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A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

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Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#161

Post by henrikschroder »

tptacek wrote: post #85
chrisweekly wrote: post #82

Earlier quoted context omitted.

Tangent: people tend to fixate on "LLC" as if it were the only reasonable corp structure for small outfits. S-Corp is often a better choice.

It's just the cheapest one to set up. I was assuming that if someone's self-employed and not deducting insurance, they're probably a sole proprietorship, and are probably sensitive to accounting costs.

You can typically deduct 100% of your health insurance costs if you have a sole proprietorship. It doesn't matter how you're self-employed, as long as you have no other coverage and your business income funds the insurance, then you can deduct 100%.

https://www.irs.gov/publications/p535#en_US_2017_publink1000...

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#162

Post by mindslight »

oh_sigh wrote: post #55
maxxxxx wrote: post #39

Earlier quoted context omitted.

Young people also will get old and not all of them will be multimillionaires so it makes sense that one generation pays for the previous because one day they will be in the same place.

How well does that system work for a generation that produces fewer adults than are present in the generation? Instead of paying for other peoples health insurance and then other people pay for mine, why can't I just save the money that I would be paying in premiums above and beyond what the rational amount would be and then pay for my own health care when I get older(or, pay for the higher premiums when I get older)…

It's ridiculously amazing that you're getting downvoted for your general point. Wishful thinking won't change market incentives, although it will help make some profiteers rich.

The young (and healthy) paying for the old (and sick) is a function that can only be provided by government, or bona fide charity. It's impossible for this to be provided by private companies because, in line with the denial behavior we're seeing, it's rational for any company to take on the overpaying low-cost customers, tell the underpaying high-cost customers to go elsewhere, and then pocket the surplus.

Having said that, I'm not personally a believer in single payer fixing everything. It certainly should be possible for routine care for financially able people to be provided completely on the open market. Immediate common-sense based reforms would go a long way. For example, hospitals/providers should be required to have one and only one price list for all payers, published months in advance. And the bundling of "insurance" with employment should be outright prohibited

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#163

Post by candiodari »

intended wrote: post #155
AFNobody wrote: post #148

Earlier quoted context omitted.

I'm not sure its fair to argue that universal healthcare is a human right despite the fact it makes economic sense. Humanity survived just fine without real healthcare and healthcare is not essential to a fair balance of power b/t the government and its citizenry. Universal healthcare needs to be argued on the economics of the issue because that is the only practical way to make it sustainable. The "feel good" stuff…

Healthcare is not hard. American healthcare is. Frankly a single payer system is simpler and faster. But this is an area where American politics and market rhetoric just lead to terrible outcomes.

In law school we were always taught that there are no rights. Rights, in practice are nothing but duties, and should be looked at like that.

You have no right to "life, liberty and the pursuit of happiness", you have a duty to not interfere with other people's life, liberty or their pursuit of their happiness. But even that is a negative duty. Positive duties, like paying tax, are more like the right to healthcare.

So this should be looked on in similar fashion. Do you have a right to healthcare ? Well, answer the question : do you have the duty to take care of others' health problems, completely irrespective of how it affects you personally (for instance, what if it takes up 90% of your time, while still not doing much more than slightly prolonging a miserable short life for them ?).

These questions are not so simple and knee-jerk statements like "right to healthcare, period" are not helpful and will do nothing but get us into a lot of trouble.

No country has "right to healthcare, period". That does not exist. For the obvious reason that it simply isn't feasible. Providing a named (but finite) list of treatments and medicine free of charge if diagnosed by a licensed physician is the furthest any country goes. In some cases that list is pretty short.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#164

Post by afarrell »

tptacek wrote: post #14

If you're a tech entrepreneur, it's the first story in here that should alarm you the most. It's about denying coverage altogether, not about denying individual claims. Outside of the "guaranteed issue" ACA market, there is virtually no due process for coverage denial. You can be denied on a whim, with little recourse. The list of conditions for which insurance outside the ACA will be denied is long and opaque. The s…

One of the reasons I moved to the UK despite the significantly lower salaries for software engineers here.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#165

Post by arethuza »

lsc wrote: post #151
gizmo686 wrote: post #147

Earlier quoted context omitted.

