
Health system sues thousands of patients, seizes pay and puts liens on homes - spking
https://www.msn.com/en-us/news/us/uva-has-ruined-us-health-system-sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/ar-AAH27ni
======
gargravarr
The out-of-network stuff is the most insane part of the American health
system. No question, it's deliberately set up to trip up those who need urgent
care. There are plenty of stories of people who go out of their way to find an
in-network hospital to have surgery with an in-network surgeon, only to be
billed for the anaesthesiologist who is out of network - something they cannot
object to because they're being put under. Even if they could ask, what choice
do they have - take the surgery while awake? So beautifully set up to screw
over the patient.

It's often said that health is a highly profitable business in America. And
yet it is astonishing how feverishly the average Joe will fight against free
healthcare because those who make the profits have convinced them it's bad for
them. Look at any country with nationalised healthcare; none of us in the UK
have a bad word to say about paying for the NHS through National Insurance if
it means we can walk into any GP's surgery or hospital and never need to worry
about money or insurance.

In the best possible way I hope the system breaks completely and it has to be
rebuilt from the ground up. Maybe then some semblance of fairness can creep
in.

~~~
tcbawo
In America, it is virtually impossible to safely retire early knowing that you
will have enough money to cover unexpected medical expenses for you and your
loved ones. Without insurance, you may be on the hook for millions of dollar
of liabilities.

~~~
ThrustVectoring
Your 401(k) is bankruptcy-exempt nationwide, IRA balances are exempt up to
state statutory limits (some states are unlimited here), Social Security
payments are fully bankruptcy-exempt, and some states will even exempt your
primary residence (eg, Texas).

Insurance is only really necessary to avoid large up-front cash payments - the
healthcare provider will treat you with the expectation that they'll negotiate
some amount of payment from your insurance provider. Past that, it's fully
legal and completely possible to set up your retirement finances so that
healthcare providers have to make you pay in advance to get any money out of
you whatsoever.

For example: move to Texas to get your IRA 100% exempt. Buy a duplex that's
also 100% exempt, live in half, and rent out the other half for cash or
physical checks. Whenever you get money from your tenant, immediately convert
it to cash and use the money to pay off credit card bills - if you're spending
via debt, they can't seize the cash accounts you're using to make purchases.

More generally, there are plenty of ways to acquire bankruptcy-exempt assets
with your non-exempt retirement savings. Delaying social security is the
easiest of these.

~~~
munk-a
It is depressing that our system is so broken that this kind of strategic
planning is needed to avoid destitution in your elder years. For everyone who
isn't familiar with bankruptcy law or hasn't been casually informed - how do
they survive retirement. If you've shifted your 401(k) money into private
investments for a better return or already burned through your IRA - if you're
retired in a state that isn't protective of your primary residence (and lots
of people have retired to places that aren't Texas) then what? Is it just
"sucks to be you, you didn't understand all these complicated rules well
enough?" and what if your mind is deteriorating, then it's on your inattentive
descendants to make sure all of this is running as it should be? Or are you
constantly losing money paying a firm to manage your affairs - essentially the
"please don't let health insurance bankrupt me" tax.

~~~
ThrustVectoring
>For everyone who isn't familiar with bankruptcy law or hasn't been casually
informed - how do they survive retirement

That's a big thing that breaks my heart to see happen. People have a giant
pile of medical bills, and a large 401(k), and decide to raid their retirement
funds to pay off the bills when there's neither a legal nor moral obligation
to do so.

>if you're retired in a state that isn't protective of your primary residence
(and lots of people have retired to places that aren't Texas) then what?

My standard advice is to limit your home equity via a mortgage or line-of-
credit. Losing a $300k house to creditors sucks, losing the $60k in home
equity on a $300k house sucks a lot less.

>and what if your mind is deteriorating, then it's on your inattentive
descendants to make sure all of this is running as it should be?

You should have a well-documented financial plan anyhow, especially if you
want to make it easy for your heirs to deal with your financial assets.

