[HN Gopher] CFPB kicks off rulemaking to remove medical bills fr...
___________________________________________________________________
CFPB kicks off rulemaking to remove medical bills from credit
reports
Author : geox
Score : 150 points
Date : 2023-09-22 18:56 UTC (4 hours ago)
(HTM) web link (www.consumerfinance.gov)
(TXT) w3m dump (www.consumerfinance.gov)
| clircle wrote:
| Get ready for more debt.
| iuhfdsakljhfads wrote:
| Does this mean I don't have to pay any medical bills unless they
| sue me? Awesome, that's one less thing!
| seatac76 wrote:
| Tangential but kudos to Rohit Chopra, he has done a stellar job
| at CFPB, between the credit reporting changes and the elimination
| of bank fees alone he has had quite the impact. Just a few years
| it looked more likely that the CFPB would be dissolved.
| capital_guy wrote:
| I agree that Chopra is excellent at his job. Unfortunately,
| It's still in danger of being dissolved. The Supreme Court is
| hearing a case in October challenging the legality of the
| agency's funding mechanism.
| https://en.wikipedia.org/wiki/Consumer_Financial_Protection_...
| voldacar wrote:
| >Its structure included a director that could not be fired by
| the President except for cause, and the ability to request
| funding from the Federal Reserve rather than the United
| States Congress
|
| I mean, that does sound pretty insane
| majormajor wrote:
| "director that could not be fired by the President except
| for cause"
|
| This is the same as the FTC and others.
|
| "This Court, as the majority acknowledges, has sustained
| the constitutionality of the FTC and similar in- dependent
| agencies. See ante, at 2, 13-16. The for-cause protections
| for the heads of those agencies, the Court has found, do
| not impede the President's ability to perform his own
| constitutional duties, and so do not breach the separation
| of powers."
|
| https://www.supremecourt.gov/opinions/19pdf/19-7_n6io.pdf
| pyuser583 wrote:
| It's different from the FTC because its funding comes
| directly from the federal reserve.
|
| So it's independent of both the President and Congress.
|
| It's more independent than many courts.
|
| What could possibly go wrong?
| [deleted]
| kadoban wrote:
| > What could possibly go wrong?
|
| They might accidentally get something done that helps
| people?
| tivert wrote:
| >> What could possibly go wrong?
|
| > They might accidentally get something done that helps
| people?
|
| Since you're missing the point: make me dictator, so I
| can finally get stuff done that helps people.
|
| Too much independence is a recipe for serious problems,
| even if (theoretically) it could be used accomplish major
| things.
| kadoban wrote:
| If there's serious problems, then Congress can act. The
| structure just makes it harder for Republicans to kill it
| quietly for an unsupportable reason.
| [deleted]
| MarkMarine wrote:
| Its structured this way because it was a reaction to the 08
| crash and subsequent bailout of wall street. Seems to be
| the only reform that came out of that area, and measured
| against how much the banks chafe against the CFPB, I'd say
| it was working.
|
| This would also challenge the federal reserve structure.
| gmerc wrote:
| Does it in the light of how the US government actually
| works?
| leereeves wrote:
| Trying to prevent some future elected government from
| changing course? I can see the appeal, but yeah, it
| sounds like a bad precedent.
| [deleted]
| MarkMarine wrote:
| Congress could always change the laws that govern it.
| This just prevents a single executive from replacing the
| head and neutering the agency as the tides change
| arcbyte wrote:
| That's not a desirable feature in a representative
| democracy.
| rightbyte wrote:
| I think you kinda want some institutional inertia though.
| MarkMarine wrote:
| Your representatives are in congress
| JumpCrisscross wrote:
| > _in danger of being dissolved_
|
| Defunded, not dissolved.
| plussed_reader wrote:
| Same ephemera.
| capital_guy wrote:
| In government there is no difference.
| kevmo wrote:
| America needs universal healthcare instead of this weird,
| expensive, less effective Frankenstein graft machine they have.
| loco5niner wrote:
| grift?
| jowea wrote:
| Graft is a word too.
|
| > graft (countable and uncountable, plural grafts) >
| (uncountable) Corruption in official life. > (uncountable)
| Illicit profit by corrupt means, especially in public life.
| consz wrote:
| I'll repost my comment from a recent thread, but this article is
| a surprise to me, I thought this had already been the case for
| years?
