Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls • Hacker News Board

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#301

Post by clairity » Wed, Feb 27, 2019, 8:17 PM UTC

kindatrue wrote: post #207

tmaly wrote: post #181

Earlier quoted context omitted.

We still cannot get a price list of medical procedures in the US thanks to the antitrust exemption provided in McCarran-Ferguson Antitrust Act of 1945. I think repealing this would be a good start. All other industries are required to provide price lists. My friend went to the ER recently for a sprained thumb. They wrapped it in some bandage and he got a bill for $14,000. His insurance is covering 80% but he is still…

Interesting trivia - health insurers kind of don't care about these big bills, despite what most people think: https://www.propublica.org/article/why-your-health-insurer-d...

not sure it's trivia. it's pretty straightforward though:

higher bills means more money insurance companies can skim off the top without patients objecting. direct costs are basically pass-throughs to policy holders. the risks are higher but execs are in it for salaries and bonuses, so that exhibits the principle agent problem.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#302

Post by sangnoir » Wed, Feb 27, 2019, 8:17 PM UTC

komali2 wrote: post #230

creaghpatr wrote: post #215

Earlier quoted context omitted.

Because it would go bankrupt and then no one would get Medicare.

But why not make it not go bankrupt?

Because "I got mine", or maybe not yet, but someday I hope to get mine and you better keep your grubby hands off my imaginary money.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#303

Post by InitialLastName » Wed, Feb 27, 2019, 8:21 PM UTC

leaveyou wrote: post #26

vamos_davai wrote: post #4

It's such an absurd expense that I wonder if I get diagnosed with cancer, I would just deny treatment, accept death, and hand my assets to loved ones. Not sure if anyone else thinks the same way.

I'm not even in US and I'm considering the same.. if the expenses go above some reasonable threshold, I don't see the point of me living enough to see my family dragged into poverty. I don't delude myself - it's not easy to do.

Part of the problem is that, especially with an illness with as complicated a treatment process as many cancers, there's no way to even estimate the expenses. Even once you get treatment, the expenses might not be accessible until the bill comes in and you find out what your insurance company will pay for.

After that, there's a sunk cost issue: once you've dropped (N*your current net worth) on treatment, what's the harm in continuing?

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#304

Post by sangnoir » Wed, Feb 27, 2019, 8:22 PM UTC

justwalt wrote: post #234

rayiner wrote: post #105

This came up last year when it was discovered that Leon Lederman had to sell his Nobel Prize to pay for cancer treatments. But there is more moral complexity to this issue than people appreciate. Cancer treatment is inherently expensive; it just doesn't seem that way in some other countries because the government pays from the outset. But I don't think that's necessarily moral, compared to something like Medicaid, wh…

I would think the average person would feel slimy/predatory buying someone else’s Nobel prize. Unless it’s the case of a friend offering to help out, but then why not just lend the money without the collateral?

Maybe it was a pharma exec?

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#305

Post by [deleted] » Wed, Feb 27, 2019, 8:27 PM UTC

throwaway5752 wrote: post #233

torpfactory wrote: post #220

Earlier quoted context omitted.

Thumb injuries are actually treated very seriously (at least more seriously than you might think) by medical professionals because thumb injuries can have very high consequences for quality of life. You can live a totally normal life without an index finger but a missing or disabled thumb is a much more significant impact.

I know. To elaborate (and reply indirectly to will_brown) I think it's impossible to say how egregious $14k is for billing without knowing how severe a sprain it is and how much they had to do to diagnose it. Maybe he walked out with a bandage, but maybe he got an x-ray or mri? And ERs are expensive because they have to handle anything from a MI, stroke, poisoning, massive trauma, or ID case. If you go to one, you ha…

[deleted]

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#306

Post by cwkoss » Wed, Feb 27, 2019, 8:29 PM UTC

chimeracoder wrote: post #174

toomuchtodo wrote: post #164

Earlier quoted context omitted.

Only in America and New Zealand are pharmaceuticals permitted to be marketed directly to consumers. Does the rest of the world not innovate? We’ve tried the free market way, let’s try it the “rest of the developed world way” next.

