Slashdot Log In
The Doctor Will See Your Credit Score Now
Posted by
ScuttleMonkey
on Sat Jan 19, 2008 12:30 AM
from the what's-up-doc dept.
from the what's-up-doc dept.
mytrip writes to mention that the same people who invented credit scores are working to create a similar system for hospitals and other health care providers. "The project, dubbed "MedFICO" in some early press reports, will aid hospitals in assessing a patient's ability to pay their medical bills. But privacy advocates are worried that the notorious errors that have caused frequent criticism of the credit system will also cause trouble with any attempt to create a health-related risk score. They also fear that a low score might impact the quality of the health care that patients receive."
Related Stories
This discussion has been archived.
No new comments can be posted.
The Fine Print: The following comments are owned by whoever posted them. We are not responsible for them in any way.
Full
Abbreviated
Hidden
Loading... please wait.
Fundamentally broken (Score:5, Insightful)
Of course this will impact the quality of healthcare that people receive. Don't be absurd. Look, as someone who is involved in his family business (12 docs, 100 total employees), the ability of patients to pay is fundamental because healthcare is a business. Doctors graduate medical school with six figures in debt, buildings cost money, running a business with good people takes money to pay your employees with and more. It is hard enough as a small business in medicine, but competing with larger hospital groups who make access like this part of their business practice (like HMOs) are making it even harder because they shunt patients who are less able to pay to the local doctors or smaller clinics, and these are the businesses that suffer the burden of non-payment.
What is the solution? Trying to figure out who has what insurance (some insurance is better than other types) and who can afford to pay for more expensive procedures is just bad medicine and bad social responsibility. Socialized medicine is not it either, however, a return to fee for service medicine is a better option for all people involved. Scrap the HMOs (who are in business to make money, not provide health care), scrap the insurance companies (middle men extracting their pound of flesh) and return to a system where you pay for services rendered with insurance for catastrophic coverage. Granted, many specialized procedures will not be utilized as much but health care coverage for two healthy people is often in the $8k-$12k/year range as it is. And what is the average American getting for that expenditure? You are paying typically out of pocket expenses on top of that as well if you do take advantage of health care services and if you prove a bad insurance risk, you get dropped entirely. Look, insurance companies are not in business to help you stay healthy, or get well... They are publicly traded companies who's bottom line is profit and that profit comes at your expense. A classic parasitic business model that has been promulgated on the American public. However, this will have to change as it is dragging down US business, small and large, big time.
Re:Fundamentally broken (Score:5, Insightful)
Parent
Re: (Score:2, Insightful)
I do enjoy your secret code for "Fuck the poor". Good for you. JEsus loves you.
Re: (Score:2, Insightful)
Promote the general welfare, not provide.
Re:Fundamentally broken (Score:5, Insightful)
I suppose this is the long running socialist vs. capitalist debate, but you really need to look at the facts... socialist-democratic societies seem to be much happier, better educated, etc. then the American free market society, bent on the idea that individual happiness is best served cold with individual self-interest.
Check out the HDI http://en.wikipedia.org/wiki/Human_Development_Index [wikipedia.org] (America is 12th), and Poverty Index http://en.wikipedia.org/wiki/Human_Poverty_Index [wikipedia.org] (America 17th), for some, albeit contestable, evidence to my claim that socialist countries seem to be doing better off than the American self-aggrandized way of life. Plus, it would appear the United States is doing nothing more than slipping further away from those top socialist countries.
- John
Parent
Re: (Score:3, Insightful)
Of course. The rest of your response is merely a propaganda formula used to make this obvious idea look less disgusting.
Re: (Score:3, Interesting)
OK, so perhaps you don't hate poor people - as if anybody would seriously suggest that. The problem is that you just don't care, you have got your own arse covered, for now at least, but I'll bet that if you run out of luck, you'll change your attitude just like that.
This cavalier attitude is the effect of modern capitalism - only 'I' matter; bunch of Ferengies the lot of you (look it up if you want). You sho
Re: (Score:3, Interesting)
And why are you against all of us joining forces to act as a single health-care-consuming entity? You know, strength in numbers.
