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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

#291

Post by kevinventullo »

notch656a wrote: post #80

Also known as 100M people who may have died without medical care, but were provided it despite their inability to pay for it. If you remove the ability for medical workers to seek payment for their services, most medical workers are just gonna say fuck it and not work for free. Medical care providers have families they have to feed too.

Is there evidence that the high cost of healthcare is due to paying frontline medical workers?

This is an honest question I don’t know the answer to, but based on my analogous experience with academia and the high cost of tuition, I would guess the answer is “no”.

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

#292

Post by lostcolony »

nonameiguess wrote: post #265
lostcolony wrote: post #243

Earlier quoted context omitted.

>> Any charges denied by the insurance were just dropped by the provider, not pushed to me. That's a provider choice, and not guaranteed.

Sure, but it's not uncommon, either. If you ever find yourself in a fight with a chronic or long-term condition, check the statement of benefits your insurer sends you every month. They're denying massive amounts of things that you never get a bill for. I even asked my main surgeon's office manager about this once, and he explained to me that insurance companies don't have any sort of upfront published caps on what t…

Oh, I know the incentives. I strongly suspect there's even an additional one you don't list - tax writeoffs.

And you're going onto a tangent that I am very much in agreement with (that the whole system is massively broken and suffers all sorts of perverse incentives), but -my- point, if you'll recall, is that not everything gets written off. People still get unexpected medical bills -all the time-, for things their insurance didn't fully cover; this despite their deductible and/or max out of pocket.

Or, as I commented before, and which you're...agreeing to, in a whole lot of words, it's a provider choice, and not guaranteed. I.e., every time you go to the doc you're rolling the die; doubly so for emergency stuff that you can't get pre-authorized. "It doesn't happen -that- often" seems to maybe be your argument, but it happens enough, and the consequences of it happening at all are devastating.

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

#293

Post by leetcrew »

colpabar wrote: post #228
notacoward wrote: post #220

Earlier quoted context omitted.

Last time I proposed this same thing in a blog comment section (Lawyers, Guns, and Money) a couple of people said "but filibuster" and the rest went straight to an absolute firehose of middle-school-level verbal abuse. I've had similar reactions from other self-proclaimed progressives. Nonetheless I stand by the idea. These big omnibus bills give every single opponent (and some "mavericks" a.k.a. turncoats in one's o…

It just seems like it'd be such a huge win from a PR angle, even if the bills fail. You could literally post screenshots of the bills in their entirety on twitter showing how simple they are (student debt is abolished, college is free, medicine is free, etc) and just say "here is what we tried to do for you, and here are the people who said no." I think the most productive change we could make to our government right…

that doesn't sound like a very good idea to me. legislation is not complex only because of pork; there are always edgecases and loopholes to be handled. I highly doubt a reasonable solution to any of the problems you listed could be described in a mere ten pages.

take student debt for instance. imo there's a decent case for erasing undergrad debt under a certain threshold, but if you took on a six figure debt to attend a fancy liberal arts college, that's on you to unfuck. similarly, people like lawyers and doctors take on a lot of education debt, but that's also priced into their respective salaries. a professional paying off an outsized debt with an outsized salary doesn't need or deserve the assistance of the median taxpayer. a naive implementation of such could potentially be net regressive.

obviously you might disagree with some of that, my point is just to show that "abolish student debt" is controversial and complex even among people that agree at a high level.

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

#294

Post by charlie0 »

I like ACA, but...

Hot take: The only reason ACA passed is because the government did not want to foot the entire healthcare bill for our aging boomer generation. So ACA became a way to partially distribute those costs to the rest of the US population by forcing them into a healthcare plan.

Sure, in theory those forced into the ACA are protected from financial disaster in case they get sick, but in practice, the younger generation won't need healthcare for quite a long time, thereby once again kicking this can of worms down the road.

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

#295

Post by notacoward »

leetcrew wrote: post #293
colpabar wrote: post #228

Earlier quoted context omitted.

