
When Medical Debt Collectors Decide Who Gets Arrested - johnny313
https://features.propublica.org/medical-debt/when-medical-debt-collectors-decide-who-gets-arrested-coffeyville-kansas/
======
hestipod
My life was ruined by badly done, and even worse ultimately unneeded surgery.
That privilege initially cost me many thousands, along with career and
insurance going away, and the subsequent struggle to survive since has cost
multiples of that. My entire future billed away. For a time I was able to
avoid collectors because of a significant savings a frugal life had left me,
but as time goes on you have to choose between medical care and other basic
needs unless you want to go into a deep financial hole at a time you have MORE
financial need like the people in this article. As a former provider, as a
patient advocate and activist, and now as a person on the edge, I never saw
anyone get out of that hole and it terrifies me every single day.

I am constantly getting third and fourth party bills for huge amounts re
things I did not consent to be sent away or billed externally. That's AFTER
asking up front AND paying huge amounts for the primary service up front.
These things come many months later and I can see one easily getting lost or
not sent properly and me ending up in a massive legal battle over debt and
summary judgements behind my back. Even with paranoid checking of old accounts
and services they continue to mess it up and debts show up later. I was ruined
by this country's medical business and ultimately it's going to be the cause
of my death as I am at the limit of what I can handle in all regards. I tried
to get out of the country for good to places I have lived and can get better
healthcare, and have at least some quality of life with my remaining health
and years, but ironically since I am so broken because of this experience it
severely limits my options. I feel trapped and hopeless.

~~~
mars4rp
I know people in HN hate to talk about politics, but this is a political
problem.

People, please vote for medicare for all candidates, it might not affect your
life now, but you don't know what the future holds for you.

~~~
wdn
Medicare for all is not a solution. The solution is make health insurance act
like insurance. Health service provider needs to post their price like all
services and products. They need to compete for our business.

~~~
fzeroracer
Absolute nonsense.

What about the poor people who only have one hospital nearby that might not
accept their insurance? What about people who go to a hospital that's in their
network, but it turns out one of the many doctors was not? The people who have
a time critical illness who can't afford to do the whole Free Market thing
right after a accident?

How does anyone know that when they arrive somewhere the exact number of
treatments needed to cure their illness? Are you expected to walk out of the
hospital and refuse treatment because you've tabulated all of the prices for
all of the services needed, then ask the ambulance to take you somewhere else?

The free market solution to health insurance simply does not work and it's
insulting to see people suggest it time and time again. It ironically only
works in heavily centralized areas where people actually have a choice, and
not the more rural areas where hospitals are far more spaced out. There's far
too many variables at play for even software engineers to manage unless you
dedicate a significant amount of your free time to maintaining an excel
spreadsheet of every hospital near you and their prices, formulate the exact
cheapest plan on the fly according to your personal needs and can pull that
out immediately when you have a medical emergency.

And that's assuming they didn't decide to go out of network the day before and
delayed updating their database.

~~~
AnthonyMouse
> What about the poor people who only have one hospital nearby that might not
> accept their insurance? What about people who go to a hospital that's in
> their network, but it turns out one of the many doctors was not? The people
> who have a time critical illness who can't afford to do the whole Free
> Market thing right after a accident?

All of these only apply to time-critical procedures. Otherwise you should be
able to use the doctor and hospital which is covered.

Let's assume that emergency medicine should be provided by cities in the same
way as other emergency services like fire companies. What's the argument for
doing it that way for _all_ medical services, including the ones that are not
time sensitive and allow you plenty of time to shop around and choose the
provider with the best combination of price, distance, scheduling
availability, etc.?

> There's far too many variables at play for even software engineers to manage
> unless you dedicate a significant amount of your free time to maintaining an
> excel spreadsheet of every hospital near you and their prices, formulate the
> exact cheapest plan on the fly according to your personal needs and can pull
> that out immediately when you have a medical emergency.

