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Simone Giertz – Back from brain surgery [video]
- tonysdg 8y agoSo glad to see Simone back on her feet. The shy robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.
- danesparza 8y agoIt really depends. I have an PPO / HSA plan where I have discounts up to a certain set "total annual amount" (currently around $5k) -- then insurance kicks in and I start paying a lot less. That $5k (for me) resets every year.
- justaman 8y agoI recently had a heart thing that put me in the hospital and included a med-flight to the hospital. Total bill was close to $40,000 if i'm not mistaken. I had to cover the $4,000 deductible but after that everything was covered. Additionally, my employer is part of something I don't understand(insurance is too damn confusing), I think its an HSA which covered an additional $2,000 towards my deductible. End of the day I only had to pay $2,000 out of pocket. Not bad.
- bloopernova 8y agoI hope you are doing OK now, and I'm glad your insurance/billing situation was resolved relatively easily. I really, really wish insurance was less confusing though! So many copays, coinsurances, deductibles, out of pocket maximum, lifetime maximum, different tiers of drug prices, etc etc. That stuff should be made simple by law.
- Rjevski 8y agoThis can’t be made simple by law when the lawmakers profit off the current situation.
- mrrsm 8y agoWith most insurance I feel like you will hit your max out of pocket before you would hit that amount. Depending on your insurance plan you could be talking $3,000-$10,000 max you would have to spend.
- VBprogrammer 8y agoI mean this in the nicest possible way; the casual way Americans talk about these things makes me wonder if they aren't suffering some form of Stockholm syndrome. The percentage of the population who don't have anything like that kind of money in savings is huge. And that is after you already pay huge amounts for insurance.
- mikestew 8y agoEver been around someone with, say, cancer and experienced the casual way they might talk about procedures that would horrify you (or at least make you a bit squeamish)? No one sympathizes with their cancer, but one would do well to make peace with reality. I have no sympathy whatsoever for my hostage-takers, but I'm unlikely to fight my way out of this one, so might as well go back to talking about out-of-pocket maximums until I can make a shiv out of this toothpick.
- fossuser 8y agoFor me it’s more that I’ve accepted it’s hopeless. Like gun control the issue has reached a stable equilibrium of political stupidity and I don’t see how it could change in the current climate.
- JacobDotVI 8y agoIt's worse than that: "63% Of Americans Don't Have Enough Savings To Cover A $500 Emergency" https://www.forbes.com/sites/maggiemcgrath/2016/01/06/63-of-americans-dont-have-enough-savings-to-cover-a-500-emergency/#63123a144e0d https://www.forbes.com/sites/maggiemcgrath/2016/01/06/63-of-...
- SketchySeaBeast 8y ago
- malaporte 8y agoMaybe the deductible part is a fixed amount and not a % of the total bill? (I have no knowledge of health care in the US - both countries I lived in have free health care)
- RandallBrown 8y agoThe deductible is (in my experience) a fixed amount. I have to pay about $5000 out of pocket before everything becomes "free".
- tehwebguy 8y agoMany plans now have a co-insurance percent, so something like 20-80% is billable back to the patient after the deductible up to the out of pocket maximum (or Really Real Deductable as I call it)
- cepp 8y agoUnless you have access to a private repository of billing and insurance data, no. There is no publicly available source for price cross lookups. This is largely due to the fact that billing, coverage and pricing varies not only from hospital to hospital but even within the same provider on the same service (a given CPT). So now, there is no way to know the likeness of billing/coverage and it's also highly likely that if she disputes the claim, or there is a renegotiation then she will end up paying significantly less.
- Kiro 8y agoDid she do it in the US? I was under the impression she did it in Sweden, which would cost her $0. EDIT: Ok, she lives in San Fransisco now. Didn't know.
- cptskippy 8y agoBecause of the way insurance tends to work in America, care providers tend to throw shit at the wall to see what sticks. In other words the first bill is always an outrageous amount of charges that may or may not be valid. Additionally there's something called a negotiated rate that an insurer has with the care provider, usually the care provider's bill does not show this rate but rater some fiction that not even those without insurance pay. If you look at the claims your insurer pays out to the care provider you will see significantly lower amounts than what's billed. If anyone knows why care providers high ball the rates on bills when insurers have negotiated rates, I'd love to hear it. Is it something in the insurer's contract that gives insured the illusion that insurance is saving them a lot? In any case I've received first medical bills in the many thousands of dollars only to have them go through four or five revisions before settling down to hundred dollars. This is because the first bill you receive reflects all of the claims to insurance (e.g. if your insurance covers 80% you're on the hook for 20%) but as the insurer and the care provider negotiate and revise the billing the price falls. In my opinion it's a horrible experience for the insured and the added stress of the huge bills certainly doesn't help with recovery.
