This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
Whelp, I just got screwed again by the lack of price transparency in the American Healthcare System. feelsbad.man.jpg
Thankfully, it's not a huge dollar figure, but it's the sheer stupidity of clinging to price opacity, which inevitably finds some way to reach into my pocket and pull out more money, that annoys me.
It was not a situation where the provider didn't have the necessary information to understand why the price ended up being what it was. When I called them to ask WTH, it took all of three minutes for them to just go through the steps of verifying the process and then explaining it to me. But that's three minutes that they should have spent going through the steps in order to give me a price before they performed the service, rather than blindsiding me with a bill after the fact.
Yes, yes, I know, they don't want to spend three minutes per patient; that adds up! And of course they don't want to; it's not only their time being spent; it's not in any way in their favor to spend those three minutes. It's my pocket that it comes out of, after all.
Moreover, it was a situation where, had they spent the three minutes and we could have then had a conversation about the price, in hindsight, I am extremely confident about how I would have made a different choice as to the way that I arranged the services that I would have liked to acquire. I literally, actually, could have personally made a different choice if I had had price information, and it's a choice that I would have preferred in terms of my personal cost/benefit analysis.
Of course, it must be remarked on that had I had this information and had I made the choice that I would have preferred, the provider would have made slightly less money. I don't think they were doing this on purpose; it's just convenient for them to not spend three minutes and also probably make more money. They just have near zero incentive to even consider doing things in a way that may be in my own interest. The only danger that they run is that if folks like me eventually get pissed off enough at these shenanigans, we'll either search desperately for a different provider who will bother spending three minutes or simply get so fed up with the constant nonsense that we just eschew that sort of service altogether. Man, it's tempting to do that, because it's just... so... constant a problem. I'm already pretty cynical for how they're going to find a way to screw me over, and apparently even that was not enough cynicism.
The snafu did, in a minor way, relate to the way the insurance policy is written. I mention this only because I would like to hold open at least some amount of plausible blame for them (it's really kind of hard to in this particular situation, but I'll mention it anyway), but the provider legitimately had 100% of the information necessary to provide me an actual price and discuss tradeoffs/courses of action prior to services being rendered. They just didn't bother.
This feeling really makes me sympathize with all the people who are so outraged. I'm sure there are tons and tons of stories where the insurance company is more to blame, too, so I sympathize with those folks feeling gut anger at them, too. It's just monumentally infuriating to have them over and over again find endless ways to screw you over and see that it's not even malevolence. It's pure apathy toward your interests as a patient combined with an addiction to doing everything possible to remain price opaque.
Suggestion: consider not paying. My conversations with a few in the know and my personal experience has led me to the understanding that in the US, in many cases, paying hospital bills is essentially optional. Like many modern systems, it's one that relies on the charity of good faith actors to subsidize deadbeats.
A while ago I went to the hospital to get a scan done. After taking an obscene amount of money from my insurance, I got no less than three invoices in the mail: one from the hospital, one from the hospital's network, and one from a radiologist society or something, all claiming that I owed them money. I never paid out a cent, and nothing ever happened.
I am not a lawyer and I don't know your specific situation, but consider the virtues of simply refusing to pay.
I'd suggest caution with this, the rules vary state by state and hospital by hospital. Some almost always go "eh" when people don't pay. Some will fuck you.
More options
Context Copy link
I know multiple people who got hospital bills sent to collections. Always the same story: they never got the bill and were certain they paid all they owed and got a nasty surprise of collections coming after them for more. I don't suppose that's good for your credit score, if that eventually happens to you.
Happened to me a couple of times. If your portion of the bill is under 500$, they legally can't report it to credit rating companies.
I move locations frequently, so bills got lost in the move. Collections called me twice. But, because they didn't know where I lived, they gave up.
They were small (100-200$) bills, but still. Odd feeling.
More options
Context Copy link
I have one of these from an unnecessary test a pediatrician ordered during a visit in which they did not bother to tell me they stopped accepting my insurance. It was a situation where I'm not unable to pay, or necessarily unwilling, but whenever I saw mail or something about it, I said to myself "I should call some offices and demand an accounting about this bullshit before I pay anything", and then it just sort of slipped through the cracks for six months. Now I get periodic emails from a "collections" agency. There has been no impact on my credit score. According to my nurse mother, they are legally not allowed to follow up on it like a regular debt or missed payment.
More options
Context Copy link
From what I've heard, they can certainly "send it to collections", in the sense that they can give it to an internal department to harass you about it. But they can't actually sell it to real collectors who ostensibly have a legally enforceable debt that they can collect from you, and who ostensibly have a legal justification to put marks on your credit score. I'd be curious to know if these individuals you know actually got marks from this specifically.
An even if they do, there's an entire playbook for effectively telling these people to fuck off. I've never had to use it, because in my experience, it never even got to the harassment part. Once again I will say that your experience may vary depending on many, many factors, but I would just urge anyone reading to appreciate that fact that just because someone shoves an invoice at you doesn't mean you have to pay it.
