US Healthcare Stinks Thread II (2 Viewers)

[BrutalPenguin]

I was taken to the ER in late October with congestive heart failure. I spent a week in the hospital, had 4 cardiac procedures, 1 cardiac surgery, who knows how much in IV drugs, EKGs, and cardiologist consults. The (undiscounted) bill came in just north of $90k. My bill after insurance is $3k + $300 in heart meds, which seems like a bargain to have a heart that functions within guidelines. So I'll say that, at least from my point of view, the US heath insurance system does not stink.

 

[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.

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)

Ok. I may be wrong, but anecdotally, I’ve seen far more major medical expenses causing financial hardship than housing disasters.

I’ve even considered relinquishing home owners insurance, as my biggest surprise home repair (foundation) wasn’t covered anyway. That was $120K out of pocket. My cumulative medical bills have far exceeded that amount. But you’re right, insurance covered most of it.

If I were uninsured, unexpected medical costs would easily outpace home repairs. And I’m far healthier than the average middle aged American.

 

[FairWarning]

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)

Still, it can cost a family $1000/month with a 12-15K deductable. Small businesses can’t afford to offer insurance.

 

[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)

Ok. I may be wrong, but anecdotally, I’ve seen far more major medical expenses causing financial hardship than housing disasters.

I’ve even considered relinquishing home owners insurance, as my biggest surprise home repair (foundation) wasn’t covered anyway. That was $120K out of pocket. My cumulative medical bills have far exceeded that amount. But you’re right, insured covered most of it.

If I were uninsured, unexpected medical costs would easily outpace home repairs. And I’m far healthier than the average middle aged American.

And you would have been part of a larger trend.

According to some sources**, the number of uninsured homeowners has risen by 60% in the past year alone. And the total property risk exposure may be as high as $3 trillion.

Not looking to derail from health insurance, but IMO context is important. And that requires quantifying and comparing other types of financial risks.

**U.S. housing market, economy at serious risk due to $3 trillion in uninsured homes

 

[matttyl]

I was taken to the ER in late October with congestive heart failure. I spent a week in the hospital, had 4 cardiac procedures, 1 cardiac surgery, who knows how much in IV drugs, EKGs, and cardiologist consults. The (undiscounted) bill came in just north of $90k. My bill after insurance is $3k + $300 in heart meds, which seems like a bargain to have a heart that functions within guidelines. So I'll say that, at least from my point of view, the US heath insurance system does not stink.

Glad you’re doing ok! I would have guessed the initial bill would have been 2-3x that amount.

 

[FreeBaGeL]

I was taken to the ER in late October with congestive heart failure. I spent a week in the hospital, had 4 cardiac procedures, 1 cardiac surgery, who knows how much in IV drugs, EKGs, and cardiologist consults. The (undiscounted) bill came in just north of $90k. My bill after insurance is $3k + $300 in heart meds, which seems like a bargain to have a heart that functions within guidelines. So I'll say that, at least from my point of view, the US heath insurance system does not stink.

Phew. Good thing that you're not a single mom of three working an hourly job that doesn't provide benefits.

 

[djmich]

I was taken to the ER in late October with congestive heart failure. I spent a week in the hospital, had 4 cardiac procedures, 1 cardiac surgery, who knows how much in IV drugs, EKGs, and cardiologist consults. The (undiscounted) bill came in just north of $90k. My bill after insurance is $3k + $300 in heart meds, which seems like a bargain to have a heart that functions within guidelines. So I'll say that, at least from my point of view, the US heath insurance system does not stink.

Phew. Good thing that you're not a single mom of three working an hourly job that doesn't provide benefits.

Correct, but the title of the thread is that healthcare insurance stinks, and this is an example of where it didn't stink. What it did highlight is that the underlying cost of healthcare, provided by healthcare providers and not insurers, stinks.

 

[FreeBaGeL]

I was taken to the ER in late October with congestive heart failure. I spent a week in the hospital, had 4 cardiac procedures, 1 cardiac surgery, who knows how much in IV drugs, EKGs, and cardiologist consults. The (undiscounted) bill came in just north of $90k. My bill after insurance is $3k + $300 in heart meds, which seems like a bargain to have a heart that functions within guidelines. So I'll say that, at least from my point of view, the US heath insurance system does not stink.

Phew. Good thing that you're not a single mom of three working an hourly job that doesn't provide benefits.

Correct, but the title of the thread is that healthcare insurance stinks, and this is an example of where it didn't stink. What it did highlight is that the underlying cost of healthcare, provided by healthcare providers and not insurers, stinks.

Ah fair enough, though I actually think that was a typo by the OP. He put the "II" on there implicating it was a continuation of the original thread that got locked, which was just "US Healthcare stinks".

Also most of the talk in here has been about US healthcare as a whole so I think everyone is assuming that's what it meant as well.

