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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

#671

Post by diob »

magicalhippo wrote: post #422
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…

Relative recently had their baby come several months early. The baby needed intensive care for a couple of months, and breathing support (CPAP) for another two. Mom lived at the hospital hotel for the duration. Baby got regular inspections of the heart, lungs and eyes (too much oxygen in the blood can lead to problems with the cornea or something), including after checkout. They got billed exactly zero. Both parents…

A lot of folks are looking at the higher US comp but aren't correctly pricing in the long-term risk.

You can be fine for years, but a single, major medical event can zero out those salary gains and lead directly to bankruptcy. It's a systemic flaw that isn't obvious until it's your turn to deal with it.

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

#672

Post by LastTrain »

frikskit wrote: post #643
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?

High fractions of Europeans speak English, eg Poland has 50% of population speaking English (for those of working age it’s probably much higher) whereas the fractions of Americans speaking non-English European languages is much lower (0.25% for Americans speaking Polish). If 50% of Americans spoke Polish by the shake of a wand, I bet there’d be more Americans in Poland than Poles in Poland.

Your wand would also need to erase the reason people speak (or don’t speak) the languages they do, otherwise what you said would already be true for the UK, Australia, etc.

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

#673

Post by no_wizard »

georgeecollins wrote: post #666
no_wizard wrote: post #640

Earlier quoted context omitted.

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.

>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.

That alone is enough to put most people out of grasp of doing this, for a multitude of reasons, of which not having the capital is only part of the equation, as you would also need to have a suitable investment on the other side to put said money, not a promise. I'm sure there are other nuances involved too.

Thats before the fact that the cost of a house in California would price most people out of the equation to begin with.

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

#674

Post by fallingfrog »

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]

No, we all hate it, but the number of senators and members of congress who would vote to replace it could be counted with one hand. The reason is simple: the insurance companies give those senators millions and millions of dollars and nobody has the cash to beat them. And we've given up at this point.

As the song goes:

"Everybody knows that the dice are loaded

Everybody rolls with their fingers crossed

Everybody knows the war is over

Everybody knows the good guys lost

Everybody knows the fight was fixed

The poor stay poor, the rich get rich

That's how it goes

Everybody knows"

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

#675

Post by dragonwriter »

polski-g wrote: post #669
stronglikedan wrote: post #573

Earlier quoted context omitted.

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.

Leaving aside the subjective impressions, the objective parts of that description are only accurate for CA, not UK, healthcare; the UK has optional add-on private insurance and care on top of the universal public system.

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

#676

Post by georgeecollins »

frikskit wrote: post #643
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?

High fractions of Europeans speak English, eg Poland has 50% of population speaking English (for those of working age it’s probably much higher) whereas the fractions of Americans speaking non-English European languages is much lower (0.25% for Americans speaking Polish). If 50% of Americans spoke Polish by the shake of a wand, I bet there’d be more Americans in Poland than Poles in Poland.

OK, but by that logic lots more USA citizens should be moving to the UK, Ireland, Spain than the other way around. That's just not the case, at least until very recently.

I could see that the appeal of Ireland can be increasing and Poland sounds cool. I'm not saying that the USA is great, it has tons of problems.

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

#677

Post by horns4lyfe »

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…

Insurance companies have become cartoonishly evil. It’s going to get really nasty out there at some point.

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

#678

Post by danpalmer »

georgeecollins wrote: post #278
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

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 with many things, in the US if you're part of the privileged minority you do well. The top 10% of earners in the US earn a lot more than the top 10% in Europe – that covers tech, high end knowledge work, that sort of stuff.

But the bottom 90% do badly. Society is very divided, and most people lack social mobility, they lack a voice on the national and international stage, they lack the security that either a social safety net or high pay would give them.

The UK is similar, although much less pronounced. I moved to Australia about 18 months ago and society here is much flatter, the difference between the top 10% and bottom 10% is much less. There are still problems here, it's not a utopia, but it's very noticeable how most people are struggling less, and how the top 10% of earners aren't living that different a life.

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

#679

Post by LastTrain »

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!

The only major differences I can think of are gun ownership and abortion. What freedoms were you referring to?

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

#680

Post by supertrope »

wagwang wrote: post #241
hex4def6 wrote: post #104

Earlier quoted context omitted.

Many years ago, I managed to stab my face with a screwdriver (not my proudest moment), and had to go to the ER. After the stitches, I was asked whether I wanted to pay with insurance. If I did, it was something like $2,000. If I didn't, there was a 75% discount off MSRP. My deductible was like 25%, so it ended up basically being the same out of pocket either way. The fact that there seems to be a 4x markup means make…

There are cases with prescriptions where its actually better to claim to be uninsured

At Costco Pharmacy I stopped using my insurance plan as the co-pay was more than the no claim cash price. I learned later that my health insurance company owns its own pharmacy and they design the claims process to bias you toward their own pharmacy. Since medical loss ratio must exceed 85% on employer health plans they realize their excess profits by jacking up prices at their pharmacy subsidiary and using their pharmacy benefit manager subsidiary and insurance product to steer you toward overpaying if you just take their suggestion (e.g. $100 if you use OptumRX mail order Pharmacy for the "savings" versus $20 cash price from Costco).
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