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

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&#x27;s Leftist government created the Medicare scheme (Medibank became a government provider of private health insurance), which exists to this day.<p>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.<p>So I&#x27;m with Bernie on this: health coverage for all is an incredibly important goal.<p>While we&#x27;re at it, let&#x27;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.

I think that&#x27;s just a corollary of &quot;63% Of Americans Don&#x27;t Have Enough Savings To Cover A $500 Emergency&quot;:<p><a href="https:&#x2F;&#x2F;www.forbes.com&#x2F;sites&#x2F;maggiemcgrath&#x2F;2016&#x2F;01&#x2F;06&#x2F;63-of-americans-dont-have-enough-savings-to-cover-a-500-emergency&#x2F;#14c251a34e0d" rel="nofollow">https:&#x2F;&#x2F;www.forbes.com&#x2F;sites&#x2F;maggiemcgrath&#x2F;2016&#x2F;01&#x2F;06&#x2F;63-of-...</a><p>EDIT: My comment is in reference to the old thread title, which was something like &quot;More than 42 percent of the 9.5 million people diagnosed with cancer from 2000 to 2012 drained their life&#x27;s assets within two years&quot;

It&#x27;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.

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.<p>What a shame they can&#x27;t see outsides themselves and realize they&#x27;re only an inch away from financial ruin.

This is honestly one of the things that most stresses me out as I get older. I don&#x27;t use my insurance much now because I&#x27;m pretty healthy, but I know my cancer risk will just go up over time.<p>I&#x27;ve considered that if something like this ever did happen, I&#x27;d move to Lithuania and do it there paying in cash over trying to do it in the US system. Universal health care can&#x27;t come fast enough.

I&#x27;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.

57% of Americans cant handle a surprise bill of $500 without going into debt. [1]<p>I don&#x27;t doubt cancer is probably the most expensive hit that we have a good chance of receiving, but I&#x27;d be inclined to point to the lack of &quot;life&#x27;s assets&quot; being fluid as the first problem to tackle.<p>[1] <a href="https:&#x2F;&#x2F;www.cbsnews.com&#x2F;news&#x2F;most-americans-cant-afford-a-500-emergency-expense&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.cbsnews.com&#x2F;news&#x2F;most-americans-cant-afford-a-50...</a>

Well I can&#x27;t speak for all countries, but here in the UK I haven&#x27;t paid a penny toward my cancer treatments.<p>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).<p>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 &quot;extra&quot; vacation days that I wasn&#x27;t expecting.<p>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&#x27;t huge), but most importantly, have completely free treatment, so I wasn&#x27;t spending the little energy I had worrying about medical bills or insurance.

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&#x27;s nothing to pass on except for the very wealthy.<p>Cancer sucks.

&gt;Cancer Complications: Confusing Bills, Maddening Errors And Endless Phone Calls<p>Hell that&#x27;s just insurance in America... if you just use it.<p>I&#x27;ve been dealing with a bill where the insurance company decided that my kid&#x27;s pediatrician was out of network all of a sudden. All the other visits to the same pediatrician have been covered, but they can&#x27;t seem to fix this one bill....<p>There&#x27;s no incentive for the company to be helpful as what am I going to do? Change insurance companies? That&#x27;s not my choice.

This is a 2019 article covering a study that covers 2000 to 2012 and doesn&#x27;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.

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&#x27;t seem that way in some other countries because the government pays from the outset.<p>But I don&#x27;t think that&#x27;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&#x27;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?<p>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.

I <i>cannot</i> even imagine the toll this would take.<p>I have a <i>very simple</i> set of recurring claims against my healthcare provider that I&#x27;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.<p>The current one has taken <i>6 months</i> to finally start reimbursing me -- and actually, they&#x27;re almost caught up! Every goddamned time, the helpful phone persons sees the problem: &quot;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&#x27;ll re-enter him correctly, delete the old entry, and resubmit your claims marked as urgent. They should be processed within 7-10 days...&quot; Very helpful staff. They seem to get it. They seem to figure it out. They seem to fix it. And it&#x27;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&#x27;s the same thing. Over and over again.<p>My reimbursements came totally out of sequence. The claim numbers don&#x27;t match. The dates on the claim number don&#x27;t match the dates on the EOB, they&#x27;re paying me back for the wrong visits!<p>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&#x27;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&#x27;ll somehow all get paid back. Again, all one insurance company and one health care provider. And it&#x27;s my insurance. And it&#x27;s top tier private tech company employer PPO type stuff.<p>My wife was in the hospital after a car crash. The first EOB I got for $200,000 saying &quot;Denied&quot;, and that number didn&#x27;t even include the surgery. I just laughed. It went to the wrong insurance, a simple call and it was sorted.<p>But I can&#x27;t fathom having less than perfect insurance (and I don&#x27;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&#x27;re helping you), and having millions of dollars in bills, and having them come in from countless different providers.. sheer misery.