 

[IC FBGCav]

It sucks, plain and simple. As someone who chose plans for a business for 20 plus years. Premiums go up every year and what is covered goes down. Unless you change carriers. But by far the biggest and most unfair practice is not telling the patient what things cost up front and what is covered by an insurance company. You can't make educated decisions in our system.

 

[fatness]

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

I don't think these are helpful numbers --- "per person" numbers. Schoolchildren don't have average loan balances of $104,215 or average medical debt balances of $1,251, for example. If I've misunderstood, please let me know. Thanks.

 

[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 I did a bit more homework on this, really just to see if it was out there. Sure enough, KFF had looked into it. 16.2% of households who had coverage all year round had medical debt with a median amount of around $2k. While 30.8% of households who didn’t have a full 12 months of coverage in the year looked at had medical debt (so roughly twice the rate), and the median amount was $3k (50% more).

So while our system is far from perfect, if the goal is to prevent medical debt, having insurance coverage year round cuts the odds of having it roughly in half, and if you end up with debt, the median amount is a third less.

 

[matttyl]

It sucks, plain and simple. As someone who chose plans for a business for 20 plus years. Premiums go up every year and what is covered goes down. Unless you change carriers. But by far the biggest and most unfair practice is not telling the patient what things cost up front and what is covered by an insurance company. You can't make educated decisions in our system.

While I fully agree (and can back up) your initial statement of premiums, and your last statement of non transparency - I’ll argue your point of view “what is covered goes down.” If you mean that your deductible or OOP goes up, that may be true - but new drugs and new treatments are available (and covered) now that weren’t available just a few years ago. My own father is getting a chemo cocktail that wasn’t available just a few years ago, and he’s doing great (all things considered). My son received wonderful care for “pseudo-tumor” (idiopathic intracranial hypertension) in a children’s hospital a few years ago that wasn’t thought of 10+ years ago. Another family member is on one of these new weight loss drugs (it’s working great, and covered by insurance) that was only approved for medical use recently.

 

[Stoneworker]

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

I don't think these are helpful numbers --- "per person" numbers. Schoolchildren don't have average loan balances of $104,215 or average medical debt balances of $1,251, for example. If I've misunderstood, please let me know. Thanks.

Thanks. The figures are per household, not per person.

Average American Household Debt in 2024: Facts and Figures

 

[IvanKaramazov]

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

I don't think these are helpful numbers --- "per person" numbers. Schoolchildren don't have average loan balances of $104,215 or average medical debt balances of $1,251, for example. If I've misunderstood, please let me know. Thanks.

Thanks. The figures are per household, not per person.

Average American Household Debt in 2024: Facts and Figures

If you scroll down a ways, there's a helpful section on just medical debt. They're looking at "medical debt in collections" which obviously is just one metric. It's capturing people whose finances are seriously messed up by medical debt, as opposed to people are just uncomfortable but still making payments. Of course, that's fine as long as we keep all that in mind.

American medical debt​

Medical debt can be difficult to track. However, it's clear that it's a growing problem.

According to The Urban Institute, 13% of Americans -- over 43 million people -- had medical debt in collections in 2022. That number is higher in communities of color, at 15%.

Some states have significantly higher numbers, too. For example, 24% of West Virginians have medical debt in collections.

The median debt also varies quite a bit. In the United States overall, the median medical debt in collections is $703. In Wyoming, Utah, Wisconsin, and Florida, that number is over $900.

While statistics are scarce, it seems likely that rising healthcare costs -- especially during a global pandemic -- have pushed these numbers higher in recent years.

That doesn't sound problematic to me at all. I'm a little bothered by the fact that people can't scrape together $700 in a pinch, but we all know that people don't have enough short-term savings. Overall, though, this isn't really a problem and probably doesn't need a solution.

Also, those are medians, which is the right measure of central tendency to use for this sort of thing. It's the right measure to use because it ignores outliers that would skew the mean in a misleading direction. Most people with medical debt have only three figures worth. But obviously there are people out there with orders of magnitude more debt than that, and that might be a problem to address. Although we already have bankruptcy law, so maybe it doesn't need to be addressed. Regardless, it's helpful to know that the median person who is getting collection notices about their doctor's bill is in for less than a single rack.

 

[IC FBGCav]

What you said is fair Matt. I don't disagree with that. Glad your peeps are doing well!

 

[Stoneworker]

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

I don't think these are helpful numbers --- "per person" numbers. Schoolchildren don't have average loan balances of $104,215 or average medical debt balances of $1,251, for example. If I've misunderstood, please let me know. Thanks.

Thanks. The figures are per household, not per person.

Average American Household Debt in 2024: Facts and Figures

If you scroll down a ways, there's a helpful section on just medical debt. They're looking at "medical debt in collections" which obviously is just one metric. It's capturing people whose finances are seriously messed up by medical debt, as opposed to people are just uncomfortable but still making payments. Of course, that's fine as long as we keep all that in mind.