|
| Reposted comment --
|
| As far as I can tell, this is the correct way to handle this? I
| haven't paid attention to any medical bills sent in the mail
| since I started working 15 years ago (I generally pay what they
| ask at the point of service), and I've never noticed any
| consequences (no denial of service anywhere, has never shown up
| in any way on my credit report, etc) -- as far as my experience
| has shown, any bills sent after the fact are completely optional
| to pay.
| joe5150 wrote:
| If the hospital/provider sends your bill to a collections
| agency, then it can definitely show up on your reports.
| Especially so if you are actually sued for the debt, in which
| case the judgement is also a public record.
|
| I've had this happen a couple times in the past when I was in
| treatment for cancer and underemployed. One agency reported the
| collections action and it went on my credit report (no
| indication that it's medical debt or anything else, so I
| imagine it would be up to the consumer to contest these things
| with the bureau?) Another collector didn't, so I never paid the
| bill or heard from them again!
| consz wrote:
| >If the hospital/provider sends your bill to a collections
| agency, then it can definitely show up on your reports.
|
| So I agree this was the impression I got _in theory_ , but in
| practice I've never seen this happen. Why is there this
| mismatch? I check my credit reports once a year, there's
| nothing showing up
| joe5150 wrote:
| It's entirely up to the hospital and the collectors they
| use (if they use any at all) how aggressively they pursue
| unpaid bills and whether they will involve your credit
| report to encourage people to pay. If you've mostly been
| going to the same places (or as another comment said, live
| somewhere where it's not as easy to send medical bills to
| collections), I can see it not really being a problem for
| you.
| eek2121 wrote:
| I have, sometimes bills go to collections without me even
| receiving a bill from the doctor/hospital themselves.
| idiotsecant wrote:
| Wow you've lived a charmed life, friend. This is not the
| experience of the vast majority of people. Medical debt is
| real, and crushing.
| knodi wrote:
| Yes, crushing indeed. Number one cause of bankruptcies in the
| US is medical expenses.
| ch4s3 wrote:
| That's not really true, or at least it would be hard to say
| for sure. Every source saying that cites the same survey
| where a majority of respondents claimed that it was at
| least a contributing factor. Its actually really hard to
| get good breakdowns of the numbers on this.
| brewdad wrote:
| It's sort of a straw that breaks the camel's back
| situation in most cases I would wager. It's less that
| medical debt caused bankruptcy than it, added on top of
| housing debt and car loans and credit cards and student
| loans etc., finally pushed a household to a point where
| getting out from under it all was too much.
| gwbas1c wrote:
| I assume you're in the US.
|
| What you're probably seeing are the bills that your service
| provider sends to insurance, and then your insurance sending
| you a statement of benefits.
|
| If these were real bills, they would keep sending them.
|
| (Sometimes these can be amusing: I had surgery in 2011, and the
| hospital billed the insurance company $100,000. The insurance
| company responded that the agreed cost for services should be
| $20,000. The hospital ended up getting $20,000. IMO, $20,000
| was plenty to pay everyone involved.)
| vondur wrote:
| I have someone in Las Vegas who stole my identity and is using
| it for medical services. I get collection notices for these
| services sent to my house (I'm not near Las Vegas) and I have
| to dispute every one of them. I've had to file police reports
| on it, but the Police in Vegas don't really care about helping
| me.
| dheera wrote:
| Had a echocardiogram that I was told would be covered but
| insurance didn't pay, and they balance billed me for $5K. I
| never paid. Got handed to debt collectors. Wrote to them saying
| it isn't my debt and to cease contacting me.
|
| If they take it to court I'll lawyer up and fight.
|
| In any case, I gave neither debt collectors nor medical office
| my residential address or mobile number. I suggest you NEVER
| give your residential address to medical offices either, or
| they'll happily tell debt collectors where you sleep. Which
| personally I think should be a HEPA violation but apparently it
| isn't.
|
| Give them a virtual mailbox or office address where you can
| receive mail.
| bdcravens wrote:
| It does go on your credit REPORT. However, the impact it has on
| your credit SCORE is what varies, especially with newer models.
| rqtwteye wrote:
| My ex had collectors calling her several times a day for months
| while she was disputing a bill. It probably depends on whether
| the hospital writes the bill off or sells it to collectors.
