US doctor forgives $650k in medical bills for cancer patients • Hacker News Board

Re: US doctor forgives $650k in medical bills for cancer patients

#341

Post by Maksadbek » Thu, Jan 07, 2021, 1:27 PM UTC

simple_phrases wrote: post #307

Maksadbek wrote: post #194

It is very good that hospitals give debts for patients. I live in Uzbekistan and my father has pancreas cancer. There are no good oncologists in my country. I've contacted many hospitals worldwide and most of them asking about 10K USD and we must pay 80% of the bills before they start curing my father and of course I can't afford this amount of money and I have no any option to get it. I am ready to be in debt for an…

This is the same case in the US. Nobody is getting cancer treatment without insurance or the ability to pay. Hospitals in the US only need to stabilize an uninsured patient, and that doesn't include treating cancer or chronic conditions.

:/

Re: US doctor forgives $650k in medical bills for cancer patients

#342

Post by sgerenser » Thu, Jan 07, 2021, 1:49 PM UTC

lotsofpulp wrote: post #111

atmosx wrote: post #48

A good question would be what can be done to fix healthcare in the US ? My understanding is that most voters don't support universal healthcare. IIRC even Obamacare was labeled as controversial. Current model costs way more, the model is clearly broken, why there is no pressure to fix it? ps. I don't want to get political or anything by mentioning Obamacare. I'm genuinely curious because the problems of the current h…

> ps. I don't want to get political or anything by mentioning Obamacare. Then try referring to the legislation by its actual name, ACA - Affordable Care Act.

Obama himself has referred to it as Obamacare. It may have started as a dig at the plan by its opponents, but now most people know it as Obamacare while ACA might as well be political jargon.

Re: US doctor forgives $650k in medical bills for cancer patients

#343

Post by sgerenser » Thu, Jan 07, 2021, 1:52 PM UTC

SamuelAdams wrote: post #205

toast0 wrote: post #78

Earlier quoted context omitted.

> My understanding is that most voters don't support universal healthcare. Medicare is almost universal healthcare for the elderly and disabled. Expand that and there you go. Obviously, expanding it to the whole country in one fell swoop would cause a lot of problems. Instead, I would drop the age requirement over many years, to give the systems time to adapt, and allow for oversight and addressing of problems. Poten…

You could also expand the VA program, a healthcare coverage system serviced by the government for veterans of the military. https://en.wikipedia.org/wiki/Veterans_Health_Administration

I have no personal experience with the VA, but unlike Medicare which seems to be almost universally liked by seniors, I’ve heard almost nothing but complaints from military members about the VA. If I were going to attempt universal health care, seems better to start by expanding the program that has the most goodwill.

Re: US doctor forgives $650k in medical bills for cancer patients

#344

Post by leetcrew » Thu, Jan 07, 2021, 3:13 PM UTC

pembrook wrote: post #340

leetcrew wrote: post #270

Earlier quoted context omitted.

> I recall debating with a friend who was against socialized healthcare recently, and then seeing them promote a GoFundMe campaign for a mutual friend’s medical bills on Facebook a few days later. > The irony was lost on him. I think the key is that Americans love to dream of themselves as wealthy philanthropists (no matter how poor they actually are). I'm not sure I see the irony either. if I'm understanding correct…

Because at scale, countries are also just a group of people pooling resources to achieve greater outcomes. The only difference between micro-socialized funding (GoFundMe) and macro-socialized funding (government healthcare) is that the government version results in massive cost savings for the entire system. Micro-socialization is the worst of both worlds. No cost savings, no preventative care, and only the most sens…

> Because at scale, countries are also just a group of people pooling resources to achieve greater outcomes.

> The only difference between micro-socialized funding (GoFundMe) and macro-socialized funding (government healthcare) is that the government version results in massive cost savings for the entire system.

there is a key difference though. in one case, a group of elected representatives is deciding what to do with everyone's resources. in the other, individuals are deciding what to do with their own resources. at a high level, they look pretty similar: a group pooling resources to help someone. but the control over allocation is completely different. this is a really important distinction to understand. most people are a lot more willing to give their resources to friends/family than to random strangers. your (compelling to me!) argument about efficiency will not convince people if you don't acknowledge the allocation part.

Re: US doctor forgives $650k in medical bills for cancer patients

#345

Post by hippich » Thu, Jan 07, 2021, 7:34 PM UTC

lotsofpulp wrote: post #121

hippich wrote: post #102

Earlier quoted context omitted.

And an insurance should be, well, an insurance. What is referred as "health insurance" is more like "health care plans" (insurers even call it "plans"). Just consider how comprehensive auto insurance is different from health insurance in practice.

Overall health is not insurable. It’s a misnomer. There is a 100% chance of everyone needing healthcare in the future. US health insurance does a few things: 1) premiums partially serve as a tax to transfer wealth from young and healthy to old an sick 2) insurers healthcare recipient from the big costs (over out of pocket maximum - $7k to $13k per year), subject to in network providers 3) Negotiates pricing and deter…

I believe you mean "overall health" as in a continuum of the living being life health. What I mean by insurance is a contract that specifies what risks can be insurance, up to what limit and how much it will cost.

You unlikely to have problems to insure a new car bought off the dealer lot. You will likely have problems insuring a very old car, with missing brakes and flat tires.

