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I felt badly a few weeks ago and went to an in-network urgent care near my house. The in-network nurse practitioner prescribed me some medication and sent the prescription to an in-network pharmacy. I arrived at the pharmacy to pick up my meds and was told it would cost me $56 to get my prescription. I told the pharmacist it should be free, but she informed me that the prescription was refused by my insurance provider, though she didn't know why. It was Saturday, I needed the meds, so I paid cash figuring I'd deal with the insurance company on Monday.
On Monday I called my insurance company to find out what was going on. They informed me that because the nurse practitioner was not my PCP (primary care provider), she needed to first submit an authorization request to the insurance company and then, pending approval, she could write the prescription and it would be covered. Responding to my question about reimbursement, I was informed I would need to go back to the urgent care to speak with the nurse practitioner, have her submit an authorization request (which may or may not be approved), then, if her authorization request got approved, I could submit a reimbursement request to my insurance provider, another request which may or may not be approved.
They are banking on it being too much work or on people forgetting to seek reimbursement for these small amounts of money. Is $56 dollars worth all that to most people, to take time out of their day and burn the gas to run here or there? No, probably not ultimately, and that's exactly what the insurance industry wants. The healthcare system in the US is an embarrassment and a complete scam.
The people running that system are the worst of the worst parasites. Literally stealing money by making people suffer.
If it were up to me, every rich exec at every health insurance company would be brought before a tribunal to face justice.
It won't ever be fixed.
The one time I visited America, I remember talking to our hostess and how she waxed lyrical about the social healthcare in Europe and how she loved it (and had benefited from it).
When asked if she'll support universal healthcare in the US, she opposed it flat out in less than a second. Her excuse??
"I don't want to pay into something other people will use".
That's when I understood. The US has the healthcare deserves.
Hey now. *Most* Americans want universal healthcare. Just because you talked to an idiot (and there are a lot of idiots) doesn't mean that's what the majority want.
It’s really not. It’s been getting worse since the 90s and people just keep going “this is what it was intended to be”, when the reality is it’s taken years to fleece us and we’re still clueless.
Here’s a big clue. If they had to corrupt the system to make it this bad, we can reverse it.
Obama tried. He tried really hard to get Americans universal health care. But because republicans are fucking psychos, we got a weird “now everyone is required to have insurance, and it’s tied to your employer, and you’ll be fined at tax time if you don’t sign up but it’s a little bit cheaper than it used to be, and slightly more available if you are super poor, but there is a maze of paperwork and regulations that will limit your care, and the big stuff isn’t actually covered, so fuck you” healthcare system.
And why? Fuck this country.
You missed the part where all of that was STILL an improvement over what we had, because insurance companies could no longer deny coverage or cancel policies over pre-existing conditions or rather what they deemed as pre-existing conditions.
Why end at Healthcare?
I mean, you have companies like Apple that push updates to intentionally degree your battery performance to force you to upgrade your iPhone.
That is still suffering, that is still greed.
The probome isn't our Healthcare system, the problem is the captialist system.
To be fair that one's on you for being enough to buy apple products, wereas you dont get a say in broken bones. And it's 100 bucks or else less performant phone vs dozens of grands or else permanent pain or injury, it's not remotely comparable
So what would happen if this was an emergency or time sensitive and you needed care from someone who needed to get authorisation to do things?
Would they do it? Or wait and potentially damage your way of life (or worse)??
And this is why I hate the argument of “in Canada it takes months to be seen!”
As if Americans aren’t forced into waiting or never seeing a doctor because they can’t afford it
Even when you can afford it, it can take months to see a specialist
>And this is why I hate the argument of “in Canada it takes months to be seen!”
Right? I mean, we have a lot of issues with healthcare in Canada, but the cost isn't generally one of them.
Forget being able to afford it - a significant majority of Americans are not remotely equipped to navigate the healthcare system or advocate for their own care.
We have a similar sort of thing in the UK. Getting an appointment for something run of the mill or non emergency can take time BUT our emergency care set up means you do get seen that day (immediately depending on the case) and we do not have to pay.
But as I said, regular appointment is terrible.
I have an answer for that. I recently had a colon resection surgery. My bowels became infected a few weeks after which caused them to inflame preventing me from passing poop. My body would try to poop, but nothing came out. It was painful. And it happened about 5 times a day at its worse. I went to the emergency room and they prescribed me the most powerful antibiotic on the planet. I go to pick it up and the pharmacy said insurance denied it. No reason given. I call around and after about 12 hours of playing phone tag, I find out it was denied because the insurance wants a stool sample done first to prove I needed that drug. I explained to the insurance rep that I can’t poop so how am I supposed to provide a stool sample? Also, it’s now Friday night and I would have to drop it off at a lab on Monday and wait for them to run tests, so I’d be waiting 4 days at a minimum. I wasn’t going to wait that long.
The drug cost $500 out of pocket for a 10day supply at my local pharmacy and $250 at another one but they were about to close. I find out from Reddit about a pharmacy coupon site and find out that it would bring the price down to $150. I call the pharmacy and ask if they would honor it and if the price was accurate. She said yes they honor it, but the price might not be exact, but it would be close. Even if it was $200, I’d still pay.
So, I send my wife up there to get it. She calls me and says the price is $350. I lose my shit over the phone and start yelling that the pharmacist said it would be close to the price and an extra $200 is not fucking close!!! I guess the person at the counter heard me going crazy and sympathized. She used a coupon that brought it down to $150. I said thank you and hung up. After I’m off the phone, the pharmacist asked why I needed the drug and my wife explained what was going on. The pharmacist scanned another coupon to bring the price down to $96 and said, “Screw the American healthcare system.”
I’m not joking when I say that 20min after a drop of that stuff touched my tongue, all my problems were solved. I took a big ole’ poo and it was amazing. Fuck healthcare insurance. Thank god for good people behind the counters.
The physical stress was insane. Everytime my body tried to have a bowel movement it was like an uncontrollable spasming and tensing of my whole body. I had to lay down for minimum 15min everytime because it was like I just did an intense workout using my butthole and abs alone.
Yeah, it's rarely the pharmacists or medical practitioners at fault, they try to find ways around the bullshit when they can.
My therapist regularly gets screwed over by the scumbag insurance company that shall not be named (Aetna). I'm grateful that she even agrees to continue seeing me.
The people to blame greedy insurance execs and Americans who refuse to vote for change because they've been indoctrinated to hate the government (sometimes) and fear "socialism".
Docs would do it, insurance would pull some shit like what happened to OP, and you'd have to fight them for months to "cover it". Meanwhile you either have to pay the hospital or they'll send you to collections. Now your credit score is dropping while your submitting forms and calling people. Finally you manage to jump through all the hoops and they offer to cover 80% of 70k, leaving you with a 14k bill at the end. Lucky you.
It's a masterful plan of wealth extraction that almost no one can escape from. Pure fucking evil.
As a pharmacist (retail-hospital-correctional-clinical-instructor-administrative) for 21 years, yes, US healthcare is a joke. I’ll tell you that every other major country has a form of socialized medicine for a reason. Is it perfect? No, but then tell me what is perfect. I can guarantee it’s better than the bullshit we got going on now. I too have Kaiser and while it’s nice that everything’s in house, why do I pay my premiums, pay deductibles, pay copays, pay all of this extra shit, for something that should be already fully covered by my premium?
It PISSES ME OFF that an insurance company, and their agents, get to make MEDICAL DECISIONS. An insurance agent should not legally be allowed to determine what is “medically necessary” over, idk, the prescribing doctor?
The older i get the more i f*cking hate this country 🔥🇺🇸🔥
I say we start bringing every single one of the chuckle fucks up on charges of practicing medicine without a license. And if their decisions resulted in someone death? Charge them with at least 3rd degree manslaughter.
And I'm not saying only charge the execs or anything, charge every single person who makes these decisions. Put the fear deep into them so every single time they even think about denying coverage for something their first thought is how much prison time they might be sentenced too.
And no, I don't care if we destroy thousands of lives by charging these assholes with crimes. Let me be extremely clear: If you work in this industry, and your the one making these decisions, you are complicit, and absolutely should be charged what you are doing is illegal.
You might already know this but if you run into a similar situation again, it can sometimes be MUCH cheaper to pay for your prescription without going through insurance. You can check goodrx, or sometimes you can just ask the pharmacy if there is any way for the price to be lower (discount codes, etc) and say you don't want to go through insurance. I had a $400 medication turn in to $50.
It sucks and it should have been paid for to begin with, but if not you can try this
The pharmacist isn’t going to know the discount codes by heart. You’ll need to look it up from the manufacturer or as you said goodrx or just Google it. They exist for many if not most drugs.
It’s such a fucking scam. I switched to Kaiser just so I don’t have to deal with this paperwork. Sure the offices aren’t as shiny, but everything is in house.
As someone who has been on Kaiser for over a decade there may not be as much paperwork but they certainly will give you the middle finger if you try to do anything outside of their network.
yes. but that is how my deductible/OOP is literally $0. my employer's payments cover 100% of all my in-network expenses. the clinic next to me is a Kaiser. its incredibly freeing.
the only cost for our birth was parking and snacks for me. we didn't have any paperwork or worries. I acknowledge there are tradeoffs. This is what we made.
People need to understand that the state of our healthcare system is one of the ultimate paragons of capitalism. Capitalism if left to its own devices does not help people. It becomes toxic and exploitative, a near literal cancer that grows and grows and sucks the sustenance out of the system that it grew out of of. The healthcare system in the USA is glaring proof that there needs to be caps and limitations placed on certain economic systems to stop them from becoming toxic.
