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

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

#301

Post by rayiner » Thu, Jun 16, 2022, 9:33 PM UTC

suture wrote: post #286

rayiner wrote: post #262

Earlier quoted context omitted.

> You are absolutely wrong in thinking Gerrymandering does not affect Congressional popular vote. Gerrymandering does not even consistently hurt democrats in the number of House seats. Dems in 2020 won the same number of seats as their share of the Congressional popular vote. > There are secondary effects you are ignoring with this incorrect belief. In recent years, since SCOTUS abandoned voting rights, the closure o…

You are very much wrong in your assessments. Closing hundreds of polling locations absolutely affects voting outcomes and number of voters. That isn’t a big lie. It is a provable fact. There is no point in discussing this topic with someone who refuses to acknowledge indisputable facts. You are completely wrong on your assessment regarding Gerrymandering. You clearly don’t understand how total national vote total has…

> Closing hundreds of polling locations absolutely affects voting outcomes and number of voters. That isn’t a big lie. It is a provable fact.

It doesn't meaningfully affect turnout in the same way Voter ID doesn't affect turnout: https://www.vox.com/policy-and-politics/2019/2/21/18230009/v.... Both parties are lying about the impacts of voting rules on turnout.

> You clearly don’t understand how total national vote total has nothing to do with whether or not Gerrymandering causes one party to have more seats than they otherwise ought to have.

You're mixing up completely different things. The Congressional popular vote represents the total number of people that voted for each party in House elections. It's an absolute number of votes, irrespective of number of seats. Republicans have won this absolute count more often than not since 1990. For example, in 2016, Republicans won 63,182,073 votes (49.1%) and Democrats won 61,765,832 votes. Also, you can cross check it against the generic Congressional ballot, which is based on polling and isn’t affected by gerrymandering: https://projects.fivethirtyeight.com/polls. Republicans are ahead right now. That’s not a “minority party.”

> Here’s a hint: A Representative from California res presents far more people than the one from North Dakota.

It's actually the opposite, though it's a rounding error. California has 53 representatives and 39 million people, or 736,000 people per rep. North Dakota has 1 representative and 760,000 people.

> https://www.motherjones.com/politics/2019/09/report-more-tha... > https://www.theguardian.com/us-news/2020/mar/02/texas-pollin... > https://www.salon.com/2019/09/12/report-reveals-nearly-1700-...

These sites are peddlers of election falsehoods, just like Breitbart or Newsmax.

The irony of all this is that progressive election lies are used to disenfranchise minorities within the Democratic Party. Disproportionately white progressives invoke the notion that Democrats have overwhelming popular support but elections are close because of dirty tricks, to boost their own power within the party. That happens at the expense of disproportionately conservative and moderate democrats, who are disproportionately minorities.

Political parties aren’t one big happy family. The truth is that there’s trade offs between the interests of different factions and we should be honest about those. If Obama hadn’t run to the right on social issues in 2008, we wouldn’t have Obamacare today (which cut the number of uninsured Black people by half). That’s the reality of the trade offs between different factions of the party.

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

#302

Post by lesuorac » Thu, Jun 16, 2022, 9:48 PM UTC

suture wrote: post #51

rayiner wrote: post #12

Earlier quoted context omitted.

Blame Democrats for the college educated urban-dominated coalition they’ve deliberately chosen. I recall some activist types talking a few years ago about whether pro life Dems like Manchin should be kicked out of the party. Though it’s the House not the Senate, Dems just lost a longtime majority-Hispanic seat in south Texas: https://www.texastribune.org/2022/06/14/texas-special-electi... . To give you an idea of the…

Republicans abandoned people who are in favor of abortion. Republicans abandoned liberal Republicans like Bill Weld. Every party abandons people. Democrats consistently hold majority views on a wide range of policy issues and consistently have more votes in national elections. Gerrymandering so that urban centers lose their voting power and other election rigging techniques is what is holding back Democratic policies…

> Gerrymandering so that urban centers lose their voting power and other election rigging techniques is what is holding back Democratic policies.

I mean gerrymandering doesn't help but the Democrats aren't one cohesive unit otherwise they'd have no issue doing stuff right now. Sure people claim they only have 50+1 in the senate so they can be filibustered but they can just remove the filibuster with 50+1 and then do w/e they want. Democrats don't achieve their "party position's" because they're not the position that each member of the party has.

The same is true for Republicans. Look at Trump's campaign promises [1] which were often parroted by Republicans in congress but they only major thing they achieved was the Tax Cuts and Jobs Act [2]. ACA was not repealed because some Republicans voted no. One thing news orgs commonly bring up with Trump is he appointed a bunch of judges but that's just because Republicans changed the filibuster so they could; if RBG retired when Obama told her too or Democrats made the same changes, Obama would have appointed a bunch more judges.

