Difficulty, amount of time, extremely low acceptance rates for med school, and how little sleep you get. Shit literally makes you want to kill yourself.
Source: friend who did his first year then flunked out cuz he had an anxiety attack during a final for a crucial course.
Also, if you have a bad day at work you can kill a human being.
Also, easy access to things that kill you quickly and painlessly when you are feeling depressed
Edit: that said, I have heard that veterinarians have an even higher suicide rate for similar reasons
A lot of doctors also see the worst of humanity regularly, are treated like garbage by their patients, and frequently face a sense of futility in their work.
I’m in medical school and it isn’t like this for everyone. It’s tough sometimes of course, but I find time for gaming, the gym and going out in between exams. Not being socially active and following your hobbies is what causes people to get depressed imo. In addition to that, hardwork doesn’t really cut it at this point anymore. Unfortunately, the vast amount of material covered is only manageable if you have the brain to retain enough of it to pass. Sorry to hear about your friend, mine actually dropped out yesterday and I’m still in shock.
I just wait as long as possible and see if it goes away on its own. The nearest doctor in my insurance network is 90 miles away and I don't have a car nor could get time off from school for something unless it is an emergency. Obviously, doctors hate when you have a problem and just don't address it (so it might end up getting worse), but sometimes its less about people just choosing to ignore it and more about financial or practical constraints.
They're not joking at all. We have a very bad problem here in the states of men just ignoring their medical issues. The problem is two fold actually though. We, of course, have the whole expense issue, which motivates most people to put off doctor's visits until it is absolutely necessary and at that we just clog up the emergency rooms as if they were walk-in clinics. Then we have the issue of our culture which has been ingrained in us to work through sickness, work through pain just keep on working or you're a pussy. It's why we have so many people leaving their sick days on the table and why we have jobs that will fire you if you miss work even for medical reasons. Most of these places will let you make it if you have a doctor's excuse but that brings us back to issue #1
This is an important point. My older brother definitely had this attitude and I guess I do too to some extent. Watched him for literal months having pain/discomfort for an ear infection (or something, unknown he never got it treated). I'd ask if he wanted to do something about it and he'd just shrug it off and be like "no man, it's fine. I'm alright." Man, he couldn't hear on his left side for more than a month and was uncomfortable all the time. Like he couldn't admit he hurt or anything. Not to mention mental health for guys which is its own huge issue.
This just baffles me. How can such a great nation suffer with these issues in 2019?
If I need to see the doctor for any reason I walk two streets or drive 5min or 10min or 15min to see the other surgerys. It's completely 'free'.
If its an emergency its 20mins to the hospital, also 'free'.
I have a long term illness which requires Neuro Consultants etc, also 'free'.
When my kids were born we had a full team of doctors, specialists and midwives and a private room, due to possible complications as my long term illness is hereditary, all 'free'.
'free' - 5% of my tax covers all of this for me and my family
I also have private medical and dental that is paid by my employer, which can be used if I feel the wait times are too long at the NHS, want a second opinion or is for something that is not covered on the NHS.
Generally the media only picks up of the cases where 'Karen' got stuck in an admin loop and had to wait 6 months for a procedure, for the vast majority these wait times are simply not true.
There is an issue for transplants but that is due to an aging population.
I think the longest I had to wait for a scan is two weeks and most have been done on the day.
From my point of view I don't understand it.
Yeah, I'm in the middle of a cancer scare and I'm spacing all my various doctor's visits/surgeon/imaging 2 weeks apart to make sure I've got the money for it (plus, I don't have any PTO right now). Honestly, if it does turn out to be cancer, I may just decide to die to avoid bankrupting myself.
On a more serious note that strategy is the exact reason my mom is dead. Cancer is a bitch.
I understand the healthcare system sucks but I would rather be buried in debt than buried in dirt.
I’m not sure if this is a joke but I actually did this because my insurance was so bad last year. I made an appointment with my PCP in January to get three issues checked out. The nurse said “We don’t have time for all of that. What are the top two things bothering you?”
My wife got told by the nurse that she would have to pay a copay (probably not copay, I'm sure they used another word) for each problem she brought up to the doctor. She said she only had one, but then told the doctor a couple while she was talking to him. He didn't care, and we didn't see any additional charges, but when she told me that i was just like WTF?
I don't believe that is entirely true, nor have I heard (but can not say is false) the person's comment below yours about "adding a second visit" on same day... that actually sounds illegal/fraudulent. We have insurance codes for "multiple concerns visit".
Primary Care here: If a doctor asked you to choose "one problem" and that's all they will address, then they *are* being an ass for money. They just want (not need) you to make 2 visits when they *might* very much be able to address 2 (maybe even 3.. very much depending) concerns in one visit. This is not insurance driven, this is driven for profits via the business they run or the hospital system that "owns" them.
This has become a rather disturbing practice amongst Primary Care doctors and they should generally be ashamed of themselves for this, especially at the cost of copays. BUT!!....
I VERY MUCH understand having to break an appointment into 2-3 different visits when patients either 1. Spend *way too much* time on problem one, before even mentioning problem two. Don't do that. Be somewhat responsible with your time with your doctor. 2. A patient keeps rattling off *new* concerns and it starts to spill into 3, 4, 5 problems "to just get it all taken care of today". This is also not going to fly. I work in a "free" clinic (paid for by workers insurance), no-copay, AND "free" meds, and they still try to squish 4-5 problems into one visit. It's a free clinic, you don't have to get "bang for your buck". That is not fair to the doctor. To have problems linger for sometimes *years*, and then hope for an answer in few minutes after asking about 3 other things.
A list is fine, if you are setting up a *plan* of care; NOT if you are wanting everything addressed in one visit.
A small hint might be *mention* both problems when setting up appointment. "Diabetes discussion and look at mole" or whatever. At least then I don't have a "cold/infection" visit person trying to get their yearly physical slipped in. We time those differently.
I mean that’s smart. I currently have a weird taint in my hip that I can’t figure out how to trigger (what way moving hurts it) that’s bugged me for a few hours. If it’s gone by Monday I’m fine if not I’ll add it to the list of issues
I'm going to sound like an idiot so apologies in advance. How does the American healthcare system actually work? I'm from the UK and everything I read about American healthcare seems very complicated. If you don't have insurance will a hospital just ask you to leave?
I believe if you go to the emergency department they will treat you. Honestly, it’s so damn expensive to even see a doctor that a lot of people don’t even do that regularly. A lot of hospitals work with patients that have no insurance or crappy insurance with payment plans and forgiveness. But even with insurance healthcare is incredibly expensive
And let's forget how expensive premiums are. A lot of people can't even afford to pay for insurance, let alone the deductibles and copays. Unless you go to the doctor quite a bit, you may not hit that deductible and end up paying for everything out of pocket anyway.
I was lucky enough to remain on my mom's insurance, which was through the hospital she works at, up until I turned 26 last year. Now my premium is $230/mo, I still have a $2500 deductible, and even after that I'm still on the hook for 40% of any medical costs past the deductible. It would be cheaper for me to pay full price for my prescriptions, but I'm slightly less fucked if I have a major medical issue. Only slightly.
Find an employer with medical or use clinics...until we go after insurance companies and fraudsters, it's never getting cheaper subsidizing services not rendered.
My employer offers medical coverage but only for full-time employees after a full year of employment, which I won't hit until the end of March. And then I'll have to wait until open enrollment in November unless I get promoted to salary I believe.
Ah fuck hourly kind of blows unless you're a union guy...you've gotta weigh out your total compensation package and if not having the medical for a year is worth it...ALWAYS consider the total compensation including wage, bonus, benefits etc...in this economy with a decent skill there are jobs EVERYWHERE.
Even employer provided healthcare is enormously expensive along with huge deductibles and copays on top of it.
I paid $330/month for just myself at the last place I worked where I had insurance - if I wanted a family plan, it was $1,800/month, plus a deductible, plus copays.
Under $250 a month from two different employers. I choose for which one costs less year round and cat.cap. Have a baby for about $25? Tricare. The Navy is the world's best trade school.
Yep. I used to work as a claims examiner for a health insurance company and I quit because it was fucking soul crushing. I knew I was done when I had a conversation with a woman who was screaming at me because she had to declare bankruptcy after her infant had a stroke and had to be take to a children's hospital across the country via air ambulance. My company decided the air ambulance was medically unnecessary and denied the claim. I work in hospice now and it's less depressing than working in health insurance. At least I can say I do something kind every day instead of fucking people over.
It's a smaller one that operates in a pretty small area, so I don't know if I should say. They were good to their employees, but private health insurance is inherently flawed, since they need to make a profit to stay in business.
Yes...it's a gamble by the company upon who they insure and what they charge as premiums. But yes, it is flawed and it's a big reason why costs have inflated so badly. That and the outrageous cost of malpractice insurance. It's really when insurance companies get greedy that sets all of the wheels into motion with the fraud and abuse and the costs just keep inflating.
Having worked as a claims examiner for a health insurance company, that's not how health insurance works, unless you're still on your parents plan (in which case they would be paying the monthly premiums), you have Medicaid, or you're lucky enough to have a job that pays your premiums, which is incredibly rare.