| consz wrote:
| But I guess that's my whole point is once they sell it to
| collectors it's equivalent to the bill not existing? My
| confusion is around wondering if I've somehow fallen through
| the cracks and got lucky or other people have the same
| experience.
|
| Why do other people pay bills they receive in the mail?
| datavirtue wrote:
| I doubt the collection agencies would even purchase these
| at this point.
| joe5150 wrote:
| That's not always the case. Some hospitals will still keep
| a record of the unpaid bill on your account even after they
| pass the debt to a collector, and the collector will report
| whether you pay to the hospital.
|
| The practice and billing parts of the system are usually
| mostly separate, so the person checking you in for your
| appointments may not know or have any way to see that you
| have unpaid bills and you won't necessarily be denied care
| for it, but there's no real standard here either.
| [deleted]
| wizerdrobe wrote:
| I feel for your ex, I have three (3) in office visits covered
| by my insurance that are overdue as of August. I've had to go
| back and forth on the phone in a Kafka-hell to get my
| insurance to cover a covered visit because of some opaque
| clerical error (and I write medical insurance review software
| and I'm still confused as to who is to blame...). Insurance
| issued a payment last month finally, but the doctor has yet
| to recognize it so I still get reminders on being "late" for
| a bill I don't ultimately owe.
|
| I cannot imagine how infuriated I would be if I were being
| punished on my credit for someone else's clerical error.
| dcow wrote:
| Do you live in California? I know CA has much more consumer-
| friendly restrictions on sending medical bills to collections.
| It essentially can't happen in CA.
| rincebrain wrote:
| I stopped getting any care at a large hospital near me's
| outpatient office because they had a bad habit of just sending
| bills to collections before my insurance responded to them, and
| then not updating anything once they did, so I'd get a debt
| collector notice and call the hospital, and they'd say "oh you
| paid that in full, you shouldn't be getting a notice" "well you
| should probably tell that to the debt collector".
|
| Over and over again.
|
| So if those started showing up on my credit report eventually,
| it'd be a significant impact, even though I was not involved in
| any failure to pay. Fortunately, they never did, but for many
| people, that's not true.
| xwdv wrote:
| They are letting the interest build to such a magnitude that
| they can eventually sue your estate and easily recover the
| losses and more if you have assets at the time of death.
| singleshot_ wrote:
| It would be surprising if this worked, given that a creditor
| who did not mitigate his damages reasonably and instead
| lurked, awaiting a windfall is not entitled to damages.
| p1mrx wrote:
| Under this system, what would be the reason to pay your medical
| bills?
| Eumenes wrote:
| I haven't paid a medical bill under $1k in years ... it never
| goes into collections and I never hear about it after the 2nd
| or 3rd letter in the mail. My providers never mention it, my
| insurance company never mentions it.
| doctorpangloss wrote:
| One thing's for sure, the lawyers and finance professionals at
| the CFPB aren't going to remove your legal defense fees and
| delinquent mortgage payments from your credit report, even
| though being in jail and being homeless also massively increase
| your mortality.
| matthewaveryusa wrote:
| Your wages can still be garnished.
| toomuchtodo wrote:
| Why should people pay their medical debt that only exists
| because Congress refuses to implement a functioning national
| healthcare delivery system?
|
| If Congress refuses to act, the executive branch can sidestep
| them providing temporary relief until Congressional reps turn
| over enough to pass material legislation to fix the system.
| nradov wrote:
| Why should people pay for food when Congress refuses to hand
| out free food for everyone?
| toomuchtodo wrote:
| > when Congress refuses to hand out free food for everyone?
|
| Can you say that when USDA food security and nutrition
| assistance benefits are around $183B a year? Certainly, it
| isn't for everyone, _but for those in need_. Why would we
| not extend similar policy to healthcare in a more efficient
| manner? No one is arguing for _free_ healthcare (although
| that phrase is used colloquially), but a more efficient
| payer and delivery system, versus all of the bloat between
| patients and providers as exists today (insurance
| companies, pharmacy benefit managers, etc). Sibling comment
| by willcipriano touches on this bloat.
|
| https://www.ers.usda.gov/data-products/ag-and-food-
| statistic...
