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Using AI to negotiate a $195k hospital bill down to $33k

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Re: Using AI to negotiate a $195k hospital bill down to $33k

#541

Post by tptacek »

banku_brougham wrote: post #538
georgeecollins wrote: post #278

Earlier quoted context omitted.

I think the reason is that people know it is a problem but ideologically they really disagree about what to do about it. The impasse creates an opportunity for profit driven actors to fight reforms. Also, democracies do dumb things sometimes. See Brexit. But also, sometimes people from other countries-- I am thinking parts of Europe-- underestimate how well paid people in the US often are. They compare the averages,…

Wrong - sorry. The reason is that politically the US public is very skillfully managed from above via divide and conquer strategies and beaureaucratic techniques (i.e. identity politics, gerrymandering voting districts). The public polling is very clear about US citizen preferences, but US Govt policy is rarely aligned that way.

No, it's not clear at all: it's been tested in actual referenda and failed. What's actually happening is people don't intuitively grok the distinction between opinion polling, where questions are asked in the abstract (and often in the best light preferred by the org sponsoring the poll) versus actual voting, where the questions are very specific and include details like "your taxes will increase by X%" or "you will lose access to your current insurance plan".

Re: Using AI to negotiate a $195k hospital bill down to $33k

#542

Post by tptacek »

sumeno wrote: post #518
nxor wrote: post #491

Earlier quoted context omitted.

People in the US can't afford aspirin? Where do you live? It's just not true

They are referring to the price that hospitals charge for aspirin, which is massively inflated, not the off the shelf cost of aspirin

Where in their comment do you see them referring to hospital care?

Re: Using AI to negotiate a $195k hospital bill down to $33k

#543

Post by snovymgodym »

Workaccount2 wrote: post #177
lifeisstillgood wrote: post #108

The rest of the western world just looks at this as wonders why Americans put up with this. Using the latest in technology to move an a bill from existential to merely crippling

Because 92% of Americans have health insurance, and 22% have totally free everything covered health insurance. Of the uninsured, most either are eligible but don't apply, have insurance through work but forgo it, or are not US citizens. All said and done, you end up with a very small sliver of people who are legitimately uninsured, which means the problem mostly exists as scary stories rather than people actually exp…

Even if you're insured it sucks.

The American healthcare system creates an immense amount of waste and is a parasite on society.

You go to the doctor and then the provider comes up with some reason why the service isn't covered by insurance. Then your insurance comes up with some reason why they don't need to cover you. Sometimes you contest it and the bill is removed or lowered.

But regardless, at every step in American healthcare, people are being paid full time salaries to overbill or missbill you for services, to invent arbitrary reasons to deny coverage, and to do everything possible so that people who pay thousands a year for a healthcare plan get as little out of it as possible.

The only silver lining is that medical debt is legally hard to collect, so non-payment is a real option for those who don't mind trashing their credit.

It's awful and the only hope for change is either a left-wing populist who guts the whole system, collective action where people withhold paymet, or an increased rate of Luigi-esque incidents that motivate the industry to self-reform. But these all seem unrealistic and liable to worsen the situation.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#544

Post by epistasis »

xnx wrote: post #531
epistasis wrote: post #411

Earlier quoted context omitted.

Oddly enough the big rhetorical push against a universal system from prior decades was about "death panels" deciding what care somebody would get. And guess what's happened with insurance? Death panels! The propaganda spin on the health care system in the US has been on overdrive ever since Hillary Clinton wanted to implement some reforms in the 1990s, leading to absolutely massive resistance to any change whatsoever…

Like Ticketmaster, health insurance companies get paid to be the "bad guys". This is a reasonable function since Americans can't seem to understand that someone must decide where limited resources go. However, there's no reason their cut should be so large.

Health insurance companies have had their profits capped at a percentage of revenues. That means that to grow profits, they must increase revenue. Which means incentives to increase care and increase costs.

Oddly enough, all the plots I have seen of cost increases don't show a massive skyrocketing of costs since the profit caps were introduced. If anything, they have been somewhat reduced.

However a reckoning must happen at some point, health care can not consume the entire economy's efforts.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#545

Post by tptacek »

smaudet wrote: post #433
fukka42 wrote: post #376

Earlier quoted context omitted.

It's hilariously out of touch, but it's what you should expect from the HN bros. They live in a bubble. I'm from the eu and earn far less than these American techbros do, but far more than my American friends who work normal jobs. They work at the DMV, a supermarket, or general office work. You know, normal people. The vast majority.

Yeah, just because the US has 300 billionaires that does not make the median salary anywhere near six figures. In fact it's quite low, somehow people are expected to survive on several thousand a year, after the rent, utilities, transport costs are all paid. https://www.fool.com/money/research/average-us-income/ These are official stats, but unofficial employment puts the number lower: https://investorshangout.com/ca…

It helps to understand the difference between the mean and the median.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#546

Post by baby »

egorfine wrote: post #253
chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

[flagged]

As soon as someone introduce these ideas people think they're a communist. See Mamdani in NY right now.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#547

Post by tptacek »

xnx wrote: post #531
epistasis wrote: post #411

Earlier quoted context omitted.

Oddly enough the big rhetorical push against a universal system from prior decades was about "death panels" deciding what care somebody would get. And guess what's happened with insurance? Death panels! The propaganda spin on the health care system in the US has been on overdrive ever since Hillary Clinton wanted to implement some reforms in the 1990s, leading to absolutely massive resistance to any change whatsoever…

Like Ticketmaster, health insurance companies get paid to be the "bad guys". This is a reasonable function since Americans can't seem to understand that someone must decide where limited resources go. However, there's no reason their cut should be so large.

Their cut is in fact very small; it's around 6.5% of total US health care spending.

https://nationalhealthspending.org/

Re: Using AI to negotiate a $195k hospital bill down to $33k

#548

Post by supertrope »

willio58 wrote: post #338
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

The United States is a democracy, but more specifically, a representative democracy. That means citizens don’t directly vote on most laws or policies—aside from certain state or local measures—but instead elect representatives to make those decisions on our behalf. The idea is that we trust them to act in our best interests. You can probably see where the problem comes in. Take, for example, a politician who campaign…

As Lawrence Lessig put it: before the general election and before the primary election, there is a "Lester" election where donors choose who is able to mount a campaign. Candidates are effectively pre-qualified by 0.0005% of Americans. It's probably an even smaller crowd than that as that includes Joe Nobody who gives $20. Those who "bundle" $1 million in donations or write a mega check themselves have exponentially more access.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#549

Post by mr_toad »

ecosystem wrote: post #74

The American Medical Association owns copyright to all the codes and their descriptions. They have an extremely restrictive and expensive licensing options and they strictly forbid training models with the codes. This month, the practice was called out ( https://www.help.senate.gov/rep/newsroom/press/chair-cassidy... ) so the Overton window may be opening. The AMA (a nonprofit!) clears ~$300M/year revenue from the co…

> extremely restrictive and expensive licensing options

The license is meaningless if training AI is considered fair use, and if you never agreed to the license.

They might be able to lean heavily on medical researchers and the like (who probably need a license for other uses), but when push comes to shove I suspect Google and OpenAI would win.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#550

Post by xnx »

tptacek wrote: post #547
xnx wrote: post #531

Earlier quoted context omitted.

Like Ticketmaster, health insurance companies get paid to be the "bad guys". This is a reasonable function since Americans can't seem to understand that someone must decide where limited resources go. However, there's no reason their cut should be so large.

Their cut is in fact very small; it's around 6.5% of total US health care spending. https://nationalhealthspending.org/

But for what? Why not something closer to credit cards, like 1%?
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