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Is there an equivalent of a 'do not resuscitate' tattoo or something you can get that's along the lines of 'do not perform for-pay medical care on me'? If I we

Is there an equivalent of a 'do not resuscitate' tattoo or something you can get that's along the lines of 'do not perform for-pay medical care on me'? If I were in the US, travelling, I'd only want immediate life saving treatment (a heart attack, say) to take effect unless I was absolutely sure of the precise cost of what I was submitting myself for. It baffles me that you can be billed unknown amounts for this. I don't do _anything_ without knowing roughly how much it costs. My rent? Known before signing. Utilities? Rates are published, there's a meter on the wall. Supermarket? Prices are right there. Taxi? Has a meter, or it's fixed price private hire. The only example I can come up with right now where prices aren't generally known before the fact is the pub. If you serve me a pint and claim it costs 15 quid rather than the expected ~5, you better believe that you're pouring that down the sink. I drove by a road toll today in Norway that cost $1. I'm given enough time to turn around and decide not to use that road. Yet Americans are getting slammed for multiple years' income whilst they're essentially unconscious? Absolute madness.

duxup 7y ago
>do not perform for-pay medical care on me It would be impossible as even doctors and hospital staff straight up don't know what is covered and what isn't from person to person with much confidence....let alone the actual pricing.
- esotericn 7y ago
  In that case then, my desired tattoo is essentially "resuscitate, that's it, I'll work the rest out myself"? Heh.
  - coldtea 7y ago
    As if they can't slap 2-3 procedures costing several grand during the resuscitating process and say they were "essential" when they were not required at all? Good like proving otherwise...
geitir 7y ago
Even with tattoos they will generally resuscitate you unless they can find signed papers
- kranner 7y ago
  Startup idea: QR code tattoo service that hosts a DNR that the tattooee has digitally signed.
  - wwweston 7y ago
    If this is a joke, it's bitingly funny. If not... why are we brainstorming ideas for an auxiliary medical information business whose apparent business model would involve fee for service to prevent beneficial-if-expensive medical interventions? That's arguably a step down from ideas to get people to click on ads. It really seems smart people out to be able to enjoy working on the hard problems of brainstorming contributions to a medical system in which effective providers are reasonably trained and rewarded, insurance risks are effectively pooled and managed, and access to care doesn't carry a risk of bankruptcy.
    - kranner 7y ago
      It really was just a joke. I agree that healthcare, esp emergency healthcare, should not bankrupt people. (But in the meantime, for only $9.99 a year...)
    - blaser-waffle 7y ago
      > auxiliary medical information business whose apparent business model would involve fee for service to prevent beneficial-if-expensive medical interventions I think you just described medical insurance
  - paranoidrobot 7y ago
    Why would a digital signature trump actual-indellible-ink-on-skin as evidence of my wishes?
lr4444lr 7y ago
This has been tried in court. The general ruling is that emergency medical care has the right to reasonably assume, absent some health care proxy to the contrary, that you wish to be resuscitated and accept all good faith care administered to this effect.
ThrustVectoring 7y ago
> Is there an equivalent of a 'do not resuscitate' tattoo or something you can get that's along the lines of 'do not perform for-pay medical care on me'? You can set yourself up to be judgment-proof, and hospitals can perform all the unwanted care they want to on you and they'll be able to collect basically $0. It's easier than it seems - move to Texas, leave all the assets in retirement accounts that you can, and plow all your liquid wealth into your primary residence.
- esotericn 7y ago
  How does that work if you're like, a working adult, with an income, not in retirement, though? If I go on holiday to the US, and for whatever reason through some minor flaw in my travel insurance (or just not having it; I imagine millions of people fly there without it each year) I'm not covered, it sounds like a person could easily rack up tens of thousands without realising if they weren't aware of this sort of thing.
  - deleted 7y ago
    [deleted]
  - chatmasta 7y ago
    If you’re not from the US, it would also be far easier for you to simply default on your debt. Actually I’m curious how medical debt is even enforced for non-citizens. Related, I have completely separate credit scores in the UK (resident) and US (citizen). I’m sure the bureaus would like to change that, but there is no system that lets them know I’m the same person.
    - aksss 7y ago
      I have a good friend that did that. Was a legal resident, accumulated tens of thousands in medical bills due to emergency services coming out of an elective surgery. He just moved back home (out of country). He’s not been pursued. They called his domestic residence multiple times but after being told he left the country and nobody knows where, they stopped.
    - 7y ago
eanzenberg 7y ago
I know this will get downvoted to oblivion, but these stories are just anecdotal. Thousands of people utilize medical care in the USA without much fanfare.
- kranner 7y ago
  I wouldn't shove even the odd catastrophic error under 'just anecdotal'.
- contravariant 7y ago
  Thousands seems a bit low... Besides even if 0.1% goes disastrously wrong financially then that's still a lot of people.
- JadeNB 7y ago
  It should get downvoted; it's heartless. Given the hundreds of millions of people in the US, the fact that thousands, or even millions, of people successfully seek medical care doesn't demonstrate much. One or two people whose lives are ruined by rent-seeking in a life-or-death matter is too many (I think one wouldn't ignore several cases of food poisoning at a restaurant and respond that hundreds had eaten there without incident); I suspect that the actual number of people affected by this sort of catastrophe is at least in the thousands. Unless you're one of the people affected (and probably not even then), you have no right to dismiss the suffering of those who have been.