This is hardly the only circumstance where there are many variables. Should
the government buy everyone the same car because there are so many different
choices between prices and safety ratings and fuel economy and performance?
How does that even help, since the solution space is the same and government
knows less about your priorities than you do?

~~~
fzeroracer
> Let's assume that emergency medicine should be provided by cities in the
> same way as other emergency services like fire companies. What's the
> argument for doing it that way for all medical services, including the ones
> that are not time sensitive and allow you plenty of time to shop around and
> choose the provider with the best combination of price, distance, scheduling
> availability, etc.?

Because for a lot of people, there is no real choice involved. If there's one
hospital around for hundreds of miles, they realistically don't have the
option to go to one further out when their job expects them to be available
for work every single day. Not to mention that requires every hospital to
offer every service and to have every type of specialist for every type of
disease.

Medical issues don't operate like a grocery store. You can't just walk into a
hospital and choose between Name Brand MRI or Store Brand MRI. It requires a
level of knowledge that most people don't have. It's knowledge I don't have!
And something I'd prefer to never have to think about when I have other shit
to deal with in real life.

> This is hardly the only circumstance where there are many variables. Should
> the government buy everyone the same car because there are so many different
> choices between prices and safety ratings and fuel economy and performance?
> How does that even help, since the solution space is the same and government
> knows less about your priorities than you do?

Your analogy falls apart because the government does make mandates for cars.
Things like safety features. And you're trying to compare buying a car which
is a fairly small subset of considerations for the average person versus
trying to purchase medical assistance which is an incredibly wide field
encompassing multiple types of examinations, surgeries, biopsies and more.
When you're looking for a car, you have some properties of a car which are
easily understandable. When you're searching for medical assistance, most
people only vaguely know what's actually wrong.

~~~
AnthonyMouse
> Because for a lot of people, there is no real choice involved. If there's
> one hospital around for hundreds of miles, they realistically don't have the
> option to go to one further out when their job expects them to be available
> for work every single day.

Federal law requires employers to provide at least unpaid sick leave. That
caps the premium a local hospital can charge over competitors at the loss of
the day's wages and the travel costs, which are both dwarfed by the amount of
money in medical expenses we're comparing them to for these bankruptcy-
inducing procedures.

> Not to mention that requires every hospital to offer every service and to
> have every type of specialist for every type of disease.

Why would it require that? There are thousands of hospitals in the US. You
don't need every hospital to do everything as long as there is some
competition for any given thing.

And far away hospitals can provide competition even if people don't actually
use them in practice. If it costs $1000 in travel and inconvenience to fly to
another city for a procedure then people won't use a local hospital that tries
to charge $10,000 more, so they charge only $900 more because it's all they
can get away with. But that's only if there's price transparency -- if you
can't find out ahead of time that it costs $10,000 more for the local hospital
then people choose it anyway and there is no incentive for them to lower their
prices, which is where we are now.

> You can't just walk into a hospital and choose between Name Brand MRI or
> Store Brand MRI. It requires a level of knowledge that most people don't
> have. It's knowledge I don't have! And something I'd prefer to never have to
> think about when I have other shit to deal with in real life.

And that option exists -- you buy an expansive low deductible insurance plan
that covers everything. That necessarily comes at the cost of very high
premiums, because it has to cover the cost of making you price-insensitive.

You can also buy a less expensive insurance plan that _doesn 't_ cover
everything and then consider anything it doesn't cover as unavailable. That's
what socialized systems generally do, because they do make people price-
insensitive but still have budgetary requirements to meet. But there's no
reason you can't get a private plan that does that either; just don't object
when it doesn't cover everything. You pay for what you get, one way or
another.

> Your analogy falls apart because the government does make mandates for cars.
> Things like safety features.

They also have mandates for medicine. There is a whole medical licensing
system. That's independent from who pays for it.

> When you're looking for a car, you have some properties of a car which are
> easily understandable. When you're searching for medical assistance, most
> people only vaguely know what's actually wrong.

