
Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls - thebent
https://www.npr.org/sections/health-shots/2019/02/26/696321475/cancer-complications-confusing-bills-maddening-errors-and-endless-phone-calls
======
cletus
In Australia the Leftist government of Gough Whitlam introduced health-
coverage-for-all in 1975 with a scheme called Medibank. In 1984 after a couple
of governments, Bob Hawke's Leftist government created the Medicare scheme
(Medibank became a government provider of private health insurance), which
exists to this day.

The most interesting stat I ever heard about Medicare was this: prior to
Medicare the number one cause of personal bankruptcy in Australia was medical
bills.

So I'm with Bernie on this: health coverage for all is an incredibly important
goal.

While we're at it, let's end the monopoly given to drug companies on the sale
of pharmaceuticals in the US. You should be able to legally import them from,
at the very least, any NAFTA country and any EU member.

~~~
JamesBarney
I'm all for universal coverage too. But reducing the profits of pharmaceutical
companies well reduce the money they have for r&d dramatically.

This will slow down the speed of pharmaceutical development. So I think it
needs to be paired with reforms to the FDA to reduce the go to market costs
for drugs.

~~~
cletus
Pharmaceutical companies spend way more on marketing than research.

If drug companies are willing to sell the exact same drug in Canada or the UK
or Germany or France for less than a percent (in some cases) of what they sell
it here for then why can't US insurance companies, hospitals and consumers buy
it for that price? There's no reason other than an artificial monopoly.

You'll note that I didn't say "anywhere" and that was deliberate. India, for
example, has decided that drug companies largely (it's complicated) don't get
monopolies from patents and thus you can buy a lot of low-cost high-quality
generics in India because no drug company is getting paid.

Obviously this is untenable at the global scale.

And before anyone lambasts India for not respecting patents here, countries do
this sort of thing all the time. In the US, for example, you can't patent
nuclear technology as a matter of national security.

~~~
chimeracoder
> If drug companies are willing to sell the exact same drug in Canada or the
> UK or Germany or France for less than a percent (in some cases) of what they
> sell it here for then why can't US insurance companies, hospitals and
> consumers buy it for that price? There's no reason other than an artificial
> monopoly.

They're willing to do that because the US is a much larger market than any of
those countries. Most pharmaceutical companies - including European companies
- make the lion's share of their profits from the US market. If they couldn't,
you'd certainly see the costs for essential medicines increase in European
countries.

> You'll note that I didn't say "anywhere" and that was deliberate. India, for
> example, has decided that drug companies largely (it's complicated) don't
> get monopolies from patents and thus you can buy a lot of low-cost high-
> quality generics in India because no drug company is getting paid.

India has pretty solid reasons for not honoring drug patents that don't apply
to the US or Europe.

~~~
mancerayder
_They 're willing to do that because the US is a much larger market than any
of those countries. Most pharmaceutical companies - including European
companies - make the lion's share of their profits from the US market. If they
couldn't, you'd certainly see the costs for essential medicines increase in
European countries._

"Willing" is a broken way to look at it. The drug prices are negotiated by the
government in the single-payer systems.

~~~
chimeracoder
> "Willing" is a broken way to look at it. The drug prices are negotiated by
> the government in the single-payer systems.

Most countries don't have single-payer systems, and even where that's the
case, "negotiated" is the broken term. For essential medications, the supplier
always has greater leverage than the purchaser.

------
zawerf
I think that's just a corollary of "63% Of Americans Don't Have Enough Savings
To Cover A $500 Emergency":

[https://www.forbes.com/sites/maggiemcgrath/2016/01/06/63-of-...](https://www.forbes.com/sites/maggiemcgrath/2016/01/06/63-of-
americans-dont-have-enough-savings-to-cover-a-500-emergency/#14c251a34e0d)

EDIT: My comment is in reference to the old thread title, which was something
like "More than 42 percent of the 9.5 million people diagnosed with cancer
from 2000 to 2012 drained their life's assets within two years"

