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Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls
- erichurkman 8y agoI wonder what the downstream effects of this are on building generational wealth. 100 years ago, when your parents died, you might inherit a home or a small amount of money. That then helped uplift the next generation. Now, if your assets are drained, you have a reverse mortgage, etc, there's nothing to pass on except for the very wealthy. Cancer sucks.
- DanCarvajal 8y agoThis was definitely the case with my grandparents, but it wasn't even cancer it was just the long term cost of care for people who live well into their 90s.
- triplewipeass 8y agoWhen I was in my early 20s, I got myself a beefy life insurance policy that covers suicide after some waiting period that has expired many years ago. I know that in case of crippling illness I can always take the easy way out while preserving my assets plus the life insurance payout. My family would be taken care of.
- viburnum 8y agoThis a good solution that scales.
- phonon 8y agoUmmm...maybe buy Aflac instead (cancer insurance).
- komali2 8y ago>My family would be taken care of. And possibly traumatized that you killed yourself so they could have money.
- triplewipeass 8y agoIn case of being stricken by an incurable disease, I'm going to die anyway. I'm sure my people will understand my choice to make a graceful exit before illness takes away any shred of my dignity.
- smallgovt 8y agoIt's interesting to me that life insurance policies exist that cover suicide. I assume it means that people over-estimate their eventual willingness to commit suicide.
- bluetidepro 8y agoI didn't know this was a thing (life insurance policy that covers suicide), very interesting.
- lotsofpulp 8y agoMy plan in a situation that would burn up all of my assets for little guarantee of meaningful gains is to off myself to prevent using up my family's assets. I wouldn't want to sacrifice the future of the rest of my family to milk a couple more years, especially with reduced quality of life. Assuming I'm mentally strong enough to, anyway. Although, nowadays with mandatory out of pocket maximums, if you have insurance, this shouldn't be as widespread of a problem.
- komali2 8y ago>off myself to prevent using up my family's assets I'd give 90% of my income if it meant my friend that "offed herself" could still be alive. Decisions like that have consequences beyond you...
- lotsofpulp 8y agoI agree, and I think one consequence of using up my family's assets would be a decrease in the probability of my kids' having secure futures, which I wouldn't want either.
- h3daz 8y agoMoving to Switzerland, you'll be compelled by law to get health insurance and you will be covered no matter what for roughly 500 bucks a month with a 300$ deductible.
- rconti 8y agoI cannot even imagine the toll this would take. I have a very simple set of recurring claims against my healthcare provider that I'm handling myself (out of network, no problem, I thought). Due to job changes I had successfully had my charges reimbursed by my previous 2 insurance companies over the past year. The current one has taken 6 months to finally start reimbursing me -- and actually, they're almost caught up! Every goddamned time, the helpful phone persons sees the problem: "Your provider was entered as an XYZ type of provider instead of a ZYX provider, so it was being sent to the wrong unit. I'll re-enter him correctly, delete the old entry, and resubmit your claims marked as urgent. They should be processed within 7-10 days..." Very helpful staff. They seem to get it. They seem to figure it out. They seem to fix it. And it's never. fucking. fixed. And so you wait 7 days. You want 10 days. Still in process (if the horrible online system even allows you to login today). You wait 14 days, thinking maybe that was 10 BUSINESS days. Then you call back. Again, and it's the same thing. Over and over again. My reimbursements came totally out of sequence. The claim numbers don't match. The dates on the claim number don't match the dates on the EOB, they're paying me back for the wrong visits! But somehow, somewhere, on the backend, someone is reconciling it. Amazingly, the amounts are adding up. I think the processors are REALLY GOOD at not accidentally double-paying, so even though they're paying me for the wrong dates here, the next time they avoid double-paying, and find ANOTHER date to pay for (properly). It actually looks like it'll somehow all get paid back. Again, all one insurance company and one health care provider. And it's my insurance. And it's top tier private tech company employer PPO type stuff. My wife was in the hospital after a car crash. The first EOB I got for $200,000 saying "Denied", and that number didn't even include the surgery. I just laughed. It went to the wrong insurance, a simple call and it was sorted. But I can't fathom having less than perfect insurance (and I don't even know how to manage to maintain good insurance while having cancer and potentially being out of work and having a partner who might not be able to work while they're helping you), and having millions of dollars in bills, and having them come in from countless different providers.. sheer misery.