------
TinyBig
This has been par for the course for UVA for some time. When I was a student
at UVA ~2 decades ago, I came down with an especially severe case of food
poisoning after having dinner at one of the dining halls. One of my friends
found me in a very bad state and took me to the ER. They refused to accept my
insurance afterwards and when I attempted to dispute the bill, threatened me
with an honor code violation (read: expulsion). They seized my tax refund
nearly a decade later after “realizing they undercharged” me.

~~~
mehhh
I ran into the something similar with Cigna and Kaiser (albiet for a much
smaller dollar amount), I called both entities prior to going to urgent care
and described the care I needed (xray, splint) and was told that the copay
would cover it. Lo and behold, I got stuck with the majority of the $500 bill,
wish I had not gone in retrospect.

~~~
Ididntdothis
that's the evil part. They can charge whatever they feel like and there is
pretty much nothing you can do besides maybe having a lawyer on retainer.

------
aussieguy1234
We had this problem in Australia.

Hospital treatement was the #1 cause of bankruptcy.

Then, 30 years ago, our universal healthcare system was introduced.

Problem solved. There is a levy on our taxes each year to pay for it, a bit
like a private health insurance premium. But its worth it. It also covers
people who can't pay, like the unemployed/disabled.

~~~
Johnny555
_It also covers people who can 't pay_

We have a similar levy in the USA, except it's mostly paid by people that
_can_ pay for healthcare, so an aspirin costs $100 when administered by a
hospital.

And since insurance companies are smart, they negotiate down those exorbitant
rates to something more reasonable, so much of the burden lies on those stuck
in the middle -- they don't have enough income to pay for health insurance,
but have enough assets to pay for healthcare so they end up paying the
exhorbitant rates because most people don't have time to rationally evaluate
and price out their healthcare and choose the most cost effective provider,
and even if they do have the time, the hospital can't tell you how much it's
going to cost until the work is done and they bill you.

Even when you _are_ insured and have a procedure done by a doctor that's
covered by your healthcare plan, sometimes another provider (like an
anesthesiologist) will do part of the procedure and you end up paying $10,000
or more out of pocket for his services.

Our system is broken in so many ways.

~~~
close04
This is the effect of lobbying (call it legalized corruption). Insurance
shouldn’t be that expensive that even middle class can’t pay for it and a
hospital shouldn’t be allowed to charge arbitrary sums for this. It’s clearly
possible since many countries successfully pull this off.

But in countries that are “for corporations, by corporations” regular people
can’t lobby their way into getting what they want or need. Only the wants and
needs of a certain few that pay for their laws are considered.

------
Johnny555
_The $164,000 billed to Waldron for intestinal surgery was more than twice
what a commercial insurer would have paid for her care_

This is one of the worst parts of USA healthcare -- why are uninsured patients
charged _more_ than insured patients? (sometimes _much_ more, like 10 times
more [1])

[1] [https://www.washingtonpost.com/national/health-
science/why-s...](https://www.washingtonpost.com/national/health-science/why-
some-hospitals-can-get-away-with-price-gouging-patients-study-
finds/2015/06/08/b7f5118c-0aeb-11e5-9e39-0db921c47b93_story.html)

~~~
maccard
It's not insane to think that a service provider would give a discounted rate
to a firm they have continuously done business with over time, who spend a
large amount of money, and consistently pay their bills in any other area of
business, so at the face of it, it seems sensible. The orders of magnitude are
terrifying however

~~~
jacobush
It still feels completely alien to me. It's not like there is a different
medical procedure is it?

~~~
patrec
If you provided something that cost $100 to produce and there are two easily
and legally segregable types of customers, one who will pay the bills in 99.9%
of cases and whom you charge $110 and one who pays the bills in 30% of cases,
how much would you charge the second type of customer?

(Having said that, I don't think the pathological cost divergences in US
healthcare are mostly explained by this)

~~~
Johnny555
But they are charging that other customer $500 for that $100 procedure. If
they charged him $110, it's much more likely that he could pay. And it's not
like insurance companies are easy to deal with, optimizing payouts means
hospitals hire entire coding departments and they still sometimes see long
delays untill payment for complicated procedures.

