Health insurance in the US sucks rocks
In case you don't live in the US and don't know, it is very common for health insurance to be tied to employment.
I've held four jobs over the last twelve months. Health insurance has been the most frustrating part of it. I'm married, I have kids. I don't want to go months without health insurance. My wife is self-employed so no employer subsidized insurance for her. We live comfortably so no option for government subsidized insurance.
The cheapest plan with insanely high annual "deductible" of something like $10,000 (the money you have to pay before insurance will pay) I can get independently is around $1000 / month. For comparison, with my current employer, my part of the insurance is around $440 month with a $3000 / year deductible.
During the past year I've four different insurance companies, one of them paid entirely out of my own pocket, no coverage for dental care for a while, no coverage for eye care for a while. Really WTF? Why are teeth and eyes so different from other medical care?
I'm now three weeks into my current position, insurance coverage with this employer began on the first of the month (so after about one week of working) — another gripe, the waiting periods to start coverage; my position before this had me working six weeks before coverage began; this time I had no idea when it would begin until I spoke to HR on my first day. I finally got my new insurance cards yesterday.
So today I decided to try to cancel my out-of-pocket coverage. I have until the sixteenth to cancel for this month. Haha, no. I can't. Not only are the human operators not working today (which granted is a Saturday), but the website is shut down for the weekend. I can't make any changes until Monday.
If the cost to me was the same, or close, I'd just buy my own insurance all the time instead of dealing with the hassles of constant change. But the costs are no-where near close. And I've got college tuition costs coming up very soon, so it's not like I'll have money to spare.
I feel like health insurance in the US is the worst of all possible worlds.
I consider myself quite politically liberal - perhaps even an Orange Booker - but health insurance is empirically poorly-suited to the free market - and the American hatred of socialist ideas is literally killing people by the thousands. It's criminal how such a developed and educated country can be so neglectful of the most vunerable people among its populace, while all its developmental peers have effective and affordable healthcare.
Healthcare (as most social programs) in a socialist country would be run by the government and the opponents would say all government programs are bloated bureaucracies that inevitably waste money. Obviously, every know metric of statistics shows that the opposite is the actual truth - we (the US) pays, on average, 2x any other western country for healthcare and outcomes are worse.
Mostly it's just redbaiting behavior meant to reach old fears of communism.
And be careful about the words "universal healthcare" as the corporate left is now using that term disingenuously to signify their backing of the progressive push for improved healthcare while they actually want to keep the health insurance companies and ACA going and expand it to cover everyone. The key is to ask them if they support a "medicare for all/single payer" program in which the government would be the one paying all the bills.
On average, the US pays about $9K per capita, while most other developed nations pay about $3-4K per capita. source
Fair point - though I'd still argue that universal healthcare is more ideologically aligned with socialist ideas than libertarian ones, and in this context the fact that the American electorate consider universal healthcare to be socialist is far more important than whether it actually is or not.
Millions. Since universal health care failed in the 90s because of right wing crap more than 2,000,000 people have died as a direct result of lack of access to healthcare. That's around 50,000 people a year!
What do you think are the biggest impediments to facts like this becoming common knowledge to the US electorate?
Ideology
As a Brit I am constantly undervaluing the fact that I can basically stroll into any hospital with my arm hanging off and they'll fix it for free. Okay, slight overstatement but you get the idea. It honestly boggles my mind when I see the occasional post on social media where someone goes to a hospital in America for one night because of a sore stomach, turns out they had mild diarrhea and gets billed $11,256 the next morning. I've watched the TV show Scrubs countless times and it does a very good job of showing just how much hospitals are driven by money and not the desire to cure people. Note here I'm not talking about the individuals who work at hospitals, more the people in charge of the whole system.
A friend of mine often likes to say, "When a hospital talks about a mission critical application, they mean billing."
Whatever happened to the good old days where we bought things by trading chickens and goats. "One heart transplant required? That'll be two and a half hens please!". Simpler times...
