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If you have an extreme health care incident, why pay the bill? Sure it would hurt your credit score not to, but if it's between that and tens/hundreds of thousa
by crazynick4 8y ago
If you have an extreme health care incident, why pay the bill? Sure it would hurt your credit score not to, but if it's between that and tens/hundreds of thousands, I think it is worth it to take the hit for 7 years. I know health care workers who give this 'unofficial' advice to their patients and I've had friends and family members do the same thing - people who had no health insurance but still got health care and paid nothing for it.
- ASalazarMX 8y agoWould this, for example, for cancer? Refusing to pay your first treatment might make access to subsequent treatments harder.
- crazynick4 8y agoIs it legal for a doctor to refuse treatments that may cost you your life? I understand that an insurance company may refuse to insure you due to preexisting conditions (or at least they were able to at some point), but I think insurance is different from showing up at a hospital in the midst of a life or death situation.
- notfromhere 8y agoHospitals have a legal obligation to stabilize you in the U.S. So they'll treat your heart attack, but they're under no obligation to offer you free cancer treatment.
- PeterisP 8y agoIn general, yes. You don't refuse emergency procedures (i.e. you're going to die right here right now without it), but life-prolonging procedures (e.g. without this procedure you have a 50% chance to die within 4 months) are a different thing. And for diseases like cancer, if you show up when you're about to die, then there's nothing much can be done; they can put you in coma on life-support to eke out some more "life" but you can't cure it anymore. And it's worth noting that in medicine there's no fundamental boundary for 'may cost you your life', or if it is, the bar is very low. Taking an x-ray may cost you your life. Not taking an x-ray may cost you your life. Dentist's anaesthesia may cost you your life. Almost every noteworthy medical decision (including purely preventative things or running tests) has some life-or-death effect, there's only a difference in quantity, not a difference in kind. There are no life-saving procedures, there are only life-prolonging procedures. A widespread recommendation that patients meeting criteria X, Y and Z should do a particular diagnostic test will result in deaths of some people, and a widespread recommendation that they shouldn't will also result in deaths of some other people, and the main question is which number of deaths is larger. On a large scale, medicine is mainly a resource allocation problem - almost everyone could and would live longer if we allocated more care towards them personally or towards that condition, however, the "price/performance ratio" of such procedures is very, very different. There are things like stopping bleeding from trauma, which are very cheap and prolong your life by as many years as you'd otherwise live, and there are drugs and procedures with a six figure price that give an average survival benefit of a few weeks over much cheaper alternatives; and for most of people who'll die in hospitals today we could extend their life by at least one day with extra care; it's just that it's currently physically impossible to do everything for everyone, even if our economy consisted 100% of doctors and nurses caring for each other, because now we can (attempt to) do so much more. So there has to be a line drawn somewhere; some care will inevitably have to be refused to some people, and the only debate can be about the criteria - whether it's medical criteria (e.g. being refused to be considered for an organ transplant since you'll likely die soon anyway for other reasons, and that transplant can give much more years to someone else), or the ability to pay for certain procedures, or some other ways. On a large scale metrics like $/QALY (price for a quality-adjusted life year) make sense, but on small scale it's difficult to judge.
- y-c-o-m-b 8y agoHaving wages garnished doesn't sound like fun, but that's just me. Healthcare incident doesn't necessarily mean 100k hospital bill or something ridiculous. It can be as little as 10k (or much less) and still do a lot of financial damage to a person. Sounds like a bad idea.
- atomical 8y agoI think most of the time you can work with the hospital and possibly get the charge cut in half. Then pay monthly payments with zero interest. Has anyone done this?
- jandrese 8y agoGetting a $250k bill cut in half doesn't help so much when you used to make $40k/year before you lost your job because of the medical emergency.
- ksdale 8y agoOne of the hospitals we had a child at had income based repayment and it was a sliding scale all the way up to 100-something thousand dollars per year of income. At the lower end of the scale, they cut your bill to a small fraction of the original bill. I'm actually surprised this doesn't come up more in discussions about the cost of healthcare. We were actually uninsured when we had our first child right around the time the ACA came into existence, and my wife had an epidural so it was about as expensive as a birth could be without a C-Section, and after the income based adjustment the bill went from something like $30,000 to only a couple thousand dollars I believe and they also offered a 12 month interest free payment plan. It was definitely not a side of the industry that I had ever heard about.