Similarly, health insurance is quite possible for healthy folks in their 20ies-40ies (maybe? just an example of the age range). And, like you said, insurance payout becomes likely certain and potentially unlimited if you try to insure someone who is 90 old.

All that doesn't mean that health insurance can not exists as a thing. It just means that insurance is a tool that applicable to a specific scenarios and not a blanket solution for health care. And what discussions happens in the US, somehow it is either health insurance takes care of everything, or it is government takes care of everything.

I think there is a place for both tools (and perhaps even more others i can't think of right now).

EDIT: another thing that bothers me about health insurances in the USA - it is expected that insurance is involved in every single case of working with health care providers. I do not think annual flu shots is a risk that needs to be insured (it is known, and can be planned upfront for). Similarly, a visit to the family practice with a cold or ear infection does not need to be insured. Bringing back car example - it would be like bundling annual oil change, or a flat tire into standard car insurance everyone have to have... In my opinion, health insurance has its place to insure unknown/unlikely events, not routine stuff.

Why it matters, in my opinion. A significant chunk of costs is in administration - both on hospital and insurance sides. And these routine visits are likely getting a large chunk of it. More importantly, when patient pays directly to the health care provider - they are much likely to be more picky about quality, costs, convenience combination, unlike going through the insurance scenario, where the decision is mostly about "who is in the network, and how close they are". Missing such a direct relationship between patients and providers, in my opinion, puts upward pressure on prices (in addition to everything else).

Re: US doctor forgives $650k in medical bills for cancer patients

#346

Post by tlrobinson » Thu, Jan 07, 2021, 8:11 PM UTC

alphabettsy wrote: post #62

tlrobinson wrote: post #44

Earlier quoted context omitted.

Are there services that will handle this nonsense for you?

There’s a whole industry segment of attorneys specializing in denied medical claims.

I want a cheap mostly automated service that monitors medical expenses looking for irregularities etc.

Re: US doctor forgives $650k in medical bills for cancer patients

#347

Post by toast0 » Thu, Jan 07, 2021, 10:08 PM UTC

sgerenser wrote: post #343

SamuelAdams wrote: post #205

Earlier quoted context omitted.

You could also expand the VA program, a healthcare coverage system serviced by the government for veterans of the military. https://en.wikipedia.org/wiki/Veterans_Health_Administration

I have no personal experience with the VA, but unlike Medicare which seems to be almost universally liked by seniors, I’ve heard almost nothing but complaints from military members about the VA. If I were going to attempt universal health care, seems better to start by expanding the program that has the most goodwill.

I've heard good things about VA health care, when people are able to get care. But there's a lot of waiting to get care, and sometimes a lot of fighting [1] to show eligibility in addition to all the waiting. Psychiatric care is reportedly much more problematic, as well.

I agree, it wouldn't be the one to expand, because of lack of goodwill, and lack of capacity for more patients.

[1] One of my relatives has symptoms associated with Agent Orange exposure, but had a lot of trouble getting the VA to cover it until recently, because (as I understand) his service records didn't show that he was in an area with exposure. Some recent laws passed changed the criteria that granted eligibility, and he's been happy with the care he's received since.

Re: US doctor forgives $650k in medical bills for cancer patients

#348

Post by Railsify » Fri, Jan 08, 2021, 4:03 AM UTC

programmertote wrote: post #272

Railsify wrote: post #199

I think there is an important point to be highlighted: We often blame the system for being expensive but in this case an individual doctor was able to say we will not collect. These decisions to charge patients a literal fortune for treatment probably always falls to an individual or small group of individuals. We should highlight this on billing documents, instead of "please pay XYZ hospital" the individual accounta…

100% this. I wrote a separate comment in this thread cautioning people that this doctor, despite this charitable act, is probably not as charitable as we might think from reading a news article. If we dig deep into his clinics' billing practices, we might see lots and lots of bogus charges billed to the insurance companies (some of which might have to be paid by the patients with high deductible/co-pay in their insur…

::fistbump:: The amount he wrote of was surely small compared to what he billed over his career. He also probably booked a loss after the write-off and claimed a larger amount to be returned on his taxes.

Re: US doctor forgives $650k in medical bills for cancer patients

#349

Post by schlowmo » Mon, Jan 11, 2021, 12:10 AM UTC

ant6n wrote: post #328

schlowmo wrote: post #156

Earlier quoted context omitted.

> The problem is you can´t easily opt back into the public system once you´re out (especially once you´re old), so there are tens of thousands (if not hundreds), that get stuck in the private system without being able to pay the fees because they´ve become poor (possibly because of health reasons), and then they get denied coverage and thus access to medical services. Although I recognize the personal hardship this c…

The point is that there exist cracks in that many people will fall through and society at large doesn't even know that they are there; society as a whole is in denial about the problem because they can look at utterly dysfunctional systems like the US and and say "we're so much better here". Part of the problem is that many of those who are aware of the problem blame the individuals themselves for falling through the…

I was commenting on a specific point made by the parent comment. It's pretty far fetched I'm in denial of the root issue when I even mentioned the real solution which you're agreeing with.

So while I get your sentiment you're really arguing against the wrong person here.

Besides that in my opinion there is a significant difference between "falling through the cracks" and making wrong decisions poorer people aren't even allowed to make - and then wanting those poorer people pay for your errors.