- bloopernova 8y ago> added stress of the huge bills I really wish people would talk about these sorts of soft costs more often. I grew up in the UK, moved to the USA in my mid 20s. While growing up, my parents divorced and my mother had to take care of me and a sibling. All 3 of us had medical conditions that needed regular care/checkups. Not once did my mum ever spend hours on the phone chasing down bills or insurance rejections. We never paid out of pocket for prescriptions, doctor visits, A&E (USA translation: ER) visits, etc. That stress, or lack of, is a huge factor in quality of life for a family. Unfortunately this sort of discussion is heavily politically charged. I really don't want to start an argument thread comparing how taxes pay for socialized care, etc.
- cobookman 8y agoOn the flip side people living in socialized healthcare Countries have other stresses. In the usa my insurance lets me go to 10 doctors for differing opinions. I can go straight to a specialist. When I need non urgent surgery it's scheduled with a few weeks instead of months.
- sourceless 8y ago$38k is probably unlikely, she'll have hit her deductible first which will have made several things fully covered and other things probably some% coinsurance, and then later hit the out of pocket limit on the plan and be fully covered from there onwards.
- viraptor 8y agoI remember someone on HN recommending to send a copy of the bill to some health billing transparency project, but I can't find the right link. Google comes up with https://www.fairhealthconsumer.org/ https://www.fairhealthconsumer.org/ although I'm pretty sure it's a different service (they don't use the submitted bills from what I understand)
- HarryHirsch 8y agoWhat's with the strange wording, why do they call patients "healthcare consumers" now?
- penguat 8y agoIf the patient is a dependent of someone, or a minor, or dies, does someone else pay? Is the consumer the person paying, or the patient?
- dv_dt 8y agoCould it be Vox's project? https://www.vox.com/2018/2/27/16936638/er-bills-emergency-room-hospital-fees-health-care-costs https://www.vox.com/2018/2/27/16936638/er-bills-emergency-ro...
- dredmorbius 8y agoI thought NPR has/had one, but can't find a reference.
- JshWright 8y agoTwo years ago my wife (25 weeks pregnant with twins) was admitted to the hospital because of some concerning ultrasound findings for one of the twins they wanted to monitor closely. Two months later they were delivered by c-section, both healthy but very small (3 lb 14oz, and 1 lb 13oz). The bigger one spent ~3 weeks in the NICU and the smaller one ~7 weeks. All told it was ~18 weeks of hospitalization (the only major procedure was the c-section, and obviously the NICU care is a little more intensive than average, but neither of the twins needed super high acuity care). Total bill was a bit over a million dollars. We were out of pocket ~$5k (our annual out of pocket max at the time).
- Damogran6 8y agoI had twince born about 6 weeks early and it worked out to about $5k per day per kid in the NICU...not including the pyloric stenosis surgery for one or, pretty much, any of the other aspects of the childbirth. Pity they stayed at the most expensive hotel of their life and they really weren't there to see it.
- TomK32 8y agoOur daughter arrived a few days late after a long weekend at the hospital when my wife decided 50 hours are enough. A cesarian at 2 in the night sure wasn't everybody's favourite but the big eyes of the little grey bundle staring at us in her first minutes is the thing we'll never forget. Didn't cost us a cent, not the US, obviously.
- deleted 8y ago[deleted]
- cobookman 8y agoMany insurance plans have a yearly max you pay for covered services. For my plan it's way less than 38k. I believe it's something like 10-12k
- schreiaj 8y agoBecause you asked about Medicare specifically, that information IS somewhat available. It'll take some digging into it but the raw data is available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FeeScheduleGenInfo/index.html https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Paymen... I will tell you it's HEAVILY dependent on the zip code and procedures. Private insurance is a whole different mess, likely going to hit deductible and be done. Last time my partner had to have surgery and billed insurance she paid $1000 and the insurance picked up the other $10k+ (precancerous mass removal, 45 minute surgery).
- CGamesPlay 8y agoIf she is covered on a self-only health insurance plan, she has to pay at most $7,350. Source: https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/2018-oop-caps.aspx https://www.shrm.org/resourcesandtools/hr-topics/benefits/pa...
