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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

#661

Post by TranquilMarmot »

egorfine wrote: post #352
willio58 wrote: post #338

Earlier quoted context omitted.

The United States is a democracy, but more specifically, a representative democracy. That means citizens don’t directly vote on most laws or policies—aside from certain state or local measures—but instead elect representatives to make those decisions on our behalf. The idea is that we trust them to act in our best interests. You can probably see where the problem comes in. Take, for example, a politician who campaign…

Ah, so Americans are okay with that system as well. Got it.

We're not okay with it, but it's so entrenched by the wealthy that the only way out will eventually be violent revolution which nobody wants.

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

#662

Post by tptacek »

DennisP wrote: post #658
tptacek wrote: post #542

Earlier quoted context omitted.

Where in their comment do you see them referring to hospital care?

The article, talking about a patient's hospital visit, mentions "the $31 low-dose aspirin, of which they'd given him four."

Ahh, good callout. Thanks!

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

#663

Post by no_wizard »

epistasis wrote: post #485
nonfamous wrote: post #467

Earlier quoted context omitted.

>>> 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. As an individual who has lived in multiple countries in three continents, I dispute that “the care most people get is better than ade…

While I don't doubt that there are endless stories of bad care, especially among the non-unionized working class, the bulk of voters with middle class lifestyles do have good care. Which is why it's so hard to make it into an issue that drives political change. > there are plenty of studies that show that Americans have lower expected lifetimes than citizens of peer countries, despite much higher per-capita health ca…

>While I don't doubt that there are endless stories of bad care, especially among the non-unionized working class, the bulk of voters with middle class lifestyles do have good care. Which is why it's so hard to make it into an issue that drives political change

This ignores the outsized influence of lobbyists, especially post Citizens United.

The majority (depending on which polls you cite, seems to range anywhere from 57% to over 70%) favor a universal healthcare solution for all citizens. Yet like many other majority opinions, this doesn't translate into legislative action in that direction, in large part thanks to lobbyists and dysfunctional partisanship. None the less policy is not reflecting the majority.

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

#664

Post by protocolture »

dekhn wrote: post #34

I had an odd but successful experience with medical billing recently. My daughter went to urgent care for an urgent problem; after things were mostly cleared up, they transferred her by ambulance to an ER (even though there was no emergency). Both the urgent care and ER were handled by our insurance but the ambulance company sent us a large bill ($4K for a short drive) which felt too large to us (they had already tri…

>While I am not surprised that such a service exists, what did surprise me is that it's just a division of my insurance company: they literally have a division that negotiates with another part of the insurance cmpany to get better coverage for patients. I was pretty lucky to notice the mail about this- there's nothing on my employer's site saying we have this coverage(!) and the vast majority of people in the US likely don't have this service.

100 years ago I used to work for the fruit company in phone support.

My KPI's were 100% customer satisfaction. However, I needed to get approval from another team to advance any kind of free/gratis repairs replacements or gifts.

That team's KPIs were opaque to me, but my understanding is that they were find as long as they offered some resistance.

Between those two pillars we got a lot of good done for customers. I dont think theres anything necessarily wrong with having internal friction like that if its designed correctly. Its probably better than having both responsibilities in a single person.

In terms of health insurance however it seems ghoulish.

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

#665

Post by georgeecollins »

jhgb wrote: post #649
georgeecollins wrote: post #630

Earlier quoted context omitted.

If this were true, the number of Americans I have known who moved to Europe would be roughly equal to the number of Europeans I have known who have moved to the US. That's not data, that's anecdote. But what is the European country where more people go there from the US than come to the US from there?

USAians are not exactly famous for commonly speaking most European languages at a level that would allow them to resettle to the respective European countries. This makes for a considerable barrier that essentially doesn't exist in the opposite direction.

I have never heard this term before, but to clarify what I mean (it's so weird to bring race into this!): I have worked with dozens of native born dutch, german, french people etc. and lots of latin people etc. But I know almost very few that I grew up with, went to school with, who moved from the US to another country. I am not saying this is good, the US is good etc. I am saying you have to understand the revealed preference vs what people tell you.

I wouldn't be surprised if this changes in the future, I am talking about the period of my life to date.

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

#666

Post by georgeecollins »

no_wizard wrote: post #640
georgeecollins wrote: post #630

Earlier quoted context omitted.

If this were true, the number of Americans I have known who moved to Europe would be roughly equal to the number of Europeans I have known who have moved to the US. That's not data, that's anecdote. But what is the European country where more people go there from the US than come to the US from there?

The two things are not equals. The US has for a western country, relaxed standards for immigration[0], in particular if you were coming from Europe, it's quite a bit easier to establish residency here. The reverse is not true. European nations aren't very immigration friendly by comparison. On top of that, the US government, assuming you keep your citizenship, does not make it easy to live abroad. US government tax p…

That's a fair point. But until recently you could move to a lot of countries in Europe for an investment less than a house in California. But I accept that could be the true reason.

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

#667

Post by lucasban »

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]

One thing also to keep in mind, is that this experience is not uniform throughout the US. Many Americans like -their- employer based insurance, even if they don’t like the system. I personally pay nothing for visits and nominal fees ($1-10) for prescriptions. I have not been hospitalized while on this insurance, but my understanding is that it is relatively low cost. I also have no monthly premium. Meanwhile, my mother works at a small business, pays a significant percentage of her income for insurance from the ACA marketplaces (the public marketplaces created during the Obama administration) with the current subsidies, subsidies that are in question under the current administration. The American healthcare payment system is broken, but we aren’t all living through the worst case scenario experiences that get the attention. Add to that the amount of money and effort that went into turning healthcare reform into yet another partisan issue, and there’s a good recipe for maintaining a broken status quo for a while yet.

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

#668

Post by no_wizard »

tptacek wrote: post #656
no_wizard wrote: post #653

Earlier quoted context omitted.

>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. This is such a weird excuse for bad policy. Ma…

What policy are you referring to? Cost-conscious students can (and most should) stay in-state, do their first year or two at a city/community college (my kids knocked out core STEM classes there --- over summers, not for cost reasons --- and found the teaching markedly better), and then transfer into a commuter university. The "average" student debt owed primarily by the top income quintile in this country and captur…

>What policy are you referring to?

The implicit policy that student loans are an acceptable and benign form of debt for the average citizen. Everything said after is predicated on this idea.

I don't think thats good policy.

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

#669

Post by polski-g »

stronglikedan wrote: post #573
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

Yes, but we also want universal healthcare. What we don't want is only universal healthcare with death panels like the UK and Canada has. Give us universal health care where we can also get insurance if we want, and we'll vote it in. That's never what comes up though. I firmly believe we could gut medicare/medicaid and the savings from the bureaucratic administration costs alone could pay for universal healthcare.

UK/CA healthcare sounds like hell. Every doctor is under the government, so even if you have money for a procedure the government doesn't want to cover, you can't get it done. And of course because there is no rationing by price there is rationing by time, so you end up with 13mo waits for an MRI.

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

#670

Post by BobbyTables2 »

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]

Its too easy to convince enough of the population to actively vote against their own interests.
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