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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

#431

Post by Thrymr »

jobs_throwaway wrote: post #302
kwanbix wrote: 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.

US health care outcomes are really not great, even if you are rich. Yes, you live longer than poor people in the US, but still do worse than Europeans, even those with lower incomes [0]. All while spending much more [1]. It's a system designed to siphon money from wherever it can (individuals, governments, companies, etc.), not to provide the best health care.

[0] "in some cases, the wealthiest Americans have survival rates on par with the poorest Europeans in western parts of Europe such as Germany, France and the Netherlands." https://www.brown.edu/news/2025-04-02/wealth-mortality-gap

[1] https://ourworldindata.org/us-life-expectancy-low

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

#433

Post by smaudet »

fukka42 wrote: post #376
throwaway0123_5 wrote: post #325

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.

Yeah, just because the US has 300 billionaires that does not make the median salary anywhere near six figures.

In fact it's quite low, somehow people are expected to survive on several thousand a year, after the rent, utilities, transport costs are all paid.

https://www.fool.com/money/research/average-us-income/

These are official stats, but unofficial employment puts the number lower:

https://investorshangout.com/carlyle-group-unveils-alarming-...

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

#434

Post by pcthrowaway »

lateforwork wrote: post #169

When UnitedHealthcare CEO was killed the public sentiment was that the health insurance companies are the bad guy—and the CEO deserved what he got. Then when stories like this come out we realize no, it is actually the hospitals. In reality the whole system is broken. Some people think single payer system is the solution but then when they talk to Canadians they realize that's not the solution either. I think the cor…

They're both the bad guy, but from the sound of it, the insurance companies are worse. They will delay cases and deny claims which result in people dying sooner rather than going through a long, costly, but ultimately life-saving treatment, to save themselves money in the long run.

The alleged shooter was clearly referencing this book which talks about it: https://en.wikipedia.org/wiki/Delay,_Deny,_Defend

I haven't read the book, I'm just recalling what I've read about it.

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

#435

Post by tptacek »

spacechild1 wrote: post #416
tptacek wrote: post #284

Earlier quoted context omitted.

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 h…

In fact many of the largest insurers are nonprofits, and insurance itself is a small faction of our total expenditure. People believe a lot of weird things about US health care economics.

https://nationalhealthspending.org/

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

#436

Post by pastureofplenty »

spelk wrote: post #309
lateforwork wrote: post #169

When UnitedHealthcare CEO was killed the public sentiment was that the health insurance companies are the bad guy—and the CEO deserved what he got. Then when stories like this come out we realize no, it is actually the hospitals. In reality the whole system is broken. Some people think single payer system is the solution but then when they talk to Canadians they realize that's not the solution either. I think the cor…

>Some people think single payer system is the solution but then when they talk to Canadians they realize that's not the solution either. I'm sorry but I don't understand this discourse. While we have gripes with the state of some hospitals that fall short of first world standards (e.g. Gatineau Hospital) and wait times for specialists for non-urgent care (it can take 2-3 months to see a dermatologist after referral f…

Many Americans desperately want to believe that other countries' healthcare systems are "just as bad" as a form of coping.

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

#437

Post by lotsofpulp »

tracker1 wrote: post #355
tptacek wrote: post #284

Earlier quoted context omitted.

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.

It's largely a side effect of a couple things... first the ACA (ObamaCare) limited the percentage of profit that insurance and medical providers can make... so they instead just grow the pie larger by inflating everything. Second is that they are allowed to have effectively vertical monopoly investments controlling multiple layers of healthcare as a whole from insurance, providers, pharma and pharmacies. Trust bustin…

> so they instead just grow the pie larger by inflating everything

So why would they deny coverage? All they have to do to earn more money is keep paying for more and more healthcare.

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

#438

Post by Aurornis »

kwanbix wrote: post #363
georgeecollins wrote: post #278

Earlier quoted context omitted.

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,…

As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. I…

> University is expensive as fck.

One thing that's hard to understand from the outside is that almost nobody actually pays those mind-blowing $60K/year tuition prices. US universities charge on a sliding scale based on the applicants' families' ability to pay.

For an extreme example: Harvard's tuition is nominally $60K per year, but for families earning $200K or less it's $0. Many prestigious universities follow similar patterns resulting in a large percentage of students paying no tuition, the middle ground of students paying some fraction, and a small number of students from wealthy families subsidizing everyone else.

For those who don't attend the prestigious universities with large endowments, average in-state state-run University tuition is under $10K, though again a large percentage of students receive some form of aids or grants to bring that number down even further.

That said, it's entirely possible or someone to go out and sign up for bad investment private university with no aid and rack up $300K of debt by graduation if they're not paying attention to anything, but it's a myth to think that everyone does this.

The average US college student graduates with around $30-40K debt depending on whether they go public or private, which isn't all that hard to pay off when our wages are already significantly higher than other countries. We're especially lucky in tech where our compensation differential relative to other countries more than makes up for the cost of university education.

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

#439

Post by game_the0ry »

chrisgeleven wrote: post #245

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…

Happy to hear this all worked out. Have you thought about reaching out to local news to get the word out? That insurance company should be called out.

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

#440

Post by dboreham »

jobs_throwaway wrote: post #302
kwanbix wrote: 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.

I have money and it still sucks. Perhaps you're thinking of billionaire money?
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