this on billing documents, instead of "please pay XYZ hospital" the individual accounta…

100% this. I wrote a separate comment in this thread cautioning people that this doctor, despite this charitable act, is probably not as charitable as we might think from reading a news article.

If we dig deep into his clinics' billing practices, we might see lots and lots of bogus charges billed to the insurance companies (some of which might have to be paid by the patients with high deductible/co-pay in their insurance plan).

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

#273

Post by leetcrew » Wed, Jan 06, 2021, 4:03 PM UTC

trynewideas wrote: post #152

pembrook wrote: post #144

Earlier quoted context omitted.

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…

Taxes in the US are labeled (accurately, but perceived negatively) around what you have — income tax, property tax, sales tax. For the most part, they aren't labeled for what they _do_ (other than Social Security and Medicare taxes, programs to which cuts are political poison). If federal taxes were broken down to, say, defense taxes, infrastructure taxes, health taxes, administrative taxes, and people saw how much o…

> For instance, people would be more aware that twice as much of the tax-derived budget goes into defense and international security than to safety net programs.

do you not consider medicare, medicaid, and social security to be safety net programs?

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

#274

Post by treespace89 » Wed, Jan 06, 2021, 4:03 PM UTC

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…

I can't see the US ever adopting a single payer health care system. However I do think they could adopt a health care justice system.

The US cares a lot about justice, and free markets. Some kind of well funded, and empowered FBI system for ensuring citizens get fair value for the money spent.

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

#275

Post by chasd00 » Wed, Jan 06, 2021, 4:06 PM UTC

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…

making cost non-negotiable would help a lot. Then the behind the scenes cat and mouse billing/reimbursement game insurance and providers play no longer exists. Providers and insurance will have to compete on price with the patient fully informed.

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

#276

Post by chasd00 » Wed, Jan 06, 2021, 4:12 PM UTC

zip1234 wrote: post #222

pg_bot wrote: post #82

Earlier quoted context omitted.

A lot needs to be fixed. Most of our problems boil down to lack of competition and regulatory capture. As a regular citizen, I would do the following. See if your state has certificate of need laws and ask your state representatives to repeal them. If your state has these laws you are likely paying 5% more for medical services with no difference in quality of care. Look into direct primary care clinics. Oftentimes yo…

Also, published prices in a standard format available on the web would go a long ways. Current state of system: How much does something cost? You will find out after the fact.

this is a huge one. healthcare seems like the only industry where you can be billed for a service without being informed of its price first.

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

#277

Post by chasd00 » Wed, Jan 06, 2021, 4:16 PM UTC

leetcrew wrote: post #270

pembrook wrote: post #144

Earlier quoted context omitted.

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 correct…

right, the gofundme is voluntary socialized medicine is mandatory. People don't like being told what to do but, given the chance, will usually volunteer.

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

#278

Post by fallingfrog » Wed, Jan 06, 2021, 4:19 PM UTC

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…

I’ve seen surveys reporting that over 90% of Democrats and a significant minority of Republicans want universal health care. It may be out of scope for this discussion to figure out why the priorities of voters do not translate to policy in the United States.

Source: https://www.google.com/amp/s/www.cbsnews.com/amp/news/2020-p...

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

#279

Post by cldellow » Wed, Jan 06, 2021, 4:19 PM UTC

cataphract wrote: post #191

Doesn't this debt forgiveness mean the patients are going to be hit with a tax bill for the amount forgiven this year?

I'm not an accountant (or an American), but I don't think so. USC 108(e)(2) says:

> No income shall be realized from the discharge of indebtedness to the extent that payment of the liability would have given rise to a deduction.

And because medical bills are deductible when itemized, I suspect they would qualify for this exemption.

[1]: https://www.law.cornell.edu/uscode/text/26/108

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

#280

Post by chasd00 » Wed, Jan 06, 2021, 4:22 PM UTC

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.)

it doesn't, that's just what the bill says. The $500 aspirin stories are about what's printed on the bill but that is no where close to what is actually paid.

This is a huge problem IMO and i mentioned it upthread. The prices printed on bills are never what's paid (unless some poor patient thinks that's what they actually owe). It's all negotiable. Taking away price negotiating and enforcing that what is on the bill is what is expected to be paid would help a lot. These ridiculous numbers would go away and people would actually know what their healthcare actually costs.

edit: here's something to try, let's say your in teh US and you have a prescription card that does not cover brand medications, only generic. Goto your pharmacist and ask them how much you'll have to pay to get the brand. Then, offer to pay them half that amount in cash. You'll be surprised at the results.