US Healthcare Stinks Thread II (1 Viewer)

[Dezbelief]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

 

[Max Power]

The markup for some simple services and supplies is crazy.

A couple years back my mother sprained her ankle while hiking in another state (outside her network). For a brief ER visit which only diagnosed a sprained ankle (no xrays), she was charged almost $500 dollars. Looking at an itemized list of her billing, she was charged $27 for an ace bandage wrap, $45 for an icepack, $30 for a 10 day supply of Tylenol. $100 bucks for the same stuff you can buy at Walgreens for $20.

 

[Nugget]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

We led Americans, employers in particular but also policymakers, to think that all of us needed to move into high deductible health plans. We had a way of referring to them back then that was euphemistic. We call them consumer driven health plans, and we call this movement consumerism.

So that was a way that we misled everybody into thinking that Americans were just chomping at the bit to be moved into health plans that require them to pay more money out of their own pockets before their coverage kicks in. It was amazing that we were able to pull that off, but we did to the point that today most Americans have to pay a lot of money out of their own pockets before their coverage will kick in even as they're paying more and more for the premiums.

So that's just one example of how we purposefully misled so many Americans to further our agenda and our agenda. Frankly, the bottom line is to enhance shareholder value because for most of these big companies that dominate the health insurance market, our for-profit companies and their stock is traded in the New York Stock Exchange.

You see how this becomes kind of circular. So for example, I recently saw a GI specialist at UC Davis. The chargemaster rate, according to my bill was $646 for a 45 minute appointment after my insurance discount. I paid $564 out of pocket for the appointment toward my $2,500 per year deductible.

I called to negotiate and I asked what it would've cost had I been cash pay had I not carried this insurance, and they told me that the cash pay rate was $380. It's like, that's weird. That's really interesting. So that is to say, because I had insurance, I actually paid roughly 48% more than a cash pay customer would've paid because the contract between my insurer and my provider said that my provider agreed to charge me the rate that the insurance company had negotiated with them, even if it was as was true here, a lot higher than what they would charge someone without my insurance. They said, and I quote, “Well, our contract is with them, not you.”

This only ends up being a good deal for me, the insured, if I end up paying my entire $2,500 deductible such that my covered healthcare beyond that point is free to me. So let's pause there for a second. What incentive does that now create for me as the insured? Well, once you get close to a deductible, you are now incentivized to try to get as much medical care as you possibly can to get your money's worth. In that year, you spent your $2,500 on four office visits and some labs as I did, and now you're like, all right, let's go. I am going to try to load up now to get my money's worth. I'm not going to wait until February to get this other thing that I think I need. I'm going to get it now because now it's quote unquote free. I ended up getting a colonoscopy that was soft recommended this year because I had hit my deductible.

And so my economically rational response was, “Okay, this is healthcare. My doctor says I might need to rule out anything serious with these GI issues. I could wait until next year and see what happens and how my symptoms progress, or I could get it before the end of the year because I'm about to hit this deductible.”

 

[Sand]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

IMO, the biggest health care myth is that the insurers goal is to keep folks healthy to reduce costs. It's not. Their goal is to deliver people to Medicare at the lowest cost. Two very different things.

That's why everyone in here should pick up Outlive by Attia and act on it.

 

[Stoneworker]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

 

[fatness]

Doctors Say Dealing With Health Insurers Is Only Getting Worse
(archived copy of Wall Street Journal article)
It's a long article and very much worth a read.

"Count doctors among the aggrieved. They deal day in and day out with insurers including UnitedHealthcare, whose chief executive, Brian Thompson, was shot to death last week by an assassin who targeted him outside the company’s annual investor conference. Doctors say their frustration is born of intimate experience and has been building for years.

Their chief complaint is the aggravation and expense of convincing insurance companies to pay them for their patients’ treatment. Even when they are ultimately approved, MRI scans and other vital but costly procedures often require days of campaigning and paperwork, say doctors. “It’s getting worse,” said Dr. Zulfiqar Ahmed, an internist in Augusta, Ga., who has practiced in the U.S. for 35 years. “This is not only UnitedHealthcare—this is universal in this country.”"

 

[Scoresman]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

Maybe its not the sole factor, but it shouldn't even be a factor at all.

 

[bcat01]

Here is a story of a local pharmacy that had been in business for over 100 years that can no longer survive today's health care system. This will greatly impact a lot of people. They are always busy so it had nothing to do with declining sales. https://dailystandard.com/archive/2024-12-19/stories/51440/a-victim-of-the-system

 

[Stoneworker]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

Maybe its not the sole factor, but it shouldn't even be a factor at all.

The so-called stat was pure dog whistle for comments just like these

 

[BobbyLayne]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

Maybe its not the sole factor, but it shouldn't even be a factor at all.

The so-called stat was pure dog whistle for comments just like these

I found the statistic by Goggling

“what is the leading cause of bankruptcy in the United States?”

What does the algorithm feed you when you enter the same query?

 

[Sand]

Doctors Say Dealing With Health Insurers Is Only Getting Worse
(archived copy of Wall Street Journal article)
It's a long article and very much worth a read.

"Count doctors among the aggrieved. They deal day in and day out with insurers including UnitedHealthcare, whose chief executive, Brian Thompson, was shot to death last week by an assassin who targeted him outside the company’s annual investor conference. Doctors say their frustration is born of intimate experience and has been building for years.

Their chief complaint is the aggravation and expense of convincing insurance companies to pay them for their patients’ treatment. Even when they are ultimately approved, MRI scans and other vital but costly procedures often require days of campaigning and paperwork, say doctors. “It’s getting worse,” said Dr. Zulfiqar Ahmed, an internist in Augusta, Ga., who has practiced in the U.S. for 35 years. “This is not only UnitedHealthcare—this is universal in this country.”"

Key words for the next decade: Concierge Care.

 

[Nugget]

More from the podcast transcript with Wendell Potter - former Cigna VP-turned-whistleblower and healthcare reform advocate.

Zooming out a level, more broadly speaking, according to KFF, family premiums for employer health coverage rose 7% in 2024. On average, an employer now pays $19,276 in premiums for family and the worker pays on average $6,296 per year. In other words, the average cost to ensure a family in the US with employer provided health insurance is around $25,000 per year.

What you said is something that you would think that policymakers at this point would recognize. We've been trying this for decades and decades now, allowing these big companies to be the gatekeepers and to be the mechanism that makes healthcare somewhat affordable for us, but it's failed miserably. The average price of a family premium that people get through the workplace now is over $25,000 and the Affordable Care Act, it does set a limit on how much we have to pay out of our own pockets, but that linen goes up every year.