~~~
lenticular
Even with insurance, folks often wind up with six figures of bills out of
pocket treating cancer. That's a huge amount for the even most frugal of the
lower or middle class.

~~~
zxcvbn4038
When my son was born he fit in my hand and spent his first three months in
NICU. I guess the nurses thought his survival was questionable so they entered
in his name into the computer as “Baby Boy”. A few months later I started
getting bills (eventually around $3 million) because there was nobody named
“Baby Boy” on my insurance. Calling the insurance to try and correct was a
nightmare - wait on hold for an hour, get 3rd degree interrogation about my
identity, wait on hold, explain that son was on insurance but not called
literally “Baby Boy”, wait on hold, get interrogated for his details on son’s
identity, wait on hold, long series of questions to determine Baby Boy isn’t
real and let me know about penalties for fraud. Three hours later done, that
covers the first $50. Decided I would never do that again, let it go to
collections and explain it to the judge. Turns out that before it goes to
collections it goes to someone with a brain who realizes “Baby Boy” is in-fact
the infant boy with identical birth date on my policy, notices stop coming. No
telling how much money they spent sending me all the nasty payment due letters
in the mean time.

~~~
bluesroo
As someone who works in healthcare software, I wouldn't interpret "Baby Boy"
that way. Different hospitals process information in different ways and it is
very common for newborns to all be entered under the same, generic name.
Sometimes different departments within the same hospital have different
systems, especially as they get more specialized (see: NICU). Maybe the birth
name you chose got entered in one place and not the other.

Just thought I'd shed some light on the issue.

------
vamos_davai
It's such an absurd expense that I wonder if I get diagnosed with cancer, I
would just deny treatment, accept death, and hand my assets to loved ones. Not
sure if anyone else thinks the same way.

~~~
untog
I don't think anyone can think about it realistically until they are in that
situation. How much is another year of your life worth to you? And to your
loved ones for that matter? (assuming we're talking terminal cancer here,
which it might not be)

I have family that suffered from cancer and spent a good lot of money
prolonging their life by about eighteen months. They were not pleasant months,
but I don't think for a second that the family would have preferred to take
the lump sum instead.

In short, every decision is horrible.

~~~
ams6110
I'm on the downward side of 50. My best years (physically) are in the past. My
kids are nearly adults. I'd rather pass on my assets to them and set them up
for a better life than piss it away on medical treatments that don't have much
hope of working.

~~~
untog
My point is that your kids might not agree with you, and it is difficult, to
say the least, to negotiate that situation. I'm not saying you're wrong, just
that everyone has a different answer.

------
grecy
It always seems any American that is against Universal Healthcare quickly
changes their tune as soon as they or their loved ones are hit with
bankruptingly large bills for things they have no control over.

What a shame they can't see outsides themselves and realize they're only an
inch away from financial ruin.

~~~
mrhappyunhappy
That’s how it is in other aspects too: unemployed? Must be lazy. Homeless?
Must be mentally I’ll or a druggy. Lost the houses? Must have been living
paycheck to paycheck. People are quick to judge others until that thing
happens to them and all of a sudden the tune changes.

------
davidscolgan
This is honestly one of the things that most stresses me out as I get older. I
don't use my insurance much now because I'm pretty healthy, but I know my
cancer risk will just go up over time.

I've considered that if something like this ever did happen, I'd move to
Lithuania and do it there paying in cash over trying to do it in the US
system. Universal health care can't come fast enough.

~~~
creaghpatr
When you get old you presumably qualify for Medicare.

~~~
komali2
Why not just make it so that you always qualify for Medicare?

~~~
creaghpatr
Because it would go bankrupt and then no one would get Medicare.

~~~
komali2
But why not make it not go bankrupt?

~~~
sangnoir
Because "I got mine", or maybe not yet, but someday I hope to get mine and you
better keep your grubby hands off my imaginary money.

------
shereadsthenews
I'd like to know where the patient with the $870 MRI bill was seen. My last
MRI was billed at over $7500. Before I started treatment for my brain tumor I
got divorced for purely financial reasons and gave all my remaining money to
my children. USA is so fucked.

