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What Happens When a Healthcare Startup Leaves You With the Bill

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

#51

Post by phren0logy »

wernercd wrote: post #47
jjoonathan wrote: post #42

Earlier quoted context omitted.

It's evil, inconvenient, and (amazingly) it's even less efficient that its government-run counterparts both inside and outside the US: http://healthcarereform.procon.org/view.resource.php?resourc... What will it take to convince people of this? Our society already accepts that markets aren't a suitable medium for every human endeavor, how long must we continue to experiment with private (basic) health insurance befor…

"it's even less efficient that its government-run counterparts" Because the VA System is so lean, mean and well run. All health care should be modeled after the gubberment Rolls eyes

I'm a physician, and I have worked in several VAs, but don't work in one presently. They vary significantly in quality, but the good ones where I have worked are excellent by any standard. In a good VA, the bang-for-the-buck is untouchable anywhere else in the US health sector without compromising on good care. Sadly, bad ones are still bad.

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

#52

Post by omnibrain »

jimktrains2 wrote: post #50
joshfraser wrote: post #23

The problem with insurance companies is that they are fundamentally conflicted. As for-profit businesses they have a fiduciary responsibility to maximize profits. Unfortunately the only way to maximize profits is to decline coverage. The problem with Obamacare is that it does nothing to fix this problem. Who wants to be the guy responsible for that many lost jobs?? So, instead they propped up the insurance companies…

Corporations do not have the responsibility to maximize profits. Why do people keep saying this? They have a responsibility to do what is best for the corporation. Sometimes that means spending more on health coverage to retain employees, or give to charity or other programs. It's not all about money. Often, it's almost all about the money:(

What about Dodge v. Ford Motor Company?

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

#53

Post by ceejayoz »

joshfraser wrote: post #35
r0m4n0 wrote: post #31

Earlier quoted context omitted.

https://www.blueshieldca.com/bsca/about-blue-shield/health-r... One of california's largest health insurance companies is a not for profit and doesn't stockpile money. why is healthcare still expensive?

Doctors would say health care is expensive because of the threat of lawsuits which forces them to carry expensive insurance. It's easier for hospitals to price gouge when they're billing a faceless corporation instead of an individual.

> Including legal fees, insurance costs, and payouts, the cost of all US malpractice suits comes to less than one-half of 1 percent of health-care spending.

http://www.slate.com/articles/health_and_science/medical_exa...

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

#54

Post by maxsilver »

alyandon wrote: post #19
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 $1…

It gets even worse than that. Some people are stuck with an HSA.

A HSA is not insurance (it covers nothing), but it looks like insurance (so hospitals still charge you the 'ten times more' price).

A $100 doctor visit, becomes $900 "charged" to your HSA (because you 'have insurance' so they can eat the artificially-inflated cost). But since HSA never covers anything, the insurance always just passes that $900 bill on to you. They stamp "THIS IS NOT A BILL" on the top, but that's a lie, it always requires you to pay money.

You call up the hospital and explain "I don't have insurance, I need the sane price." They say "we can't give you that price, you have insurance." No one in healthcare understands that HSA's aren't insurance, and cover nothing, so no one will let you pay a manageable sum of money.

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

#55

Post by lsc »

jackgavigan wrote: post #32

There is, sometimes, a tendency on the part of young, ambitious entrepreneurs, to be overly optimistic and assume that they can gatecrash an industry they know nothing about, set up a slick website and disrupt the big, bloated, uncool incumbents. Sometimes that works out but I believe that a new entrants chances of success are a lot higher if they have somebody on board who is actually familiar with the industry sect…

I have Kaiser. It's vastly simplified because the people paying for my care are the same people who are providing my care. They also seem to have a real "get you up and running so you can get back to work" kind of attitude, which meshes well with my own values.

I mean, consider for a moment how much of a pain in the ass it is to get an insurance claim on your house or your car or whatever filled. Multiply that by the complexity of medicine, and... yeah. You can see how it would get complex fast.

Maybe this is an area where horizontal integration is the order of the day?

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

#57

Post by k-mcgrady »

fr0sty wrote: post #40
k-mcgrady wrote: post #33

Earlier quoted context omitted.

I could see this being really useful. There are many times I have needed questions answered by the doctor (e.g. I've been diagnosed with x - can I still do y safely) and the only way is with an appointment which wastes both our time. I wish my local GP would set aside 1 hour per day to answers questions via email or phone. It would make things much more efficient.

The issue with that, is there's no good way for the doctor to get paid for doing it. Prior to 2009 there was no billing code for phone calls or email and currently the rules around what is a "billable" consultation are complex and the coverage by insurers is far from uniform. More info here: http://patients.about.com/od/followthemoney/f/Why-Doctors-Wo...

I was thinking more about my own healthcare system where the government pays the doctor. So his salary would just stay the same. In the US or other systems like it I can see how that would be an issue.

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

#58

Post by michaelochurch »

jrochkind1 wrote: post #36
michaelochurch wrote: post #18

Earlier quoted context omitted.

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 horr…

I'm curious what you think "the founding values of technology" are, and when they were established (the founding of "technology"? Like the wheel? Or just transistor-based technology?), and by whom/what.

I'm curious what you think "the founding values of technology" are

I'm talking about the pay-it-forward culture of the 1950-70s Valley when it was cheap to live there and people did everything they could to help each other out. This was the era when Hewlett-Packard refused to do a layoff: instead, it cut costs with a 10% pay cut and a day off work every other week. There was a time when software had an R&D culture, and Northern California was full of people trying to do something new and interesting.

Now, startups are a safety career for failed McKinseys and Goldmanites, whose VC friends put them into executive positions and let them boss nerds around, but it wasn't always that way. You didn't go in thinking you'd be a billionaire, but you could get what would now be an upper-middle-class lifestyle and work in the sort of R&D environment that doesn't exist anymore, because the slimeballs killed it.

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

#59

Post by michaelochurch »

jackgavigan wrote: post #32

There is, sometimes, a tendency on the part of young, ambitious entrepreneurs, to be overly optimistic and assume that they can gatecrash an industry they know nothing about, set up a slick website and disrupt the big, bloated, uncool incumbents. Sometimes that works out but I believe that a new entrants chances of success are a lot higher if they have somebody on board who is actually familiar with the industry sect…

There is, sometimes, a tendency on the part of young, ambitious entrepreneurs, to be overly optimistic and assume that they can gatecrash an industry they know nothing about, set up a slick website and disrupt the big, bloated, uncool incumbents.

Also, disrupting American health insurance is like "disrupting" terrorism. (It took 10 years to get one guy.) It's not something you can pull off in an afternoon. You're facing evil. Not irritating inefficiencies, but an adversary with a history of killing people to further its own ends.

Startup people think that the natives in whatever they want to "disrupt" are stupid. That they're facing accidental inefficiency instead of malignancy. In fact, the bad guys have just as many smart people as we do in tech. It's just that their smart people have been focused on building relationships, people-hacking, negotiation, litigation and loophole-finding, while we've been reading papers about category theory. Underestimating them is a bad call. Engineers turned founders make the same mistakes with "dumb" VCs and lose their shirts.

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

#60

Post by matdes »

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.

And the moderators of HN can still choose to use their discretion to remove certain articles, without necessarily banning an entire news outlet.
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