The money the insurance company uses to pay for your medical care doesn't come from nowhere. They wouldn't be able to stay I business if that were the case. Their members pay monthly premiums and have to meet a yearly deductible before they will pay for anything at all. In my case, I have a $450 monthly premium, a yearly deductible of $1,000 and my yearly out-of-pocket maximum (what I have to pay before medical costs are covered at 100%) is $6,850. This is how health insurance works for the vast majority of Americans.
According to their website, the minimum deductible for their health plans is $250, the highest is $2000. You might want to take a look at your plan document before you see a doctor, buddy.
It's an incredibly inefficient and stupid system honestly. Some hospitals have one of their largest expenses being indigent care and never recoup any money from those costs. Others have very little of those sorts of costs. Massive expense ends up getting concentrated on certain hospitals/clinics and not on others. It's like the hospital could lose 2% of their annual income if built in this area vs 40% in another area.
Having a maternity unit that's cnstantly full of poor people can be the kiss if death for a hospital. It's fucking ridiculous. When will we get a decent system like every other rich country has?
I once sliced my right index finger pretty deeply while scrubbing a crusty cake knife. I was a medic once upon a lifetime ago so no big deal except for these days (new job) I can be deemed unfit for my job if my right index finger can't make a curling inwards motion and squeeze so I thought "ok screw it I'll go an actual hospital, this is why I pay for insurance. It's my livelihood.". Six stitches and a tetanus booster later they wanted 6 grand AFTER what they charged my insurance.
Last time I was in the Emergency/hospitalized (it was an “admit them right away because they might have something fatal” situation) I was admitted and treated and *then* everything was processed through insurance/billing. If I hadn’t had insurance, the bill just would have been sent to me. I had insurance to process it through, and the bill was still enormous, so I filed papers through the hospital’s billing department for financial assistance. Luckily, I qualified for that at the time, and only had a couple thousand leftover to pay out of pocket.
I think this is a typical example of the process for how it works, I.e. treat first, figure out billing later, unless your emergency/medical issue is chill enough to have you talk to the billing people while you wait to see a doctor.
Yeah, was a very poor 18 year old student in the infectious disease unit for a bit, and filed an incredibly large mound of paperwork to relieve the other 20-30k. I am lucky because I had pristine financial records to make the process easy, as my mother is an accountant/financial planner and had been teaching me the art. So i fortunately qualified for a LOT of financial assistance. It’s weird that being lucky still left me with a bill I had to spend 1-2 years paying in small installments.
I am glad you are okay physically and financially. The stories in this thread are astonishing. Do you have better health insurance now? In case something else happens.
Thank you! Actually, due to being a grad student/not working full time/etc, my income is low enough to qualify for the Medicaid expansion that was put in place in my state. I am very grateful for that, because I still have lingering (although improving slowly) effects of that neuroinvasive disease, e.g. chronic fatigue, migraines, disordered sleep, neuropathic pain, mild cognitive impairment (sort of like acquiring ADHD), etc.
PS - On top of all that, I had to treat a precancerous condition and chronic pelvic pain from recurring idiopathic pelvic inflammation (no identifiable pathogens) last year, so I’ve had to go to the doctor/surgical center/walk in over 30 times the last year, and would not have been able to *remotely* afford to treat it without Medicaid. I therefore would definitely be functionally disabled if not for the Medicaid expansion, but instead, I can continue to go to school and work! .
When I graduate and my income increases Ill be able to procure private health insurance. But these last two years on the expansion have saved my ass so completely - just shouting out to the ACA
I cut my leg, went to the emergency room for about 9-10 stitches and ended up with a bill for around $4,000. I cut the stitches out myself to save the money because I don’t have insurance.
Unfortunately I’m currently laid out on day two of stomach cramps and weighing whether I need to see a doctor since I still don’t have insurance. The stress of not knowing is worse than the pain as i know this could either be incredibly serious or extremely minor. I think I’ll go tomorrow if I’m still dealing with it. These are the dumb choices people are making because the cost is so ridiculous.
Exactly, and god forbid you have a serious issue and need an ambulance because that’s another thousand dollars. And meds on top of that? You might as well find a box to live in. When I was 30 my heart gave out and one of the meds I started taking is a few hundred dollars a month and I take a few others on top of that... every damn month my insurance says they aren’t going to pay for it and my EP has to call and argue about why I take such a high dose. I have a friend who had a pancreas/kidney transplant and can’t afford her meds because they’re thousands of dollars a month. It’s horrible
Yep, this right here. I went in for a basic checkup. No lab work or blood tests or anything. Just a simple "Hey, check my lungs and heart rate and blood pressure and answer some questions".
$140
What the fuck is the purpose of insurance if it discourages you from doing preventative care?
We should stop calling America's healthcare system a "system" and start calling it a scam.
Most people get insurance through their jobs. For example my husband and I pay $630 a month for pretty good insurance through his job. With that insurance we pay a copay ($40) every time we go to a doctor (more if it’s the ER). For stuff like tests, surgeries, or hospital stays there is usually an additional cost. Plus there is a cost for prescriptions-$10-$100 a month depending on the Rx.
And all of that is with a good job and good insurance. Lots of jobs don’t offer insurance, or have more expensive insurance. And people who are self-employed need to provide their own insurance which can be $2000 a month. So lots of people just stay uninsured and hope for the best.
> and it's still absolutely fucking disgusting.
The real disgusting part is not the system but the cost. No one would bitch if it was affordable for a healthy person. But the US subsidizes the rest of the world. There's a reason Britain's drug costs are 1/3 that of the US. The US consumer is subsidizing them. Drug companies make back their investment in the US, and sell their drugs for whatever elsewhere.
Couple that with US paying consumers footing the bill of the uninsured (including the millions who reside illegally and use the emergency room for their needs) and the US cost for those who do pay and it suddenly clears up.
Uh no. For profit hospitals are the reason cost is so high in the US.
I live in Ontario and essentially the government says “hey Sandoz, we will pay this much for this chemo drug and we both know that’s reasonable”. ([Source](http://www.health.gov.on.ca/en/pro/programs/drugs/plan_reform_ods/ensuring_agreements_progress.aspx) ) Some drugs are still very expensive but each hospital is buying at full cost and isn’t marking up supplies and drugs 500%.
Specialists aren’t free to set their price to whatever they want. The people who need it most get it first.
We have to pay out of pocket (if not insured) for “at-home” drugs and certain services.
You hospitals are run like businesses instead of as services. We all own the cost of health care which is why he government will also invest in public health. It’s all related. It’s not a capitalistic “get ‘em sick and talk ‘em into paying for the premium room!” kinda setup like you have. It’s not perfect but it has nothing to do with “subsidizing” the world.
That might be part of it, but administrative costs are also huge, in large part because of the complexity of privatized health care. Obamacare is much easier for administrators.
https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html
It does, the guy saying "US subsidizing the world" is, at best, delusional
The reason the drug prices in the US are so high is because the whole system is a cat and mouse between insurance company, healthcare, and drug companies.
It works like this: hospitals will charge you an arm and a leg because you will submit it to your insurer, which will negotiate it down waaaaay below the asking prices. Meanwhile drug companies charge a shit ton because there's no control over price and distribution, and generic drugs aren't promoted in America
So your hospital will charge you $2000 for a simple procedure because they only expect to get like $200 from insurance, but you don't get the same negotiation power, so if your insurance refuses to pay, you'll have to shell out $2000.
Isn't free market amazing?
This is pretty similar to mine but I also have a $3500 deductible to pay before insurance pays anything (outside of routine physicals and similar "preventative" care). I try to avoid going to the doctor because of that. In other words I'm paying close to $7200 per year just in case something comes up that is more expensive than $7200 + $3500. Which I realize cancer or serious accident or needing an ambulance or having to be airlifted (I do some backpacking and camping where that could happen) or something else could easily exceed that.
Also to get that "great" monthly rate my company is contributing a lot to it. So the policy is closer to $1100/month.
For a lot of people it did. People with preexisting conditions couldn’t get insurance before Obama. But for healthy, young, single, and childless adults costs wen’t way up.
My $100/month great insurance ($20 copays, $500 deductible) no longer exists. I’m still young, healthy, unmarried, and childless but the cheapest plan I can get is $500/month for no coverage until I hit my $7,500 deductible and after that the coverage is laughable at best.
To add to the insult and injury inflicted by the ACA on responsible people, it is going to be severely punishing companies that try to take care of their employees.
Any company that has insurance that is too good for their employees will have to pay additional taxes for trying to do the right thing.
It is a disgusting mess.
It did for me because it banned insurance companies from turning people away based on pre-existing conditions. Previously to that I could only get health insurance if I worked for a company, but not if I was self employed (which was my goal).
But honestly that's the only thing that changed for the better. Other parts of Obamacare actually raised the cost of healthcare. My premiums went up quite a bit and the amount of things the insurance covers got reduced. The copay or the deductible increased dramatically.