Socialized fire services and police forces ok? (Score:5, Insightful)
Do you also stand by this argument regarding fire services and police forces protecting your house and neighbourhood? Do you prefer private fire protection to publicly taxed fire departments, and private law enforcement over public police? Just curious as perplexed as it seems to me as an outsider that "socialized" fire and police protection seem acceptable but "socialized medicine" appear to be less acceptable in the USA. Wondering where the difference between these services is seen by the American public?
Parent
Re:Fundamentally broken (Score:5, Insightful)
That's a nice fantasy.
The great 'free market' has some 12% of America living below the poverty line. 12% of America can't even afford an 'adequate standard of living' as it is. People just above the poverty line number in the millions... you really think a family of 4 making $22,000 is going to have the sort of disposable income needed for a hip replacement EVEN if medicine was a free market?
And the cost of food, fuel, heat, and rent are rising faster than wages.
Given that a (relatively) unregulated free market can't even make the BASIC NECESSECITIES of life suitably affordable to a LARGE fraction of Americans, what on earth makes you think exotic surgery, and medical procedures would be??
And even if it 'worked': Reducing a procedure thats been bloated out to $1,500,000 (due to the 'massive regulation inefficiencies' you claim) down to even $150,000 is still a death sentence to a *huge* number of people. Even $50,000 is out of reach.
Parent
Re: (Score:3, Interesting)
A significant percentage of America lives like this; 'extreme' isn't a word I'd use.
4 people and only one is working and barely making above minimum wage.
'barely'? A lot of states are sitting around the $6/hour mark for minimum wage.
$6hr * 40hrs/wk * 52wk/s per year = $12,480 -gross- (and that's assuming you can get 40hrs... a lot of the time at these low level jobs jerk you around for hours giving you 6 and 7 hour shifts etc, which really eats into your income. If one person is
Re: (Score:3, Insightful)
Something that is woefully missing from all of these rants about bringing
socialized medicine to the US is how do deal with the costs of becoming
a Doctor or running a hospital short of just refusing to pay the Doctors.
This is the current HMO approach and this is the current medicare approach.
All it does is make it make less sense to be a doctor.
No one seems genuinely interested in making medical care less expensive
to produce. All anyon
Re: (Score:3, Interesting)
But... how far should we be expected to go for the poor? If someone works hard for their wages, and has worked to possess at least some skill in even a simple area, but cannot afford basic healthcare, housing, and food, I believe society should have a secure safety net in place for th
Re:Fundamentally broken (Score:4, Funny)
Parent
Re:Fundamentally broken (Score:5, Informative)
Health care budget, 2005: $19bn
Population of Canada: 33,390,000 (approx.)
$19bn / 33,390,000 = approximately $569 / year, or $47/month.
Average health insurance premium in the USA: $308/month.
Still think that it's cheaper?
Parent
Re:Fundamentally broken (Score:5, Insightful)
My ability to pay has nothing to do with my credit or money in my bank. It has everything to do if my insurance decides to screw me or screw you. An MRI I needed a couple of years ago which was supposed to be covered by insurance cost me 1500. My insurance paid them 1100. Both of those parties are just trying to screw me for cash. Instead of working with insurance companies the MRI people just pull a number out of their butts. Their inability to work with my good insurance or the insurance's inability to pay fair prices puts me in the middle of a capatalistic nightmare where my own health is used as leverage points to see who can bill the most and pay out the least. This is incredible! The most pathetic part of this was that I was told by the MRI people that if my insurance refused to pay anything they had a nice low cash price of 300 dollars. In other words theyre making money at 300, but bill 1500!
Sorry, but the only way out of this nightmare is mass socialization of medicine and getting away from the idea that my illness should make you rich.
Parent
Re:Fundamentally broken (Score:4, Insightful)
We already have a form of socialized medicine here in the US. I've been unemployed for several years, I'm a Type II diabetic with other, unrelated health issues, and I get all my medical care from the US government, free of charge. If I were working, I'd have to pay a co-pay, but not much. How? Oh, it was easy! All I had to do was spend three years in the US Navy, including 7 months in Tonkin Gulf back in '72.
