What Happens When a Healthcare Startup Leaves You With the Bill • Hacker News Board

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#11

Post by shepardrtc » Thu, Jul 03, 2014, 3:39 PM UTC

This seems similar to third-party warranty companies. They offer full coverage for low amounts, but when the time comes for them to pay up, they're impossible to deal with. Can't reach them on the phone, they need things to be faxed(!) over, and then because of so-and-so reason, it won't be covered.

Healthcare shouldn't be handled by startups. Its too expensive and there's too much riding on it for something that could go belly-up at any moment to handle.

Of course, that brings up the question: How do you actually start an insurance company? I'd imagine that in a perfect world, the government could guarantee your coverage until you get enough in your coffers to handle things without a backup.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#12

Post by eggbrain » Thu, Jul 03, 2014, 3:43 PM UTC

I had a conversation with a friend recently who was a doctor. He was telling me that he had 3 patients in a fairly short period of time that had come in with mysterious symptoms (they were all in their 70's) and that had died soon after being admitted. While he knew that he had technically done everything by the book to treat them, he worried that he had made a mistake along the way that possibly could have been the cause of their death.

It made me appreciate that the code that I produce as a web developer most of the time would never have me facing those same ethical dilemmas -- there are very few times a bug in a web app would cause people to die or to be financially ruined.

In this case, however, you can see what happens when an ambitious startup ends up trying to apply things web developers had done for years (A/B testing, "design" decisions) to avenues of life where people's livelihood or health is at stake -- people can end up getting hurt. "Failing hard and fast", the motto many people have regarding startups, cannot be taken with the same arrogance. If you want to change the world in ways that impact people on a personal level, be ready to be very careful with the trust your customers put in you.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#13

Post by korzun » Thu, Jul 03, 2014, 3:45 PM UTC

HarryHirsch wrote: post #10

With bogus physician bills my SOP is to call the office and tell them that I will let the bill run to collection and dispute it in court. This strategy never failed, physicians are mortally afraid of having to admit that their billing practice is questionable. With refunds from the insurance company I have found that a nice letter "please pay up 10 days from now or I will get a title in court" works wonders. I never…

A mature way to handle this is to ask for a copy of the bill for clients that are paying directly, without insurance.

Please don't take me to court now.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#14

Post by r0m4n0 » Thu, Jul 03, 2014, 3:45 PM UTC

With a healthcare startup, you will almost always pay more. Large insurance companies are able to bargain the best rates through many means based upon their size.

Even when the provider disagrees (with capitated services for example) and bills the member, the larger insurance companies will reimburse the member and then bill the provider.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#15

Post by rlvesco7 » Thu, Jul 03, 2014, 3:47 PM UTC

I'm sorry but I've had all these problems and many more with traditional health care companies. As a diabetic I'm intimately familiar with the health care system. It's a hard space to work in and I'm happy to see startups trying to tackle it. But it won't solved soon. Unlike Dropbox, where they "solved" sync more or less there is no one thing in health care, but many.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#16

Post by korzun » Thu, Jul 03, 2014, 3:48 PM UTC

michaelochurch wrote: post #3

minimaxir wrote: post #2

This is actually a Valleywag article, which is a banned domain on HN so the original link is using a workaround to show the article. ( http://valleywag.gawker.com/what-happens-when-a-healthcare-s... ) In this case, the article is actually pretty good.

Valleywag shouldn't be banned. It can be a bit gleeful about the Valley's moral meltdown, but it's the only outfit in "the tech press" that tells the truth. Everything else is payola.

Most of ValleyWag articles are extremely biased and twisted.

There are actually too many things to list, their Uber coverage, their coverage of start-up 'parties' and how people are throwing money there (while Gawker holds the same parties) etc.

Then you have this:

https://www.youtube.com/watch?v=_jtmFlUg56w

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#17

Post by GotAnyMegadeth » Thu, Jul 03, 2014, 3:51 PM UTC

Sorry for over repeating what people always say, but I am genuinely so grateful for the UK's NHS.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#18

Post by michaelochurch » Thu, Jul 03, 2014, 3:51 PM UTC

minimaxir wrote: post #4

michaelochurch wrote: post #3

Earlier quoted context omitted.

Valleywag shouldn't be banned. It can be a bit gleeful about the Valley's moral meltdown, but it's the only outfit in "the tech press" that tells the truth. Everything else is payola.

I agree that Valleywag shouldn't be banned on the basis that they often contribute unique articles not discussed by other tech outlets. (e.g. http://valleywag.gawker.com/the-laundry-quarters-startup-is-... ) Although to be fair, there are a few "rich people in tech suck because they're rich" articles which are more hostile.

Although to be fair, there are a few "rich people in tech suck because they're rich" articles which are more hostile.

Not because they're rich, but because they've departed so far from the founding values of technology.

Picking on the average "Google bus" rider is mean-spirited and pointless, but the "leaders" of private-sector technology really are rapacious assholes. This sector of the economy really is run by horrible human beings and pointing out is not mindless hostility, but confronting one of the most important issues that our generation faces.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#19

Post by alyandon » Thu, Jul 03, 2014, 3:55 PM UTC

will_brown wrote: post #9

I have posted it before, but any time a healthcare thread pops up I like to mention a project I co-founded (before Obamacare/Affordable Healthcare Act). Primary care coverage for $20/month $10 copay for ARNP/PA visits and $25 copay for Doctor visit. Even if someone is covered on the exchange this type of primary care plan can be far more cost effective than paying the copays under many of the plans. See: http://pfccm…

It is absolutely ridiculous how pricing schemes like that are even legal. Have insurance that covers a non-typical lab test? They bill $1000 to your carrier (regardless of what th e contracted rate will be) and you are usually responsible for a fraction of that because of deductibles. Don't have insurance and are a cash-only customer? They bill you $150. Have insurance and insurance declines to pay? You get billed $1000.

A real example of this, my son had a routine vaccination performed at a Baylor clinic and my insurance company drug their feet on remitting payment to them. So, Baylor turned around and invoiced me for $1250 and was ready to send that to collections. Turns out that the agreed rate with my insurance carrier for that vaccination was well under $100.

Re: What Happens When a Healthcare Startup Leaves You With the Bill

#20

Post by arethuza » Thu, Jul 03, 2014, 4:00 PM UTC

GotAnyMegadeth wrote: post #17

Sorry for over repeating what people always say, but I am genuinely so grateful for the UK's NHS.

I get private healthcare in the UK through my job - the only time we have used it was when my teenage son got his tonsils out.

What was amusing was that at one point the anaesthetist came up and said there had been a mistake in the billing and I'd have to pay part of the bill directly. Having heard all the horror stories from the US I was thinking it was going to be a huge amount of money - he very apologetically gave me a bill for £12.00 (yes, twelve pounds) :-)

[NB Worth noting that although we do have private health care, anything serious that has happened to us over the last few years was fixed by the NHS].