And unlike, say, choosing between buying a $250k Lamborghini vs a $20k Toyota,
the patient has to choose the $250k bypass surgery or he'll die. Which is why
this can't fairly be judged purely in business terms, customers have little
choice in whether or not they purchase healthcare services.

~~~
maccard
I don't think anyone in this tree disagrees with you here - the question the
parent asked was how much should they charge? If the dollar cost of the
procedure is $90, and insurance companies pay $100 and pay every time, how
much should someone who has a 30% chance of paying pay for the procedure?

~~~
jessaustin
Please stop repeating this. Insurance companies do _not_ "pay every time".
Hospitals have to employ entire departments of RNs to argue with insurance
firms that this procedure was justified and that test was necessary. Cash
patients don't get to make that argument!

~~~
wiggles_md
And not only do they not pay every time, even when they agree to pay they
frequently don’t pay on time!

------
Aloha
This utterly sickens me - it also gave me a thought - If the uninsured could
pay medicare or medicaid pricing for services, they may not need insurance to
cover their care.

The uninsured should always get the lowest price the hospital is willing to
charge anyone for that service, period.

------
artixtn
Reading this article just down right sickens me... Corruption is everywhere,
people who do the right thing get screwed over in the end. Why can't we just
adopt the European model or Canadian model. This is the very reason why I just
want to leave the US.

~~~
save_ferris
It’s getting harder and harder to envision what retirement will look like for
millennials, between this and student loans.

An incredible number of boomers are going bankrupt due to medical expenses and
have nothing for retirement.

I like to think we’ll have together in 30 years, but if the last 30 years is
any indication, we’re in big trouble.

~~~
dv_dt
It's hard to envision any good outcome with the current system. But if we pass
a universal healthcare like Medicare for all, and forgive student loans, and a
number of other measures like girding against climate change, then for the
first time in long time I could a positive trend for the majority US
residents.

~~~
rayiner
The “majority of US residents” have private healthcare and don’t have student
loans. That majority will pay more taxes to make life better for the minority
of people who don’t have those things.

I’m in favor of universal healthcare, but billing it as something that will
help the majority is disingenuous. This is the most likely outcome. Costs stay
the same or go down a little bit, but nowhere near what it would take to make
costs competitive, even as a percentage of GDP, with Europe. That means taxes
will have to go up, and by a lot because our public sector is so inefficient
compared to Europe. (It costs is 7 times more to build a mile of subway than
France, why on earth would you expect building a hospital to be any
different?) These taxes will have to be paid by the middle class—because
that’s how it’s done in Europe. It’ll be totally unfeasible to have much
higher capital gains or corporate taxes than France. (Which has low business
taxes and pays for universal healthcare through regressive taxes.) At the end
of the day, the middle class household making $80k/year will pay a lot more
taxes, and their out-of-pocket healthcare spending won’t go down by much,
because they had employer-paid healthcare to begin with.

But the hourly workers and those folks will be able to see doctors! And that
will be a good thing. But it will also be quite unpleasant for the majority of
people who we’re doing okay under the current system.

~~~
Procrastes
A friend of mine studied healthcare management for his thesis. One of the
hidden costs in US Healthcare is the waste and duplication that comes from
competition. His example was a town with enough population to support a single
CT machine. They are expensive to maintain, but there was enough use to
justify it.

One hospital bought a CT machine. Doctors who are the most important customers
for any commercial hospital, began to sign contracts with that hospital
because it made access to the CT machine for their patients easier. The other
two local hospitals had to compete and bought their own. Now there were three
machines and only enough patients to support one of them. That didn't reduce
the maintenance costs. The cost inevitably is passed on to all patients. This
is only one example from hundreds where competition led to unnecessary cost
from duplication. Add to that the overhead for people who specialize in
insurance billing because the competing companies are different and very
complex, add to that the profit for the investors in the hospitals, the profit
for the investors in the insurance companies and that's not even touching the
similar stack for pharmaceuticals and supplies. That's not even adding in the
cost of delayed and emergency treatment due to lack of preventative medicine
for the uninsured and the under insured. All of that adds up to the $99 bag of
$0.99 saline that comes out of your pocket one way or the other.

It would be difficult to create a more wasteful or expensive system if you set
out to do it on purpose.