- Ididntdothis 7y ago
  One of the “pleasures” of working in a cube farm is that you get to overhear a lot phone calls. I hear a lot of people spending hours and hours arguing with providers and insurance over billing mistakes. Based on this I believe it’s pretty common. My girlfriend got hit with a $300000 bill after a surgery. It was a mistake (several actually) but it took her almost a year and literally 100s of phone calls to clear this.
- cletus 7y ago
  Only a minority of people get murdered too. Most people walk around alive and happy. In Australia, the number one reason for personal bankruptcy prior to the Hawke Labor government introducing Medicare in the 1980s was unexpected medical expenses [1]. insurance is the USA is largely tied to having a job. You can buy your own insurance but it's terrible in comparison to better employment-based health insurance and the reason for that is exactly why we need a public safety net. Company insurance plans a) form a group and b) have negotiating power with insurance companies. The first part is really important. Being diagnosed with diabetes and then having diabetes-related medical expenses be excluded from personal insurance as a pre-existing condition is Bad. Really Bad. The only way insurance works is if you consider the total expenses of a sufficiently large group of people. Companies, unions and government organizations are the only way to get this in the US. [1] https://www.abc.net.au/news/2019-05-18/bob-hawke-what-did-australia-have-before-medicare/11124180 https://www.abc.net.au/news/2019-05-18/bob-hawke-what-did-au...
empath75 7y ago
I had two insurance companies and both times I had kids, they hit us with $10k bills a year after the birth because they couldn’t sort out insurance. I had to threaten to sue them twice to stop them from trying to collect on their idiotic fuckups.
contravariant 7y ago
Yep, all the things you mention are effectively contracts (in the broad sense) where both parties commit to previously agreed upon terms. It's for this reason that most countries have some kind of mandatory insurance against emergency medical treatment where the person being treated basically has no choice (even if they're conscious) and is thus incapable of forming a valid contract. You're right that in this scenario it's weird to expect someone to still pay for their treatment, but if you can't force people to be fully insured against such costs you need to force them to pay for costs they couldn't freely consent to.
- esotericn 7y ago
  I suppose there's probably an equivalent scenario if a non-EU visitor falls ill in the UK. Or if a UK citizen drives a car with (unknown to them) invalid insurance and destroys the side of a house or whatever.
  - jsty 7y ago
    > I suppose there's probably an equivalent scenario if a non-EU visitor falls ill in the UK. The NHS charges at 150% of their standard charges for non-EU nationals. For most people this is a moot point since short-term visitors are required to have insurance anyway, and long-term visitors pay a surcharge which covers them for all NHS services. https://www.nhs.uk/using-the-nhs/nhs-services/visiting-or-moving-to-england/how-to-access-nhs-services-in-england/ https://www.nhs.uk/using-the-nhs/nhs-services/visiting-or-mo...
swsieber 7y ago
Freight shipping can be a little like that.
musha68k 7y ago
As an EU citizen who watched “Breaking Bad” I always assumed that in the US there actually would be some kind of insurance check even in emergency situations. I’m glad to learn that people in reality though, do get taken care of when in need. Anything else would be highly unethical, really. Life > debt. With regards to your hypothetical scenario as a Norwegian citizen: are you sure your Norwegian social security wouldn’t reimburse you in case of emergency treatment in the US? I know for a fact that Austrian social security would be pretty much obliged to (I would guess it’s the same for many other EU countries).
- pmorici 7y ago
  It's against the law in the US for a hospital emergency room to turn away a patient based on ability to pay if they also accept Medicare. Practically speaking they all accept Medicare. https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
mnm1 7y ago
America has decided only one party needs to be a signatory of a contract and it will apply to both. No consciousness needed because there is nothing to agree to. Everything has already been pre-agreed to. This is the same in our other industries. Good luck if you cable provider, retailer, hotel, airline, landlord, or other service fucks you over. You agreed to some insane bullshit in the thousand page 2pt font popup that probably didn't even load correctly so now you are fucked. At least it's not a matter of life or death there, though, but it sure is a matter of our entire society being structured this way to take advantage of people and fuck them over for money. Police? Oh yes, they are some of the biggest thieves and are allowed not only legal violence, but legal theft. Corporations are often worse than the government. They will gladly kill thousands for minor profits. Hundreds of thousands or millions if they are not Americans. Minor crimes are just part of doing business. In our society, everything is a calculation, and lives have a dollar value. It's not very high, although admittedly, higher than most of the rest of the world. This mindset permeates the entire culture and society to the point that it's virtually indistinguishable from them. It's no wonder we as Americans cannot and do not trust each other. You simply never know who is out to fuck you over. You just know that there are many and that you will be fucked over. The more money you have, the more you can insulate yourself from it to the point where enough money gives you the privilege to fuck over other people in previously described manner. This also explains why people love their guns so much. Some people just get fucked over for money. Others, especially minorities, often get fucked over for their lives.

