42 percent of new cancer patients lose their life savings • Hacker News Board

Re: 42 percent of new cancer patients lose their life savings

#191

Post by tracker1 » Fri, Oct 19, 2018, 9:56 PM UTC

btilly wrote: post #145

rayiner wrote: post #34

Earlier quoted context omitted.

> These are enormously beneficial to insurance companies (they essentially have unlimited liability without them) and there is a ton of money to have the caps reinstated. I don't understand why you'd phrase it this way. Under the ACA, 80% of premiums have to go to medical care. A dollar saved providing care disproportionately benefits the premium payers, not the company. People act like all this money comes out of in…

If you actually want insurance, then that is exactly the right way to phrase it. The purpose of insurance is to provide me a way to pay for disasters that I otherwise could not afford. To that end I make payments that, on average, leave me poorer. But since I can afford the payments and can't afford the disaster, it leaves my expected quality of life better off by reducing the variance in my expected outcomes. When I…

Similarly, they've largely stopped negotiating and just raise rates and premiums.

Re: 42 percent of new cancer patients lose their life savings

#192

Post by fatjokes » Fri, Oct 19, 2018, 9:56 PM UTC

rhcom2 wrote: post #40

stewbrew wrote: post #31

Earlier quoted context omitted.

In the US, it would have been sufficient to vote for a different party. Enjoy the government, the majority of you people voted for.

In the US we are currently enjoying the government (at least in the executive) that the majority of people did not vote for.

It's pretty close though.

Re: 42 percent of new cancer patients lose their life savings

#193

Post by chimeracoder » Fri, Oct 19, 2018, 9:57 PM UTC

davvolun wrote: post #187

chris_va wrote: post #171

Earlier quoted context omitted.

To play devil's advocate, looking at 5-year survival rates by country, you'd be 15-20% more likely to survive in the US after you contract cancer than in the Netherlands. YMMV.

Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country.

> Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country.

The population survival rates for cancer in the US are higher than any other OECD country. That already includes people who don't have insurance or otherwise can't afford treatment.

Re: 42 percent of new cancer patients lose their life savings

#194

Post by DanBC » Fri, Oct 19, 2018, 9:57 PM UTC

rayiner wrote: post #135

FabHK wrote: post #121

Earlier quoted context omitted.

What strikes me as disingenuous about your posture is this: You are basically arguing that the insurers are introducing lifetime caps (making life much worse for the affected individuals, basically nullifying the whole point of insurance) not out of concern for their profit margin, but out of the goodness of their hearts to keep the premiums low for the paying public. That strikes me as unlikely. Of course, if you do…

> not out of concern for their profit margin, but out of the goodness of their hearts to keep the premiums low for the paying public. Lowering premiums allows insurers to win customers away from competing insurers. It's e.g. why HP sells business laptops with awful LCD panels. It's not because HP makes fat profits on each laptop (their margins are razor thin). It's because the lower price allows them to take sales aw…

> In the UK, the guy would've needed to live 12-13 years to justify spending that much. He had an aggressive cancer and died a year later, while receiving treatment. Under the U.K. system, the NHS would've been willing to pay well under $100,000 with that prognosis.

This is simply untrue.

There's too much wrong with your link to debunk it. It's almost entirely wrong. Mostly, there is a different QALY threshold applied when drugs are used for people with life expectancy of under 24 months, and also they're using an unsourced value for QALYs.

Re: 42 percent of new cancer patients lose their life savings

#195

Post by icoder » Fri, Oct 19, 2018, 10:00 PM UTC

expertentipp wrote: post #97

ttul wrote: post #27

* In the United States.

In most of the world, even in poorer EU states, these super advanced and expensive treatments are not available and people simply die without getting a chance. Occassionaly one hears in media about some crowdfunding campaing for „unique treatment in the US”.

Although a good point on itself to ponder about, I don't think in this particular discussion it is logical to compare the US to non-EU and poor EU countries.

Re: 42 percent of new cancer patients lose their life savings

#196

Post by tracker1 » Fri, Oct 19, 2018, 10:02 PM UTC

toomuchtodo wrote: post #18

thrower123 wrote: post #16

Earlier quoted context omitted.

> (A Crowdpac campaign has funded close to $4 million dollars to challenge Susan Collins when she's up for reelection due to her supreme court vote; that most likely won't scale) This sort of thing should be illegal, particularly when it is out-of-state interests injecting money. If you live in another state, vote out your own reps you don't like. The harassment the poor woman has been put through lately is obscene.