[1]: https://www.politifact.com/truth-o-meter/promises/list/?prom... [2]: https://en.wikipedia.org/wiki/Tax_Cuts_and_Jobs_Act_of_2017

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

#303

Post by noelsusman » Thu, Jun 16, 2022, 9:48 PM UTC

maxerickson wrote: post #216

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…

Emergency rooms at hospitals that accept Medicare are not allowed to deny care under EMTALA. Hospitals that do not accept Medicare can run a 24 hour, high level of service department and deny care all they want. There's no requirement to provide non-stabilizing care.

Which hospitals don't accept Medicare?

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

#304

Post by BeFlatXIII » Thu, Jun 16, 2022, 9:51 PM UTC

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…

IMO, your proposal should separate emergency care, "capital investment", cosmetic, and routine healthcare. Cosmetic & routine should be more market-driven. However, emergency care is unplanned by definition (so can't be properly budgeted for). "Capital investment" would cover the range of expensive procedures ranging from "needed within the next five years to prevent an early death from cancer, but otherwise not time-sensitive" to expensive quality-of-life upgrades, such as knee replacements. Emergency & investment services would need something other than pure market pricing.

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

#305

Post by noelsusman » Thu, Jun 16, 2022, 9:53 PM UTC

dathmar wrote: post #115

nimbius wrote: post #97

not that it honestly matters. the whole cabal of private healthcare has become such a teetering house of cards post covid that credit reporting agencies no longer count medical debt in your score. https://www.forbes.com/advisor/personal-finance/medical-debt...

My wife had a decent chunk of medical debt when we got married which was long before COVID. Even at that time medical debt didn't count terribly against her. Maybe a 10 pt drop in her score. And eventually the debt fell off her credit.

This is one of many reasons why hospitals charge so much. Medical debt is extremely difficult to actually collect because refusing to pay has basically no consequences. Hospitals have to eat those costs and make up for it by squeezing patients who do pay for as much as possible.

I did the same thing with an ER bill I couldn't afford a while back. I just never paid it and suffered virtually no consequences.

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

#306

Post by rglover » Thu, Jun 16, 2022, 10:02 PM UTC

david_l_lin wrote: post #87

Just watched John Q (2002) last night, and can't believe that despite all the attention it gets, nothing has changed at all. Can't say I'm surprised though.

That's because a parent hasn't taken a loaded gun into an ER and held a bunch of people hostage.

Yet.

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

#307

Post by trashface » Thu, Jun 16, 2022, 10:05 PM UTC

silicon2401 wrote: post #229

If you have insurance with an out of pocket max, how is it possible to end up paying for more than that?

"Surprise" or balance billing was one way.

Basically you go to a hospital that is "in network", get some work done, but it turns out that some doctor (often some side-channel like a radiologist) who reviewed your case was out of network. So your insurance doesn't cover him and the hospital sends you the full bill. Out of pocket max doesn't matter, because that only limits costs where insurance actually accepts the claim.

It was outlawed by US congress this year (The "no surprises" bill), but there are some exceptions like ground ambulances, so I guess we citizens are supposed to remember not to take those to the hospital unless we are rich.

Yes, its insane.

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

#308

Post by heavyset_go » Thu, Jun 16, 2022, 10:12 PM UTC

corrral wrote: post #245

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. They absolutely can. They just can't refuse care if you're actively dying or your condition's quickly deteriorating (they have to "stabilize" you). This makes the ER loophole, such as it is, usel…

This is an important distinction. Nobody is getting free chemo or radiation therapy, treatment for chronic illness or anything like. For example, diabetics are not going to get a supply of insulin from the ER, especially if they can't pay, and someone with cancer isn't going to get treatment, either. Plenty of people die in the US from the inability to afford the medical care they need to live.

If you're brought into the ER because of a heart attack or are bleeding profusely, your care won't be denied, but you will pay for it in some way later.

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

#309

Post by notch656a » Thu, Jun 16, 2022, 10:18 PM UTC

JaimeThompson wrote: post #300

notch656a wrote: post #281

Earlier quoted context omitted.

>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/

Got it, the typical person can browse reddit, come up with an "ok" diet for $2 day, saving them $3+ a day vs what even the typical working class person spends on food. And simultaneously you believe it is achievable to save this $3+ per day eating following your reddit suggestion while somehow not being able to use $2 of those $3+ to pay your medical bills?

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

#310

Post by notch656a » Thu, Jun 16, 2022, 10:22 PM UTC

kevinventullo wrote: post #291

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”.

I think that's only a fraction. I agree we should eliminate licensing and regulations, which in part are responsible for burdensome administrative parasites.