And then this was to accommodate big insurance companies. They insisted if there had to be a cap for it. To be a huge cap today, a family could have to pay $18,900 out of the family's bank account before their coverage will kick in, and that's on top of the premiums.

But big insurance companies have spent enormous sums of money getting politicians to buy into the notion that we have to have them that we can't do without 'em. And politicians sadly don't pay a lot of attention to how other systems around the world really operate. We spend twice as much per capita on healthcare in this country as the average of other developed countries, and our outcomes are much worse and our access to care is much worse, and we still have about 30 million people who don't have health insurance.

So what we have got is a system that is not working, and I don't think that politicians really think that next year it's going to get appreciably better because these guys are in the business to make money, and the status quo is extraordinarily profitable for them, so simplifying it.

Another fun fact about our healthcare system is that we spend about $4 trillion every year on healthcare currently, and about a third of that goes to administrative costs that are made necessary because of our multi-payer as opposed to a single payer system. The Medicare program, which is a government run single payer system, the original version of it, the administrative costs are very low compared to private insurance and the private version of Medicare.

 

[BobbyLayne]

I tried Googling “what is the leading cause of personal bankruptcy in _________? for several countries. No one else seems have this issue besides Americans. None, nada, zero, zip, zilch. Does not exist anywhere except in the United States.

Why is that?

Medical bankruptcies occur when consumers are forced to declare bankruptcy because of the cost of medical treatments. However, there is no single definition of a “medical bankruptcy.”

In a 2009 study of all bankruptcies in 2007, researchers classified a “medical bankruptcy” as one where persons had mortgaged a home to pay medical bills, had medical bills greater than $1,000, or had lost at least two weeks of work due to illness.

According to that definition, 62.1 percent of all bankruptcies in the United States were “medical bankruptcies.”

A 2015 study by the Kaiser Family Foundation found that medical bills caused 1 million U.S. adults to declare bankruptcy every year and that 26 percent of Americans age 18 to 64 struggled to pay medical bills. The most common cause of medical debt, according to this study, was an unexpected refusal by insurance companies to pay for a medical procedure.

As it turns out, medical bankruptcy is almost unheard of outside of the United States. Other developed economies (except China) have single-payer health care systems where medical costs are financed by taxes, not by premium-financed insurance. In these countries, there are no out-of-pocket costs for medical care and thus no bankruptcy caused by medical debts.

In countries without single-payer systems besides the United States, there is generally no requirement that medical procedures be provided without payment, and thus procedures are paid for prior to treatment being rendered.

 

[BobbyLayne]

Doctors Say Dealing With Health Insurers Is Only Getting Worse
(archived copy of Wall Street Journal article)
It's a long article and very much worth a read.

"Count doctors among the aggrieved. They deal day in and day out with insurers including UnitedHealthcare, whose chief executive, Brian Thompson, was shot to death last week by an assassin who targeted him outside the company’s annual investor conference. Doctors say their frustration is born of intimate experience and has been building for years.

Their chief complaint is the aggravation and expense of convincing insurance companies to pay them for their patients’ treatment. Even when they are ultimately approved, MRI scans and other vital but costly procedures often require days of campaigning and paperwork, say doctors. “It’s getting worse,” said Dr. Zulfiqar Ahmed, an internist in Augusta, Ga., who has practiced in the U.S. for 35 years. “This is not only UnitedHealthcare—this is universal in this country.”"

Key words for the next decade: Concierge Care.

I ran into that about 6-7 years ago. Had the same GP for the first 18 years I was in NYC. Board certified, John Hopkins alum, Central Park West location, phenomenal communicator.

One day I showed up for my annual physical and his office manager told me they have stopped taking all insurance claims. During the exam I asked what’s up, and he told me he was moving to a concierge model.

OK, how does that work?

Well, not much different than your relationship with your lawyer. Flat initiation fee up front ($3K but it’s gone up since), then monthly retainer fee. Time & expense after the retainer is exhausted, 100% out of pocket.

 

[Nugget]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

IMO, the biggest health care myth is that the insurers goal is to keep folks healthy to reduce costs. It's not. Their goal is to deliver people to Medicare at the lowest cost. Two very different things.

That's why everyone in here should pick up Outlive by Attia and act on it.

I'm not even sure it is at the lowest cost. They get paid per visit and for every prescription. They are buying medical offices and pharmacy benefit managers. They get paid a % of every transaction - they don't have an incentive to keep the costs down.

 

[CletiusMaximus]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

I've not read the CNBC article but these numbers don't really make sense. What do the percentages refer to? These seem to be items that put dumb people in financial distress but no one files bankruptcy because of student loans or mortgage debt as those debts are non-dischargeable in bankruptcy. No one "provides help to friends" and then seeks to discharge that debt in bankruptcy. Of course a personal bankruptcy is in most cases the result of more than just one factor, but medical debt is undoubtedly one of the highest individual categories of debt that people seek to discharge in bankruptcy. What things "cause" a personal bankruptcy? Most commonly it is an unexpected uncovered medical event or divorce.

 

[Stoneworker]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

Maybe its not the sole factor, but it shouldn't even be a factor at all.

The so-called stat was pure dog whistle for comments just like these

I found the statistic by Goggling

“what is the leading cause of bankruptcy in the United States?”

What does the algorithm feed you when you enter the same query?

I don't draw conclusions from "Goggle" searches. I actually read the content.

There is nothing (that I found anyway) that shows what actual debt amounts were associated with each category. That's the piece that is most important.

Hypothetical Example
Filer A lists: 1) mortgage debt ($100K) 2) medical debt ($10K)
Filer B lists: 1) lost job ($50K) 2) medical debt ($5K)

100% of filers listed medical debt as a key contributor. But it wasn't the "major cause"

The headline "the leading cause of bankruptcy" is blatantly misleading without associated debt amounts

 

[Stoneworker]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

I've not read the CNBC article but these numbers don't really make sense. What do the percentages refer to? These seem to be items that put dumb people in financial distress but no one files bankruptcy because of student loans or mortgage debt as those debts are non-dischargeable in bankruptcy. No one "provides help to friends" and then seeks to discharge that debt in bankruptcy. Of course a personal bankruptcy is in most cases the result of more than just one factor, but medical debt is undoubtedly one of the highest individual categories of debt that people seek to discharge in bankruptcy. What things "cause" a personal bankruptcy? Most commonly it is an unexpected uncovered medical event or divorce.