- OnACoffeeBreak 8y agoThis is a 2019 article covering a study that covers 2000 to 2012 and doesn't mention the Affordable Care Act signed into law in 2010. Insurance landscape has changed quite a bit in the USA since ACA, which makes this not very interesting. What I would be interested in is repeating the study now and comparing results.
- corbet 8y agoI would expect the results to be no different - the article was talking about people who already have insurance. I've been through the incredible medical-bill maze that results from cancer treatment since then; it's just the same. The ACA was explicitly designed to perpetuate the current insurance system, why would you expect the situation to have improved?
- lotsofpulp 8y agoBefore ACA, there were lifetime benefit limits. After ACA, there is no limit, so it will have greatly changed the situation that people facing years of very expensive treatment faced. Now, you are spending a max of $10k per year on in network providers, or whatever your annual out of pocket max is. Before the insurance company had the option of telling you that you've maxed out your benefits and you're on your own, and/or not offering health insurance coverage for you in the future period. The removal of lifetime benefits, ability to deny pre-existing conditions, and setting a maximum range between the lowest premium that can be offered and highest premium that can be offered greatly improved access to health insurance benefits for everyone. At the expense of making it more expensive for the young and healthy, but obviously someone has to pay, and we as a nation don't want it to be via taxes.
- cannonedhamster 8y agoI got cancer in 2018. Very little has changed. It's still very expensive.
- moviuro 8y agoGDPR-friendly: https://text.npr.org/s.php?sId=696321475 https://text.npr.org/s.php?sId=696321475
- _Microft 8y agoThanks!
- davidscolgan 8y agoThis is honestly one of the things that most stresses me out as I get older. I don't use my insurance much now because I'm pretty healthy, but I know my cancer risk will just go up over time. I've considered that if something like this ever did happen, I'd move to Lithuania and do it there paying in cash over trying to do it in the US system. Universal health care can't come fast enough.
- creaghpatr 8y agoWhen you get old you presumably qualify for Medicare.
- komali2 8y agoWhy not just make it so that you always qualify for Medicare?
- creaghpatr 8y agoBecause it would go bankrupt and then no one would get Medicare.
- emddudley 8y agoA lot can happen before age 65, and cancer doesn't wait!
- maerF0x0 8y ago
- vamos_davai 8y agoIt's such an absurd expense that I wonder if I get diagnosed with cancer, I would just deny treatment, accept death, and hand my assets to loved ones. Not sure if anyone else thinks the same way.
- Filligree 8y agoA lot of cancers have good a prognosis, especially if diagnosed early. Would you still do so if your chance of long-term survival and full remission, with treatment, is 50% or higher?
- pacala 8y agoProblem is, the treatment provider offers no hard guarantees: full remission or your money back. The claimed success rates could be based on research studies, which have a reputation to be systemically flawed. > Over a 10-year stretch, he said, Amgen’s scientists had tried to replicate the findings of 53 “landmark” studies in cancer biology. Just six of them came up with positive results. https://slate.com/technology/2016/04/biomedicine-facing-a-worse-replication-crisis-than-the-one-plaguing-psychology.html https://slate.com/technology/2016/04/biomedicine-facing-a-wo...
- vamos_davai 8y agoI think it depends on cost. Maybe if the cost is 5x my yearly income, then it's probably not worth it for me to continue going on.
- leaveyou 8y agoI'm not even in US and I'm considering the same.. if the expenses go above some reasonable threshold, I don't see the point of me living enough to see my family dragged into poverty. I don't delude myself - it's not easy to do.
