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Comment by wvh | Hacker News Reader

I think I just started to understand why the US has such a low unemployment rate but so many are paid minimal wage...

The US is the epitome of bullshit, bureaucratic jobs. Medical billing, for example, is someone taking the list of procedures a medical office performs and plugs that into a computer so that the "codes" the office uses can match the "codes" the healthcare provider uses.

I know what you're thinking, that describes a LUT (lookup table). Yes, you would be correct, a LUT is an actual profession in the USA.

Even more crazy is that the reason these jobs persist is so that hospitals can maximize the profit and the likelihood of being covered by insurance.

I’ve never encountered an example of a real “bullshit job” (but have encountered a lot of ignorance about what different jobs entail.) Dealing with medical billing codes is not just a table lookup. It’s actually quite fuzzy and some judgment is required because the codes don’t match 1:1. (Not does the procedure the doctor actually did match perfectly to any code.) (And you can be criminally prosecuted for not doing it correctly if you’re talking about Medicare or Medicaid.)

Grocery bagging, likewise, is hardly a bullshit job. I shop at whole foods precisely so I don’t have to bag my own groceries. (And a good bagger can do it far better than I can.)

How do you evaluate the quality of the bagging if you don't know how to do a good job?

Are they just faster?

In my experience they’re faster, pack the bags with less wasted space (but not heavily, just good at fitting things appropriately), and importantly they’re not distracted by dealing with the cashier for payment or coupons or whatever other questions may arise.

Well it's not just that, your medical coder must try different related codes to see if the insurance will take a different code if the first proposed code isn't accepted by the health insurance company. 98765 not covered? Try 98764, that might be a covered procedure...

I’m sorry but this doesn’t bely my point. This sounds like insurance companies and healthcare providers have made healthcare needlessly complex. If they are the same procedure why should 2 codes exist at all?

Your example is the epitome of bullshit.

There is a tremendous amount of tech in medicine and considerable investment at larger healthcare systems. If medical coding were such a simple automateable problem it would have been done (I mean it’s freaking billing... absolutely the strongest and direct financial incentives to solve).

The first mistake/flaw you’re making is that the healthcare provider uses codes. That is most often not the case. Even if they do, it gets more complicated with submitting claims.

There are plenty of LUTs in healthcare that are managed by the EMR, billing ain’t one.

> If medical coding were such a simple automateable problem it would have been done

This profession exists only in the US. What are the other modern healthcare systems doing so they don’t need a coder? I’ll leave that for you to discover.

Out of ~80M hourly wage workers, only ~500k of them are paid minimum wage. Given the size of the workforce and the fact that starter jobs do exist, that's not 'so many' at all..

[1] https://www.bls.gov/opub/reports/minimum-wage/2017/home.htm

People outside the US tend to not understand how unbelievably wealthy the country is. I’ve posted stats, you can check my history, but accounting for cost of living and taxes there are no states as poor as wealthy EU countries on average. If you ever find an Italian, talk to him about life in small towns. People are just tired of hearing about the USA because of our cultural domination, and because the media only plays bad news.

Have you ever been to the southern US? Specifically Mississippi or Alabama or even some parts of Georgia?

Or West Virginia?

Italy is not a typical "wealthy EU country".

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