If you have a more definitive source that can better clarify the numbers, I'm all for it.

I used the CNBC article because it ties to the 66.5% figure

 

[Nugget]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

Maybe its not the sole factor, but it shouldn't even be a factor at all.

The so-called stat was pure dog whistle for comments just like these

I found the statistic by Goggling

“what is the leading cause of bankruptcy in the United States?”

What does the algorithm feed you when you enter the same query?

I don't draw conclusions from "Goggle" searches. I actually read the content.

There is nothing (that I found anyway) that shows what actual debt amounts were associated with each category. That's the piece that is most important.

Hypothetical Example
Filer A lists: 1) mortgage debt ($100K) 2) medical debt ($10K)
Filer B lists: 1) lost job ($50K) 2) medical debt ($5K)

100% of filers listed medical debt as a key contributor. But it wasn't the "major cause"

The headline "the leading cause of bankruptcy" is blatantly misleading without associated debt amounts

Is your point that medical debt isn't a big deal, or that it isn't the biggest deal, or that you want more information?

3M American adults have at least $10k in medical debt. 400-450k personal bankruptcies per year.

This article suggest 58% of debts recorded in collections were for medical bills - Link

 

[matttyl]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

 

[BobbyLayne]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

Maybe its not the sole factor, but it shouldn't even be a factor at all.

The so-called stat was pure dog whistle for comments just like these

I found the statistic by Goggling

“what is the leading cause of bankruptcy in the United States?”

What does the algorithm feed you when you enter the same query?

I don't draw conclusions from "Goggle" searches. I actually read the content.

There is nothing (that I found anyway) that shows what actual debt amounts were associated with each category. That's the piece that is most important.

Hypothetical Example
Filer A lists: 1) mortgage debt ($100K) 2) medical debt ($10K)
Filer B lists: 1) lost job ($50K) 2) medical debt ($5K)

100% of filers listed medical debt as a key contributor. But it wasn't the "major cause"

The headline "the leading cause of bankruptcy" is blatantly misleading without associated debt amounts

Leading is usually not construed to mean ancillary, but you do you.

 

[BobbyLayne]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

There is always nuance within the statistics. A lot of medical gets transferred to CC or HELOC debt - in and of themselves, horrible choices to make - which serves to further cloud the statistics.

Bottom line is it’s not a minor issue caused by a subset of finical dunces. It is a major issue, and it could happen to almost any of us.

Incredibly, it only happens in the U.S.

Nowhere else.

Why is that normalized?

 

[Stoneworker]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

Thanks. You beat me to it.

Total debt in the U.S. is $17.69 trillion, so medical debt makes of 1.2% of all U.S. consumer debt

Average loan balance per person is $104,215, making average medical debt balance $1,251.

 

[Stoneworker]

Medical debt is the leading cause of bankruptcy in the United States, accounting for 66.5% of all bankruptcies.

To citizens of every other industrialized nation on the planet, that is a foreign and baffling fact which they are wholly unfamiliar with.

As I posted in the other thread, the 66.5% figure is misleading.

It implies that medical debt is a sole factor causing bankruptcy. But in fact filers cite multiple factors and medical was just the most frequently listed.

Other factors include:

Unaffordable mortgage - 45%
Living beyond one's means - 44%
Providing help to friend/relatives - 28%
Student loans - 25%
Divorce or separation - 24%

CNBC article

Maybe its not the sole factor, but it shouldn't even be a factor at all.

The so-called stat was pure dog whistle for comments just like these

I found the statistic by Goggling

“what is the leading cause of bankruptcy in the United States?”

What does the algorithm feed you when you enter the same query?

I don't draw conclusions from "Goggle" searches. I actually read the content.

There is nothing (that I found anyway) that shows what actual debt amounts were associated with each category. That's the piece that is most important.

Hypothetical Example
Filer A lists: 1) mortgage debt ($100K) 2) medical debt ($10K)
Filer B lists: 1) lost job ($50K) 2) medical debt ($5K)

100% of filers listed medical debt as a key contributor. But it wasn't the "major cause"

The headline "the leading cause of bankruptcy" is blatantly misleading without associated debt amounts

Is your point that medical debt isn't a big deal, or that it isn't the biggest deal, or that you want more information?

3M American adults have at least $10k in medical debt. 400-450k personal bankruptcies per year.

This article suggest 58% of debts recorded in collections were for medical bills - Link

I listed some additional facts on overall U.S. debt for perspective. Up to others to determine whether it's a "big deal." Clearly, some do.

 

[NutterButter]

This medical debt we're talking about is out of pocket costs besides premiums correct? Are these for claims that the insurance company is denying? Do people not check with the insurance company before getting a procedure done to ensure its covered or are these procedures of last resort for an illness where covered treatments didn't work?

 

[matttyl]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

There is always nuance within the statistics. A lot of medical gets transferred to CC or HELOC debt - in and of themselves, horrible choices to make - which serves to further cloud the statistics.

Bottom line is it’s not a minor issue caused by a subset of finical dunces. It is a major issue, and it could happen to almost any of us.

Incredibly, it only happens in the U.S.

Nowhere else.

Why is that normalized?

Because are the only place that has medical insurance, which for many is still a choice to either purchase or not purchase. You can’t choose to go uninsured in this country if you want to. Perhaps you feel the insurance isnt affordable.

 

[matttyl]

This medical debt we're talking about is out of pocket costs besides premiums correct? Are these for claims that the insurance company is denying? Do people not check with the insurance company before getting a procedure done to ensure its covered or are these procedures of last resort for an illness where covered treatments didn't work?

Yes, medical debt is owed to the medical provider (while medical insurance premiums are owed to the insurance carrier). So the “medical debt” is for medical services rendered, both covered and not covered by insurance. Even if “covered”, the insurance policy could still have a $6-8k deductible, and possibly even higher max out of pocket - and that’s what people oftentimes can’t afford to pay. Sure they could have a policy with lower deductibles and OOPs, but it would come with a larger premium.

 

[Dezbelief]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

Thanks. You beat me to it.

Total debt in the U.S. is $17.69 trillion, so medical debt makes of 1.2% of all U.S. consumer debt

Average loan balance per person is $104,215, making average medical debt balance $1,251.

Student loans, cars and houses are expected debts that most lenders have vetted to prevent bankruptcy; medical debt is usually unexpected and nobody cares if it bankrupts a person or not.