- InitialLastName 8y agoPart of the problem is that, especially with an illness with as complicated a treatment process as many cancers, there's no way to even estimate the expenses. Even once you get treatment, the expenses might not be accessible until the bill comes in and you find out what your insurance company will pay for. After that, there's a sunk cost issue: once you've dropped (N*your current net worth) on treatment, what's the harm in continuing?
- ucaetano 8y agoMore than 42% of 9.5M people with cancer drained life's assets within 2 years in the US.
- porphyrogene 8y agoThe publication is NPR so that it is US news goes somewhat without saying. However, this is something that Americans need to understand is exceptional for a nation of its resources.
- mbostleman 8y agoSo what is the solution? More than 42% went all in with the constraint being their personal assets. If that constraint was lifted, then what would the next constraint be? Obviously the additional assets would come from other people, and probably not voluntarily (which is a different issue), but what would be the limiting factor then? Also, I assume the new pool of assets would be available not just to the 42% that were willing to put all of their own in but to the remaining 58% as well. The US may be a nation of relatively high resources, but they aren't infinite. What do the rules look like for this in other nations?
- shereadsthenews 8y agoHow about if we have a single entity who pays doctors and hospitals fair and reasonable rates, we fire hundreds of thousands of bureaucrats we don't need, and we fund it all out of general revenues, saving roughly 2 trillion dollars per year, while at the same time improving life expectancy and other health outcomes?
- news_to_me 8y agoSocialist!! /s
- mbostleman 8y agoFor sure, there's all kinds of ways to make money go further. But there still has to be a rule for a constraint.
- crimsonalucard 8y agoThis makes me so angry at doctors.
- jonlucc 8y agoWhy at the doctors specifically?
- crimsonalucard 8y agoThey hoard Monopolized knowledge that can likely be known by a cancer technician. Then they charge a premium for it. The therapy, doctor visits and all that come from them and they charge that much because you're dying and you need access to their monopolized knowledge. Reduce 12 years of training to 4 years and lower the selection criteria of students entering a specialty and I'll show you an economy where doctors are not in always stressed out and paid fairly. Grades never correlate with how good a doctor is, so why are we filtering the supply of doctors based off of that criteria. It's insane. We need more software engineers so we bootcamp it. We need more cancer specialists we should lower the selection criteria and train specialists without the overhead of 12 years of training where the majority of that training is irrelevant and used to only filter and reduce the supply of doctors. Then they hide behind the bureaucracy as if they aren't in control. I know I'm in good hands because said doctor knows organic chemistry and had a high enough GPA to get into medschool.
- maire 8y agoMalpractice insurance takes a surprising % of doctor's income. Delivering babies is particularly expensive. It reached the point that the doctor that delivered my babies no longer carries malpractice insurance.
- elliekelly 8y agoDid he proactively disclose that to you or did it just come up in conversation? Attorneys in many states aren't required to have malpractice insurance but must disclose to clients if their malpractice insurance doesn't meet some minimum standard. Edit to add that I also suspect the health insurance companies are a big part of driving up the malpractice insurance costs. For example, if there's some sort of error in a routine surgery where the patient is left permanently disabled the patient won't necessarily be the one suing the doctor but the insurance company might go after the doctor's malpractice insurance to "soften the blow" of the additional cost of caring for/insuring the patient.
- this_user 8y agoIn the US.
- RIMR 8y agoI hate to be political, but anyone who looks at these numbers, and believe that the system is working properly as intended is absolutely an enemy of American Prosperity.
- lghh 8y agoI would argue that the system is working as intended, it's just not to your or my or most other people's benefit.
- FilterSweep 8y agoI would say both your comments are true.
- zawerf 8y agoI think that's just a corollary of "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/#14c251a34e0d https://www.forbes.com/sites/maggiemcgrath/2016/01/06/63-of-... EDIT: My comment is in reference to the old thread title, which was something like "More than 42 percent of the 9.5 million people diagnosed with cancer from 2000 to 2012 drained their life's assets within two years"
- tashoecraft 8y agoThat was my initial thought, and it's definitely related, but the term used here is assets which people generally have a lot more of then just raw cash savings.
