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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

#581

Post by xnx »

tptacek wrote: post #555
xnx wrote: post #550

Earlier quoted context omitted.

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

I don't know how to answer that. I think the system is pretty inefficient in a variety of ways. If you universalized Medicare, eliminating insurance entirely, you'd get costs somewhere in between Medicare's current admin overhead and the overhead of private insurance (you mechanically would not get Medicare's current overhead, because the majority of your customers would have much lower claims than Medicare's all-sen…

> But the largest inefficiencies are all on the providers side. We simply pay practitioners too much

I agree. The complex insurance billing system enables his by obfuscating prices and limiting ability to comparison shop.

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

#582

Post by vecinu »

stronglikedan wrote: post #578
kwanbix wrote: post #363

Earlier quoted context omitted.

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…

> This is why quality of life in Europe, is so superior. That's very subjective, and I would rather have my freedoms instead of your/their liberties, thanks!

[flagged]

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

#583

Post by onionisafruit »

mr_toad wrote: post #566
onionisafruit wrote: post #150

Earlier quoted context omitted.

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.

What I mean is using it without paying the license, because if GP is accurate there is no copyright preventing it.

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

#584

Post by throw310822 »

xp84 wrote: post #168

> Long story short, the hospital made up its own rules, its own prices, and figured it could just grab money from unsophisticated people This is the core truth that all of healthcare in the US spins out from. A few personal experiences which back this up: 1. I received a $1500 bill because an ambulance that was sent when I called 911 was an "out of network ambulance". I looked it up: One small ambulance company in SF…

I find it curious that people are celebrating when they manage to not pay (part of) an absurdly wrong bill that can only be either the result of gross incompetence or- much more probably- an attempt at fraud. The actual happy ending of such a story would be that the healthcare provider is sued for damages and/ or attempted fraud, and has to pay back a large multiple of what has asked.

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

#585

Post by tptacek »

xnx wrote: post #581
tptacek wrote: post #555

Earlier quoted context omitted.

I don't know how to answer that. I think the system is pretty inefficient in a variety of ways. If you universalized Medicare, eliminating insurance entirely, you'd get costs somewhere in between Medicare's current admin overhead and the overhead of private insurance (you mechanically would not get Medicare's current overhead, because the majority of your customers would have much lower claims than Medicare's all-sen…

> But the largest inefficiencies are all on the providers side. We simply pay practitioners too much I agree. The complex insurance billing system enables his by obfuscating prices and limiting ability to comparison shop.

That's true, but it's a problem single-payer doesn't fix; that's my big issue with it (it locks in rapacious rates and preferences for the health provider industry, making them palatable to consumers by hiding the payer).

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

#586

Post by dragonwriter »

tptacek wrote: post #575
dragonwriter wrote: post #565

Earlier quoted context omitted.

> 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 fam…

Provide numbers. Sanders, for instance, funded his proposed system by (among other things) taxing capital gains at the level of ordinary income. I'm critical of the US system, but I have exactly the opposite diagnosis you do: my concern with the system is that, by the numbers, it appears to function by driving way too much spending on "actual" care.

> Provide numbers. Sanders, for instance, funded his proposed system by (among other things) taxing capital gains at the level of ordinary income.

Not tax penalizing non-capital income is sort of an essential reform in the era of increasing automation anyway; I'm not sure what point you are trying to make there. The average middle income family isn't making a substantial share of their income in forms taxed as long-term capital gains, so that seems...unrelated to the focus of your argument.

> I'm critical of the US system, but I have exactly the opposite diagnosis you do: my concern with the system is that, by the numbers, it appears to function by driving way too much spending on "actual" care.

It does both (particularly, in the “actual care” angle, as regards low-benefit, high-cost measures near the end of life.) We have a system based on denying and economically incentivizing younger people to avoid and defer care, but then doing much less of that with (most of) the elderly.

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

#587

Post by paulryanrogers »

topaz0 wrote: post #539
ecosystem wrote: post #74

The American Medical Association owns copyright to all the codes and their descriptions. They have an extremely restrictive and expensive licensing options and they strictly forbid training models with the codes. This month, the practice was called out ( https://www.help.senate.gov/rep/newsroom/press/chair-cassidy... ) so the Overton window may be opening. The AMA (a nonprofit!) clears ~$300M/year revenue from the co…

$300M/year is less than $1 per person. This is not why healthcare is expensive.

The opaque costs add up. If nothing else all the layers make things slow, when time is the difference between life/health and death/illness.

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

#588

Post by epistasis »

nxor wrote: post #498
onli wrote: post #443

Earlier quoted context omitted.

Careful there, thats a rightwing propaganda point. Immigration into an aging society does not raise healthcare costs, it lowers it. See https://archive.is/XxfTH (and note that this is a NZZ article, a right-wing publication by now, so not slanted towards being immigration friendly).

Are people ever allowed to criticize migration?

Who's not being allowed to criticize immigration? Critique of a critique is pretty much the furthest thing from "disallowing" critique.

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

#589

Post by gusgus01 »

tptacek wrote: post #571
gusgus01 wrote: post #567

Earlier quoted context omitted.

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…

I don't think I could be any clearer that I am (1) talking about Americans with private health insurance and (2) not making a normative judgement about which system is better, but rather a positive claim about the political challenge of changing the system (its large group of stakeholders who are better off under it).

Oh I'm clear about the demographic you are trying to discuss, my point was I'm not sure this all stemmed from a discussion about that specific demographic. It started at "people in US", then went to "most", then by the time you got involved in the thread you were defending a statement about people with private health insurance.

I could have made this comment at the level where it went off the rails, but I thought making it at the leaf level would help everyone involved see the deviation between what was said and what was being argued.

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

#590

Post by supertrope »

tptacek wrote: post #535
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…

The people who want to keep their own plan are almost definitionally not innumerate! They would be worse off financially under M4A. That doesn't make M4A bad policy (I think it's bad policy for other reasons), but it does take "people are being irrational" off the table in a discussion like this.

Even if you keep your plan it's getting enshittified every year.

It's that time of year again - enroll for 2026 benefits. My employer raised employee premiums by 10%, raised the deductible, added more administrative burden such as "step therapy" (the insurance company denies your claim for a drug until you've tried a cheaper but less effective drug, even if you've already done "step therapy" while on another health plan!) Your employer will change the plan premiums and structure every single year. They can lay you off, exclude expensive drugs, exclude doctors, etc. Some specialties like anesthesiology and psychiatry are usually not in network. In extreme cases an employer can change health administrators mid-year and your deductible will reset.

https://www.pwc.com/us/en/industries/health-industries/libra... https://kffhealthnews.org/news/article/workplace-health-insu...

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