 

[BobbyLayne]

You can’t choose to go uninsured in this country if you want to. Perhaps you feel the insurance isnt affordable.

Health insurance coverage is no longer mandatory at the federal level - hasn’t been for nearly 6 years. Some states still require you to have health insurance coverage to avoid a tax penalty. But you can definitely choose to not have health insurance (recommendation: don’t do that.)

Personally, I have no dog in the fight. $0 premiums, $0 co-pay, $0 out of pocket liability. For life. I earned that privilege from the U S government by putting my life at risk for my country multiple times.

My experience with the VA medical care system has been phenomenal; the care I have received the last 6 years has been orders of magnitude better than 30+ years of employer sponsored plans. IME

For most folks, though, you’re getting the short end of the stick. Primarily because the driver for the healthcare system is increasing shareholder value. By any means necessary.

 

[NutterButter]

This medical debt we're talking about is out of pocket costs besides premiums correct? Are these for claims that the insurance company is denying? Do people not check with the insurance company before getting a procedure done to ensure its covered or are these procedures of last resort for an illness where covered treatments didn't work?

Yes, medical debt is owed to the medical provider (while medical insurance premiums are owed to the insurance carrier). So the “medical debt” is for medical services rendered, both covered and not covered by insurance. Even if “covered”, the insurance policy could still have a $6-8k deductible, and possibly even higher max out of pocket - and that’s what people oftentimes can’t afford to pay. Sure they could have a policy with lower deductibles and OOPs, but it would come with a larger premium.

So is this debt more bc of those max oop costs or bc of denied claims?

 

[John123]

There's not much any of us can do individually to change policy, but if this issue matters to you I encourage you to donate to the following charity. They purchase medical debt at a discount and estimate that they pay off $100 in medical debt for every $1 donated:

Undue Medical Debt Homepage

Undue Medical Debt makes it easy for donors to make an impactful difference in the lives of those struggling with medical debt.

unduemedicaldebt.org

If this seems too good to be true google them. They are well known and legit.

 

[belljr]

You can’t choose to go uninsured in this country if you want to. Perhaps you feel the insurance isnt affordable.

Health insurance coverage is no longer mandatory at the federal level - hasn’t been for nearly 6 years. Some states still require you to have health insurance coverage to avoid a tax penalty. But you can definitely choose to not have health insurance (recommendation: don’t do that.)

Personally, I have no dog in the fight. $0 premiums, $0 co-pay, $0 out of pocket liability. For life. I earned that privilege from the U S government by putting my life at risk for my country multiple times.

My experience with the VA medical care system has been phenomenal; the care I have received the last 6 years has been orders of magnitude better than 30+ years of employer sponsored plans. IME

For most folks, though, you’re getting the short end of the stick. Primarily because the driver for the healthcare system is increasing shareholder value. By any means necessary.

Correct you can go around with no insurance now with no penalty. However some states still charge a penalty for no insurance. My SiL had no insurance for a long time she would just pay the fine

 

[Stoneworker]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

Thanks. You beat me to it.

Total debt in the U.S. is $17.69 trillion, so medical debt makes of 1.2% of all U.S. consumer debt

Average loan balance per person is $104,215, making average medical debt balance $1,251.

Student loans, cars and houses are expected debts that most lenders have vetted to prevent bankruptcy; medical debt is usually unexpected and nobody cares if it bankrupts a person or not.

13.4% of U.S. homeowners don't have homeowners insurance.

So which is the bigger personal financial risk...unexpected medical bills or unexpected home damage/loss?

 

[matttyl]

You can’t choose to go uninsured in this country if you want to. Perhaps you feel the insurance isnt affordable.

Health insurance coverage is no longer mandatory at the federal level - hasn’t been for nearly 6 years. Some states still require you to have health insurance coverage to avoid a tax penalty. But you can definitely choose to not have health insurance (recommendation: don’t do that.)

Personally, I have no dog in the fight. $0 premiums, $0 co-pay, $0 out of pocket liability. For life. I earned that privilege from the U S government by putting my life at risk for my country multiple times.

My experience with the VA medical care system has been phenomenal; the care I have received the last 6 years has been orders of magnitude better than 30+ years of employer sponsored plans. IME

For most folks, though, you’re getting the short end of the stick. Primarily because the driver for the healthcare system is increasing shareholder value. By any means necessary.

That was meant to be “can”, sorry. I’m in the industry myself. Was typing too fast on my phone.

 

[CletiusMaximus]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

Is always odd when credit card debt is included as a separate category. I get why they do it, but people aren't consuming credit cards like they are consuming medical services, cars and houses. The direct cause/effect on bankruptcy is of course complicated and I agree with @Stoneworker that the 65% figure some cite is mostly BS. Reliable bankruptcy statistics typically just look at broad trends like filing numbers, inflation, unemployment, interests rates. They can track categories of debts listed but that is hard to do. However, it is worth pointing out that medical debt and credit card debt are both readily dischargeable in bankruptcy. Student loan debt is non-dischargeable under federal law - it stays with you, but that doesn't mean its not a factor in the reason someone filed. Mortgage and auto debt is secured debt, even if auto loans are frequently under-secured. People don't file chapter 7 to discharge home mortgage debt unless they've already been through a foreclosure, lost the home and are discharging a personal deficiency debt. Chapter 13 is a different story not worth getting into here imo. In my limited experience, most people who file a consumer bankruptcy with an auto loan on the list will "reaffirm" that debt because they don't want to lose their car. This means they are declining the discharge on their car loan even though its almost always a crappy upside-down debt but they don't want to lose that truck.

Divorce is also a very common cause of personal insolvency, but again that's not a debt category, its just a financial disaster because expenses increase while income remains the same.

 

[BobbyLayne]

You can’t choose to go uninsured in this country if you want to. Perhaps you feel the insurance isnt affordable.

Health insurance coverage is no longer mandatory at the federal level - hasn’t been for nearly 6 years. Some states still require you to have health insurance coverage to avoid a tax penalty. But you can definitely choose to not have health insurance (recommendation: don’t do that.)

Personally, I have no dog in the fight. $0 premiums, $0 co-pay, $0 out of pocket liability. For life. I earned that privilege from the U S government by putting my life at risk for my country multiple times.

My experience with the VA medical care system has been phenomenal; the care I have received the last 6 years has been orders of magnitude better than 30+ years of employer sponsored plans. IME

For most folks, though, you’re getting the short end of the stick. Primarily because the driver for the healthcare system is increasing shareholder value. By any means necessary.