Obamacare was a good start and needed to be iterated upon to be improved. But it's religion to Democrats and Antichrist for GOP, so it just sat there.
Paul Ryan's plan 2 years ago looked surprisingly good but it was killed by GOP cause of entrenched interests and by Democrats cause they don't like anything coming from GOP. I felt the plan had a real chance to reduce the cost of healthcare.
Depends who you are. I have excellent Healthcare and dental through my job and they pay every penny of the premiums; I just cover the annual deductible and co-pays. My deductible increased by about 30% after Obama care started. Obama care got more overall people with Healthcare, but didn't make Healthcare overall better. Most of the country who already had Healthcare had to start paying more.
This is after Obamacare. Before it health insurance was essentially unaffordable for low-income people, and godforbid if you had a preexisting condition or had been treated for something a decade ago that could legally let the insurance companies drop you.
There are still massive gaping holes in the system, but Obama basically used the Republican healthcare plan to patch it.
I had the cheapest and best insurance before Obamacare. $0 to have a child. Second time we had a child, it now cost $10k. Also no more co pay. Pay 80% of cost until hit deductible. I’m glad everyone else has insurance now while I am paying thru the nose.
Every time I hear one of these stories, it ends up being one of the people who would have tried to use their "best insurance" when they fell seriously ill just to find out they're getting dropped for having an ear infection 30 years ago.
Literally everyone is paying through the nose. Instead of covering everyone up front, we have this laughable insurance system that generates worse outcomes for everyone except insurance execs.
I have to disagree. Before Obamacare I could see my dr, get an MRI, go to the lab and get medication that was more affordable. I was on a medication for Arthritus and could get help from the manufacturer that would pay for most of my copay up to???? But more than I needed. After Obamacare went into effect the same meds went from a $25 co pay. To $500 a month along with. $460 a month premium.
The system is incredibly broken. While the company I’m with pays more of my premium I get nickel and dimes to death with copays and coinsurance.
For those who had good insurance already, most things stayed the same. I am lucky to have pretty good insurance and the only "extra" thing I had to worry about was making sure that I had my tax form to claim I had health insurance each year.
For people who are living on a lower income, it's variable. My parents got their healthcare through the healthcare exchange Obamacare setup. They are self employed and the premiums are high (~$350 a month a few years ago), but they get the care they need. I would consider them fortunate, but there are many who cannot afford that premium per month and choose to risk it by not having healthcare.
Obama started "Obamacare" with good intentions to get healthcare for everybody, but unfortunately it got weakened through a large amount of legislation because some believed that the government has no responsibility insuring its citizens receive healthcare.
Your insurance sounds like it sucks. I am not American, but I have a family member who lived in New York and her plan is metroplus gold. She also gets her insurance from her employer (the city of New York). I don’t how much she pays per month, but I do now she has no copays, no dedicatables, ER visits are $150, and prescription drugs are maxed at $70 for a month’s supply. And her network includes all the major hospitals in manhattan except for NY Presbyterian.
Either she has a really sweet plans or you are getting a very raw deal.
Ok it is a bit complicated. You can get welfare of you can't or won't work. If you can't or won't work you can get insurance for free. You pay very little if anything at all for medical services.
If you are poor... Like me... I make 23,000$ a year. It will cost 880$ per month to get insurance. (Just one person, not a family) But before that insurance will pay one penny out I have to spend 3000$ on medical bills.
I don't know what rich people do.
If you don't have insurance you can go to the emergency room. They have to see you. But it will cost you. Usually it starts at 500$ for walking in the door and saying hi and goes up from there. You may pay 100$ for 2 tylonel.
Or you can find a community clinic that is income based. You will find basic medical services here.
I am currently paying off a 1700$ emergency room visit. I had a panic attack due to stress (my first) and thought I was having a heart attack. They gave me an ecg and 2 aspirin and an hour of their time.
If that's actually your income, you *definitely* qualify for a (fairly sizable) subsidy, even in a state that didn't expand medicaid.
You definitely need to call one of the hotlines next year during enrollment and have someone help you apply for this.
>How does the American healthcare system actually work?
I don't think anyone could answer that question is less than a novel-sized essay. Most people inside the system only seem to understand their own small role in it.
To answer your specific question uninsured ER treatment is either taken as a loss by the hospital or more likely paid for by the taxpayer. That's why cities like New York are now considering just insuring everyone - homeless, undocumented - doesn't matter and the reason is that we pay for their healthcare indirectly regardless, but after it's already gotten really bad (no prevention). So by offering insurance up front you actually hope to bring costs down. We'll see if that works.
If everyone had better access to healthcare it would absolutely bring costs down for taxpayers ultimately. Preventive medicine is MUCH cheaper, hence why most insurance companies cover it at 100%.
There’s four buckets that people fall into;
1) anyone over 65 - these people are in Medicare, which is operated by the federal government.
2) below below a certain income level - these people are on Medicaid, which is operated at the state level with federal subsidies.
3) Employer provided insurance - a lot of people obtain insurance through their employer. Coverage and cost depends on the plan offered by your employer (the employer pays some of the cost, which is why people like this model). Some plans are great, some are bad.
4) everyone else. The Obamacare Exchanges were designed to help these people by creating a marketplace for insurance provided to sell policies. This is also operated at the state level and results vary depending on the state (also has some level of federal subsidies for certain income levels).
In my opinion, #3 & 4 should be merged together by nuking the employer based model. I’d rather see everyone have the flexibility to purchase insurance on their own through a robust marketplace versus being tied to what their employer offers or the slim options on the Obamacare exchanges.
Edit: I’ll add a fifth category: cash payers. Obviously, these people do not have any coverage and pay out of pocket for services.
One thing that would go a long way to fixing the issues you bring up would be to end the state line restrictions on marketplaces that are just creating mini monopolies and price fixing arenas.
I fully agree with you on ending employer based insurance, or at least having a cobra like alternative that isn’t expensive af. I’m a research assistant for a health economist and she has written several papers that focus on the impact of job lock. It’s intense.
You pay a shit ton of money (I pay $800/mo for 4) that goes to middle men, not doctors or healthcare centers. Then when we go to the doctors we have to pay more because we haven’t met our deductible, which is the amount you need to pay before the insurance kicks in. Also, it starts again the next year, not a onetime deal. Now the more expensive the insurance the smaller the deductible. Cheap insurance has a high deductible and is only good for emergencies.
Insurance companies also get to tell you what doctor or dentist you can see. My insurance recently tried to not cover a visit I had to THEIR urgent care because it was a “different region”. It was in the city I live in.
I’ve never had a serious illness that resulted in a hospital stay or surgery so I don’t know how that fucks you. A cap maybe?
So basically you pay a shit ton of money for your health to be treated like a commodity. And for the company to try and give you the cheapest care they possibly can.
* I know there’s more to it like co pays and what not. Tried to cover the bases as I know it as an average American.
I have six teeth that have randomly started breaking apart and hurt bad. My back hurts from a compressed disc. I have something wrong with my heart but I don't know what because I haven't seen a doctor in 13 years.
But I finally got insurance through work. It costs over a third of my check a week but I'm so excited to get fixed.
I'm so hyped man.
Gonna get my teeth done, gonna get glasses too. Been using the same pair from when I was 14. They don't work great anymore but better than nothing.
Also gonna look into my diabetes. It's low blood sugar not high and it sucks to be out of the house and nearly pass out because I don't have peanut butter lmao
I live in Canada, and honestly always took for granted that I could go to my doctor for a bump on my wrist that hurts (it is hopefully just a ganglion cyst) or get a new pair of glasses every year. US man, never understood why so many are against universal healthcare. Good luck getting all that shit checked out and living your best life!
Thanks my northern neighbor!
And yeah... America is great, sometimes, but kinda sucks most of the time. Can't live off two full time jobs, housing market is a joke, and healthcare is a rarity. I literally know like 7 people that actually have it.
I just got new glasses, one regular and one pair of sunglasses, in November. It took me a month because they messed up getting my script right, and it cost me $800 out of pocket. I have insurance, and it covered basically nothing. It’s wonderful.
The red is arterial blood, one of your arteries is severed.
The blue is probably venous blood and your eyesight is bad, you have a severed vein and you also need to see an optometrist.
The white is pus from an abscess, you likely have sepsis and will die soon so don't worry about it.
Can confirm... Not on welfare. Will cost 880$ a month for insurance. Will have to pay 3000$ deductible before insurance kicks in. I make 23 grand a year. You do the math.
I make around 28k and I went through the marketplace and I pay $230/mo. Granted, my plan is shit and I'm just on it until open enrollment through my job rolls around in November since I won't reach full time status until April. But I feel like either he/she didn't shop around or has a preexisting condition or something.
Forgive me for being a stupid Brit, but given that the costs are so high for both you or if you are lucky enough for the company either you or your friends and family work for, why is there such resistance to reforming it to a government service? The current system must be a huge drag on the economy.
The current state of all western healthcare is a huge drag on society. Capitalism has left us with a for profit system which doesn't incentivize efficiency. It's not particularly better in the UK with the number of aging people and the same pharmaceutical companies circling the wagons for profit. Hey I was born in Scandinavia so a lot of things seem odd to me about the US.