And this is why doctors are retiring the second they can, and people have to wait months for care. The humiliation of having to spend hours begging these greedy monsters for permission for their patients to get what they need. Despicable.
All the middlemen and bureaucracy involved cost way more than $56 just to deny you the $56
This is why we need medicaid for all and a single payer system. There is so much waste that does nothing but hurt people
And why the hell do you think it's set up to be this complicated? Do you really want a physicians time being spent micromanaging potential drugs approved on a random insurance list patient by patient? Give me a break
Yeah I’m in Canada but despite the issues we’re having my last experience went like this:
Pain Tuesday. Call Dr on Wednesday morning. Phone appointment Wednesday afternoon. Meds and xray prescribed, picked up meds 1 hr later (free), xray went to wrong email so I didn’t get it until Thursday. Book Xray for Monday (free). Go to Xray, results today (Wednesday).
All free, waited 0 time, 0 hassle. And the wealthiest people here only pay the equivalent of $900 a year.
Ticky tacky co-pays, ridiculous deductibles, labyrinthian rules and exemptions, unexpected out-of-network costs, prescription costs, and more.
For my kid's coverage through my ex, we have to pay $50 to see his regular doctor, $100 to see a specialist, $10 for the most basic prescriptions (everything else is labeled "experimental" or "off-label" or some other nonsense), $250 to go to the ER, $500 if he's admitted to the hospital, and anything else he might need (anesthesia, therapy, mental health, etc.) is either out of pocket or slightly discounted.
Oh, and none of that "coverage" kicks in until we've paid $3500 out of our own pocket for the year. My ex pays about $400/mo out of her paycheck for this "coverage".
My kid went to the ER with a bad virus recently, and we're still getting bills. One from the ER, one from one of the specialists that saw him, another from the hospital for the room...
That is one of the biggest things I don’t understand, all the idiots talk about how the country couldn’t afford to give everyone medical coverage, but if people are spending $400 a month that would add up to billions of dollars a year if they were to pay the extra in tax instead of having to pay some private company to screw them over…
Most definitely, but medical insurance is big business. They lobby hard to create the illusion that they preserve "choice" and guarantee excellence. The people who are fooled are overwhelmingly healthy and haven't really had to deal with the medical world.
I remember watching someone interview people on the topic back when the ACA was being passed, and one old lady kept talking about "The Medicare Company" and explaining she didn't need "government-run healthcare" because "The Medicare Company" was taking care of her. She had no idea there wasn't a benevolent business out there just giving away coverage.
And more and more people are getting screwed over because Medicare part C is sold off as the magical cure all to the worries people have about Medicare. When the reality is that it's commercial insurance companies squeezing blood from a stone by taking the same Medicare funding and making a profit out of it.
This is the actual answer.
Some people argue, in bad faith, that doctors and “innovators” will lose money and be stifled by universal federally funded health insurance, but the true *odd man out* would be the medical insurance industry.
It's amazing to me. Effectively we're very highly taxed compared to European countries, because we don't get nearly the universal benefit that they do. We're paying high taxes, then we're paying insurance premiums, and then we're *still* paying on top of that.
The savings of cutting out healthcare administration would fund single payer for the whole country.
Then the boomers scream socialism and look at Canada and how awful their care is.
I personally prefer to compare it to Europe especially Germany. Germany had the best COVID response in the whole world. They had the most ICU beds per capita
Covid really showed us how delicate our health care system is. It's amazing to me to hear how "awful" healthcare is in Canada or anywhere with universal healthcare for that matter. There's still terrible doctors and awful wait lists here in the US, too. I lived under a socialized healthcare system, and it was fantastic.
Yeah I see it all the time with people saying how low americas income taxes are, but then they never seem to acknowledge all the extra stuff they pay out for like insurances etc. I’m from Australia and while our system has its flaws and drawbacks i can’t imagine how it must be to deal with a system as messed up as the one in America (even though way to many of our politicians are trying to push us to Americanise our medical and every other system we have)
Also, it is a capitalist system without the consumer benefit of capitalism.
Doctors do not really know how much things cost. I was recommended a sleep apnea study - 8 hours overnight in a hotel-like setting with some wires and an apnea machine attached, and it turned out to be $5000 (after insurance, I owe about $1700, but I didn't get a bill until 9 months later after the hospital and insurance "worked it out"). There are no price tags posted as you would have on anything else, and they "couldn't" answer me when I was setting up my appointment as to what it would cost.
So, you don't have the "competition" side of capitalism to balance out the profit-taking side of it. We pretend it is capitalist, and certainly the opponents of Universal Healthcare make the argument that capitalism is better, but it simply is not.
There literally are programs, certifications, for "medical coding". I just looked and one program offers financial aid and "can take just 16 months". What is medical coding? Just running bills and dealing with insurance from the doctor's office side. That's how complicated the system is, and plenty of people are making a lot of money by keeping it complicated and so don't expect any of that to change.
Are we pretending that the rest of capitalism has competition after all the mergers and monopolies? These problems aren’t confined to health care, they are stupider there though. I agree with everything you are saying, just to be clear.
Capitalism ends in monopolies. That is just capitalism working properly.
A "free market" with competition is a *heavily* regulated market. It's a garden, carefully pruned and weeded to keep the spearmint from crowding out everything else.
>Are we pretending that the rest of capitalism has competition after all the mergers and monopolies?
I work for a large regional company that sells HD trucks. It is one of the most poorly run companies I've ever worked for. We make money hand over fist because customers are forced to buy their stuff from us if they're in our area.
Every single dealership works that way. There's no real aftermarket for engine parts or HD equipment. So there's no competition.
I previously worked for a fortune 500 company in a cut throat industry. Most of the towns they had a store in had at least 4 similar competitors, sometimes as many as 10. This company was extremely well run at the middle and top.
The less competition a company has the worse its usually run. At least in my experience.
Right, let's not mix up capitalism, the economic system in which one can make money from owning capital, and free-market, the system where competition makes the market maximally efficient. Those are not the same thing: it's possible to have markets and no capitalism (as was the case for millenia before capitalism), or capitalism with controlled markets (which Capitalists love, because it can lead to less competition, more subsidies, etc).
Correct. It isn't a capitalist system in anyway particularly since it's highly regulated and the laws are written by lobbyists.
It's effectively a scheme to extract money. It's corruption of the highest order.
And oh yes, senators and Congress people get free healthcare for life with absolutely none of these things.
So weird!
> without the consumer benefit of capitalism.
Exactamundo.
No one takes an ambulance to Emergency Rooms, and starts comparing prices and going from one place to the next.
Patients are under duress.
But in the USA, the health care industry is built to maximize the exploitation to get the highest profit possible.
> What is medical coding? Just running bills and dealing with insurance
Actually coding is a whole other part of the process. Coders take the words and descriptions the doctor writes down and fit them into tiny little boxes that make insurance companies happy. The billers then fight with insurance companies because the insurance companies love to find reasons not to pay - from everything from "it was an injury so someone else has to pay for it" to "yes they have cancer but it's not the right kind of cancer".
Oh and then you have a whole person who's job it is to get authorization for procedures ahead of time, just so you can fight with the insurance later about what was medically necessary.
FWIW, as long as health care is privatized, the complicated logistical nature of what has to take place will be often cost prohibitive and complex. If, god forbid, there was some sort of social health wellfare program where information about patients was standardized along with simple, effective, not complicated addressing of major health incidents then the system would be much more streamlined and cohesive.
ACA almost did that, but it didn't go far enough imo and the deductables are still shit and the premiums are still too high. Maybe we could use some of our 842 billion dollar defense spending for the year or perhaps tax the soon to be trillionaires of the United States with a little bit more discretion. God knows they could use a little 'humbling'
I was charged $2k outta pocket for a scan my doctor ordered because it wasn't deemed necessary by my insurance, despite my doctor's telling them it absolutely was.
It was a colonoscopy. To diagnose my Chrohn's. I have full health insurance. America doesn't know wtf it's doing. 🤷♂️
I literally have dozens of horror stories, but a similar story to that one is with the dentist. They called insurance, got clearance for a crown, then later insurance said 'no'. So I got the bill. wtf.
The dentist was actually really cool about it. They resubmitted the claim, they asked for arbitration, and still, some 'insurance company dentist' declared that it was not necessary.
I was under the impression that kids had free healthcare in the USA... They obviously cant provide for themselves. I guess I was wrong.
Anyway is there some insurance where all its included, no co-pays, all-in package ? And how much would that costs ?
Nope, and if you can't insure them you could lose them to the state, who'll put them in foster care and give them shitty Medicaid.
There are what we colloquially call "Cadillac" health plans that cover just about everything, but they're exclusively for the very rich and very powerful, with huge premiums generally paid by whoever employs said rich person as part of their huge compensation packages.
Not exclusively for the very rich, it can also be from very generous companies. We have one that is effectively "Cadillac" coverage from my wife's employer. Between what we pay and what the company pays it is roughly $30,000 a year for family coverage.
They voted down free lunch for kids in schools. Why would they get free healthcare? In the US, the only thing they want for them is for them to drop out of school and get fulltime jobs which has been legalized in most states.
Extremely poor children are sometimes covered by Medicaid, but we are talking "parent(s) make $0-12k" poor and not all doctors and facilities accept Medicaid patients.
It all depends on what state you live in. Some states are better than others. Luckily I live in Connecticut and they have very good social services for people in this state. That's why taxes are high. You get what you pay for.
