3 ms·

Elites on the Edge

14 points by gwintrob 6y ago

deleted 6y ago
[deleted]
rayiner 6y ago
> The top layer, the fabled 1% or 10% or wherever you want to draw the line, don’t lose everything when somebody gets cancer. The author describes as “plausible” the random Twitter story that someone with insurance lost 20 years of savings when their wife got cancer. It’s a big country and stuff happens, but it’s useful to know the actual facts: https://healthpayerintelligence.com/news/cancer-patients-paid-5.6b-out-of-pocket-cancer-costs-in-2018 https://healthpayerintelligence.com/news/cancer-patients-pai... > In a case study, a patient with lymphoma paid out-of-pocket healthcare costs from $6,446 in a large employer-sponsored health plan to $12,931 in a health plan on the individual health insurance market. These are significant sums, but not at the level of wiping out someone’s life savings unless they’re very poor. (And in that case, they’d be covered by Medicaid, which strictly limits cost sharing.) Note that annually, Americans spend about $5.6 billion on out of pocket costs for cancer care. There are about 1.8 million diagnosed cases of cancer per year, so that’s about $3,100 per case.
- JamesBarney 6y ago
  This just doesn't square with my lived experience. Literally just 5 minutes ago a close friend messaged me out of the blue that he got hit with a million dollar bill for going to the hospital for chronic inflammatory progressive demyelinating disease. Insurance is covering $750,000 of that and he's going to be charged $250,000. Now of course that amount won't be paid (because he just graduated grad school with an art history degree) but there's really no point in him saving any money if a debt collector can seize it at a moment's notice. I had a friend in high school who got cancer and had insurance. At the 10th anniversary of his death his parents mentioned they were still paying off medicals debts accrued from that. They mentioned half of this was for experimental treatments that they knew were going to be paid out of pocket for. But half was due to standard cancer care that insurance was arguing it shouldn't pay for some reason. Like the hospital using an out of network doctor without telling them type of stuff. Similar things have happened to myself and my wife, where after paying for care we receive a secondary bill 10 times higher than the first for out of network items we unknowingly consumed.
  - bhupy 6y ago
    I mean, if we're throwing around lived experiences, my mother had thyroid cancer and after health insurance we ended up spending ~$1,000 all things considered. These kinds of anecdotes are important, but for every anecdote on one side of the equation, there exists an anecdote on the other. The only way to meaningfully make sense of the status quo is by looking at the system as a whole so that we know what the median experience is vs the outliers.
    - JamesBarney 6y ago
      Oh I know it works quite often. > These kinds of anecdotes are important, but for every anecdote on one side of the equation, there exists an anecdote on the other. I think this would be mean catastrophic insurance failure isn't very rare.
    - brutusborn 6y ago
      I agree that we need to look at the system as a whole, but outliers also tell us a lot. The examples above where families become financially ruined by healthcare cl probably happen rarely, if at all, in a country with socialized healthcare. To me, the fact that it can happen even once in the US acts more as a red flag than a meaningful statistic.
      - rayiner 6y ago
        > The examples above where families become financially ruined by healthcare cl probably happen rarely, if at all, in a country with socialized healthcare. Sure, but the scenario where a family has extra money in their pockets because they don’t get sick also happens more often than in a country with socialized healthcare.
  - rayiner 6y ago
    The US system has many corner cases because it’s not centralized. Since the ACA banned lifetime maximums a decade ago, out-of-network fees are the most common reason for high out of pocket costs. But the aggregate data suggests those large sums aren’t typical.

14 points by gwintrob 6y ago

deleted 6y ago

[deleted]

> The top layer, the fabled 1% or 10% or wherever you want to draw the line, don’t lose everything when somebody gets cancer. The author describes as “plausible” the random Twitter story that someone with insurance lost 20 years of savings when their wife got cancer. It’s a big country and stuff happens, but it’s useful to know the actual facts: https://healthpayerintelligence.com/news/cancer-patients-paid-5.6b-out-of-pocket-cancer-costs-in-2018 https://healthpayerintelligence.com/news/cancer-patients-pai... > In a case study, a patient with lymphoma paid out-of-pocket healthcare costs from $6,446 in a large employer-sponsored health plan to $12,931 in a health plan on the individual health insurance market. These are significant sums, but not at the level of wiping out someone’s life savings unless they’re very poor. (And in that case, they’d be covered by Medicaid, which strictly limits cost sharing.) Note that annually, Americans spend about $5.6 billion on out of pocket costs for cancer care. There are about 1.8 million diagnosed cases of cancer per year, so that’s about $3,100 per case.

JamesBarney 6y ago
This just doesn't square with my lived experience. Literally just 5 minutes ago a close friend messaged me out of the blue that he got hit with a million dollar bill for going to the hospital for chronic inflammatory progressive demyelinating disease. Insurance is covering $750,000 of that and he's going to be charged $250,000. Now of course that amount won't be paid (because he just graduated grad school with an art history degree) but there's really no point in him saving any money if a debt collector can seize it at a moment's notice. I had a friend in high school who got cancer and had insurance. At the 10th anniversary of his death his parents mentioned they were still paying off medicals debts accrued from that. They mentioned half of this was for experimental treatments that they knew were going to be paid out of pocket for. But half was due to standard cancer care that insurance was arguing it shouldn't pay for some reason. Like the hospital using an out of network doctor without telling them type of stuff. Similar things have happened to myself and my wife, where after paying for care we receive a secondary bill 10 times higher than the first for out of network items we unknowingly consumed.
- bhupy 6y ago
  I mean, if we're throwing around lived experiences, my mother had thyroid cancer and after health insurance we ended up spending ~$1,000 all things considered. These kinds of anecdotes are important, but for every anecdote on one side of the equation, there exists an anecdote on the other. The only way to meaningfully make sense of the status quo is by looking at the system as a whole so that we know what the median experience is vs the outliers.
  - JamesBarney 6y ago
    Oh I know it works quite often. > These kinds of anecdotes are important, but for every anecdote on one side of the equation, there exists an anecdote on the other. I think this would be mean catastrophic insurance failure isn't very rare.
  - brutusborn 6y ago
    I agree that we need to look at the system as a whole, but outliers also tell us a lot. The examples above where families become financially ruined by healthcare cl probably happen rarely, if at all, in a country with socialized healthcare. To me, the fact that it can happen even once in the US acts more as a red flag than a meaningful statistic.
    - rayiner 6y ago
      > The examples above where families become financially ruined by healthcare cl probably happen rarely, if at all, in a country with socialized healthcare. Sure, but the scenario where a family has extra money in their pockets because they don’t get sick also happens more often than in a country with socialized healthcare.
- rayiner 6y ago
  The US system has many corner cases because it’s not centralized. Since the ACA banned lifetime maximums a decade ago, out-of-network fees are the most common reason for high out of pocket costs. But the aggregate data suggests those large sums aren’t typical.