For one thing Dr Lister taught everyone that half-an-animal is full of germs and you shouldn't have it in a hospital. For another that's a non sequitor of an reply.
whats even more disgusting is, people think things like the affordable care act (obamacare) help the situation. it certainly does not... if you listen closely the US governments best efforts at helping human beings is getting them the "opportunity" for affordable "health insurance". forcing everyone through the machination of the for-profit insurance kill boards... if they can afford it.
insurance != healthcare
the united states does not value human beings, end of story.
I'd amend that to:
insurance < healthcare
And yet at the same time I understand why it must be difficult to find a solution to healthcare that suits everyone. If you make the people pay themselves by insurance, one-off payments etc, then people will be pissed. If you make them pay through taxes people will moan about it and most likely find something else to hate on the government about. The real issue is simply the fact that as selfish as it seems, people value their own well-being over others. It would be cracking if all doctors and nurses worked for free, but that is outright not fair and impossible, so the money must come from somewhere. As much as they want to help people, they can only do so by keeping themselves alive.
I'm in Australia and work as a nurse, while doing my diploma our government was looking at the US healthcare system as a viable option, the stink that kicked up was astronomical. Our liberal government (not liberal like the US, they are our Right wing government) don't like the fact they have to pay for healthcare and want to cut the funding. the ever wonderful bags of shit also each year cut funding in aged care (where I currently work) how anyone can think healthcare shouldn't be free to all is mindboggling.
It’s actually not too hard, I found out. Just realize the people who think that, tend to also think that women should be punished for having sex by being forced to have children they don’t want (abortion). They think all fat people are evil and lazy and deserve their situation, no matter the cause/start of it all. They think gay people deserve HIV. Homeless people deserve it because they did something evil. Drug addicts deserve their lot for doing drugs. Etc etc etc.
At the end of the day, folks like this don’t want healthcare for everyone because they’re in this mindset where if something bad happens to you, especially because you didn’t follow their moral code, it’s because you did something to deserve it, and it’s your own responsibility to pay the price.
I don't think that most people believe most of the things that you listed. Sure, there are some but the bulk of conservatives don't.
I think it's just a matter of perspective and experience. Part of it is the simple tendency for people to judge themselves by their intentions and others by their outcomes.
I'm Canadian and the CEO of the company I work at was complaining about the Canadian health care system a few years ago. He complained about wait times (caused by triage and not especially different than American wait times for time sensitive things), taxes going to pay for people who didn't take care of themselves and a few other things. Not especially different from American anti-universal coverage talking points.
This year we expanded into the states and he got to witness first hand the full cost of the American system as he oversaw the creation of a health plan for American employees. It costs his company and the employees a lot more than in Canada. Staggeringly more so, and there's still uncertainty about what happens with chronic ilness, and the possibility of retroactive denials. It also stifles business. His business literally could not have opened in the USA until it was succesfull enough to find a proper health insurance program.
In Canada when I joined on, I gambled and joined a startup that didn't have supplimental health care for the first 1.5 years of it's life. This meant that I was on the hook for my families vision and dental. Worst case I would have been on the hook for a few thousand in a dental emergency.
If this was in the USA I could not in good conscience taken that risk. I have a wife and two kids and a medical emergency would have ruined us.
My point is, this CEOs mind was changed because he got more information and a broader perspective than most people are able to get. Most of us only get a tiny piece of the full picture.
I'm not sure what the answer is, but it can start by talking to people we all disagree with in good faith. It can be helped by not being condescending or assuming that the worst possible reasons for supporting a political stance.
good point. unfortunately those folks seem to be the loudest it's utterly horrible they think this way and will never change
When I first started working full-time, several years ago, my employer offered a low-option, low-cost plan, and a high-option, more expensive plan. Looking back on those days now, it seems unbelievable that I paid around $60 a month for the low-option plan (that still had thousands of providers in my area) with a deductible of around $350. That plan was a unicorn. Within two years of employment the insurance company discontinued the plan and told everyone that the only new low-cost option would be an HSA. Ever since, I've watched my deductible and prescription drug costs explode. Just today I had to pick up an antibiotic and both pharmacists I worked with looked me in the eyes and said, "Do you know how much this is?" It was $90 with insurance.
If you're interested you can see how much of it is prescribed in England, and what the cost is to the English NHS.