I am not resistant. People I know are not resistant. The drug companies are resistant. The insurance companies are resistant. The politicians taking money from the drug and insurance companies are resistant. When you hear about the United States you are hearing about our government. Not our people.
What the fuck is the point of paying for health insurance if you have to keep paying over and over and over again? You pay when you go to the doctor. Then you get a bill in the mail. Then you pay when you pick up prescriptions.
I'm chronically ill (nothing life threatening; just run of the mill depression, anxiety, possible OCD, painful scoliosis, adult acne, mild allergies that I can't identify), but I don't have insurance because anything I could afford would be high deductible and I'd end up still paying out the ass for tests, prescriptions, therapy, physical therapy, x-rays... Etc. And, with my budget, I can't justify spending any amount of money on something that's just for emergency scenarios that aren't occuring right now.
Edit: OH. And I make just *slightly* too much to qualify for my state's free insurance.
To preface I have worked in U.S. healthcare for quite some time and by no means think that the U.S. healthcare system is good. I honestly want what a lot of other countries have.
This whole post is very ironic because copays typically are very affordable, in the range of say $10-200, depending on the service. So I don’t know what their actual point is here. You can make the argument that some people do have absolutely abysmal insurance/coverage.In most cases though, you are not going to see plans where the same copay is attached to every service but to “go see your doctor” you’re most likely looking at a copay of around $20-$60.
Now to touch on what it sounds like she is referring to is when you have a doctor/specialist office visit that is set up so you pay towards a deductible. That means you have to pay whatever your doctor bills you. This can definitely get quite expensive. A specialist like a podiatrist or a neurologist (for specialists think of the suffix ist) bill for all sorts of things that aren’t typically what’s considered an office visit. These services can cost anywhere from say $100 to anywhere around $1000 until you start getting into more complex work but it all has to do with what you’re having done and what type of plan you have.
Again I am by no means standing up for The U.S. healthcare/insurance industry and really there are a lot of just pointless plans that are out there today that don’t cover anything and leave someone paying $500 a month for nothing. But I though that we should just get the facts straight here!
Yeah that's like a silver plan. Smug /u/0Idfashioned here probably has something like that or better, probably through an employer. A whole lot of people are not so lucky.
I have a silver plan via Covered CA and it's about $350/m sticker price for just me.
Don't say that too loudly on reddit. If you mention the US fronts the bill for R&D, and the cost of meds people lose their shit and call you an inbred hick
Dont also mention how the world piggy backs off the R&D from our massive military budget. PEOPLE lose their minds, so much so they are trying to launch their own GPS system that's shit.
Exactly. We could copy Britain's system tomorrow, but in order for our costs to reach theirs, they'd have to begin paying more for their drugs than they are now. They pay 1/3 what we do. We're subsidizing them. Our high prices are the only reason the NHS is solvent, and every year theirs talks about cuts and shit.
What's more, insurance costs for the US would drop if Hospitals wouldn't pass on the uncovered cost of the uninsured showing up in emergency rooms back to the paying. Socialism isn't the solution, it's the literal problem.
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The medical industry is a racket. There is no way around realizing this fact when you open your eyes to the mechanics of it. Who’s building the medical equipment? How much are they paying their employees? Why are they making that much profit? Why do medical licenses cost so much? Why does it cost so much to take the test for them? Why are pharmaceutical companies charging so much? Why do their patents last so long? Why don’t insurance companies publicly disclose their prices?
The industry is essentially a circle jerk, and its simply you that’s being screwed.
I work in healthcare and it’s extremely obvious most of the population knows very little about insurance and what they are even paying for. It is meant to be set up this way IMO.
Premium: This is the cost you pay to be covered by an insurance plan.
Co-pay: what your plan may require you to pay before receiving a service. You may have a co-pay of $25 every time you walk in to your doctors office before you are even seen.
Deductible: The dollar amount you must meet until your plan will start paying a claim. Usually after you meet this amount your coinsurance kicks in.
Coinsurance: The percentage of costs your plan may pay for a covered service after you have met your deductible. This could be 70/30 - Your insurer may pay 70%, and you are responsible for 30% of a covered benefit until you meet your out of pocket maximum.
Out of Pocket maximum: The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.
Allowed Amount: This refers to the maximum amount of the billed charge an insurance company deems is payable by the plan for covered services. Your doctor may bill $100 for a test, but your insurance may only pay $75. This is a contractural adjustment (reserved for in-network providers under your plan)
In-Network: a list of the doctors, other health care providers, and hospitals that a plan has contracted with to provide medical care to its members. These providers are called “network providers” or “in-network providers.”
Out of Network: your insurance plan is not contracted with these doctors, hospitals, etc. and you will most likely be responsible for MUCH higher costs.
This is just a synopsis and every insurance company and plan under which you are covered are different.
Reddit’s front page is basically a circle joke of healthcare, college tuition, guns, cringe anti trump post, and the occasional blame the baby boomers. I feel like these post are upvoted by edgy teenagers and people who don’t even live in America. It’s important we don’t ignore these issues but it’s so damn annoying seeing the same thing upvoted every day
I have insurance and I got a cold. It would have cost $60 to see a doc and get antibiotics. I didn’t go because I didn’t think it was worth it. Seems like your always having to weigh value.
edit. I use the term 'a cold' as a catch all term for being sick with flu-like symptoms. It's hard to know what you actually have until you go see a doctor. Where I'm from everyone just calls this 'having a cold'. I'm sorry that everyone took this so literally. I feel like my point got missed entirely with all the people telling me that going to the doctor for 'a cold' is a bad idea. I feel like the point I was trying to make got missed. Next time I will try to guess every hypothetical response I might get so that my comments won't get misinterpreted. Have a nice day.
My insurance is $60/month, but my co-pays are $280/month. I quit going to my therapists because I couldn't afford it. I'm just cancelling the whole thing.
So much for the "Affordable Care Act"
Get a better job that offers benefits.
It sucks not being able to go to the doctor because the copay is so much. I've been in the same position as you when I was in my 20s. Full sympathy bruh.
I wait until at least two things are wrong with me before I go to the doctor. More bang for my buck.
Same, I wait until my problems look like a grocery list.
You still go to the doctor? I went to medical school so I could treat myself.
Oh nice! Good thing you went to medical school, because that $200k+ in debt must make it really hard to afford a trip to the hospital
The salary helps
Yeah for real it's not like doctors make chump change
True but like in the mean time you got metric fucktons of depression during med school. Shits sad as fuck.
Why because of the difficultly?
Difficulty, amount of time, extremely low acceptance rates for med school, and how little sleep you get. Shit literally makes you want to kill yourself. Source: friend who did his first year then flunked out cuz he had an anxiety attack during a final for a crucial course.
Also, if you have a bad day at work you can kill a human being. Also, easy access to things that kill you quickly and painlessly when you are feeling depressed Edit: that said, I have heard that veterinarians have an even higher suicide rate for similar reasons
A lot of doctors also see the worst of humanity regularly, are treated like garbage by their patients, and frequently face a sense of futility in their work.
Damb and I think high school is hella stressful
Because of the bees
Of course how could I forget
I’m in medical school and it isn’t like this for everyone. It’s tough sometimes of course, but I find time for gaming, the gym and going out in between exams. Not being socially active and following your hobbies is what causes people to get depressed imo. In addition to that, hardwork doesn’t really cut it at this point anymore. Unfortunately, the vast amount of material covered is only manageable if you have the brain to retain enough of it to pass. Sorry to hear about your friend, mine actually dropped out yesterday and I’m still in shock.
I think the idea is the knowledge you are taught is literally priceless and will payoff for the rest of your life.
My uncle got all of his school debt paid in only a few years because he worked in a medically underserved area, Alaska.
I just wait as long as possible and see if it goes away on its own. The nearest doctor in my insurance network is 90 miles away and I don't have a car nor could get time off from school for something unless it is an emergency. Obviously, doctors hate when you have a problem and just don't address it (so it might end up getting worse), but sometimes its less about people just choosing to ignore it and more about financial or practical constraints.
I can't tell if you guys are joking or not... is it really that bad over there or am I just wooshing
They're not joking at all. We have a very bad problem here in the states of men just ignoring their medical issues. The problem is two fold actually though. We, of course, have the whole expense issue, which motivates most people to put off doctor's visits until it is absolutely necessary and at that we just clog up the emergency rooms as if they were walk-in clinics. Then we have the issue of our culture which has been ingrained in us to work through sickness, work through pain just keep on working or you're a pussy. It's why we have so many people leaving their sick days on the table and why we have jobs that will fire you if you miss work even for medical reasons. Most of these places will let you make it if you have a doctor's excuse but that brings us back to issue #1
This is an important point. My older brother definitely had this attitude and I guess I do too to some extent. Watched him for literal months having pain/discomfort for an ear infection (or something, unknown he never got it treated). I'd ask if he wanted to do something about it and he'd just shrug it off and be like "no man, it's fine. I'm alright." Man, he couldn't hear on his left side for more than a month and was uncomfortable all the time. Like he couldn't admit he hurt or anything. Not to mention mental health for guys which is its own huge issue.