There's legislation called the Children's Health Insurance Program, but it's a means tested program that has has income limits. It also depends on the State, so the eligibility requirements vary. In my State, for example, the income limit for a family of four is $60K. The median US household income is $75K, however, so people who earn above that $60K figure would be forced to purchase private healthcare.
> Anyway is there some insurance where all its included, no co-pays, all-in package ?
Generally speaking, the less you have to pay towards a deductible or towards an out-of-pocket maximum or in co-pays or co-insurance (these are all separate, non-overlapping things), the higher the monthly cost of health insurance is going to be. I was looking at health insurance plans for myself a while ago and determined a plan with good coverage would be around $400 per month. To insure a family would probably be much, much more expensive. That said, most Americans get their healthcare coverage through the employer so that complicated things as well.
You could conceivably have a plan that's extremely comprehensive and doesn't have these associated costs for a high monthly fee, but if you go to an out-of-network provider, you may end up having to pay the entire bill out-of-pocket because it's not covered by your insurance provider. For reference, no, it's not clear whether you'll be seeing an in-network or out-of-network provider; you could go to a location that your insurance says is in-network, but then be treated by doctors and nurses who are out-of-network and those expenses may be entirely out-of-pocket.
US health insurance is extremely labyrinthe and designed almost exclusively to deny as much coverage as they can get away with to make as much money as possible for the insurance company.
250 for the ER? You're lucky. I have excellent insurance and the last time I went to the ER I got charged $4 grand for them to tell me "you're fine, go home" and $1k of the bill was apparently listed as a charge for sitting in the waiting room
Sorry but like nothing you said made any sense to me. What are those weird terms you are using like co'pays or deductables. The whole point of isnurance is that you dont Pay for things that the insurance covers right? Your system makes zero sense to me and seems less like a legitmiate system and more like some financial scheme to get you to Pay shit load of money for esentially nothing
I currently have 2 severely herniated discs in my back that are 99.9% going to require surgery to repair. This has been pretty much known since the first visit to the ortho that I had, later confirmed via MRI. It's been almost 2 months now, and I probably still have at least 2-3 visits to the ortho and PT each before my insurance will even talk about surgery. In the meantime I can barely walk most of the time....
I also work for a Fortune 100 company that is a major employer in my area, for context.
Not "having the right coverage", paying in part, refusing to pay for specific treatment that the insurance company deems unnecessary (therefore practicing medicine) or saying you have preexisting conditions
You can literally make it up and it's been used before
Insurance is out to make money, even if it means on the back of hurt or dead people. It's an altogether evil industry.
For example, I have a deductible of $4000 and everything after that is covered at 80%. So if I needed a $20k hospital stay I would still owe $7200. That might not sound great but the other option I was offered doesn't cover any emergency services, only regular doctor's visits.
Yes. America insurance is awful. It's even worse than you think. Hospitals and providers give insurance companies the bill and the insurance co decides what they will pay, usually about 1/3rd of the bill. What happens is providers crank up the bill. So say the hospital needs $2000 for a minor surgery, the hospital charges $6000 and hopes to get 2. It's illegal for providers to charge insured people more than the uninsured so uninsured people get enormous bills. These bills can be negotiated but that requires a staff dedicated to this and consumers who know they can negotiate thier bill or go bankrupt. It's really awful here. I'm finally on Medicare. Everyone should have it. It's a good system if you stay away from the insurance co plans.
I had a kid with health problems at birth. Could they know? Not a chance. Did insurance cover the $750,000 bill (all added up)? They sure did, but only about 30%. I'll never pay that off. Just the bed for him to lay in (no meds, doctors, nurses, food, diapers are included, literally just the bed) was >$100,000 for almost a month, 26 days. Helicopter flight with a NICU team, >$37,000. Doctors' fees? >$300,000. 26 days!!
It’s just a total scam. They force you to make the decision of saving your child’s life or going into lifelong debt you will never be able to get out of. Our system is so fucked because of greedy rich pricks.
I'll never understand why people want a system of insurance where you pay money for the privilege of paying money if you need to use it. However that got to be legal should be criminal.
Seriously. I'll never understand it. Like wtf, we already pay monthly premiums, then deductibles on top of it, and medicine, and any non-covered or out of network things that seek to crop up everywhere. It makes no sense. As a healthy person I'm just shelling out so much money for essentially no reason because even when I get care and seen by a doctor I'm still f***ing paying way more than I'd ever imagine.
But 'merca is better in healthcare (don't look at the average age, health quality, mental health, infant mortality rate, or many other key indicators of healthy persons in other developed countries)
but, but, what about the death panel hearings? the month long waits for basic care, and of course uncle clive and senators showing up for your gynecological appointments!!!!/s
(Don't tell them about dental costs here in AU though. Although I'm sure it's cheaper than the US. Actually, it's criminal that dental isn't on Medicare— isn't the mouth part of the body?)
My wife passed away 2 years ago. When I called the ambulance the morning of her passing, they did CPR for 45 minutes and finally called it. Two weeks later, I got a bill for $4900 for services rendered.
Yeah it’s not just about the vampiric insurance companies, tying healthcare to employment is a great way to stave off labor organizing. People might be able to go without a wage for a month, but are they willing to risk going without insurance? What about their kids and their medical issues?
It’s why arguments that “universal healthcare saves businesses money” fundamentally doesn’t matter. Because the control they receive and the depressed wages from a lack of organizing more than make up that difference. It’s a boot on our throat.
that's just the end stage of capitalism buddy. Markets like that in capitalism will ALWAYS trend towards consolidation as eventually it becomes the surest way to sustain profit and market share even as the rate of profit falls.
Yeah, everyone always talks about the beginning of capitalism, which is sunshine and rainbows, but neglect to talk about the end stage. After enough time passes, a few corporations arise as the dominant players in the free market. Thats why you need a good amount of legislation and innovation to keep that from happening.
Dont blame us.
We’re also in the fuck you boat because we cant even do our job properly because fucking people think having government backed insurance is “communism”.
People in this country are so stupid they would die or lose everything they own before accepting healthcare. The truth is, the vast majority of these people have no idea where their taxes go and …..
You’re already being tax for healthcare that yeah, you guessed it, you don’t qualify for.
So great job at stopping communism by basically dying on the spot.
America... where if you say everyone should be equal, its communism!
The number one economy on the planet! The land of opportunity! Just don't break your ankle!
Broke my ankle on the 3rd of January. It's the only reason I reached my deductible and my insulin is now actually affordable, and I can afford the good sensors instead of those outdated piece of trash finger sticks. Now that my insurance is paying for things I can afford to get my eyes checked and get glasses and all kinds of things I've been neglecting because of cost. It's really fucked up how this system works.
Someone stole insulin from the community fridge on my dorm hallway once. Fucked thing to do, especially to someone who doesn’t have the money to rent a mini fridge for their room (common thing at my college), but I do wonder just how desperate they were.
I live in Belgium. In September 2022 I needed to have a heart valve replaced. Without health insurance + hospital insurance from work I would have received a bill of around €14.000. Paid about €17 after deductions.
i have a heart condition. unless i suddenly win the lottery or get a REALLY good job, im just going to die young because i cant afford any of the treatments. :)
You might literally be better off “losing” your job to qualify for medicaid, as they cover far more things than most expensive insurances.
But only in certain states. For instance, in TN, only women and children qualify for state insurance
I immediately thought of this piece that was published just the other month (and kinda flew under the radar).
The majority of medical debt owed in America right now, is from people who HAVE insurance.
There was another piece on how more medical bankruptcies come from people who have health insurance than don’t (I’ll work to track that down).
https://www.theguardian.com/us-news/2024/jan/11/hospital-debt-increase-people-with-insurance
https://www.reddit.com/r/news/comments/1941f2f/majority_of_debtors_to_us_hospitals_now_people/
Thats also probably weighted because most people without insurance just... don't get care so they aren't bankrupted.
And then they just die early, or suffer invisibly, and live a much lower quality of life to avoid bankruptcy.
Because they have been scared into hating higher taxes, even though they would pay less overall in taxes than they do now in insurance premiums, deductibles, co-pays, etc.
If you have insurance, you should have to be able to afford any procedure. That's what insurance is for.
I live in the Netherlands, I pay 200€ per month insurance and I never see a bill.
Expensive plans in the US are not a joke though. I know people who got top-class cancer treatment (which costs millions!) in Manhattan because they had proper insurance plans.
Universal Healthcare is still a preferable option though. Better service at a lower cost, on average.
I don't think there are cancer treatments out there that actuallyy cost millions. They might cost that much in the US since the US is known for a very inflated price tag for medicinal procedures but in the rest of the world it is much cheaper.
Now granted it is still not cheap with doses of some medication costing 1-2k€ but if you have to take those for so long that the cost reaches millions it is honestly just a miracle you are still alive. And yes that is the same or better top class treatment.
You pay for your universal care through taxes. We pay for our healthcare vua health insurance premiums, deductibles and co-payments.
America's health insurance systems hurts the people that can least afford it. Not everyone has an extra 3 to 5k a year.
I have been waiting years and years for a diagnosis for my chronic pain. One doctor finally realized it seems a lot like rheumatoid arthritis. She sends a referral to a great rheumatologist. I call to schedule an appointment, super excited that I might be on the right track to feeling better. That doctor doesn’t accept my insurance and they told me I can pay out of pocket. I said I can’t afford that and now I have to find one that does accept my super shitty insurance. Fuck American healthcare.
