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Using AI to negotiate a $195k hospital bill down to $33k

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Re: Using AI to negotiate a $195k hospital bill down to $33k

#411

Earlier quoted context omitted.

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I think the reason is that people know it is a problem but ideologically they really disagree about what to do about it. The impasse creates an opportunity for profit driven actors to fight reforms. Also, democracies do dumb things sometimes. See Brexit. But also, sometimes people from other countries-- I am thinking parts of Europe-- underestimate how well paid people in the US often are. They compare the averages,…

Oddly enough the big rhetorical push against a universal system from prior decades was about "death panels" deciding what care somebody would get. And guess what's happened with insurance? Death panels!

The propaganda spin on the health care system in the US has been on overdrive ever since Hillary Clinton wanted to implement some reforms in the 1990s, leading to absolutely massive resistance to any change whatsoever. Even the changes implemented by Obama, which were a HUGE improvement in access, barely made it across the legislative line, and dismantling that access to the health care system has been a huge rallying cry for one of the major political parties. I won't say which one because mentioning that fact results in people turning off their brains and downvoting.

The US healthcare has optimized for availability and higher access to the most treatment options. This does not mean evenly distributed treatment options, but that people have the chance to get access to things more quickly.

And for most people, the healthcare system works fairly great. There are exceptions, like the denial described in this thread, and they usually get lots of attention because holy hell is that a messed up situation. But the everyday care that most people get is better than adequate.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#412
post #51

Having lived in Europe 10 years (I am from south America), it is crazy that the rest of the world doesn't follow Europe's health coverage: everybody is covered, all the time, you can be covered either by public insurance (was my case) or private. There are no preconditions. Kids get covered for almost everything up until they are 18 or 21 (don't remember), drugs for adults is only 5 euro each. No matter the cost. And…

> US health care which is probably one of the worst in the world Not really. If you have money, the US system is one of the best. It just really, really sucks if you don't have money.

What % of the US population would you think have to pay to get that "best" care?

Would a household making $250,000 have enough to pay for that best care? That would mean 2% [1] of US household. Other comment in the thread mentioned earning "6 figures" and not being able to pay.

A health system that is affordable to 2% of the population is definitely not working.

[1] https://www.factcheck.org/2008/04/americans-making-more-than...

Re: Using AI to negotiate a $195k hospital bill down to $33k

#413

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

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One can argue what people wants is to be ruled by old convicted felon dictator.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#414

Earlier quoted context omitted.

> So like these are less serious issues if you are paid an extra $1-200k/ year Ok but to be fair most people in the US aren't making "extra $1-200k / year" over a person in Europe. They aren't even making $100k / year to begin with.

Almost 40% of the USA is on medicare, medicaid, or entitled to VA benefits or military healthcare. It's only a narrow majority that depends on unsubsidized private healthcare, and those people skew in the upper income levels.

You believe the top 60% of the nation skew in the upper income levels? Median pay is $61k a year for the entire country. The top 1% skews to the upper income levels. The rest are charged $30 for a dose of aspirin and can't afford it.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#416

Earlier quoted context omitted.

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Scarcity is a fact of every country's health system and you'll quickly find stories with similar fact patterns with e.g. the NHS. There's not a lot to recommend the US system as implemented today, but the problem isn't "insurance-based health care"; lots of countries have insurance-based health care.

The problem is that the insurance is provided by private companies whose incentive is to earn as much money as possible, at cost of the people in need of medical care. In my country, I never heard of anyone going bancrupt over a hospital bill. It just isn't a thing.

Here's a fun story: my sister was living with an exchange student from the US. Some day the student was complaining about intense intestinal pain she's had for the past few days. My sister told her to go the hospital. The student asked her if she was crazy. My sister then had to explain her that hospitals are free and won't bancrupt her...

Re: Using AI to negotiate a $195k hospital bill down to $33k

#417

Earlier quoted context omitted.

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To the extent that U.S. voters want to maintain the status quo, which many (though not most) voters do wish to do, it's largely driven by an individualist mindset in which the worst thing that can happen is somebody else getting something that they didn't "earn".

I’d love to see a poll asking Americans: “Do you want to maintain the status quo?”

Re: Using AI to negotiate a $195k hospital bill down to $33k

#418

Earlier quoted context omitted.

> So like these are less serious issues if you are paid an extra $1-200k/ year Ok but to be fair most people in the US aren't making "extra $1-200k / year" over a person in Europe. They aren't even making $100k / year to begin with.

It's hilariously out of touch, but it's what you should expect from the HN bros. They live in a bubble. I'm from the eu and earn far less than these American techbros do, but far more than my American friends who work normal jobs. They work at the DMV, a supermarket, or general office work. You know, normal people. The vast majority.

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Re: Using AI to negotiate a $195k hospital bill down to $33k

#419
post #377

Earlier quoted context omitted.

> The United States is a democracy, but more specifically, a representative democracy. As your following explanation makes clear, it's actually an unrepresentative democracy.

There are very few countries in the world that are not a representative democracy. Switzerland is a well-known example of a country where citizens directly vote on most legislation, but in most other countries, you have a parliament, congress, etc that represents the people.

unfortunately, they represent a party before representing the people

Re: Using AI to negotiate a $195k hospital bill down to $33k

#420

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

How comfortable are you with naming and shaming the company? I don't think things are going to change if we don't call this stuff out loudly and publicly.

That's awful but I'm glad you were able to figure this out. I've had my own problems with insurance companies, but nothing to this level. I can't imagine the frustration, especially with YOUR CHILD'S HEALTH on the line.

Five years back I ended up getting surgery for a herniated disc. I was in immense and crippling pain. Before having the surgery, we decided to go through a round epidural shots. I had done that 20 years previously and it resolved the problem, so why wouldn't I?

Turns out my insurance company (who I will name: BCBSIL) delegated the approval for the epidurals through some kind of extra bureaucratic process with a 3rd party. It took days and additional effort on our end to get approved.

I remind you, I was in crippling pain at the time.

The delays getting this approved lead to me taking more Ibuprofen than I would otherwise have taken, which in turn lead to signs of internal bleeding. I had to ease off the Ibuprofen and significantly increase the amount of codeine (a drug which does not sit well with me) just to get by. Now not only did I have to wait for the approval, but I then had to wait for the signs of internal bleeding to go away before the doctor would give me the shot (which was the right call, even though it sucked).

Delays, compounding delays, compounding delays, all while I was absolutely miserable.

Anyway, I finally got approved and got the shot and it kinda helped, but didn't fix the issue. I had a second shot, got worse, and then decided we had no choice but to schedule the surgery.

The most frustrating thing (but something I am glad for) is that the surgery was approved immediately.

It's so maddening how inconsistent the whole thing is.

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