~~~
maxerickson
CT scanners and all the shit you need to run them don't cost that much.

The insurance I used to have negotiated with the hospital to charge ~$2000 for
a five minute CT. The radiologist charged like $30 to interpret it. You can a
buy a brand new machine every year with 5 or 6 patients a day.

The anecdote may have been true in 1982 or something.

Meanwhile, no one else can buy a CT because the state regulates who gets to
own one.

~~~
AstralStorm
Actually the maintenance costs less than $60 per patient and most of it is in
autoinjector, some in coolant and checks. You're being gouged. Source: in
Poland, checked the costs.

The cost of a new full size CT machine with surrounding equipment is quarter
of a million USD though. Some are more expensive than others, but you can get
a new good one for this much.

USG costs few tens of thousands, and maintenance is super cheap, mostly
consumable gel, some $8 per patient.

MRI machines are more expensive at half million USD and $120 per patient.
(cooling costs)

This includes salaries.

Hospital bed is like $12 per night, staff included.

Germany and Sweden have even better healthcare, mostly due to larger number of
doctors and nurses. Not that much more expensive too. Our education and
salaries don't keep up.

~~~
omgtehlion
Even in russia you can get MRI for $50 (depending on body part and resolution
it might go as far as $300).

Possible solution to duplication: decouple tech (test labs) from doctors
(hospital)

~~~
MandieD
Oddly enough, it seems like tech is closer to doctors in Germany than in the
US. Just about every Hausarzt (general practitioner) and every internist and
ob/gyn has an ultrasound machine in their practice and uses it themselves.
When I've been in the emergency room, the doctor does the ultrasound, not a
technician, though nurses set up and run EKGs.

And it's all amazingly cheap compared to the US, even as a private pay
patient. An overnight hospital stay is about 200 EUR, including the attending
doctor's fee.

~~~
JoeAltmaier
That's interesting. In the US, these things go for $10K or so. Maybe they
lease them? At $500/mo if it got used every day, that's be under $20 per use.

~~~
MandieD
No idea, but there's a lively enough market that I've seen older ultrasound
machines at veterinarians' offices.

Vet services, by the way, do cost approximately as much as they do in the US,
at least for birds.

------
ASalazarMX
The moral of the history is: Not everything should be run by businessmen.

~~~
ars
That's the wrong moral, this hospital is state run.

------
Ididntdothis
Stuff like this simply shouldn’t happen in a developed country. It’s insane
that this can’t get solved.

~~~
mschuster91
Too many people with connections profit off of the current situation, the
poorest people pay the price.

This is why there is no demand for real change and why all previous efforts
got essentially stonewalled.

~~~
vkou
It's actually the middle class that pays the price, through insurance
premiums, out-of-pocket co-pays, and high deductibles. Poor people have
Medicaid.

Medicaid, which even happens to pay reasonable amounts for procedures
performed. The entire system would re-adjust into a sustainable steady-state,
if all prices were equivalent to Medicaid reimbursements. But I suppose that
under such a model, the average middle-aged surgeon wouldn't be able to afford
their third summer home...

~~~
munk-a
Medicaid is probably the second best place to be in the US system after
Medicare - but it suffers from extreme politicization of care (good luck
trying to get HRT or an abortion on Medicaid), rationing, shortage of supply
(not all providers are required to or will service Medicaid patients) and
stringent requirements to ensure continued availability (these in particular
are getting much worse under pushes to get rid of "welfare queens" _sigh_).

That said, the only way to win is to not play - never get sick and emigrate
before you have any serious health issues.