| dmoy wrote:
| Note that Medicare and Medicaid budget dwarfs federal
| food budget
|
| It's like literally an order of magnitude more spending
| bogwog wrote:
| > versus all of the bloat between patients and providers
| as exists
|
| bloat _and_ illegal monopolization:
| https://www.reuters.com/legal/us-accuses-investment-firm-
| ane...
| jefftk wrote:
| _> Certainly, [free food] isn 't for everyone, but for
| those in need. Why would we not extend similar policy to
| healthcare in a more efficient manner?_
|
| But we do have a similar system for healthcare! If you're
| poor enough you qualify for Medicaid [1], and if you
| don't qualify for Medicaid but your income is too low to
| afford the full price plans the ACA provides pro-rated
| subsidies.
|
| It's not that different from SNAP, and both are a mix of
| working well and poorly.
|
| [1] Unless you live in Alabama, Florida, Georgia, Kansas,
| Mississippi, North Carolina, South Carolina, South
| Dakota, Tennessee, Texas, Wisconsin, Wyoming, which opted
| out of Medicaid expansion. Even though expansion had the
| federal government covering >90% of costs...
| datavirtue wrote:
| Food is the only thing congress has happened to manage.
| Prices have been low and stable for generations due to
| agricultural policies. Everything else has spiraled out of
| control.
| willcipriano wrote:
| US citizens, per captia, spend more on socialized medicine
| than any other nation. Then we pay again for the private
| system. With those facts in mind I see no moral reason to
| pay, we already did.
|
| https://data.oecd.org/healthres/health-spending.htm
| DoneWithAllThat wrote:
| Civil action could be started against you in court. If you
| don't show up the other party would win a default judgement. If
| you did you could and likely would still lose and have to pay.
| At that point your assets could be legally taken from you and
| wages garnished.
| LapsangGuzzler wrote:
| My understanding is that medical debt would still be
| collectible and could be sold to third party debt collectors.
| It just couldn't hurt your credit report.
| fisherjeff wrote:
| I mean, getting sent to collections _sucks_ regardless of
| whether it affects your credit score - see, e.g., patio11's
| recent blog post[0]. If you don't pay, chances are you will
| still regret it.
|
| [0] https://www.bitsaboutmoney.com/archive/the-waste-stream-
| of-c...
| mike_d wrote:
| Only emergency rooms are legally obligated to treat you to the
| point of stabilization.
|
| As most doctors are now part of hospital ran conglomerates, a
| failure to pay your bill for an orthopedic consult can still be
| recorded in the hospitals system and you could be denied an
| appointment by your OBGYN.
| wefarrell wrote:
| The obvious consequence would be that people go to the
| emergency room for any kind of healthcare. That's a much
| worse outcome for hospitals so I doubt they would deny people
| primary care.
| mike_d wrote:
| Emergency rooms are already the treatment of last resort
| for the uninsured. Visit any ER on a Tuesday afternoon in a
| major city and you'll be stuck in a two hour queue behind
| what are 95% primary care issues.
|
| The $400 Tylenol people love to complain about in the
| hospital is a direct result of the government mandate to
| treat thousands of patients a day effectively for free
| because we can't get our shit together and provide
| universal healthcare.
| wefarrell wrote:
| It's terrible for a hospital's business to have their ER
| clogged by people who don't have emergencies and can't
| pay. It means they see a much lower volume of people who
| can pay.
|
| So they aren't going to deny people primary care because
| doing so will just cause them to wind up in the ER.
| mike_d wrote:
| > It's terrible for a hospital's business to have their
| ER clogged by people who don't have emergencies and can't
| pay.
|
| It is already a big enough problem they don't seem to
| care. Hospitals in less affluent areas are getting
| interest free loans from the state to keep emergency care
| from bankrupting them:
| https://calmatters.org/health/2023/08/california-
| hospitals-b...
|
| > So they aren't going to deny people primary care
| because doing so will just cause them to wind up in the
| ER.
|
| You seem to be confused that I am speaking to some
| hypothetical future situation. Hospital networks require
| you to either pay outstanding balances or meet with
| someone to arrange a payment plan before you can be seen.
| Taking away the ability to report to credit is only going
| to make them more aggressive in this practice.
| mindslight wrote:
| Have you been to an "emergency" room lately?
| callalex wrote:
| Nope, and almost everyone reading this hasn't either.