That was meant to be “can”, sorry. I’m in the industry myself. Was typing too fast on my phone.

yeah I knew that & kind of thought that was the case, but wanted to clarify that point

over the years you’ve been a great resource on the boards helping people navigate the labyrinth

 

[Nugget]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

Thanks. You beat me to it.

Total debt in the U.S. is $17.69 trillion, so medical debt makes of 1.2% of all U.S. consumer debt

Average loan balance per person is $104,215, making average medical debt balance $1,251.

And yet 58% of collections balances are medical debt. Some loans you choose.

 

[BobbyLayne]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

Is always odd when credit card debt is included as a separate category. I get why they do it, but people aren't consuming credit cards like they are consuming medical services, cars and houses. The direct cause/effect on bankruptcy is of course complicated and I agree with @Stoneworker that the 65% figure some cite is mostly BS. Reliable bankruptcy statistics typically just look at broad trends like filing numbers, inflation, unemployment, interests rates. They can track categories of debts listed but that is hard to do. However, it is worth pointing out that medical debt and credit card debt are both readily dischargeable in bankruptcy. Student loan debt is non-dischargeable under federal law - it stays with you, but that doesn't mean its not a factor in the reason someone filed. Mortgage and auto debt is secured debt, even if auto loans are frequently under-secured. People don't file chapter 7 to discharge home mortgage debt unless they've already been through a foreclosure, lost the home and are discharging a personal deficiency debt. Chapter 13 is a different story not worth getting into here imo. In my limited experience, most people who file a consumer bankruptcy with an auto loan on the list will "reaffirm" that debt because they don't want to lose their car. This means they are declining the discharge on their car loan even though its almost always a crappy upside-down debt but they don't want to lose that truck.

Divorce is also a very common cause of personal insolvency, but again that's not a debt category, its just a financial disaster because expenses increase while income remains the same.

good post, I’m definitely not trying to paint with a broad brush, oversimplify, or diminish the nuanced aspects.

that said, I would guess maybe a third (perhaps half) of my NYC friends were born and/or raised somewhere other than the United States. the systemic issues and misaligned motives of our healthcare is just so unbelievable to everyone in the RotW.

but Americans just say sigh and say “yeah whaddayagonnado, eh.”

 

[Terminalxylem]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

We led Americans, employers in particular but also policymakers, to think that all of us needed to move into high deductible health plans. We had a way of referring to them back then that was euphemistic. We call them consumer driven health plans, and we call this movement consumerism.

So that was a way that we misled everybody into thinking that Americans were just chomping at the bit to be moved into health plans that require them to pay more money out of their own pockets before their coverage kicks in. It was amazing that we were able to pull that off, but we did to the point that today most Americans have to pay a lot of money out of their own pockets before their coverage will kick in even as they're paying more and more for the premiums.

So that's just one example of how we purposefully misled so many Americans to further our agenda and our agenda. Frankly, the bottom line is to enhance shareholder value because for most of these big companies that dominate the health insurance market, our for-profit companies and their stock is traded in the New York Stock Exchange.

You see how this becomes kind of circular. So for example, I recently saw a GI specialist at UC Davis. The chargemaster rate, according to my bill was $646 for a 45 minute appointment after my insurance discount. I paid $564 out of pocket for the appointment toward my $2,500 per year deductible.

I called to negotiate and I asked what it would've cost had I been cash pay had I not carried this insurance, and they told me that the cash pay rate was $380. It's like, that's weird. That's really interesting. So that is to say, because I had insurance, I actually paid roughly 48% more than a cash pay customer would've paid because the contract between my insurer and my provider said that my provider agreed to charge me the rate that the insurance company had negotiated with them, even if it was as was true here, a lot higher than what they would charge someone without my insurance. They said, and I quote, “Well, our contract is with them, not you.”

This only ends up being a good deal for me, the insured, if I end up paying my entire $2,500 deductible such that my covered healthcare beyond that point is free to me. So let's pause there for a second. What incentive does that now create for me as the insured? Well, once you get close to a deductible, you are now incentivized to try to get as much medical care as you possibly can to get your money's worth. In that year, you spent your $2,500 on four office visits and some labs as I did, and now you're like, all right, let's go. I am going to try to load up now to get my money's worth. I'm not going to wait until February to get this other thing that I think I need. I'm going to get it now because now it's quote unquote free. I ended up getting a colonoscopy that was soft recommended this year because I had hit my deductible.

And so my economically rational response was, “Okay, this is healthcare. My doctor says I might need to rule out anything serious with these GI issues. I could wait until next year and see what happens and how my symptoms progress, or I could get it before the end of the year because I'm about to hit this deductible.”

The system is being gamed by all parties - insurer, physician, and patient, which is gross.

 

[matttyl]

This medical debt we're talking about is out of pocket costs besides premiums correct? Are these for claims that the insurance company is denying? Do people not check with the insurance company before getting a procedure done to ensure its covered or are these procedures of last resort for an illness where covered treatments didn't work?

Yes, medical debt is owed to the medical provider (while medical insurance premiums are owed to the insurance carrier). So the “medical debt” is for medical services rendered, both covered and not covered by insurance. Even if “covered”, the insurance policy could still have a $6-8k deductible, and possibly even higher max out of pocket - and that’s what people oftentimes can’t afford to pay. Sure they could have a policy with lower deductibles and OOPs, but it would come with a larger premium.

So is this debt more bc of those max oop costs or bc of denied claims?

While I’ve not seen a breakdown, my guess would be more of the former. That said, with more and more health plans shifting to tighter networks (hmo vs PPO), more claims are now “out of network”, and this by definition “denied” - but due to who performed the service rather than the service itself being denied.

Also, more and more of it is because we still have 25-30M people with no insurance at all - so really neither of the reasons above you listed.

 

[Terminalxylem]

Doctors Say Dealing With Health Insurers Is Only Getting Worse
(archived copy of Wall Street Journal article)
It's a long article and very much worth a read.

"Count doctors among the aggrieved. They deal day in and day out with insurers including UnitedHealthcare, whose chief executive, Brian Thompson, was shot to death last week by an assassin who targeted him outside the company’s annual investor conference. Doctors say their frustration is born of intimate experience and has been building for years.

