Why is Jonathan's health insurance not covering the treatment? Is it because of the terminality? Or because of the way the US health insurance system works?

I have very little experience with American insurance systems, but it seems that the public is asked to fund the costs of a family which was let down by the insurance system, and which desperately asks for more time with Jonathan.

Personally, this makes me less inclined to donate; donating would feel like I am throwing money at a problem which a foreign country (one of the richest in the world) is not able to fix itself.

And I'm going to get very political for a moment here: There is a lot of enthusiasm on HN for "market forces", and a lot of hero worship of people who could build their wealth in part because things like a lack of decent healthcare make doing business in the US very cheap.

I wish Jonathan Dale nothing but the best. Supporting him because he needs it is great and compassionate, but supporting him because he's One Of Us, when HN is usually so happy to cheerlead for a system that caused this in the first place? It makes me cringe.

If you're the only X-believer in a community of Y-believers and you get cancer, well, it's not that the Y-believers want you to die, it's just that you're not part of their church and hence your fundraiser will get nowhere.

This is not a good system.

And it ignores that people do not have an equal start in life. You get born into a wealthy, well-connected environment, and, well, even if you do some coke and maybe kill some people with your car, your community is still going to stand by you.

It's generally not a question of having to actively alienate people. Not being in a wealthy/powerful community is enough. The Y-believers don't have to hate that lone X-believer to fail to fund his medical bills. They just have to think of the X-believer as somebody else's problem.

If you get born into the wrong environment, all you've got is "the people who think no one deserves to get left out in the cold" - and those people's resources are stretched way past the breaking point. How much do we pay nurses? Does charity provide for adequate medical care for poor inner-city black kids? No.

This libertarian stuff pretends to be progressive, but the actual outcome of the suggested policies is incredibly regressive. It's no coincidence that libertarianism is a politics espoused by the already-privileged.

In the end, I am very happy to choose human dignity being more important than property rights as the hill to die on.

Unfortunately, some people find that appealing. Time will tell which is the proper philosophy.

In our case, we are very lucky. Both my Aunt and stepmother have good drug plans that refund their expenses. However, their treatments still cost thousands of dollars out of pocket. They're relatively lucky - they're both seniors who were well prepared and highly insured. Even luckier, they don't have dependents.

I can imagine many, many circumstances under which someone with a family, even in our relatively good health care environment simply could not afford many of the drugs they need. For example, in many cases, complete drug coverage is a premium offering through private insurers. I'm not sure how many healthy people in their mid-30s would really consider premium health insurance a huge priority, especially if they have families. Rather, the tendency could be to assume that their good health will hold and they won't need insurance.

In response to your valid criticism, I do agree with most of what you say. But, I would also argue that cancer is an asshole and, if I were in a situation where saving my life could bankrupt my family, I'd sure pray that my community put helping me out above making a political statement about the quality of prescription drug coverage in Canada!!

I have friends and family in Europe and Canada. One relative in Canada was told that they would have to wait several months for an x-ray needed for diagnosis (and might die by that time), so came to the US for treatment instead. A relative in Europe was told that he was too old to qualify for treatment, so he came to the US for treatment instead.

From what I've been told, some treatment options that are expensive or not-fully covered in the US may not even be available at all in Europe or Canada.

So, while the US has much work to do, I think the more socialized systems of some other countries are not better in all respects.

I was raised with Medicare, but I see nothing but problems with how it is administered. And, I hope that your country doesn't follow our mistakes...

Why is it structured this way? Why don't they just directly bill the insurance without requiring large outlays upfront from the patient?

There is help for prescription costs - people can get deductions for long term meds.

Luckily, most people do not pay prescription cost. About 80% of people on a prescription have some exemption or other.

There are big problems with medication non-compliance, even for serious life-critical meds (cancer meds; HIV meds; transplant surgery meds) but it seems the cost (free or high cost) is not relevant - non-compliance is similar in the UK and in the US.

There are some problems with the English NHS, but "getting access to meds" is not one of them. Unless you count fantastically expensive new cancer meds that add maybe a week of poor quality life.

If you are lucky you have a good insurance plan and your employer provides disability insurance that covers your lost salary which recovering.

In no other developed country (or should I say in no developed country) do people die because they can not pay their medical bills.

The system has to change.

Something analogous to a Red Cross/Crescent which does not want to influence policy directly, only to help individuals.

This is why, for many people, it's a big deal to be an atheist: if the main community for you is the church, you're not just foregoing religious and moral support, but also the material kind.

It's certainly an understandable reaction to point out that the problem is bigger than one person on giveitforward.org, and that the US health insurance system with insurers being given cheap excuses like coverage ending with your employment contract (rendering your health coverage useless whenever you have a severe disease) or allowing insurers to retroactively (sometimes by 10 or 20 years) invoke a preexisting-condition clause means that many more people have to beg the last months of subsistence off of their friends, family, and community. Or just sit in a corner and die, if they're not well-connected socially.

