
America’s Health-Care Crisis Is a Gold Mine for Crowdfunding - frgtpsswrdlame
https://www.bloomberg.com/news/articles/2017-06-12/america-s-health-care-crisis-is-a-gold-mine-for-crowdfunding
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ryguytilidie
As someone said below, we should be embarassed we live in a society where
someone needs to raise funds or go broke for medical treatment.

I'm starting my own business and the cost of health insurance is absolutely
insane. If we come to the conclusion that we want our fellow countrymen to die
or go broke versus live healthy, I think we should just shut it all down and
call it a day.

~~~
grondilu
> I'm starting my own business and the cost of health insurance is absolutely
> insane.

Why do you think that is? Why is medicine so expensive? Don't we live in a
highly-technological society? Shouldn't the price of medical treatment follow
the downward path taken by other technical domains, like computer devices?

~~~
michaelchisari
Because medicine (and medical care) is considered truly inelastic. When you
need it, you _need_ it. There's no comparison shopping or waiting until you
can afford it.

The free market rules that work for consumer goods start to really break down
for inelastic goods.

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johnwatson11218
I am about half way through this book

[https://www.amazon.com/dp/B00957T4QK/ref=cm_sw_r_cp_awdb_CEV...](https://www.amazon.com/dp/B00957T4QK/ref=cm_sw_r_cp_awdb_CEVqzb6T0MXJH)

And I think it makes many good points about our health care system. Thinking
about why I don't use geico insurance for routine maintenance on my car was a
very interesting thought experiment.

~~~
TuringNYC
I see what you are getting at (i.e., health insurance should be for
catastrophic events rather than routine visits.)

The problem is that in the US, routine visit costs are wildly inflated. Try
going in to get a vaccine or a cold and you get wildly dispersed and large
quotes. This is because the insurance system is two things in one: a real
insurance plan + a negotiated ratecard. When you go for routine/preventative
care with insurance, you get fairly reasonable values on the rate card --
without it, they can (and usually do) charge you anything, and often you don't
even know the cost until afterwards.

Until there are realistic rates for simple/routine/preventative needs, I don't
see how insurance can be restricted to catastrophic cases only.

~~~
michaelchisari
_health insurance should be for catastrophic events rather than routine
visits_

But routine visits often severely reduce the rate of catastrophic events.
Catching cancers early, assessing risk factors, etc.

~~~
johnwatson11218
Like I mentioned in the top comment, I'm still reading the book, so I'm
interested to see how things like moral hazard and preventative care are
addressed. In the first chapter he advocates splitting our system into two
parts. The first would be government supplied cradle to grave health insurance
that only covers unexpected, catastrophic events. The idea being that 90% of
the population would never even file a claim. For everything else the author
recommends the free market with doctors and providers competing for our
business.

He gives the example of LASIK eye surgery. Apparently it isn't covered by
insurance and has to be paid for with cash. After 20 years you can find it as
low as $299 in some cities while some doctors charge more and claim to offer a
higher quality service.

I'm still not clear on how a bad lifestyle that leads to diabetes which leads
to foot amputation would be dealt with under this system but I'm enjoying the
book anyway.

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skywhopper
Overheard on Twitter: What if... we had this one giant GoFundMe for all
medical bills that everyone paid into?

~~~
hkmurakami
I'd go do every medical test and examination I'd be entitled to since I no
longer have a cost associated with it.

I.e. What CA Single payer is proposing.

~~~
michaelchisari
> every medical test and examination

You would be a statistical outlier. People don't go to the hospital for fun.

~~~
hkmurakami
That's verbatim what the nirse's union is saying...

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michaelchisari
Citation needed.

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hkmurakami
Citation: friend who is active in local politics who was at the CA state DNC
convention last month in meetings.

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davidf18
Cities are states are free to work the the Federal Government to set up
healthcare for their citizens.

