7 ms·

Under this system, what would be the reason to pay your medical bills?

by p1mrx 3y ago

matthewaveryusa 3y ago
Your wages can still be garnished.
LapsangGuzzler 3y ago
My understanding is that medical debt would still be collectible and could be sold to third party debt collectors. It just couldn't hurt your credit report.
toomuchtodo 3y ago
Why should people pay their medical debt that only exists because Congress refuses to implement a functioning national healthcare delivery system? If Congress refuses to act, the executive branch can sidestep them providing temporary relief until Congressional reps turn over enough to pass material legislation to fix the system.
- nradov 3y ago
  Why should people pay for food when Congress refuses to hand out free food for everyone?
  - toomuchtodo 3y ago
    > when Congress refuses to hand out free food for everyone? Can you say that when USDA food security and nutrition assistance benefits are around $183B a year? Certainly, it isn't for everyone, but for those in need. Why would we not extend similar policy to healthcare in a more efficient manner? No one is arguing for free healthcare (although that phrase is used colloquially), but a more efficient payer and delivery system, versus all of the bloat between patients and providers as exists today (insurance companies, pharmacy benefit managers, etc). Sibling comment by willcipriano touches on this bloat. https://www.ers.usda.gov/data-products/ag-and-food-statistics-charting-the-essentials/food-security-and-nutrition-assistance/?topicId=d7627f77-6cee-4ab9-bbb9-8c74d4778941 https://www.ers.usda.gov/data-products/ag-and-food-statistic...
    - dmoy 3y ago
      Note that Medicare and Medicaid budget dwarfs federal food budget It's like literally an order of magnitude more spending
    - jefftk 3y ago
      > Certainly, [free food] isn't for everyone, but for those in need. Why would we not extend similar policy to healthcare in a more efficient manner? But we do have a similar system for healthcare! If you're poor enough you qualify for Medicaid [1], and if you don't qualify for Medicaid but your income is too low to afford the full price plans the ACA provides pro-rated subsidies. It's not that different from SNAP, and both are a mix of working well and poorly. [1] Unless you live in Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, Wyoming, which opted out of Medicaid expansion. Even though expansion had the federal government covering >90% of costs...
    - bogwog 3y ago
      > versus all of the bloat between patients and providers as exists bloat and illegal monopolization: https://www.reuters.com/legal/us-accuses-investment-firm-anesthesia-company-texas-monopoly-scheme-2023-09-21/ https://www.reuters.com/legal/us-accuses-investment-firm-ane...
  - willcipriano 3y ago
    US citizens, per captia, spend more on socialized medicine than any other nation. Then we pay again for the private system. With those facts in mind I see no moral reason to pay, we already did. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm
  - datavirtue 3y ago
    Food is the only thing congress has happened to manage. Prices have been low and stable for generations due to agricultural policies. Everything else has spiraled out of control.
    - supertrope 3y ago
      Agriculture can be mechanized. Diagnosis and treatment of disease and injury has not yet been automated. America has an awful medical financing system where a hospital sends a bill for 10x the market price and then the health insurance boasts that they got you a 90% discount.
fisherjeff 3y ago
I mean, getting sent to collections sucks regardless of whether it affects your credit score - see, e.g., patio11’s recent blog post[0]. If you don’t pay, chances are you will still regret it. [0] https://www.bitsaboutmoney.com/archive/the-waste-stream-of-consumer-finance/ https://www.bitsaboutmoney.com/archive/the-waste-stream-of-c...
mike_d 3y ago
Only emergency rooms are legally obligated to treat you to the point of stabilization. As most doctors are now part of hospital ran conglomerates, a failure to pay your bill for an orthopedic consult can still be recorded in the hospitals system and you could be denied an appointment by your OBGYN.
- nradov 3y ago
  That's true from an EMTALA standpoint. But in certain circumstances once a doctor-patient relationship has been established and a course of treatment has started the doctor may be legally and/or ethically bound to either continue that treatment or pass the patient over to another willing doctor. They aren't necessarily always allowed to immediately drop a patient for failure to pay.
  - singleshot_ 3y ago
    Keyword: “abandonment.”
- dcow 3y ago
  Hospitals and doctors don’t do this. It’s unethical to deny someone treatment because you’re not sure they can pay.
  - repiret 3y ago
    Emergency rooms don’t do this. Non-emergency health providers of all sorts will deny you services if you have an outstanding balance.
  - mike_d 3y ago
    I assume you live outside the United States. Healthcare here is... special.
  - gensym 3y ago
    It may be unethical, but it happens all the time. My father got cancer in 2020 and died earlier this year. During that time, I was continuously shocked at the delays in tests and treatments that he experienced because specialists wouldn't see him until he had approval from Medicare. Without those delays, I think there's a good chance that we'd be looking forward to another Christmas with him. (We live in the US if this anecdote didn't make it obvious).
Eumenes 3y ago
I haven't paid a medical bill under $1k in years ... it never goes into collections and I never hear about it after the 2nd or 3rd letter in the mail. My providers never mention it, my insurance company never mentions it.
DoneWithAllThat 3y ago
Civil action could be started against you in court. If you don’t show up the other party would win a default judgement. If you did you could and likely would still lose and have to pay. At that point your assets could be legally taken from you and wages garnished.
jeffbee 3y ago
Medical “debts” are almost always unilateral fees you never agreed to. No provider will state upfront what the fees will be! I got billed after the birth of my first child for services that had not been rendered by a physician who wasn’t even present, which my attorney characterized as “fraud” in a stern letter but that the hospital viewed as “debt”. I prevailed obviously but imagine the range of outcomes.
- FireBeyond 3y ago
  The other people to contact there are your insurers. Despicable as some of them may be, they too hate provider fraud. Even if they don't appear to do something to censure the provider, it is on their file, and enough complaints will be problematic. I had a similar situation with a kidney stone. Transferred from my hospital to another by ambulance - I was moved from the ambulance gurney to the surgery bed in the hallway of the ER, and was billed for a ER visit among everything else, though no care had been rendered, no ER staff had been involved (hospital transport techs), it just happened to happen in the ER, and not even in a room.
doctorpangloss 3y ago
One thing’s for sure, the lawyers and finance professionals at the CFPB aren’t going to remove your legal defense fees and delinquent mortgage payments from your credit report, even though being in jail and being homeless also massively increase your mortality.
CPLX 3y ago
They can sue you. Presumably an actual legal judgement against you would still go on your credit report, as it does today.