American medical debt​

Medical debt can be difficult to track. However, it's clear that it's a growing problem.

According to The Urban Institute, 13% of Americans -- over 43 million people -- had medical debt in collections in 2022. That number is higher in communities of color, at 15%.

Some states have significantly higher numbers, too. For example, 24% of West Virginians have medical debt in collections.

The median debt also varies quite a bit. In the United States overall, the median medical debt in collections is $703. In Wyoming, Utah, Wisconsin, and Florida, that number is over $900.

While statistics are scarce, it seems likely that rising healthcare costs -- especially during a global pandemic -- have pushed these numbers higher in recent years.

That doesn't sound problematic to me at all. I'm a little bothered by the fact that people can't scrape together $700 in a pinch, but we all know that people don't have enough short-term savings. Overall, though, this isn't really a problem and probably doesn't need a solution.

Also, those are medians, which is the right measure of central tendency to use for this sort of thing. It's the right measure to use because it ignores outliers that would skew the mean in a misleading direction. Most people with medical debt have only three figures worth. But obviously there are people out there with orders of magnitude more debt than that, and that might be a problem to address. Although we already have bankruptcy law, so maybe it doesn't need to be addressed. Regardless, it's helpful to know that the median person who is getting collection notices about their doctor's bill is in for less than a single rack.

Thank you for pointing that out as I didn't get that far in that particular article.

Agree that $703 median medical debt in collections provides good perspective on the overall magnitude of the issue.

Also agree that by its very nature medical debt can get out of hand quickly. I got this from another source:

Approximately 14 million people (6% of adults) in the U.S. owe over $1,000 in medical debt and about 3 million people (1% of adults) owe medical debt of more than $10,000.

KFF: The Burden of Medical Debt in the United States

 

[Judge Smails]

I have always opted for the premium PPO offered for my family. I’ve had some big expenses, including a widowmaker with a stent (over $100K) and now melanoma surgery with biopsies, etc. Never more than a few thousand out of pocket. So to me insurance is great for catastrophic things if you have the right coverage.

Pricing transparency still sucks. The whole game of cash pay being 1/4 the price of the insurance amount, co pays for wellness visits etc is terrible. System is broken in a lot of ways, but the coverage for catastrophic events is good in most cases

 

[Mitchie]

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

I don't think these are helpful numbers --- "per person" numbers. Schoolchildren don't have average loan balances of $104,215 or average medical debt balances of $1,251, for example. If I've misunderstood, please let me know. Thanks.

Thanks. The figures are per household, not per person.

Average American Household Debt in 2024: Facts and Figures

If you scroll down a ways, there's a helpful section on just medical debt. They're looking at "medical debt in collections" which obviously is just one metric. It's capturing people whose finances are seriously messed up by medical debt, as opposed to people are just uncomfortable but still making payments. Of course, that's fine as long as we keep all that in mind.

American medical debt​

Medical debt can be difficult to track. However, it's clear that it's a growing problem.

According to The Urban Institute, 13% of Americans -- over 43 million people -- had medical debt in collections in 2022. That number is higher in communities of color, at 15%.

Some states have significantly higher numbers, too. For example, 24% of West Virginians have medical debt in collections.

The median debt also varies quite a bit. In the United States overall, the median medical debt in collections is $703. In Wyoming, Utah, Wisconsin, and Florida, that number is over $900.

While statistics are scarce, it seems likely that rising healthcare costs -- especially during a global pandemic -- have pushed these numbers higher in recent years.

That doesn't sound problematic to me at all. I'm a little bothered by the fact that people can't scrape together $700 in a pinch, but we all know that people don't have enough short-term savings. Overall, though, this isn't really a problem and probably doesn't need a solution.

Also, those are medians, which is the right measure of central tendency to use for this sort of thing. It's the right measure to use because it ignores outliers that would skew the mean in a misleading direction. Most people with medical debt have only three figures worth. But obviously there are people out there with orders of magnitude more debt than that, and that might be a problem to address. Although we already have bankruptcy law, so maybe it doesn't need to be addressed. Regardless, it's helpful to know that the median person who is getting collection notices about their doctor's bill is in for less than a single rack.

I'd say median can be very misleading, let's think about it another way, 43 million people have medical debt, so 21.5 million have debt less than 700, that could range anywhere from $1-700, yeah most people should probably be able to figure out how to pay that, some can't but ok. Now let's think about the upper half, 21.5 million have debt of 700 - ???, this # could be 1K, 10K, 50K, who knows. For a lot of people this amount is crippling to their finances.

 

[Stoneworker]

That doesn't sound problematic to me at all. I'm a little bothered by the fact that people can't scrape together $700 in a pinch, but we all know that people don't have enough short-term savings. Overall, though, this isn't really a problem and probably doesn't need a solution.

