Banks and hospitals are cashing in when patients can't pay for health care • Hacker News Board

Re: Banks and hospitals are cashing in when patients can't pay for health care

#41

Post by klyrs » Thu, Nov 17, 2022, 4:51 PM UTC

antisthenes wrote: post #22

If you have obscene hospital bills, just don't pay them. Worst case scenario, you will get sued and have a lien put on your house.This still doesn't obligate you to pay. You can just let inflation eat away at the bill for years on end. People need to hit these profiteering practices right in the wallet. I'll take bad credit over actual bankruptcy any day.

> You can just let inflation eat away at the bill for years on end.

Can we really? Wouldn't that require that our income tracks inflation? Because that's not true for perhaps most people in the US. Only executive-level income is beating inflation.

I think the option most available is to die poor and have your pitiful assets distributed to your creditors.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#42

Post by theGnuMe » Thu, Nov 17, 2022, 4:51 PM UTC

starkd wrote: post #8

elzbardico wrote: post #7

What is incredibly amazing is how much health care costs in the US. Government expenditures Per Capita are over twice of the nations like Canada, UK, Australia, and Japan. And most of this for medicare, for which only a fraction of the population is eligible. And yet, this is not enough, and people need private health insurance. Then you look at the prices of common medications, and most of them (mind you, a lot of t…

In no way is this a free market. Not even close. There are so many market distortions that prevent a healthy market place from operating. If you recall, the ACA act was supposed to help solve many of these problems by making it more affordable. It appears to have exacerbated it.

ACA increases the subscriber pool. The main issue now is the high deductibles which causes folks to ration care. Otherwise your premiums are scaled based on income. You also do get some primary care visits included and a few other things. That's so you catch things earlier before they get expensive. What the ACA really does though, is reduce the financial impact of a catastrophic event. So you are covered and out of pocket say a max of $10k vs $100k+. So let's say you get diagnosed with cancer, well the $10k is manageable (excluding the insurance games).

Re: Banks and hospitals are cashing in when patients can't pay for health care

#43

Post by theGnuMe » Thu, Nov 17, 2022, 4:52 PM UTC

dsfyu404ed wrote: post #11

elzbardico wrote: post #7

What is incredibly amazing is how much health care costs in the US. Government expenditures Per Capita are over twice of the nations like Canada, UK, Australia, and Japan. And most of this for medicare, for which only a fraction of the population is eligible. And yet, this is not enough, and people need private health insurance. Then you look at the prices of common medications, and most of them (mind you, a lot of t…

Everything bad anyone ever said about the Big Dig applies to healthcare. It's a giant feeding trough for the subsidized industries. They get rich. The people who make the feeding trough run get power and influence. Taxpayers get poor results per dollar to the detriment of all the other things society could have spent that money doing. And idiots who are hoodwinked by the veneer of plausible deniability defend the sys…

Just look at crypto for massive deregulation. It would be a disaster.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#44

Post by stevebmark » Thu, Nov 17, 2022, 4:53 PM UTC

Great article. It’s important to understand that hospitals are the enemy in American healthcare. (All of its layers are the enemy, but hospitals are often overlooked).

Many hospitals are viscous for-profit machines that fraudulently maintain a non-profit status. They employ CFOs and business analysts to maximize profits unrelated to care quality. They hire “medical coders” whose entire job is to find the highest price way to legally bill you for services. (Is a surgery followed by stitches from a second doctor one procedure or two? Can we bill higher for medication if we can’t bill more for surgery? Can we charge a “room fee”?). And medical coder fees often show up on hospital bills sent to patients! The non profit mission of hospitals has long ago been lost to maximizing profits.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#45

Post by Consultant32452 » Thu, Nov 17, 2022, 4:56 PM UTC

jleyank wrote: post #2

Healthcare feels like something that should be a regulated monopoly if not provided by the government. Profiting off the misfortune of others seems a bit dirty.

In the US healthcare is regulated to be a monopoly. For example, a children's hospital chain wanted to expand to my city. They had to get permission from their local competition to open the hospital. As part of their terms, they had to limit their provided services for 5 years (no level 1 trauma care).

