Re:Using AI to negotiate a $195k hospital bill down to $33k
by xnorswap on Wednesday October 29, 2025 @04:12AM
(#45744049)
Some Monocolonal antibodies are available for free on the NHS.
The criteria is what are called QALYs, quality-adjusted-life-years.
There's a figure that's given to a increasing a person's life by a year, adjusting for the quality of that.
It's set at a level. Given years of allowing below that level and denying anything above it, it has become entrenched as a level where that same money invested elsewhere would then have more effect overall on the nation's health. Preventative medicine can be scored against the same criteria.
It can be seen as harsh when treatments are denied, but drug manufacturers work with the NHS ( technically NICE who are the body responsible ) to either reduce the cost of their drugs to fall below that level, or offer rebates when the drugs aren't effect, to thumb the scales so that the drug appears to give more QALYs per money spent.
This brings down the cost so that NHS patients can and do receive MABs and other groundbreaking treatments.
It's not a perfect system, and it can seem harsh denying a class of patients drugs, but it seems more fair to me than basing it on level of insurance, which seems to be the system in America.
The American system has a compounding effect on making people scared of losing their jobs. This in turn makes people scared to exercise their employment rights, which are already scant compared to Europe.
The criteria is what are called QALYs, quality-adjusted-life-years.
There's a figure that's given to a increasing a person's life by a year, adjusting for the quality of that.
It's set at a level. Given years of allowing below that level and denying anything above it, it has become entrenched as a level where that same money invested elsewhere would then have more effect overall on the nation's health. Preventative medicine can be scored against the same criteria.
It can be seen as harsh when treatments are denied, but drug manufacturers work with the NHS ( technically NICE who are the body responsible ) to either reduce the cost of their drugs to fall below that level, or offer rebates when the drugs aren't effect, to thumb the scales so that the drug appears to give more QALYs per money spent.
This brings down the cost so that NHS patients can and do receive MABs and other groundbreaking treatments.
It's not a perfect system, and it can seem harsh denying a class of patients drugs, but it seems more fair to me than basing it on level of insurance, which seems to be the system in America.
The American system has a compounding effect on making people scared of losing their jobs. This in turn makes people scared to exercise their employment rights, which are already scant compared to Europe.