Also, those are medians, which is the right measure of central tendency to use for this sort of thing. It's the right measure to use because it ignores outliers that would skew the mean in a misleading direction. Most people with medical debt have only three figures worth. But obviously there are people out there with orders of magnitude more debt than that, and that might be a problem to address. Although we already have bankruptcy law, so maybe it doesn't need to be addressed. Regardless, it's helpful to know that the median person who is getting collection notices about their doctor's bill is in for less than a single rack.

I'd say median can be very misleading, let's think about it another way, 43 million people have medical debt, so 21.5 million have debt less than 700, that could range anywhere from $1-700, yeah most people should probably be able to figure out how to pay that, some can't but ok. Now let's think about the upper half, 21.5 million have debt of 700 - ???, this # could be 1K, 10K, 50K, who knows. For a lot of people this amount is crippling to their finances.

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

The average U.S. household credit card debt is approx. $8,900 (Motley Fool 12/10/24)

Americans are good at getting into debt that could be crippling to their finances, regardless of the type.

 

[dickey moe]

Should just rename this the "Debt Stinks" thread. Why must we maintain this much debt all around to maintain our standard of living compared to say.... two generations ago?

 

[Alex P Keaton]

That doesn't sound problematic to me at all. I'm a little bothered by the fact that people can't scrape together $700 in a pinch, but we all know that people don't have enough short-term savings. Overall, though, this isn't really a problem and probably doesn't need a solution.

Also, those are medians, which is the right measure of central tendency to use for this sort of thing. It's the right measure to use because it ignores outliers that would skew the mean in a misleading direction. Most people with medical debt have only three figures worth. But obviously there are people out there with orders of magnitude more debt than that, and that might be a problem to address. Although we already have bankruptcy law, so maybe it doesn't need to be addressed. Regardless, it's helpful to know that the median person who is getting collection notices about their doctor's bill is in for less than a single rack.

I'd say median can be very misleading, let's think about it another way, 43 million people have medical debt, so 21.5 million have debt less than 700, that could range anywhere from $1-700, yeah most people should probably be able to figure out how to pay that, some can't but ok. Now let's think about the upper half, 21.5 million have debt of 700 - ???, this # could be 1K, 10K, 50K, who knows. For a lot of people this amount is crippling to their finances.

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

The average U.S. household credit card debt is approx. $8,900 (Motley Fool 12/10/24)

Americans are good at getting into debt that could be crippling to their finances, regardless of the type.

It’s amazing to me that people let this happen. Spend less. Get a 2nd (or 3rd) job. Don’t have a 4th or 5th kid. Don’t buy an iPhone. Etc.

It isn’t that hard to stay out of debt.

 

[fatness]

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

This is not what CFPB said.
The $3100 is medical debt that shows up on credit reports. It does not include medical debt paid using home equity lines, credit cards, borrowing from family members, etc.

The average medical balance on credit reports increased from $2,000 to over $3,100:

 

[Stoneworker]

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

This is not what CFPB said.
The $3100 is medical debt that shows up on credit reports. It does not include medical debt paid using home equity lines, credit cards, borrowing from family members, etc.

What shows up on the credit reports is the bills in collections ("For the 15 million Americans with medical bills on their credit reports..."). How people pay for the bills (i.e. cash, credit cards, unpaid, HELOC, etc) is not stated.

So while I agree it's not quite apples-to-apples, it's not simply additive either which is apparently your interpretation.

I'll admit the "medical bills in collections" should have been made more clear, but it's still quite useful info for perspective vs CC balances

If you've got better info to contribute, then please do

 

[Nugget]

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

This is not what CFPB said.
The $3100 is medical debt that shows up on credit reports. It does not include medical debt paid using home equity lines, credit cards, borrowing from family members, etc.

What shows up on the credit reports is the bills ("For the 15 million Americans with medical bills on their credit reports..."). How people pay for the bills (i.e. cash, credit cards, unpaid, HELOC, etc) is not stated.

So while I agree it's not quite apples-to-apples, it's not additive either which is apparently your interpretation.

If you've got better info to contribute, then please do

Bills don't show up on credit reports until they are past due. If it is paid with a credit card or HELOC, it won't show up as meidcal debt.

3M people have medical collections over $10K. 400-450K people file for personal BK each year. Average change in net worth in BK is about 25K.

If you want to push a narrative that medical billing isn't a big deal, go for it.

As to the bolded - don't be like that.

 

[Stoneworker]

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

This is not what CFPB said.
The $3100 is medical debt that shows up on credit reports. It does not include medical debt paid using home equity lines, credit cards, borrowing from family members, etc.

What shows up on the credit reports is the bills ("For the 15 million Americans with medical bills on their credit reports..."). How people pay for the bills (i.e. cash, credit cards, unpaid, HELOC, etc) is not stated.