- mosselman 8y agoYikes, what a bill. My mother had brain surgery a few years ago and didn’t have to pay for anything besides the insurance she always pay for which amounts to a few hundred euros a year.
- ryanmercer 8y ago>Yikes, what a bill. Yeah, cancer-related bills can add up fast. Worse, they'll send you bills for years after the fact... my father had been dead almost a decade from his cancer and the occasional bill would still come and my mom would have to spend hours arguing with them on the phone "uh yeah, he's dead, he's been dead, this happened a decade ago, get your shit together" and they'd usually be all 'oops our bad' almost like they were trying to double dip. We need some serious healthcare reform in the US.
- mosselman 8y agoCan’t imagine how hurtful and frustrating that can be. People make jokes about the health care system in th US, but in reality there isn’t anything funny about it.
- bloopernova 8y agoWe've encountered double dipping too, in dentist's bills and various healthcare bills. It's this whole circular firing squad of people charging others as much as possible for every little thing. Individually you may do OK, but the system is made more and more complex and stressful with each extra charge.
- jandrese 8y agoThe worst thing about this is that it teaches patients to ignore bills from hospitals, because so much of the time the bill is bullshit. They're just fishing for rubes that will pay it without realizing that the insurance is already paying for it. Then when a real bill comes they get angry at you for ignoring it, even though it was mostly indistinguishable from their bullshit bills.
- Mountain_Skies 8y ago
- bootloop 8y agoSo this country doesn't make enough money to be able to keep some unlucky people alive without throwing them or their family into poverty? Or is it simply that nobody cares for anybody else as long as you are better off then them?
- visarga 8y agoI think the second explanation works better - if we look at the way people vote. It's a religious thing to abandon people in suffering to banks and creditors. This way the holy right to make money is put in the first position.
- WhompingWindows 8y agoI believe it is highly American to believe in self-sufficiency and to minimize the role of luck in success or failure. Whether we go back to the Protestant work ethic, the Puritan sensibility, gold rushes, unfettered capitalism, the Gilded Age, and our current second gilded age, to me it is clear that caring for others is a secondary concern for many Americans. Just look at the "makers/takers" model of our populace put forward by the top current lawmakers. In this framework, sick people are takers and capitalists are makers.
- TeMPOraL 8y ago> to believe in self-sufficiency and to minimize the role of luck in success or failure. I think that, frankly, those two are in opposition to one another. Self-sufficiency at scale is a game of numbers and luck; systems of thinking that try to put more emphasis on mutual support and shared responsibility for success seem to work more towards eliminating luck as a factor.
- NegativeK 8y agoThis is never how it's framed when you actually discuss these problems with people who believe in small government. Every time I've pressed the issue, it's a two pronged response: A) Healthcare costs are too high, and it's due to malpractice/overregulation/other government influences. B) In the event that an individual can't afford healthcare, the community will pick up the tab -- and have the money to do it, since the government isn't taxing it away from them.
- ArtWomb 8y agoGet well, Simone! Truly amazing that you were able to get your vision fully restored. Real life on YouTube is better than any other content out there ;)
- zachruss92 8y agoThis video literally made my morning. If anyone deserves a successful recovery it's Simone. I admire her authenticity and humor, even in the face of something as terrifying as brain surgery. Hopefully when she's feeling up to it we'll be entertained again by shitty robots again :)
- goshx 8y agoI’ve never worried so much about someone I never actually met. The time after her surgery without updates on her twitter account was hard and it’s funny to see that a lot of people felt that way (if you read the tweets from that time you’ll see what I am talking about). It is great to see her doing so well. Medicine has come a long way... the bills not so much.
- throwaway5752 8y agoIt's really sobering to think about how often this happens per day, to less charismatic/attractive people without social media presences or worse/no insurance. Very happy for Simone (and felt the same way as you following the story) but also trying to take the opportune to empathize with a wider group of people.
- PuffinBlue 8y agoWe live in a world of marvels. Often we talk of the future and it's wonders waiting to be discovered, but the here and now has become equally astonishing. The breadth, depth and scale of human ingenuity and endeavour is jaw-dropping and here Simone and her story is another example. Maybe I'm being trite by looking for the good in the bad but pause for a moment and think of all that has been learned, how we have built a society and developed infrastructure such that at this particular confluence of time and space we as a species are capable of performing this life saving surgery. And half a world away I follow the story through yet more confluences of knowledge and development. It is astonishing. i know it's tempting to take it for granted but take a step back and think about it for a moment. It's astonishing. I'm 32. I can only imagine how much more marvels I'll witness in my life, either remotely or in person.
