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Yes, so this is where the brains and effort (and time, forgot time) come in. The anecdotes in your links (that I read - can't get through all of them right now

by 0xBDB 2y ago

Yes, so this is where the brains and effort (and time, forgot time) come in. The anecdotes in your links (that I read - can't get through all of them right now) have a common theme, which is that people died because they either needed very expensive and/or experimental treatment that probably would not be affordably provided to them under any plausible healthcare system, or else they got a bill, decided they couldn't pay it, and did without or tried to self-ration their healthcare. The correct course of action in that case is to call the healthcare provider and negotiate A) a 90+% discount and B) a payment plan, both of which are pretty readily available in the American system. You have to know that's possible, and you shouldn't have to, but it is possible. Then you reach out to the charities, government programs, and/or nonprofits from my original link to cover what you still can't afford. Same deal if you get screwed by an insurance company as in the Guardian article. This is, again, not something I'm trying to defend. It's not the way a sane healthcare system would run. But it is a system that works, more or less, for those who know how to work within it.

zrn900 2y ago
> The anecdotes The anecdotes show that this is not an 'occasional' or 'edge case' thing but a systemic thing. The statistics show that at least 40,000 people die a year for not having enough money for healthcare and these are the people we know. The statistics don't include those who never go to the hospital to avoid risking medical bankruptcy for their families even if they die themselves. Just being in a hospital bed for one night without anything being done costs $3000/night, whereas waiting in the ER without anything being done can cost $100/hour. https://www.marketwatch.com/story/woman-gets-688-35-er-bill-for-spending-7-hours-in-the-waiting-room-without-being-treated-11635794483 https://www.marketwatch.com/story/woman-gets-688-35-er-bill-... This is a systemic thing. Its not 'not a sane healthcare system'. Its literally a machine that kills people to maximize profit. And it became like this only because people let it and justified this or that other thing in the system.
- 0xBDB 2y ago
  > Just being in a hospital bed for one night without anything being done costs $3000/night No, it doesn't. It costs whatever you can negotiate it to cost. I've been without insurance; one experience isn't data, but in my experience just telling the hospital you haven't got insurance is, again, good for 90+% off by itself. https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medical-bills-heres-how-to-lower-your-costs.html https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medic... Hospitals (ed: non-profit ones, but I'm pretty sure similar rules apply elsewhere) in particular are required by federal law to have 'well-publicized' financial assistance policies. https://www.irs.gov/charities-non-profits/financial-assistance-policies-faps https://www.irs.gov/charities-non-profits/financial-assistan... > Its literally a machine that kills people to maximize profit. If that were true it would do a good job of maximizing profit. It's not even that good. Healthcare margins in the U.S. are 0.7%, which sucks. If you're the proverbial evil billionaire or whatever you'd rather own almost anything else. https://www.nadapayments.com/blog/what-is-the-average-profit-margin-in-the-healthcare-industry https://www.nadapayments.com/blog/what-is-the-average-profit... The whole reason I started this thread is because it bugs me when we attribute to malice what is obviously stupidity.
  - zrn900 2y ago
    > It costs whatever you can negotiate it to cost That's a really surreal proposition. People who are sick cannot 'negotiate' anything. People who are recently treated and are recovering from an illness are the same. Something that is life-critical cannot be up for negotiation to start with, but lets allow it for argument's sake. What if you 'negotiate' and the hospital and the insurance company just reject? Do you have pockets deep enough to fight with their lawyers for years? Do you have the time? One person against corporate behemoths. That defies logic. > If that were true it would do a good job of maximizing profit It does. It keeps both the availability of doctors and hospital beds to create artificial scarcity. It does vertical integration and ensures that whatever you do in healthcare ranging from getting insurance to going to hospital, from medicines to secondary care stays within the corporate shareholdership network that owns the entire conglomerate. > when we attribute to malice what is obviously stupidity. The reason that the system gets away with murdering people for profit is that people attribute to stupidity what should be attributed to malice. If large corporations are killing people for profit like they are, malice should be attributed to the actions of all the upper echelons of the corporate world rather than any kind of incompetence.

by 0xBDB 2y ago

zrn900 2y ago

> The anecdotes The anecdotes show that this is not an 'occasional' or 'edge case' thing but a systemic thing. The statistics show that at least 40,000 people die a year for not having enough money for healthcare and these are the people we know. The statistics don't include those who never go to the hospital to avoid risking medical bankruptcy for their families even if they die themselves. Just being in a hospital bed for one night without anything being done costs $3000/night, whereas waiting in the ER without anything being done can cost $100/hour. https://www.marketwatch.com/story/woman-gets-688-35-er-bill-for-spending-7-hours-in-the-waiting-room-without-being-treated-11635794483 https://www.marketwatch.com/story/woman-gets-688-35-er-bill-... This is a systemic thing. Its not 'not a sane healthcare system'. Its literally a machine that kills people to maximize profit. And it became like this only because people let it and justified this or that other thing in the system.

0xBDB 2y ago
> Just being in a hospital bed for one night without anything being done costs $3000/night No, it doesn't. It costs whatever you can negotiate it to cost. I've been without insurance; one experience isn't data, but in my experience just telling the hospital you haven't got insurance is, again, good for 90+% off by itself. https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medical-bills-heres-how-to-lower-your-costs.html https://www.cnbc.com/2020/10/28/you-can-negotiate-your-medic... Hospitals (ed: non-profit ones, but I'm pretty sure similar rules apply elsewhere) in particular are required by federal law to have 'well-publicized' financial assistance policies. https://www.irs.gov/charities-non-profits/financial-assistance-policies-faps https://www.irs.gov/charities-non-profits/financial-assistan... > Its literally a machine that kills people to maximize profit. If that were true it would do a good job of maximizing profit. It's not even that good. Healthcare margins in the U.S. are 0.7%, which sucks. If you're the proverbial evil billionaire or whatever you'd rather own almost anything else. https://www.nadapayments.com/blog/what-is-the-average-profit-margin-in-the-healthcare-industry https://www.nadapayments.com/blog/what-is-the-average-profit... The whole reason I started this thread is because it bugs me when we attribute to malice what is obviously stupidity.
- zrn900 2y ago
  > It costs whatever you can negotiate it to cost That's a really surreal proposition. People who are sick cannot 'negotiate' anything. People who are recently treated and are recovering from an illness are the same. Something that is life-critical cannot be up for negotiation to start with, but lets allow it for argument's sake. What if you 'negotiate' and the hospital and the insurance company just reject? Do you have pockets deep enough to fight with their lawyers for years? Do you have the time? One person against corporate behemoths. That defies logic. > If that were true it would do a good job of maximizing profit It does. It keeps both the availability of doctors and hospital beds to create artificial scarcity. It does vertical integration and ensures that whatever you do in healthcare ranging from getting insurance to going to hospital, from medicines to secondary care stays within the corporate shareholdership network that owns the entire conglomerate. > when we attribute to malice what is obviously stupidity. The reason that the system gets away with murdering people for profit is that people attribute to stupidity what should be attributed to malice. If large corporations are killing people for profit like they are, malice should be attributed to the actions of all the upper echelons of the corporate world rather than any kind of incompetence.