Parent
Experiences in socialized medicine (Score:3, Informative)
It seems to work a bit better than what you're describing (and way better than the Romanian system), but it has some severe downsides.
I get deducted 4,5 % of my salary each month (6% if you have children), and that pays for the monthly fee at the "mutual" (our form of medical care based on the ), which gives me basic health coverage.
By "basie", I mean "call us if you're dying
Re:Fundamentally broken (Score:5, Interesting)
This doesn't even address the fact that Vet labs can do MRIs for less then $200. I know it isn't the same thing but if they can buy the equipment, pay the staff, train the staff, and offer the services at those prices, they it shouldn't be much more difficult for a hospital or imaging lab to do the same.
So why is the cost of a MRI $1500? Because they can charge that much, it is the only reason, their break even point is far less then that and likely even less of the machine is paid for and in maintenance mode. I'm willing to bet that $300 is the real costs (staff, using the machine, electric per use and so on) and they only wanted to cover that with the Cash billing. To me, that makes a firm $1500 a little bit stupid. It is a medical procedure, not a Car or Big Screen TV.
I don't buy into the socialized medicine, but I think there is some things that can happen to make it more affordable to the less capable of paying for it. I don't have much sympathy for the GPs situation either, but saying it costs X dollars because that's what they standardized on is a little shady if you ask me. Especially when someone is being told that their lives or quality of health could depend having the test/procedure or not. If it was a TV or car and fear wasn't part of the choice in having it, then I could agree. In any other profession, the life and death fear factor along would be enough to get fraud charges dropped on the sales staff in most states.
Parent
Re:Fundamentally broken (Score:4, Insightful)
Parent
Re:Fundamentally broken (Score:5, Insightful)
Not to dispute your choice of profession, but you're just plain wrong here. My husband receives Medicare, and even with that coverage, we still have to pay money out-of-pocket for every single medicine, and for every other service he needs. Case in point: my husband needs surgery to re-position and/or fuse a couple of diseased vertebrae in his lower back. The one surgeon in the area who does this kind of surgery wanted about $70,000, but Medicare only covers 80% (sometimes less) of anything you claim, leaving us to pay a $14,000 balance. That doctor also expected an additional $17,000-ish for the hospital, none of which is covered by Medicare he told us. So, my husband's total bill would have been at least $17,400 if the hospital were covered at the usual 80%, or upwards of $31,000 if the doctor is right about lack of coverage.
We are both disabled, and that second (more likely) figure is well over two years' pay for us! How the hell are we supposed to afford that kind of expense and still pay for a roof over our heads? I mean, seriously, WTF!?
As for Medicaid, whether you pay anything or not depends on the particular implementation of that program where you live. Where I live now, I haven't been able to establish what costs there might be, but where I came from in Florida, you have to pay back every penny the government spends on you should you ever come into some money down the road, no matter how much or how little. Case in point: Over the course of a couple of years, I had accrued several thousand in medical bills, all of which the government agency providing my general medical coverage paid for. I ended up being injured in a car accident (other driver rear-ended us) and received a $10,000 settlement from the offending driver's auto insurance company. Well, I got about $3000 of that settlement, my lawyer took another $2500 or something, and the government agency providing my coverage took the rest. My medical coverage was then terminated because I got too much money from the settlement. I never got back onto that program.
Translation: I paid for no less than 70% of my medical expenses, despite supposedly having health coverage. And yes, it's a Medicaid-affiliated program.
As for Social Security, Your google search has sources which claim that there were errors in the government cost estimates. What no one seems to want to tell people is that we have a surplus of funding that had been built up decades ago, and which is expected to run dry in around 2020ish. At that point, the program will still be at break-even. Take a look at The US budget for 2008 [wikipedia.org]. Expenses add up to $2.9 trillion, while the government is showing receipts of only $2.66 trillion. What the Wikipedia article doesn't say is just how much of that spending is pork and how much actually gets spent properly (I'm guessing 50:50 or worse).
