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She paid husband's hospital bill. A year after his death, they wanted more money

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Re: She paid husband's hospital bill. A year after his death, they wanted more money

#91

Post by AnthonyMouse »

causi wrote: post #76
AmericanChopper wrote: post #69

Earlier quoted context omitted.

I could also cherry-pick some statistics to try prove a point. But the point I’m actually making is that the healthcare I had access to in the US was far better than the healthcare I had access to in New Zealand (or anywhere else), regardless of how much I was willing to pay. Complaints about systemic issue of healthcare costs in the US are perfectly valid (and there are other somewhat unique problems with it as well…

the healthcare I had access to in the US was far better than the healthcare I had access to in New Zealand (or anywhere else), regardless of how much I was willing to pay. Can you back that up with data?

The US has some of the best healthcare providers in the world. They also have some very bad ones. But gains are harder to achieve than losses in healthcare, so when you average in the bottom of the barrel you get some bad numbers even if both the median and the best available provider is above the international average.

Basically, healthcare quality in places that are both very rural and very poor (e.g. West Virginia and Mississippi) can be awful and it brings down the average even though the system provides better outcomes for most people in most other parts of the US.

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#92

Post by grecy »

AmericanChopper wrote: post #69
causi wrote: post #49

Earlier quoted context omitted.

The maternal mortality rate for the US is 4.7 times higher than New Zealand's. The infant mortality rate is 61% higher.

I could also cherry-pick some statistics to try prove a point. But the point I’m actually making is that the healthcare I had access to in the US was far better than the healthcare I had access to in New Zealand (or anywhere else), regardless of how much I was willing to pay. Complaints about systemic issue of healthcare costs in the US are perfectly valid (and there are other somewhat unique problems with it as well…

>the healthcare I had access to in the US was far better than the healthcare I had access to in New Zealand

No, it wasn't.

Factually, your sister is 4.7 times more likely to die giving birth in the US than in New Zealand.

The outcomes in US healthcare are terrible, and it's extremely expensive.

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#93

Post by adhesive_wombat »

adamredwoods wrote: post #63
sydbarrett74 wrote: post #3

To the hospital systems and insurance companies, the confusion is a feature, not a bug. They assume most patients and their families will just knuckle under and pay what they're told they owe. Since the health care sector is one of the largest political donors, elected officials have little incentive to fix anything, so they nibble at the edges and call it reform.

Another technique is to pass the burden of proof onto the consumer. The hospital creates a new charge, and it is up to the patient to prove it should have been covered by insurance. For example, showing something like meeting your yearly out-of-pocket is a difficult task. Sometimes it's up to the consumer to connect the two departments, insurance and the hospital billing, on the phone at the same time. Seems simple b…

C.f. Executive Function Theft

https://hedgehoglibrarian.com/2023/08/14/executive-function-...

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#94

Post by supertrope »

INTPenis wrote: post #21

What baffles me are these people who constantly show up to defend the US health care system, when there is clearly a plethora of real end user testimony showing how detrimental it is to the health of most United States citizens. Maybe HN isn't the best site to discuss this on, I'm guessing most of you work for some large tech sector business that offers good insurance. But most of the world is not made up of tech wor…

If you have a good job and don’t have any chronic medical conditions and have never been hospitalized and no one you care about has experienced those things the US medical-industrial complex is fine.

Healthy Americans want the payroll deductions for health insurance employee contribution, Medicare, Social Security, income tax to be as small as possible. When we get sick or injured we want no wait highest quality maximum intervention medical care and low co-pays.

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#95

Post by kelseyfrog »

db48x wrote: post #84
kelseyfrog wrote: post #53

Earlier quoted context omitted.

And the institutionalization and legal enshrining[1] of work ethic. Basically the two tier healthcare system has a legal basis for it's existence and structural support in the form of economic incentives to continue in perpetuity, and sustain itself. This is going to seem either extremely obvious or completely bonkers depending on your point of view. so it makes an interesting scissor statement. Furthermore one compo…

That’s not quite true. It is true that we often see work as virtuous, but it’s not enshrined in law. It’s just a side effect that health insurance (not health _care_, just health _insurance_) is a perk offered by your employer. During WWII, Congress enacted price and wage controls that have caused us a lot of problems. With millions of men out of the labor force (because they were conscripted), and no way to compete…

Yep, we're all well aware of the origins of employer healthcare in the United States.

However, I don't want to confuse the etiology of employer healthcare and the social reproduction of employer healthcare as it exists today. In other words, just because a thing has an origin, doesn't mean that the original cause continues to exist nor can we avoid examining proximal causes.

I'm a bit confused what you meant by "it's not enshrined in law." I think we both agree that there doesn't exist a statement of law like "Employer healthcare is a benefit of virtuous employment." Rather, the motivating factors for the ACA compliance[1] are congruent in the minds of a contingent with the idea that a work ethic justifies rewards.

There are many such programs that are congruent with work ethic such as Earned Income Tax Credit(EITC)[2], unemployment benefit requirements(looking for work[3]), and FMLA requirements(work >12 months)[4].