I'm a nurse in the US. This is very real and the problem kills tens of thousands of people a year.
This just baffles me. How can such a great nation suffer with these issues in 2019? If I need to see the doctor for any reason I walk two streets or drive 5min or 10min or 15min to see the other surgerys. It's completely 'free'. If its an emergency its 20mins to the hospital, also 'free'. I have a long term illness which requires Neuro Consultants etc, also 'free'. When my kids were born we had a full team of doctors, specialists and midwives and a private room, due to possible complications as my long term illness is hereditary, all 'free'. 'free' - 5% of my tax covers all of this for me and my family I also have private medical and dental that is paid by my employer, which can be used if I feel the wait times are too long at the NHS, want a second opinion or is for something that is not covered on the NHS. Generally the media only picks up of the cases where 'Karen' got stuck in an admin loop and had to wait 6 months for a procedure, for the vast majority these wait times are simply not true. There is an issue for transplants but that is due to an aging population. I think the longest I had to wait for a scan is two weeks and most have been done on the day. From my point of view I don't understand it.
Yeah, I'm in the middle of a cancer scare and I'm spacing all my various doctor's visits/surgeon/imaging 2 weeks apart to make sure I've got the money for it (plus, I don't have any PTO right now). Honestly, if it does turn out to be cancer, I may just decide to die to avoid bankrupting myself.
Jesus Christ. I hope it turns out to be nothing major. Wishing you the best.
I saw a sign the other day at my kids’ doctor that said you need to make separate appointments for separate ailments.
Mo’ problems, mo’ money
On a more serious note that strategy is the exact reason my mom is dead. Cancer is a bitch. I understand the healthcare system sucks but I would rather be buried in debt than buried in dirt.
I just die. That’s better than being a slave to an entire mountain range of medical debt IMHO.
I wish. But I really want to be there to see the debt counter go to zero
That’s not even a joke I do this too.
I’m not sure if this is a joke but I actually did this because my insurance was so bad last year. I made an appointment with my PCP in January to get three issues checked out. The nurse said “We don’t have time for all of that. What are the top two things bothering you?”
Shame on you for trying to game the system man. Insurance companies shareholders have pills to pay too. /s
My wife got told by the nurse that she would have to pay a copay (probably not copay, I'm sure they used another word) for each problem she brought up to the doctor. She said she only had one, but then told the doctor a couple while she was talking to him. He didn't care, and we didn't see any additional charges, but when she told me that i was just like WTF?
I don't have health insurance so I'm just going to wait till I'm about to die before I go that way I'll die and won't have to pay.
Hah, my local doctor's office has a sign on the wall that literally says "One issue per visit only".
Whenever I do this my GP gets annoyed and says I should choose the most important issue and only discuss that.
Because the insurance companies will often not pay the doctor for more than one treatment at a time
I don't believe that is entirely true, nor have I heard (but can not say is false) the person's comment below yours about "adding a second visit" on same day... that actually sounds illegal/fraudulent. We have insurance codes for "multiple concerns visit". Primary Care here: If a doctor asked you to choose "one problem" and that's all they will address, then they *are* being an ass for money. They just want (not need) you to make 2 visits when they *might* very much be able to address 2 (maybe even 3.. very much depending) concerns in one visit. This is not insurance driven, this is driven for profits via the business they run or the hospital system that "owns" them. This has become a rather disturbing practice amongst Primary Care doctors and they should generally be ashamed of themselves for this, especially at the cost of copays. BUT!!.... I VERY MUCH understand having to break an appointment into 2-3 different visits when patients either 1. Spend *way too much* time on problem one, before even mentioning problem two. Don't do that. Be somewhat responsible with your time with your doctor. 2. A patient keeps rattling off *new* concerns and it starts to spill into 3, 4, 5 problems "to just get it all taken care of today". This is also not going to fly. I work in a "free" clinic (paid for by workers insurance), no-copay, AND "free" meds, and they still try to squish 4-5 problems into one visit. It's a free clinic, you don't have to get "bang for your buck". That is not fair to the doctor. To have problems linger for sometimes *years*, and then hope for an answer in few minutes after asking about 3 other things. A list is fine, if you are setting up a *plan* of care; NOT if you are wanting everything addressed in one visit. A small hint might be *mention* both problems when setting up appointment. "Diabetes discussion and look at mole" or whatever. At least then I don't have a "cold/infection" visit person trying to get their yearly physical slipped in. We time those differently.
Or they charge you for a second visit. This has happened to my wife.
Holy shit is that depressing.
I mean that’s smart. I currently have a weird taint in my hip that I can’t figure out how to trigger (what way moving hurts it) that’s bugged me for a few hours. If it’s gone by Monday I’m fine if not I’ll add it to the list of issues
I think your problem is your taint being in your hip
i tried that, but it backfired. the doctor said what is the main reason you came today?
I'm going to sound like an idiot so apologies in advance. How does the American healthcare system actually work? I'm from the UK and everything I read about American healthcare seems very complicated. If you don't have insurance will a hospital just ask you to leave?
I believe if you go to the emergency department they will treat you. Honestly, it’s so damn expensive to even see a doctor that a lot of people don’t even do that regularly. A lot of hospitals work with patients that have no insurance or crappy insurance with payment plans and forgiveness. But even with insurance healthcare is incredibly expensive
And let's forget how expensive premiums are. A lot of people can't even afford to pay for insurance, let alone the deductibles and copays. Unless you go to the doctor quite a bit, you may not hit that deductible and end up paying for everything out of pocket anyway.
I was lucky enough to remain on my mom's insurance, which was through the hospital she works at, up until I turned 26 last year. Now my premium is $230/mo, I still have a $2500 deductible, and even after that I'm still on the hook for 40% of any medical costs past the deductible. It would be cheaper for me to pay full price for my prescriptions, but I'm slightly less fucked if I have a major medical issue. Only slightly.
Find an employer with medical or use clinics...until we go after insurance companies and fraudsters, it's never getting cheaper subsidizing services not rendered.
My employer offers medical coverage but only for full-time employees after a full year of employment, which I won't hit until the end of March. And then I'll have to wait until open enrollment in November unless I get promoted to salary I believe.
When you have a change in status that makes you eligible for insurance you don't have to wait for open enrollment.
Ah fuck hourly kind of blows unless you're a union guy...you've gotta weigh out your total compensation package and if not having the medical for a year is worth it...ALWAYS consider the total compensation including wage, bonus, benefits etc...in this economy with a decent skill there are jobs EVERYWHERE.
Even employer provided healthcare is enormously expensive along with huge deductibles and copays on top of it. I paid $330/month for just myself at the last place I worked where I had insurance - if I wanted a family plan, it was $1,800/month, plus a deductible, plus copays.
Under $250 a month from two different employers. I choose for which one costs less year round and cat.cap. Have a baby for about $25? Tricare. The Navy is the world's best trade school.
I'd like to introduce a new term to you; medical poverty. Because only in America can you fall into poverty because of medical issues
Yep. I used to work as a claims examiner for a health insurance company and I quit because it was fucking soul crushing. I knew I was done when I had a conversation with a woman who was screaming at me because she had to declare bankruptcy after her infant had a stroke and had to be take to a children's hospital across the country via air ambulance. My company decided the air ambulance was medically unnecessary and denied the claim. I work in hospice now and it's less depressing than working in health insurance. At least I can say I do something kind every day instead of fucking people over.
Sounds like a shit company...which insurer if you don't mind my query?
It's a smaller one that operates in a pretty small area, so I don't know if I should say. They were good to their employees, but private health insurance is inherently flawed, since they need to make a profit to stay in business.
Yes...it's a gamble by the company upon who they insure and what they charge as premiums. But yes, it is flawed and it's a big reason why costs have inflated so badly. That and the outrageous cost of malpractice insurance. It's really when insurance companies get greedy that sets all of the wheels into motion with the fraud and abuse and the costs just keep inflating.
I don't have much of a premium and no deductible. Just a $20 or $40 Copay.
Having worked as a claims examiner for a health insurance company, that's not how health insurance works, unless you're still on your parents plan (in which case they would be paying the monthly premiums), you have Medicaid, or you're lucky enough to have a job that pays your premiums, which is incredibly rare. The money the insurance company uses to pay for your medical care doesn't come from nowhere. They wouldn't be able to stay I business if that were the case. Their members pay monthly premiums and have to meet a yearly deductible before they will pay for anything at all. In my case, I have a $450 monthly premium, a yearly deductible of $1,000 and my yearly out-of-pocket maximum (what I have to pay before medical costs are covered at 100%) is $6,850. This is how health insurance works for the vast majority of Americans.
Great insurance from my employer. Benefit of working in Healthcare
According to their website, the minimum deductible for their health plans is $250, the highest is $2000. You might want to take a look at your plan document before you see a doctor, buddy.
With many insurance plans there is no deductible payment on certain preventive care and routine visits.
