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>Average nurse practitioner salary 115k. Why are they putting medical debt on credit cards?

Are you asking why they couldn't afford 70% of an average salary (which, there is a 50% chance this person made less than the average) in one shot?

Your entire post seems to be victim blaming based on a few sentences of context. You don't know what other debts and obligations these people had, nor what other avenues they tried to exercise.

Maybe what they are asking is how someone making an average of 115k, who is also in healthcare doesn’t have better health coverage and still decides to have a kid.

That's not at all a normal cost of having a kid. It says she ended up with twins and they were born prematurely. That said, I have no idea why it wasn't covered or how she ended up getting stuck with the bill. I've had catastrophic occurrences like this, too, years worth of spine surgeries in which I racked up a few million dollars of expenses, but my out of pocket max was $4,000 and that was all I ever had to pay in a year. Any charges denied by the insurance were just dropped by the provider, not pushed to me.

So it raises the question of what kind of shitty coverage she had that was able to do this, or if she just had no coverage at all for some reason, which as far I understand, is supposed to be illegal after PPACA (you can always buy from the exchanges and they can't say no).

>> Any charges denied by the insurance were just dropped by the provider, not pushed to me.

That's a provider choice, and not guaranteed.

Sure, but it's not uncommon, either. If you ever find yourself in a fight with a chronic or long-term condition, check the statement of benefits your insurer sends you every month. They're denying massive amounts of things that you never get a bill for. I even asked my main surgeon's office manager about this once, and he explained to me that insurance companies don't have any sort of upfront published caps on what they're willing to pay and for what, so both sides are kind of winging it. The providers simply bill some very large number that they know is so ridiculous that it has to be larger than the max that will get reimbursed, figuring that by doing so they'll at least guarantee they get that max and not inadvertently sell themselves short.

So when you see things like a $14,000 charge for someone consulting over video for 10 minutes of work, or $800 for a bandaid, and you wonder how the hell a charge can possibly be that high, the answer is often that it isn't. That's just an artifact of this blind bidding thing going on between providers and insurers where providers send the largest conceivable bill they can to insurers knowing damn well they won't actually get that much.

This also feeds back into why insurance companies have such a horrible incentive to default deny everything. They know the providers are overcharging and charging for bullshit. Both sides are forced into taking equally extreme baseline negotiating positions by the total lack of pricing transparency.

It points at a very specific dysfunction of our system that goes well beyond the question of whether the government or private insurance purchasers should bear the bulk of the cost. This is a totally separate and orthogonal problem that both buyer and seller, no matter who they are, treat all transactions, no matter how mundane, like it's a blind silent auction for a rare Vermeer that hasn't seen a public market in 300 years.

Oh, I know the incentives. I strongly suspect there's even an additional one you don't list - tax writeoffs.

And you're going onto a tangent that I am very much in agreement with (that the whole system is massively broken and suffers all sorts of perverse incentives), but -my- point, if you'll recall, is that not everything gets written off. People still get unexpected medical bills -all the time-, for things their insurance didn't fully cover; this despite their deductible and/or max out of pocket.

Or, as I commented before, and which you're...agreeing to, in a whole lot of words, it's a provider choice, and not guaranteed. I.e., every time you go to the doc you're rolling the die; doubly so for emergency stuff that you can't get pre-authorized. "It doesn't happen -that- often" seems to maybe be your argument, but it happens enough, and the consequences of it happening at all are devastating.

The American Dream. Must make 115k+ (what is that, 2x or 3x the average American?) and pay out the ass for coverage just so you can have the privilege of having a kid without being judged by random people on the internet.

I’ve made much less than 115k for most of my working life and I never had such shitty coverage. I don’t agree that having twins or whatever should be 80k, don’t get me wrong. But if you’re in healthcare and make enough to have a decent plan and choose not to, and on top of that you decide to have kid/s, you know what you’re getting into.

At 38k a year I had a max out of pocket of 7k. It can be done.

It’s as if I opened a web server in my home with all the ports open, a password that is “changeme” and then complained that someone else should’ve been protecting me.

She wouldn't of had any coverage at all. Obamacare puts the out of pocket max well below 80k. At that income level and field, that's a choice. Is the idea that I'm supposed to pick up the tab or feel sorry for her? I make less than she does and I pay for my health insurance.

From both the context and the picture it's clear she's not actually, you know, retiring. The amount in someone's retirement account is meaningless unless you know their age and their income. Yeah, $10k isn't a lot if you're in your 60s and living a lifestyle that costs 6+ figures a year; it's a lot if you're making $30k a year and are in your 20s, and quite understandable if in your 30s at that income level. Three jobs are quoted because yeah, they probably are part time (and just saying "works 60 hours a week" or whatever doesn't carry the same punch), but -they may not be able to get a full time job-. Or else...you know, they might have healthcare.

The emergency room has ludicrously high costs, and none of his medical history. You're literally saying "don't expect to be able to see your primary care provider, go to the emergency room instead" -because of existing debt-.

You're making a lot of assumptions...all of which miss the point. Why is life shattering medical debt a common thing we tolerate in this country, given every other Western country has managed to make it a rarity? But, to your assumptions - maybe and she gave birth prematurely and ended up being seen by a hospital who were out of network and her insurance didn't cover it. Or even went to an in-network hospital, but was seen by doctors who were out of network, as frequently can happen, especially in emergencies when you can't personally vet the doctor is in network for you before you see them. Certainly, something unexpected happened (maybe even the pregnancy itself! Something to look forward to with the Supreme Court set to overturn Roe v Wade), and insurance wasn't there. Why is that acceptable in this country?

I work in healthcare and grew up poor in the US, and had medical debt of my own so I can read between the lines here. People absolutely get screwed over by medical debt, I'm just saying these are terrible examples of that happening.

> When people use number of jobs rather than hours worked per week it's typically beacuse number of jobs is greater than one and hours is less than forty.

It’s hard to imagine a person wanting to take on multiple jobs if instead they had the option to work one for the needed amount of hours and pay. Hours at one job != hours at three jobs, especially when you add in commuting time and lack of benefits because you’re not full time.

Your entire post is really rather uncharitable and judgmental towards these people but, anyway:

> Why are they putting medical debt on credit cards?

Doesn't say they did - reads to me like they built up debt on the credit card with regular living expenses while servicing the medical debt.

Medical debt is very low recourse. If you don't pay your electric bill they shut the power off, they won't unamputate your leg if you fail to pay. If you don't have substantial assets, taking the credit hit is the better choice. I can't envision a situation where it makes sense to trade low recourse medical debt for high recourse credit card debt.

You don't know their whole story, stop judging people from your high horse.

> You don't know their whole story

I'm pretty sure that's on purpose.

> number of jobs is greater than one and hours is less than forty.

It could also be the companies aren't willing to have someone on full-time, because then they'd have to pay for medical and other benefits.

Oh boy, think you might be living in a bubble.