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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

#561

Post by jack_tripper »

alistairSH wrote: post #318
timeon wrote: post #291

Earlier quoted context omitted.

Credit score is another thing I have hard time comprehend. I wanted to borrow car outside of EU and was not unable to because there was no record on me with some private company that stored data about credit cards. That was wild experience - like some social credit in China. I just prefer rule of law than these hacks on society.

How do they track credit-worthiness inside the EU? I thought Germany had something equivalent? Maybe it's government-managed instead of private? Not that I like the US system, but it sort of makes sense (barely).

>How do they track credit-worthiness inside the EU? I thought Germany had something equivalent?

It's funny that your parent says "I just prefer rule of law than these hacks on society", when Germany's credit check institution, Schufa, acts like that, not super different to China's social credit score he mentioned.

You can't get a rental in China with a bad credit score, and like that, good luck getting a landlord in Germany to lent you his property with a bad Schufa.

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

#562

Post by andy99 »

egorfine wrote: post #253
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…

[flagged]

Edit: just saw an earlier better comment saying the same thing: https://news.ycombinator.com/item?id=45737190

Countries with “free” also healthcare ration it and don’t cover everything.

Socialized insurance is still insurance, and at least in Canada it’s the only game in town, so if you have a procedure that is denied or not available your choice is basically to go to the US and pay for it and be in the same position as an uninsured American.

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

#563

Post by fredophile »

Uehreka wrote: post #534
wing-_-nuts wrote: post #509

Earlier quoted context omitted.

>the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. If you had said the median tech worker? I might have believed you, but the median family? No way.

Idk, speaking as a big Medicare-for-all supporter, this would definitely explain why MfA always polls well at first, until people start asking if they can keep their current plan. I know at this point in the debate we’re supposed to write those people off as either innumerate, a minority, or too risk-averse for their own good, but honestly if it turned out that that stat was true, that would explain a lot. And it wou…

Why does Medicare for all mean I can't keep private health insurance? There are countries that have systems like this in place.

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

#564

Post by epistasis »

xnx wrote: post #550
tptacek wrote: post #547

Earlier quoted context omitted.

Their cut is in fact very small; it's around 6.5% of total US health care spending. https://nationalhealthspending.org/

But for what? Why not something closer to credit cards, like 1%?

The complexity is far higher than credit card processing, including extensive price negotiation with individual health care providers. Though we call it "insurance" it's just as much a "buyer's club" for health care services.

Large employers (e.g. Google) are also generally "self-insured" meaning that the "insurance" component is offloaded to the purchaser, the employer of the insured individuals. In those cases, the health care insurer processes the claims from health care providers, determines if they were justified, or if the treatment/diagnostic/drug is justified by coverage determinations of the provider, etc, but the employer (e.g. Google) just pays the claims in the end too.

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

#565

Post by dragonwriter »

tptacek wrote: post #559
dragonwriter wrote: post #553

Earlier quoted context omitted.

> Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. The US spends nearly as much in taxpayer funds as a share of GDP as other developed countries (and v…

Again, you can just do the math on this. You're making an argument about the macro costs of our system --- I think those costs are fucked, too. But I'm not talking about that; I'm talking about the actual experience of an ordinary middle-income family with private health insurance. That family would likely (in fact, almost certainly) be worse off in a single-payer system. I'd appreciate if you'd avoid using language…

> Again, you can just do the math on this. You're making an argument about the macro costs of our system --- I think those costs are fucked, too. But I'm not talking about that; I'm talking about the actual experience of an ordinary middle-income family with private health insurance.

Yes, you can just do the math, and changing nothing about the US except transition to a European style universal system, the median family would face lower aggregate tax, out-of-paycheck, and out-of-pocket costs than they do now, with less health insecurity around unexpected events (either health or employment), unless the tax increases necessary were deliberately and perversely targeted to avoid that.

That’s a direct consequence of the difference in the macro-level costs: they aren’t separate, orthogonal concerns. People just have a hard time accepting that the US health care system is structurally constructed right now to waste vast hordes of money preventing people from accessing health care, but that’s exactly what it does.

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

#566

Post by mr_toad »

onionisafruit wrote: post #150
pbhjpbhj wrote: post #138

Earlier quoted context omitted.

A code is not an artistic expression and so can't be copyrightable. The layout of a book of codes, for sure, but the information in it... might be protectable with other IPR but not copyright. Does not stop people threatening you though. This is my opinion only, not legal advice, and does not relate to my employment.

And yet people are collectively paying $300M licensing these non-copyrightable codes? With that kind of money somebody must have looked into not paying for licensing

I’m sure it’s crossed the mind of many people in the industry. But it’s a comprehensive taxonomy of all diseases, medical conditions, causes, procedures and treatments. Starting from scratch would be much more expensive than just paying the licensing.

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

#567

Post by gusgus01 »

tptacek wrote: post #452
jkartchner wrote: post #414

Earlier quoted context omitted.

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.

There are numbers on this, and their comment is probably directionally correct; the median household with private insurance earns more than 400% of household FPL (KFF). By subtracting Medicaid and fixed-income seniors from the picture, you are sharply biasing the median upwards.

I would say if you ignore the poorest 40% of the population, you've got quite the slim margin to go before you are no longer talking about "Most" Americans, which the OP was pretty explicitly talking about.

He was saying "Most people in the US" don't make 100-200k more, and that they probably don't even make 100k. This was in response to the generalization that "people from other countries ... underestimate how well paid people in the US often are".

Now there was talk of getting the political motivation to change things, so I guess everyone is assuming Medicaid/Medicare/VA recipients don't want to change the system, but that wasn't really established, nor was that really being refuted.

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

#568

Post by egorfine »

robrenaud wrote: post #484
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

A lot of employed people like the status quo for the healthcare that they receive. "In contrast to their largely negative assessments of the quality and coverage of healthcare in the U.S., broad majorities of Americans continue to rate their own healthcare’s quality and coverage positively. Currently, 71% of U.S. adults consider the quality of healthcare they receive to be excellent or good, and 65% say the same of t…

So basically they accept and approve of them being bankrupted by an unfortunate medical event no matter how top tier their health insurance package. Right?

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

#569

Post by egorfine »

selfmodruntime wrote: post #560
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

The US is gigantic . Imagine if every EU member, however rich, poor, or corrupt from Bulgaria to Germany had to enact one healthcare system.

India is larger and yet.

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

#570

Post by tptacek »

fredophile wrote: post #563
Uehreka wrote: post #534

Earlier quoted context omitted.

Idk, speaking as a big Medicare-for-all supporter, this would definitely explain why MfA always polls well at first, until people start asking if they can keep their current plan. I know at this point in the debate we’re supposed to write those people off as either innumerate, a minority, or too risk-averse for their own good, but honestly if it turned out that that stat was true, that would explain a lot. And it wou…

Why does Medicare for all mean I can't keep private health insurance? There are countries that have systems like this in place.

There are countries that have single-payer systems and widespread supplemental insurance. But if you universalized Medicare, you'd immediately do at least two big things to the market:

(1) You'd eliminate the system of advantages and supports that cause employers to offer private insurance, which is where most people get their insurance from.

(2) You'd create a huge adverse selection problem --- the more effective/useful Medicare is, the fewer families will want to spent $24k/yr on private insurance, meaning the families left on private insurance have a reason to want it, meaning the composition of the risk pool would shift dramatically.

Like, if we ever did M4A, we'd probably end up with a widespread system of supplemental insurance; we already have it with Medicare! But that's not the same thing as keeping your existing plan.

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