By this point, I really shouldn't have to say this, but I will anyway: Stop the wars, stop the government waste, tax the rich more than you tax the poor, and put a fucking cap on the raw cost of medical care. There is NO ETHICAL REASON WHATSOEVER that (quoting a previous poster) an MRI should cost $300 for an individual but $1500 for an insurance company, that a mass-produced vial of insulin should cost $75 for one month's supply, that any pill of any kind should cost more than a few cents each, or that the aforementioned back surgery should cost anywhere close to $96,000.
And to think, this is how I felt *before* I watched "SiCKO". What scares me the most is that practically everything in that movie as far as mainstream US health care is concerned is fact. I'd be better off dead than ill in this country.
Parent
Re:Fundamentally broken (Score:5, Interesting)
You have to stop reading propaganda. The "severe debt" is usually a misrepresentation of an overall governmental debt which has been shrinking throughout Europe ever since most governments adopted "balanced budget" policies back in the 1980s. Many European governments routinely end up with budgetary surpluses which leads to a lively debate on how to spend them, with some advocating rapid debt reduction while others investment in other things. The same applies to Canada, which also sports socialized medicare and which has been running budgetary surpluses for almost a decade now.
As a matter of fact, the most debt inducing and downright ruinous economic policy is practiced by none other then the "free market knows best", "conservative" goofuses running the USA, where the government debt is spiralling completely out of control, with most of the money going to gigantic military contractors and mercenaries with no conceivable return on that investment to the average taxpayer other then piles of dead foreign people and rapidly increasing general global hostility, not to mention othe wee things such as the devastating trade imbalances.
It isn't, although some greed-monkeys, like our "small medical businessman" GP, do oh-so-dearly want it to be true.
See above. Most EU governments project declining debts, while the US debt is increasing astronomically, despite of the ever more obvious and heavy-handed attempts by the US elites to instill a vicious dog-eat-dog "society" in there, with clear-cut stratification of the economic royalty and the de-facto indentured slaves underneath.
Parent
Re:Fundamentally broken (Score:5, Insightful)
If you ask me, profiting off human suffering is immoral and un-American.
Parent
Re:Fundamentally broken (Score:5, Interesting)
As a Candian living in the US, you're preaching to the already converted, but still bewildered and dismayed, if not appalled.
I'll add an interesting tidbit of information. Three out of four voters in the US is a member of the American Association of Retired Persons [wikipedia.org]. Sounds perfectly reasonable, given that older folks tend to be the ones that vote, but problematic when you consider that AARP is fundamentally an insurance company.
Insurance companies are Really Big business. And if Warren Buffett's investment preferences are any indication, more profitable than ever. I don't see them going away any time soon despite the gradual awareness by the electorate that their healthcare system, when viewed in the context of the rest of the industrialised world, is an embarassment.
Parent
how about having a MDFICO (quality of provider)? (Score:3, Insightful)
Re:how about having a MDFICO (quality of provider) (Score:2)
Re:how about having a MDFICO (quality of provider) (Score:5, Interesting)
Parent
Re:how about having a MDFICO (quality of provider) (Score:3, Interesting)
I'm going to say it right now... (Score:4, Insightful)
There's no such thing as a free lunch.
Re: (Score:2, Insightful)
Re:I'm going to say it right now... (Score:4, Insightful)
Parent
Wow (Score:2, Interesting)
This only makes an existing problem worse. (Score:5, Informative)
This means that only those with money have proper access to health care, treatment and diagnosis.
In Australia, private cover is only designed to be an add-on for existing government-provided cover via the Pharmaceutical benefits scheme and Medicare. Medicare levies are paid on an income-ramped scale, and you can be exempt in some cases from paying altogether.
In this way, those that can afford good health care (i.e high incomes) enable those who cannot (low incomes) with at least a baseline medical cover that is far more extensive than the government health grants in the US of A.
This introduction of a credit-rating style scheme only makes the problem worse. Someone may have been unemployed and become very ill, and ended up being unable to pay medical bills promptly/at all. They may later have become employed - perhaps even at a high income, but will therefore still be cursed with a poor medical credit rating and be turned away from healthcare.
No one should be denied medical treatment in this way, and the fact that this system is being developed suggests there is something wrong with excessively privatized health like in the United States.