- vonmoltke 8y agoThe abstract to the paywalled study cites the average expenditure being about $92k per person in the study. While it is still ridiculous that people should have to pay that much to fight off an illness, that is a disturbingly low value for an "entire life's assets", particularly considering the study was restricted to people who are 50 or older (with an average age of 68.6).
- lojack 8y agoNone of the surveys linked in this article go over age distribution of savings -- something I'd expect to be inversely proportional to incidences of cancer.
- lenticular 8y agoEven with insurance, folks often wind up with six figures of bills out of pocket treating cancer. That's a huge amount for the even most frugal of the lower or middle class.
- zxcvbn4038 8y agoWhen my son was born he fit in my hand and spent his first three months in NICU. I guess the nurses thought his survival was questionable so they entered in his name into the computer as “Baby Boy”. A few months later I started getting bills (eventually around $3 million) because there was nobody named “Baby Boy” on my insurance. Calling the insurance to try and correct was a nightmare - wait on hold for an hour, get 3rd degree interrogation about my identity, wait on hold, explain that son was on insurance but not called literally “Baby Boy”, wait on hold, get interrogated for his details on son’s identity, wait on hold, long series of questions to determine Baby Boy isn’t real and let me know about penalties for fraud. Three hours later done, that covers the first $50. Decided I would never do that again, let it go to collections and explain it to the judge. Turns out that before it goes to collections it goes to someone with a brain who realizes “Baby Boy” is in-fact the infant boy with identical birth date on my policy, notices stop coming. No telling how much money they spent sending me all the nasty payment due letters in the mean time.
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- deisner 8y ago"But none of these is her most gnawing, ever present concern. That would be the convoluted medical bills that fill multiple binders, depleted savings accounts that destroy early retirement plans and so, so many phone calls with insurers and medical providers." Is it like this in other OECD countries? I ask because I'm told that we in America have "the best health care system in the world."
- lotsofpulp 8y agoNo, my family in Canada and UK don't deal with any of this. In the US, it's not even worth your time figuring out how much your treatment will cost, other than whether or not the provider is in network or not. Assume it's the out of pocket maximum for your insurance, because when you go to a provider, you sign a blank check that says you will be responsible for whatever chargers they make up during the course of your treatment. So your only ally is the insurance company, who has the power to deny payment for things like $15 worth of linens (which was actually a few pieces of paper towel).
- shereadsthenews 8y agoYou can't figure out whether your provider is in or out. Just yesterday I got a bill from someone I've never heard of who turns out to be a "Medication Safety Specialist" who allegedly rendered services to me worth $392. You'd think such a person would just be a functionary of the hospital who in any case bill me $27k every day, but actually they are some kind of mercenary who bill patients directly.
- lotsofpulp 8y agoYes, it's crazy how difficult these little things are. During birth, should one stand outside their wife's delivery room and ask each provider to wait outside while you look up if they are in network or not on your insurance company's app? At least we have apps to do that nowadays.
- shereadsthenews 8y ago
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- BucketSort 8y agoAt what point do we become so outraged that people are being killed for profit that we actually change things? Our culture is so obscene. We need to change our attitude on egregious wealth from admiration to disgust. When you see a mansion, you should see the trampling of lives for exorbitant luxury; when you see a million dollar car, you should see children going hungry; but what you really see is something you can be someday, that you may one day be that big shot everyone admires, you don't see the suffering this culture brings. And in the end, it robs you from what is important and good in life: loving others. So this greed is not only destructive to the world, it is also destructive to your experience of life.
- Miner49er 8y agoVery unfortunate this is being downvoted. It's simply true. Lots of resources and time are wasted on pointless things. If we organised our society better we could end so much suffering and have more time for the things that really matter in life.
- BucketSort 8y agoIt's because my negative tone. And I'm sorry for my tone. It's just that every day I see us slipping further and further into becoming a completely corrupt country without any humanitarian values. In the end, I love everyone just the same, I'm just so disappointed in what we are allowing ourselves to become.