I don't see how it's different. There are plenty of subtleties when buying
anything expensive that aren't readily apparent, like that car insurance can
be more than the car payment, or that some models depreciate faster than
others so you have to account for future resale value, or that some models
have more frequent repairs, or more _expensive_ repairs. Some people buy based
on style and only later find out through experience the total cost of
ownership is $40,000 higher than they expected.

It's the same thing with healthcare, but it's the same thing with healthcare
_either way_. Regardless of who is paying, which doctor has the best patient
outcomes? Which medication is more effective? What clinical trials are there
for your condition? You can ask your doctor, but first you have to choose your
doctor. And then, in the end, they only advise you what to do. It's still your
decision and your life.

~~~
TheDong
> Federal law requires employers to provide at least unpaid sick leave. That
> caps the premium a local hospital...

Not really. The law you're referring to is the Family and Medical Leave Act
(FMLA), which only applies for childbirth and "serious health conditions".
Most things you can shop around for also aren't serious enough to qualify, so
you're not entitled to such unpaid sick leave.

But also, it's kinda a moot point because laws like that only apply to people
that know them or can afford an attourney. Just like the person in the linked
article didn't know she couldn't be harassed quarterly by the court system
(rather, just yearly) due to being disabled, those who are most in need of
that law are unlikely to know about it nor to have an attourney.

> If it costs $1000 in travel and inconvenience to fly to another city for a
> procedure then people won't use a local hospital that tries to charge
> $10,000 more

This assumes that people have both perfect knowledge of their procedure and
the prices of all hospitals, and that people value money over convenience.

I know for a fact that I can fly to another country with free healthcare and
get a procedure for cheaper than I can get it in the US, but hardly anyone
does that regardless. It's just too inconvenient.

I also know for a fact that people rarely have even decent knowledge. Plenty
of people buy incredibly overpriced cell-phone plans or internet. The free
market hasn't been able to get those prices anywhere close what they should be
even though people can switch providers, compare prices, and aren't stressed
about their health.

~~~
ceejayoz
FMLA has an even bigger gaping loophole - it only applies to employers with
50+ employees. That excludes an _enormous_ number of people.

------
nitwit005
> His friend bailed him out the next morning, but at the bond hearing, the
> judge granted the $500, minus court fees, to the hospital.

I know it's not the subject of this, but this sounds like it's probably
illegal? He's seizing money that was supposed to be returned to someone other
than the defendant.

~~~
derekp7
Yeah, that's the thing they don't tell you up front. When you bail someone
out, you are legally giving them that money. So if the money is owed to
something else (such as fines / court costs, or a legal judgement) those funds
are redirected in the end.

------
whateverm4n
This is happening in Kansas. Everyone feels bad, but not enough to actually
vote based on the issue. That suggests it isn't really a major issue for them.

Not only do they suffer, but numerous people in progressive states also suffer
because right-leaning states like Kansas vote the country towards these types
of repressive laws.

~~~
dunnevens
I live in Kansas. We currently have a Democratic governor who is quite
progressive by this state's standards. She's in her job because the voters
rejected another 4 years of Brownback-style austerity. Brownback ended his
term with ~21 percent approval. Currently, the state still doesn't have the
ACA Medicaid expansion, but we're very close to having enough votes in the
legislature. I'm cautiously optimistic about next year's legislative session.

The voters do respond, eventually. But the ship is slow to turn. With the wave
of rural Kansas hospital closures, farmers going out of business due to the
tariffs, and stories like the one linked, Medicaid expansion is very popular
with the voters. The pressure is only going to grow.

~~~
hestipod
Medicaid as it exists denies a lot of people for various reasons. It has poor
coverage and providers aren't obligated to take it so many do not. Simply
closing the AHCA/Medicaid gap in the red states who refused to do so years ago
isn't going to change much overall and is quite a hollow "victory" for those
states.

~~~
dev_dull
I read back some of your history. I hope the dark clouds break in your life
and you get some much needed warm rays of hope. It’s sad what happens to
people in this country stuck in the kafkaesque twilight of our medical system.
And then to be rejected by friends and family...