| This is not a helpful or productive comment. Instead
| consider saying "at my last visit to the ER, I
| encountered many people seeking treatment for XYZ which I
| do not think should be considered an emergency" or
| something similar so others can learn from your
| experience that they don't have.
| nradov wrote:
| That's true from an EMTALA standpoint. But in certain
| circumstances once a doctor-patient relationship has been
| established and a course of treatment has started the doctor
| may be legally and/or ethically bound to either continue that
| treatment or pass the patient over to another willing doctor.
| They aren't necessarily always allowed to immediately drop a
| patient for failure to pay.
| singleshot_ wrote:
| Keyword: "abandonment."
| dcow wrote:
| Hospitals and doctors don't do this. It's unethical to deny
| someone treatment because you're not sure they can pay.
| repiret wrote:
| Emergency rooms don't do this. Non-emergency health
| providers of all sorts will deny you services if you have
| an outstanding balance.
| gensym wrote:
| It may be unethical, but it happens all the time. My father
| got cancer in 2020 and died earlier this year. During that
| time, I was continuously shocked at the delays in tests and
| treatments that he experienced because specialists wouldn't
| see him until he had approval from Medicare. Without those
| delays, I think there's a good chance that we'd be looking
| forward to another Christmas with him.
|
| (We live in the US if this anecdote didn't make it
| obvious).
| mike_d wrote:
| I assume you live outside the United States. Healthcare
| here is... special.
| jeffbee wrote:
| Medical "debts" are almost always unilateral fees you never
| agreed to. No provider will state upfront what the fees will
| be! I got billed after the birth of my first child for services
| that had not been rendered by a physician who wasn't even
| present, which my attorney characterized as "fraud" in a stern
| letter but that the hospital viewed as "debt". I prevailed
| obviously but imagine the range of outcomes.
| FireBeyond wrote:
| The other people to contact there are your insurers.
| Despicable as some of them may be, they too hate provider
| fraud. Even if they don't appear to do something to censure
| the provider, it is on their file, and enough complaints will
| be problematic.
|
| I had a similar situation with a kidney stone. Transferred
| from my hospital to another by ambulance - I was moved from
| the ambulance gurney to the surgery bed in the hallway of the
| ER, and was billed for a ER visit among everything else,
| though no care had been rendered, no ER staff had been
| involved (hospital transport techs), it just happened to
| happen in the ER, and not even in a room.
| drak0n1c wrote:
| Hopefully they have a plan for a better mechanism to discourage
| frivolous ambulance calls and ER visits. Those resources are
| overloaded by casual abuse resulting in higher costs and wait
| times for those who truly need emergency care. Without an
| alternate disincentive that problem will only get worse with this
| change.
| jkingsman wrote:
| I think having cost be the anti-abuse disincentive is the worst
| of all worlds -- cost is clearly not an effective deterrent of
| abuse given our current state of overutilization. It IS a
| deterrent in the case of avoidance, or arguably worse, a
| punishment in the case of attendance, for those who DO need it.
|
| I'm a volunteer EMT and my org runs free clinics staffed by
| doctors+nurses at major events to handle emergencies. It's
| truly free -- we don't bill anyone, insurance included -- but
| I've had people in dire medical distress avoid coming with me
| because they're afraid of the bill. Hell, I've had people in
| the midst of full blown psychosis and their single lucid
| thought is to yell "DON'T TAKE ME I CAN'T AFFORD AN AMBULANCE
| BILL" and my heart breaks.
|
| The American healthcare system is continuously setting and
| raising the high water mark for how deeply in failure the
| system is, but bankrupting people is not the holistic solution
| we need, in my opinion.
| _jal wrote:
| The hilarious thing is that the emergency room mandate has long
| been used as an excuse for opposing universal coverage. People
| used to say thing like "nobody in America is dying because they
| can't go to the hospital," as if that was bar.
|
| Now it apparently serves an excuse for claiming ER should cost
| more. Truly a universal policy, I guess.
| init2null wrote:
| People make "frivolous" visits because they are legally
| required to stabilize patients. This is what passes for a
| social safety net in the US, and we have failed in developing
| anything better for those not covered by Medicaid.
|
| People often make frivolous ambulance calls if they have
| trouble getting to the hospital or PCP.
|
| There are often reasons, and we would have a more reliable,
| more humane system if we focused on cheaper care over
| penalizing the poor. Providing only guaranteed emergency care
| is absurdly expensive.