- cletus 8y agoIn Australia the Leftist government of Gough Whitlam introduced health-coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple of governments, Bob Hawke's Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day. The most interesting stat I ever heard about Medicare was this: prior to Medicare the number one cause of personal bankruptcy in Australia was medical bills. So I'm with Bernie on this: health coverage for all is an incredibly important goal. While we're at it, let's end the monopoly given to drug companies on the sale of pharmaceuticals in the US. You should be able to legally import them from, at the very least, any NAFTA country and any EU member.
- chaosbutters 8y agodoesn't matter who is president in 2020, if the senate isn't blue. And right now, it doesn't look like the senate will even hit 50/50.
- metalliqaz 8y agoThe political system in the US biases area over population. The Senate will remain conservative as long as rural states remain conservative, and that will never change.
- rootusrootus 8y agoI'm not sure I'd bet on that. Cities are almost universally liberal, and even rural states start to turn blue as they get their own big cities.
- cannonedhamster 8y agoUnfortunately without proportional voting being mandated purple states like Texas remain solidly red due to vast gerrymandering purposefully made to deny people the right to their representation by diluting their vote. This is actually the main cause of polarization in the US as candidates need to play to their base instead of moderating to play to a moderate base.
- shereadsthenews 8y agoI'd like to know where the patient with the $870 MRI bill was seen. My last MRI was billed at over $7500. Before I started treatment for my brain tumor I got divorced for purely financial reasons and gave all my remaining money to my children. USA is so fucked.
- Marsymars 8y agoWe've got private MRI clinics in Canada, and Googling prices for my city gives a number of clinics with prices in the 700 CAD range.
- nradov 8y agoFor non-emergency imaging studies it's worth shopping around. Prices really can vary by a factor of 10× between facilities in the same area. For those with private insurance, most major insurance companies offer some sort of cost estimator on their web sites which allow members to see which radiology centers are cheaper. (I do appreciate that this is a bad experience for patients.)
- rarecoil 8y agoI needed an MRI a few years ago, and my insurance provider actually called me to tell me about insurance-preferred imaging centers, and how much the out-of-pocket cost would be at those centers vs. the one my MRI was initially scheduled at.
- nradov 8y agoYes some payers will check the stream of incoming X12 278 Prior Authorization messages for expensive procedures and then attempt to steer members toward lower cost options. This helps to hold down costs for the healthcare system as a whole.
- madengr 8y agoOther than cash, how do you give money over $15k without being nailed by the gift tax? Keeping as much money in retirement savings seems wise as those are exempt from liens.
- pastor_elm 8y agoI remember the radiolab episode on worth[0]. Is another month of life with cancer worth x amount of dollars? Who should pay 100k for a medication that might let you live a month longer with pancreatic cancer. I imagine most Americans don't look at it that way. [0]https://www.wnycstudios.org/story/worth https://www.wnycstudios.org/story/worth
- kevmo 8y agoI published a piece on debt in America last week and touched in the subject of medical debt. When you look at it from a broader perspective, most Americans are in a financially dire situation. 42% sounds lower than I would have expected. Americans are Drowning in Debt: https://thenib.com/americans-are-drowning-in-debt https://thenib.com/americans-are-drowning-in-debt
- cpursley 8y agoYep, paying off my debt (except mortgage, which is affordable and only 15-year term) has been the most liberating thing I've done. Learning to live below my means was difficult (still is), but absolutely worth it.
- cabaalis 8y ago57% of Americans cant handle a surprise bill of $500 without going into debt. [1] I don't doubt cancer is probably the most expensive hit that we have a good chance of receiving, but I'd be inclined to point to the lack of "life's assets" being fluid as the first problem to tackle. [1] https://www.cbsnews.com/news/most-americans-cant-afford-a-500-emergency-expense/ https://www.cbsnews.com/news/most-americans-cant-afford-a-50...
