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The real treat would be using AI to stop regulatory capture so you don't end up in a country where it's okay to be presented with a 195K bill that can be magic

by jimbohn 11mo ago

The real treat would be using AI to stop regulatory capture so you don't end up in a country where it's okay to be presented with a 195K bill that can be magically lowered if you insist hard enough.

xnorswap 11mo ago
It seems pretty messed up when a $30k bill is written up like a big win.
- candiddevmike 11mo ago
  Their brother presumably didn't have insurance, and it sounds like some pretty major procedures involving specialists, equipment, and hospital intake. While the outcome was horrible, all of those people need to get paid for the services rendered somehow if we want folks in the US to continue receiving this standard of care.
  - runako 11mo ago
    > While the outcome was horrible, all of those people need to get paid for the services rendered somehow if we want folks in the US to continue receiving this standard of care. Food for thought: - this approach produces systemic outcomes that are worse and cost more than other approaches - there are lots of ways for people to get paid to provide medical care. Medical professionals do not work for free in other countries, and they buy the same equipment and drugs from the same suppliers as Americans do. - we are allowed to look at how other countries have solved this problem without hitting people with giant medical bills. We are allowed to apply those solutions here. - the US standard of care is overall not particularly high in the global rankings. We may decide that we don't want to continue providing this standard of care, we may decide we want to be in the top 10 globally.
  - computerex 11mo ago
    Except everything in America is ludicrously priced. The cost of supplies and equipment is not even close to being realistic in America vs what you'd be charged for equal care in another country.
  - bgirard 11mo ago
    > Another was a code that was inpatient only and because it was an emergency he had never been admitted. The threads says this was 4 hours of work and they billed for things that weren't even used.
- bobtheborg 11mo ago
  $30K NOT counting some expenses (cardiologist, ER docs)??? > Bills were a few thousand here for the cardiologist, another few there for the ER docs, a bit for the radiologist. I helped my sister-in-law negotiate these down but they weren’t back breakers. Then the hospital bill came: $195k. This is a story about that.
- clutchdude 11mo ago
  To a lot of people, that's out of the fire and into the frying pan.
meowface 11mo ago
I think there's more than just regulatory capture at play here, unfortunately. America is an odd place. I think a public option is the only feasible path forward.
- giancarlostoro 11mo ago
  Hospital billing involves the 'mafia'-like influence game of having good insurance (which means being hired at the right company, with the right 'influence' over the hospital network in question) and covering the costs of the other patients who cannot afford it and refuse to pay. Hospital billing has the least teeth of any debt in the US. If you haggle a billing department long enough, they'll desperately take anything you give them.
harrall 11mo ago
I’m not sure there is regulatory capture at play necessarily. I notice regular doctors and dentists do this too. They’ll bill my insurance for extras in case they’ll pay and when insurance says no, the doctor doesn’t bill me either. Everyone is just trying to suck the most money out of everyone else. It sucks if you’re self-pay because you don’t have the weight of a whole company to do that due diligence for you.
noir_lord 11mo ago
As someone with medical conditions from a country with universal publicly funded health care, while it may not be flawless (though in terms of actual medical treatment, no complaints either) it sure does seem to be a whole hell of a lot better than the alternative. Not once have I had a sleepless night since been diagnosed over a decade ago about insurance, co-pay or how to afford my drugs/medical treatment. I’m on two prescriptions per month, total cost to me is £114 a year (about 150 bucks). Folks over in the US are getting hosed, twice the per capita with a worse outcome and it costs you a fortune on top personally. That healthcare is tied to employment is just the insane cherry on top (I’m aware of the historical reasons why that happened but should have been fixed not long after).
- ryao 11mo ago
  Are the outcomes in the US worse? Not that long ago (a couple months ago in fact), I looked at public data comparing cancer survival rates, which put the outcomes in the US at least 10% better than those in the UK. That was additive, such that a 20% survival rate in the UK for a type of cancer is at least a 30% survival rate in the US. The 10%+ better outcome in the US applied to all types of cancers for which I found public data. I believe the reason for higher US success rates was that the US used more aggressive treatments that the UK would not, since neither does the NHS pay for them nor do their doctors offer them. It is easy to complain about the US system, but the reason that the per capita cost of health care in the US is high could be because the US will try expensive things that the UK’s NHS never would have attempted (since spending exorbitant amounts on aggressive treatments with low chances of success to attain US success rates would drive the per capita cost of medicine to what could be US levels). The high US pricing of those treatments could be further amplified by attempts to take advantage of ignorance. Amplification to take advantage of ignorance was clearly the case in the article author’s case. I feel like the opposite viewpoint in favor of the US system is not well represented in online discourse, which could very well be because those who were not served well by the UK’s NHS are dead. There are anecdotes about people coming to the US for treatments that they could not receive in the UK or Europe, which is consistent with that. That said, I have only looked at data for cancer survival rates and not other illnesses, but the cancer data alone contradicts what you wrote. Perhaps reality is in the middle where the UK system is better for routine issues (i.e. you avoid sticker shock), but the US system is better for anything that falls outside of that (i.e. you have a better chance to live). There is evidence both systems have plenty of room for improvement.