| wilg wrote:
| IIRC this gap exists in states (guess which!) that opted out
| of Medicaid expansion. So a solution is available if states
| take it.
| init2null wrote:
| To be fair, someone making $25,000 a year will have almost
| as much trouble paying out of pocket for an MRI as someone
| making $15,000. But the former won't qualify for Medicaid
| and the heavily-discounted health insurance won't do much
| to help with their first $10,000 of medical debt.
|
| Good but worthless advice to the majority living without
| any savings: don't get sick and don't get injured. Can
| anyone blame them if they avoid expensive testing? Medicaid
| is a great bandage, but the US needs a better system.
| LapsangGuzzler wrote:
| This is a nationwide problem, it's not restricted to states
| that opted out of expansion. Federal Law requires that ERs
| treat anyone who comes in, regardless of ability to pay.
| Until the poor are able to access other resources like
| urgent care clinics, this is going to continue to be a
| problem.
| sp0rk wrote:
| > Hopefully they have a plan for a better mechanism to
| discourage frivolous ambulance calls and ER visits. Those
| resources are overloaded by casual abuse resulting in higher
| costs and wait times for those who truly need emergency care.
|
| Do you have any statistics regarding this? I'm sure there are
| some people that use the services unnecessarily, but is it
| really enough that it's a significant issue?
| corinroyal wrote:
| Imagine thinking a visit to the ER was "frivolous". As if
| significant numbers of people would subject themselves to an ER
| for fun. Imagine looking at a situation in which significant
| numbers of people have no other access to care but ERs and
| think, "Those freeloaders!" What sort of twisted mirror-world
| ethics are these? How does one get to the point where they
| could type this, read it over, and hit send? You'd think the
| shame alone would be lethal.
| indymike wrote:
| > Without an alternate disincentive that problem will only get
| worse with this change.
|
| The ER is the only place that people can get care when they are
| uninsured and not wealthy. Your family doc will say no.
| Immediate care will say no. But the ER can't say no. People in
| this situation are mostly upper lower class and lower middle
| class who have lost their jobs or fell into an administrative
| crack. If you are poor, you will qualify for something to cover
| the cost. It's terrifying and is probably one of the best
| arguments for reform there is.
| shadowgovt wrote:
| This is yet another problem that could, hypothetically, be
| addressed by centralizing / single-payering the system.
|
| With one administrator having access to all that data, it would
| be straightforward to see where ERs and ambulances are being
| over-used for non-emergencies and address that in the community
| with both more funding for preventative care and intervention /
| education initiatives to get people using preventative care.
| amluto wrote:
| > Without an alternate disincentive
|
| The problem isn't (IMO) an insufficient disincentive -- it's
| lack of a credible alternative. I have perfectly fine
| insurance, and getting an appointment for a merely slightly
| urgent issue is a pain in the rear. If I'm traveling, it's
| almost impossible.
|
| COVID made this all worse. Last year, I saw a resort clinic
| (well staffed by assorted medical professionals) turning away
| anyone with any symptoms of illness and sending them straight
| to the ER (10 miles or so away through the snow) because they
| "might have COVID".
| foobiekr wrote:
| Urgent care facilities ought to be offloading ERs in most
| cases. Something as trivial as needing some stitches is an ER
| visit instead. I think this kind of ends up trivializing ER.
|
| That and drug seeking...
| jorblumesea wrote:
| [flagged]
| Uvix wrote:
| We pay for it one way or another. I'd rather pay for actual
| usage instead of getting taxed for stuff I might or might not
| have used.
| ericmay wrote:
| In the US you get it from both ends. You pay for insurance,
| they decline your claims, you have co-pays, minimums, etc.
| and then you pay more than you otherwise might because the
| hospitals have to cover those who need care but don't have
| insurance. That's why your aspirin is $300. You're paying for
| lots of other people.
|
| And _then_ you also pay taxes for Medicare and Medicaid
| programs, the VA, and other various, duplicative programs.
|
| I don't have a strong opinion on either system on its own
| philosophical merits, but what I see today is that the health
| insurance industry is a jobs program with extra cost added in
| for profits and I'm just not really sure what the point of it
| is.
|
| If we are willing to let people die on the streets and refuse
| care, let's get the government out and just go all-private.
