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Sick and struggling to pay, 100M people in the U.S. live with medical debt

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Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#251

Post by hedora »

olddustytrail wrote: post #231
bombcar wrote: post #180

Earlier quoted context omitted.

> The survey was designed to reach adults who currently have health care debt or have had health care debt in the last five years . In order to do this, the probability panel sample included an oversample of panel members with annual household incomes less than $30,000, individuals with current or past health care debt (n=641) were included in the sample. In addition, 52 adults with past or current health care debt w…

> So they intentionally targeted people with debt, so the "63% percent of respondents" is not able to No, that's not how it works. You oversample a group you are interested in and then weight it. To be honest, you don't know enough about statistics to evaluate this. You should either learn more or accept the conclusions of those who know more.

> ...to be read as "63% percent of Americans".

> The 100M in the title is extrapolated, and is likely correct,

What's the problem with their comment, exactly?

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#252

Post by bombcar »

olddustytrail wrote: post #231
bombcar wrote: post #180

Earlier quoted context omitted.

> The survey was designed to reach adults who currently have health care debt or have had health care debt in the last five years . In order to do this, the probability panel sample included an oversample of panel members with annual household incomes less than $30,000, individuals with current or past health care debt (n=641) were included in the sample. In addition, 52 adults with past or current health care debt w…

> So they intentionally targeted people with debt, so the "63% percent of respondents" is not able to No, that's not how it works. You oversample a group you are interested in and then weight it. To be honest, you don't know enough about statistics to evaluate this. You should either learn more or accept the conclusions of those who know more.

Even the study itself says "63% of respondents with debts".

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#254

Post by [deleted] »

notch656a wrote: post #119
Clent wrote: post #96

Earlier quoted context omitted.

You are assuming $1000 is easy to pay off. This is simply not true for the working poor.

$1000 is $2 / day for les than 2 years (if you can do math unlike commenter below, that's including nearly 20% APR). I'm sorry but even the poor in america can come up with some way to make $14 in a week, if nothing else by picking up some cans. I live in a city where a segment of impoverished people come up with ways to spend $20+ a day in fentanyl, and they don't seem to have much trouble coming up with that even w…

[deleted]

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#255

Post by Sohcahtoa82 »

paxys wrote: post #203

America has socialized healthcare with a hundred extra steps and implemented in the most inefficient way possible so that everyone comes out worse. Hospitals aren't allowed to deny care (obviously). They will bill people outrageous amounts and know that they will only ever see a fraction of it. So prices for people who do pay are raised considerably to make up for it. People don't get early preventive care due to cos…

> Hospitals aren't allowed to deny care (obviously). They will bill people outrageous amounts and know that they will only ever see a fraction of it. So prices for people who do pay are raised considerably to make up for it.

This supposed truth is widely misunderstood to the point of simply being not true.

Hospital ERs will stabilize you. That's all.

If you have something that requires long-term care like diabetes or cancer, you're fucked. If you have Type 1 Diabetes and can't afford insulin, the hospital won't just give you a supply. They'll wait until you're about to die from diabetic ketoacidosis.

A friend of mine had testicular cancer but had no money for treatment and no insurance. Hospitals straight-up told him that they won't treat him unless he's terminal. That's right, they wouldn't take care of him until he's on death's door, at which point all they'll be able to do is pump him full of painkillers to make him comfortable for his last couple hours. Luckily, the ACA passed, banning pre-existing condition clauses, and he was able to get some affordable insurance and treatment. Of course, anyone that has had cancer can tell you it likely never goes away [0]. He's always worried that a new tumor will appear somewhere.

[0] https://xkcd.com/931/

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#256

Post by pocketero-dan »

sparklingmango wrote: post #189

Some standout stats for me: - Hospitals recorded their most profitable year on record in 2019, notching an aggregate profit margin of 7.6% - From 2012 to 2016, prices for medical care surged 16%, almost four times the rate of overall inflation - Last year the average annual deductible for a single worker with job-based coverage topped $1,400, almost four times what it was in 2006... Family deductibles can top $10,000…

Proposed colossal change: a common practice of paying for healthcare out of pocket, instead of through healthcare insurance.

Yes, this sounds unreasonable right now because prices are so high. But bear with me for a second.

Most healthcare in the US is paid through insurance. Insurance creates moral hazard. Insured patients generally don't even need to know the prices of what they're buying, much less negotiate those prices. And here's a dirty secret: insurers don't care much either. They simply add a margin on top of their actuarially-forecasted cost. So healthcare prices rise dramatically over time, because relatively few people are directly exposed to them and push back on them. From this perspective, healthcare insurance is a problem, not a solution.