by jimbohn 11mo ago

The real treat would be using AI to stop regulatory capture so you don't end up in a country where it's okay to be presented with a 195K bill that can be magically lowered if you insist hard enough.

xnorswap 11mo ago

It seems pretty messed up when a $30k bill is written up like a big win.

candiddevmike 11mo ago
Their brother presumably didn't have insurance, and it sounds like some pretty major procedures involving specialists, equipment, and hospital intake. While the outcome was horrible, all of those people need to get paid for the services rendered somehow if we want folks in the US to continue receiving this standard of care.
- runako 11mo ago
  > While the outcome was horrible, all of those people need to get paid for the services rendered somehow if we want folks in the US to continue receiving this standard of care. Food for thought: - this approach produces systemic outcomes that are worse and cost more than other approaches - there are lots of ways for people to get paid to provide medical care. Medical professionals do not work for free in other countries, and they buy the same equipment and drugs from the same suppliers as Americans do. - we are allowed to look at how other countries have solved this problem without hitting people with giant medical bills. We are allowed to apply those solutions here. - the US standard of care is overall not particularly high in the global rankings. We may decide that we don't want to continue providing this standard of care, we may decide we want to be in the top 10 globally.
- computerex 11mo ago
  Except everything in America is ludicrously priced. The cost of supplies and equipment is not even close to being realistic in America vs what you'd be charged for equal care in another country.
- bgirard 11mo ago
  > Another was a code that was inpatient only and because it was an emergency he had never been admitted. The threads says this was 4 hours of work and they billed for things that weren't even used.
bobtheborg 11mo ago
$30K NOT counting some expenses (cardiologist, ER docs)??? > Bills were a few thousand here for the cardiologist, another few there for the ER docs, a bit for the radiologist. I helped my sister-in-law negotiate these down but they weren’t back breakers. Then the hospital bill came: $195k. This is a story about that.
clutchdude 11mo ago
To a lot of people, that's out of the fire and into the frying pan.

meowface 11mo ago

I think there's more than just regulatory capture at play here, unfortunately. America is an odd place. I think a public option is the only feasible path forward.

giancarlostoro 11mo ago
Hospital billing involves the 'mafia'-like influence game of having good insurance (which means being hired at the right company, with the right 'influence' over the hospital network in question) and covering the costs of the other patients who cannot afford it and refuse to pay. Hospital billing has the least teeth of any debt in the US. If you haggle a billing department long enough, they'll desperately take anything you give them.

harrall 11mo ago

I’m not sure there is regulatory capture at play necessarily. I notice regular doctors and dentists do this too. They’ll bill my insurance for extras in case they’ll pay and when insurance says no, the doctor doesn’t bill me either. Everyone is just trying to suck the most money out of everyone else. It sucks if you’re self-pay because you don’t have the weight of a whole company to do that due diligence for you.

noir_lord 11mo ago

As someone with medical conditions from a country with universal publicly funded health care, while it may not be flawless (though in terms of actual medical treatment, no complaints either) it sure does seem to be a whole hell of a lot better than the alternative. Not once have I had a sleepless night since been diagnosed over a decade ago about insurance, co-pay or how to afford my drugs/medical treatment. I’m on two prescriptions per month, total cost to me is £114 a year (about 150 bucks). Folks over in the US are getting hosed, twice the per capita with a worse outcome and it costs you a fortune on top personally. That healthcare is tied to employment is just the insane cherry on top (I’m aware of the historical reasons why that happened but should have been fixed not long after).

ryao 11mo ago
Are the outcomes in the US worse? Not that long ago (a couple months ago in fact), I looked at public data comparing cancer survival rates, which put the outcomes in the US at least 10% better than those in the UK. That was additive, such that a 20% survival rate in the UK for a type of cancer is at least a 30% survival rate in the US. The 10%+ better outcome in the US applied to all types of cancers for which I found public data. I believe the reason for higher US success rates was that the US used more aggressive treatments that the UK would not, since neither does the NHS pay for them nor do their doctors offer them. It is easy to complain about the US system, but the reason that the per capita cost of health care in the US is high could be because the US will try expensive things that the UK’s NHS never would have attempted (since spending exorbitant amounts on aggressive treatments with low chances of success to attain US success rates would drive the per capita cost of medicine to what could be US levels). The high US pricing of those treatments could be further amplified by attempts to take advantage of ignorance. Amplification to take advantage of ignorance was clearly the case in the article author’s case. I feel like the opposite viewpoint in favor of the US system is not well represented in online discourse, which could very well be because those who were not served well by the UK’s NHS are dead. There are anecdotes about people coming to the US for treatments that they could not receive in the UK or Europe, which is consistent with that. That said, I have only looked at data for cancer survival rates and not other illnesses, but the cancer data alone contradicts what you wrote. Perhaps reality is in the middle where the UK system is better for routine issues (i.e. you avoid sticker shock), but the US system is better for anything that falls outside of that (i.e. you have a better chance to live). There is evidence both systems have plenty of room for improvement.