Their chief complaint is the aggravation and expense of convincing insurance companies to pay them for their patients’ treatment. Even when they are ultimately approved, MRI scans and other vital but costly procedures often require days of campaigning and paperwork, say doctors. “It’s getting worse,” said Dr. Zulfiqar Ahmed, an internist in Augusta, Ga., who has practiced in the U.S. for 35 years. “This is not only UnitedHealthcare—this is universal in this country.”"

Key words for the next decade: Concierge Care.

I ran into that about 6-7 years ago. Had the same GP for the first 18 years I was in NYC. Board certified, John Hopkins alum, Central Park West location, phenomenal communicator.

One day I showed up for my annual physical and his office manager told me they have stopped taking all insurance claims. During the exam I asked what’s up, and he told me he was moving to a concierge model.

OK, how does that work?

Well, not much different than your relationship with your lawyer. Flat initiation fee up front ($3K but it’s gone up since), then monthly retainer fee. Time & expense after the retainer is exhausted, 100% out of pocket.

It’s a great way for clinicians to give the middle finger to insurers. Problem is, it caters to the wealthy, and arguably violates the Hippocratic Oath.

 

[matttyl]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

We led Americans, employers in particular but also policymakers, to think that all of us needed to move into high deductible health plans. We had a way of referring to them back then that was euphemistic. We call them consumer driven health plans, and we call this movement consumerism.

So that was a way that we misled everybody into thinking that Americans were just chomping at the bit to be moved into health plans that require them to pay more money out of their own pockets before their coverage kicks in. It was amazing that we were able to pull that off, but we did to the point that today most Americans have to pay a lot of money out of their own pockets before their coverage will kick in even as they're paying more and more for the premiums.

So that's just one example of how we purposefully misled so many Americans to further our agenda and our agenda. Frankly, the bottom line is to enhance shareholder value because for most of these big companies that dominate the health insurance market, our for-profit companies and their stock is traded in the New York Stock Exchange.

You see how this becomes kind of circular. So for example, I recently saw a GI specialist at UC Davis. The chargemaster rate, according to my bill was $646 for a 45 minute appointment after my insurance discount. I paid $564 out of pocket for the appointment toward my $2,500 per year deductible.

I called to negotiate and I asked what it would've cost had I been cash pay had I not carried this insurance, and they told me that the cash pay rate was $380. It's like, that's weird. That's really interesting. So that is to say, because I had insurance, I actually paid roughly 48% more than a cash pay customer would've paid because the contract between my insurer and my provider said that my provider agreed to charge me the rate that the insurance company had negotiated with them, even if it was as was true here, a lot higher than what they would charge someone without my insurance. They said, and I quote, “Well, our contract is with them, not you.”

This only ends up being a good deal for me, the insured, if I end up paying my entire $2,500 deductible such that my covered healthcare beyond that point is free to me. So let's pause there for a second. What incentive does that now create for me as the insured? Well, once you get close to a deductible, you are now incentivized to try to get as much medical care as you possibly can to get your money's worth. In that year, you spent your $2,500 on four office visits and some labs as I did, and now you're like, all right, let's go. I am going to try to load up now to get my money's worth. I'm not going to wait until February to get this other thing that I think I need. I'm going to get it now because now it's quote unquote free. I ended up getting a colonoscopy that was soft recommended this year because I had hit my deductible.

And so my economically rational response was, “Okay, this is healthcare. My doctor says I might need to rule out anything serious with these GI issues. I could wait until next year and see what happens and how my symptoms progress, or I could get it before the end of the year because I'm about to hit this deductible.”

The system is being gamed by all parties - insurer, physician, and patient, which is gross.

You, but when my wife hit her OOP max after her appendectomy- I told her to go visit any doc she might need to (GP, lady doc, dermatologist, so on) as it was all “free” till the end of that policy year. No reason not to. Like playing with house money.

 

[Terminalxylem]

As of February of this year, total US unpaid medical debt was about $220B. That’s a lot.

But total credit card debt (some of which could be medical expenses) is currently $1.166T (with a T). Roughly 5 times larger. But even that isn’t the largest total consumer debt in US. It’s not even #2.

Total auto loan debt is $1.644T. Americans took out $184B in new car loans in q3 of this year alone.

Total student loan debt is around $1.77T.

Now when it comes to “bankruptcy”, isn’t it the case that it’s easier to file for medical debt than for the others listed? I honestly don’t know. And I don’t mean to say that medical debt isn’t a problem, it obviously is.

Thanks. You beat me to it.

Total debt in the U.S. is $17.69 trillion, so medical debt makes of 1.2% of all U.S. consumer debt

Average loan balance per person is $104,215, making average medical debt balance $1,251.

Student loans, cars and houses are expected debts that most lenders have vetted to prevent bankruptcy; medical debt is usually unexpected and nobody cares if it bankrupts a person or not.

13.4% of U.S. homeowners don't have homeowners insurance.

So which is the bigger personal financial risk...unexpected medical bills or unexpected home damage/loss?

Depends on the person, but medical bills can easily exceed the average home value. And the likelihood of a costly health problem surely exceeds that of extensive home damage/loss.

Too lazy to look it up, but what are lifetime housing versus healthcare expenditures in the US?

 

[Terminalxylem]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

We led Americans, employers in particular but also policymakers, to think that all of us needed to move into high deductible health plans. We had a way of referring to them back then that was euphemistic. We call them consumer driven health plans, and we call this movement consumerism.

So that was a way that we misled everybody into thinking that Americans were just chomping at the bit to be moved into health plans that require them to pay more money out of their own pockets before their coverage kicks in. It was amazing that we were able to pull that off, but we did to the point that today most Americans have to pay a lot of money out of their own pockets before their coverage will kick in even as they're paying more and more for the premiums.

So that's just one example of how we purposefully misled so many Americans to further our agenda and our agenda. Frankly, the bottom line is to enhance shareholder value because for most of these big companies that dominate the health insurance market, our for-profit companies and their stock is traded in the New York Stock Exchange.

You see how this becomes kind of circular. So for example, I recently saw a GI specialist at UC Davis. The chargemaster rate, according to my bill was $646 for a 45 minute appointment after my insurance discount. I paid $564 out of pocket for the appointment toward my $2,500 per year deductible.

I called to negotiate and I asked what it would've cost had I been cash pay had I not carried this insurance, and they told me that the cash pay rate was $380. It's like, that's weird. That's really interesting. So that is to say, because I had insurance, I actually paid roughly 48% more than a cash pay customer would've paid because the contract between my insurer and my provider said that my provider agreed to charge me the rate that the insurance company had negotiated with them, even if it was as was true here, a lot higher than what they would charge someone without my insurance. They said, and I quote, “Well, our contract is with them, not you.”