duxup 7y ago

>do not perform for-pay medical care on me It would be impossible as even doctors and hospital staff straight up don't know what is covered and what isn't from person to person with much confidence....let alone the actual pricing.

esotericn 7y ago
In that case then, my desired tattoo is essentially "resuscitate, that's it, I'll work the rest out myself"? Heh.
- coldtea 7y ago
  As if they can't slap 2-3 procedures costing several grand during the resuscitating process and say they were "essential" when they were not required at all? Good like proving otherwise...

geitir 7y ago

Even with tattoos they will generally resuscitate you unless they can find signed papers

kranner 7y ago
Startup idea: QR code tattoo service that hosts a DNR that the tattooee has digitally signed.
- wwweston 7y ago
  If this is a joke, it's bitingly funny. If not... why are we brainstorming ideas for an auxiliary medical information business whose apparent business model would involve fee for service to prevent beneficial-if-expensive medical interventions? That's arguably a step down from ideas to get people to click on ads. It really seems smart people out to be able to enjoy working on the hard problems of brainstorming contributions to a medical system in which effective providers are reasonably trained and rewarded, insurance risks are effectively pooled and managed, and access to care doesn't carry a risk of bankruptcy.
  - kranner 7y ago
    It really was just a joke. I agree that healthcare, esp emergency healthcare, should not bankrupt people. (But in the meantime, for only $9.99 a year...)
  - blaser-waffle 7y ago
    > auxiliary medical information business whose apparent business model would involve fee for service to prevent beneficial-if-expensive medical interventions I think you just described medical insurance
- paranoidrobot 7y ago
  Why would a digital signature trump actual-indellible-ink-on-skin as evidence of my wishes?

lr4444lr 7y ago

This has been tried in court. The general ruling is that emergency medical care has the right to reasonably assume, absent some health care proxy to the contrary, that you wish to be resuscitated and accept all good faith care administered to this effect.