For the quantity prescribed you can check here: https://openprescribing.net/chemical/
And for the cost you can check here (find the drug, then check the [medicinal forms] section: https://bnf.nice.org.uk/
(People in England pay £8.80 per item, normally per month, but many people have a low-income or medical exemption so pay nothing.)
The plans I had as options when I started working and the plans I have now are much different, in almost entirely worse ways.
What always boggles my mind is I'll go to someone that's totally in my network and then I'll get a bill for like 80-150 bucks. I mean wtf is the real cost you know. Before I had Insurance, when I was paying out of pocket, it seems like it was always cheaper than it is now that I have insurance.
The biggest problem I have with Health Care is that you go to see a doctor, and then that doctor doesn't really give you any of their time. They just rush you through so they can get as many people as they can in a day because that's more money. They literally come in and see me for like 45 seconds and then say have a good day. And then you say well hold on I had some questions and they act all irritated.
Or they want you (and the insurance company even more strongly) wants you to have separate appointments for everything. "I came in for this cough, but could you look at my sore ankle, too?" What do you mean that won't be covered without a new appointment?
Nah, I meant questions on what I went in for to begin with.
One question per appointment seems to be what they want.
I'm talking for the issue I went in about though. I mean it is reasonable for me to have questions. Thats why I went in. Basically, say I went in because of a broken nose. If I have questions about my broken nose, that seems fair.
I am scared to go to the doctor for fear I wo 't be treated because every single time they rush me out. Im talking within 180 seconds max they are ready to get me out. I am so worried about taking off work and spending money on nothing, I just don't go.
My state has decided since my wife gets insurance, and we don't live together, I cannot qualify for Medicaid with no exceptions. Gotta love Oklahoma, right?
American healthcare just seems so... Alien. Parroting what others have said already, but in Canada my province charges $100 a month for healthcare, or $150 for a family (if I'm recalling correctly). The majority or employers cover this though. Most plans also include drug coverage around 50%, but usually much higher at 80-90%.
Anecdotally, in the past decade I've gotten stitches, broken my thumb and had it dealt with at the hospital (including imaging, etc), been to the doctor several times - and paid nothing out of pocket for any of it.
I am sorry you all have to deal with that shit show. What a corporate hijacking, and in plain sight. Ugh.
Rant time. I am 29, live in America, and have MS. The treatment I receive monthly through an IV is billed to my insurance for $18,000. Every month. I don't see a bill for the whole amount but by May of this year, I owe $5,000 so far. I now work two jobs to help pay for my medical bills.
Leave it to American health insurance to make a disabled person have to work two jobs to stay afloat and to afford a medicine I can't go without.
And then you read news stories of companies like Goldman Sachs suggesting that curing people is bad, because then the payments stop.
https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patients-a-sustainable-business-model.html
And suddenly it is very tempting to believe that's been the drug companies modus operandi for a couple of decades now, and the reason that so called miracle cures started to dry up in the sixties: better profits in a drug someone needs forever.
Yes, I agree. I am starting to believe more and more that big pharma stays with the plan that will benefit their pockets more.
my wife and i just left the US precisely because we were tired of paying 700 dollars a month for "healthcare" with a 10,000 dollar deductible
For my daughter's first birthday the hospital sent us a bill for several thousand dollars our insurance refused to cover. We were one hour late checking out of the hospital due to the hospital staff being slow processing us. We got charged as if we spent an entire day at the hospital.
I'm an attorney. Most my friends are lawyers. I did the math for the time it would take to argue everything and weighed it against paying several thousand dollars. I paid.
For some people it makes sense to put the money in a bank, and then fly to the UK and pay for NHS treatment if needed. The price you'll be charged as a non-resident will be 150% of the national tariff, plus flights and hotels for other people.
Here are the national tariff rates. https://improvement.nhs.uk/resources/national-tariff-1719/
Medical tourism is a thing I've known about since AIDS became an epidemic in the 1980s. Lots of places to get different / cheaper care than the US besides the UK.
We pay tax on income to cover health but if you're not employed you're still covered for everything. Doctors visits still cost but if you can't afford it the public hospital is 100% free.