For example, where I live in NYC (at least prior to Obamacare) 450,000 New
Yorkers without health insurance could go to one of many Community Health
Centers funded by Feds, State and other sources as well as go to one of 11
public hospitals.

Interestingly, ObamaCare cut the DSH funding to these and similar public
hospitals throughout the country. [1]

Part of the funding in NY State / NY City comes from $4.35 state and an
additional $1.50 city tax per pack on cigarettes. The tax revenues are then
put into Medicaid funding which in the case of NY State is matched 1:1 by the
Federal Govt.

Trumpcare should restore the DSH funding that ObamaCare unwisely cut and
increase the funding for Community Health Centers. States should increase
tobacco taxes and use those funds to help pay for healthcare for their
residents.

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

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cmurf
This is both market failure and government failure. And the reason why we're
arguing is the politics demands fighting for government or for the free
market.

Health care industry in the U.S. includes hospitals, doctors, R&D,
pharmaceuticals, insurance. All of those things are for-profit, but are also
anti-competitive because they don't voluntarily, or by law, publish prices;
they have conglomerated (mergers) more than banks; we confuse insurance with
payment plans, a fair chunk of insurance cost is a payment plan for
predictable procedures colds, annual checkups, pregnancy, aging. Aging is
probably the biggest part of the payment plan because almost everyone is going
to have problems related to it eventually.

My main criticism with ACA and proposed AHCA is that it effectively subsidizes
a busted system. The U.S. spends 3x per capita for healthcare that does not
cover everyone, compared to OECD countries who do cover everyone. U.S. pays
more money to cover fewer people. It's an inherently classist system.

To really solve this we have to be willing to merge private insurance,
Medicare, Medicaid, FEHB, military and veterans medicine, into one system. All
of the conglomeration says is this is a natural monopoly but we keep trying to
force something that's inherently anti-competitive to be competitive. It'd
still be unfair but metric tons better than what we have, to just hand over
the whole mess to a team made up of epistomologists and economists and then
adopt their recommendation.

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awalton
Go with me here, what if instead of paying into a crowdfunding campaign, these
people paid into a central pool of money, and then when they had exceptional
health care costs, they could dip into this pool and pay off their bill?

Imagine what kind of revolution that'd make.

~~~
jklein11
I understand you are being sarcastic, but this is how both single payer
systems and private insurance market places work. The only difference is, in
one system people are elected to determine how the central pool of money is
collected and distributed and in the other decisions are driven by
shareholders.

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clamprecht
What about medical tourism? Seems like a possible solution for non-emergency
care. Paul Buchheit tweeted a few years ago that he wanted to fund the "Uber
of medical tourism". The tweet seems to be gone (not sure why?), but here's my
previous comment about it:

[https://news.ycombinator.com/item?id=10731415](https://news.ycombinator.com/item?id=10731415)

~~~
davidcbc
Seems like a really bad solution for people who are poor

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michaelchisari
Or those who need emergency care.

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cpr
Health sharing co-ops have been at this for some time, based on Christian
principles.

Samaritan Ministries, e.g., is $500/month for family and generally pays 100%
of medical expenses, though no guarantees.

Our monthly check goes directly to someone else in the group. Minimal overhead
for admin.

Also grandfathered in the ACA.

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naaaaak
America's Health-Care Crisis???

You mean Obamacare didn't end skyrocketing costs and fix what it purported to?
You mean the sole accomplishment of a corrupt President didn't accomplish
anything? Say it isn't so!

Now explain why Marxist idiots "need" to "save" it.

~~~
sctb
You're not welcome to start flamewars like this, and you've been using this
account primarily to post ideological comments, which counts as an abuse of
the site. Please post civilly and substantively or not at all.

[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

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subverter
Woah, woah – you're telling me people _voluntarily_ help each other pay their
medical expenses without the government forcing them to?!

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michaelchisari
Crowdsourcing medical expenses is a point of national and economic
embarrassment, not pride.

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ahallock
This is not an argument.

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michaelchisari
If not, then neither is the post I'm responding to.

