When Medical Debt Collectors Decide Who Gets Arrested • Hacker News Board

Re: When Medical Debt Collectors Decide Who Gets Arrested

#231

Post by cloverich » Thu, Oct 24, 2019, 1:57 AM UTC

Broken_Hippo wrote: post #167

ars wrote: post #130

Earlier quoted context omitted.

> please vote for medicare for all No thank you. I've helped people with medicare and it's the worst health insurance I've ever encountered, with insane rules and brain-twisting billing practices. I have absolutely no desire to inflict this on the entire country. When you are promoting medicare - have you actually tried it? Are you speaking from a position of knowledge? I have, it's terrible. But worst of all it does…

I've not had Medicare, but know it is fraught with issues. So is the VA. I've also been under American health care through a job, been uninsured, and now am covered under Norway's health care system. And I wouldn't trade my current system. I'd rather have medicare than nothing, and know that the issues it has can be fixed. Just because something has problems doesn't mean that it isn't better than nothing and doesn't…

Medical school debt isn't a major factor (speaking as an MD with medical school debt who doesn't even practice). Great to get rid of it, but I don't think it will impact care either way. A better target would be letting student's start medical school earlier instead of after undergrad, and letting them pre-specialize into surgery and primary care. As is even family physician's have to go to medical school for four years and _then_ specialize in primary care. I think that's absurd. They should merge primary care into medical school and churn out primary care physicians by default, who could then optionally specialize.

Also my wife is a Dentist. She works 4 days a week and does extremely well. If malpractice and costs were an issue for Dentist's in the US, they would work more. I know a lot of dentists but not a single one that works 5 days a week. And of course no residency required. Its got to be the best career choice in the US today.

As for firing people... I agree probably not. But most Hospitals _do_ run on a tight margin (like 5% or less), and the majority of their costs are staff.

But overall, if you've experienced the system at all, you know how utterly wasteful and unorganized it is. Its difficult to fathom a system with more waste, which is especially ironic since there's so many smart people running around. I think single payer, whatever the flaws, would absolutely be a major change in the right direction.

Re: When Medical Debt Collectors Decide Who Gets Arrested

#232

Post by AnthonyMouse » Thu, Oct 24, 2019, 7:26 AM UTC

TheDong wrote: post #155

AnthonyMouse wrote: post #138

Earlier quoted context omitted.

> Because for a lot of people, there is no real choice involved. If there's one hospital around for hundreds of miles, they realistically don't have the option to go to one further out when their job expects them to be available for work every single day. Federal law requires employers to provide at least unpaid sick leave. That caps the premium a local hospital can charge over competitors at the loss of the day's wa…

> Federal law requires employers to provide at least unpaid sick leave. That caps the premium a local hospital... Not really. The law you're referring to is the Family and Medical Leave Act (FMLA), which only applies for childbirth and "serious health conditions". Most things you can shop around for also aren't serious enough to qualify, so you're not entitled to such unpaid sick leave. But also, it's kinda a moot po…

> Most things you can shop around for also aren't serious enough to qualify, so you're not entitled to such unpaid sick leave.

But now you're not making an argument for socialized medicine, you're just making an argument for requiring unpaid sick leave for a scheduled medical procedure.

> But also, it's kinda a moot point because laws like that only apply to people that know them or can afford an attourney.

Are there many laws that don't work this way? Would the same people be any better off if the government would pay for their medical procedure but they didn't get it because they didn't know that?

> This assumes that people have both perfect knowledge of their procedure and the prices of all hospitals

Which is the point of requiring price transparency. Your doctor should provide you with a list of all the places that can do the procedure along with their locations and prices and any other information useful to choose between them.

> and that people value money over convenience.

But that is the mechanism by which it operates -- there is a point where the money is worth more than the convenience, and once people actually know the amount of money required, that limits how much providers can overcharge because past that the inconvenience is less than paying the money.

There is nothing wrong with choosing convenience. It's the thing that allows trade offs between price and convenience to exist. Maybe the clinic near the big city will always have the best price because it has the most patients to amortize fixed costs over, so the rural clinic can only stay in business by charging more per patient. If the higher price is worth not having to travel to the city -- and people know that -- then people will choose to patronize it, which is how we know its value exceeds its costs. If everybody chooses to travel to the city for the lower price then we know the rural clinic costs more than it's worth, which is the same mechanism that causes it to fold.

> I know for a fact that I can fly to another country with free healthcare and get a procedure for cheaper than I can get it in the US, but hardly anyone does that regardless. It's just too inconvenient.

Because flying to another country is very inconvenient, and not at all inexpensive on its own. So the limit it places on overcharging is not very strict. Especially when you don't actually know how much you'll be charged, so you don't even realize that it would have been worth it to do that until after it's already done.

The inconvenience is much less to go to another town than another country, so that would provide a much lower limit on how much anyone can overcharge before people would do that. If they were actually provided with the price differences -- so why aren't we doing that?

Re: When Medical Debt Collectors Decide Who Gets Arrested

#233

Post by dunnevens » Thu, Oct 24, 2019, 11:31 AM UTC

dillondoyle wrote: post #230

dunnevens wrote: post #170

Earlier quoted context omitted.

I have kept up a little. The GOP establishment is scrambling to keep Kris Kobach out of the race, but he's popular with the sort of voter who shows up in droves to the Republican primaries. So, he's the front runner. Considering his loss in the 2018 gubernatorial race, KS Democrats are hoping he'll win the primary. He's as unpopular with general election voters as Brownback now is. Democratic side is full of candidat…

Glad you like Boller - or minimally think she is interesting / courageous ;) I think there's a struggle to motivate national $$ with a moderate message/candidate. But I think we all might be surprised that the truth, the honest personal story, (and the insider electability politics) might be even more valuable than some liberal issue crusader.

Bollier seems alright. Have a feeling she'll be the nominee. She's already gotten one person to drop out. And I don't mind her. I'm personally to her left but, then again, I'm to the left of almost every politician in this state. I accept that as one the prices I pay for living in Kansas and not California. :)

She is courageous to a certain degree. But, her move might be accepted more here than in other red states. Kansas is one of the last red states where truly moderate Republicans can still be found in the wild. The moderates have been willing to endorse Democrats from time to time. Laura Kelly was the beneficiary of such in 2018. Many of them will probably endorse Bollier next year.

2020 should be an interesting election year. Kansas waffles between Trump being above or below water in approval. Kansas is also one of the leading states hit by farmer bankruptcies thanks to the tariffs. On top of that, Kelley has decent approval ratings and has been doing a good job. All this combined might make more people than usual willing to "hold their nose" and vote for a Democrat. Trump is almost certain to win, but the state races could be wild.