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

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

#231

Post by refurb » Fri, Oct 19, 2018, 11:29 PM UTC

DanBC wrote: post #210

chimeracoder wrote: post #176

Earlier quoted context omitted.

> But quite evidently, the US system leads to harrowing quandaries for many ill people and their families, worse overall health outcomes, higher overall costs, and richer health insurance CEOs than what's done in all other developed countries; and I still don't understand why you appear to defend it. We're specifically talking about cancer treatment in this thread, where the data is pretty clear: the US has dramatica…

> the US has dramatically better survival rates for cancer in the US, No, the US massively over-tests and over-diagnoses cancer at very early stages, but this does not lead to better quality of life nor to longer life.

Overdiagnoses?

I thought the US had bad preventative healthcare.

Any sources you’d like to share? Sounds like BS.

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

#232

Post by feistypharit » Fri, Oct 19, 2018, 11:29 PM UTC

debacle wrote: post #53

anigbrowl wrote: post #26

Thanks, capitalism. Snarky as that may sound, it's a simple statement of fact: our society places a higher value on capital allocation than human life, and so the most vulnerable people are stripped of their assets and dignity to satisfy the demand for wealth. Frankly, I think socialized medicine would also reduce violence in society if deployed as part of a larger economic realignment.

The real value of the work output of a single human life tends very close to zero, unfortunately. Excepting some intrinsic value to life, in the grand scheme of things most people's lives are not worth very much.

There are infinitely many ways other than work value by which to value a human life. Some day, I hope you learn this. Most of what really differentiates you from anyone else is luck.

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

#233

Post by greedo » Fri, Oct 19, 2018, 11:31 PM UTC

alejohausner wrote: post #43

zrail wrote: post #29

Earlier quoted context omitted.

You're being very misleading when you say "in most cases". There are a lot of very common cancers that respond very well to treatment. "If you or your child has cancer, could you bring yourself to not spend every penny you have?" This is what health insurance is for. You buy insurance so that you don't have to worry about monetary decisions and can make decisions based on quality of life.

That's not really true. A few cancers can be put into permanent remission (eg Hodgkins'), but most cancers kill you regardless of what you do.

As a cancer survivor, this is completely unfounded in fact. Most cancers are treatable, as long as they haven't metastasized. Even cancers that have metastasized can be treated successfully, though the standard of care is much more difficult.

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

#234

Post by refurb » Fri, Oct 19, 2018, 11:31 PM UTC

DanBC wrote: post #149

njarboe wrote: post #84

Earlier quoted context omitted.

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 seems to be pushing a myth: expensive treatments must be better treatments, right? We have very good evidence that these new, expensive, treatments do not extend life and that they make quality of life worse. England set up something called the Cancer Drugs Fund. This provided access to new medication that hadn't yet been assessed for value; that were in the process of being assessed; or that had been assessed a…

Life expectancy is a terrible measure of the quality of a healthcare system.

It’s like using average salary as a measure of how intelligent someone is.

Is there a correlation? Sure, but a weak one and many other factors impact it.

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

#235

Post by greedo » Fri, Oct 19, 2018, 11:33 PM UTC

tracker1 wrote: post #201

alejohausner wrote: post #24

Perhaps the real problem is that chemo, radiation, and surgery don't really cure cancer, in most cases. There is a lot of bad science in cancer research. The "science" that bothers me the most is the use of 5-year survival rates. Suppose that a cancer that starts at age 60 becomes symptomatic at age 65, and kills the patient at age 70. Scenario 1: you are 60 years old, get screened, and opt for treatment (who wouldn'…

Right now my grandmother has stage 4 cancer, and has opted to not treat. The chances were very low for survival and the process painful. I'm pretty sure I would opt similarly if over 60. It sucks, and it's hard to see her that way. I'm heading over to see her after work in a few minutes (she's gotten worse the past couple days). I don't think it's responsible to always opt for treatment. It sucks and it's a hard deci…

Your family doesn't have to pay ANY of your medical bills when you die. Hospitals will try to guilt them into paying, but there's no legal obligation (this doesn't apply to spouses, but there are ways to protect them).

