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Americans Are Skipping Doctor Visits Due to Costs

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Re: Americans Are Skipping Doctor Visits Due to Costs

#51

Post by stvltvs »

glimshe wrote: post #48
halfjoking wrote: post #43

I believe modern medicine is fraudulent. So I didn’t just not get the Covid vaccine, but I canceled my health insurance during Covid. I will never go back to paying for insurance or even going to a doctor in the US unless there is an overwhelming consensus acknowledging the harms of this study: https://pubmed.ncbi.nlm.nih.gov/36055877/ [1] This system ends only when enough people refuse it. I know I won’t ever give t…

To all other people on HN: don't follow this person's advice if you live in the US. They are likely relatively healthy and has never experienced the crushing financial burden of long term, or serious health issues. The financial risk of living with insurance is high enough as it is, but living without insurance is madness if you have any sort of asset that can be taken away by creditors - assuming, obviously, that yo…

Yep, this year would have buried my family in medical debt, or buried one of us, without health insurance. Insurance sucks, but we USians haven't created a better alternative yet.

Re: Americans Are Skipping Doctor Visits Due to Costs

#52

Post by atmavatar »

glimshe wrote: post #48
halfjoking wrote: post #43

I believe modern medicine is fraudulent. So I didn’t just not get the Covid vaccine, but I canceled my health insurance during Covid. I will never go back to paying for insurance or even going to a doctor in the US unless there is an overwhelming consensus acknowledging the harms of this study: https://pubmed.ncbi.nlm.nih.gov/36055877/ [1] This system ends only when enough people refuse it. I know I won’t ever give t…

To all other people on HN: don't follow this person's advice if you live in the US. They are likely relatively healthy and has never experienced the crushing financial burden of long term, or serious health issues. The financial risk of living with insurance is high enough as it is, but living without insurance is madness if you have any sort of asset that can be taken away by creditors - assuming, obviously, that yo…

Tragically, even having good insurance isn't a perfect guard against crushing medical debt due to the whole in-network vs. out-of-network bullshit involved.

If you have to go through a procedure of any complexity in a hospital, you may discover after the fact one or more of the doctors that were brought in were out-of-network despite the hospital being in-network, and suddenly, you're stuck with a giant bill insurance won't cover.

There's a reason some people have secondary, tertiary, and even quaternary insurance nowadays to cover things each previous providers don't.

We truly need to burn down the current system and reset to something sane.

Re: Americans Are Skipping Doctor Visits Due to Costs

#53

Post by danans »

wrp wrote: post #47
danans wrote: post #36

Earlier quoted context omitted.

> Their old GP retired and sold his clinic to a "concierge" system/network Concierge medicine is a luxury service where you pay an annual out of pocket membership fee to have a doctor always on call, including home visits. Its popular among the very wealthy, but not affordable for most people.

I've read comments that concierge medicine is cost effective if you require frequent visits, as with many older patients. Would like to know if this is true.

Concierge medicine fees are thousand per year in addition to insurance, deductibles, and copays, not in lieu of those expenses.

The doctors I know of who practice it have very wealthy clientele for whom convenience and access is the important factor, not the cost.

Re: Americans Are Skipping Doctor Visits Due to Costs

#54

Post by beej71 »

Even if you go in for your free checkup, all the clinics know the tricks for turning it billable.

Years ago a study came out that most Americans couldn't afford an emergency $400 medical bill. (For non-Americans, $400 for an emergency is nothing.) I doubt the situation has improved.

Re: Americans Are Skipping Doctor Visits Due to Costs

#55

Post by nhance »

In my mind, one of the most likely consumers of our data is insurance companies. It really exposes to me how messed up the idea of health insurance really is.

As an insurance company, you are incentivized to de-risk your pool as much as possible, and by spending a few dollars you're able to get to the earliest possible signals of who might be needing services very easily. Things like complaining about a sore throat on social media to friends, or even within private messages, are all things you might be interested in. Other signals, purchase history, location history, contact tracing, all of these provide potential ways to spot early risk and increase rates/push out the undesirable members of the pool.

Of all of the potential customers of our data, I keep coming back to insurance companies as having the most interest in these signals. When you can identify risks correctly, you can trim out or adjust rates to make things as safe as possible for your income stream.

This has a reactionary component to it that hurts us all. With most of our communication being digital now, I find myself thinking twice about putting out anything that could be taken as a signal to an insurance company. As an avid runner with most of our events organized online, this presents a social cost because I just won't engage in some conversations for fear of how companies will use whatever I might engage with against me.

