5 ms·

New York City plans to wipe out $2B in medical debt for 500k residents

30 points by Judyrabbit 3y ago

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bdcravens 3y ago
NYC isn't exactly forgiving the debt, but is working with a non-profit that basically buys debt for pennies on the dollar, and then doesn't collect on it, wiping it clean (and presumably updating credit reports showing it as paid) They are spending $18M to wipe out the $2B.
- artninja1988 3y ago
  And where does the nonprofit have the money from?
  - RobRivera 3y ago
    Donations They get funded Through donations.
  - bdcravens 3y ago
    In this case, NYC is giving them the $18M; this is just under 1% of the debt amount, so I assume that's enough to buy debt that is unlikely to be collected on anyways.
- iamdbtoo 3y ago
  They have to buy the debt in order to forgive it.
- notatoad 3y ago
  is this a workaround for debt forgiveness counting as income for tax purposes?
  - bdcravens 3y ago
    No. They'll still likely have to pay taxes on those amounts. I don't think it matters who forgives the debt.
  - jareklupinski 3y ago
    it sure seems like donating 1k to a charity to wipe away >1M of debt should make you a millionnaire
- deleted 3y ago
  [deleted]
Loranubi 3y ago
That sounds nice, but won't medical providers/companies just increase prices next year since the feedback they get is that everything is being paid?
- tmalsburg2 3y ago
  The answer is in the second paragraph.
anotherhue 3y ago
Advertised cost of healthcare: $2B. Actual cost of healthcare: $18MM. I wish we could get these discounts up front and skip the whole dance.
- inamberclad 3y ago
  It sounds like this isn't the cost of service, but the residual cost of buying defaulted debts. The hospitals and insurers have already written off the service as a loss and are trying to recoup anything they can by selling the debts for pennies on the dollar. Unfortunately, that means that your payments are shouldering the burden of someone else's inability to pay the ludicrous cost of healthcare. We can fix this by 1. Refusing care without payment at the time of service, which isn't possible, or even moral, in many cases. 2. Nationalizing healthcare and directly supporting healthcare with taxes so that payment is guaranteed to the service providers.
- IG_Semmelweiss 3y ago
  We cant. Its a very complex history. One reason for this huge differential is because hospitals get paid a % of the losses in fed subsidies based on the nominal charge number stated on the invoices,[1] not the actual COGS. For some history; with reimbursement formulas in our prior cost-plus system, a hospital's reimbursement was partly determined by its charges (the invoice). Hospitals discovered that by manipulating the charges, they could increase their total reimbursement.[2] This was the bastard origin of the charge gaming culture at hospitals. It is hard to uproot now. This cukture found a new home with the federal loss subsidy. This subsidy was an ask by hospitals to the government when the govt was trying to get uninsured to be seen at hospitals. So now they scratch each others backs. Insurance play along with it. In theory you would think it's harmless (since the amount paid is the allowed, full stop) but it muddies the waters further. Why would insurance muddy the waters on itself on purpose? It makes them look amazing in front of employer clients. Think discount of 75% on a $200 charge vs a 50% discount on $100. 75% sounds a lot bettet to the employer. But the employer is paying the exact same. Its a marketing gimmick for insurers. Hospital makes more federal dollars on that loss. Govt pays more in healthcare subsidies. Hardworking people without Insurance... get royally screwed. [1] I cant remember now the 3-letter name of the program, but I'll link to it once i do. [2] https://www.econlib.org/library/Enc1/HealthInsurance.html https://www.econlib.org/library/Enc1/HealthInsurance.html
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30 points by Judyrabbit 3y ago

deleted 3y ago

[deleted]

NYC isn't exactly forgiving the debt, but is working with a non-profit that basically buys debt for pennies on the dollar, and then doesn't collect on it, wiping it clean (and presumably updating credit reports showing it as paid) They are spending $18M to wipe out the $2B.

artninja1988 3y ago
And where does the nonprofit have the money from?
- RobRivera 3y ago
  Donations They get funded Through donations.
- bdcravens 3y ago
  In this case, NYC is giving them the $18M; this is just under 1% of the debt amount, so I assume that's enough to buy debt that is unlikely to be collected on anyways.
iamdbtoo 3y ago
They have to buy the debt in order to forgive it.
notatoad 3y ago
is this a workaround for debt forgiveness counting as income for tax purposes?
- bdcravens 3y ago
  No. They'll still likely have to pay taxes on those amounts. I don't think it matters who forgives the debt.
- jareklupinski 3y ago
  it sure seems like donating 1k to a charity to wipe away >1M of debt should make you a millionnaire
deleted 3y ago
[deleted]

Loranubi 3y ago

That sounds nice, but won't medical providers/companies just increase prices next year since the feedback they get is that everything is being paid?

tmalsburg2 3y ago
The answer is in the second paragraph.

anotherhue 3y ago

Advertised cost of healthcare: $2B. Actual cost of healthcare: $18MM. I wish we could get these discounts up front and skip the whole dance.

inamberclad 3y ago
It sounds like this isn't the cost of service, but the residual cost of buying defaulted debts. The hospitals and insurers have already written off the service as a loss and are trying to recoup anything they can by selling the debts for pennies on the dollar. Unfortunately, that means that your payments are shouldering the burden of someone else's inability to pay the ludicrous cost of healthcare. We can fix this by 1. Refusing care without payment at the time of service, which isn't possible, or even moral, in many cases. 2. Nationalizing healthcare and directly supporting healthcare with taxes so that payment is guaranteed to the service providers.
IG_Semmelweiss 3y ago
We cant. Its a very complex history. One reason for this huge differential is because hospitals get paid a % of the losses in fed subsidies based on the nominal charge number stated on the invoices,[1] not the actual COGS. For some history; with reimbursement formulas in our prior cost-plus system, a hospital's reimbursement was partly determined by its charges (the invoice). Hospitals discovered that by manipulating the charges, they could increase their total reimbursement.[2] This was the bastard origin of the charge gaming culture at hospitals. It is hard to uproot now. This cukture found a new home with the federal loss subsidy. This subsidy was an ask by hospitals to the government when the govt was trying to get uninsured to be seen at hospitals. So now they scratch each others backs. Insurance play along with it. In theory you would think it's harmless (since the amount paid is the allowed, full stop) but it muddies the waters further. Why would insurance muddy the waters on itself on purpose? It makes them look amazing in front of employer clients. Think discount of 75% on a $200 charge vs a 50% discount on $100. 75% sounds a lot bettet to the employer. But the employer is paying the exact same. Its a marketing gimmick for insurers. Hospital makes more federal dollars on that loss. Govt pays more in healthcare subsidies. Hardworking people without Insurance... get royally screwed. [1] I cant remember now the 3-letter name of the program, but I'll link to it once i do. [2] https://www.econlib.org/library/Enc1/HealthInsurance.html https://www.econlib.org/library/Enc1/HealthInsurance.html

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