~~~
vkou
All of these problems come from Medicaid and Medicare paying a lot less for
procedure performed (In line with what Canada, and Europe pays) than the
public market. It's a drain on most hospital budgets.

If all procedures performed were done at Medicaid-like prices, hospitals and
physicians, and pharma firms, and, by proxy, insurers and medical schools
would have to tighten their belts, and figure out how to cut costs. That's the
entire point of such an exercise. We can't let health costs grow in an
unbounded manner.

~~~
PorterDuff
100% agree with the drain on hospital budgets, at least so far as I know.

Dunno how 'Medicare for all' will work out if you simply start paying
providers what Medicare currently pays. Dictating a price might work in the
long run but would be plenty hairy in the short.

~~~
munk-a
A lot of people that get paid a lot of money for doing absolutely nothing will
lose their job - tough luck for them.

I can sympathize with the on-the-ground employees but the businesses they're
keeping the lights on in are leeches on the healthcare market - I posted
separately on this article going into the specific functions of PBMs,
Pharmaceutical Manufacturers, Providers and Insurers if you're curious about
the details, but there is a ton of inefficiency here.

~~~
PorterDuff
I'm thinking partly in terms of paying US health professionals what they make
in places like France. A certain amount of hilarity would ensue.

------
sershe
Ok so dumb question I always wanted to ask, about the arbitrary prices. Let's
say I have no insurance and I collapse on the street, get rushed to the
hospital and revived, after which they send me a bill for $10k. I didn't agree
to any treatment; I didn't sign anything. What prevents me from saying that I
won't pay it - not in "you can send it to collections" way, but in a "this is
a fraudulent bill" way, like I don't owe anything at all? If the hospital can
claim by fiat the price was $10k after the fact, how come I cannot claim by
fiat the price was $100, or send the hospital a counter-bill for $9900 for
having had the privilege of touching my chest? I mean, a car dealership cannot
send me a bill after the fact for an extra $10k for driving off the lot?
(Semi-)serious question, actually. What would they do? There's no contract.

Even if I did sign something in an emergency, I may be able to claim to not
have been capable enough to reason about it, due to shock/mental issues given
the emergency.

~~~
speedplane
> Ok so dumb question I always wanted to ask, about the arbitrary prices.
> Let's say I have no insurance and I collapse on the street, get rushed to
> the hospital and revived, after which they send me a bill for $10k. I didn't
> agree to any treatment; I didn't sign anything. What prevents me from saying
> that I won't pay it - not in "you can send it to collections" way, but in a
> "this is a fraudulent bill" way, like I don't owe anything at all?

Not a dumb question. If you don't have insurance, you can make such claim, and
very likely you'll never have to pay. If you do have insurance, it's very
likely that your insurance has pre-existing contracts with the hospital. Even
though the hospital can't force you to do anything, it's likely that they can
force the insurance to pay.

------
fdrw
>...is taxpayer supported and state-funded, not a company with profit motives
and shareholder demands. Like other nonprofit hospitals, it pays no federal,
state or local taxes on the presumption it offers charity care and other
community benefits valued at least as much as those breaks. Gov. Ralph Northam
(D), a pediatric neurologist, oversees its board.

------
purplezooey
We could have solved this in the 1970s or 1980s, but didn't, wonder why not.
Vote next time.

------
Ancalagon
I really wish one of the big corps not currently in the healthcare scheme
would lobby to change or disrupt the healthcare industry. I recall Amazon,
Chase, and Berkshire Hathaway were trying to do this for there employees, but
I havent heard the result of that for a while. The current players are too
entrenched for any one entity without a lot of capital to disrupt.

------
AstralStorm
Yes, the main goal of US healthcare system is profit, not health. Totally
wrong priorities.

------
imulligan
The USA is a pure capitalistic country and appears to have little or no
sympathy for the poor and disenfranchised.

~~~
newguy1234
Yup, which makes you wonder why poor people go to the USA compared to say the
Netherlands or some European country. If you are poor in the USA, you will be
exploited.

