Majority of debtors to US hospitals now people with health insurance

High deductible, for-profit insurance policies to blame.

{{ “We always used to consider bad debt, especially bad debt write-offs from a hospital perspective, those [patients] that have the ability to pay but don’t,” said Colleen Hall, senior vice-president for Kodiak Solutions, a billing, accounting and consulting firm that works closely with hospitals and performed the analysis.

“Now, it’s not as if these patients across the board are even able to pay, because [out-of-pocket costs are] such an astronomical amount related to what their general income might be.” }}

Majority of debtors to US hospitals now people with health insurance | US healthcare | The Guardian



A friend I had dinner tonight with his son is in hospital. Serious stuff. The son is very problematic. He is 67. He has a supplemental policy.

His older stepfather is sorting the bills he has not been paying. The stepson is crazy.

Stepdad needs to see if the supplemental is paid up and needs to see if it is full coverage. The cheap stepson probably does not have full coverage. The son is probably running up over $300k in medical bills.

Crazy stepson will find out the bill was paid by stepdad and be peaved at stepdad. The savings will be substantial. Assuming it is not too late to pay the bill.

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Re: 67 year old friend.

If in the US he should be on Medicare. The policies for supplemental are standardized. Supplemental covers the deductible.

He might have Medicare Advantage? Or high deductible Part D?

He has traditional Medicare and a supplemental. But he got sick as he was supposed to be paying the bill for the supplemental and he often does not pay his bills. Supplemental policies are a mix of things. Not everything is covered but I am not an expert on that. I may be somewhat wrong. There is a risk there.

If the son has a Medicare Supplement, there’s no way he’s got $300,000 in unpaid Medicare bills. I have a high-deductible Plan G and my costs are capped at $2,800/yr for 2024.

Maybe he’s got pre-age 65 medical bills still overdue? With unlimited price gouging, those of course could be substantial.



All the plans are published in the annual Medicare book. All the plans are the same. You select the one you want. But the companies have different rates and sometimes extras like gym membership.

Medicare Part D is the one with more variables. And Medicare Advantage plans.

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Good to hear. I will get there. Meanwhile, the son is age 67 and a mess. The bigger question is did he even pay the bill to have the supplement?

No not $300k but the deductible. I did not know the limits of that.

Sounds as if the son chose the lowest cost plan thinking he didn’t need health insurance. That was the high deductible plan. But he lost the bet when it turned out he had a need for insurance.

People short of funds and in good health can make that choice. But its a gamble you can lose.


…and when making that choice you need to understand that you have (hopefully not unconsciously) chosen to self-insure for the amount of that high deductible, and so need a plan and emotional preparation,

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@pauleckler @flyerboys

He has been physically very sick for years. He is mentally a piece of work as well. But right now he is acutely sick. Just before getting sick he sold his second property. Sad thing is he has money for the moment and does not want to pay his bills. His step father is about to take his money and negotiate paying those bills while he is in hospital. The savings will be huge. Get paid on pennies on the dollar or not at all.

When he gets out of hospital he is going to be royally peaved at his step father. My friend is bracing for that.

This is called accountability. It only works if there are consequences for one’s actions. Are we as a society willing to allow those consequences to occur with health care? If a person gambles by being underinsured, are we willing to deny him care or force him and his family into bankruptcy to pay for that care?

Take Leap’s example of the irresponsible son. Should the stepfather pay the medical bills? Should taxpayers (which is what will happen if no one pays for the care)? Or should the son just be denied care, i.e., he gambled on health insurance and lost?

The father won’t pay the bills.

The society will end up eating some of it. He has Medicare and a supplemental. Just like you do.

None of this is a moral issue. There are moral overtones that do not apply This is about the nuts and bolts of how this is paid for when most of it is going on Medicare regardless.

Our, for-profit “accountability” health care system costs about twice as much as the Gov’t-funded universal health care model followed by most large industrialized nations. And Americans die from it 3 or 4 years sooner than the Europeans, Canadians, or Australians.

I’d be fine with the “accountability” model if it was cheaper, or produced superior results as measured by life expectancy. But since it’s failing on both metrics, why does the American public let it continue?

The only reason I can find is that Americans are willing to pay double the cost for inferior health care, as long as Blacks, Hispanics, and undeserving Whites suffer even more. It’s just nuts.



And here I thought insurance executives were about martini lunches.

I’m all for single-payer health care, but only for reasons of providing more equitable care. I’m not so naive to believe such a system would do much to solve the financial problem. Global health care costs are rising faster than global GDP. That is independent of health system and dictated more by demographics and the types of diseases more common these days that tend not to be cure but only controlled.

We don’t actually have an “accountable” health care system. That would require more broadly and consistently declining service to those who can’t pay and charging premiums and deductibles based on risk (e.g., the obese pay more). That would be heartless. It probably would work financially, but it wouldn’t be a pleasant society.

That is what I was trying to point out in my previous post.

I believe health care costs will put enormous financial strains on most OECD nations unless and until the general population become more accountable for their health status. This means eating better and exercising more. The rapidity by which populations are growing fatter is going to cause a decline in health service quality globally. The complications of obesity combined with an aging demographic is just too expensive.

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