~~~
madengr
Other than cash, how do you give money over $15k without being nailed by the
gift tax? Keeping as much money in retirement savings seems wise as those are
exempt from liens.

~~~
bluesroo
On top of the yearly exemption, you have a lifetime exemption in the US of
$11.18M.

~~~
CurrentlyYouDo
Currently you do. At a recent visit to my estate planning attorney he said
it's likely that will be cut in half in the next few years. I don't recall
whether it was because there's a time limit on that particular part of the law
that's going to run out, or because it was likely the ruling parties would
switch and they would vote it back down. But either way just remember that it
can change in either direction at just about any time.

------
cabaalis
57% of Americans cant handle a surprise bill of $500 without going into debt.
[1]

I don't doubt cancer is probably the most expensive hit that we have a good
chance of receiving, but I'd be inclined to point to the lack of "life's
assets" being fluid as the first problem to tackle.

[1] [https://www.cbsnews.com/news/most-americans-cant-
afford-a-50...](https://www.cbsnews.com/news/most-americans-cant-
afford-a-500-emergency-expense/)

~~~
BucketSort
It's amazing that you got down voted so much. Do people not like facing
reality or something?

------
Sahhaese
Well I can't speak for all countries, but here in the UK I haven't paid a
penny toward my cancer treatments.

I also kept my job despite being off work for nearly a year going through
chemo, and I even got sick pay for all of that time. (Not at full wage, but
still a very generous proportion of it).

Post-treatment I went back to my same workplace, doing the same job, and found
out that I had even acrued annual leave at full rate during the 9 months I was
off sick, so had 25 "extra" vacation days that I wasn't expecting.

Yes, this is more than the legal baseline, but even the legal baseline would
let me keep my job, acrue leave, get some sick pay (although the statuatory
sick pay isn't huge), but most importantly, have completely free treatment, so
I wasn't spending the little energy I had worrying about medical bills or
insurance.

------
erichurkman
I wonder what the downstream effects of this are on building generational
wealth. 100 years ago, when your parents died, you might inherit a home or a
small amount of money. That then helped uplift the next generation. Now, if
your assets are drained, you have a reverse mortgage, etc, there's nothing to
pass on except for the very wealthy.

Cancer sucks.

~~~
DanCarvajal
This was definitely the case with my grandparents, but it wasn't even cancer
it was just the long term cost of care for people who live well into their
90s.

------
duxup
>Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone
Calls

Hell that's just insurance in America... if you just use it.

I've been dealing with a bill where the insurance company decided that my
kid's pediatrician was out of network all of a sudden. All the other visits to
the same pediatrician have been covered, but they can't seem to fix this one
bill....

There's no incentive for the company to be helpful as what am I going to do?
Change insurance companies? That's not my choice.

~~~
xkcd-sucks
A cynical viewpoint might add that if the patient has a terminal illness, and
if they are overcharged, then the process can be dragged out past the
patient's lifespan and their estate just might not get around to it.

~~~
duxup
I think they just expect I'll get tired of it and pay.

------
OnACoffeeBreak
This is a 2019 article covering a study that covers 2000 to 2012 and doesn't
mention the Affordable Care Act signed into law in 2010. Insurance landscape
has changed quite a bit in the USA since ACA, which makes this not very
interesting. What I would be interested in is repeating the study now and
comparing results.

~~~
corbet
I would expect the results to be no different - the article was talking about
people who already have insurance. I've been through the incredible medical-
bill maze that results from cancer treatment since then; it's just the same.
The ACA was explicitly designed to perpetuate the current insurance system,
why would you expect the situation to have improved?

~~~
lotsofpulp
Before ACA, there were lifetime benefit limits. After ACA, there is no limit,
so it will have greatly changed the situation that people facing years of very
expensive treatment faced. Now, you are spending a max of $10k per year on in
network providers, or whatever your annual out of pocket max is. Before the
insurance company had the option of telling you that you've maxed out your
benefits and you're on your own, and/or not offering health insurance coverage
for you in the future period.