> Only in America and New Zealand are pharmaceuticals permitted to be marketed directly to consumers. Marketing does not only include direct-to-consumer advertising. > Does the rest of the world not innovate? Pharmaceuticals are a global market. As it turns out, European pharmaceutical companies make a disproportionate share of their revenues from pharmaceutical sales in the US. But to answer your question: statistic…

> Marketing does not only include direct-to-consumer advertising.

The other flavor bribes doctors to overprescribe - it is much worse.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#307

Post by pmoriarty » Wed, Feb 27, 2019, 8:32 PM UTC

cletus wrote: post #138

JamesBarney wrote: post #65

Earlier quoted context omitted.

I'm all for universal coverage too. But reducing the profits of pharmaceutical companies well reduce the money they have for r&d dramatically. This will slow down the speed of pharmaceutical development. So I think it needs to be paired with reforms to the FDA to reduce the go to market costs for drugs.

Pharmaceutical companies spend way more on marketing than research. If drug companies are willing to sell the exact same drug in Canada or the UK or Germany or France for less than a percent (in some cases) of what they sell it here for then why can't US insurance companies, hospitals and consumers buy it for that price? There's no reason other than an artificial monopoly. You'll note that I didn't say "anywhere" and…

"India, for example, has decided that drug companies largely (it's complicated) don't get monopolies from patents and thus you can buy a lot of low-cost high-quality generics in India because no drug company is getting paid."

The main incentive for the US to enforce patents is that it is at the forefront of technology development, so many patents are held by US companies.

As the lead the US has in technology lessens, as it has been predicted (and has already started) to do so for quite some time due to its poor education system and decreased funding and prioritization of science, other countries will catch up and overtake the US on the technology front, and they'll be the ones getting patents. Then it's quite possible that the US won't care quite as much about patents, and may even start "stealing" technology from other countries.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#308

Post by pnutjam » Wed, Feb 27, 2019, 8:32 PM UTC

ams6110 wrote: post #267

flexie wrote: post #136

Earlier quoted context omitted.

And that's the essence of this: In the developed world, this is all but a US specific issue. Cancer and other life threatening diseases rarely bankrupt Europeans, Canadians, Australians, Kiwis, Japanese etc.

I don't know about the rest of the world, but bankruptcy in the USA is not really the catastrophe you might think it is. You can keep a lot of your assets, generally including your retirement accounts, at least some equity in your home, your car, your personal property. Your credit is badly dinged and you'll have trouble borrowing money for a while, but even that is only a temporary setback. I know people who have go…

If you read the article, you would note that Bankruptcy increases the risk of death significantly.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#309

Post by malyk » Wed, Feb 27, 2019, 8:38 PM UTC

Cd00d wrote: post #280

ams6110 wrote: post #255

Earlier quoted context omitted.

OK but a sprained thumb is not something that can't wait until morning. Take a couple of Advil and put some ice on it.

That assumes the patient _knows_ it's only a sprain.

It's likely the same for any break that is in the "not sure if is sprain or break" range.

Years ago I crashed my mountain bike and had a high suspicion that I had broken one of my fingers. Urgent care was closed by the time I got home and cleaned up and my college roommate was in town so I met up with him after taping my fingers together to prevent unnecessary/unplanned movement. Urgent care confirmed a break the next morning, and fixed everything for $300. Healed perfectly.

Anyway, anecdotes are just that, but the emergency room is not the place to go for "simple" things like a possible sprain, minor break.

Re: Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls

#310

Post by maerF0x0 » Wed, Feb 27, 2019, 8:42 PM UTC

maerF0x0 wrote: post #56

davidscolgan wrote: post #3

This is honestly one of the things that most stresses me out as I get older. I don't use my insurance much now because I'm pretty healthy, but I know my cancer risk will just go up over time. I've considered that if something like this ever did happen, I'd move to Lithuania and do it there paying in cash over trying to do it in the US system. Universal health care can't come fast enough.

> Universal health care can't come fast enough. What do you mean by "Universal healthcare"?

For the haters out there. I was genuinely asking a clarification question because "Universal Healthcare" can often mean compulsory insurance purchase, Single payer, single provider or other means too ...

As with many things I think the details of how is critically important...

more info: https://en.wikipedia.org/wiki/Universal_health_care