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

#236

Post by matorl » Fri, Oct 19, 2018, 11:36 PM UTC

kxyvr wrote: post #209

kbos87 wrote: post #118

I recently watched a family member go through this. A few things that were sobering to see: - Three weeks in she was buried in paperwork. One chemo treatment would turn into 4-5 invoices from different subcontractors at a single hospital, some covered by her insurance, others not covered. Her insurer denied claims arbitrarily and made her go through a bunch of invasive and unnecessary procedures to prove her illness.…

I'm sorry your family member went through this. That's terrible and no one should have to deal with that kind of treatment. I'll echo much of what you said. When I was 21, I was diagnosed and treated for malignant melanoma (skin cancer) that had metastasized to my lymph nodes. The treatment worked and I've been healthy for many years. That said, it changed the way and manner in which I deal with billing and insurance…

Great advice, thanks.

...also, you've called out a very significant pain point for lots of people in the American health system, i.e. managing and paying bills while dealing with the Kafka-esq processes. Your process is steps towards a solution.

Can your process of ensuring bills are paid correctly be turned into a business? Can it sold as a service - not to hospitals, not to employers, not to insurance companies - but to us? We buy the service and know we can trust it has our interests at heart, esp. when we are at our most vulnerable.

I've had to jump through hoops with insurance bills before, it isn't pleasant and I've got good health insurance.

Pricing structure would be challenging...monthly and use when needed, per transaction, etc?

(didn't do any deep searching before posting, so I'm betting a hospital billing concierge service already exists...)

Service should be called Auntie Kafka.

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

#237

Post by refurb » Fri, Oct 19, 2018, 11:37 PM UTC

moonbug wrote: post #62

so_tired wrote: post #49

I am sympathetic. From HN stories, the US health care situations seems abysmal. BUT, i want to make 3 counter points, if only for the sake of discussion. a. Cancer for many is a terminal disease. There are always some very very expensive and experimental or marginal treatments. If u have money, and are going to die, and decide to spend all you can to squeeze an extra year of life , i am very sympathetic but even the…

Except that net US personal taxation isn't far off that found across the EU.

The EU varies a lot in personal tax rates.

The higher end of the EU is much higher than the US.

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

#238

Post by refurb » Fri, Oct 19, 2018, 11:46 PM UTC

disordinary wrote: post #204

I had an uncle who was quite well off and ran an exotic car garage in the US. He had all the insurance, etc. His wife got cancer, insurance wouldn't cover some of the treatment. She died, he went bankrupt, then killed himself. I'm glad I live in a country where I literally don't even think about treatment or care, it's just not something I worry about. I've had a few relatives in NZ who've had cancer, they've all had…

The likelihood is if a cancer drug isn’t covered in the US, it’s not covered in NZ.

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

#239

Post by anigbrowl » Sat, Oct 20, 2018, 12:18 AM UTC

anonuser123456 wrote: post #66

anigbrowl wrote: post #26

Thanks, capitalism. Snarky as that may sound, it's a simple statement of fact: our society places a higher value on capital allocation than human life, and so the most vulnerable people are stripped of their assets and dignity to satisfy the demand for wealth. Frankly, I think socialized medicine would also reduce violence in society if deployed as part of a larger economic realignment.

Don't blame capitalism for regulatory capture. The healthcare industry has done a fantastic job at ensuring consumers can only choose the options the industry wants.

Your second sentence does a great job of rebutting your first one ¯\(°_o)/¯

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

#240

Post by chimeracoder » Sat, Oct 20, 2018, 12:21 AM UTC

DanBC wrote: post #203

chimeracoder wrote: post #168

Earlier quoted context omitted.

> This seems to be pushing a myth: expensive treatments must be better treatments, right? We have very good evidence that these new, expensive, treatments do not extend life and that they make quality of life worse. It's not pushing any myth at all. As explained elsewhere government-run systems like the NHS do attach actual dollar amounts to treatments that are effective and do extend life, but for which they're not…

> where they determine how "good" a person's life is No they don't. This is not true. > This is not, as you are implying, saying "this treatment is ineffective or harmful, so we won't pay for it". It is literally saying "we understand that this treatment would extend this person's life by 5 years, but it costs £50,000, and based on their condition, we're only willing to spend £25,000 to extend their life by 5 years.…

> No they don't. This is not true.

That is literally what QALY is.

> Find just one single medication that i) extends life by 5 years ii) costs just £10,000 per year and iii) has been banned.

It seems like you don't understand how coverage works for cancer treatment. The question isn't whether the medication is banned outright - it's whether it will be approved to be used for a specific patient in their treatment plan (paid for by the NHS).