- y-c-o-m-b 8y agoYes people do this all the time, but YMMV. I could be wrong, but I believe the hospital is not obligated to work with you. Depends on who you talk to, the type of procedure it was, your household income and more. You're making $70k/year supporting a family of 4 in a tech-hub like the Bay Area, but say you had an accident vacationing in Texas and now on the hook for $8k in hospital bills. Will the hospital look at your cost of living or will they see 70k and assume you should pay in full?
- jandrese 8y agoIt's not just the 7 years on your credit score, it's having collection agencies hound you incessantly. It's having people constantly trying to scam your bank to drain your account. It is legal threats against you, your family, your friends, your employer, etc... You're basically dropping you bloody name to a pool of sharks who have little respect for what is legal or ethical.
- sigfubar 8y agoWhat does it mean to be "hounded" by collection agencies? I've allowed some of my debts to go unpaid because I considered repayment to be a poor deal. Yes, I've received phone calls, which I answered and calmly informed the caller that (a) the conversation was being recorded; and (b) this was the last time they called me because I was invoking the FDCPA. I've never had to repeat this more than twice. Yes, I've received things in the mail, which I simply threw into paper recycling. Eventually, these stopped as well. A debt collector has yet to physically come to my home, however, having grown up in 1990s Russia, I'm prepared to take care of them in a swift, permanent, and legal way.
- beaconstudios 8y ago> I've allowed some of my debts to go unpaid because I considered repayment to be a poor deal. Could you elaborate on this? I don't know if it's what you intended but it just comes off like you defrauded a company.
- vkou 8y agoIf defaulting on a debt is fraud, then why do lenders charge a premium for credit risk? They do it because, in most cases, it is not fraud - defaults are just a fact of business. Being a lender is not a ticket to free, zero-risk money. Both parties in a lender/borrower transaction understand that there is a risk of default, as well as consequences for a default. In a secured loan, the borrower loses the secured item. In an unsecured loan, more of the risk falls to the lender (which is why unsecured loans have much higher interest rates.)
- headmelted 8y ago"take the hit for 7 years" This is the advice I've heard given to people who are severely underwater on a mortgage, but the idea that you can get sick one time and be financially ruined is still astonishing to me. I guess everywhere has some legislation that is just bonkers, though. I only just recently found out from a friend that you can't legally walk away from a mortgage here (UK) without declaring bankruptcy like you can in the States, which is bananas.
- gascan 8y agothe idea that you can get sick one time and be financially ruined is still astonishing to me. FWIW I'm not aware of many people who come down with a cold and are financially ruined. The people I know who are in crippling medical debt have, for example, had both kidneys replaced. While I'm not happy they are in those circumstances, it's not hard to picture two replacement kidneys and all the other treatments involved as mind-bendingly expensive. It seems worthwhile to distinguish, at least a little bit, severity when we are talking about this.
- headmelted 8y agoStill though (and correct me if I'm wrong), but if you get sick tomorrow with some ailment for which treatment is complex (and therefore expensive) AND you don't have insurance - your options are to find the money or go bankrupt? That's nuts in 2018 in a wealthy democracy.
- chimeracoder 8y ago> Still though (and correct me if I'm wrong), but if you get sick tomorrow with some ailment for which treatment is complex (and therefore expensive) AND you don't have insurance - your options are to find the money or go bankrupt? That's nuts in 2018 in a wealthy democracy. Treating complex conditions (like cancer) is exactly where the US excels, compared to other countries. Yes, it's expensive, but the alternative is, well, dying. Since the grandparent mentioned the UK specifically, I'll point out that the US has dramatically higher survival rates for treatable forms of cancer than the UK does. For prostate cancer - generally one of the most treatable forms of cancer, if treated properly - people in the US have over a 90% chance of survival[0]. The UK, on the other hand, has absolutely abysmal surival rates - second-worst of all OECD countries, and a mortality-to-incidence ratio that's almost twice what you see in the US. Yes, the US could do a better job at making that top-of-the-line care accessible to more people, but even then, the baseline care for complex treatments specifically is actually much higher than what the UK provides. [0] That's over the entire population, so it's including people who are uninsured and can't afford the most expensive treatments.