So while I agree it's not quite apples-to-apples, it's not additive either which is apparently your interpretation.

If you've got better info to contribute, then please do

Bills don't show up on credit reports until they are past due. If it is paid with a credit card or HELOC, it won't show up as meidcal debt.

3M people have medical collections over $10K. 400-450K people file for personal BK each year. Average change in net worth in BK is about 25K.

If you want to push a narrative that medical billing isn't a big deal, go for it.

As to the bolded - don't be like that.

Medical debt isn't nearly as widespread or large an issue as you and others are trying to make it either on an absolute basis or relative to other U.S. financial challenges.

There you go. You got what you wanted

 

[IvanKaramazov]

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

This is not what CFPB said.
The $3100 is medical debt that shows up on credit reports. It does not include medical debt paid using home equity lines, credit cards, borrowing from family members, etc.

The average medical balance on credit reports increased from $2,000 to over $3,100:

Again, that seems pretty good to me. To put it in perspective, $3K is less than what I would expect to pay if I had to replace my roof or my furnace. That's an amount that adults really ought to be able to handle on short notice.

 

[IC FBGCav]

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

This is not what CFPB said.
The $3100 is medical debt that shows up on credit reports. It does not include medical debt paid using home equity lines, credit cards, borrowing from family members, etc.

The average medical balance on credit reports increased from $2,000 to over $3,100:

Again, that seems pretty good to me. To put it in perspective, $3K is less than what I would expect to pay if I had to replace my roof or my furnace. That's an amount that adults really ought to be able to handle on short notice.

You are a long time member here that I respect. Should everyone have personal responsibility to have 3k in the bank. Sure, I get that. And if the board only wanted Bitcoin when I started the crypto buying we would have 10x the investment. Instead we lost. That isn't the problem.

The care isn't good and the price goes up. That is the problem.

 

[IvanKaramazov]

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

This is not what CFPB said.
The $3100 is medical debt that shows up on credit reports. It does not include medical debt paid using home equity lines, credit cards, borrowing from family members, etc.

The average medical balance on credit reports increased from $2,000 to over $3,100:

Again, that seems pretty good to me. To put it in perspective, $3K is less than what I would expect to pay if I had to replace my roof or my furnace. That's an amount that adults really ought to be able to handle on short notice.

You are a long time member here that I respect. Should everyone have personal responsibility to have 3k in the bank. Sure, I get that. And if the board only wanted Bitcoin when I started the crypto buying we would have 10x the investment. Instead we lost. That isn't the problem.

The care isn't good and the price goes up. That is the problem.

Fair enough. I'm not looking to go too far down this particular rabbit hole.

Have a good Christmas, IC.

 

[Terminalxylem]

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 I did a bit more homework on this, really just to see if it was out there. Sure enough, KFF had looked into it. 16.2% of households who had coverage all year round had medical debt with a median amount of around $2k. While 30.8% of households who didn’t have a full 12 months of coverage in the year looked at had medical debt (so roughly twice the rate), and the median amount was $3k (50% more).

So while our system is far from perfect, if the goal is to prevent medical debt, having insurance coverage year round cuts the odds of having it roughly in half, and if you end up with debt, the median amount is a third less.

That doesn’t seem as big a disparity as I’d expect, though I assume the age and health status of the two groups is very different.

 

[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 I did a bit more homework on this, really just to see if it was out there. Sure enough, KFF had looked into it. 16.2% of households who had coverage all year round had medical debt with a median amount of around $2k. While 30.8% of households who didn’t have a full 12 months of coverage in the year looked at had medical debt (so roughly twice the rate), and the median amount was $3k (50% more).

So while our system is far from perfect, if the goal is to prevent medical debt, having insurance coverage year round cuts the odds of having it roughly in half, and if you end up with debt, the median amount is a third less.

That doesn’t seem as big a disparity as I’d expect, though I assume the age and health status of the two groups is very different.

I assume you mean the $ amount rather than the rate who have medical debt. I also would have assumed it would be higher, but that’s an average if a few million people.

 

[Terminalxylem]

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 I did a bit more homework on this, really just to see if it was out there. Sure enough, KFF had looked into it. 16.2% of households who had coverage all year round had medical debt with a median amount of around $2k. While 30.8% of households who didn’t have a full 12 months of coverage in the year looked at had medical debt (so roughly twice the rate), and the median amount was $3k (50% more).

So while our system is far from perfect, if the goal is to prevent medical debt, having insurance coverage year round cuts the odds of having it roughly in half, and if you end up with debt, the median amount is a third less.

That doesn’t seem as big a disparity as I’d expect, though I assume the age and health status of the two groups is very different.

I assume you mean the $ amount rather than the rate who have medical debt. I also would have assumed it would be higher, but that’s an average if a few million people.