Moving to Switzerland, you&#x27;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.

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.

It&#x27;s not just the billing that sucks. It&#x27;s also the care, or lack thereof, in the health care system.<p>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&#x27;d expect they&#x27;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.

&quot;But none of these is her most gnawing, ever present concern.<p>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.&quot;<p>Is it like this in other OECD countries? I ask because I&#x27;m told that we in America have &quot;the best health care system in the world.&quot;

&gt; &quot;<i>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.</i>&quot;<p>The article mentions a variety of causes but I&#x27;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?

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.<p>Americans are Drowning in Debt: <a href="https:&#x2F;&#x2F;thenib.com&#x2F;americans-are-drowning-in-debt" rel="nofollow">https:&#x2F;&#x2F;thenib.com&#x2F;americans-are-drowning-in-debt</a>

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&#x27;t look at it that way.<p>[0]<a href="https:&#x2F;&#x2F;www.wnycstudios.org&#x2F;story&#x2F;worth" rel="nofollow">https:&#x2F;&#x2F;www.wnycstudios.org&#x2F;story&#x2F;worth</a>

Has anyone tried flying to another country for more affordable treatment after the diagnosis?<p>Countries like Germany and some south american countries have much more affordable treatment even factoring in the lodging and flying.

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?

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?

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&#x27;s assets. I wouldn&#x27;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&#x27;m mentally strong enough to, anyway. Although, nowadays with mandatory out of pocket maximums, if you have insurance, this shouldn&#x27;t be as widespread of a problem.

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?

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

Our healthcare system is wildly inefficient. A major overhaul would need to take place --- for me, as long as biotech and pharma innovation&#x2F;production is not negatively affected (because I actually want to cure cancer) then I&#x27;m all for hearing options.

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&#x27;ve had a good run, time to not participate in these horrendous medical systems.

I have good healthcare through employer, but god forbid - i have no idea what&#x27;d happen even with the insurance.<p>Unexpected health problems are the only reasons i&#x27;d go back to my home country to get treatment. US healthcare is nuts.

In the US.

Recent discussion on “U.S. Health Care Spending Highest Among Developed Countries” (50 days ago, 698 points, 522 comments):<p><a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=18851823" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=18851823</a><p>Opinion – “A Better Path to Universal Health Care: The United States should look to Germany, not Canada, for the best model.”:<p><a href="https:&#x2F;&#x2F;www.nytimes.com&#x2F;2019&#x2F;02&#x2F;20&#x2F;opinion&#x2F;health-care-germany.html" rel="nofollow">https:&#x2F;&#x2F;www.nytimes.com&#x2F;2019&#x2F;02&#x2F;20&#x2F;opinion&#x2F;health-care-germa...</a><p>Decade old Frontline episode – “Sick Around The World: Five Capitalist Democracies and How They Do It”:<p><a href="https:&#x2F;&#x2F;www.pbs.org&#x2F;wgbh&#x2F;pages&#x2F;frontline&#x2F;sickaroundtheworld&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.pbs.org&#x2F;wgbh&#x2F;pages&#x2F;frontline&#x2F;sickaroundtheworld&#x2F;</a><p>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’”:<p><a href="https:&#x2F;&#x2F;www.nytimes.com&#x2F;2019&#x2F;02&#x2F;23&#x2F;us&#x2F;politics&#x2F;medicare-for-all-lobbyists.html" rel="nofollow">https:&#x2F;&#x2F;www.nytimes.com&#x2F;2019&#x2F;02&#x2F;23&#x2F;us&#x2F;politics&#x2F;medicare-for-...</a>

Canadian version of Breaking Bad:<p>&quot;You have cancer. Treatment starts next week.&quot;<p>The end.

More than 42% of 9.5M people with cancer drained life&#x27;s assets within 2 years <i>in the US</i>.

GDPR-friendly: <a href="https:&#x2F;&#x2F;text.npr.org&#x2F;s.php?sId=696321475" rel="nofollow">https:&#x2F;&#x2F;text.npr.org&#x2F;s.php?sId=696321475</a>

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.

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&#x27;s money. How much money would you spend to increase someone&#x27;s life by a minute, an hour, a day, a month, etc?<p>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.<p>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.<p>Our healthcare system is broken, but not for the reason people think. It&#x27;s broken because it&#x27;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&#x27;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.<p>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.<p>The solution isn&#x27;t free healthcare for everyone. The US government does not have the money to even begin to do something like that.