I want to be transparent and stress that this is much more in line with a critical analysis of the US legal code and policy than a logical argument, and carries with it all of the nuance and assumptions that any critical legal analysis does.

1. "ACA, employers with 50 or more full-time employees (or the equivalent in part-time employees) must provide health insurance to 95% of their full-time employees or pay a penalty to the IRS." https://www.nolo.com/legal-encyclopedia/is-my-employer-requi...

2. "Encouraging work" https://obamawhitehouse.archives.gov/blog/2016/01/29/earned-...

3. https://www.usa.gov/unemployment-benefits

4. https://www.dol.gov/general/topic/benefits-leave/fmla

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#96

Post by HDThoreaun »

orwin wrote: post #64
varjag wrote: post #14

Earlier quoted context omitted.

If you can afford it the healthcare in the States can be quite good. And there's a massive number of Americans who can afford it. I can't say off the cuff what share of the population is that but Americans being ever on the verge of bankruptcy is mostly a cliche.

I mean, in France we have a 'life expectancy' metric (82.5) and a 'life expectancy with good health', which is on average, the age someone born in 2023 will reach before getting daily pain or start loosing independence. The number is 76.5 year old (10th in Europe). What's 'funny' is that our life expectancy with good health match USA life expectancy this year.

American culture places a lot of importance on individualism. This means people are free to make choices that will lower their life expectancy without fear of judgement. So Americans don't live as long. Doesn't really prove anything about the quality of health care.

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#97

Post by TRiG_Ireland »

hulitu wrote: post #44
grecy wrote: post #24

Earlier quoted context omitted.

> largest political donors You pay politicians, and you get the outcomes you want. Every other country in the world calls it bribery.

> Every other country in the world calls it bribery. This is, unfortunately, not true for the majority of "democratic" countries. They call it "lobby". They avoid to call it "conflict of interest".

In principle, there's nothing wrong with lobbying. Legislators cannot be specialists on everything that needs to be done. Bat conservation charities lobby the government on issues related to bat conservation. Deaf associations lobby the government on issues related to education of Deaf students and Deaf accessibility. Lobbying from commercial interests is infinitely more suspect, of course, but still sometimes reasonable. The trick is to have very strong laws about openness: lobbyists should be registered, and minutes of meetings should be published.

Ireland's Regulation of Lobbying Act (2015) [1] is something of a gold standard, which some other countries are considering using as a model [2].

[1]: https://www.lobbying.ie/help-resources/information-for-lobby... [2]: https://www.politico.eu/article/ireland-lobbying-clampdown-m...

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#98

Post by supertrope »

maerF0x0 wrote: post #41

We simply need a sort of statute of limitations for B2C transactions. - Your employer can incorrectly pay you for a long time and then demand the money back. - A hospital bill can come (afaik) anytime in the future - You can dispute charges, the provider can fail to provide customer service, but your credit score is negatively affected. Etc. We need bills that focus on favoring the "little guy" in the fight so that w…

A lot of health plans consider any bill presented more than a year from the date of service forfeited. Medical billing is notoriously slow, opaque, and fragmented. On the insurance side they tend to be super slow in payment running 120 days behind forcing the hospital to de facto provide vendor credit to insurance companies that are way better capitalized than they are.

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#99

Post by rwmj »

HDThoreaun wrote: post #96
orwin wrote: post #64

Earlier quoted context omitted.

I mean, in France we have a 'life expectancy' metric (82.5) and a 'life expectancy with good health', which is on average, the age someone born in 2023 will reach before getting daily pain or start loosing independence. The number is 76.5 year old (10th in Europe). What's 'funny' is that our life expectancy with good health match USA life expectancy this year.

American culture places a lot of importance on individualism. This means people are free to make choices that will lower their life expectancy without fear of judgement. So Americans don't live as long. Doesn't really prove anything about the quality of health care.

I can assure you that eating and drinking yourself to death is entirely possible in France too :-)

Re: She paid husband's hospital bill. A year after his death, they wanted more money

#100

Post by moribvndvs »

sydbarrett74 wrote: post #3

To the hospital systems and insurance companies, the confusion is a feature, not a bug. They assume most patients and their families will just knuckle under and pay what they're told they owe. Since the health care sector is one of the largest political donors, elected officials have little incentive to fix anything, so they nibble at the edges and call it reform.

Absolutely. I work in HIT for small to medium size practices. We all know how badly insurance is treating us as patients, but what’s not as well known is how much they squeeze medical providers (example [1]). Hospitals and networks have the weight to navigate insurance, but small independent offices don’t and are also getting absolutely fucked over. In addition to staffing issues, rising operational costs, excessive demand, slow turn around in receipts, rising complexity in software and regulatory compliance, a lot of local doctors are selling to networks and hospitals or just straight up closing doors. Large entities absorb all the same problems primarily by economies of scale which can result in poor individual care, increased out of pocket costs, amongst other things.

[1] https://www.npr.org/sections/health-shots/2023/08/15/1193754...

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