This only ends up being a good deal for me, the insured, if I end up paying my entire $2,500 deductible such that my covered healthcare beyond that point is free to me. So let's pause there for a second. What incentive does that now create for me as the insured? Well, once you get close to a deductible, you are now incentivized to try to get as much medical care as you possibly can to get your money's worth. In that year, you spent your $2,500 on four office visits and some labs as I did, and now you're like, all right, let's go. I am going to try to load up now to get my money's worth. I'm not going to wait until February to get this other thing that I think I need. I'm going to get it now because now it's quote unquote free. I ended up getting a colonoscopy that was soft recommended this year because I had hit my deductible.

And so my economically rational response was, “Okay, this is healthcare. My doctor says I might need to rule out anything serious with these GI issues. I could wait until next year and see what happens and how my symptoms progress, or I could get it before the end of the year because I'm about to hit this deductible.”

The system is being gamed by all parties - insurer, physician, and patient, which is gross.

You, but when my wife hit her OOP max after her appendectomy- I told her to go visit any doc she might need to (GP, lady doc, dermatologist, so on) as it was all “free” till the end of that policy year. No reason not to. Like playing with house money.

Not “wrong” by any means, but I’m not a fan of utilizing the system in this manner.

 

[matttyl]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

We led Americans, employers in particular but also policymakers, to think that all of us needed to move into high deductible health plans. We had a way of referring to them back then that was euphemistic. We call them consumer driven health plans, and we call this movement consumerism.

So that was a way that we misled everybody into thinking that Americans were just chomping at the bit to be moved into health plans that require them to pay more money out of their own pockets before their coverage kicks in. It was amazing that we were able to pull that off, but we did to the point that today most Americans have to pay a lot of money out of their own pockets before their coverage will kick in even as they're paying more and more for the premiums.

So that's just one example of how we purposefully misled so many Americans to further our agenda and our agenda. Frankly, the bottom line is to enhance shareholder value because for most of these big companies that dominate the health insurance market, our for-profit companies and their stock is traded in the New York Stock Exchange.

You see how this becomes kind of circular. So for example, I recently saw a GI specialist at UC Davis. The chargemaster rate, according to my bill was $646 for a 45 minute appointment after my insurance discount. I paid $564 out of pocket for the appointment toward my $2,500 per year deductible.

I called to negotiate and I asked what it would've cost had I been cash pay had I not carried this insurance, and they told me that the cash pay rate was $380. It's like, that's weird. That's really interesting. So that is to say, because I had insurance, I actually paid roughly 48% more than a cash pay customer would've paid because the contract between my insurer and my provider said that my provider agreed to charge me the rate that the insurance company had negotiated with them, even if it was as was true here, a lot higher than what they would charge someone without my insurance. They said, and I quote, “Well, our contract is with them, not you.”

This only ends up being a good deal for me, the insured, if I end up paying my entire $2,500 deductible such that my covered healthcare beyond that point is free to me. So let's pause there for a second. What incentive does that now create for me as the insured? Well, once you get close to a deductible, you are now incentivized to try to get as much medical care as you possibly can to get your money's worth. In that year, you spent your $2,500 on four office visits and some labs as I did, and now you're like, all right, let's go. I am going to try to load up now to get my money's worth. I'm not going to wait until February to get this other thing that I think I need. I'm going to get it now because now it's quote unquote free. I ended up getting a colonoscopy that was soft recommended this year because I had hit my deductible.

And so my economically rational response was, “Okay, this is healthcare. My doctor says I might need to rule out anything serious with these GI issues. I could wait until next year and see what happens and how my symptoms progress, or I could get it before the end of the year because I'm about to hit this deductible.”

The system is being gamed by all parties - insurer, physician, and patient, which is gross.

You, but when my wife hit her OOP max after her appendectomy- I told her to go visit any doc she might need to (GP, lady doc, dermatologist, so on) as it was all “free” till the end of that policy year. No reason not to. Like playing with house money.

Not “wrong” by any means, but I’m not a fan of utilizing the system in this manner.

Well, my family was hit by this circumstance, but in the completely opposite situation. Coming up on 10 years ago next week, my little sister was in a horrible accident. Needed to be taken by chopper to the hospital for live saving surgery - she had fractured her skull and face. She was in ICU for roughly 2 weeks - over two calendar years so hit her max OOP for two different years in one hospital trip.

 

[Stoneworker]

13.4% of U.S. homeowners don't have homeowners insurance.

So which is the bigger personal financial risk...unexpected medical bills or unexpected home damage/loss?

Depends on the person, but medical bills can easily exceed the average home value. And the likelihood of a costly health problem surely exceeds that of extensive home damage/loss.

Do you have a source for the bolded?

Because the 2024 uninsured losses from Hurricane Helene alone are estimated at $20-30 billion. Milton at $4-6 billion.

These and similar natural disasters are now predictably an annual event (e.g. CA wildfires > $11 billion)

 

[Terminalxylem]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

We led Americans, employers in particular but also policymakers, to think that all of us needed to move into high deductible health plans. We had a way of referring to them back then that was euphemistic. We call them consumer driven health plans, and we call this movement consumerism.

So that was a way that we misled everybody into thinking that Americans were just chomping at the bit to be moved into health plans that require them to pay more money out of their own pockets before their coverage kicks in. It was amazing that we were able to pull that off, but we did to the point that today most Americans have to pay a lot of money out of their own pockets before their coverage will kick in even as they're paying more and more for the premiums.

So that's just one example of how we purposefully misled so many Americans to further our agenda and our agenda. Frankly, the bottom line is to enhance shareholder value because for most of these big companies that dominate the health insurance market, our for-profit companies and their stock is traded in the New York Stock Exchange.

You see how this becomes kind of circular. So for example, I recently saw a GI specialist at UC Davis. The chargemaster rate, according to my bill was $646 for a 45 minute appointment after my insurance discount. I paid $564 out of pocket for the appointment toward my $2,500 per year deductible.

I called to negotiate and I asked what it would've cost had I been cash pay had I not carried this insurance, and they told me that the cash pay rate was $380. It's like, that's weird. That's really interesting. So that is to say, because I had insurance, I actually paid roughly 48% more than a cash pay customer would've paid because the contract between my insurer and my provider said that my provider agreed to charge me the rate that the insurance company had negotiated with them, even if it was as was true here, a lot higher than what they would charge someone without my insurance. They said, and I quote, “Well, our contract is with them, not you.”