Where does this type of behavior lead when practiced at scale?

Re: Americans Are Skipping Doctor Visits Due to Costs

#56

Post by beej71 »

halfjoking wrote: post #43

I believe modern medicine is fraudulent. So I didn’t just not get the Covid vaccine, but I canceled my health insurance during Covid. I will never go back to paying for insurance or even going to a doctor in the US unless there is an overwhelming consensus acknowledging the harms of this study: https://pubmed.ncbi.nlm.nih.gov/36055877/ [1] This system ends only when enough people refuse it. I know I won’t ever give t…

> This system ends only when enough people refuse it.

More likely it ends when enough people vote in politicians that regulate it.

Living without insurance in the US is great if you have no assets or if you're fantastically wealthy and can afford million dollar healthcare bills.

If you don't fit into one of those groups, get insurance.

Edit: I do absolutely agree that this system is broken at a fundamental level.

Re: Americans Are Skipping Doctor Visits Due to Costs

#57

Post by kube-system »

nielsbot wrote: post #25
kube-system wrote: post #10

Earlier quoted context omitted.

> The ultimate solution is [...] making for-profit health insurance illegal. > Every other free country in the world has [...] ... and most also have private health insurance too. Some have a higher percentage of people with private health insurance than even the US does, often in a supplementary role.

(Not sure if you're arguing for or against a privatized health insurance system) I guess that countries that provide public health insurance don't have people skipping doctor visits because of costs, even if the majority of residence also have private insurance.

I’m not arguing for either. I’m just pointing out that the “other countries” the parent commenter is referring to as a benchmark didn’t eliminate private health insurance.

Re: Americans Are Skipping Doctor Visits Due to Costs

#58

Post by effingwewt »

beej71 wrote: post #56
halfjoking wrote: post #43

I believe modern medicine is fraudulent. So I didn’t just not get the Covid vaccine, but I canceled my health insurance during Covid. I will never go back to paying for insurance or even going to a doctor in the US unless there is an overwhelming consensus acknowledging the harms of this study: https://pubmed.ncbi.nlm.nih.gov/36055877/ [1] This system ends only when enough people refuse it. I know I won’t ever give t…

> This system ends only when enough people refuse it. More likely it ends when enough people vote in politicians that regulate it. Living without insurance in the US is great if you have no assets or if you're fantastically wealthy and can afford million dollar healthcare bills. If you don't fit into one of those groups, get insurance. Edit: I do absolutely agree that this system is broken at a fundamental level.

Politicians listen to their constituents exactly never [1]

[1] https://news.stanford.edu/2018/02/26/americans-dont-think-ea...

Re: Americans Are Skipping Doctor Visits Due to Costs

#59

Post by floor2 »

beej71 wrote: post #54

Even if you go in for your free checkup, all the clinics know the tricks for turning it billable. Years ago a study came out that most Americans couldn't afford an emergency $400 medical bill. (For non-Americans, $400 for an emergency is nothing .) I doubt the situation has improved.

That often quoted (or misquoted?) study was wildly misleading and became complete misinformation through the retelling.

People who said they'd pay using a credit card got reported in the media as being "unable to afford" the expense. The original study might have been an interesting finding on the transition to a cashless society, but for millions of Americans, paying using a credit card is the default rather than carrying cash and dealing with change, and not actually indicative of lacking funds to pay for something.

Re: Americans Are Skipping Doctor Visits Due to Costs

#60

Post by floor2 »

atmavatar wrote: post #52
glimshe wrote: post #48

Earlier quoted context omitted.

To all other people on HN: don't follow this person's advice if you live in the US. They are likely relatively healthy and has never experienced the crushing financial burden of long term, or serious health issues. The financial risk of living with insurance is high enough as it is, but living without insurance is madness if you have any sort of asset that can be taken away by creditors - assuming, obviously, that yo…

Tragically, even having good insurance isn't a perfect guard against crushing medical debt due to the whole in-network vs. out-of-network bullshit involved. If you have to go through a procedure of any complexity in a hospital, you may discover after the fact one or more of the doctors that were brought in were out-of-network despite the hospital being in-network, and suddenly, you're stuck with a giant bill insuranc…

Hurray I get to spread some good news today. The issue you're describing was fixed by the 2022 "No Surprises Act". See this for details: https://www.cms.gov/newsroom/fact-sheets/no-surprises-unders...
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