 _“Why have you made me your target? Have I become a burden to you?”_

~~~
hestipod
Thank you for your kindness, but it won't happen. It's not happened in all
these years and the need and issues are worse now. If I had been born in the
first world with a proper social safety net I would have had help rebuilding
from the start of this, and support to survive were that not possible. I've
known people in my shoes who have that safety and live because of it. In this
country its all about profits and if you aren't a producer of profits you
don't get the privilege of life. I have to accept its over. All resisting that
and fighting does it take more away and make the end worse and take away more
agency. I can't stand anymore "Praying to Jesus changed my life" or "just do
this hard and unstable job that even a young healthy person struggles with"
advices, and seeing how many people respond with arguments about how "the
market" is the right answer without caring that human life is involved. I am
sick of all of it.

------
grumple
> Hassenplug replied, “Well, this will end when one of us dies.”

So he's going to continue to waste:

1) his own time. 2) the other guy's time. 3) a judge's time (and therefore
taxpayer money).

Aside from the moral implications of the method of debt collection itself
(harassing the most helpless), this is basically a crime against everyone.
Such a waste.

~~~
t0mas88
I'm genuinely surprised this guy hasn't been murdered yet.

If several defendants got to the point of committing suicide you would expect
at some point one of them breaks and you end up with a mass shooting at the
debt collectors office or a hospital or something? They have nowhere to go,
totally hopeless situation, and there are a lot of them. So the probability of
running into one with a serious mental health issue and a gun are non-zero.

------
rfhjt
I think this condition is the result of knowingly doing wrong things, in the
general sense. The right thing to do now is to start a campaign, attract
attention and make an initiative to reform healthcare. You have nothing to
lose.

------
tracker1
I have strong feelings on how much medical reform needs to happen, and some
ideas on how it can be done without socializing the system as a whole.

That said, I don't understand why nobody has tried to organize protests
outside the courthouse or hospital over this. 90 people in one session are
plenty to leverage a pretty big protest. The black eye to the court or
hospital in question could definitely lead to some changes. If there are other
counties in OK facing the same issues, they could protest at the state level
and probably get better protective legislation in place.

I fail to understand how apathy has lead to such passive lack of any kind of
action for reform.

~~~
snagglegaggle
The system preys on those that are isolated and may not have a support system.
There's a similar issue with involuntary psychiatric care -- you're more
likely to be committed (especially for no good reason) if you are alone and
have no one who can get you legal aid on the outside. While in, they keep you
isolated and too medicated to function.

~~~
hestipod
It's depressing (ha!) how accurate this cynical sounding stuff is. I have had
to be really cautious as my usually avoidant and blaming family have
threatened to try and have me locked up by exaggerating things when I have
told them how severely depressed I am as a result of my situation. They don't
care to help in any practical way and ignore me in general. They know I have
no financial stability. They know taking such action would put me in five to
six figure unrecoverable debt here. It's the same with "mental health
providers". You cannot be open without fear of debt and losing more agency.
It's why I occasionally rant online as I have no safe space irl. My mental
issues are entirely side effects of my physical and financial issues...but
those root problems are avoided.

------
alistproducer2
Can someone cc the Sanders or Warren campaign. This is ripe for national
debate. Hard to imagine this isnt a good wedge issue.

~~~
chrisabrams
Sure will do that now.

------
Clubber
Highest prison population in the world by both per capita and total number,
and people get thrown in jail because they can't pay their medical bills. How
much more corrupt can this country get?

What do we do when voting doesn't make a difference?

~~~
bjornsing
As I read the OP they get thrown in jail for not appearing in court. Isn’t
that very different?

~~~
_jal
It is not very different. People don't show up for a variety of reasons,
including inability[1] and plaintiff shenanigans[2].

But yes, people looking for a reason to blame the victim will use process
arguments like that to ignore the reality of what is happening.

[1] We're talking about people with medical issues and no money; that can mean
no car or no house or no personal mobility.

[2] As anecdata, someone I know was sued for nonpayment of a loan. Papers were
served by mail and arrived the day of the hearing; postal carrier timing meant
it arrived right as she would have had to appear, even if she hadn't been at
work. Default judgement, and she didn't have the money to hire a lawyer to
contest it. See how that works?