The removal of lifetime benefits, ability to deny pre-existing conditions, and
setting a maximum range between the lowest premium that can be offered and
highest premium that can be offered greatly improved access to health
insurance benefits for everyone. At the expense of making it more expensive
for the young and healthy, but obviously someone has to pay, and we as a
nation don't want it to be via taxes.

------
rayiner
This came up last year when it was discovered that Leon Lederman had to sell
his Nobel Prize to pay for cancer treatments. But there is more moral
complexity to this issue than people appreciate. Cancer treatment is
inherently expensive; it just doesn't seem that way in some other countries
because the government pays from the outset.

But I don't think that's necessarily moral, compared to something like
Medicaid, which requires people to spend down their assets first before the
government will pay. The median net worth for someone between 65-74 is
$225,000. Why should the government spend tax dollars to protect those savings
for people unfortunate enough to get cancer, when there are many people
unfortunate enough to never enter the middle class and be in a position to
save that kind of money in the first place? Isn't it unfair to spend tax
dollars protecting the inheritance of an upper-middle-class kid when that
money could be given to a kid that never had a hope of an inheritance?

Put differently, there is a huge moral difference between the government
ensuring that everyone can get cancer treatment, and the government
intervening to protect the financial and social status of people fortunate
enough to have significant assets.

~~~
justwalt
I would think the average person would feel slimy/predatory buying someone
else’s Nobel prize. Unless it’s the case of a friend offering to help out, but
then why not just lend the money without the collateral?

~~~
AnIdiotOnTheNet
Could have been a museum or something.

------
rconti
I _cannot_ even imagine the toll this would take.

I have a _very simple_ set of recurring claims against my healthcare provider
that I'm handling myself (out of network, no problem, I thought). Due to job
changes I had successfully had my charges reimbursed by my previous 2
insurance companies over the past year.

The current one has taken _6 months_ to finally start reimbursing me -- and
actually, they're almost caught up! Every goddamned time, the helpful phone
persons sees the problem: "Your provider was entered as an XYZ type of
provider instead of a ZYX provider, so it was being sent to the wrong unit.
I'll re-enter him correctly, delete the old entry, and resubmit your claims
marked as urgent. They should be processed within 7-10 days..." Very helpful
staff. They seem to get it. They seem to figure it out. They seem to fix it.
And it's never. fucking. fixed. And so you wait 7 days. You want 10 days.
Still in process (if the horrible online system even allows you to login
today). You wait 14 days, thinking maybe that was 10 BUSINESS days. Then you
call back. Again, and it's the same thing. Over and over again.

My reimbursements came totally out of sequence. The claim numbers don't match.
The dates on the claim number don't match the dates on the EOB, they're paying
me back for the wrong visits!

But somehow, somewhere, on the backend, someone is reconciling it. Amazingly,
the amounts are adding up. I think the processors are REALLY GOOD at not
accidentally double-paying, so even though they're paying me for the wrong
dates here, the next time they avoid double-paying, and find ANOTHER date to
pay for (properly). It actually looks like it'll somehow all get paid back.
Again, all one insurance company and one health care provider. And it's my
insurance. And it's top tier private tech company employer PPO type stuff.

My wife was in the hospital after a car crash. The first EOB I got for
$200,000 saying "Denied", and that number didn't even include the surgery. I
just laughed. It went to the wrong insurance, a simple call and it was sorted.

But I can't fathom having less than perfect insurance (and I don't even know
how to manage to maintain good insurance while having cancer and potentially
being out of work and having a partner who might not be able to work while
they're helping you), and having millions of dollars in bills, and having them
come in from countless different providers.. sheer misery.

------
h3daz
Moving to Switzerland, you'll be compelled by law to get health insurance and
you will be covered no matter what for roughly 500 bucks a month with a 300$
deductible.