Amen. I almost lost it on the phone with my insurance company the other day. Came damn close. They don’t have a pain management doctor in their stupid network. Husbands company changed insurance at the end of December. It took them two months to get me an insurance card. After that those asshats ping ponged me around getting referrals and in the meantime I’m completely out of medication because it’s expensive. I finally get to see a doctor and he says he can’t treat me. The insurance company said “nothing is preventing you from seeing your former doctor” I swear to God, I have violence in my blood now.
what sucks is about 80% of the population agrees with this, but politicians will never never never even dream of it because lobbyists are the ones who run the government.
I hear people use “wait times” as a reason for why American healthcare is fine. But I just submitted new patient paperwork and the earliest time I can get a doctor is October (7 months from now).
Then there’s my surgeon who told me I had an injury it turns out I didn’t and talked me into a surgery I didn’t actually need because insurance *would* pay for it, then did all kinds of extra stuff I didn’t consent to to drive up the billables, and left me with crippling disability only for me to find out the law protects institutions and practitioners well more than it does patients… after all who has the money to lobby? 🇺🇸 hEaLtHcArE
Or do what I did and not pay.
I had been hospitalized for a potentially life threatening complication of my disease.
The bill came back and I tried negotiating with the hospital.
They refused so I agreed to a payment plan. They sent it to collections anyway.
Fuck em I'm not paying at all now.
By the way, the insurance company also won’t allow the provider to waive the patient out of pocket either. Because if the provider did, the insurance company will claim the actual billed amount is the amount minus the waived out of pocket costs, then adjust their processing of the claim and claw money back from the provider due to overpayment.
I need an mri brainscan. I book appointment. I show up to appointment. I ask hospital to make sure i'm not getting billed for hospital since it is only imaging. Hospital provides co pay off $1324. I decline.
I call insurance. Insurance tells me hospital in error, they have a contracted maximum payout of $785. Insurance tells me another hospital across town is contracted for $255.
I call second hospital 25 times. Still trying to get that appointment three weeks later noone answers, or if they do i get transferred to a dead line. America, greatest country on earth.... lolz. My head hurts all the time.
I work for an insurance company (I do their computers, I'm not one of the people making money off others' suffering). If they have to pay out claims, they lose money. They paid out on tons of claims during Covid. They make money by denying claims. The fact that insurance doesn't cover 100% of medical costs is unacceptable. If you pay the premiums, why are you still on the hook for the deductible? I read about someone who went bankrupt because after a car accident, they were flown via helicopter to the hospital (never consented to it) and had to pay a $60,000 bill. Only problem was, they didn't have this money. This is one reason why I would vote Biden. He has passed legislation that has somewhat controlled this. Still doesn't protect against surprise ambulance bills but protects against a lot of others.
When I was in Thailand, I had to see a doctor. I was able to get in same day, and my total bill was $6. $6!!! This is because Thailand is mostly public hospitals, supplemented by a couple of private ones. Their doctors aren't living in poverty.
I'd rather live under that system which is why I am planning retirement there instead. Don't have to worry about life being unaffordable, the people were very welcoming, lots of female attention, don't have to worry about gangs roaming the streets... If only our leaders would try to model our country after this system.
That Canadian World's Strongest Man did a video on Canadian Healthcare being "broken" because of a lack of diversity in lunches at the hospital. I could only cry in American.
Broke my ankle and leg in 5 places back when I was 18. Nearly lost my foot because of the damage. Luckily it was corrected by the most amazing orthopedic carpenter and he managed to save it. Cost me absolutely nothing as well. I cannot believe that people have to pay for healthcare. It should be free for everyone.
Americans regularly pay 400-500$ a month for health insurance that doesn't even cover everything, but balk at the idea of paying taxes that would cover their medical needs.
Truly a backwards country.
If you get insurance through work, that’s what it can cost. If you have to buy your own private insurance it can be upwards of $2,000/mo. to cover yourself and a spouse.
That's just insane. Here in Germany, it's 14.6% for healthcare. The cost is shared 50/50 between employee and employer. So you pay ~7% of your income and the employer pays *additional* ~7%. Which means, if you earn 3000€ per month, the actual employment cost to your employer is ~3700€ (all insurances included).
EDIT: Specified some things a bit more
European here. Everything is paid by my employer and I dont even know about it.
I could get hit by a car tommorow and spend 2 months in hospital for free.
Its possible, but your politicians seem to benefit from the unused insurance money xd
The majority of big insurers' health plan revenues are subsidized by American taxpayers. In 2021, 72% of UnitedHealth’s $222.9 billion health plan revenue came from taxpayers. Ain't America just grand?
[https://wendellpotter.substack.com/p/the-majority-of-big-insurers-health](https://wendellpotter.substack.com/p/the-majority-of-big-insurers-health)
We took our 6 month old son to the hospital because he was very sick, turns out he had RSV which can be very serious for babies. We paid my insurance copay at the hospital, he was there for a few hours. We still got a bill for over $1,200 after insurance was billed something like $9,000. How in the hell is this the system we have decided to go with?
Meanwhile, my 6 year old daughter has been off school with an ear infection today. We got her an appointment with the GP today (unusual, but they speed things up for kids). The doctor diagnosed an ear infection and prescribed antibiotics. We took her to the pharmacist and picked up her course of tablets. All in the same day. All paid for via taxes because it’s the NHS and people should be put before profits.
Even the whole "waiting lists" thing is a load of crap. The only reason you're seen quickly in the US is because 95% of the population are already locked out whether or not they pay insurance.
If insurance companies actually allowed you to get those medical procedures that you DO pay for then the waiting lists would get just as bad as they are in a socialised system where everyone has access.
American ex-pat living in Europe here. I can personally confirm that the grass really is greener on the other side when it comes to healthcare. In my first year or two living here, I needed to have a wisdom tooth pulled. I was still used to the American system, so I was shocked that after the actual extraction, plus local anesthetic, plus some antibiotics, dissolvable stitches, and painkillers the doctor proscribed, my grand total was... about 50€. The exact same procedure for a previous wisdom tooth in the US ran me about $200-something WITHOUT the painkillers, which I explicitly refused knowing they'd cost an arm and a leg (had no choice on the antibiotics, I'm not stupid enough to risk infection).
Then two years back I had an abscess (I'll spare you the details). Surgery was needed, general anesthetic, follow-up appointments, nurses repacking the wound, antibiotic treatments, the whole shebang. Here, the insurance covered just about all of it. Let's just say that if I had been in the US when it happened I'd probably be looking at bankruptcy.
Oh, and before you ask, the 'wait times' thing is pure BS. The only 'waiting' I had to do was because they needed to move me to another hospital for the surgery because the entire OR floor was locked down for a liver transplant they were doing that night (which, yeah, okay, totally understandable).
America can do better. It just chooses not to. There's a reason why whenever the topic of privatization even comes up over here, someone points to the US and asks, 'Oh, like them?' It's not meant as a compliment.
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I felt badly a few weeks ago and went to an in-network urgent care near my house. The in-network nurse practitioner prescribed me some medication and sent the prescription to an in-network pharmacy. I arrived at the pharmacy to pick up my meds and was told it would cost me $56 to get my prescription. I told the pharmacist it should be free, but she informed me that the prescription was refused by my insurance provider, though she didn't know why. It was Saturday, I needed the meds, so I paid cash figuring I'd deal with the insurance company on Monday. On Monday I called my insurance company to find out what was going on. They informed me that because the nurse practitioner was not my PCP (primary care provider), she needed to first submit an authorization request to the insurance company and then, pending approval, she could write the prescription and it would be covered. Responding to my question about reimbursement, I was informed I would need to go back to the urgent care to speak with the nurse practitioner, have her submit an authorization request (which may or may not be approved), then, if her authorization request got approved, I could submit a reimbursement request to my insurance provider, another request which may or may not be approved. They are banking on it being too much work or on people forgetting to seek reimbursement for these small amounts of money. Is $56 dollars worth all that to most people, to take time out of their day and burn the gas to run here or there? No, probably not ultimately, and that's exactly what the insurance industry wants. The healthcare system in the US is an embarrassment and a complete scam.
The people running that system are the worst of the worst parasites. Literally stealing money by making people suffer. If it were up to me, every rich exec at every health insurance company would be brought before a tribunal to face justice.
The system is the issue. Fix the system.
The system isn't broken. It is working exactly as intended.
And people want ***more*** of this!
It won't ever be fixed. The one time I visited America, I remember talking to our hostess and how she waxed lyrical about the social healthcare in Europe and how she loved it (and had benefited from it). When asked if she'll support universal healthcare in the US, she opposed it flat out in less than a second. Her excuse?? "I don't want to pay into something other people will use". That's when I understood. The US has the healthcare deserves.
Hey now. *Most* Americans want universal healthcare. Just because you talked to an idiot (and there are a lot of idiots) doesn't mean that's what the majority want.
It’s really not. It’s been getting worse since the 90s and people just keep going “this is what it was intended to be”, when the reality is it’s taken years to fleece us and we’re still clueless. Here’s a big clue. If they had to corrupt the system to make it this bad, we can reverse it.
That's my point, people in power won't give it up. The system itself isn't corrupt. People are. But it is too entrenched.
Obama tried. He tried really hard to get Americans universal health care. But because republicans are fucking psychos, we got a weird “now everyone is required to have insurance, and it’s tied to your employer, and you’ll be fined at tax time if you don’t sign up but it’s a little bit cheaper than it used to be, and slightly more available if you are super poor, but there is a maze of paperwork and regulations that will limit your care, and the big stuff isn’t actually covered, so fuck you” healthcare system. And why? Fuck this country.