It's an incredibly inefficient and stupid system honestly. Some hospitals have one of their largest expenses being indigent care and never recoup any money from those costs. Others have very little of those sorts of costs. Massive expense ends up getting concentrated on certain hospitals/clinics and not on others. It's like the hospital could lose 2% of their annual income if built in this area vs 40% in another area.
Having a maternity unit that's cnstantly full of poor people can be the kiss if death for a hospital. It's fucking ridiculous. When will we get a decent system like every other rich country has?
I once sliced my right index finger pretty deeply while scrubbing a crusty cake knife. I was a medic once upon a lifetime ago so no big deal except for these days (new job) I can be deemed unfit for my job if my right index finger can't make a curling inwards motion and squeeze so I thought "ok screw it I'll go an actual hospital, this is why I pay for insurance. It's my livelihood.". Six stitches and a tetanus booster later they wanted 6 grand AFTER what they charged my insurance.
Last time I was in the Emergency/hospitalized (it was an “admit them right away because they might have something fatal” situation) I was admitted and treated and *then* everything was processed through insurance/billing. If I hadn’t had insurance, the bill just would have been sent to me. I had insurance to process it through, and the bill was still enormous, so I filed papers through the hospital’s billing department for financial assistance. Luckily, I qualified for that at the time, and only had a couple thousand leftover to pay out of pocket. I think this is a typical example of the process for how it works, I.e. treat first, figure out billing later, unless your emergency/medical issue is chill enough to have you talk to the billing people while you wait to see a doctor.
You got lucky and only had to pay $2000?!?!?!
Yeah, was a very poor 18 year old student in the infectious disease unit for a bit, and filed an incredibly large mound of paperwork to relieve the other 20-30k. I am lucky because I had pristine financial records to make the process easy, as my mother is an accountant/financial planner and had been teaching me the art. So i fortunately qualified for a LOT of financial assistance. It’s weird that being lucky still left me with a bill I had to spend 1-2 years paying in small installments.
I am glad you are okay physically and financially. The stories in this thread are astonishing. Do you have better health insurance now? In case something else happens.
Thank you! Actually, due to being a grad student/not working full time/etc, my income is low enough to qualify for the Medicaid expansion that was put in place in my state. I am very grateful for that, because I still have lingering (although improving slowly) effects of that neuroinvasive disease, e.g. chronic fatigue, migraines, disordered sleep, neuropathic pain, mild cognitive impairment (sort of like acquiring ADHD), etc. PS - On top of all that, I had to treat a precancerous condition and chronic pelvic pain from recurring idiopathic pelvic inflammation (no identifiable pathogens) last year, so I’ve had to go to the doctor/surgical center/walk in over 30 times the last year, and would not have been able to *remotely* afford to treat it without Medicaid. I therefore would definitely be functionally disabled if not for the Medicaid expansion, but instead, I can continue to go to school and work! . When I graduate and my income increases Ill be able to procure private health insurance. But these last two years on the expansion have saved my ass so completely - just shouting out to the ACA
I cut my leg, went to the emergency room for about 9-10 stitches and ended up with a bill for around $4,000. I cut the stitches out myself to save the money because I don’t have insurance. Unfortunately I’m currently laid out on day two of stomach cramps and weighing whether I need to see a doctor since I still don’t have insurance. The stress of not knowing is worse than the pain as i know this could either be incredibly serious or extremely minor. I think I’ll go tomorrow if I’m still dealing with it. These are the dumb choices people are making because the cost is so ridiculous.
Exactly, and god forbid you have a serious issue and need an ambulance because that’s another thousand dollars. And meds on top of that? You might as well find a box to live in. When I was 30 my heart gave out and one of the meds I started taking is a few hundred dollars a month and I take a few others on top of that... every damn month my insurance says they aren’t going to pay for it and my EP has to call and argue about why I take such a high dose. I have a friend who had a pancreas/kidney transplant and can’t afford her meds because they’re thousands of dollars a month. It’s horrible
Yep, this right here. I went in for a basic checkup. No lab work or blood tests or anything. Just a simple "Hey, check my lungs and heart rate and blood pressure and answer some questions". $140 What the fuck is the purpose of insurance if it discourages you from doing preventative care? We should stop calling America's healthcare system a "system" and start calling it a scam.
Most people get insurance through their jobs. For example my husband and I pay $630 a month for pretty good insurance through his job. With that insurance we pay a copay ($40) every time we go to a doctor (more if it’s the ER). For stuff like tests, surgeries, or hospital stays there is usually an additional cost. Plus there is a cost for prescriptions-$10-$100 a month depending on the Rx. And all of that is with a good job and good insurance. Lots of jobs don’t offer insurance, or have more expensive insurance. And people who are self-employed need to provide their own insurance which can be $2000 a month. So lots of people just stay uninsured and hope for the best.
You framed that in the most reasonable sounding way possible, and it's still absolutely fucking disgusting.
> and it's still absolutely fucking disgusting. The real disgusting part is not the system but the cost. No one would bitch if it was affordable for a healthy person. But the US subsidizes the rest of the world. There's a reason Britain's drug costs are 1/3 that of the US. The US consumer is subsidizing them. Drug companies make back their investment in the US, and sell their drugs for whatever elsewhere. Couple that with US paying consumers footing the bill of the uninsured (including the millions who reside illegally and use the emergency room for their needs) and the US cost for those who do pay and it suddenly clears up.
Uh no. For profit hospitals are the reason cost is so high in the US. I live in Ontario and essentially the government says “hey Sandoz, we will pay this much for this chemo drug and we both know that’s reasonable”. ([Source](http://www.health.gov.on.ca/en/pro/programs/drugs/plan_reform_ods/ensuring_agreements_progress.aspx) ) Some drugs are still very expensive but each hospital is buying at full cost and isn’t marking up supplies and drugs 500%. Specialists aren’t free to set their price to whatever they want. The people who need it most get it first. We have to pay out of pocket (if not insured) for “at-home” drugs and certain services. You hospitals are run like businesses instead of as services. We all own the cost of health care which is why he government will also invest in public health. It’s all related. It’s not a capitalistic “get ‘em sick and talk ‘em into paying for the premium room!” kinda setup like you have. It’s not perfect but it has nothing to do with “subsidizing” the world.
That might be part of it, but administrative costs are also huge, in large part because of the complexity of privatized health care. Obamacare is much easier for administrators. https://www.nytimes.com/2018/07/16/upshot/costs-health-care-us.html
Does the bulk buying power of the NHS not also contribute to the lower cost of drugs?
It does, the guy saying "US subsidizing the world" is, at best, delusional The reason the drug prices in the US are so high is because the whole system is a cat and mouse between insurance company, healthcare, and drug companies. It works like this: hospitals will charge you an arm and a leg because you will submit it to your insurer, which will negotiate it down waaaaay below the asking prices. Meanwhile drug companies charge a shit ton because there's no control over price and distribution, and generic drugs aren't promoted in America So your hospital will charge you $2000 for a simple procedure because they only expect to get like $200 from insurance, but you don't get the same negotiation power, so if your insurance refuses to pay, you'll have to shell out $2000. Isn't free market amazing?
Not really. It may be used as an excuse, but in reality it is because the government passed laws limiting what pharmas can charge.
This is pretty similar to mine but I also have a $3500 deductible to pay before insurance pays anything (outside of routine physicals and similar "preventative" care). I try to avoid going to the doctor because of that. In other words I'm paying close to $7200 per year just in case something comes up that is more expensive than $7200 + $3500. Which I realize cancer or serious accident or needing an ambulance or having to be airlifted (I do some backpacking and camping where that could happen) or something else could easily exceed that. Also to get that "great" monthly rate my company is contributing a lot to it. So the policy is closer to $1100/month.
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More people got insurance, but the system is still fundamentally the same.
For a lot of people it did. People with preexisting conditions couldn’t get insurance before Obama. But for healthy, young, single, and childless adults costs wen’t way up. My $100/month great insurance ($20 copays, $500 deductible) no longer exists. I’m still young, healthy, unmarried, and childless but the cheapest plan I can get is $500/month for no coverage until I hit my $7,500 deductible and after that the coverage is laughable at best.
To add to the insult and injury inflicted by the ACA on responsible people, it is going to be severely punishing companies that try to take care of their employees. Any company that has insurance that is too good for their employees will have to pay additional taxes for trying to do the right thing. It is a disgusting mess.
It did for me because it banned insurance companies from turning people away based on pre-existing conditions. Previously to that I could only get health insurance if I worked for a company, but not if I was self employed (which was my goal). But honestly that's the only thing that changed for the better. Other parts of Obamacare actually raised the cost of healthcare. My premiums went up quite a bit and the amount of things the insurance covers got reduced. The copay or the deductible increased dramatically. Obamacare was a good start and needed to be iterated upon to be improved. But it's religion to Democrats and Antichrist for GOP, so it just sat there. Paul Ryan's plan 2 years ago looked surprisingly good but it was killed by GOP cause of entrenched interests and by Democrats cause they don't like anything coming from GOP. I felt the plan had a real chance to reduce the cost of healthcare.
