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Comment by gambiting | Hacker News Reader

"and managing hospital bills that would soon follow. The donor network takes over medical costs once a patient officially enters the program, but there was still the matter of the pricey care that preceded it."

It never occurred to me that the American healthcare system is so ruthless that even if someone dies your family has to pay for your care. How absolutely cruel and awful.

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DNRs are very common in America for a reason separate from the rest of the world - elsewhere they tend to be mostly a philosophical choice to minimize your own personal pain and cost on society. In America they primarily exist to shield family members from cost - it isn't uncommon for a funeral to be accompanied by a lot of additional stress because your father was kept alive for five additional days at a cost of 50k/day and suddenly the surviving family is trying to sort out grief, finding a quarter of a million dollars (or potentially sending the entire estate into bankruptcy) and the additional tens of thousands of dollars funerals cost.

Death in America is pretty darn expensive.

Edit: I'd clarify something - in the US (like almost everywhere) debt cannot be inherited alone. An estate can be declared bankrupt when someone dies and then debtors are limited to just taking chunks out of the estate to the best of their ability - but if shared property is held by the deceased then it can cause serious harm to inheritors. My favorite example is a multi-generational house which can force inheritors into debt to keep the roof over their head.

>> in the US (like almost everywhere) debt cannot be inherited alone

In Poland(where I'm from) it can. When my father died I basically had to make a choice within a few weeks of his death - either refuse the inheritance entirely, or accept it with all his known and unknown debts. The second options meaning that if someone comes to me in 10 years time saying "hey I have this paper signed by your dad 20 years ago saying he owes me a million dollars" well, I now legally owe this person a million dollars. There is no concept of an estate of the deceased that gets settled first before any inheritance is given out(if anything remains). No, you have to make a choice whether you accept everything(including debts) or literally nothing at all. And you have to make the choice quickly because you cannot manage anything owned or related to the deceased(their bank accounts, mortgages etc) until you make the decision.

Through inflicting financial pain, the US healthcare system is supposed to motivate consumers to seek out higher value, leading to competition and efficiency. But since medical services are a classic example of "market failure", all that's left is unavoidable pain.

The country I live in has three healthcare systems: Public (Free), Social security (Payroll funded) and Private (Paid by yourself or your optional private insurance).

The private one has the shortest waiting times and doctors are assigned less patients.

Some things that have happened to me in the private system and I didnt like were:

- Having to pay my bill about two hours after waking up from anesthesia. Literally signing the credit card receipts while on my hospital bed.

- Another time, having to sign an IOU before being admitted, on the emergency room bed.

- One of my doctors throwing away all my medical records, because "they were old and took too much space".

Yeah, it's a complete mess too. It really depends on the situation. For adults, with their own coverage, most medical debts are covered by the deceased's estate until it is insolvent. Family members are not required to pay the debt (unless a spouse in a community property state) though the hospital/insurance companies will absolutely try to get you to pay.

However, some states have laws that require adult children to pay the debts of their parents should they end up in a nursing home or similar.

I am kinda surprised at that part. Why would the family be responsible for his costs beyond what insurance would cover? It is not their debt.

> Why would the family be responsible for his costs

I think for the same reason that your family gets control of your assets. Neither transfer is deserved, but if you allow one then you have to also allow the other.

No. Debt is never transferred from one family member to another unless agreed to contractually.

If no will is drawn up, the estate will be transferred to the next-of-kin after all debts are settled.

Sorta - this issue is a bit more complex when it comes to shared property. If you live in a multi-generational home technically owned by your grandfather and he passes away then the house may be seized during any debt resolution or bankruptcy filing.

Debts don't get passed on but they can eliminate the value of estates being transferred.

I think it's perfectly legitimate to question whether any assets or debts should be transferred on death but right now society is such that some people will be depending on that inheritance since they're inheriting the roof that they've been living under all their life.

This may come as a surprise to you, as it did me... https://en.wikipedia.org/wiki/Filial_responsibility_laws

Depends on the locale. As I understand it, in Korean law, both assets and debts are transferred to next of kin when one dies. Relatives of debtors have to go through a legal procedure to make sure that they don't become next-in-line for any debts or assets when the debtor dies.

I'm assuming she's referring to managing the bills which will need to be paid out of the son's estate.

If you’re over 18, the bill belongs to the adult, even if they are on their parents insurance.

That is my thought. They can get what insurance will pay for but the dead person is the one who legally owes them.

Oh, you sweet, innocent child...

In general, in America, parents are not responsible for adult children's medical bills, even when on shared insurance. Managing != paying for out of her own pocket.

Wait until you hear about our funerary system.

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