- BucketSort 8y agoIt's amazing that you got down voted so much. Do people not like facing reality or something?
- DigiMortal 8y agoOur healthcare system is wildly inefficient. A major overhaul would need to take place --- for me, as long as biotech and pharma innovation/production is not negatively affected (because I actually want to cure cancer) then I'm all for hearing options.
- duxup 8y ago>Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls Hell that's just insurance in America... if you just use it. I've been dealing with a bill where the insurance company decided that my kid's pediatrician was out of network all of a sudden. All the other visits to the same pediatrician have been covered, but they can't seem to fix this one bill.... There's no incentive for the company to be helpful as what am I going to do? Change insurance companies? That's not my choice.
- ThrustVectoring 8y agoFile a regulatory complaint. Boom, now they have incentive to fix things.
- xkcd-sucks 8y agoA cynical viewpoint might add that if the patient has a terminal illness, and if they are overcharged, then the process can be dragged out past the patient's lifespan and their estate just might not get around to it.
- duxup 8y agoI think they just expect I'll get tired of it and pay.
- smallgovt 8y agoI’m confused. If you have medical insurance, shouldn’t you only pay up to your deductible? Is this saying people’s life assets don’t cover the deductible? Or, people are uninsured?
- josefresco 8y agoFrom the article: "Their high-deductible insurance policy meant they had to spend $6,000 before their insurance started covering her treatment expenses. They hit their annual out-of-pocket maximum of $10,000 well before the year was over." Even with a lower deductible, many plans have annual and lifetime limits.
- smallgovt 8y agoOk, so basically the article says most ppl don’t have 20k in savings?
- komali2 8y agoThe deductible might be huge, and there's also this magic new thing I've just discovered (or United invented out of nowhere) called "co-insurance" and "maximum out of pocket" which I call "deductible #2." Then when you actually try to use the insurance you pay monthly for (but don't get to use until you reach the deductible #1 and #2?) they may just send the bill to you with a lot of legalese that amounts to "we don't cover this, or we do but we have better lawyers, get fucked peasant." Luckily the debt collection industry is incompetent so all you gotta do is keep replying with "please mail proof of debt" and you're golden!
- lotsofpulp 8y agoAll of the terms you listed are easily understandable concepts clearly explained on healthcare.gov or any health insurance company's website, and they've been a thing for decades. How much clearer can maximum out of pocket be? Edit: I do think in network and out of network should be easier/faster to figure out though.
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- tehlike 8y agoI have good healthcare through employer, but god forbid - i have no idea what'd happen even with the insurance. Unexpected health problems are the only reasons i'd go back to my home country to get treatment. US healthcare is nuts.
- rayiner 8y agoThis came up last year when it was discovered that Leon Lederman had to sell his Nobel Prize to pay for cancer treatments. But there is more moral complexity to this issue than people appreciate. Cancer treatment is inherently expensive; it just doesn't seem that way in some other countries because the government pays from the outset. But I don't think that's necessarily moral, compared to something like Medicaid, which requires people to spend down their assets first before the government will pay. The median net worth for someone between 65-74 is $225,000. Why should the government spend tax dollars to protect those savings for people unfortunate enough to get cancer, when there are many people unfortunate enough to never enter the middle class and be in a position to save that kind of money in the first place? Isn't it unfair to spend tax dollars protecting the inheritance of an upper-middle-class kid when that money could be given to a kid that never had a hope of an inheritance? Put differently, there is a huge moral difference between the government ensuring that everyone can get cancer treatment, and the government intervening to protect the financial and social status of people fortunate enough to have significant assets.
- justwalt 8y agoI would think the average person would feel slimy/predatory buying someone else’s Nobel prize. Unless it’s the case of a friend offering to help out, but then why not just lend the money without the collateral?
- AnIdiotOnTheNet 8y agoCould have been a museum or something.
- sangnoir 8y agoMaybe it was a pharma exec?