This only ends up being a good deal for me, the insured, if I end up paying my entire $2,500 deductible such that my covered healthcare beyond that point is free to me. So let's pause there for a second. What incentive does that now create for me as the insured? Well, once you get close to a deductible, you are now incentivized to try to get as much medical care as you possibly can to get your money's worth. In that year, you spent your $2,500 on four office visits and some labs as I did, and now you're like, all right, let's go. I am going to try to load up now to get my money's worth. I'm not going to wait until February to get this other thing that I think I need. I'm going to get it now because now it's quote unquote free. I ended up getting a colonoscopy that was soft recommended this year because I had hit my deductible.

And so my economically rational response was, “Okay, this is healthcare. My doctor says I might need to rule out anything serious with these GI issues. I could wait until next year and see what happens and how my symptoms progress, or I could get it before the end of the year because I'm about to hit this deductible.”

The system is being gamed by all parties - insurer, physician, and patient, which is gross.

You, but when my wife hit her OOP max after her appendectomy- I told her to go visit any doc she might need to (GP, lady doc, dermatologist, so on) as it was all “free” till the end of that policy year. No reason not to. Like playing with house money.

Not “wrong” by any means, but I’m not a fan of utilizing the system in this manner.

Well, my family was hit by this circumstance, but in the completely opposite situation. Coming up on 10 years ago next week, my little sister was in a horrible accident. Needed to be taken by chopper to the hospital for live saving surgery - she had fractured her skull and face. She was in ICU for roughly 2 weeks - over two calendar years so hit her max OOP for two different years in one hospital trip.

I understand, just fundamentally disagree with treating healthcare like other consumer purchases. Centralized, single payer clearly seems like the best way to provide universal care, but we’re stuck with a fragmented business model instead.

 

[Terminalxylem]

13.4% of U.S. homeowners don't have homeowners insurance.

So which is the bigger personal financial risk...unexpected medical bills or unexpected home damage/loss?

Depends on the person, but medical bills can easily exceed the average home value. And the likelihood of a costly health problem surely exceeds that of extensive home damage/loss.

Do you have a source for the bolded?

Because the 2024 uninsured losses from Hurricane Helene alone are estimated at $20-30 billion. Milton at $4-6 billion.

These and similar natural disasters are now predictably an annual event (e.g. CA wildfires > $11 billion)

I don’t, but eventually, we’re all gonna be hospitalized, need an operation, have a kid or two, develop heart disease/cancer/diabetes/etc., and die of something. I find it hard to believe the likelihood of natural disaster causing catastrophic loss of property even approaches those risks.

 

[Stoneworker]

13.4% of U.S. homeowners don't have homeowners insurance.

So which is the bigger personal financial risk...unexpected medical bills or unexpected home damage/loss?

Depends on the person, but medical bills can easily exceed the average home value. And the likelihood of a costly health problem surely exceeds that of extensive home damage/loss.

Do you have a source for the bolded?

Because the 2024 uninsured losses from Hurricane Helene alone are estimated at $20-30 billion. Milton at $4-6 billion.

These and similar natural disasters are now predictably an annual event (e.g. CA wildfires > $11 billion)

I don’t, but eventually, we’re all gonna be hospitalized, need an operation, have a kid or two, develop heart disease/cancer/diabetes/etc., and die of something. I find it hard to believe the likelihood of natural disaster causing catastrophic loss of property even approaches those risks.

Of course we all need medical coverage, but the vast majority of that is insured. The apples-to-apples comparison is with uninsured risk/losses (i.e. the type that may cause bankruptcy)

 

[CletiusMaximus]

Money with Katie Podcast Link -

The Biggest Healthcare Myths, with an Insurance VP Turned Whistleblower​

We led Americans, employers in particular but also policymakers, to think that all of us needed to move into high deductible health plans. We had a way of referring to them back then that was euphemistic. We call them consumer driven health plans, and we call this movement consumerism.

So that was a way that we misled everybody into thinking that Americans were just chomping at the bit to be moved into health plans that require them to pay more money out of their own pockets before their coverage kicks in. It was amazing that we were able to pull that off, but we did to the point that today most Americans have to pay a lot of money out of their own pockets before their coverage will kick in even as they're paying more and more for the premiums.

So that's just one example of how we purposefully misled so many Americans to further our agenda and our agenda. Frankly, the bottom line is to enhance shareholder value because for most of these big companies that dominate the health insurance market, our for-profit companies and their stock is traded in the New York Stock Exchange.

You see how this becomes kind of circular. So for example, I recently saw a GI specialist at UC Davis. The chargemaster rate, according to my bill was $646 for a 45 minute appointment after my insurance discount. I paid $564 out of pocket for the appointment toward my $2,500 per year deductible.

I called to negotiate and I asked what it would've cost had I been cash pay had I not carried this insurance, and they told me that the cash pay rate was $380. It's like, that's weird. That's really interesting. So that is to say, because I had insurance, I actually paid roughly 48% more than a cash pay customer would've paid because the contract between my insurer and my provider said that my provider agreed to charge me the rate that the insurance company had negotiated with them, even if it was as was true here, a lot higher than what they would charge someone without my insurance. They said, and I quote, “Well, our contract is with them, not you.”

This only ends up being a good deal for me, the insured, if I end up paying my entire $2,500 deductible such that my covered healthcare beyond that point is free to me. So let's pause there for a second. What incentive does that now create for me as the insured? Well, once you get close to a deductible, you are now incentivized to try to get as much medical care as you possibly can to get your money's worth. In that year, you spent your $2,500 on four office visits and some labs as I did, and now you're like, all right, let's go. I am going to try to load up now to get my money's worth. I'm not going to wait until February to get this other thing that I think I need. I'm going to get it now because now it's quote unquote free. I ended up getting a colonoscopy that was soft recommended this year because I had hit my deductible.

And so my economically rational response was, “Okay, this is healthcare. My doctor says I might need to rule out anything serious with these GI issues. I could wait until next year and see what happens and how my symptoms progress, or I could get it before the end of the year because I'm about to hit this deductible.”

The system is being gamed by all parties - insurer, physician, and patient, which is gross.

Not to cross-contaminate with the other thread, but its also complicated by the fact that companies like UHG (UHC/Optum/UMR) are insurers but also providers, also create and administer claims for self-funded employer plans, are in pharma, home care, medical supply and assisted living/end of life.