Both numbers are surprising.

But even if medical debt isn’t as bad as I thought, I still contend we spend waaaay too much for healthcare, relative to the results we achieve. Why should US healthcare cost roughly twice the percentage of our (large) GDP than other OECD countries, for example?

 

[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 I did a bit more homework on this, really just to see if it was out there. Sure enough, KFF had looked into it. 16.2% of households who had coverage all year round had medical debt with a median amount of around $2k. While 30.8% of households who didn’t have a full 12 months of coverage in the year looked at had medical debt (so roughly twice the rate), and the median amount was $3k (50% more).

So while our system is far from perfect, if the goal is to prevent medical debt, having insurance coverage year round cuts the odds of having it roughly in half, and if you end up with debt, the median amount is a third less.

That doesn’t seem as big a disparity as I’d expect, though I assume the age and health status of the two groups is very different.

I assume you mean the $ amount rather than the rate who have medical debt. I also would have assumed it would be higher, but that’s an average if a few million people.

Both numbers are surprising.

But even if medical debt isn’t as bad as I thought, I still contend we spend waaaay too much for healthcare, relative to the results we achieve. Why should US healthcare cost roughly twice the percentage of our (large) GDP than other OECD countries, for example?

Because we consume so much more of it is one reason. We aren’t a healthy culture, or at least as healthy as many of our competitors. You know what I see all over the place here in the US, in each and every town I drive through - fast food joints. You know what I don’t see in Europe? Fast food joints.

But I totally agree that what we spend on standardized things is crazy (I think the other thread had the example of an appendectomy being like 4-10x here what it would cost in Europe).

 

[Terminalxylem]

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 I did a bit more homework on this, really just to see if it was out there. Sure enough, KFF had looked into it. 16.2% of households who had coverage all year round had medical debt with a median amount of around $2k. While 30.8% of households who didn’t have a full 12 months of coverage in the year looked at had medical debt (so roughly twice the rate), and the median amount was $3k (50% more).

So while our system is far from perfect, if the goal is to prevent medical debt, having insurance coverage year round cuts the odds of having it roughly in half, and if you end up with debt, the median amount is a third less.

That doesn’t seem as big a disparity as I’d expect, though I assume the age and health status of the two groups is very different.

I assume you mean the $ amount rather than the rate who have medical debt. I also would have assumed it would be higher, but that’s an average if a few million people.

Both numbers are surprising.

But even if medical debt isn’t as bad as I thought, I still contend we spend waaaay too much for healthcare, relative to the results we achieve. Why should US healthcare cost roughly twice the percentage of our (large) GDP than other OECD countries, for example?

Because we consume so much more of it is one reason. We aren’t a healthy culture, or at least as healthy as many of our competitors. You know what I see all over the place here in the US, in each and every town I drive through - fast food joints. You know what I don’t see in Europe? Fast food joints.

But I totally agree that what we spend on standardized things is crazy (I think the other thread had the example of an appendectomy being like 4-10x here what it would cost in Europe).

Yes, we are an unhealthy population, but that isn’t the main reason our healthcare costs so much.

Our fragmented, for-profit system, with multiple unnecessary middle people is the problem.

 

[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 I did a bit more homework on this, really just to see if it was out there. Sure enough, KFF had looked into it. 16.2% of households who had coverage all year round had medical debt with a median amount of around $2k. While 30.8% of households who didn’t have a full 12 months of coverage in the year looked at had medical debt (so roughly twice the rate), and the median amount was $3k (50% more).

So while our system is far from perfect, if the goal is to prevent medical debt, having insurance coverage year round cuts the odds of having it roughly in half, and if you end up with debt, the median amount is a third less.

That doesn’t seem as big a disparity as I’d expect, though I assume the age and health status of the two groups is very different.

I assume you mean the $ amount rather than the rate who have medical debt. I also would have assumed it would be higher, but that’s an average if a few million people.

Both numbers are surprising.

But even if medical debt isn’t as bad as I thought, I still contend we spend waaaay too much for healthcare, relative to the results we achieve. Why should US healthcare cost roughly twice the percentage of our (large) GDP than other OECD countries, for example?

Because we consume so much more of it is one reason. We aren’t a healthy culture, or at least as healthy as many of our competitors. You know what I see all over the place here in the US, in each and every town I drive through - fast food joints. You know what I don’t see in Europe? Fast food joints.

But I totally agree that what we spend on standardized things is crazy (I think the other thread had the example of an appendectomy being like 4-10x here what it would cost in Europe).

Yes, we are an unhealthy population, but that isn’t the main reason our healthcare costs so much.

Our fragmented, for-profit system, with multiple unnecessary middle people is the problem.

There are many reasons. There have been quite a few studies done showing that roughly 50% of our total healthcare spend is on lifestyle related issues (smoking, obesity, drinking).