Money is considered speech. The legislative and judicial branches condone such actions, and the example you take issue with is the result of representatives having national impact (in this case, voting for the appointment of a supreme court judge).

Requiring open finances for any organization that donates to political campaigns or advertisements for, or against a given party or candidate would go a long way.

Eliminating corporate personhood as a legal construct or adding a non-living entity construct as an amendment would help too.

Re: 42 percent of new cancer patients lose their life savings

#197

Post by refurb » Fri, Oct 19, 2018, 10:03 PM UTC

Interestingly, medical bankruptcies aren't all that much higher in the US versus Canada, who has universal medical coverage[1].

Turns out that a major cause of medical bankruptcies is the inability to work, not just the medical bills.

[1]https://www.theatlantic.com/business/archive/2009/09/bankrup...

Re: 42 percent of new cancer patients lose their life savings

#198

Post by refurb » Fri, Oct 19, 2018, 10:08 PM UTC

njarboe wrote: post #84

zrail wrote: post #14

Earlier quoted context omitted.

Yeah, the study appears to be looking at 2000–2012. The lifetime limit ban started on March 23rd 2010, according to this Vox article: https://www.vox.com/policy-and-politics/2017/2/15/14563182/o... Thanks Obama.

Every European health care system, I believe, has some way of limiting the amount of care provided to people. It is just not so out in the open as a dollar cap on what people can get in a lifetime. Not every possible, super-expensive procedure is approved to be available to people through the public healthcare system. (Would love to hear of a country that has "universal health care" that does not limit what procedure…

This is definitely one of the drivers of lower healthcare costs outside the US.

A good example is the cbc.ca article where two friends were diagnosed with the same cancer. The one in the US got treated with the latest cancer drug and is remission, where the woman living in Canada has to sell her house to pay for it.[1]

"It's crazy that I live in Canada, but now I'm looking at having to sell my house for coverage of my medication."

[1]https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-...

Re: 42 percent of new cancer patients lose their life savings

#199

Post by jahaja » Fri, Oct 19, 2018, 10:09 PM UTC

Retric wrote: post #182

jahaja wrote: post #126

Earlier quoted context omitted.

That link measures peoples perception. My perception is that the influence of money is blatantly epidemic in US politics. But it uses an euphemism; lobbying. Luckily it's not corruption if it's legal.

Lobbing is not inherently corrupt. When a small group cares a lot about a specific issue say astronomers and light pollution lobbing is simply trying to get politions to pay attention to an issue. That effort is not free, in some cases they approach the issue by mailing or dolling people directly, in others they pay somone else to make these calls and phrase things in political terms etc. Now, that does open the door…

Why is it important for you to issue a petty nuance to this that you should, and probably do, realise that I already acknowledge?

Compare: "China is actually not inherently undemocratic there's a lot of local officials etc being voted in".

Yes, but on the systemic, overall, scale there's a blatant democratic deficit present for all to see.

Re: 42 percent of new cancer patients lose their life savings

#200

Post by Alex63 » Fri, Oct 19, 2018, 10:09 PM UTC

1. I think the title may be a little misleading. Only 3% declare bankruptcy, though higher numbers deplete all their savings. It's hard to find a good estimate of per capita "savings". A search indicates that the median savings account balance in the US is about $5,000. The median 401(K) appears to be about $36,000. Based on this, I'll assume that means the typical out-of-pocket costs of cancer treatment are somewhere around $30,000. That seems in line with what the out-of-pocket costs for 5 years of treatment might be under my current coverage.

2. The problem with any discussion of healthcare issues is that we are naturally swayed by our empathy for those who are suffering. Almost all of us would choose to pay whatever was needed to save a loved one, and would grant that ability to others if we could. It seems simple enough to say "we should spend less money on the military/international aid/tax breaks for corporations/the NEA/etc." if it means that we can provide affordable treatment to those who are suffering. Unfortunately, until the singularity arrives there is probably always going to be a cost that is too high, and hard decisions must be made. As a Canadian, I know that one of the downsides of universal healthcare is that some treatments must be rationed and bureaucrats will make decisions affecting the life of my loved ones. Now that I live in the US I can avail myself of diagnostics and treatments that may simply not be available in Canada. The cost may beggar me and the likelihood of a positive outcome may be remote, but it is my choice, and a choice that may not be available under other systems.

3. No, I have not read all of the comments. As with many HN comment pages, the marginal value of descendant comments seems to drop off quickly.