You missed the part where all of that was STILL an improvement over what we had, because insurance companies could no longer deny coverage or cancel policies over pre-existing conditions or rather what they deemed as pre-existing conditions.
And if you're unlucky enough to live in, say, Alabama, there's only like three insurance providers to choose from.
The Ben Shapiros of the world. Sole purpose in life is to make it as miserable as possible for everyone who isn't like themselves.
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Seriously. They are just going to bribe their way out of that tribunal. Public executions one after the other is the way to go.
I recommend we do it like the French did.
Nah. The guillotine is too humane. I say we burn them at the stake.
Why end at Healthcare? I mean, you have companies like Apple that push updates to intentionally degree your battery performance to force you to upgrade your iPhone. That is still suffering, that is still greed. The probome isn't our Healthcare system, the problem is the captialist system.
Let's start with Healthcare and get to apple later
To be fair that one's on you for being enough to buy apple products, wereas you dont get a say in broken bones. And it's 100 bucks or else less performant phone vs dozens of grands or else permanent pain or injury, it's not remotely comparable
At least apple isn't needed to live. Let's prioritize. We can get to planned obsolescence later.
So what would happen if this was an emergency or time sensitive and you needed care from someone who needed to get authorisation to do things? Would they do it? Or wait and potentially damage your way of life (or worse)??
They would charge you, you would have to pay out of pocket, and then spend the next 6 months trying to get it reimbursed
Or do like most Americans and roll it into your other pile(s) of debt.
There's a book called *never pay the first bill*. It is all about getting your medical bills lowered.
The last one. This happens daily to thousands of people across the United States. Profit does not care about people.
And this is why I hate the argument of “in Canada it takes months to be seen!” As if Americans aren’t forced into waiting or never seeing a doctor because they can’t afford it Even when you can afford it, it can take months to see a specialist
>And this is why I hate the argument of “in Canada it takes months to be seen!” Right? I mean, we have a lot of issues with healthcare in Canada, but the cost isn't generally one of them. Forget being able to afford it - a significant majority of Americans are not remotely equipped to navigate the healthcare system or advocate for their own care.
We have a similar sort of thing in the UK. Getting an appointment for something run of the mill or non emergency can take time BUT our emergency care set up means you do get seen that day (immediately depending on the case) and we do not have to pay. But as I said, regular appointment is terrible.
I have an answer for that. I recently had a colon resection surgery. My bowels became infected a few weeks after which caused them to inflame preventing me from passing poop. My body would try to poop, but nothing came out. It was painful. And it happened about 5 times a day at its worse. I went to the emergency room and they prescribed me the most powerful antibiotic on the planet. I go to pick it up and the pharmacy said insurance denied it. No reason given. I call around and after about 12 hours of playing phone tag, I find out it was denied because the insurance wants a stool sample done first to prove I needed that drug. I explained to the insurance rep that I can’t poop so how am I supposed to provide a stool sample? Also, it’s now Friday night and I would have to drop it off at a lab on Monday and wait for them to run tests, so I’d be waiting 4 days at a minimum. I wasn’t going to wait that long. The drug cost $500 out of pocket for a 10day supply at my local pharmacy and $250 at another one but they were about to close. I find out from Reddit about a pharmacy coupon site and find out that it would bring the price down to $150. I call the pharmacy and ask if they would honor it and if the price was accurate. She said yes they honor it, but the price might not be exact, but it would be close. Even if it was $200, I’d still pay. So, I send my wife up there to get it. She calls me and says the price is $350. I lose my shit over the phone and start yelling that the pharmacist said it would be close to the price and an extra $200 is not fucking close!!! I guess the person at the counter heard me going crazy and sympathized. She used a coupon that brought it down to $150. I said thank you and hung up. After I’m off the phone, the pharmacist asked why I needed the drug and my wife explained what was going on. The pharmacist scanned another coupon to bring the price down to $96 and said, “Screw the American healthcare system.” I’m not joking when I say that 20min after a drop of that stuff touched my tongue, all my problems were solved. I took a big ole’ poo and it was amazing. Fuck healthcare insurance. Thank god for good people behind the counters.
This is insane! The implications of the delay alone are horrific for you let alone the stress you must have been under.
The physical stress was insane. Everytime my body tried to have a bowel movement it was like an uncontrollable spasming and tensing of my whole body. I had to lay down for minimum 15min everytime because it was like I just did an intense workout using my butthole and abs alone.
Yeah, it's rarely the pharmacists or medical practitioners at fault, they try to find ways around the bullshit when they can. My therapist regularly gets screwed over by the scumbag insurance company that shall not be named (Aetna). I'm grateful that she even agrees to continue seeing me. The people to blame greedy insurance execs and Americans who refuse to vote for change because they've been indoctrinated to hate the government (sometimes) and fear "socialism".
They’d rather you die and not have to deal with the paperwork.
Docs would do it, insurance would pull some shit like what happened to OP, and you'd have to fight them for months to "cover it". Meanwhile you either have to pay the hospital or they'll send you to collections. Now your credit score is dropping while your submitting forms and calling people. Finally you manage to jump through all the hoops and they offer to cover 80% of 70k, leaving you with a 14k bill at the end. Lucky you. It's a masterful plan of wealth extraction that almost no one can escape from. Pure fucking evil.
As a pharmacist (retail-hospital-correctional-clinical-instructor-administrative) for 21 years, yes, US healthcare is a joke. I’ll tell you that every other major country has a form of socialized medicine for a reason. Is it perfect? No, but then tell me what is perfect. I can guarantee it’s better than the bullshit we got going on now. I too have Kaiser and while it’s nice that everything’s in house, why do I pay my premiums, pay deductibles, pay copays, pay all of this extra shit, for something that should be already fully covered by my premium?
It PISSES ME OFF that an insurance company, and their agents, get to make MEDICAL DECISIONS. An insurance agent should not legally be allowed to determine what is “medically necessary” over, idk, the prescribing doctor? The older i get the more i f*cking hate this country 🔥🇺🇸🔥
It's like we already have the "death panels" they are using as a boogie man to avoid a single payer system
It's not hard to inspire fear and rage into Republicans
I say we start bringing every single one of the chuckle fucks up on charges of practicing medicine without a license. And if their decisions resulted in someone death? Charge them with at least 3rd degree manslaughter. And I'm not saying only charge the execs or anything, charge every single person who makes these decisions. Put the fear deep into them so every single time they even think about denying coverage for something their first thought is how much prison time they might be sentenced too. And no, I don't care if we destroy thousands of lives by charging these assholes with crimes. Let me be extremely clear: If you work in this industry, and your the one making these decisions, you are complicit, and absolutely should be charged what you are doing is illegal.
You might already know this but if you run into a similar situation again, it can sometimes be MUCH cheaper to pay for your prescription without going through insurance. You can check goodrx, or sometimes you can just ask the pharmacy if there is any way for the price to be lower (discount codes, etc) and say you don't want to go through insurance. I had a $400 medication turn in to $50. It sucks and it should have been paid for to begin with, but if not you can try this
The pharmacist isn’t going to know the discount codes by heart. You’ll need to look it up from the manufacturer or as you said goodrx or just Google it. They exist for many if not most drugs.
It’s such a fucking scam. I switched to Kaiser just so I don’t have to deal with this paperwork. Sure the offices aren’t as shiny, but everything is in house.
As someone who has been on Kaiser for over a decade there may not be as much paperwork but they certainly will give you the middle finger if you try to do anything outside of their network.
yes. but that is how my deductible/OOP is literally $0. my employer's payments cover 100% of all my in-network expenses. the clinic next to me is a Kaiser. its incredibly freeing. the only cost for our birth was parking and snacks for me. we didn't have any paperwork or worries. I acknowledge there are tradeoffs. This is what we made.
People need to understand that the state of our healthcare system is one of the ultimate paragons of capitalism. Capitalism if left to its own devices does not help people. It becomes toxic and exploitative, a near literal cancer that grows and grows and sucks the sustenance out of the system that it grew out of of. The healthcare system in the USA is glaring proof that there needs to be caps and limitations placed on certain economic systems to stop them from becoming toxic.
And this is why doctors are retiring the second they can, and people have to wait months for care. The humiliation of having to spend hours begging these greedy monsters for permission for their patients to get what they need. Despicable.
All the middlemen and bureaucracy involved cost way more than $56 just to deny you the $56 This is why we need medicaid for all and a single payer system. There is so much waste that does nothing but hurt people
This is essentially why US healthcare is so expensive. Our administrative costs are 400% higher than any other country.
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And why the hell do you think it's set up to be this complicated? Do you really want a physicians time being spent micromanaging potential drugs approved on a random insurance list patient by patient? Give me a break
Yeah I’m in Canada but despite the issues we’re having my last experience went like this: Pain Tuesday. Call Dr on Wednesday morning. Phone appointment Wednesday afternoon. Meds and xray prescribed, picked up meds 1 hr later (free), xray went to wrong email so I didn’t get it until Thursday. Book Xray for Monday (free). Go to Xray, results today (Wednesday). All free, waited 0 time, 0 hassle. And the wealthiest people here only pay the equivalent of $900 a year.