Don't get me wrong, there are admittedly some obstacles to patients paying out of pocket right now. My point is that we know properly functioning markets set fair prices, and we know our healthcare market is dysfunctional. Healthcare insurance plays a part in that dysfunction.

Patients negotiating directly for better prices eliminates moral hazard and restores market function. Strategically, that would finally restore pressure on healthcare providers, who have become accustomed to raising prices with very little push-back. Without some kind of push-back, providers will continue raising prices - because they can.

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#257

Post by dragonwriter »

pocketero-dan wrote: post #256
sparklingmango wrote: post #189

Some standout stats for me: - Hospitals recorded their most profitable year on record in 2019, notching an aggregate profit margin of 7.6% - From 2012 to 2016, prices for medical care surged 16%, almost four times the rate of overall inflation - Last year the average annual deductible for a single worker with job-based coverage topped $1,400, almost four times what it was in 2006... Family deductibles can top $10,000…

Proposed colossal change: a common practice of paying for healthcare out of pocket, instead of through healthcare insurance. Yes, this sounds unreasonable right now because prices are so high. But bear with me for a second. Most healthcare in the US is paid through insurance. Insurance creates moral hazard. Insured patients generally don't even need to know the prices of what they're buying, much less negotiate those…

> My point is that we know properly functioning markets set fair prices

For frequently-repeated purchases of goods with robust competition for close alternatives where the approximate total infinite-horizon costs and utilities resulting from the decision are both entirely experienced by the participants to the exchange and very clear before or quickly after it occurs so that behavior can rapidly adjust to more optimal alternatives when suboptimal choices are made, in other words where the perfect knowledge assumption underlying rational choice theory is, while it is never actually accurate, at least closely approximated in the relevant market, and there are no externalities making inefficient in the global sense actions efficient from the perspective of participants.

Medical care very much does not fit this pattern.

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#258

Post by jjoonathan »

justinzollars wrote: post #235
jjoonathan wrote: post #166

Earlier quoted context omitted.

We pay nearly double for our privatized monstrosity, compared to the most expensive socialized systems. Such savings! So cheap! Very efficient! Can the treasury possibly bear the expense of spending less than double? ------ Yeah, a transition is going to be an expensive shitshow and now is not a good time, but just about any other time in the last decade was a good time and in a year or two it will be a decent time a…

Politics aside, money puts a cap on everything: wars, social services, etc. The issue at hand is to take something the public spends nothing on, that the government gets for "free" and to put that on the public balance sheet - a huge cost. I guess we could balance that out with a tax, but who would like that? And even if we were to raise taxes - it wouldn't help our balance sheet since we already spend 30% more than…

> Politics aside, money puts a cap

What part of "we pay nearly double" didn't make it through?

We can't afford the enormous premium we are paying for privatized care.

> I guess we could balance that out with a tax

Payroll tax. In the vacancy left by private insurance. Scribble off one memo line, write in another. Come on, this is a 101 level objection.

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#259

Post by suture »

rayiner wrote: post #197
lotsofpulp wrote: post #24

Earlier quoted context omitted.

The Dems might have had 60 seats in name only, but even that was for a few months (Jul 2009 to Jan 2010). More importantly, a couple Democrats like Lieberman do not tow the party line, and frequently vote like Repubs, so I would not say Democrats ever had 60 seats. https://en.wikipedia.org/wiki/2008_United_States_Senate_elec... > Democrats held at least 57 seats as a result of the election. When the new senators were…

They had 60 votes to get Obamacare enacted, which was a historic achievement. Obviously your coalition won’t agree on everything and you have to keep the marginal votes on board. That’s just how politics works. My point is that there is a more potent democratic coalition out there even within the framework of the Senate system. To the contrary, the Senate system long benefited Democrats because it favors working clas…

The country and politics of the nation have shifted. The divide is rural/urban now. The cities have the vast majority of the wealth but not the accompanying representation. The rural areas of the country are overwhelmingly conservative and increasingly white nationalist in sentiment. What the state of things 50 years ago was is no longer relevant.

Re: Sick and struggling to pay, 100M people in the U.S. live with medical debt

#260

Post by marcusverus »

kube-system wrote: post #102

This is the expected result of median deductibles being larger than median savings accounts. Small amounts of debt <$1000 are not necessarily problematic amounts of debt, especially considering that they can typically be paid off over time with no interest.

The article also studiously ignores the fact that the median net worth is more than 100X the median medical debt.
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