 

[tommyGunZ]

Every country has unique attributes that factor in to healthcare costs. The vices matty points out are true, but there are other ways in which the US has efficiency advantages that should allow us to distribute care more effectively and cheaper.

Much like the issue with gun violence, the elephant in the room is well known, but there are profits, interests, and ideology involved that prevent us from solutions that seemingly every other civilized country on earth have already enacted. Hopefully our children and grandchildren have more courage than we do.

 

[Navin Johnson]

That doesn't sound problematic to me at all. I'm a little bothered by the fact that people can't scrape together $700 in a pinch, but we all know that people don't have enough short-term savings. Overall, though, this isn't really a problem and probably doesn't need a solution.

Also, those are medians, which is the right measure of central tendency to use for this sort of thing. It's the right measure to use because it ignores outliers that would skew the mean in a misleading direction. Most people with medical debt have only three figures worth. But obviously there are people out there with orders of magnitude more debt than that, and that might be a problem to address. Although we already have bankruptcy law, so maybe it doesn't need to be addressed. Regardless, it's helpful to know that the median person who is getting collection notices about their doctor's bill is in for less than a single rack.

I'd say median can be very misleading, let's think about it another way, 43 million people have medical debt, so 21.5 million have debt less than 700, that could range anywhere from $1-700, yeah most people should probably be able to figure out how to pay that, some can't but ok. Now let's think about the upper half, 21.5 million have debt of 700 - ???, this # could be 1K, 10K, 50K, who knows. For a lot of people this amount is crippling to their finances.

The average U.S. household medical debt is approx. $3,100 (CFPB 4/29/24)

The average U.S. household credit card debt is approx. $8,900 (Motley Fool 12/10/24)

Americans are good at getting into debt that could be crippling to their finances, regardless of the type.

Yes but the variance in medical debt is what gets you.

 

[Stoneworker]

All those categorically bashing the U.S. "for-profit" healthcare system may want to take a look at how the U.K. is doing with its celebrated government-run system, the NHS. Spoiler alert: It's in crisis


- A recent study revealed that 8 million people in the United Kingdom are waiting for their care, with 40 percent waiting for more than 18 weeks. An incredible 14,000 people died just last year while waiting for care in England’s emergency rooms. -The Hill 9/19/24

- In 2010, 94% of people attending [emergency rooms] were seen within 4 hours; by May 2024 that figure had dropped to just over 60% More than 100,000 infants waited more than 6 hours last year and nearly 10% of all patients are now waiting for 12 hours or more. - Summary of Lord Darby's independent findings to House of Lords - 11/15/24

- As of 2024, the NHS is experiencing severe staff shortages, with nursing vacancies being particularly acute. According to NHS figures, there are about 47,000 nursing vacancies in NHS England alone, accounting for over 10% of the total nursing workforce. - Dynamic Health Staff 4/30/24

- Ambulance workers and nurses held their first strikes in 30 years over pay and conditions. New England Journal of Medicine 7/8/23

- The UK has appreciably higher cancer mortality rates than other countries. - Lord Darby report


Sources
* The National Health Service is in serious trouble - Lord Darby Report
* At Breaking Point or Already Broken? The National Health Service in the United Kingdom - NEJM
* The UK’s Looming Nurse Shortage Crisis in 2024 - Dynamic Health Staff
* England’s strained health care system should ring alarms in the US - The Hill

 

[dickey moe]

All those categorically bashing the U.S. "for-profit" healthcare system may want to take a look at how the U.K. is doing with its celebrated government-run system, the NHS. Spoiler alert: It's in crisis


- A recent study revealed that 8 million people in the United Kingdom are waiting for their care, with 40 percent waiting for more than 18 weeks. An incredible 14,000 people died just last year while waiting for care in England’s emergency rooms. -The Hill 9/19/24

- In 2010, 94% of people attending [emergency rooms] were seen within 4 hours; by May 2024 that figure had dropped to just over 60% More than 100,000 infants waited more than 6 hours last year and nearly 10% of all patients are now waiting for 12 hours or more. - Summary of Lord Darby's independent findings to House of Lords - 11/15/24

- As of 2024, the NHS is experiencing severe staff shortages, with nursing vacancies being particularly acute. According to NHS figures, there are about 47,000 nursing vacancies in NHS England alone, accounting for over 10% of the total nursing workforce. - Dynamic Health Staff 4/30/24

- Ambulance workers and nurses held their first strikes in 30 years over pay and conditions. New England Journal of Medicine 7/8/23

- The UK has appreciably higher cancer mortality rates than other countries. - Lord Darby report


Sources
* The National Health Service is in serious trouble - Lord Darby Report
* At Breaking Point or Already Broken? The National Health Service in the United Kingdom - NEJM
* The UK’s Looming Nurse Shortage Crisis in 2024 - Dynamic Health Staff
* England’s strained health care system should ring alarms in the US - The Hill

This is what you can expect with nationalized health care in countries with relatively large populations - rationed care where a considerable percentage will die while waiting.