- roenxi 8y agoThe issue with that is that it represents a breakdown of property rights. I'd like, but don't know how, to find a less judgmental way of putting that point because from what I've heard the US healthcare system is unfair and unpleasent. That said - what you are describing is in a strictly literal sense theft. This quickly comes back to grandparent's point that the terms 'we' and 'survive' need to be more established. I can't imagine a single person who thinks that a situation that gives rise to advice like that is acceptable.
- deleted 8y ago[deleted]
- ThrustVectoring 8y agoHealthcare billing is too broken for me to endorse blindly paying things. Routine care, co-pays, planned procedures, sure, pay your goddamn bills. Get hit by a car, loaded into an ambulance, and stuck with a $15k bill that your insurance company refuses to pay because it's "out of network"? Tell them to pound sand, they have no right to extract your life savings in rents simply because they happened to be the hospital closest to the relevant ambulance. Yes, it's technically "theft", but the property right being violated has no business being granted in the first place.
- Nelson69 8y agoThis is slightly off topic, but I'll ask. I refinanced my house and as part of the process I get copies of the credit reports pulled. Anyone know why they last a lot longer than 7 years? It has all my mailing addresses for over 20 years. They asked me about a student loan I had paid off 10+ years prior. Is the "7 year" thing just a myth?
- yardie 8y agoIt can stay on there indefinitely but they can only use the last 7 years. They can ask about that 10+ year debt but you’re under no obligation to answer it.
- lostlogin 8y agoThis sounds like a socialised healcare system by stealth.
- ajross 8y ago> people who had no health insurance but still got health care This is a harmful myth. It's possible to get emergency care under pretty much any conditions. Everything else isn't available. You can use this trick if you got hit by a truck or had a big infection. It doesn't work to get a hip replacement, or chemo, or post-stroke occupational therapy, or a prosthetic, or a pacemaker, or... That stuff requires insurance. You need to stop telling your friends that fraud is the answer and start telling them to sign up for care.
- 01100011 8y agoMy ex mother in law was a lazy, morbidly obese dependent of the state who received well over a million USD in care during the last 10 years of her life. Even when her moron of a husband cancelled their insurance policy she still managed to spend months in the critical ICU section of UC Irvine while they cut out a bread loaf-sized section of necrotic flesh and rebuilt her intestinal tract. They didn't, and couldn't, pay anything. She received care, without insurance, for heart failure(including oxygen concentrator and tanks), a pulmonary embolism, and back pains(among other things which I can't fully recall and am actively trying to forget). I'm not saying it happens to everyone, but it does happen.
- kwoff 8y agoWhat is wrong with you? You're a horrible person.
- balt_s 8y agoThat's a pretty unfair moral judgment to throw out; considering that every use of resources involves at least an implicit tradeoff, I'll go ahead and risk damnatio by wondering aloud how many people in poor countries could be saved by the use of a fraction of this resource expenditure.
- dang 8y agoPlease don't add a personal attack to a nasty comment.
- paulie_a 8y agoLoan officers typically don't even take medical debt into account for mortgages.
- sigvirt 8y agoBeing potentially wiped out by a healthcare incident is not simply a matter of the looming bill. Your recommendation (i.e. to carry on by ignoring the bill) assumes the illness causes little disruption and the cure is complete. Many illnesses or injuries take much time to recover. Sometimes proper medical care cannot be obtained. Sometimes doctors don't want to take on a case, or even care to be honest. Others might withold a cure to generate recurring therapy revenue. Especially in the US, medical fraud and waste is monumental and the social safety net is insubstantial. These things will disintegrate a life more surely than a bill. Employers and creditors become impatient. Opportunistic predators circle about. If people are in debt, and without savings, then life circumstance unravels quickly at any non-trivial interruption.
- edelans 8y agohonesty ? respect ? integrity ? As someone who doesn't live une the US, maybe I can't figure the whole complexity of such a situation, be it really strikes me that people can recommend to fraud people that saved their life...
- watersb 8y agoEffectively, more like 10 years. Getting paperwork together took a while, medical bills arrive at odd times, often delay of six months. About 60 days for the actual bankruptcy to go through (the “Discharge Date”). Then another 60 days as the bankruptcy is recorded on the credit record. It says here that public records will be automatically dropped from my credit file after the appropriate interval. No action required. That would be 12 months from now. I wonder if that will actually happen. Note that bankruptcy shows on a credit report, so if you are applying for a job, or trying to rent a flat, you are going to be asked about it. And so on. I strongly advise against having a medical crisis. Stay normal as long as possible. Good luck.