This is so backwards (Score:5, Insightful)
We also need real accountability for credit reporting agencies. Simply requiring them to change incorrect information after the damage is already for done and requiring each of us to police the companies on our own dime - is crazy. They're immune for normal charges of libel, and should not be.
There was an Opinion Article about this... (Score:2)
In my local paper, there was an opinion article about this that pointed out that credit scores reflect (for the most part) voluntary debt, while medical debt is involuntary debt.
Most people can decide to buy a more expensive car than a less expensive car, or put a new TV on a credit card. But breaking a bone isn't a voluntary decision.
well, even in the light universe... (Score:4, Funny)
Xev: No.
Receptionist: A D-class standard waiver?
Xev: Sorry.
Receptionist: Any waivers of any kind?
Xev: No.
Receptionist: Then cash will be fine.
Xev: Pardon?
Receptionist: Precious metals or bankable equivalents.
Xev: We have no precious metals or bankable anything.
Receptionist: Then your situation becomes a class 1313.
Xev: What's that?
Receptionist: Ignored.
Xev: You can't do that.
Receptionist: I'm afraid I have no choice. Policy is policy.
Kai: We will pay you later.
Receptionist: I'm sorry, MEDSAT does not accept credit.
Xev: This is an emergency!
Receptionist: I understand. Please inform the next person to appear on the screen.
Xev: Hey, lady, watch! Lexx, blow up that little red moon we just passed.
Black is white! Socialized medicine can't work! (Score:5, Insightful)
Argue, if you want, that health care shouldn't be universal on some sort of social Darwinist grounds ("The sick should die, because they are weak!"), but please stop trying to suggest that there's something inherently unworkable about government-provided health care. It's sort of like arguing that the Earth is flat or that water runs uphill: it's clearly contradicted by fact.
Re: (Score:3)
France (Score:3)
I have a huge problem with this (Score:3, Insightful)
I've changed employers, since then, because I grew tired of being stuck on LTD, and was 'acquired' by another company last year. Same insurance (Aetna became BCBS), similar benefits.
I go to the Pharmacy to grab my Monthly Maintenance Medication this month, only to find out that my employer removed that coverage from the benefits package. Now, I'm paying $750/month for medicine to keep me alive. No Biggie -- I go in for my monthly labwork, only to discover that my blood draws and hematologic shit isn't covered anymore. Well, now I'm kinda getting worried, because It's going to cost me another 1200 to get my lab work done. (We're at $1950/month just to keep me alive, right now, where it used to be $100 -- $80 for my meds, and $20 for the labwork).
Add on top the trips to the Dentist (I've spent over $6K with my Dentist in the past 2 years recovering from the hell that chemotherapy and Barium treatment does to your teeth), and I'm looking to probably spend $24,000 this _year_ on medical bills alone. While Flex plans help, it's really not that much.
This begs the question -- If I had chosen a different career path, and if I was working as a busboy at a restaurant, would I still be alive today?
I'm not saying that Social Medical coverage is the answer. I'm not saying that I know the answer, but, think about things like this:
My brother has a daughter that has Cystic Fibrosis. My brother barely scrapes by on minimum wage. He literally has $250K worth of medical bills from his daughter alone. He can't afford a house, I bought him the car that he drives, and every penny of his money (and every ounce of his love) goes to making sure that his daughter is alive, safe, and cared for.
Yes, I understand that Doctors work very hard to get where they are. I have two engineering degrees, and I am still paying those off at this point in time. I also understand the costs of finding and keeping good talent and staff. At what point do we say, "Your daughter can't live because you can't pay," or, "you can't live because you can't pay?"
I honestly don't think that anyone has a good answer for any of this.
Re:I have a huge problem with this (Score:4, Insightful)
Parent
Socialized Medicine? (Score:5, Insightful)
Re: (Score:3, Insightful)
In such a system, health-care will be non-universal, and this misses the point of health-care, just as much as a police force or fire brigade working non-universally misses the point.
Re: (Score:3, Insightful)
Re:While they are at it, can they track doctors? (Score:5, Insightful)
If you want to figure out how much I'm charging, good luck: each different plan with each distinct insurance company charges different prices for different procedures or visit types, which is often considered proprietary information so I'm not allowed to know or publicize what it is anyway, lest I collude with other physicians to get better a payment schedule.
