4 ms·

I think if I get cancer I'm just going to have to die. I can't leave my wife destitute.

by chrisbennet 8y ago

ArrayList 8y ago
Can't she get a job?
- toomuchtodo 8y ago
  And spend the rest of her life paying back medical debts that she shouldn't have to? To me, this sounds like indentured servitude and not acceptable in a first world country.
  - henryfjordan 8y ago
    Divorce is an option. Legally divorce then cut a new will to leave 100% to the wife before you start your treatment. That way she's only out half at most if the medical debts take everything. You'd have to be careful to not treat any money or assets as communal but so long as you go through the motions there's not much anyone can do.
    - jakelazaroff 8y ago
      It's crazy that the U.S. healthcare system is so messed up that this is actually being made as a serious suggestion.
    - croon 8y ago
      That sounds like the sort of hacky solution I would be ashamed to ship, but would do if the project is systemically badly managed to the point where you can't expect the sources of problems to be fixed.
ams6110 8y ago
Here's the thing. Cancer comes in basically two types. That which is treatable, and that which isn't. This can be either because of the type of cancer, or based on how early/late it was detected. A lot of (possibly most of?) the money spent treating cancer is spent in cases that have very little chance for long term success. I don't think it really is, but it almost seems like a deliberate attempt to extract all the wealth from the patient before he dies.
- harshreality 8y ago
  It's not deliberate, but that's just how the incentives align. You have expensive treatments with outcomes not much better than control/placebo[1], but doctors and hospital administrators prefer to have nicer houses and drive better cars, so this is what you get. It's not their problem if patients pay tens or hundreds of thousands of dollars more, based on the hope of being in the small percentage of those who get good outcomes. Medical services are an inelastic good. If someone has a problem that's a serious threat to life or happiness, they will spend every penny they have and some they don't on the slightest chance to avoid it. Competition, for various reasons[2], doesn't work well. [1] In some cases where the intervention has slight mean/median benefit. In other cases, the outcomes are no better than control/placebo, even on average, but studies funded by drug companies or medical suppliers suggest that the intervention outcomes are better than controls, due to scientific mistakes or even intentional fraud (starting with bad experimental design, then cherry-picking data and cherry-picking studies). [2] Comparison shopping works well for choosing suppliers of standardized drugs and services, in non-emergencies, but even that's usually torpedoed by what your insurance will cover; If you have the luxury, you can compare various brands of drugs that have generic versions. You can comparison shop for prices for blood draws and scans (CT/MRI). Beyond simple things like that, the treatments are not identical so comparing costs is difficult. Also, patents. Nobody will raise the price of a drug 100% in a day, but companies build in fatter and fatter margins because they have a patent monopoly, and everyone else is doing it to. There is no price control through competition except where there are genuine equivalent goods. Since healthcare is largely price-inelastic, without strong competition on the supply side, you get runaway costs. This shouldn't be a surprise.
- jopsen 8y ago
  > A lot of (possibly most of?) the money spent treating cancer is spent in cases that have very little chance for long term success. Citation needed. But really, in this case shouldn't we ask if the 42% who loose their life savings had an easily curable cancer or not? It's the rich that spend most money, and they don't manager to spend everything.
- nowarninglabel 8y ago
  It'd be helpful to track down where the wealth goes. It seems to be broken down between the care provider, hospital, pharmaceutical companies and possibly the insurance company. Has anyone fully tracked down averages on where the money tends to go (possibly different for different types of cancer?)
Pica_soO 8y ago
Just repatriate to a country with a decent medical system.

I think if I get cancer I'm just going to have to die. I can't leave my wife destitute.

ArrayList 8y ago

Can't she get a job?

toomuchtodo 8y ago
And spend the rest of her life paying back medical debts that she shouldn't have to? To me, this sounds like indentured servitude and not acceptable in a first world country.
- henryfjordan 8y ago
  Divorce is an option. Legally divorce then cut a new will to leave 100% to the wife before you start your treatment. That way she's only out half at most if the medical debts take everything. You'd have to be careful to not treat any money or assets as communal but so long as you go through the motions there's not much anyone can do.
  - jakelazaroff 8y ago
    It's crazy that the U.S. healthcare system is so messed up that this is actually being made as a serious suggestion.
  - croon 8y ago
    That sounds like the sort of hacky solution I would be ashamed to ship, but would do if the project is systemically badly managed to the point where you can't expect the sources of problems to be fixed.

ams6110 8y ago

Here's the thing. Cancer comes in basically two types. That which is treatable, and that which isn't. This can be either because of the type of cancer, or based on how early/late it was detected. A lot of (possibly most of?) the money spent treating cancer is spent in cases that have very little chance for long term success. I don't think it really is, but it almost seems like a deliberate attempt to extract all the wealth from the patient before he dies.

harshreality 8y ago
It's not deliberate, but that's just how the incentives align. You have expensive treatments with outcomes not much better than control/placebo[1], but doctors and hospital administrators prefer to have nicer houses and drive better cars, so this is what you get. It's not their problem if patients pay tens or hundreds of thousands of dollars more, based on the hope of being in the small percentage of those who get good outcomes. Medical services are an inelastic good. If someone has a problem that's a serious threat to life or happiness, they will spend every penny they have and some they don't on the slightest chance to avoid it. Competition, for various reasons[2], doesn't work well. [1] In some cases where the intervention has slight mean/median benefit. In other cases, the outcomes are no better than control/placebo, even on average, but studies funded by drug companies or medical suppliers suggest that the intervention outcomes are better than controls, due to scientific mistakes or even intentional fraud (starting with bad experimental design, then cherry-picking data and cherry-picking studies). [2] Comparison shopping works well for choosing suppliers of standardized drugs and services, in non-emergencies, but even that's usually torpedoed by what your insurance will cover; If you have the luxury, you can compare various brands of drugs that have generic versions. You can comparison shop for prices for blood draws and scans (CT/MRI). Beyond simple things like that, the treatments are not identical so comparing costs is difficult. Also, patents. Nobody will raise the price of a drug 100% in a day, but companies build in fatter and fatter margins because they have a patent monopoly, and everyone else is doing it to. There is no price control through competition except where there are genuine equivalent goods. Since healthcare is largely price-inelastic, without strong competition on the supply side, you get runaway costs. This shouldn't be a surprise.
jopsen 8y ago
> A lot of (possibly most of?) the money spent treating cancer is spent in cases that have very little chance for long term success. Citation needed. But really, in this case shouldn't we ask if the 42% who loose their life savings had an easily curable cancer or not? It's the rich that spend most money, and they don't manager to spend everything.
nowarninglabel 8y ago
It'd be helpful to track down where the wealth goes. It seems to be broken down between the care provider, hospital, pharmaceutical companies and possibly the insurance company. Has anyone fully tracked down averages on where the money tends to go (possibly different for different types of cancer?)

Pica_soO 8y ago

Just repatriate to a country with a decent medical system.