~~~
mnm1
I was sued and the order to appear never arrived. I spoke to the judge and she
said it doesn't matter. If it was sent out with USPS, it's considered
delivered. They don't have to prove it was even delivered.

~~~
bpodgursky
This article was clear that the judge required defendants to be properly
served. I can't speak to everywhere, but I thought that was pretty standard
practice.

~~~
77pt77
You mean the judge that never even studied law?

~~~
bpodgursky
Yes, that one, if you read the article like I did:

> He made sure no one was arrested unless they’d been reached by personal
> service or certified mail.

> As long as the defendant had been properly served, the judge’s answer was
> always yes.

I'm not trying to justify anything else, but the experience of being arrested
without being properly served does not align with the article in question.

------
77pt77
> Judges don’t need a law degree in Kansas, or many other states, to preside
> over cases like these

You can't make this up!

~~~
snagglegaggle
I think this is completely fine. You'd rather be ruled by a credentialed class
that could have opinions completely divorced from reality?

The law is supposed to be human and obvious. Any case that "requires" a JD and
ten years experience is likely full of trash.

~~~
knolax
If the law was human and obvious we wouldn't need lawyers in the first place.
The system as it is is already complex enough that someone without a law
degree would have great difficulty navigating it. Having uncredentialed judges
won't make the laws simpler they'll just make an already dysfunctional system
even worst.

~~~
snagglegaggle
There is no inherent need for lawyers; that one is required to navigate a
legal system reflects poorly on it.

------
Keverw
wow, didn't know this happens over medical debt. I always thought just tons of
letters and harassing phone calls. I know we don't have debtor prisons but if
you are fined (say a guilty on a traffic ticket) and you don't pay, it can be
considered contempt if you don't pay it and can then be jailed. I wonder if
they are doing this for student loan debts, which some can't even be
discharged in bankruptcy, and few states are suspending driver licenses over
student loan debts similar to how they punish people who are behind on child
support.

Also crazy you can be a judge without a law degree, even if you want to a be a
lawyer there's a long process without going to law school, like years of a
apprenticeship. Feel like that opens up the judge to being manipulated by
lawyers. Just seems like more evidence that the so called justice system isn't
really just. Then the whole private prisons and prisons not really focused on
rehabilitation, people get released and don't know what to do on the outside
so they reoffend and get comfortable with prison. I guess in prison at least
you get food and probably warmer than being cold on the streets homeless.
There's some books I've been wanting to read on these topics, but haven't got
around to it yet. Apparently people unknowingly commits three felonies a day,
and of course being ignorant is a excuse either as you must memorize and
understand thousands of pages of legal gibberish.

Feel like our nation has veered so far off course than our original principles
and ideals, and then if you watch the news... Very disturbing stuff happening
all over the place. Really saddening. Plus I feel like our education system is
dumbing people down, but that's an entire other topic. But not sure if any
other countries are that much better, seems like everywhere has it's problems.

~~~
Ididntdothis
”judge without a law degree”

That one is really shocking. I don’t even understand how this can work if the
judge isn’t highly trained.

------
anovikov
It keeps striking me. Really have no idea how this crap could be happening. Is
that a consequence of democracy? But none of the other rich and democratic
countries has any of that shit. Here is Cyprus we have same life expectancy as
in the U.S. (ok 3 months shorter) and the healthcare is paid for by a tax of
2.65% of income (but it is charged on any and all income including those kinds
of it exempt from any other taxes, except there is a cap of taxable income of
180,000 EUR per person per year). On top of that there are purely symbolical
charges (say a doctor visit is usually 1 euro) probably only to keep track of
these visits. Seems to be enough. And no it's not Soviet-style healthcare, and
doctors are not poor - they all drive new BMWs, have good houses and stuff,
and appear to be doing just as well as their American colleagues. What's going
on there in the U.S. people?!

------
privateSFacct
A quick suggestion.

If things are really this dire sign up for platinum coverage under a total in-
network HMO like Kaiser. Platinum 90 0/10 as an example.

If you have serious medical costs these plans are MAJORLY subsidized because
they don't discriminate on pre-existing conditions.

You CANNOT go out of network.