Under this system, what would be the reason to pay your medical bills?

by p1mrx 3y ago

Under this system, what would be the reason to pay your medical bills?

matthewaveryusa 3y ago

Your wages can still be garnished.

LapsangGuzzler 3y ago

My understanding is that medical debt would still be collectible and could be sold to third party debt collectors. It just couldn't hurt your credit report.

toomuchtodo 3y ago

Why should people pay their medical debt that only exists because Congress refuses to implement a functioning national healthcare delivery system? If Congress refuses to act, the executive branch can sidestep them providing temporary relief until Congressional reps turn over enough to pass material legislation to fix the system.

nradov 3y ago
Why should people pay for food when Congress refuses to hand out free food for everyone?
- toomuchtodo 3y ago
  > when Congress refuses to hand out free food for everyone? Can you say that when USDA food security and nutrition assistance benefits are around $183B a year? Certainly, it isn't for everyone, but for those in need. Why would we not extend similar policy to healthcare in a more efficient manner? No one is arguing for free healthcare (although that phrase is used colloquially), but a more efficient payer and delivery system, versus all of the bloat between patients and providers as exists today (insurance companies, pharmacy benefit managers, etc). Sibling comment by willcipriano touches on this bloat. https://www.ers.usda.gov/data-products/ag-and-food-statistics-charting-the-essentials/food-security-and-nutrition-assistance/?topicId=d7627f77-6cee-4ab9-bbb9-8c74d4778941 https://www.ers.usda.gov/data-products/ag-and-food-statistic...
  - dmoy 3y ago
    Note that Medicare and Medicaid budget dwarfs federal food budget It's like literally an order of magnitude more spending
  - jefftk 3y ago
    > Certainly, [free food] isn't for everyone, but for those in need. Why would we not extend similar policy to healthcare in a more efficient manner? But we do have a similar system for healthcare! If you're poor enough you qualify for Medicaid [1], and if you don't qualify for Medicaid but your income is too low to afford the full price plans the ACA provides pro-rated subsidies. It's not that different from SNAP, and both are a mix of working well and poorly. [1] Unless you live in Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, Wyoming, which opted out of Medicaid expansion. Even though expansion had the federal government covering >90% of costs...
  - bogwog 3y ago
    > versus all of the bloat between patients and providers as exists bloat and illegal monopolization: https://www.reuters.com/legal/us-accuses-investment-firm-anesthesia-company-texas-monopoly-scheme-2023-09-21/ https://www.reuters.com/legal/us-accuses-investment-firm-ane...
- willcipriano 3y ago
  US citizens, per captia, spend more on socialized medicine than any other nation. Then we pay again for the private system. With those facts in mind I see no moral reason to pay, we already did. https://data.oecd.org/healthres/health-spending.htm https://data.oecd.org/healthres/health-spending.htm
- datavirtue 3y ago
  Food is the only thing congress has happened to manage. Prices have been low and stable for generations due to agricultural policies. Everything else has spiraled out of control.
  - supertrope 3y ago
    Agriculture can be mechanized. Diagnosis and treatment of disease and injury has not yet been automated. America has an awful medical financing system where a hospital sends a bill for 10x the market price and then the health insurance boasts that they got you a 90% discount.