ThrustVectoring 7y ago

> Is there an equivalent of a 'do not resuscitate' tattoo or something you can get that's along the lines of 'do not perform for-pay medical care on me'? You can set yourself up to be judgment-proof, and hospitals can perform all the unwanted care they want to on you and they'll be able to collect basically $0. It's easier than it seems - move to Texas, leave all the assets in retirement accounts that you can, and plow all your liquid wealth into your primary residence.

esotericn 7y ago
How does that work if you're like, a working adult, with an income, not in retirement, though? If I go on holiday to the US, and for whatever reason through some minor flaw in my travel insurance (or just not having it; I imagine millions of people fly there without it each year) I'm not covered, it sounds like a person could easily rack up tens of thousands without realising if they weren't aware of this sort of thing.
- deleted 7y ago
  [deleted]
- chatmasta 7y ago
  If you’re not from the US, it would also be far easier for you to simply default on your debt. Actually I’m curious how medical debt is even enforced for non-citizens. Related, I have completely separate credit scores in the UK (resident) and US (citizen). I’m sure the bureaus would like to change that, but there is no system that lets them know I’m the same person.
  - aksss 7y ago
    I have a good friend that did that. Was a legal resident, accumulated tens of thousands in medical bills due to emergency services coming out of an elective surgery. He just moved back home (out of country). He’s not been pursued. They called his domestic residence multiple times but after being told he left the country and nobody knows where, they stopped.
  - 7y ago

eanzenberg 7y ago

I know this will get downvoted to oblivion, but these stories are just anecdotal. Thousands of people utilize medical care in the USA without much fanfare.

kranner 7y ago
I wouldn't shove even the odd catastrophic error under 'just anecdotal'.
contravariant 7y ago
Thousands seems a bit low... Besides even if 0.1% goes disastrously wrong financially then that's still a lot of people.
JadeNB 7y ago
It should get downvoted; it's heartless. Given the hundreds of millions of people in the US, the fact that thousands, or even millions, of people successfully seek medical care doesn't demonstrate much. One or two people whose lives are ruined by rent-seeking in a life-or-death matter is too many (I think one wouldn't ignore several cases of food poisoning at a restaurant and respond that hundreds had eaten there without incident); I suspect that the actual number of people affected by this sort of catastrophe is at least in the thousands. Unless you're one of the people affected (and probably not even then), you have no right to dismiss the suffering of those who have been.
Ididntdothis 7y ago
One of the “pleasures” of working in a cube farm is that you get to overhear a lot phone calls. I hear a lot of people spending hours and hours arguing with providers and insurance over billing mistakes. Based on this I believe it’s pretty common. My girlfriend got hit with a $300000 bill after a surgery. It was a mistake (several actually) but it took her almost a year and literally 100s of phone calls to clear this.
cletus 7y ago
Only a minority of people get murdered too. Most people walk around alive and happy. In Australia, the number one reason for personal bankruptcy prior to the Hawke Labor government introducing Medicare in the 1980s was unexpected medical expenses [1]. insurance is the USA is largely tied to having a job. You can buy your own insurance but it's terrible in comparison to better employment-based health insurance and the reason for that is exactly why we need a public safety net. Company insurance plans a) form a group and b) have negotiating power with insurance companies. The first part is really important. Being diagnosed with diabetes and then having diabetes-related medical expenses be excluded from personal insurance as a pre-existing condition is Bad. Really Bad. The only way insurance works is if you consider the total expenses of a sufficiently large group of people. Companies, unions and government organizations are the only way to get this in the US. [1] https://www.abc.net.au/news/2019-05-18/bob-hawke-what-did-australia-have-before-medicare/11124180 https://www.abc.net.au/news/2019-05-18/bob-hawke-what-did-au...