| If we aren't willing to do that we should drop the jobs
| programs and waste (insurance) and just go with tax-based
| healthcare and eliminate redundant programs (Medicare,
| Medicaid, etc.) and also the subsidization of insurance
| companies.
|
| Getting people the care they need to is almost certainly
| going to lead to a healthier and happier population that's
| more productive as well, which is another economic benefit.
| [deleted]
| gnulinux wrote:
| Absolutely not true and this is simply American propaganda.
| The truth is American insurance industry is an extremely
| inefficient middleware that makes everything more expensive
| and worse than other developed countries. [1]
|
| [1] "US spends most on health care but has worst health
| outcomes among high-income countries, new report finds "
| https://www.cnn.com/2023/01/31/health/us-health-care-
| spendin...
|
| Not to mention it's complete lunacy to think taxes are low in
| the US. I live in US but also pay taxes in a different
| country (that I'm a citizen of) that has healthcare and all
| the Federal tax I pay to US is significantly more (the other
| country is a fraction of fraction of US taxes). Not to
| mention, US taxes are extraordinarily, out-of-this-world
| level complicated if you have foreign assets so you pay
| thousands of $$$ to a CPA as well.
| skyyler wrote:
| I'd much rather pay a small percentage of my income and have
| a guarantee that my fellow Americans aren't suffering through
| treatable illness.
| hnrodey wrote:
| I think it should be acceptable that unpaid medical debt appears
| on the credit report. The medical debt should be removed once the
| debt is paid.
|
| The above is for medical debt only and how I would prefer the
| system to work. There are other good comments about possible
| second and third order effects from such changes to debt
| reporting.
| user3939382 wrote:
| The newest FICO models already exclude this debt, though this is
| a much more significant step since most lenders and loan types
| you care about use very old FICO models that do include it and
| are unlikely to be updated any time soon.
| nradov wrote:
| Do you know why lenders still use very old FICO models? Is this
| just inertia, or are the new models more expensive, or do the
| old models predict default risk better for those loan types?
| FireBeyond wrote:
| More expensive, for one. That's why CreditKarma and other
| 'free score' services often use Vantage, rather than FICO.
| user3939382 wrote:
| Just a complete guess. Banks and related insurance are using
| historical data with prediction models to forecast risk. Once
| the FICO version changes all that data is apples to oranges
| and the forecasting is less accurate.
| dmoy wrote:
| I think up until last year it was federal policy for Fannie
| Mae & Freddie Mac to use fico 5, and the rest of the industry
| kinda follows.
|
| Now I think they can use a new model, but it's probably some
| inertia on changing.
| dylan604 wrote:
| I hope this truly has the effect that it is meant to have. But
| being the pessimistic type towards US healthcare and insurance
| and credit agencies, I really expect this to go nowhere, or
| become so watered down that it is essentially meaningless.
| Madmallard wrote:
| Great time for disabled people to die because they won't be able
| to get care. Disabled people can't pay for psychotic medical
| bills as it is and this will just result in medical providers
| denying care without upfront pay.
| mehlmao wrote:
| I've never had a doctor run a credit report on me before, have
| you?
| Madmallard wrote:
| organizations will start doing it to protect profits probably
| adamsb6 wrote:
| What are going to be the second-order consequences of such a
| policy?
|
| Are providers going to run credit checks on you before they agree
| to take you on as a patient?
|
| Require that you sign a document that gives them the right to
| garnish your wages for non-payment?
|
| Require up-front payment for services?
|
| Increase prices to cover the revenue lost to people that realize
| how little consequence there is for non-payment?
| jfghi wrote:
| Be less profitable by not price gouging?
| cyanydeez wrote:
| In America, hospitals cannot refuse emergency care.
|
| So, while price gouging and insurance gouging are a thing,
| the actual hospitals may be poorly compensated in many
| places.
|
| That's why rural areas are losing hospitals.
| flangola7 wrote:
| > In America, hospitals cannot refuse emergency care.
|
| How is that unique to America? What other developed nation
| doesn't have this rule?
| jfghi wrote:
| I agree entirely but just don't think that credit reports
| solve or help anything in this domain.
| JumpCrisscross wrote:
| > _don't think that credit reports solve or help anything
| in this domain_
|
| They help hospitals collect. Not saying that makes it
| right. Just that it has a purpose beyond greed and
| gouging.