There is a lower bound on income to qualify for ACA subsidies because the ACA also expanded medicaid to cover people below that threshold. Unfortunately, the portion of the ACA requiring states to expand medicaid was ruled unconstitutional. As a result, 19 states have choosen not to expand medicaid, leaving a portion of the population to poor to qualify for ACA subsidies, but too rich to qualify for medicaid. I shoul…

Am I right in thinking this is uniquely American? The states that need welfare the most seem to be most strongly against said welfare, even when the more wealthy states are footing most of the bill.

There was a similar thing here in the UK with the Brexit vote - the regions that got the least money from the EU voted most strongly to remain and the regions that got the most money voted to leave:

https://www.prospectmagazine.co.uk/politics/which-uk-regions...

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#166

Post by shard972 »

komali2 wrote: post #130
whatshisface wrote: post #128

Earlier quoted context omitted.

If enough people didn't have access to insurance, then there would be pressure on hospitals to find ways to reduce prices (so that their volume could go up). As it stands the medical industry is allowed to hold the poor for ransom ("accept our increased costs or they won't get treated") against the US's deep but finite pockets. Before, we had the (very poor) demand elasticity of people paying everything they had and…

>pressure on hospitals to reduce prices Elsewhere it has been said: choosing between bankruptcy for your family or cancer care for your child isn't an actual choice, it's two loaded guns pointed at your skull. One held by the hospital, the other by the insurance company. The reason first world countries choose universal healthcare is that healthcare is a human right. Full stop. It is not an economic issue. If you wan…

> The reason first world countries choose universal healthcare is that healthcare is a human right. Full stop.

I'm sure they said that in soviet Russia too. It's all good to say X,Y or Z is a right until you actually cash in on that right.

I mean you don't even have to look to the soviet union, what is goinig on with the VA? Obama was working to fix that smaller universal healthcare system from actually just waiting years for people to die but I haven't heard any good news comming out of there recently.

The rest of your claims are just nonsensical in this context since your just assuming universal healthcare works because the government decrees it to be universal.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#167

Post by Feniks »

whatshisface wrote: post #128
tptacek wrote: post #123

Earlier quoted context omitted.

You have a young family of four, and can barely afford insurance premiums. Basically, without insurance, every single year you're hitting on a blackjack 17 against bankruptcy. You see the ACA penalty, and you see the insurance premium cost, but you're not factoring in the 5-digit cost of virtually any significant medical expense. Rising insurance premiums aren't good for anyone. The ACA set out to fix the problem of…

If enough people didn't have access to insurance, then there would be pressure on hospitals to find ways to reduce prices (so that their volume could go up). As it stands the medical industry is allowed to hold the poor for ransom ("accept our increased costs or they won't get treated") against the US's deep but finite pockets. Before, we had the (very poor) demand elasticity of people paying everything they had and…

Unfortunately doctors have a moral and legal imperative to treat everyone regardless of medical insurance. Yes it would be a lot easier if a hospital could deal with non paying patients by chugging them off the roof but the reality is that almost nobody wants that.

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#169

Post by hestefisk »

candiodari wrote: post #163
intended wrote: post #155

Earlier quoted context omitted.

Healthcare is not hard. American healthcare is. Frankly a single payer system is simpler and faster. But this is an area where American politics and market rhetoric just lead to terrible outcomes.

In law school we were always taught that there are no rights. Rights, in practice are nothing but duties, and should be looked at like that. You have no right to "life, liberty and the pursuit of happiness", you have a duty to not interfere with other people's life, liberty or their pursuit of their happiness. But even that is a negative duty. Positive duties, like paying tax, are more like the right to healthcare. S…

http://jeffsachs.org/2017/06/jeffrey-sachs-america-can-save-...

Re: A Glimpse into the Bureaucratic Hell of Denying Health Insurance Claims

#170

Post by Feniks »

ModernMech wrote: post #4
maxxxxx wrote: post #2

It's hard to believe that the country is putting up with a system that can bankrupt you any time you get sick and there is pretty much nothing you can do other than being lucky or having a lot of money already. The actual medical care is fine but the billing practices are just ridiculous. I would call them fraudulent in a lot of cases.

Is it really hard to believe though? The ones who are lucky and have the money are fine with the situation. The unlucky ones with no money are too busy fighting diseases, insurance companies, and bill collectors, they don't have time to change the system. Dealing with insurance when you have a serious illness is a full time job. The people who need change most are literally fighting for their lives. Meanwhile, health…

Yep America never made the decision that universal healthcare is part of a modern civilization.
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