And while some doctors may be competing for your business, as a primary care physician, I'm not - our practice (like many) limits new patients. I take Medicaid and uninsured patients along with commercial insurance, and my panel is overflowing. I'm happy to say I love my job, but the long hours, mountains of paperwork, and 13 year old car are typical of my colleagues - we're not exactly living high off the hog, or running our hands through a mountain of gold coins.
By law in the United States, no hospital with an emergency room can turn away anyone for needed care, but I can see why the folks doing elective surgeries might want to be sure you can pay your bill. This is America after all, and we are apparently a long way off from figuring out what virtually every other industrialized democracy has: private insurers are in it for the money, and are not necessarily aligned with your best interests.
Parent
Re: (Score:3)
The government, nominally, does whatever it does in the "best interest" of all citizens. At least, it says so, and there is, at least, some truth in that. Also, people who get involved in government do so for reasons other than to enrich themselves as much as possible; there are, in government, other currencies of power besides money. Corporations haven't even got a withered little figleaf of concern for anything other than profit. In other words, the gove
Re:Ignorance knows no bounds (Score:5, Informative)
Just so you know, I'm insured by the Ontario Health Insurance Plan. It's what we call a Crown Corporation - a company run for the benefit of the people of my province. It's formed by an act of the Provincial Parliament, and answers to the government, but is in all other aspects a real company - other than it's forbidden by law to make a profit. Yes, part of my Ontario Income Tax is used to fund the company, so I pay my premiums as a matter of course, rather than seperately. Last year I paid about $5500CDN in Ontario tax - total - and I make a pretty good salary. So, the risk you speak of is shared by all in Ontario through having a Crown Corporation. BTW - if it does make a profit, the money is put back into the public purse. People pay what they can afford, and other than having some fat-cat bureaucrats who make inflated salaries, it's cost effective for us - no one is trying to make money for shareholders, they try to give good care.
It's not perfect by any stretch, sure. We don't have enough doctors, but OHIP is trying to remedy that in a reasonable way. Yes, I've waited for hours in an emergency room, but that was after a rather nasty accident on the highway flooded the place with the severely injured and I just had a sore back. I went to a clinic the next day and received the care I needed - I just walked in, showed them my OHIP card and got medical care that fixed me up.
I have choice in health care providers, do need to pay some out of pocket expenses (i.e. prescriptions, crutches etc.), and get excellent care when I really need it. I haven't looked for the numbers, but I'm pretty sure our outcomes are very close to yours. There are horror stories of course, but there are also just as many examples of people getting stellar care.
It works pretty damned well, we get very good care and I don't need to worry that I'll be bankrupted by getting sick and having someone trying to profit from my misfortune. I'll take a little less quality for half the price, thankyouverymuch.
Soko
Parent
Re: (Score:3, Insightful)
There's a fairly large set of holes defined by the "underinsured" and the "uninformed".
The uninformed are
Re: (Score:3, Insightful)
All Americans have health care, even those that cannot afford it, and the idea that there are people without access to health care is a myth that inflames the clueless and serves the purposes of political propaganda. The quality is mediocre, but what do you expect with socialized medicine. It is not hypothetical, I was one of those invisible souls raised on government health care for the destitute.
Ah, yes. As President Bush said - if you need health care, just go to the ER.
Sorry, nope. As an ER doctor, I can tell you there are many things you will never get that way. Need a pap smear? Nope, we don't do them in the ER? Need surgery and chemotherapy for your advanced cervical cancer? Again, sorry - we don't do that in the ER. Maybe when you come in bleeding out from your vagina, we'll admit you, but you won't be getting definitive care. Need surgery for your broken arm? Nope - that's not an emergen
Re:Capitalism and Healthcare Don't Mix (Score:5, Insightful)
Matters of life and death are not ruled by bargain-seeking behavior, and thus the entire driving forces of supply and demand are thrown completely out of whack. Anyone who's spent any time studying economics should recognize that the fundamental assumption of modern economic theory doesn't apply here.
Parent