------
triplewipeass
When I was in my early 20s, I got myself a beefy life insurance policy that
covers suicide after some waiting period that has expired many years ago. I
know that in case of crippling illness I can always take the easy way out
while preserving my assets plus the life insurance payout. My family would be
taken care of.

~~~
komali2
>My family would be taken care of.

And possibly traumatized that you killed yourself so they could have money.

~~~
triplewipeass
In case of being stricken by an incurable disease, I'm going to die anyway.
I'm sure my people will understand my choice to make a graceful exit before
illness takes away any shred of my dignity.

------
01100011
It's not just the billing that sucks. It's also the care, or lack thereof, in
the health care system.

I remember taking my friend to a Dr. visit when he had a brain tumor. The
parking was confusing, with signs threatening fines of hundreds of dollars for
parking anywhere near the building(this was at UCSD in La Jolla). This was at
a cancer center, where you'd expect they'd prioritize access for patients. He
went in for an eye exam, and the doctor was getting extremely agitated because
my friend had problems communicating and performing a few tasks as quickly as
the doctor wanted. Very few people in the hospitals seemed equipped to handle
someone who had problems seeing, walking and communicating.

------
deisner
"But none of these is her most gnawing, ever present concern.

That would be the convoluted medical bills that fill multiple binders,
depleted savings accounts that destroy early retirement plans and so, so many
phone calls with insurers and medical providers."

Is it like this in other OECD countries? I ask because I'm told that we in
America have "the best health care system in the world."

~~~
lotsofpulp
No, my family in Canada and UK don't deal with any of this. In the US, it's
not even worth your time figuring out how much your treatment will cost, other
than whether or not the provider is in network or not. Assume it's the out of
pocket maximum for your insurance, because when you go to a provider, you sign
a blank check that says you will be responsible for whatever chargers they
make up during the course of your treatment. So your only ally is the
insurance company, who has the power to deny payment for things like $15 worth
of linens (which was actually a few pieces of paper towel).

~~~
shereadsthenews
You can't figure out whether your provider is in or out. Just yesterday I got
a bill from someone I've never heard of who turns out to be a "Medication
Safety Specialist" who allegedly rendered services to me worth $392. You'd
think such a person would just be a functionary of the hospital who in any
case bill me $27k every day, but actually they are some kind of mercenary who
bill patients directly.

~~~
lotsofpulp
Yes, it's crazy how difficult these little things are.

During birth, should one stand outside their wife's delivery room and ask each
provider to wait outside while you look up if they are in network or not on
your insurance company's app? At least we have apps to do that nowadays.

~~~
shereadsthenews
Yes, you should. When my wife gave birth the first time there was an endless
parade of idiots who uselessly entered the room for a moment and then left and
later sent a huge bill. We also got a bill from the anesthesiologist who was
not present because my wife didn't want it and for the supposed attending
obstetrician who, although they were paged, never showed up. We had to go
through disputes of all those things and even though we prevailed on all of
them, my attorney had to get paid.

~~~
lotsofpulp
I would definitely recommend actually doing that, but I kind of meant "should
we do that" in a sense of "should we be behaving like this in a civilized
society"?

------
whack
> " _Their high-deductible insurance policy meant they had to spend $6,000
> before their insurance started covering her treatment expenses. They hit
> their annual out-of-pocket maximum of $10,000 well before the year was
> over._ "

The article mentions a variety of causes but I'm having a hard time figuring
out which ones are most important. In the example above with a $10k out-of-
pocket maximum, how much money did these patients actually end up paying? Is
that the main reason for their bankruptcy, or is it their loss of income? Does
disability insurance cover things like cancer, and if not, are there similar
programs that do?

------
kevmo
I published a piece on debt in America last week and touched in the subject of
medical debt. When you look at it from a broader perspective, most Americans
are in a financially dire situation. 42% sounds lower than I would have
expected.

Americans are Drowning in Debt: [https://thenib.com/americans-are-drowning-in-
debt](https://thenib.com/americans-are-drowning-in-debt)

~~~
cpursley
Yep, paying off my debt (except mortgage, which is affordable and only 15-year
term) has been the most liberating thing I've done. Learning to live below my
means was difficult (still is), but absolutely worth it.