fisherjeff 3y ago

I mean, getting sent to collections sucks regardless of whether it affects your credit score - see, e.g., patio11’s recent blog post[0]. If you don’t pay, chances are you will still regret it. [0] https://www.bitsaboutmoney.com/archive/the-waste-stream-of-consumer-finance/ https://www.bitsaboutmoney.com/archive/the-waste-stream-of-c...

mike_d 3y ago

Only emergency rooms are legally obligated to treat you to the point of stabilization. As most doctors are now part of hospital ran conglomerates, a failure to pay your bill for an orthopedic consult can still be recorded in the hospitals system and you could be denied an appointment by your OBGYN.

nradov 3y ago
That's true from an EMTALA standpoint. But in certain circumstances once a doctor-patient relationship has been established and a course of treatment has started the doctor may be legally and/or ethically bound to either continue that treatment or pass the patient over to another willing doctor. They aren't necessarily always allowed to immediately drop a patient for failure to pay.
- singleshot_ 3y ago
  Keyword: “abandonment.”
dcow 3y ago
Hospitals and doctors don’t do this. It’s unethical to deny someone treatment because you’re not sure they can pay.
- repiret 3y ago
  Emergency rooms don’t do this. Non-emergency health providers of all sorts will deny you services if you have an outstanding balance.
- mike_d 3y ago
  I assume you live outside the United States. Healthcare here is... special.
- gensym 3y ago
  It may be unethical, but it happens all the time. My father got cancer in 2020 and died earlier this year. During that time, I was continuously shocked at the delays in tests and treatments that he experienced because specialists wouldn't see him until he had approval from Medicare. Without those delays, I think there's a good chance that we'd be looking forward to another Christmas with him. (We live in the US if this anecdote didn't make it obvious).

Eumenes 3y ago

I haven't paid a medical bill under $1k in years ... it never goes into collections and I never hear about it after the 2nd or 3rd letter in the mail. My providers never mention it, my insurance company never mentions it.

DoneWithAllThat 3y ago

Civil action could be started against you in court. If you don’t show up the other party would win a default judgement. If you did you could and likely would still lose and have to pay. At that point your assets could be legally taken from you and wages garnished.

jeffbee 3y ago

Medical “debts” are almost always unilateral fees you never agreed to. No provider will state upfront what the fees will be! I got billed after the birth of my first child for services that had not been rendered by a physician who wasn’t even present, which my attorney characterized as “fraud” in a stern letter but that the hospital viewed as “debt”. I prevailed obviously but imagine the range of outcomes.

FireBeyond 3y ago
The other people to contact there are your insurers. Despicable as some of them may be, they too hate provider fraud. Even if they don't appear to do something to censure the provider, it is on their file, and enough complaints will be problematic. I had a similar situation with a kidney stone. Transferred from my hospital to another by ambulance - I was moved from the ambulance gurney to the surgery bed in the hallway of the ER, and was billed for a ER visit among everything else, though no care had been rendered, no ER staff had been involved (hospital transport techs), it just happened to happen in the ER, and not even in a room.

doctorpangloss 3y ago

One thing’s for sure, the lawyers and finance professionals at the CFPB aren’t going to remove your legal defense fees and delinquent mortgage payments from your credit report, even though being in jail and being homeless also massively increase your mortality.

CPLX 3y ago

They can sue you. Presumably an actual legal judgement against you would still go on your credit report, as it does today.