Not only can they do so, there are debt collectors who specialize in medical debt.
Well, all I can say for sure is that I've never met one asking about the hospital bills I never paid, and that debt collectors are notorious for collecting on things they have no business doing so. Consult your local and state laws.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
Not charity. The good faith actors have something to lose -- credit rating, property, time in court if they're sued by the collections agency. The deadbeats don't. So it's anarcho-tyranny. YOU, respectable working-to-upper-middle-class person, must pay those hospital bills. You might be able to knock them down some but you will pay or you will go to the poorhouse. YOU, Mr. Frequent Flyer drug-seeking deadbeat, you're fine, carry on.
They can't sell it to the real debt collectors. They can sell it to medical debt collectors who can't take your property or hit your credit.
More options
Context Copy link
My understanding is that there are many cases in which there is essentially nothing substantive that they can do, not even touching your credit score. I don't know if this changes if you, for example, sign something ahead of time that explicitly says you agree to pay with specified remediation if you don't, etc. This is why I urge the poster to evaluate their position for the freedom to decline paying, and consider taking that option if it exists.
My understanding from a lot of searching old reddit threads on the topic a few years ago is that it varies greatly. Sometimes they send it to collections and you can negotiate paying pennies on the dollar. Sometimes the hospital plays hardball and will get a order order to garnish your wages or bank account.
Personally, I'm speaking from two different articles of personal experience:
I don't know the parameters of how these reddit people were sought after. Perhaps I've seen so much success because I establish myself as a nonpayer immediately. I've heard from sources on the internet sounding credible that there's some arcane legal black magicks wherein one can be bound to a largely fictitious debt by sending its conjurer so much as a single dollar. Some sign on penalty of perjury that they are owed an imaginary debt on the hopes the legal ritual will coerce payment from targets. I'm sure there's a lot of Weird Tricks that people can use to extract money from hapless victims.
However, my personal experience with medical bills has been as follows: I go to the hospital to get something done, I get something in the mail that says something to the effect of "after your insurance paid 100 gorillion dollars, your remaining balance is 10 gorillion dollars, please send check or money order", I throw this demand directly into the trash, and I never hear about it ever again. It goes to the same black void as the jury summons. One time I got three invoices, from three different organizations, demanding three separate pounds of flesh for one thing I got done at a hospital. I ignored them all, and never heard from any of them ever again.
I'm not saying that this is applicable to all bills one can receive from a hospital, or that this maneuver could be pulled in any American jurisdiction, etc. I'm just saying that people getting demands from hospitals should consider their nonpayment options, if available.
It's been said that you can't con an honest man, but this may be another wisdom that modernity has turned on its head.
Looks like it might vary a lot by state: https://old.reddit.com/r/personalfinance/comments/14towop/what_happens_if_you_can_never_pay_back_your/jr5zc7b/
Also "It's relatively uncommon to sue over medical debt for a lot of reasons - including that the patient often doesn't have the money, also because it's easy to make a bogus counterclaim for medical malpractice , and nobody wants to deal with that over an unpaid $1300 invoice."
Example of someone getting wages garnished: https://old.reddit.com/r/personalfinance/comments/ue3xgd/getting_wage_garnishment_for_medical_bills_was/
More options
Context Copy link
More options
Context Copy link
Do you sign the documents at the hospital they give you where you agree to be responsible for any bills you accrue? If not, how do you talk them out of making you sign?
More options
Context Copy link
Just like ignoring a jury summons, this works until it doesn't. Yes, you can get away with it often. You can also get fucked when someone actually bothers to take the next step instead of saying "Eh, fuck it."
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
It’s optional if you’re poor or a criminal. If you have fixed, easily confiscated assets like property, a brokerage account etc then I think they can and will just go through the courts and get a lien.
They cannot repo your property or hit your credit score. Medical debt is worth even less than regular debt and normal collections agencies won't touch it. Hospitals will happily negotiate your bill down to pennies on the dollar because the chances are, they just won't get anything if you say 'fuck you'.
Acting like an Indian small business owner dealing with contractors will get the debt cleared easily.
So if I’m a respectable middle class person and I don’t want to pay my deductible or whatever, I just email the hospital and say “I don’t want to pay $10,000, how about $500?” and then…they just say “yeah sure, you got us, here’s the link”?
More options
Context Copy link
More options
Context Copy link
I'm honestly not sure about the laws around medical debt; I am reasonably sure that they do not do this, but consult a lawyer first. I am not a lawyer.
More options
Context Copy link
I would like to stress that I don't know the exact conditions under which this works—so please take this strategy at your own advisement and peril—but I have had multiple hospital visits in my life so far and have gotten away with paying exactly $0 by simply ignoring demands for money. These were organizations that had all of my info, my insurance, knew where I worked and lived, etc—and so far I've experienced no durable negative repercussions.
Your mileage may vary.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link