------
pastor_elm
I remember the radiolab episode on worth[0]. Is another month of life with
cancer worth x amount of dollars? Who should pay 100k for a medication that
might let you live a month longer with pancreatic cancer. I imagine most
Americans don't look at it that way.

[0][https://www.wnycstudios.org/story/worth](https://www.wnycstudios.org/story/worth)

------
wpdev_63
Has anyone tried flying to another country for more affordable treatment after
the diagnosis?

Countries like Germany and some south american countries have much more
affordable treatment even factoring in the lodging and flying.

~~~
justin66
Having to fly to receive treatment seems like it might significantly affect
the likelihood of a full recovery. Cancer patients tend to have compromised
immune systems and airplanes are filthy.

~~~
cannonedhamster
As a cancer patient, wear a mask. I travel for work all the time, even right
after chemo. I'm not older, which makes for a stronger immune system in the
first place, but planes just require hand sanitizer and a face mask. The real
problem would be you would have to be able to pay out of pocket for lodging,
translation services, treatment, etc. and in most cases overall survival is
better in the US for late stage cancer.

------
g3houdini
This same issue exists for autoimmune disease as well as many other diseases.
My understanding is that the hospitals were going to post the costs for
treatments and make the process more transparent. Has this happened?

------
smallgovt
I’m confused. If you have medical insurance, shouldn’t you only pay up to your
deductible? Is this saying people’s life assets don’t cover the deductible?
Or, people are uninsured?

~~~
komali2
The deductible might be huge, and there's also this magic new thing I've just
discovered (or United invented out of nowhere) called "co-insurance" and
"maximum out of pocket" which I call "deductible #2."

Then when you actually try to use the insurance you pay monthly for (but don't
get to use until you reach the deductible #1 and #2?) they may just send the
bill to you with a lot of legalese that amounts to "we don't cover this, or we
do but we have better lawyers, get fucked peasant."

Luckily the debt collection industry is incompetent so all you gotta do is
keep replying with "please mail proof of debt" and you're golden!

~~~
lotsofpulp
All of the terms you listed are easily understandable concepts clearly
explained on healthcare.gov or any health insurance company's website, and
they've been a thing for decades.

How much clearer can maximum out of pocket be?

Edit: I do think in network and out of network should be easier/faster to
figure out though.

~~~
ok_coo
There are plenty of times when in/out network is an impossible thing to
determine or plan for.

I had an out patient surgery about a year ago and while my doctor and every
admin I talked said that everything would be in network, I still had someone
sneak in who was supposedly out of network.

Then came the bill of what should have been ~$300 was around $2500. I got that
BS waived only by called my doctor's office and talking with them about it.
Once we talked it all through, the nurses called the _head management of
company that ran the out patient surgery clinic_ in order to get it removed.
It feels like people have to do you favors in order to get your actual correct
billing.

Our health care system is so royally f'ed in the U.S. It desperately needs
fixing and I hope it does before something serious happens to myself or my
wife because it's currently feels like gambling with ruination. No $2.5k isn't
ruination but health care is the only thing in this country where I go in
knowing NOTHING about what my final bill will actually be.

~~~
cwkoss
If you tell everyone who admits you "I don't consent to any procedures or care
from out of network providers", could you sue any out-of-network providers who
operate anyway for malpractice?

Or I wonder if a similar "HIPAA trap" could be constructed by categorically
revoking consent to share your PMI with any out-of-network individuals and
companies?

~~~
cannonedhamster
Typically the people performing the operations don't know if they are out of
network. That's handled by a separate billing department.

------
lotsofpulp
My plan in a situation that would burn up all of my assets for little
guarantee of meaningful gains is to off myself to prevent using up my family's
assets. I wouldn't want to sacrifice the future of the rest of my family to
milk a couple more years, especially with reduced quality of life. Assuming
I'm mentally strong enough to, anyway. Although, nowadays with mandatory out
of pocket maximums, if you have insurance, this shouldn't be as widespread of
a problem.