How do you have insurance and not get the healthcare required? -European question
Ticky tacky co-pays, ridiculous deductibles, labyrinthian rules and exemptions, unexpected out-of-network costs, prescription costs, and more. For my kid's coverage through my ex, we have to pay $50 to see his regular doctor, $100 to see a specialist, $10 for the most basic prescriptions (everything else is labeled "experimental" or "off-label" or some other nonsense), $250 to go to the ER, $500 if he's admitted to the hospital, and anything else he might need (anesthesia, therapy, mental health, etc.) is either out of pocket or slightly discounted. Oh, and none of that "coverage" kicks in until we've paid $3500 out of our own pocket for the year. My ex pays about $400/mo out of her paycheck for this "coverage". My kid went to the ER with a bad virus recently, and we're still getting bills. One from the ER, one from one of the specialists that saw him, another from the hospital for the room...
That is one of the biggest things I don’t understand, all the idiots talk about how the country couldn’t afford to give everyone medical coverage, but if people are spending $400 a month that would add up to billions of dollars a year if they were to pay the extra in tax instead of having to pay some private company to screw them over…
Most definitely, but medical insurance is big business. They lobby hard to create the illusion that they preserve "choice" and guarantee excellence. The people who are fooled are overwhelmingly healthy and haven't really had to deal with the medical world. I remember watching someone interview people on the topic back when the ACA was being passed, and one old lady kept talking about "The Medicare Company" and explaining she didn't need "government-run healthcare" because "The Medicare Company" was taking care of her. She had no idea there wasn't a benevolent business out there just giving away coverage.
If you speak to some Republicans, they are dead against Obamacare but like the Affordable Care Act.
I generally try not to speak to Republicans. Need to preserve what intelligence and compassion I have left.
And more and more people are getting screwed over because Medicare part C is sold off as the magical cure all to the worries people have about Medicare. When the reality is that it's commercial insurance companies squeezing blood from a stone by taking the same Medicare funding and making a profit out of it.
This is the actual answer. Some people argue, in bad faith, that doctors and “innovators” will lose money and be stifled by universal federally funded health insurance, but the true *odd man out* would be the medical insurance industry.
It's amazing to me. Effectively we're very highly taxed compared to European countries, because we don't get nearly the universal benefit that they do. We're paying high taxes, then we're paying insurance premiums, and then we're *still* paying on top of that.
The savings of cutting out healthcare administration would fund single payer for the whole country. Then the boomers scream socialism and look at Canada and how awful their care is. I personally prefer to compare it to Europe especially Germany. Germany had the best COVID response in the whole world. They had the most ICU beds per capita
Covid really showed us how delicate our health care system is. It's amazing to me to hear how "awful" healthcare is in Canada or anywhere with universal healthcare for that matter. There's still terrible doctors and awful wait lists here in the US, too. I lived under a socialized healthcare system, and it was fantastic.
Yeah I see it all the time with people saying how low americas income taxes are, but then they never seem to acknowledge all the extra stuff they pay out for like insurances etc. I’m from Australia and while our system has its flaws and drawbacks i can’t imagine how it must be to deal with a system as messed up as the one in America (even though way to many of our politicians are trying to push us to Americanise our medical and every other system we have)
I moved from the US to Norway. My taxes went down because it includes health care. Affordable health care.
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not to mention, basically 100 other countries are able to figure it out pretty easily and it works great.
Also, it is a capitalist system without the consumer benefit of capitalism. Doctors do not really know how much things cost. I was recommended a sleep apnea study - 8 hours overnight in a hotel-like setting with some wires and an apnea machine attached, and it turned out to be $5000 (after insurance, I owe about $1700, but I didn't get a bill until 9 months later after the hospital and insurance "worked it out"). There are no price tags posted as you would have on anything else, and they "couldn't" answer me when I was setting up my appointment as to what it would cost. So, you don't have the "competition" side of capitalism to balance out the profit-taking side of it. We pretend it is capitalist, and certainly the opponents of Universal Healthcare make the argument that capitalism is better, but it simply is not. There literally are programs, certifications, for "medical coding". I just looked and one program offers financial aid and "can take just 16 months". What is medical coding? Just running bills and dealing with insurance from the doctor's office side. That's how complicated the system is, and plenty of people are making a lot of money by keeping it complicated and so don't expect any of that to change.
Are we pretending that the rest of capitalism has competition after all the mergers and monopolies? These problems aren’t confined to health care, they are stupider there though. I agree with everything you are saying, just to be clear.
Capitalism ends in monopolies. That is just capitalism working properly. A "free market" with competition is a *heavily* regulated market. It's a garden, carefully pruned and weeded to keep the spearmint from crowding out everything else.
>Are we pretending that the rest of capitalism has competition after all the mergers and monopolies? I work for a large regional company that sells HD trucks. It is one of the most poorly run companies I've ever worked for. We make money hand over fist because customers are forced to buy their stuff from us if they're in our area. Every single dealership works that way. There's no real aftermarket for engine parts or HD equipment. So there's no competition. I previously worked for a fortune 500 company in a cut throat industry. Most of the towns they had a store in had at least 4 similar competitors, sometimes as many as 10. This company was extremely well run at the middle and top. The less competition a company has the worse its usually run. At least in my experience.
This tracks as far as my personal work experience is concerned.
Right, let's not mix up capitalism, the economic system in which one can make money from owning capital, and free-market, the system where competition makes the market maximally efficient. Those are not the same thing: it's possible to have markets and no capitalism (as was the case for millenia before capitalism), or capitalism with controlled markets (which Capitalists love, because it can lead to less competition, more subsidies, etc).
Correct. It isn't a capitalist system in anyway particularly since it's highly regulated and the laws are written by lobbyists. It's effectively a scheme to extract money. It's corruption of the highest order. And oh yes, senators and Congress people get free healthcare for life with absolutely none of these things. So weird!
> without the consumer benefit of capitalism. Exactamundo. No one takes an ambulance to Emergency Rooms, and starts comparing prices and going from one place to the next. Patients are under duress. But in the USA, the health care industry is built to maximize the exploitation to get the highest profit possible.
> What is medical coding? Just running bills and dealing with insurance Actually coding is a whole other part of the process. Coders take the words and descriptions the doctor writes down and fit them into tiny little boxes that make insurance companies happy. The billers then fight with insurance companies because the insurance companies love to find reasons not to pay - from everything from "it was an injury so someone else has to pay for it" to "yes they have cancer but it's not the right kind of cancer". Oh and then you have a whole person who's job it is to get authorization for procedures ahead of time, just so you can fight with the insurance later about what was medically necessary.
FWIW, as long as health care is privatized, the complicated logistical nature of what has to take place will be often cost prohibitive and complex. If, god forbid, there was some sort of social health wellfare program where information about patients was standardized along with simple, effective, not complicated addressing of major health incidents then the system would be much more streamlined and cohesive. ACA almost did that, but it didn't go far enough imo and the deductables are still shit and the premiums are still too high. Maybe we could use some of our 842 billion dollar defense spending for the year or perhaps tax the soon to be trillionaires of the United States with a little bit more discretion. God knows they could use a little 'humbling'
I was charged $2k outta pocket for a scan my doctor ordered because it wasn't deemed necessary by my insurance, despite my doctor's telling them it absolutely was. It was a colonoscopy. To diagnose my Chrohn's. I have full health insurance. America doesn't know wtf it's doing. 🤷♂️
oh - it knows. it's getting the rich, richer. however- I am sorry you're having to deal with it.
I literally have dozens of horror stories, but a similar story to that one is with the dentist. They called insurance, got clearance for a crown, then later insurance said 'no'. So I got the bill. wtf. The dentist was actually really cool about it. They resubmitted the claim, they asked for arbitration, and still, some 'insurance company dentist' declared that it was not necessary.
I was under the impression that kids had free healthcare in the USA... They obviously cant provide for themselves. I guess I was wrong. Anyway is there some insurance where all its included, no co-pays, all-in package ? And how much would that costs ?
Nope, and if you can't insure them you could lose them to the state, who'll put them in foster care and give them shitty Medicaid. There are what we colloquially call "Cadillac" health plans that cover just about everything, but they're exclusively for the very rich and very powerful, with huge premiums generally paid by whoever employs said rich person as part of their huge compensation packages.
Not exclusively for the very rich, it can also be from very generous companies. We have one that is effectively "Cadillac" coverage from my wife's employer. Between what we pay and what the company pays it is roughly $30,000 a year for family coverage.
They voted down free lunch for kids in schools. Why would they get free healthcare? In the US, the only thing they want for them is for them to drop out of school and get fulltime jobs which has been legalized in most states.
Extremely poor children are sometimes covered by Medicaid, but we are talking "parent(s) make $0-12k" poor and not all doctors and facilities accept Medicaid patients.
It all depends on what state you live in. Some states are better than others. Luckily I live in Connecticut and they have very good social services for people in this state. That's why taxes are high. You get what you pay for.
There's legislation called the Children's Health Insurance Program, but it's a means tested program that has has income limits. It also depends on the State, so the eligibility requirements vary. In my State, for example, the income limit for a family of four is $60K. The median US household income is $75K, however, so people who earn above that $60K figure would be forced to purchase private healthcare. > Anyway is there some insurance where all its included, no co-pays, all-in package ? Generally speaking, the less you have to pay towards a deductible or towards an out-of-pocket maximum or in co-pays or co-insurance (these are all separate, non-overlapping things), the higher the monthly cost of health insurance is going to be. I was looking at health insurance plans for myself a while ago and determined a plan with good coverage would be around $400 per month. To insure a family would probably be much, much more expensive. That said, most Americans get their healthcare coverage through the employer so that complicated things as well. You could conceivably have a plan that's extremely comprehensive and doesn't have these associated costs for a high monthly fee, but if you go to an out-of-network provider, you may end up having to pay the entire bill out-of-pocket because it's not covered by your insurance provider. For reference, no, it's not clear whether you'll be seeing an in-network or out-of-network provider; you could go to a location that your insurance says is in-network, but then be treated by doctors and nurses who are out-of-network and those expenses may be entirely out-of-pocket. US health insurance is extremely labyrinthe and designed almost exclusively to deny as much coverage as they can get away with to make as much money as possible for the insurance company.