empath75 7y ago

I had two insurance companies and both times I had kids, they hit us with $10k bills a year after the birth because they couldn’t sort out insurance. I had to threaten to sue them twice to stop them from trying to collect on their idiotic fuckups.

contravariant 7y ago

Yep, all the things you mention are effectively contracts (in the broad sense) where both parties commit to previously agreed upon terms. It's for this reason that most countries have some kind of mandatory insurance against emergency medical treatment where the person being treated basically has no choice (even if they're conscious) and is thus incapable of forming a valid contract. You're right that in this scenario it's weird to expect someone to still pay for their treatment, but if you can't force people to be fully insured against such costs you need to force them to pay for costs they couldn't freely consent to.

esotericn 7y ago
I suppose there's probably an equivalent scenario if a non-EU visitor falls ill in the UK. Or if a UK citizen drives a car with (unknown to them) invalid insurance and destroys the side of a house or whatever.
- jsty 7y ago
  > I suppose there's probably an equivalent scenario if a non-EU visitor falls ill in the UK. The NHS charges at 150% of their standard charges for non-EU nationals. For most people this is a moot point since short-term visitors are required to have insurance anyway, and long-term visitors pay a surcharge which covers them for all NHS services. https://www.nhs.uk/using-the-nhs/nhs-services/visiting-or-moving-to-england/how-to-access-nhs-services-in-england/ https://www.nhs.uk/using-the-nhs/nhs-services/visiting-or-mo...

swsieber 7y ago

Freight shipping can be a little like that.

musha68k 7y ago

As an EU citizen who watched “Breaking Bad” I always assumed that in the US there actually would be some kind of insurance check even in emergency situations. I’m glad to learn that people in reality though, do get taken care of when in need. Anything else would be highly unethical, really. Life > debt. With regards to your hypothetical scenario as a Norwegian citizen: are you sure your Norwegian social security wouldn’t reimburse you in case of emergency treatment in the US? I know for a fact that Austrian social security would be pretty much obliged to (I would guess it’s the same for many other EU countries).

pmorici 7y ago
It's against the law in the US for a hospital emergency room to turn away a patient based on ability to pay if they also accept Medicare. Practically speaking they all accept Medicare. https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...

mnm1 7y ago

America has decided only one party needs to be a signatory of a contract and it will apply to both. No consciousness needed because there is nothing to agree to. Everything has already been pre-agreed to. This is the same in our other industries. Good luck if you cable provider, retailer, hotel, airline, landlord, or other service fucks you over. You agreed to some insane bullshit in the thousand page 2pt font popup that probably didn't even load correctly so now you are fucked. At least it's not a matter of life or death there, though, but it sure is a matter of our entire society being structured this way to take advantage of people and fuck them over for money. Police? Oh yes, they are some of the biggest thieves and are allowed not only legal violence, but legal theft. Corporations are often worse than the government. They will gladly kill thousands for minor profits. Hundreds of thousands or millions if they are not Americans. Minor crimes are just part of doing business. In our society, everything is a calculation, and lives have a dollar value. It's not very high, although admittedly, higher than most of the rest of the world. This mindset permeates the entire culture and society to the point that it's virtually indistinguishable from them. It's no wonder we as Americans cannot and do not trust each other. You simply never know who is out to fuck you over. You just know that there are many and that you will be fucked over. The more money you have, the more you can insulate yourself from it to the point where enough money gives you the privilege to fuck over other people in previously described manner. This also explains why people love their guns so much. Some people just get fucked over for money. Others, especially minorities, often get fucked over for their lives.