Bay Area couple shocked by $200K hospital bill for rabies shots • Hacker News Board

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#131

Post by TheNewsIsHere » Wed, Apr 12, 2023, 9:31 PM UTC

dheera wrote: post #111

seanmcdirmid wrote: post #104

Earlier quoted context omitted.

When I was living in China working for Microsoft, our company provided insurance had a cap on claims paid ($100k), so while everything was cheap enough via the private system, I wondered if I was screwed if I ever got cancer or something really bad.

Yeah that doesn't sound like insurance to me at all.

It used to be common here in the US too, to have a cap on the amount an insurance policy would pay out.

My first “adult”/non-parental healthcare insurance policy had a yearly maximum and a lifetime maximum. This was pre-Affordable Care Act.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#132

Post by seanmcdirmid » Wed, Apr 12, 2023, 10:41 PM UTC

JohnFen wrote: post #124

seanmcdirmid wrote: post #98

Earlier quoted context omitted.

Was this before or after the ACA? As far as I understand it, the ACA got rid of ceilings on benefits and added a max pay per year.

Much before. But what did her in wasn't benefit ceilings, but rather the insurance company fighting everything they were obligated to pay out. it wore her down. It's very hard to fight the insurance company while at the same time fighting cancer. She got down to 80 pounds, couldn't eat, sleep, or do much of anything more than just hang in there. Constantly engaging in dispute resolution with the insurance company was…

Ok, I'm just wondering, because I think the law would firmly be on her side if it happened after the ACA was passed (they can no longer call policies with benefit ceilings as health insurance, you have an out of pocket maximum that is pretty hard set in stone...the dispute would just be in if something was covered at all or not). That still leaves plenty of things wrong with our system, of course.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#133

Post by Gunnerhead » Thu, Apr 13, 2023, 2:26 AM UTC

TheNewsIsHere wrote: post #130

maxerickson wrote: post #96

Earlier quoted context omitted.

Doctors could, to some approximation anyway, go on strike. They endorse the system we have by working in it (and have not been silent participants in building either).

That particular deck is stacked against the favor of doctors and patients. After all, a care facility can probably be reasonably confident that if a patient needs help, doctors will feel compelled to care for them. Put another way, would you want to walk into a hospital/ER/your doctors office for something acute and get an apology that care is unavailable because the doctors are on strike?

I imagine he’s suggesting a strike where they do not fill out the necessary billing paperwork, like Japanese bus drivers didn’t collect fares or the Canadian customs officers didn’t collect tariffs during their strikes. Not sure if that’s possible, but that’s how I’d think they can strike.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#134

Post by TheNewsIsHere » Thu, Apr 13, 2023, 3:10 AM UTC

Gunnerhead wrote: post #133

TheNewsIsHere wrote: post #130

Earlier quoted context omitted.

That particular deck is stacked against the favor of doctors and patients. After all, a care facility can probably be reasonably confident that if a patient needs help, doctors will feel compelled to care for them. Put another way, would you want to walk into a hospital/ER/your doctors office for something acute and get an apology that care is unavailable because the doctors are on strike?

I imagine he’s suggesting a strike where they do not fill out the necessary billing paperwork, like Japanese bus drivers didn’t collect fares or the Canadian customs officers didn’t collect tariffs during their strikes. Not sure if that’s possible, but that’s how I’d think they can strike.

This would absolutely work when the EHR/EMR is down. Otherwise, most of that stuff is automated and pulled directly from the medical/surgical records in the EHR/EMR.

Re: Bay Area couple shocked by $200K hospital bill for rabies shots

#135

Post by etrautmann » Thu, Apr 13, 2023, 6:47 AM UTC

maxerickson wrote: post #103

etrautmann wrote: post #100

Earlier quoted context omitted.

It seems uncommon for one group to strike on behalf of another group. Pragmatically that seems very unlikely to happen even if theoretically possible. Policy level changes seem more likely to me.

Okay, but the point is sort of that doctors are not in fact blameless for the system that they helped build and continue to participate in. Like sure, they aren't solely to blame, and it would probably be hard for individual doctors to successfully push for systematic changes, but the flip side to that is that they don't get to say "Oopsie doopsie, it sure isn't great".

I disagree. Doctors did not build the insurance billing system that we have today, and are not implicated in creating the incredible complexity and challenge that exists for patients. They provide the care, and don't get to view the costs born by patients.