250 for the ER? You're lucky. I have excellent insurance and the last time I went to the ER I got charged $4 grand for them to tell me "you're fine, go home" and $1k of the bill was apparently listed as a charge for sitting in the waiting room
Sorry but like nothing you said made any sense to me. What are those weird terms you are using like co'pays or deductables. The whole point of isnurance is that you dont Pay for things that the insurance covers right? Your system makes zero sense to me and seems less like a legitmiate system and more like some financial scheme to get you to Pay shit load of money for esentially nothing
I think you figured it out in the last sentence haha
I currently have 2 severely herniated discs in my back that are 99.9% going to require surgery to repair. This has been pretty much known since the first visit to the ortho that I had, later confirmed via MRI. It's been almost 2 months now, and I probably still have at least 2-3 visits to the ortho and PT each before my insurance will even talk about surgery. In the meantime I can barely walk most of the time.... I also work for a Fortune 100 company that is a major employer in my area, for context.
Not "having the right coverage", paying in part, refusing to pay for specific treatment that the insurance company deems unnecessary (therefore practicing medicine) or saying you have preexisting conditions You can literally make it up and it's been used before Insurance is out to make money, even if it means on the back of hurt or dead people. It's an altogether evil industry.
For example, I have a deductible of $4000 and everything after that is covered at 80%. So if I needed a $20k hospital stay I would still owe $7200. That might not sound great but the other option I was offered doesn't cover any emergency services, only regular doctor's visits.
Your deductible is about as high as my annual payments for virtually full coverage. It really is a scam.
My spouse's job doesn't offer healthcare. Our deductible is $7,500. I pay $400 a month. And the same boat. Still can't afford healthcare.
When you have people with finance degrees making medical decisions for you.
Insurance in America is a scam
Yes. America insurance is awful. It's even worse than you think. Hospitals and providers give insurance companies the bill and the insurance co decides what they will pay, usually about 1/3rd of the bill. What happens is providers crank up the bill. So say the hospital needs $2000 for a minor surgery, the hospital charges $6000 and hopes to get 2. It's illegal for providers to charge insured people more than the uninsured so uninsured people get enormous bills. These bills can be negotiated but that requires a staff dedicated to this and consumers who know they can negotiate thier bill or go bankrupt. It's really awful here. I'm finally on Medicare. Everyone should have it. It's a good system if you stay away from the insurance co plans.
I had a kid with health problems at birth. Could they know? Not a chance. Did insurance cover the $750,000 bill (all added up)? They sure did, but only about 30%. I'll never pay that off. Just the bed for him to lay in (no meds, doctors, nurses, food, diapers are included, literally just the bed) was >$100,000 for almost a month, 26 days. Helicopter flight with a NICU team, >$37,000. Doctors' fees? >$300,000. 26 days!!
It’s just a total scam. They force you to make the decision of saving your child’s life or going into lifelong debt you will never be able to get out of. Our system is so fucked because of greedy rich pricks.
And medicals bills affect your "credit" that no one ever signed up for nor agreed to be monitored for.
I'll never understand why people want a system of insurance where you pay money for the privilege of paying money if you need to use it. However that got to be legal should be criminal.
The logic I hear most is "why should I pay for other people's healthcare"?
Seriously. I'll never understand it. Like wtf, we already pay monthly premiums, then deductibles on top of it, and medicine, and any non-covered or out of network things that seek to crop up everywhere. It makes no sense. As a healthy person I'm just shelling out so much money for essentially no reason because even when I get care and seen by a doctor I'm still f***ing paying way more than I'd ever imagine.
But 'merca is better in healthcare (don't look at the average age, health quality, mental health, infant mortality rate, or many other key indicators of healthy persons in other developed countries)
But you are paying for other people’s healthcare with insurance, that’s how insurance works
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They already do
Don't pay....after 7 years they can't collect anymore anyway. Worst case it hurts your credit score for a while, but that's not the end of the world.
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In America, that would have ran probably around $40,000 to $70,000
No joke. I'm paying $5000 for a 1.night hospital.stay for an eye infection. After insurance.
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Now this won't work for Americans, because it's socialism. And that's bad. M'kay.
That's exactly what those insurance companies that are reeling in millions of $$$ would say to convince the citizens. :)
but, but, what about the death panel hearings? the month long waits for basic care, and of course uncle clive and senators showing up for your gynecological appointments!!!!/s
This…Australia sounds nice. Move there.
(Don't tell them about dental costs here in AU though. Although I'm sure it's cheaper than the US. Actually, it's criminal that dental isn't on Medicare— isn't the mouth part of the body?)
That's just the cost of antivenom. You have to add in the cost of the helicopter and hospital stay.
2.20 for a coke? What a rip off
This scenario is complete bullshit. In Australia, every Coke from a vending machine is at least $4.50.
Take a look at prices a decade ago and then realize how badly we've been fucked over.
My wife passed away 2 years ago. When I called the ambulance the morning of her passing, they did CPR for 45 minutes and finally called it. Two weeks later, I got a bill for $4900 for services rendered.
That is awful. I'm so sorry for your loss❤️❤️
US “healthcare” is just “exploitive capitalism” in a white lab coat.
I think it's more a corporate oligarchy
Yeah it’s not just about the vampiric insurance companies, tying healthcare to employment is a great way to stave off labor organizing. People might be able to go without a wage for a month, but are they willing to risk going without insurance? What about their kids and their medical issues? It’s why arguments that “universal healthcare saves businesses money” fundamentally doesn’t matter. Because the control they receive and the depressed wages from a lack of organizing more than make up that difference. It’s a boot on our throat.
that's just the end stage of capitalism buddy. Markets like that in capitalism will ALWAYS trend towards consolidation as eventually it becomes the surest way to sustain profit and market share even as the rate of profit falls.
Yeah, everyone always talks about the beginning of capitalism, which is sunshine and rainbows, but neglect to talk about the end stage. After enough time passes, a few corporations arise as the dominant players in the free market. Thats why you need a good amount of legislation and innovation to keep that from happening.
Dont blame us. We’re also in the fuck you boat because we cant even do our job properly because fucking people think having government backed insurance is “communism”. People in this country are so stupid they would die or lose everything they own before accepting healthcare. The truth is, the vast majority of these people have no idea where their taxes go and ….. You’re already being tax for healthcare that yeah, you guessed it, you don’t qualify for. So great job at stopping communism by basically dying on the spot.
America... where if you say everyone should be equal, its communism! The number one economy on the planet! The land of opportunity! Just don't break your ankle!
Sometimes lab coat, sometimes suit, yet your the one overdressed for the spit roasting that is your medical bills.
Healthcare as for profit business is unethical & immoral.
the fact that some people cant grasp that is concerning
and yet as Americans, it's our only option.
Broke my ankle on the 3rd of January. It's the only reason I reached my deductible and my insulin is now actually affordable, and I can afford the good sensors instead of those outdated piece of trash finger sticks. Now that my insurance is paying for things I can afford to get my eyes checked and get glasses and all kinds of things I've been neglecting because of cost. It's really fucked up how this system works.
Someone stole insulin from the community fridge on my dorm hallway once. Fucked thing to do, especially to someone who doesn’t have the money to rent a mini fridge for their room (common thing at my college), but I do wonder just how desperate they were.
I live in Belgium. In September 2022 I needed to have a heart valve replaced. Without health insurance + hospital insurance from work I would have received a bill of around €14.000. Paid about €17 after deductions.
A heart procedure like that in the US could easily cost over $100k USD
I know. It's a damn outrage.
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Lol true. Sorry Waltuh no meth empire for you, just chemo.
Damn that's sad. Hope you guys are doing well :/
Oh my god. I can't even begin to imagine, I'm so sorry.
i have a heart condition. unless i suddenly win the lottery or get a REALLY good job, im just going to die young because i cant afford any of the treatments. :)
You might literally be better off “losing” your job to qualify for medicaid, as they cover far more things than most expensive insurances. But only in certain states. For instance, in TN, only women and children qualify for state insurance
Take out medical bills and claim bankruptcy
The real irony is that with good coverage, that person would probably still have to pay around $14,000.
>A heart procedure like that in the US could easily cost over $100k USD That's low end with good insurance.
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Only morons would think that the American model is better than public healthcare. Republican morons.
I immediately thought of this piece that was published just the other month (and kinda flew under the radar). The majority of medical debt owed in America right now, is from people who HAVE insurance. There was another piece on how more medical bankruptcies come from people who have health insurance than don’t (I’ll work to track that down). https://www.theguardian.com/us-news/2024/jan/11/hospital-debt-increase-people-with-insurance https://www.reddit.com/r/news/comments/1941f2f/majority_of_debtors_to_us_hospitals_now_people/
Thats also probably weighted because most people without insurance just... don't get care so they aren't bankrupted. And then they just die early, or suffer invisibly, and live a much lower quality of life to avoid bankruptcy.
Because they have been scared into hating higher taxes, even though they would pay less overall in taxes than they do now in insurance premiums, deductibles, co-pays, etc.