~~~
komali2
>off myself to prevent using up my family's assets

I'd give 90% of my income if it meant my friend that "offed herself" could
still be alive.

Decisions like that have consequences beyond you...

~~~
lotsofpulp
I agree, and I think one consequence of using up my family's assets would be a
decrease in the probability of my kids' having secure futures, which I
wouldn't want either.

------
pulse7
Maybe it will not be easy to read this: In this particular case the US can
learn something from past socialist regimes - or from Germany and many other
western countries, which already learned, that OBLIGATORY state medical
insurance solves such issues. It is not the ideal solution, but the best
compromise available. Who would like to get cancer and fight with private
insurance company while being ill?

~~~
Asooka
> past socialist regimes

Ok, I agree with the spirit of your post, but don't ever hold up the USSR or
Venezuela or any of the others. It's obvious you don't know how shit actually
worked back then, so let me tell you. It was a prime example of an underfunded
system that was forced to meet bullshit metrics and shit was falling apart. If
you wanted treatment for anything more major than the flu you basically had to
bribe the doctors. Otherwise you could e.g. go to the ER bleeding out, be left
to bleed out and just be written off as "well he died outside the operating
room, nothing we could do guv'nor, metric for people surviving the OR = met".
Mixups were constant, corruption was rampant and the doctors who were in this
mess were all day-drinking to cope with it. To this day government healthcare
back home is underfunded and oversubscribed and you need to pass doctors
bribes to get priority treatment. Or you can go to a private clinic that
openly just takes money on top of your standard insurance, thank god.

Previous socialist regimes are what NOT to do when you're implementing
government services. Look at what they did and do the opposite.

------
cwkoss
It would be cool if you could sue for emotional damages and timecost of
resolving the issue when someone fraudulently bills you.

------
DigiMortal
Our healthcare system is wildly inefficient. A major overhaul would need to
take place --- for me, as long as biotech and pharma innovation/production is
not negatively affected (because I actually want to cure cancer) then I'm all
for hearing options.

------
SQL2219
At some point a lot of us will have to make the decision if we want to go
through this type of nightmare, physically and financially. When do you say,
I've had a good run, time to not participate in these horrendous medical
systems.

------
tehlike
I have good healthcare through employer, but god forbid - i have no idea
what'd happen even with the insurance.

Unexpected health problems are the only reasons i'd go back to my home country
to get treatment. US healthcare is nuts.

------
this_user
In the US.

------
js2
Recent discussion on “U.S. Health Care Spending Highest Among Developed
Countries” (50 days ago, 698 points, 522 comments):

[https://news.ycombinator.com/item?id=18851823](https://news.ycombinator.com/item?id=18851823)

Opinion – “A Better Path to Universal Health Care: The United States should
look to Germany, not Canada, for the best model.”:

[https://www.nytimes.com/2019/02/20/opinion/health-care-
germa...](https://www.nytimes.com/2019/02/20/opinion/health-care-germany.html)

Decade old Frontline episode – “Sick Around The World: Five Capitalist
Democracies and How They Do It”:

[https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/](https://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/)

What I don’t know is how we get from here to there. The health insurance
companies are already gearing up to fight MFA – “Health Care and Insurance
Industries Mobilize to Kill ‘Medicare for All’”:

[https://www.nytimes.com/2019/02/23/us/politics/medicare-
for-...](https://www.nytimes.com/2019/02/23/us/politics/medicare-for-all-
lobbyists.html)

------
vinceguidry
Canadian version of Breaking Bad:

"You have cancer. Treatment starts next week."

The end.

~~~
karakot
A real Canadian version is the following:

\- You've got a backpain? Here is your ibuprofen peal.

\- But I have very severe back pain.

\- Here is your bigger ibuprofen peal, come back in 6 month to see the
specialist.

6 month later in US:

\- Congratulations, you've got cancer.

3 years and more than $1M in bills later:

\- This is the end.

------
ucaetano
More than 42% of 9.5M people with cancer drained life's assets within 2 years
_in the US_.