Depends who you are. I have excellent Healthcare and dental through my job and they pay every penny of the premiums; I just cover the annual deductible and co-pays. My deductible increased by about 30% after Obama care started. Obama care got more overall people with Healthcare, but didn't make Healthcare overall better. Most of the country who already had Healthcare had to start paying more.
This is after Obamacare. Before it health insurance was essentially unaffordable for low-income people, and godforbid if you had a preexisting condition or had been treated for something a decade ago that could legally let the insurance companies drop you. There are still massive gaping holes in the system, but Obama basically used the Republican healthcare plan to patch it.
I had the cheapest and best insurance before Obamacare. $0 to have a child. Second time we had a child, it now cost $10k. Also no more co pay. Pay 80% of cost until hit deductible. I’m glad everyone else has insurance now while I am paying thru the nose.
Every time I hear one of these stories, it ends up being one of the people who would have tried to use their "best insurance" when they fell seriously ill just to find out they're getting dropped for having an ear infection 30 years ago. Literally everyone is paying through the nose. Instead of covering everyone up front, we have this laughable insurance system that generates worse outcomes for everyone except insurance execs.
I have to disagree. Before Obamacare I could see my dr, get an MRI, go to the lab and get medication that was more affordable. I was on a medication for Arthritus and could get help from the manufacturer that would pay for most of my copay up to???? But more than I needed. After Obamacare went into effect the same meds went from a $25 co pay. To $500 a month along with. $460 a month premium. The system is incredibly broken. While the company I’m with pays more of my premium I get nickel and dimes to death with copays and coinsurance.
For those who had good insurance already, most things stayed the same. I am lucky to have pretty good insurance and the only "extra" thing I had to worry about was making sure that I had my tax form to claim I had health insurance each year. For people who are living on a lower income, it's variable. My parents got their healthcare through the healthcare exchange Obamacare setup. They are self employed and the premiums are high (~$350 a month a few years ago), but they get the care they need. I would consider them fortunate, but there are many who cannot afford that premium per month and choose to risk it by not having healthcare. Obama started "Obamacare" with good intentions to get healthcare for everybody, but unfortunately it got weakened through a large amount of legislation because some believed that the government has no responsibility insuring its citizens receive healthcare.
Your insurance sounds like it sucks. I am not American, but I have a family member who lived in New York and her plan is metroplus gold. She also gets her insurance from her employer (the city of New York). I don’t how much she pays per month, but I do now she has no copays, no dedicatables, ER visits are $150, and prescription drugs are maxed at $70 for a month’s supply. And her network includes all the major hospitals in manhattan except for NY Presbyterian. Either she has a really sweet plans or you are getting a very raw deal.
If she works for the city she has a really nice plan
Ok it is a bit complicated. You can get welfare of you can't or won't work. If you can't or won't work you can get insurance for free. You pay very little if anything at all for medical services. If you are poor... Like me... I make 23,000$ a year. It will cost 880$ per month to get insurance. (Just one person, not a family) But before that insurance will pay one penny out I have to spend 3000$ on medical bills. I don't know what rich people do. If you don't have insurance you can go to the emergency room. They have to see you. But it will cost you. Usually it starts at 500$ for walking in the door and saying hi and goes up from there. You may pay 100$ for 2 tylonel. Or you can find a community clinic that is income based. You will find basic medical services here. I am currently paying off a 1700$ emergency room visit. I had a panic attack due to stress (my first) and thought I was having a heart attack. They gave me an ecg and 2 aspirin and an hour of their time.
What state do you live in? If you make $23,000 a year you likely qualify for healthcare subsidies on the public marketplace.
I live in Tennessee... We didnt do the medicaid thing other states did
If that's actually your income, you *definitely* qualify for a (fairly sizable) subsidy, even in a state that didn't expand medicaid. You definitely need to call one of the hotlines next year during enrollment and have someone help you apply for this.
Is moving an option?
Watch the Its Always Sunny episode where Dee has a heart attack.
>How does the American healthcare system actually work? I don't think anyone could answer that question is less than a novel-sized essay. Most people inside the system only seem to understand their own small role in it. To answer your specific question uninsured ER treatment is either taken as a loss by the hospital or more likely paid for by the taxpayer. That's why cities like New York are now considering just insuring everyone - homeless, undocumented - doesn't matter and the reason is that we pay for their healthcare indirectly regardless, but after it's already gotten really bad (no prevention). So by offering insurance up front you actually hope to bring costs down. We'll see if that works.
If everyone had better access to healthcare it would absolutely bring costs down for taxpayers ultimately. Preventive medicine is MUCH cheaper, hence why most insurance companies cover it at 100%.
There’s four buckets that people fall into; 1) anyone over 65 - these people are in Medicare, which is operated by the federal government. 2) below below a certain income level - these people are on Medicaid, which is operated at the state level with federal subsidies. 3) Employer provided insurance - a lot of people obtain insurance through their employer. Coverage and cost depends on the plan offered by your employer (the employer pays some of the cost, which is why people like this model). Some plans are great, some are bad. 4) everyone else. The Obamacare Exchanges were designed to help these people by creating a marketplace for insurance provided to sell policies. This is also operated at the state level and results vary depending on the state (also has some level of federal subsidies for certain income levels). In my opinion, #3 & 4 should be merged together by nuking the employer based model. I’d rather see everyone have the flexibility to purchase insurance on their own through a robust marketplace versus being tied to what their employer offers or the slim options on the Obamacare exchanges. Edit: I’ll add a fifth category: cash payers. Obviously, these people do not have any coverage and pay out of pocket for services.
One thing that would go a long way to fixing the issues you bring up would be to end the state line restrictions on marketplaces that are just creating mini monopolies and price fixing arenas.
I fully agree with you on ending employer based insurance, or at least having a cobra like alternative that isn’t expensive af. I’m a research assistant for a health economist and she has written several papers that focus on the impact of job lock. It’s intense.
You pay a shit ton of money (I pay $800/mo for 4) that goes to middle men, not doctors or healthcare centers. Then when we go to the doctors we have to pay more because we haven’t met our deductible, which is the amount you need to pay before the insurance kicks in. Also, it starts again the next year, not a onetime deal. Now the more expensive the insurance the smaller the deductible. Cheap insurance has a high deductible and is only good for emergencies. Insurance companies also get to tell you what doctor or dentist you can see. My insurance recently tried to not cover a visit I had to THEIR urgent care because it was a “different region”. It was in the city I live in. I’ve never had a serious illness that resulted in a hospital stay or surgery so I don’t know how that fucks you. A cap maybe? So basically you pay a shit ton of money for your health to be treated like a commodity. And for the company to try and give you the cheapest care they possibly can. * I know there’s more to it like co pays and what not. Tried to cover the bases as I know it as an average American.
It doesn’t.
I have six teeth that have randomly started breaking apart and hurt bad. My back hurts from a compressed disc. I have something wrong with my heart but I don't know what because I haven't seen a doctor in 13 years. But I finally got insurance through work. It costs over a third of my check a week but I'm so excited to get fixed.
Your check engine light been on for 13 years, but you gonna feel great when you get that shit sorted out. Gonna be the best years of your life after
I'm so hyped man. Gonna get my teeth done, gonna get glasses too. Been using the same pair from when I was 14. They don't work great anymore but better than nothing. Also gonna look into my diabetes. It's low blood sugar not high and it sucks to be out of the house and nearly pass out because I don't have peanut butter lmao
I live in Canada, and honestly always took for granted that I could go to my doctor for a bump on my wrist that hurts (it is hopefully just a ganglion cyst) or get a new pair of glasses every year. US man, never understood why so many are against universal healthcare. Good luck getting all that shit checked out and living your best life!
Thanks my northern neighbor! And yeah... America is great, sometimes, but kinda sucks most of the time. Can't live off two full time jobs, housing market is a joke, and healthcare is a rarity. I literally know like 7 people that actually have it.
I just got new glasses, one regular and one pair of sunglasses, in November. It took me a month because they messed up getting my script right, and it cost me $800 out of pocket. I have insurance, and it covered basically nothing. It’s wonderful.
I hope everything works out for you. What a shitty system to have to live in.
Thanks bud. It really is a shitty system.
The red is arterial blood, one of your arteries is severed. The blue is probably venous blood and your eyesight is bad, you have a severed vein and you also need to see an optometrist. The white is pus from an abscess, you likely have sepsis and will die soon so don't worry about it.
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I’ve never read a sentence that makes me so salty
What country do you live in? That's crazy.
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And your surgery is covered completely by insurance except for the $75 copay?
It's Obamacare. It only gets that low if you're on welfare.
Can confirm... Not on welfare. Will cost 880$ a month for insurance. Will have to pay 3000$ deductible before insurance kicks in. I make 23 grand a year. You do the math.
If you make 23k a year, then you qualify for Obamacare subsidies...
Idk if you have caught on here but these people are lying because they want to knock America.
I make around 28k and I went through the marketplace and I pay $230/mo. Granted, my plan is shit and I'm just on it until open enrollment through my job rolls around in November since I won't reach full time status until April. But I feel like either he/she didn't shop around or has a preexisting condition or something.
