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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

#551

Post by GuinansEyebrows »

tptacek wrote: post #542
sumeno wrote: post #518

Earlier quoted context omitted.

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?

i think in this case, if you're at all familiar with what US hospitals charge for the small stuff, it's a safe assumption that when someone says aspirin costs $30 a dose, they're not talking about buying it at a CVS. of many folks on hacker news dot com i trust you to bridge that gap instead of nitpicking!

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

#552

Post by nine_zeros »

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…

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

#553

Post by dragonwriter »

tptacek wrote: post #317
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,…

Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. So when you're talking about how bad the American system is, you're really talking about a minority of…

> Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays.

The US spends nearly as much in taxpayer funds as a share of GDP as other developed countries (and vastly more on a per capita basis), with even more in private costs on top of it. It is simply dishonest to say that the "wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays", because neither the US wage premium nor any lower tax burden are attributable to differences in healthcare systems, but rather are in spite of the far greater burden of the US healthcare system.

OTOH, it is true that a major challenge is that people respond with this line to any proposed major structural changes to the US system.

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

#554

Post by hshdhdhehd »

dekhn wrote: post #451
codegeek wrote: post #386

Earlier quoted context omitted.

I hear you that you didn't have to pay something crazy but the fact that you ultimately paid $500 for a short ride and you think it was "successful experience" is how they fool us. You think you got a deal when they are still laughing all the way to the bank for charging you $500 for a short ride.

I don't know, I don't run an ambulance company- what should the cost be (either to me, my insurance company, or to the government)? Can't be cheap to fully staff an ambulance with EMTs.

Zero to you. Whatever it reasonably costs to government. A bit from you later in tax, but much more from Bezos.

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

#555

Post by tptacek »

xnx wrote: post #550
tptacek wrote: post #547

Earlier quoted context omitted.

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%?

I don't know how to answer that. I think the system is pretty inefficient in a variety of ways. If you universalized Medicare, eliminating insurance entirely, you'd get costs somewhere in between Medicare's current admin overhead and the overhead of private insurance (you mechanically would not get Medicare's current overhead, because the majority of your customers would have much lower claims than Medicare's all-seniors patients do, and overhead is a ratio).

But the largest inefficiencies are all on the providers side. We simply pay practitioners too much, enforce artificial scarcity of practitioners, and prescribe too many services.

So if we're talking about "The American System" as a whole --- which is what the thread is about --- it behooves us first to consider the question "how much better would things be if we simply zeroed this category of expense out". The answer is, to a first approximation, we would get a 6.5% price break. I would not drive even a couple blocks out of my way to get a 6.5% price break on a pack of chicken breasts.

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

#556

Post by ksclarke »

magicalhippo wrote: post #422
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…

Relative recently had their baby come several months early. The baby needed intensive care for a couple of months, and breathing support (CPAP) for another two. Mom lived at the hospital hotel for the duration. Baby got regular inspections of the heart, lungs and eyes (too much oxygen in the blood can lead to problems with the cornea or something), including after checkout. They got billed exactly zero. Both parents…

The whole time I was reading this, as someone from the U.S., I was wondering what country the writer was from, because it sure as #$@! wasn't written by someone in the U.S. When I got to that part, I was, "Oh. Okay. That makes sense."

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

#557

Post by tptacek »

GuinansEyebrows wrote: post #551
tptacek wrote: post #542

Earlier quoted context omitted.

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

i think in this case, if you're at all familiar with what US hospitals charge for the small stuff, it's a safe assumption that when someone says aspirin costs $30 a dose, they're not talking about buying it at a CVS. of many folks on hacker news dot com i trust you to bridge that gap instead of nitpicking!

That's an odd argument to make in this thread, because whatever the drivers of burdensome consumer health spending are, they're not overpriced hospital aspirin.

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

#559

Post by tptacek »

dragonwriter wrote: post #553
tptacek wrote: post #317

Earlier quoted context omitted.

Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. So when you're talking about how bad the American system is, you're really talking about a minority of…

> Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. The US spends nearly as much in taxpayer funds as a share of GDP as other developed countries (and v…

Again, you can just do the math on this. You're making an argument about the macro costs of our system --- I think those costs are fucked, too. But I'm not talking about that; I'm talking about the actual experience of an ordinary middle-income family with private health insurance. That family would likely (in fact, almost certainly) be worse off in a single-payer system.

I'd appreciate if you'd avoid using language like "simply dishonest" with me in the future. It's easy to tell me I'm wrong about something without accusing me of commenting in bad faith. This is in the guidelines. Thanks in advance!

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

#560

Post by selfmodruntime »

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]

The US is gigantic. Imagine if every EU member, however rich, poor, or corrupt from Bulgaria to Germany had to enact one healthcare system.
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