If thousands of very public uninsured and preventable deaths have happened without a change this likely won't make the difference

Not that abstaining is reprehensible

But it sounds as though you think that not donating to this individual will have some indirect effect on improving things for other people in the future.

No, if you have the funds to both campaign for a systemic solution and help the individuals that are currently in trouble because of the systemic problem, then you are of course free to do so.

Suggesting that one is more important of our time, energy and money than the other is, however, a valid opinion [1].

[1]: It is valid if my assumptions about the insurance not covering Jonathan and other such cases were true; that may not be so.

Despite many members of HN being wealthy and/or well connected there are just as many of us that struggle to pay rent let alone for medical expenses. At the same time I and I'm sure others appreciate that this kind of thing is a very lonely and depressing experience with many dark thoughts. So here is a bro shoulder squeeze. Any of us could be in the same situation as you, it is a fact. Good luck man.

Aside:

I think it would be nice if us geeks/hackers had a healthcare plan for our community. A HN healthcare fund that both covered the basics in different countries and also pulled together contacts and information about new treatments for illness/disease, some holistic approach to be intelligently hitting the 'big killers' that are likely to strike.

If you think about it, many of the things likely to 'whack' us are going to be similar due to lifestyle. Overweight, back problems just as a typical example. If somebody out in SV thinks it a good idea then mention it to PG. Then ycombinator could not just be a incubator, but take us from cradle to grave! :)

Original post: https://news.ycombinator.com/item?id=7390638

Over the last few months, I've finally found a good balance between food and the medicines I must take to simply survive. I am still paying ongoing medical costs which insurance is paying a large chunk of, however, insurance doesn't pay for everything. Just some rough numbers based on costs submitted to insurance shows that a single day in the hospital is roughly $3,000/day and a single gamma knife treatment is roughly $100,000. The gamma knife treatment is the best available option for treating tumors in my brain, however, getting that approved by insurance isn't easy. The last time it happened, the neurosurgeon had to submit a written statement indicating that my life expectancy was at least 6 months beyond the time of treatment or they wouldn't pay.

The money from the fundraiser is being used in one of 3 ways: Medical expenses, Putting food on the table, or final expenses which include funeral costs and paying off the house and car debt so that my family will have a roof over their heads when my time comes. For those that have given, I will never be able to say thank you enough nor will I ever be able to repay you. I do hope that your generosity will be repaid to you ten-fold in some way. I've seen many of you give small amounts and many of you give large amounts, however, the common theme is that you are giving what you can while also wishing you could give me. From me to you, whatever you give is precious. Even it is only $5 it is precious because you have taken the time to give and demonstrated that you believe in providing hope and compassion to others and because those $5 donations add up quickly when it is thousands of people giving.

I lost my grandmother this month from cardiac arrest. Because of my health, I couldn't attend her funeral. That was and continues to be a very painful thing for me. She was always there to make sure I was taken care of and even spent several weeks with us helping to keep me fed and motivated despite her own health failing her. She passed at 80 years, 8 months, and 8 days of age and the legacy she left me was to help others as much as you can. Even though my own health is failing, I am doing whatever I can to bring attention to others whose situations are just as bad, if not worse, as mine.

At this point, even though my prognosis has not changed, I am feeling better. I still have trouble moving around as I run out of energy quickly and fight pain constantly. There is still no cure for the type of cancer I have and the treatments I am on will likely cease to be effective at some point. While there is likely to be a point at which all treatment options have been exhausted, I continue to have hope that a cure may be found before that happens. Quite honestly, even if it meant that I was physically unable to do anything and even if it meant that I had lost a substantial amount of my cognitive function, if I was alive I would be fine. That is truthfully the only thing that I have ever wanted. I simply want to live, to watch my children grow, and to die of old age with my soul mate by my side.

I want to bring your attention to some other individuals whose situations are, I think, worse than mine.

First, there is Nathalie. She is a 15 year old who is battling a rare form of cancer. She is trying to get access to a drug which could very well save her life and might even save mine one day. She meets all of the requirements except for her age. Because she isn't 18, she can't get the drug until it's been approved by the FDA. You can learn more about her situation at http://www.4nathalie.com/

Second, there is Ben. He is a father of 4 who was diagnosed with cancer of the Brain and central nervous system in December and given weeks to live. He's fought an impossible battle and managed to exceed doctors expectations. At this point, he has exhausted all available treatment options and may soon meet his end. I'm not entirely sure what the needs of his family are at this time, however, he does have a fundraiser at http://www.gofundme.com/ben-fights-brain-cancer

If you feel the need to give but are unable to give to more than one of us, I would ask that you give to either Nathalie or Ben. Although my family does need the help, I want to leave this world better than I found it and that starts by helping others. If my time comes, I would rather that my legacy be that of someone who helped others rather than that of someone who begged for help as others in need were left standing alone.

Thank you again for all that you have done for me and my family. I know that I will never be able to repay your kindness.

Jonathan Dale

https://d4l3.com/blogs/darthclue