Health care as a matter of pure practice is better in the U.S.A., but it's too damned expensive.

 

[Navin Johnson]

All those categorically bashing the U.S. "for-profit" healthcare system may want to take a look at how the U.K. is doing with its celebrated government-run system, the NHS. Spoiler alert: It's in crisis


- A recent study revealed that 8 million people in the United Kingdom are waiting for their care, with 40 percent waiting for more than 18 weeks. An incredible 14,000 people died just last year while waiting for care in England’s emergency rooms. -The Hill 9/19/24

- In 2010, 94% of people attending [emergency rooms] were seen within 4 hours; by May 2024 that figure had dropped to just over 60% More than 100,000 infants waited more than 6 hours last year and nearly 10% of all patients are now waiting for 12 hours or more. - Summary of Lord Darby's independent findings to House of Lords - 11/15/24

- As of 2024, the NHS is experiencing severe staff shortages, with nursing vacancies being particularly acute. According to NHS figures, there are about 47,000 nursing vacancies in NHS England alone, accounting for over 10% of the total nursing workforce. - Dynamic Health Staff 4/30/24

- Ambulance workers and nurses held their first strikes in 30 years over pay and conditions. New England Journal of Medicine 7/8/23

- The UK has appreciably higher cancer mortality rates than other countries. - Lord Darby report


Sources
* The National Health Service is in serious trouble - Lord Darby Report
* At Breaking Point or Already Broken? The National Health Service in the United Kingdom - NEJM
* The UK’s Looming Nurse Shortage Crisis in 2024 - Dynamic Health Staff
* England’s strained health care system should ring alarms in the US - The Hill

This is what you can expect with nationalized health care in countries with relatively large populations - rationed care where a considerable percentage will die while waiting.

Health care as a matter of pure practice is better in the U.S.A., but it's too damned expensive.

I have been in Germany for almost 17 years and the only thing I have ever had to wait on was 2 days for an MRI on my ankle.

 

[Joe Bryant]

All those categorically bashing the U.S. "for-profit" healthcare system may want to take a look at how the U.K. is doing with its celebrated government-run system, the NHS. Spoiler alert: It's in crisis


- A recent study revealed that 8 million people in the United Kingdom are waiting for their care, with 40 percent waiting for more than 18 weeks. An incredible 14,000 people died just last year while waiting for care in England’s emergency rooms. -The Hill 9/19/24

- In 2010, 94% of people attending [emergency rooms] were seen within 4 hours; by May 2024 that figure had dropped to just over 60% More than 100,000 infants waited more than 6 hours last year and nearly 10% of all patients are now waiting for 12 hours or more. - Summary of Lord Darby's independent findings to House of Lords - 11/15/24

- As of 2024, the NHS is experiencing severe staff shortages, with nursing vacancies being particularly acute. According to NHS figures, there are about 47,000 nursing vacancies in NHS England alone, accounting for over 10% of the total nursing workforce. - Dynamic Health Staff 4/30/24

- Ambulance workers and nurses held their first strikes in 30 years over pay and conditions. New England Journal of Medicine 7/8/23

- The UK has appreciably higher cancer mortality rates than other countries. - Lord Darby report


Sources
* The National Health Service is in serious trouble - Lord Darby Report
* At Breaking Point or Already Broken? The National Health Service in the United Kingdom - NEJM
* The UK’s Looming Nurse Shortage Crisis in 2024 - Dynamic Health Staff
* England’s strained health care system should ring alarms in the US - The Hill

Interesting. I did not know this.

 

[matttyl]

So Thursday woke up with a bit of a tummy ache, thought it was something I’d eaten the day before. Go to work and it’s getting worse, so go home before lunch to finish the day WFH. It’s getting really bad now to the point where I don’t think I can drive myself, so I call some family to take me to ER. I get there and get taken straight in, hooked up to IV. They ask me where my pain is on a 1-10. Initially I said 4 or 5, mainly cause the nurse was cute and I wanted to look tough but I was hurting. Back pain and my huevos hurt to go with lower abdominal pain. Was fearing appendicitis or worse diverticulitis. After a CT scan (which I got pretty quick), and my pain creeping up to a 6 on my scale, was told it was kidney stone and the doc telling me I should have said 8 or 9 as they generally don’t give morphine at a 5 or 6 (but I was shaking in pain).

Anyway, kidney stone suck - but I’ll be curious to find out what this 3 hours in the ER will cost me. They had me pay $1,400ish while I was there saying if you pay up front you get a 20% discount. The lady was shocked that my deductible was so high, I told her it had just reset the day before and she was like “oh, right.”