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

#51

Post by conductr » Thu, Nov 17, 2022, 5:04 PM UTC

dan_quixote wrote: post #5

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.

I'd say it's cruel . Paying interest on some medical procedure because you (and likely almost everyone else) cannot afford the eye-watering cost? What else do we need to convince people that this is not sustainable? Maybe a collapse in this medical loan market? One has to assume the major players (hospitals, insurance, etc) have firewalled themselves from this system.

> Maybe a collapse in this medical loan market?

That won't properly highlight the issue. It's just a financial shell game of bailouts and buying and selling of paper. It doesn't impact the patients. It's not ideal but the only solution is for the patient to be rejected for insufficient funds/inability to pay. Then, when people finally realize they can't get a doctor appointment because they literally can not afford healthcare in our current system, they will expect the government to provide it.

What's funny/ironic to me is that people that are against single payor in the US always like to point to other non-US countries and say how care is restricted or people with cancer/needing surgery are on a long waiting list, etc. I don't know if that's even true but we've all heard it somewhere by now and it becomes a part of their truth (not unlike like politics). And it's what they're most afraid of, being cut out... when not being able to afford something is the very definition of being cut out.

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

#52

Post by lob_it » Thu, Nov 17, 2022, 5:04 PM UTC

advisedwang wrote: post #33

lob_it wrote: post #4

They do indicate that upwards of 70% of the population are on prescription meds. https://newsnetwork.mayoclinic.org/discussion/nearly-7-in-10... You don't go there for health Wealth breeds health :)

The USA is #54-41 in the world for life expectancy [1] depending on whose data you use. [1] https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

Life expectancy is a personal goal and akin to the DNA lottery. You can't win if you don't play :)

"Just because all of the other kids do it" is more relevant today than ever :p

https://www.toledoblade.com/a-e/food/2015/06/23/70-of-Americ...

Edit: I didn't make the stats :)

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

#53

Post by DavidPeiffer » Thu, Nov 17, 2022, 5:07 PM UTC

cvccvroomvroom wrote: post #17

Anecdotal example: I was in a coffee shop in Redding CA. There was a lady with a nasal infusion pump tube in her nose. I struck up a conversation with her. It turns out she had Stage IV cancer and was about to go before a bankruptcy magistrate to fight to keep her clothes, housing, and vehicle. Her creditors were the doctors and hospitals who were going after her while she was still alive.

> It turns out she had Stage IV cancer and was about to go before a bankruptcy magistrate to fight to keep her clothes, housing, and vehicle.

There are protections that vary significantly by state, and it's interesting to look through the variations in policy. Some states exempt a single firearm (regardless of value).

If memory serves right, 401k's are protected by ERISA rules, but many states have IRA protections as well. Iowa exempts the entire homestead up to 1/4 acre in a city, regardless of its value.

Having to deal with all of those items while battling a terrible disease puts someone in a disadvantaged position, but if you're ever in a position to help someone, it is good to be aware what exemptions exist. If your house is exempted, don't do a HELOC to pay medical bills.

https://www.nolo.com/legal-encyclopedia/california-bankruptc...

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

#54

Post by mistrial9 » Thu, Nov 17, 2022, 5:08 PM UTC

stevebmark wrote: post #44

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 pric…

> that hospitals are the enemy in American healthcare

no, not every hospital is run this way. Many are, of course.. how can constructive engagement get past these shrill and urgent criticisms, and make positive change?

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

#55

Post by BugsJustFindMe » Thu, Nov 17, 2022, 5:15 PM UTC

mistrial9 wrote: post #54

stevebmark wrote: post #44

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 pric…

> that hospitals are the enemy in American healthcare no, not every hospital is run this way. Many are, of course.. how can constructive engagement get past these shrill and urgent criticisms, and make positive change?

My perspective isn't universal, but it's true enough that your objection reads like an attempt to subversively derail to me. Just thought you should know how what you just said might come across.

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

#56

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

notch656a wrote: post #38

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.

Lol I got some medical bills when police dragged me to the hospital against my will (not psych related, insane warrantless attempt to search me "internally" for drugs, never consented to anything, was not intoxicated and doctors documented I was completely asymptomatic and non-altered mental status) >People need to hit these profiteering practices right in the wallet. Here in Arizona there is a hospital system that a…

I remember reading a detailed story of a guy in Arizona who experienced this. He ended up suing the state (he was arrested by state police) and the doctor and won, but it was a long battle. I wish I had a link. Sounds like a horror story, I wouldn't wish that on my worst enemy.

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

#57

Post by ericd » Thu, Nov 17, 2022, 5:18 PM UTC

anonuser123456 wrote: post #10

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…

The invisible hand of the market has been crushed by the boot of government policy/regulation. It's bootleggers and baptists at national scale.

Care to explain? From where I'm sitting, it looks like private equity firms and hospital networks have created local monopolies/cartels in healthcare by buying up lots of little doctor's offices, and running the same playbooks around revenue maximization.

I guess it's hard to defect and run a smaller office, because of the demands of dealing with insurance, as well as doctor licensure, but afaik the AMA isn't a governmental agency so much as a professional organization interested in keeping doctor salaries elevated by restricting the entry of new doctors into the field, and they seem to be one of the major problems.

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

#58

Post by AlexTWithBeard » Thu, Nov 17, 2022, 5:20 PM UTC

kelseyfrog wrote: post #49

AlexTWithBeard wrote: post #27

Earlier quoted context omitted.

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.

Customers demand it, but customers are not willing to pay for it.

With a choice to pay $1k "with a small probability of surprise bill" or $5k all-included most patients will prefer the former.

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

#59

Post by digdugdirk » Thu, Nov 17, 2022, 5:23 PM UTC

mistrial9 wrote: post #54

stevebmark wrote: post #44

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 pric…

> that hospitals are the enemy in American healthcare no, not every hospital is run this way. Many are, of course.. how can constructive engagement get past these shrill and urgent criticisms, and make positive change?

In this case, I think that having more people constructively engage with the fact that these "shrill and urgent criticisms" are the reality for the vast majority of Americans would make for a positive change.

If the vast majority of bank tellers sucker punch you in the face after completing a transaction, the correct response is to implement a sweeping reform of bank tellers - not to do a deep dive root analysis on the positives and negatives that bank tellers add to the banking experience.

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

#60

Post by delecti » Thu, Nov 17, 2022, 5:29 PM UTC

hungryforcodes wrote: post #32

delecti wrote: post #31

Earlier quoted context omitted.

Two things can be bad.

That's true -- but in this case there is an irrational bias. The people on HN who criticize crypto obviously don't invest in it and have no skin in the game. They just want to feel superior. But it doesn't affect them at all. But this really could -- and yet they are silent...

This is primarily a forum for nerdy stuff. The crypto space is much more on-topic for discussion here because of its technical origins, so it gets discussed more. If you want more discussions of other topics, post about them, and they'll get discussed if other people also want those dicussions.