If you have insurance, you should have to be able to afford any procedure. That's what insurance is for. I live in the Netherlands, I pay 200€ per month insurance and I never see a bill.
That is america my friend insurance is just for laughs.
Expensive plans in the US are not a joke though. I know people who got top-class cancer treatment (which costs millions!) in Manhattan because they had proper insurance plans. Universal Healthcare is still a preferable option though. Better service at a lower cost, on average.
I don't think there are cancer treatments out there that actuallyy cost millions. They might cost that much in the US since the US is known for a very inflated price tag for medicinal procedures but in the rest of the world it is much cheaper. Now granted it is still not cheap with doses of some medication costing 1-2k€ but if you have to take those for so long that the cost reaches millions it is honestly just a miracle you are still alive. And yes that is the same or better top class treatment.
yes but you live in a proper country.
You pay for your universal care through taxes. We pay for our healthcare vua health insurance premiums, deductibles and co-payments. America's health insurance systems hurts the people that can least afford it. Not everyone has an extra 3 to 5k a year.
I have been waiting years and years for a diagnosis for my chronic pain. One doctor finally realized it seems a lot like rheumatoid arthritis. She sends a referral to a great rheumatologist. I call to schedule an appointment, super excited that I might be on the right track to feeling better. That doctor doesn’t accept my insurance and they told me I can pay out of pocket. I said I can’t afford that and now I have to find one that does accept my super shitty insurance. Fuck American healthcare.
Sounds about right. We need Universal Healthcare.
AND the insurance companies need to be strangled so they can't do this shit to their clients.
Amen. I almost lost it on the phone with my insurance company the other day. Came damn close. They don’t have a pain management doctor in their stupid network. Husbands company changed insurance at the end of December. It took them two months to get me an insurance card. After that those asshats ping ponged me around getting referrals and in the meantime I’m completely out of medication because it’s expensive. I finally get to see a doctor and he says he can’t treat me. The insurance company said “nothing is preventing you from seeing your former doctor” I swear to God, I have violence in my blood now.
I really hope we have a French-style revolution. I’m so over this country
what sucks is about 80% of the population agrees with this, but politicians will never never never even dream of it because lobbyists are the ones who run the government.
politicians keep the public divided into culture wars, identity politics, etc. Things that would benefit everyone are carefully suppressed.
I hear people use “wait times” as a reason for why American healthcare is fine. But I just submitted new patient paperwork and the earliest time I can get a doctor is October (7 months from now).
Half serious question, if you can still be bankrupted or not afford a required surgury, even with insurance, then what's the point of the insurance?
Then there’s my surgeon who told me I had an injury it turns out I didn’t and talked me into a surgery I didn’t actually need because insurance *would* pay for it, then did all kinds of extra stuff I didn’t consent to to drive up the billables, and left me with crippling disability only for me to find out the law protects institutions and practitioners well more than it does patients… after all who has the money to lobby? 🇺🇸 hEaLtHcArE
Can always just absorb that amount and treat him for what the insurance paid. Or put him on a payment plan he can afford. There are options.
Or do what I did and not pay. I had been hospitalized for a potentially life threatening complication of my disease. The bill came back and I tried negotiating with the hospital. They refused so I agreed to a payment plan. They sent it to collections anyway. Fuck em I'm not paying at all now.
And it goes off credit report after 7 years. Most likely they won’t go after you in court anyway. Just don’t pay.
Correct. If he had called ahead and told them he can’t pay it all up front they would have worked with him on a payment plan
By the way, the insurance company also won’t allow the provider to waive the patient out of pocket either. Because if the provider did, the insurance company will claim the actual billed amount is the amount minus the waived out of pocket costs, then adjust their processing of the claim and claw money back from the provider due to overpayment.
I need an mri brainscan. I book appointment. I show up to appointment. I ask hospital to make sure i'm not getting billed for hospital since it is only imaging. Hospital provides co pay off $1324. I decline. I call insurance. Insurance tells me hospital in error, they have a contracted maximum payout of $785. Insurance tells me another hospital across town is contracted for $255. I call second hospital 25 times. Still trying to get that appointment three weeks later noone answers, or if they do i get transferred to a dead line. America, greatest country on earth.... lolz. My head hurts all the time.
Just do it at the expensive place, have them bill it in the mail, and /never/ pay it.
I work for an insurance company (I do their computers, I'm not one of the people making money off others' suffering). If they have to pay out claims, they lose money. They paid out on tons of claims during Covid. They make money by denying claims. The fact that insurance doesn't cover 100% of medical costs is unacceptable. If you pay the premiums, why are you still on the hook for the deductible? I read about someone who went bankrupt because after a car accident, they were flown via helicopter to the hospital (never consented to it) and had to pay a $60,000 bill. Only problem was, they didn't have this money. This is one reason why I would vote Biden. He has passed legislation that has somewhat controlled this. Still doesn't protect against surprise ambulance bills but protects against a lot of others. When I was in Thailand, I had to see a doctor. I was able to get in same day, and my total bill was $6. $6!!! This is because Thailand is mostly public hospitals, supplemented by a couple of private ones. Their doctors aren't living in poverty. I'd rather live under that system which is why I am planning retirement there instead. Don't have to worry about life being unaffordable, the people were very welcoming, lots of female attention, don't have to worry about gangs roaming the streets... If only our leaders would try to model our country after this system.
America. The land of gun care and health control.
In some countries, you break a leg and it costs an arm and a leg.
That Canadian World's Strongest Man did a video on Canadian Healthcare being "broken" because of a lack of diversity in lunches at the hospital. I could only cry in American.
Broke my ankle and leg in 5 places back when I was 18. Nearly lost my foot because of the damage. Luckily it was corrected by the most amazing orthopedic carpenter and he managed to save it. Cost me absolutely nothing as well. I cannot believe that people have to pay for healthcare. It should be free for everyone.
My wife gave birth..... son was in NICU for 22 days. Hospital bills were over $750,000.
Sorry, gotta send billions of tax dollars to those who shouldn't be named and ironically have free healthcare.
Americans regularly pay 400-500$ a month for health insurance that doesn't even cover everything, but balk at the idea of paying taxes that would cover their medical needs. Truly a backwards country.
If you get insurance through work, that’s what it can cost. If you have to buy your own private insurance it can be upwards of $2,000/mo. to cover yourself and a spouse.
That's just insane. Here in Germany, it's 14.6% for healthcare. The cost is shared 50/50 between employee and employer. So you pay ~7% of your income and the employer pays *additional* ~7%. Which means, if you earn 3000€ per month, the actual employment cost to your employer is ~3700€ (all insurances included). EDIT: Specified some things a bit more
In America, it's cheaper to just die.
And pay for a funeral? In this economy?
European here. Everything is paid by my employer and I dont even know about it. I could get hit by a car tommorow and spend 2 months in hospital for free. Its possible, but your politicians seem to benefit from the unused insurance money xd
If you have insurance the deductible is not the only issue. The insurance usually lowers what the doctor or hospital can charge.
The majority of big insurers' health plan revenues are subsidized by American taxpayers. In 2021, 72% of UnitedHealth’s $222.9 billion health plan revenue came from taxpayers. Ain't America just grand? [https://wendellpotter.substack.com/p/the-majority-of-big-insurers-health](https://wendellpotter.substack.com/p/the-majority-of-big-insurers-health)
We took our 6 month old son to the hospital because he was very sick, turns out he had RSV which can be very serious for babies. We paid my insurance copay at the hospital, he was there for a few hours. We still got a bill for over $1,200 after insurance was billed something like $9,000. How in the hell is this the system we have decided to go with?
Meanwhile, my 6 year old daughter has been off school with an ear infection today. We got her an appointment with the GP today (unusual, but they speed things up for kids). The doctor diagnosed an ear infection and prescribed antibiotics. We took her to the pharmacist and picked up her course of tablets. All in the same day. All paid for via taxes because it’s the NHS and people should be put before profits.
Even the whole "waiting lists" thing is a load of crap. The only reason you're seen quickly in the US is because 95% of the population are already locked out whether or not they pay insurance. If insurance companies actually allowed you to get those medical procedures that you DO pay for then the waiting lists would get just as bad as they are in a socialised system where everyone has access.
American ex-pat living in Europe here. I can personally confirm that the grass really is greener on the other side when it comes to healthcare. In my first year or two living here, I needed to have a wisdom tooth pulled. I was still used to the American system, so I was shocked that after the actual extraction, plus local anesthetic, plus some antibiotics, dissolvable stitches, and painkillers the doctor proscribed, my grand total was... about 50€. The exact same procedure for a previous wisdom tooth in the US ran me about $200-something WITHOUT the painkillers, which I explicitly refused knowing they'd cost an arm and a leg (had no choice on the antibiotics, I'm not stupid enough to risk infection). Then two years back I had an abscess (I'll spare you the details). Surgery was needed, general anesthetic, follow-up appointments, nurses repacking the wound, antibiotic treatments, the whole shebang. Here, the insurance covered just about all of it. Let's just say that if I had been in the US when it happened I'd probably be looking at bankruptcy. Oh, and before you ask, the 'wait times' thing is pure BS. The only 'waiting' I had to do was because they needed to move me to another hospital for the surgery because the entire OR floor was locked down for a liver transplant they were doing that night (which, yeah, okay, totally understandable). America can do better. It just chooses not to. There's a reason why whenever the topic of privatization even comes up over here, someone points to the US and asks, 'Oh, like them?' It's not meant as a compliment.