- whack 8y ago> "Their high-deductible insurance policy meant they had to spend $6,000 before their insurance started covering her treatment expenses. They hit their annual out-of-pocket maximum of $10,000 well before the year was over." The article mentions a variety of causes but I'm having a hard time figuring out which ones are most important. In the example above with a $10k out-of-pocket maximum, how much money did these patients actually end up paying? Is that the main reason for their bankruptcy, or is it their loss of income? Does disability insurance cover things like cancer, and if not, are there similar programs that do?
- mruts 8y agoThis is unfortunate, but what do you want to do, have the government pay for it? Maybe there are a lot of people with cancer who will get better and live for X number of years. But many people are going to die in a year or two and we would just end up spending millions of dollars on them, essentially wasting the government's money. How much money would you spend to increase someone's life by a minute, an hour, a day, a month, etc? And if there was a maximum amount the government was willing to pay, then people would just be talking about how the government is deciding the price of life. Maybe you could devise a fair system in which every individual has a certain dollar amount allocated to all the healthcare in their life, and then if they go over that, they would have to pay it themselves. But I think people would be upset about that as well. At the end of the day, every system we create (bridges, power plants, cars, etc) is implicitly or explicitly deciding the price of a human life. People are uncomfortable with that idea, so they try to think of things in different terms. Our healthcare system is broken, but not for the reason people think. It's broken because it's this public-private Frankenstein monster of rent-seeking, self-dealing, and corruption. It was terrible to begin with, but Obamacare made it so much worse. The system has become so complex that the government can't properly model or anticipate how legislation would affect the long-term stability of the system. Over the years, the government has legislated bug fixes over bug fixes, patches over patches. What needs to be done is replace this horrible and inefficient beast with a completely free market system. Just get rid of all of the laws and start anew. I guarantee you that the free market would be able to offer reasonably priced insurance plans that would service a variety of needs. The solution isn't free healthcare for everyone. The US government does not have the money to even begin to do something like that.
- asark 8y agoWhat do other wealthy states with populations who generally prefer their healthcare system to one like ours (the US) do? That'd be a good place to start looking. Plenty of examples. Like, all of them, pretty much. > The solution isn't free healthcare for everyone. I mean....
- mruts 8y agoit’s not a coincidence that the US is much wealthier and home to much more innovation than socialist European countries. Clearly our system is bad, but there are multiple ways to skin a cat.
- grecy 8y agoIt always seems any American that is against Universal Healthcare quickly changes their tune as soon as they or their loved ones are hit with bankruptingly large bills for things they have no control over. What a shame they can't see outsides themselves and realize they're only an inch away from financial ruin.
- mrhappyunhappy 8y agoThat’s how it is in other aspects too: unemployed? Must be lazy. Homeless? Must be mentally I’ll or a druggy. Lost the houses? Must have been living paycheck to paycheck. People are quick to judge others until that thing happens to them and all of a sudden the tune changes.
- pulse7 8y agoMaybe it will not be easy to read this: In this particular case the US can learn something from past socialist regimes - or from Germany and many other western countries, which already learned, that OBLIGATORY state medical insurance solves such issues. It is not the ideal solution, but the best compromise available. Who would like to get cancer and fight with private insurance company while being ill?
- Asooka 8y ago> past socialist regimes Ok, I agree with the spirit of your post, but don't ever hold up the USSR or Venezuela or any of the others. It's obvious you don't know how shit actually worked back then, so let me tell you. It was a prime example of an underfunded system that was forced to meet bullshit metrics and shit was falling apart. If you wanted treatment for anything more major than the flu you basically had to bribe the doctors. Otherwise you could e.g. go to the ER bleeding out, be left to bleed out and just be written off as "well he died outside the operating room, nothing we could do guv'nor, metric for people surviving the OR = met". Mixups were constant, corruption was rampant and the doctors who were in this mess were all day-drinking to cope with it. To this day government healthcare back home is underfunded and oversubscribed and you need to pass doctors bribes to get priority treatment. Or you can go to a private clinic that openly just takes money on top of your standard insurance, thank god. Previous socialist regimes are what NOT to do when you're implementing government services. Look at what they did and do the opposite.