~~~
refurb
Yes, but bankruptcy due to health reasons is actually quite common in Canada
as well.

Why? If you’re sick enough you can’t work or pay your bills so you go
bankrupt.

It’s not just healthcare costs.

 _Survey research commissioned by the Canadian government found that despite
having a government-run health system, medical reasons (including uninsured
expenses), were cited as the primary cause of bankruptcy by approximately 15
percent of bankrupt Canadian seniors (55 years of age and older)._

~~~
Kurtz79
Not sure for Canada, but in many EU countries, if you are employed, you will
keep receiving a large percentage of your salary when on extended sick leave,
mostly paid by social security after the first few days.

[https://www.researchgate.net/figure/Paid-sick-days-and-
sick-...](https://www.researchgate.net/figure/Paid-sick-days-and-sick-leave-
in-22-countries-worker-at-median-earnings-full-time_fig1_41720650)

My mother was on sick leave for many months for breast cancer and the illness
had a relatively small impact in terms of family finances.

------
moviuro
GDPR-friendly:
[https://text.npr.org/s.php?sId=696321475](https://text.npr.org/s.php?sId=696321475)

~~~
_Microft
Thanks!

------
RIMR
I hate to be political, but anyone who looks at these numbers, and believe
that the system is working properly as intended is absolutely an enemy of
American Prosperity.

~~~
lghh
I would argue that the system is working as intended, it's just not to your or
my or most other people's benefit.

~~~
FilterSweep
I would say both your comments are true.

------
mruts
This is unfortunate, but what do you want to do, have the government pay for
it? Maybe there are a lot of people with cancer who will get better and live
for X number of years. But many people are going to die in a year or two and
we would just end up spending millions of dollars on them, essentially wasting
the government's money. How much money would you spend to increase someone's
life by a minute, an hour, a day, a month, etc?

And if there was a maximum amount the government was willing to pay, then
people would just be talking about how the government is deciding the price of
life. Maybe you could devise a fair system in which every individual has a
certain dollar amount allocated to all the healthcare in their life, and then
if they go over that, they would have to pay it themselves. But I think people
would be upset about that as well.

At the end of the day, every system we create (bridges, power plants, cars,
etc) is implicitly or explicitly deciding the price of a human life. People
are uncomfortable with that idea, so they try to think of things in different
terms.

Our healthcare system is broken, but not for the reason people think. It's
broken because it's this public-private Frankenstein monster of rent-seeking,
self-dealing, and corruption. It was terrible to begin with, but Obamacare
made it so much worse. The system has become so complex that the government
can't properly model or anticipate how legislation would affect the long-term
stability of the system. Over the years, the government has legislated bug
fixes over bug fixes, patches over patches.

What needs to be done is replace this horrible and inefficient beast with a
completely free market system. Just get rid of all of the laws and start anew.
I guarantee you that the free market would be able to offer reasonably priced
insurance plans that would service a variety of needs.

The solution isn't free healthcare for everyone. The US government does not
have the money to even begin to do something like that.

~~~
asark
What do other wealthy states with populations who generally prefer their
healthcare system to one like ours (the US) do? That'd be a good place to
start looking. Plenty of examples. Like, all of them, pretty much.

> The solution isn't free healthcare for everyone.

I mean....

~~~
mruts
it’s not a coincidence that the US is much wealthier and home to much more
innovation than socialist European countries.

Clearly our system is bad, but there are multiple ways to skin a cat.

~~~
asark
Color me skeptical that our healthcare system contributes to our being more
innovative than our peers. Looking at the way it distributes risk (bumpily and
with little certainty) and the immense cost of it, I'd expect precisely the
opposite.

> Clearly our system is bad, but there are multiple ways to skin a cat.

I'd love to see a hyper-free-market system work for this. It'd be great. So
much simpler. I'd like to see it happen somewhere else first, though.
Meanwhile all our best examples are _not that_ and I'll take something working
in practice over working in theory any day.