- goodells 8y agoThe whole system is awe-inspiring. Have a medical emergency? We'll send a several-ton box on wheels speeding your way within minutes. If you're in a city, the traffic lights will turn red as the emergency vehicle approaches to make passing safer. Paramedics trained in evidence-based pre-hospital medicine will perform the interventions most likely to save you based on their field impression. And when you arrive at the hospital it gets really cool - at a level 1 trauma center, they should be prepared to give you a CT scan and treat you in 10 minutes or less. That might involve snaking a tiny wire through your arteries all the way from your leg to your head, or administering one of thousands of drugs that has exactly the desired effect. It's easy to take it all for granted but the technology and systems in place to take care of us are amazing.
- XorNot 8y agoI have weirdly conflicted feelings when I see ambulances go by these days. Because part of me feels this sense of overwhelming pride watching that system work to save someone, people getting out of the way etc. But then I remember it's only happening because someone's in severe trouble in the first place so it's like "humanity is awesome...oh something not good is happening"
- tomclive 8y agoThat's put a smile on my face to see her looking well but ouch, that's quite a bill. I had a transnasal craniotomy (surgery through the nose) back in 2012 to remove a pituitary tumour. Not technically brain surgery, but they did need to cut a hole in my skull to get to it. I spent a week or so in ICU to recover. Luckily being UK based I didn't have a bill of any kind to pay afterwards and was paid in full while I recovered.
- sk_hazratali 8y agoWith most insurance I feel like you will hit your max out of pocket before you would hit that amount. Depending on your insurance plan you could be talking $3,000-$10,000 max you would have to spend. <a href="https://www.sherekhudahazratali.com/2015/07/khwaja-moinuddin-chishti-ra-quotes-in.html">khwaja https://www.sherekhudahazratali.com/2015/07/khwaja-moinuddin... moinuddin chishti quotes in hind</a>
- RRiccio 8y agoHaving gone through all of this recently with my little brother, I can definitely relate. Her account of the pre and post surgery are spot on, as well as the worries around this operation (will he survive? will his personality change? will the operation be a success? what will be the consequences?). And I'm glad she had insurance, even more so considering she lives in the US. In our case he had it too, but where we live the top neurosurgeons unfortunately don't accept it – you need to pay the operation yourself. It can be incredibly expensive as she mentioned. It's great to hear she's doing fine. I don't recall ever being so happy about the health situation of someone I didn't know 10 minutes before. What a beautiful video.
- sp332 8y agoEven if the surgeon doesn't deal with the insurance company directly, you should at least be able to submit the bill to them yourself?
- RRiccio 8y agoThe way it works in Brazil – maybe in other similar countries as well – is that insurance only covers specific doctors which have partnerships with the insurer. A common question when you're talking about a doctor or call his office is "which insurance plans does she accept?". Usually it's 2 or 3 plans, and thus you end up maintaining in your life a network of doctors that work with your specific insurance – so that whenever you have a problem you know where you can get treatment without spending extra. This creates a relationship where doctors get paid much less than they would normally charge (e.g. $20 for an insurance-paid appointment vs. $100 for a customer-paid appointment). But this way they end up receiving a steady number of clients from the insurer. And in most cases doctors have to accept this deal because they don't have enough demand on their own. Naturally, that's not the case for top neurosurgeons. They have way too much demand and can make only a few surgeries per week. So virtually none of the top ones agree to being "accredited". They make an order of magnitude more money by charging the customer directly. If you decide to use a "non-accredited" doctor you have to pay out of your own pocket. Typical insurers won't reimburse you in this case, and even the high end ones will give you back only up to 10 or 15%. They do cover for hospital expenses (room, nurses, meals, etc.), but these are a small fraction of the cost of brain surgery. There are some different insurance plans that will reimburse your customer-paid appointments/procedures, but – since the cost for these visits is way higher – these are plans that only multi-millionaires can afford.
- cwkoss 8y agoShe is so funny, I love the pun story with Dr. Reddy. Great human being, glad things went well for her.
- 67_45 8y agoThis video does not follow guidelines. I have been coming to hackernews for 6 years and I have never seen a bubble-gum pop YouTuber appear so close to the front page. Why was the Jake Paul apology video not posted? It has the same substance, ie it's emotional content that doesn't follow guidelines.
- xupybd 8y agoGlad to see she's doing alright. I played the brain tumour game a few years back. Healing can really take the wind out of your sails so I'm glad to see she still seems to have a lot of energy.