~~~
lotsofpulp
No health insurance can deny insurance coverage for pre existing conditions
since ACA was passed.

~~~
Animats
No. No _US health insurance sold via the ACA marketplace_ can deny coverage
for pre-existing conditions. There are new "short term" insurance policies
which are not ACA compliant, and do not cover pre-existing conditions.

[1] [https://www.commonwealthfund.org/blog/2019/short-term-
plans-...](https://www.commonwealthfund.org/blog/2019/short-term-plans-large-
bills-consumers)

~~~
lotsofpulp
Thanks for that info. I don’t understand why those are allowed to exist, and
more importantly, why people buy them.

~~~
ceejayoz
People buy them because 90% of the customers are happy evangelists. "I pay
next to nothing for my health insurance!"

The other 10% actually wound up having to use it, and discovered why the ACA
said they don't count as insurance.

------
tracker1
I'm reminded of some lines from "A Christmas Carol." "Are there no workhouses?
Are there no prisons?" ... It's wild how many changes to embolden debt
collections happens in so many places, often snuck in by a few legislators
that just don't think they'll get called out and generally don't. I'm lucky to
live in a state that to my knowledge has a lot of protections in place and
makes it harder to charge interest or sue over medical debt.

I would like to see some billing revisions take place and make the majority of
collections susceptible to review. Also, limit the rates that a facility can
charge limited to no more than a 20% variance. Of course now that insurance
companies don't act with a fiduciary responsibility, this also needs to
change. Obamacare, as well intended as it is/was, has introduced some fierce
unintended consequences.

As someone who was saddled with a $138k set of bills (after insurance, before
Obamacare), it's rough. I make decent money and still had to spend the better
part of a decade working 60-70 hour weeks with a day job and side work to pay
it off. If they made medical debt a tax credit, it isn't even a deduction most
of the time, I'd bet there'd be more interest in actually adjusting the
course.

I would like to see the collective coverage for Medicare, Medicaid, VA
Medical, and Federal Employee coverage combined into a non-profit medical
insurance anyone can get a policy from with a single policy that can and does
negotiate with fiduciary responsibility. Of course, then the congress would
handcuff such an organization and make it unable to wield its' negotiating
ability.

~~~
tracker1
I'm not sure I understand the downvotes... unless those downvoting likes how
things are and feel the medical industries should just run roughshod over the
population.

~~~
wglb
Downvotes (which you shouldn't complain about) often mean disagreement.

~~~
tracker1
There was a bit there... and without an actual reply, it's hard to know what
part or parts someone took offense to or disagreement with. I'm fine with
being down-voted, but would prefer to have at least some insight into the why.
As it is, there was no furthering any discussion which is less than
productive.

------
InTheArena
“ More than half of the debt in collections stems from medical care, which,
unlike most other debt, is often taken on without a choice or an understanding
of the costs. Since the Affordable Care Act of 2010, prices for medical
services have ballooned; insurers have nearly tripled deductibles — the amount
a person pays before their coverage kicks in — and raised premiums and copays,
as well. As a result, tens of millions of people without adequate coverage are
expected to pay larger portions of their rising bills.”

ACA has been yet another screwup on top of the cluster-Fsck that is the US
health care healthcare system. Medicare can’t even force payment restrIctions
or transparency. It’s not in politicians interest to fix it - they raise all
their money by either running on medical reform(fixing it would take that
issue and revenue stream off the money) or protecting it. Why else do you
think that a supermajority under Obama made the problem worse?

It’s time to form a separate states controlled mechanism for doing this. The
federal government has proven to be either completely and totally inept, or
corrupt beyond all imagination.

------
wpdev_63
Obviously it goes without saying, shop around. Fly to another country if you
have to. Canadian/Mexican doctors are more than happy to take cash and will
often charge less than half what they charge here. Obviously there's medical
problems you can't travel for but more often than not you can.