~~~
marcyb5st
It baffles me as well. Especially considering that the "American Dream"
(technically defined as Social Mobility [1]) is more achievable in Europe.
Especially in Scandinavian countries which are also the "happiest" countries
on the planet.

[1]
[https://en.wikipedia.org/wiki/Social_mobility](https://en.wikipedia.org/wiki/Social_mobility)

------
efitz
The way we pay for medical care in the US is screwed up.

That said...

I’ve always thought it weird that people feel entitled to free (or massively
discounted) medical care.

Consider the case where some business could sell you a product or service that
might add years to your life. How much is that worth? Why is it somehow unfair
or immoral if someone buys such a product or service, without considering
their ability to pay, and bankrupts themself?

Yes the issues are more complex here in the US due to the opacity and
arbitrariness of medical billing, but if we set that aside, how much is your
health worth to you?

~~~
michaelscott
I've seen this type of argument by a few people who are against state medical
care (not saying you're one of those in particular).

The product or service that extends your life is essentially not critical to
survival or even just your status quo health-wise. From an economic
perspective, this is a price elastic situation so charge as you like (i.e.
basically according to supply/demand).

The situation that is actually the problem (and way more common, of course) is
that if I'm in a life threatening situation I don't have the option to chose a
particular product or service, that's price inelastic and not beholden to
supply/demand. So you're comparing apples to oranges from an economic
viewpoint, especially when we're talking about something as critical as
healthcare.

~~~
johnday
For what it's worth, there are _some_ UK parties, where if they got into power
I suspect they would nationalise such a product/service for the betterment of
everybody.

------
oceanghost
This violates our long-held arrangement-- that they can keep charging these
ridiculous prices because we have no intention of paying them.

~~~
SketchySeaBeast
Turns out the entity with the money and lawyers can change the agreement at
any time - who knew?

------
whiddershins
I mean, I don’t blame them for trying to get paid for treatment they provided.
The problem is generally that these patients aren’t covered by private or
public insurance at the time of treatment, correct?

I mean, someone has to pay for the treatment somehow, right?

I’m not sure what is interesting exactly about this article.

People being uninsured and unable to afford health insurance is a huge
problem. Medical providers attempting to get paid for services they provide
seems like what they should do.

~~~
_bxg1
It's an example of how incredibly dystopian the system as a whole has become.
The individual mechanisms aren't egregiously wrong in isolation; it's the big
picture that's clearly broken.

------
ArtDev
A criminal racket. Where is the outrage?!

------
ptah
Use the right tool for the job. Consider that possibly free-market capitalism
is not the right tool to solve health care

------
mcthrowaway123z
Hippocratic oath meet capitalism

------
worik
A two word solution: Socialised medicine. The civilised world does it, about
time the USA caught up. Socialised medicine is not perfect, but the USA spends
the most for the worst results. How American!

~~~
hourislate
Socialized Medicine might solve the payment problem for people that can't
afford it but I lived under the Canadian System of Health Care (OHIP) and much
prefer the Health Care I have in the USA (TX). The service/quality of care I
receive in the USA is far superior in my opinion.

Here is a breakdown of Ontario, Canada's debt.

[https://en.wikipedia.org/wiki/Ontario_government_debt](https://en.wikipedia.org/wiki/Ontario_government_debt)

>Health and education together account for more than 50% of Ontario's spending
($61.3B and $29.1B, respectively)

If you don't mind paying incredibly high taxes for health care or having other
people subsidize it for you, then you will probably enjoy socialized medical
care.

~~~
thebooktocome
> If you don't mind paying incredibly high taxes for health care or having
> other people subsidize it for you, then you will probably enjoy socialized
> medical care.