| jfghi wrote:
| I'd have to see data in order to confirm this is true.
| Once a delinquency gets placed on a credit report paying
| the bill doesn't help the person that owes. It also
| assumes that the people not paying are choosing to do so
| rather than not being able to. Given the debts are sold
| at a steep discount, I'd say it's more efficient to have
| lower prices up front which could potentially be
| affordable for more of the customers.
| p_j_w wrote:
| >In America, hospitals cannot refuse emergency care.
|
| Can they do this in any developed country?
|
| >That's why rural areas are losing hospitals.
|
| Maybe a system with only privately run hospitals is a
| stupid plan.
| bushbaba wrote:
| Please do upfront pricing. It's so annoying getting a bill
| afterwards how the fully covered treatment was actually not
| covered and multiple thousands. Leading to haggling with the
| insurance company and hospital.
| dheera wrote:
| Upfront pricing AND optional upfront payment for non-
| emergency services. If you choose to pay upfront you should
| receive no further bills, period.
| toomuchtodo wrote:
| > Starting in 2022, there are new protections that prevent
| surprise medical bills. If you have private health insurance,
| these new protections ban the most common types of surprise
| bills. If you're uninsured or you decide not to use your
| health insurance for a service, under these protections, you
| can often get a good faith estimate of the cost of your care
| up front, before your visit. If you disagree with your bill,
| you may be able to dispute the charges. Here's what you need
| to know about your new rights.
|
| https://www.cms.gov/newsroom/fact-sheets/no-surprises-
| unders...
|
| https://www.cms.gov/NOSURPRISES
|
| https://www.consumerfinance.gov/about-us/blog/no-
| surprises-a...
| darth_avocado wrote:
| The problem is that disputing claims is hard and puts an
| unnecessary burden on the patient at a time when they are
| struggling elsewhere. Companies operate in bad faith and
| more needs to be done to regulate companies (hospitals and
| insurers).
| AuryGlenz wrote:
| Why the hell shouldn't that apply to people that are going
| to use insurance? The reason our healthcare costs are so
| high is because everyone with insurance past their
| deductible is price insensitive. People might at least care
| about their copay enough to make a difference.
|
| I know providers will balk because they negotiate with
| different insurers, but if they know how much they're going
| to bill after the fact surely they can give you an estimate
| before.
| flutas wrote:
| My favorite ones.
|
| "Payment is due at the time services are rendered"
|
| So you pay what they say it costs.
|
| Then months later you get a random bill from them for more.
| thmsths wrote:
| How can they reasonably expect you to pay in these
| circumstances? They were clear about wanting payment
| upfront, you agreed to the price, (presumably) paid them,
| received the service/treatment. That should be the end of
| the story. What legal basis do they possibly have to send a
| bill months later? "We felt like we needed more money
| because we had a bad quarter" is not going to cut it.
| callalex wrote:
| Because what are you gonna do about it? They have the
| ability (unless this goes through) to prevent you from
| seeking employment, renting, or buying a roof over your
| head if you don't bend over and do whatever they tell you
| to do.
| nradov wrote:
| In many cases the patient has insurance with set co-pays
| so providers collect only the co-pay at time of service
| based on a good faith assumption that the insurer will
| pay the rest of the claim at an agreed rate. But if the
| insurer doesn't pay by a certain deadline then the
| provider might bill the patient for the balance. Then the
| patient has to argue with their insurer over the claim.
|
| This is a screwed up system that leaves patients caught
| in the middle of commercial disputes. But providers do
| deserve be paid for services rendered and it would be
| unfair to just stiff them.
| bb88 wrote:
| But also, the patient paid for health insurance for the
| explicit reason that insurance provides protection
| against surprise costs, often paying thousands of dollars
| per year for it.
|
| So fuck the patient? That's the current regime.
| YeBanKo wrote:
| How can you do an upfront pricing for emergency situations?
| FireBeyond wrote:
| Wait til you hear about how United Healthcare was sued for
| not covering Lifeflight flights from car accidents because
| "no preauthorization was obtained"...
| YeBanKo wrote:
| Can you link to a good source for this story?
| rqtwteye wrote:
| How about the insurers and providers working together on
| reasonable billing and not make patients pay random charges
| over which they had no control and information about cost?
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