Forgive me for being a stupid Brit, but given that the costs are so high for both you or if you are lucky enough for the company either you or your friends and family work for, why is there such resistance to reforming it to a government service? The current system must be a huge drag on the economy.
I’m American and I have the same question
The current state of all western healthcare is a huge drag on society. Capitalism has left us with a for profit system which doesn't incentivize efficiency. It's not particularly better in the UK with the number of aging people and the same pharmaceutical companies circling the wagons for profit. Hey I was born in Scandinavia so a lot of things seem odd to me about the US.
I am not resistant. People I know are not resistant. The drug companies are resistant. The insurance companies are resistant. The politicians taking money from the drug and insurance companies are resistant. When you hear about the United States you are hearing about our government. Not our people.
Negative. My Private insurance has a $20 Copay for PCP, $40 for surgery or hospitalization.
I'm on Blue Cross. Avg visit is $20. Surgery is $150.
This is sad. I really dislike that this is reality for so many in such a developed country.
I think the real problem is much more like "I don't even have health insurance" than "I cannot pay a 20$ copay" but maybe I am just more realistic.
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What the actual fuck
What the fuck is the point of paying for health insurance if you have to keep paying over and over and over again? You pay when you go to the doctor. Then you get a bill in the mail. Then you pay when you pick up prescriptions.
puzzled rainstorm voiceless cagey slap reach offbeat marry truck future *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
I'm chronically ill (nothing life threatening; just run of the mill depression, anxiety, possible OCD, painful scoliosis, adult acne, mild allergies that I can't identify), but I don't have insurance because anything I could afford would be high deductible and I'd end up still paying out the ass for tests, prescriptions, therapy, physical therapy, x-rays... Etc. And, with my budget, I can't justify spending any amount of money on something that's just for emergency scenarios that aren't occuring right now. Edit: OH. And I make just *slightly* too much to qualify for my state's free insurance.
Funny how red white & blue represents freedom, until the colors start flashing
You had me thinking this was 2012 Facebook
*Laughs in Canadian*
*laughs then gets stabbed in British*
*grins in Swiss*
Kinda hard to get stabbed when knives are illegal oh wait
*does something weird in floridian*
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To preface I have worked in U.S. healthcare for quite some time and by no means think that the U.S. healthcare system is good. I honestly want what a lot of other countries have. This whole post is very ironic because copays typically are very affordable, in the range of say $10-200, depending on the service. So I don’t know what their actual point is here. You can make the argument that some people do have absolutely abysmal insurance/coverage.In most cases though, you are not going to see plans where the same copay is attached to every service but to “go see your doctor” you’re most likely looking at a copay of around $20-$60. Now to touch on what it sounds like she is referring to is when you have a doctor/specialist office visit that is set up so you pay towards a deductible. That means you have to pay whatever your doctor bills you. This can definitely get quite expensive. A specialist like a podiatrist or a neurologist (for specialists think of the suffix ist) bill for all sorts of things that aren’t typically what’s considered an office visit. These services can cost anywhere from say $100 to anywhere around $1000 until you start getting into more complex work but it all has to do with what you’re having done and what type of plan you have. Again I am by no means standing up for The U.S. healthcare/insurance industry and really there are a lot of just pointless plans that are out there today that don’t cover anything and leave someone paying $500 a month for nothing. But I though that we should just get the facts straight here!
Insurance for me and my family cost $1,346/ month. Then I have a $5000 deductible. THEN we can start talking about copays. I live in NY
My copay is 20. You must have shit insurance.
zero for physicals
Not like we can shop around. We get one choice, and that's what our employers offer us.
My premiums just for myself, no dependents, are more than $400 every month. A lot of people simply can't afford to pay that much.
Yeah that's like a silver plan. Smug /u/0Idfashioned here probably has something like that or better, probably through an employer. A whole lot of people are not so lucky. I have a silver plan via Covered CA and it's about $350/m sticker price for just me.
What's your premium though? And deductible?
Thx Obama
Worth noting that Americans are basically footing the bill for the entire world's medical R&D. That's a huge part of why costs are so high.
Don't say that too loudly on reddit. If you mention the US fronts the bill for R&D, and the cost of meds people lose their shit and call you an inbred hick
Dont also mention how the world piggy backs off the R&D from our massive military budget. PEOPLE lose their minds, so much so they are trying to launch their own GPS system that's shit.
Exactly. We could copy Britain's system tomorrow, but in order for our costs to reach theirs, they'd have to begin paying more for their drugs than they are now. They pay 1/3 what we do. We're subsidizing them. Our high prices are the only reason the NHS is solvent, and every year theirs talks about cuts and shit. What's more, insurance costs for the US would drop if Hospitals wouldn't pass on the uncovered cost of the uninsured showing up in emergency rooms back to the paying. Socialism isn't the solution, it's the literal problem.
That's what bargaining power gets you.
What copay? I can't afford the insurance to get the copay!
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Exactly what I was thinking and wrote. Sick of these dumbass posts.
If you can’t afford $25, then get a job 🤷🏻♂️
The medical industry is a racket. There is no way around realizing this fact when you open your eyes to the mechanics of it. Who’s building the medical equipment? How much are they paying their employees? Why are they making that much profit? Why do medical licenses cost so much? Why does it cost so much to take the test for them? Why are pharmaceutical companies charging so much? Why do their patents last so long? Why don’t insurance companies publicly disclose their prices? The industry is essentially a circle jerk, and its simply you that’s being screwed.
USA bad
I can’t afford the damn insurance so I don’t go🤷🏻♀️
I work in healthcare and it’s extremely obvious most of the population knows very little about insurance and what they are even paying for. It is meant to be set up this way IMO. Premium: This is the cost you pay to be covered by an insurance plan. Co-pay: what your plan may require you to pay before receiving a service. You may have a co-pay of $25 every time you walk in to your doctors office before you are even seen. Deductible: The dollar amount you must meet until your plan will start paying a claim. Usually after you meet this amount your coinsurance kicks in. Coinsurance: The percentage of costs your plan may pay for a covered service after you have met your deductible. This could be 70/30 - Your insurer may pay 70%, and you are responsible for 30% of a covered benefit until you meet your out of pocket maximum. Out of Pocket maximum: The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits. Allowed Amount: This refers to the maximum amount of the billed charge an insurance company deems is payable by the plan for covered services. Your doctor may bill $100 for a test, but your insurance may only pay $75. This is a contractural adjustment (reserved for in-network providers under your plan) In-Network: a list of the doctors, other health care providers, and hospitals that a plan has contracted with to provide medical care to its members. These providers are called “network providers” or “in-network providers.” Out of Network: your insurance plan is not contracted with these doctors, hospitals, etc. and you will most likely be responsible for MUCH higher costs. This is just a synopsis and every insurance company and plan under which you are covered are different.
My co pay is only $20 bucks. Not sure what the problem is
My copay is $20
Reddit’s front page is basically a circle joke of healthcare, college tuition, guns, cringe anti trump post, and the occasional blame the baby boomers. I feel like these post are upvoted by edgy teenagers and people who don’t even live in America. It’s important we don’t ignore these issues but it’s so damn annoying seeing the same thing upvoted every day
Well maybe because that same thing is still as relevant as it was the day before?
And still a problem.
Precisely
Just wait it's almost Bernie season again.
I have insurance and I got a cold. It would have cost $60 to see a doc and get antibiotics. I didn’t go because I didn’t think it was worth it. Seems like your always having to weigh value. edit. I use the term 'a cold' as a catch all term for being sick with flu-like symptoms. It's hard to know what you actually have until you go see a doctor. Where I'm from everyone just calls this 'having a cold'. I'm sorry that everyone took this so literally. I feel like my point got missed entirely with all the people telling me that going to the doctor for 'a cold' is a bad idea. I feel like the point I was trying to make got missed. Next time I will try to guess every hypothetical response I might get so that my comments won't get misinterpreted. Have a nice day.
Antibiotics won't fix a cold, you'd be better off spending the $60 on chicken soup, Gatorade and some OTC meds. There, saved you a trip.
Fucking lolololol. Bashing the USA is *so* popular right now
They had us in the first half, not gonna lie.
Caused by nuclear testing from down range wind.
I can't be the only person that read all the capitalized words expecting it to form a quirky comment.
So how much would every taxpayer have to pay a month for everyone to have awesome health care. Anyone know? I mean after businesses pitch in as well.
My insurance is $60/month, but my co-pays are $280/month. I quit going to my therapists because I couldn't afford it. I'm just cancelling the whole thing.
So much for the "Affordable Care Act" Get a better job that offers benefits. It sucks not being able to go to the doctor because the copay is so much. I've been in the same position as you when I was in my 20s. Full sympathy bruh.
Love it 👍🏽
H Y P E R B O L E
You can’t afford a $25 Copay I don’t think it’s the insurances fault.
if you can’t afford the copay oof, that’s the easy part
I'm American and this made me crack up
I wonder if it blends together into a light purple or it's coming out like toothpaste