- Sahhaese 8y agoWell I can't speak for all countries, but here in the UK I haven't paid a penny toward my cancer treatments. I also kept my job despite being off work for nearly a year going through chemo, and I even got sick pay for all of that time. (Not at full wage, but still a very generous proportion of it). Post-treatment I went back to my same workplace, doing the same job, and found out that I had even acrued annual leave at full rate during the 9 months I was off sick, so had 25 "extra" vacation days that I wasn't expecting. Yes, this is more than the legal baseline, but even the legal baseline would let me keep my job, acrue leave, get some sick pay (although the statuatory sick pay isn't huge), but most importantly, have completely free treatment, so I wasn't spending the little energy I had worrying about medical bills or insurance.
- g3houdini 8y agoThis same issue exists for autoimmune disease as well as many other diseases. My understanding is that the hospitals were going to post the costs for treatments and make the process more transparent. Has this happened?
- js2 8y agoRecent discussion on “U.S. Health Care Spending Highest Among Developed Countries” (50 days ago, 698 points, 522 comments): https://news.ycombinator.com/item?id=18851823 https://news.ycombinator.com/item?id=18851823 Opinion – “A Better Path to Universal Health Care: The United States should look to Germany, not Canada, for the best model.”: https://www.nytimes.com/2019/02/20/opinion/health-care-germany.html https://www.nytimes.com/2019/02/20/opinion/health-care-germa... Decade old Frontline episode – “Sick Around The World: Five Capitalist Democracies and How They Do It”: https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ What I don’t know is how we get from here to there. The health insurance companies are already gearing up to fight MFA – “Health Care and Insurance Industries Mobilize to Kill ‘Medicare for All’”: https://www.nytimes.com/2019/02/23/us/politics/medicare-for-all-lobbyists.html https://www.nytimes.com/2019/02/23/us/politics/medicare-for-...
- wpdev_63 8y agoHas anyone tried flying to another country for more affordable treatment after the diagnosis? Countries like Germany and some south american countries have much more affordable treatment even factoring in the lodging and flying.
- justin66 8y agoHaving to fly to receive treatment seems like it might significantly affect the likelihood of a full recovery. Cancer patients tend to have compromised immune systems and airplanes are filthy.
- cannonedhamster 8y agoAs a cancer patient, wear a mask. I travel for work all the time, even right after chemo. I'm not older, which makes for a stronger immune system in the first place, but planes just require hand sanitizer and a face mask. The real problem would be you would have to be able to pay out of pocket for lodging, translation services, treatment, etc. and in most cases overall survival is better in the US for late stage cancer.
- 01100011 8y agoIt's not just the billing that sucks. It's also the care, or lack thereof, in the health care system. I remember taking my friend to a Dr. visit when he had a brain tumor. The parking was confusing, with signs threatening fines of hundreds of dollars for parking anywhere near the building(this was at UCSD in La Jolla). This was at a cancer center, where you'd expect they'd prioritize access for patients. He went in for an eye exam, and the doctor was getting extremely agitated because my friend had problems communicating and performing a few tasks as quickly as the doctor wanted. Very few people in the hospitals seemed equipped to handle someone who had problems seeing, walking and communicating.
- SQL2219 8y agoAt some point a lot of us will have to make the decision if we want to go through this type of nightmare, physically and financially. When do you say, I've had a good run, time to not participate in these horrendous medical systems.
- vinceguidry 8y agoCanadian version of Breaking Bad: "You have cancer. Treatment starts next week." The end.
- karakot 8y agoA real Canadian version is the following: - You've got a backpain? Here is your ibuprofen peal. - But I have very severe back pain. - Here is your bigger ibuprofen peal, come back in 6 month to see the specialist. 6 month later in US: - Congratulations, you've got cancer. 3 years and more than $1M in bills later: - This is the end.
- cwkoss 8y agoIt would be cool if you could sue for emotional damages and timecost of resolving the issue when someone fraudulently bills you.