I have no problem with my bracket (32%) going up to 50-60% or so if it means I
don't have to worry about my parents getting the kind of care they're getting
now under the American system.

~~~
halostatue
The best part is that it isn’t that high and the parent you’re responding to
is speaking relatively nonsense.

I’m in one of the higher tax brackets in Canada and my _net_ tax rate for 2018
was 28.74%—and that is both _federal_ and _provincial_ taxes.

Per Revenue Canada documentation, the 2019 rates will be: * 15% on the first
$47,630 of taxable income, plus * 20.5% on the next $47,629 of taxable income
(on the portion of taxable income over 47,630 up to $95,259), plus * 26% on
the next $52,408 of taxable income (on the portion of taxable income over
$95,259 up to $147,667), plus * 29% on the next $62,704 of taxable income (on
the portion of taxable income over 147,667 up to $210,371), plus * 33% of
taxable income over $210,371

Ontario adds on to that:

* 5.05% on the first $43,906 of taxable income, + * 9.15% on the next $43,907, + * 11.16% on the next $62,187, + * 12.16% on the next $70,000, + * 13.16 % on the amount over $220,000

[https://www.canada.ca/en/revenue-
agency/services/tax/individ...](https://www.canada.ca/en/revenue-
agency/services/tax/individuals/frequently-asked-questions-
individuals/canadian-income-tax-rates-individuals-current-previous-years.html)

I’m in the third tax bracket. My wife and I together would be in the fourth
(but income taxes are not blended that way).

So…no, Canadian taxes are not, and have never been as bad as people say.
(Before I émigrated, my wife and I made the same amount of money one year—and
I paid more in state and US federal taxes than she did, in the 90s.)

And I get healthcare and a healthy society out of it.

------
bawana
The capitalist solution is......

GROUPON

This speaks to the opacity of pricing in the healthcare industry. There should
be a price list at the door of the hospital for common services.

~~~
nimish
I would love to know how I could price discriminate when I was in crippling
kidney stone pain.

Price transparency is only a minor issue.

------
jhare
"for-profit hospital" industry. It's not your pal. It's there for your money.

~~~
ars
Quite an ironic statement. This hospital is entirely state run and non-profit.

------
donclark
How is our health system legally mandatory? Why do we HAVE to pay into
medicaid etc. if the system is not run efficiently? Why is there not an
alternative?

~~~
munk-a
Because the market has been fully captured by current players and new entrants
either play along or are forced out of business - but generally don't even try
to join because of the prohibitive barriers to entry.

Medicaid is one of the less broken parts of the system actually.

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egdod
Seems unremarkable. Most businesses will do this if you owe them money and
don’t pay.

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rayiner
There are good arguments against our existing healthcare system, but this is
not one of them. Collections is an issue whether or not you have universal
healthcare, it just happens one step removed. What exactly do you think
happens when you don’t pay your taxes? The government takes pity on you and
lets you off the hook? In my county, the government auctions off a lien on
your house when you fall behind on your property taxes.

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SketchySeaBeast
No, this is an excellent case of universal healthcare. In countries with it,
this situation - an emergency illness leading to a pile of debt, doesn't
happen. There's a huge difference between "you didn't pay your taxes" and "you
got stick and are now stuck with a bill you can never hope to pay off".

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F147H34D
It's pretty sad to think someone could be in a situation where they are sick
and simply won't go to the doctor to get help -- because they can't afford it.
The last thing someone should have to worry about when trying to recover from
cancer or some other illness/injury is how is this bill going to get paid. I'm
in law enforcement, imagine how many less calls there would be if the person
calling the police had to pay for the service (directly, full cost).
Healthcare should be in the same bucket as other public services, regardless
of the income generated by that person.

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PorterDuff
Am I missing something here?

. Hospital system is a bastard to people who owe them $$$$.

. This is an argument for government-run healthcare.

. Hospital system is run by the government.

I'm certainly not against copying someone else's system (Switzerland?
Singapore? it isn't like they're the same) but just assume nothing good will
happen. There's too many iron rice bowls, including actual providers, plus you
have to fix the plane while it's flying.

Best to deal with the world as it is and keep your head down. That memory care
center in Thailand is starting to look pretty good.