Also note that hospitals is one of the very few businesses that you have to
get permission from other hospitals to open. It's a cartel.

~~~
XorNot
If this were as viable as you are implying, then everyone would do it already.

~~~
keiferski
Honestly, in my experience, most Americans are simply unaware of viable
alternatives. America is a sort of universe-unto-itself, where it's possible
to live your entire life without knowing much about the outside world. I
imagine China is fairly similar.

------
w1nst0nsm1th
> Another woman said she watched, a decade ago, as a deputy came to the door
> for her diabetic aunt and took her to jail in her final years of life.

Another horror storie from america. This rare gem mix otherwise common issues
of debt, failling healthcare and jailing.

It's 3 year and half I take interest of the inner working of american society,
since Trump declared he didn't understand why the US didn't use its nuke more
often.

I think at every article I have reached the bottom... Yet everytime I learn
something worse from another story.

America is on the decline. Corruption, greed and madness is literaly ruining
the country from the inside.

No country will defeat you ; you will defeat yourself.

------
geggam
Debtors prison is back folks

------
ekianjo
Out of topic but they seem to be using film photography to illustrate that
article. Medium Format if not large. Very nice to see.

~~~
CharlesW
The photographer:
[https://www.edmundfountain.com/ABOUT/](https://www.edmundfountain.com/ABOUT/)

~~~
ekianjo
Thanks for finding it out!

------
SomaticPirate
Government funded healthcare on some level would help to alleviate a modicum
of this catastrophe. I doubt it would be a magic bullet but medical debt
damages society by incentivizing disaster health care instead of preventive
care.

~~~
Gibbon1
If you wanted a small fix as opposed to my preferred solution of burn it to
the ground as an example to every other shitty industry. That fix would be to
require insurance companies to be the primary bag holder. Not the patient. AKA
a the 'independent' anesthesiologist can't sue the patient, he has to sue the
insurance company. At least in that case everyone involved has deep pockets
and a strong hand.

The reason I say burn it all down is medical billing would be considered
outright criminal fraud and extortion in any other industry.

Imagine your mechanic engaging in surprise billing. Well yes my bill of $2500
was just for removing and installing the transmission. The $15,000 is the
independent transmission rebuilders fee.

~~~
snagglegaggle
I agree. The idea is the insurance negotiates on my behalf. If they don't pay,
I don't pay, and I don't understand how we arrived at the existing status quo.

~~~
lotsofpulp
Because not all providers are contracted with your insurance. If there exists
an agreement between your insurance and the provider (I.e. in network), then
the insurance company does pay for everything beyond the out of pocket
maximum.

~~~
XorNot
Remember kids, always have a friend at the door to the OR checking IDs and
corporate affiliations while you're under to avoid unexpected bills! (The US
system is literally insane)

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jdkee
It’s almost like parts of the U.S. never made it to the 20th century...

www.nytimes.com/2018/05/22/opinion/alabama-poverty-sewers.amp.html

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NTDF9
Healthcare here is so f-ed up, I can't believe we don't produce more medical
refugees to other countries. All this shit show makes Mexico look like an
advanced country.

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doggydogs94
At the end of the day, somebody has to pay for the health care.

~~~
novalis78
...indeed. that's why healthcare itself needs to be as inexpensive as
possible. we need entrepreneurs working on making the care a commodity. And if
necessary policymakers to defend that position.

~~~
concordDance
To make it inexpensive you'd have to deregulate it a bit...

I'm a fan of people being allowed to sell medical services regardless of
qualifications, BUT being required to explicitly state and advertise their
(lack of) qualifications. Have more continuous rather than binary
qualifications too.

That would drive prices down for the poorest, allowing them to purchase
healthcare, while not really affecting the rest of us who can afford the
inflated prices.

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black_puppydog
I'm gonna echo here what I heard on a podcast the other day:

somehow "socialism" is a dirty word in the US, even though the US citizens
absolutely love their socialism when they get it.