Then you have organizations like the AMA who have a monopoly control over how many doctors can be created. There were lawsuits in the past because they would not let medical schools open. This reduced supply and kept wages sky high.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#46

Post by jessaustin » Thu, Nov 17, 2022, 4:57 PM UTC

starkd wrote: post #8

elzbardico wrote: post #7

What is incredibly amazing is how much health care costs in the US. Government expenditures Per Capita are over twice of the nations like Canada, UK, Australia, and Japan. And most of this for medicare, for which only a fraction of the population is eligible. And yet, this is not enough, and people need private health insurance. Then you look at the prices of common medications, and most of them (mind you, a lot of t…

In no way is this a free market. Not even close. There are so many market distortions that prevent a healthy market place from operating. If you recall, the ACA act was supposed to help solve many of these problems by making it more affordable. It appears to have exacerbated it.

Laws written by insurance firms may be expected to benefit insurance firms. In our system, the interests of average citizens are not a priority.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#47

Post by Mezzie » Thu, Nov 17, 2022, 4:59 PM UTC

iso1631 wrote: post #36

Mezzie wrote: post #25

Earlier quoted context omitted.

In addition to people mentioning the information asymmetry, healthcare demand is also inelastic and not substitutable. I have MS. If I sub out my treatment, I increase my odds of losing the ability to ever walk again. Likewise, if I have a relapse and end up in the hospital, I need steroids immediately.

Healthcare demand seems to be boosted by the profit motive. The healthcare industry has an incentive to increase healthcare usage - by oversubscribing unneeded drugs and procedures and through constant daytime adverts about "talk to your GP about thing which has a list of side effects longer than the commercial break "

Yeah, this is definitely part of the reason for the cost, but overall healthcare is pretty inelastic.

(Ads for meds are so odd: I spent a couple of years in Canada and they don't do that there and it was bizarre coming back to the US and hearing them.)

Another reason for this is that Americans are so litigious: tests are ordered because otherwise the patient can sue. Which in turn is the case because the only way to hold companies/professionals accountable is to sue them. I'm not sure what the answer is.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#48

Post by caycep » Thu, Nov 17, 2022, 5:01 PM UTC

zdragnar wrote: post #28

elzbardico wrote: post #7

What is incredibly amazing is how much health care costs in the US. Government expenditures Per Capita are over twice of the nations like Canada, UK, Australia, and Japan. And most of this for medicare, for which only a fraction of the population is eligible. And yet, this is not enough, and people need private health insurance. Then you look at the prices of common medications, and most of them (mind you, a lot of t…

An interesting story I heard on the radio: A father got a call from his daughter that she went to the emergency room, because she had a vitamin C pill stuck in her throat and she was scared. In NY, they are required to give an estimate of costs, and estimated $1600 for the exam and the can of ginger ale they gave her to drink so she could swallow it. Fast forward a few weeks, and they got the bill. They ended up char…

slightly OT, but I'm hoping the new CGRP meds will eventually be OTC. They work well and don't have any major issues that would make sumatriptan prescription (small risk of cardiac related issues and serotonin syndrome). That being said...just came on the market so the powers that be need to "recover their investment"...

Re: Banks and hospitals are cashing in when patients can't pay for health care

#49

Post by kelseyfrog » Thu, Nov 17, 2022, 5:03 PM UTC

AlexTWithBeard wrote: post #27

chasd00 wrote: post #24

Earlier quoted context omitted.

the "invisible hand" can't work because there is no price list available to consumers. That's the craziest thing to me, you can't get a price list for a procedure ahead of time and compare with competitors to get a better deal. There's no way for price discovery to work without an informed consumer.

So... Imagine there's a law banning surprise bills. No longer separate bills from a hospital and then from a surgeon and then from anesthesiologist and then from the janitor. No "oopsie, sorry, your pimple removal went wrong and you had a cardiac arrest, here's your bill". How much better will things become?

A law? How come hospitals and doctors that don't have surprise bills out-compete those that do? Surely if this was a thing that patients cum customers demanded, there would be a provider willing to step in an supply it.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#50

Post by syzarian » Thu, Nov 17, 2022, 5:03 PM UTC

starkd wrote: post #8

elzbardico wrote: post #7

What is incredibly amazing is how much health care costs in the US. Government expenditures Per Capita are over twice of the nations like Canada, UK, Australia, and Japan. And most of this for medicare, for which only a fraction of the population is eligible. And yet, this is not enough, and people need private health insurance. Then you look at the prices of common medications, and most of them (mind you, a lot of t…

In no way is this a free market. Not even close. There are so many market distortions that prevent a healthy market place from operating. If you recall, the ACA act was supposed to help solve many of these problems by making it more affordable. It appears to have exacerbated it.

The ACA did not exacerbate the mess. It merely allowed more people access to the system and put in some curbs to the exploitation. A truly free market health care system would be horrible and dystopian. Some things ought not be a free market and health care is one of them.