It just seems like it'd be such a huge win from a PR angle, even if the bills fail. You could literally post screenshots of the bills in their entirety on twitter showing how simple they are (student debt is abolished, college is free, medicine is free, etc) and just say "here is what we tried to do for you, and here are the people who said no." I think the most productive change we could make to our government right…

that doesn't sound like a very good idea to me. legislation is not complex only because of pork; there are always edgecases and loopholes to be handled. I highly doubt a reasonable solution to any of the problems you listed could be described in a mere ten pages. take student debt for instance. imo there's a decent case for erasing undergrad debt under a certain threshold, but if you took on a six figure debt to atte…

A single sentence bill might indeed be too short to address edge cases and attract support, but it can still be single topic and probably no more than ten or twenty pages. Literally no legislator actually reads all of these 1000-page entire-legislative-agenda monstrosities. At best they have their own aides do it and summarize the highlights. More often, they just follow their own party's "leadership" on what parts to use as excuses.

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

#296

Post by sparklingmango »

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…

Medical patients are not really "consumers" in the normal sense of the word. A patient may be unconscious when they arrive at a hospital and doctors will just start to treat them (as they should). A patient's doctor may refuse to change where they'll do the operation even if it'll save their patient a lot of money. A patient may decide they're going to have a procedure done at a surgery center, a facility that is typically much cheaper than a hospital, but they can't predict if they'll have a complication that will drastically change the cost of their procedure. Patients can't just walk up to a menu and decide that because they have chest tightness they want a stent put in. That's not how medicine works. The doctor typically sets the treatment plan and there's very little veering off that plan. The doctor really isn't even the one that sets the prices. Insurance companies are heavily involved in that and it varies by health insurance and plan.

The cheapest prices in US healthcare are the prices paid by Medicare. There are so many people on Medicare so this leads to a lot of bargaining power. Hospitals would never refuse to treat Medicare patients (because there are so many). So, Medicare decides "We're only going to pay $10,000 for a total knee replacement." And hospitals have to say "Okay, sounds good. Can't really say no to 60 million patients." Insurance companies do not have that type of bargaining power. They say "We only want to pay $20,000 for a total knee replacement." And the hospital goes "Nope, we're charging you $30,000." And the insurance company sheepishly goes, "Okay..." and then sets really high premiums, deductibles, and out of pocket maxes so they don't have to bear the weight of the cost.

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

#297

Post by burmer »

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…

hm, interesting. Even better: potentially, instead of negotiating prices one on one, we could form some sort of large collective enterprise that was beholden to us so that it could negotiate prices on our behalf. I'd bet if there was such an group that represented a large enough % of us, we could get some pretty good deals. Now, what would we call it...

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

#298

Post by SoftTalker »

silicon2401 wrote: post #271
SoftTalker wrote: post #269

Earlier quoted context omitted.

It's not like you can get whatever, whenever medical care in Europe. Whether private or public, the entity that's paying the bills will be making decisions on what procedures are or are not "necessary" and how much they will pay. My uncle in Denmark had cancer, and they basically put him in a hospice-type facility to die, because anything else would have not been justified due to his age, the cost, and the low probab…

> In the USA, he or his family would likely have demanded aggressive surgery and/or chemo or radiation In the US, if you can't afford it, medical care basically isn't even an option. If you have a lot of money, then you're set. In Europe if you don't have much money, you at least have some options, and if you have a lot of money, you can still go to the US. Or if you're open to $100k's of debt, you could've easily go…

Well, I'm saying that he had no options. He went to a (very nice) facility to die. They kept him comfortable and relatively pain-free.

Any other option he had, should he have wished to pursue it, would have been outside of the Danish social medical system.

That may be "better" than what would have happened in the USA under Medicare/Medicaid, but my point was there really wasn't a choice in the matter for him. He didn't have to pay for it, other than the taxes he paid his whole life, so I guess there's that.

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

#300

Post by JaimeThompson »

notch656a wrote: post #281
JaimeThompson wrote: post #279

Earlier quoted context omitted.

Yes if you are careful, but that isn't what I said. You are assuming that the base spent on food is 0 + 2 when that wasn't what I said.

>difference between eating ok and not eating. >difference > eating ok > not eating If you're not eating it follows you're eating $0 worth of food. So it is what you said, unless you're implying someone is spending money on food without eating any of it. I'm interested in the meals you suggest that you think are "eating ok" while maintaining the nutrition to work, $2 all in per day (food cost + transport to buy the fo…

There are multiple meals per day if one has to skip some of them to make ends meat then they are "not eating" those meals.

It's a bit more complicated than you are making it out to be, it would not hurt to remember you are talking about fellow human beings and not just numbers in a spreadsheet.

As for inexpensive ways to eat please see https://old.reddit.com/r/EatCheapAndHealthy/

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