Is it very expensive to see doctors in USA? (split topic)

[fresh]

is it very expensive to see doctors in USA ?

How much difference does it make with or without health insurance ?

[Delta1212]

Depends on what you're going for. An annual physical is free or relatively inexpensive (like $20-$30) with most insurance. Without insurance it can range from a little more than the above co-pay to $100-$200 depending on where you are getting it done.

 

Hospital visits, on the other hand, are almost always expensive with or without insurance. One person I know went with intense abdominal pain, got a hospital bed for a few hours, some pain killers and an ultrasound that didn't show anything but that they think may have broken up a kidney stone by accident and a prescription for antibiotics.

 

The final bill was $7,000 about $5,000 of which was covered by insurance.

[CharonY]

Note that these may be negotiated rate with insurance. To pay out of pocket the cost can be way higher, but many are willing to negotiate in case of hardship. I am not sure how insurance companies compare, but there is a study by Anderson (I forgot the journal but he worked at Johns Hopkins) around 2004 which compared the charge for medicare and for uninsured patients. If memory serves the ratio was somewhere between 2-4 (i.e. double to quadrupole) the charge for uninsured patients, depending on the type of hospitals (with for-profits unsurprisingly being at the upper end).

[swansont]

is it very expensive to see doctors in USA ?

How much difference does it make with or without health insurance ?

Last year my mom had a pulmonary embolism. Ambulance, care from the pulmonary emergency response team and a couple of days in hospital. The bill was $122,000. With insurance the out-of-pocket expense was a few thousand.

 

Without insurance, getting sick can wipe you out and make you go into heavy debt. (Not that a few thousand dollars is change you find under the sofa cushions)

[Delta1212]

Last year my mom had a pulmonary embolism. Ambulance, care from the pulmonary emergency response team and a couple of days in hospital. The bill was $122,000. With insurance the out-of-pocket expense was a few thousand.

 

Without insurance, getting sick can wipe you out and make you go into heavy debt. (Not that a few thousand dollars is change you find under the sofa cushions)

Ambulance rides are murder in terms of expense, and God forbid they take you to an out of network hospital while you're unconscious.

[fresh]

@The bill was $122,000. With insurance the out-of-pocket expense was a few thousand.

 

OMG ! expense spent in hospital can eat you up ! it is an unreasonable cost.

Ambulance rides are another robbery.

Being healthy is the best way to save money.

 

i wonder how much insurance premium you should pay every year ? it is not a small amount.

[DrP]

Your health care system sounds crap. It should not cost you more than what you pay in taxes.

 

Most people I know have zero savings. Obviously some of the middle class do and of course the rich... but the majority of working class people are skimping and scraping as it is and do not have £1K to put away as savings - they would laugh at you if you suggested it... but then they do not need it for medical emergencies as they already pay for that out of their taxes.

[swansont]

Your health care system sounds crap. It should not cost you more than what you pay in taxes.

 

 

The US health care system is decoupled from taxes, for a lot of people* (less so now than previously, though). And since the people in power are serving the rich, and they don't want to pay taxes, the people in power are trying to make sure that such tax income doesn't exist. For most it's insurance (or lack thereof), whether through work, or with a private policy.

 

We have medicare (over 65 or disabled), medicaid (very low income) and tricare (military retirees). Government employees get some level of healthcare coverage as part of their compensation, as with most large employers. There are some government efforts to subsidize some care. for others, but nothing resembling national insurance.

[DrP]

I really enjoyed the series 'Breaking Bad'... Loved it. But over here it would consist of about 1 episode. Mr White goes to school and collapses... he is rushed to hospital and diagnosed.... his friends and family are sad.... they hope his medical treatment and chemo are successful. Mr White goes back to work again, no financially worse off than before he discovered or was treated for his condition as the government pay for it all... including some sick pay while he is off work. He dies or survives based on his progress in his treatments... not based on whether he can afford them.

[Phi for All]

I really enjoyed the series 'Breaking Bad'... Loved it. But over here it would consist of about 1 episode. Mr White goes to school and collapses... he is rushed to hospital and diagnosed.... his friends and family are sad.... they hope his medical treatment and chemo are successful. Mr White goes back to work again, no financially worse off than before he discovered or was treated for his condition as the government pay for it all... including some sick pay while he is off work. He dies or survives based on his progress in his treatments... not based on whether he can afford them.

 

Cool. So we adopt the exact system the UK has for healthcare, which incidentally saves us about $5000/year per person! And if everyone puts half the extra into a mandatory retirement account, and gets an extra $2500 to spend or save as they like, we're all much better off.

 

What else could help us have more savings?

[Delta1212]

I really enjoyed the series 'Breaking Bad'... Loved it. But over here it would consist of about 1 episode. Mr White goes to school and collapses... he is rushed to hospital and diagnosed.... his friends and family are sad.... they hope his medical treatment and chemo are successful. Mr White goes back to work again, no financially worse off than before he discovered or was treated for his condition as the government pay for it all... including some sick pay while he is off work. He dies or survives based on his progress in his treatments... not based on whether he can afford them.

[Strange]

 

Cool. So we adopt the exact system the UK has for healthcare, which incidentally saves us about $5000/year per person!

 

 

That is an extraordinary report. I had no idea that the US system was quite so messed up.

[Phi for All]

That is an extraordinary report. I had no idea that the US system was quite so messed up.

 

If you're dealing with actual doctors and nurses, the care is decent and even superlative in some areas. But the wealthy insist that health is a private business matter, and force us to use insurance as a means to access a viable risk pool, ensuring that profit is the priority. Insurance is great when you know the value of something and want to protect it, but it's a pretty awful way to keep people healthy. I think the wealthy expect the rest of us to settle for a fixed value on our health, the way we do with life insurance.

 

The US injects capitalism where it has no business. We spend more for almost everything except gasoline, so we tend to have very little savings.

[ecoli]

But the wealthy insist that health is a private business matter, and force us to use insurance as a means to access a viable risk pool, ensuring that profit is the priority.

 

come on, Phi... you are being disingenuous by labeling 'the wealthy' as some unanimous group that all agree on health insurance policy.

[Lord Antares]

This is incredible for me to read. In my country, one's medical insurance is automatically deducted from the paycheck (a small amount at that) and they are free to come get diagnosed or treated as many times as they like without further pay, be it an emergency or not. I believe some groups of people have completely free healthcare as well. I cannot believe how expensive it is over there.

 

is it really true that doctors will refuse to treat you if you don't have the money, even if it's an emergency? I've heard that. I find it hard to believe. I would assume they would at least treat you and send you a bill afterwards. Can anyone verify?

[ecoli]

is it really true that doctors will refuse to treat you if you don't have the money, even if it's an emergency? I've heard that. I find it hard to believe. I would assume they would at least treat you and send you a bill afterwards. Can anyone verify?

 

This is correct, emergency rooms are required to treat anyone

[Lord Antares]

Aha, so it was just anti-American propaganda what I've heard. Or simple misinformation.

In any case, it did not seem reasonable to me.

[John Cuthber]

 

This is correct, emergency rooms are required to treat anyone

To whom do they then send the bill?

If it's the patient then it's not propaganda to point this out.

The last figures I saw said that the US spends roughly twice as much per capita as most countries, without getting significantly better health outcomes

[Strange]

The last figures I saw said that the US spends roughly twice as much per capita as most countries, without getting significantly better health outcomes

 

 

According to the article above, it is much worse than that. The state pays about twice as much per capita, but the individual also pays about twice as much. The total cost is even higher.

 

So even if one agrees with the principles of the US system, it is still totally broken in its implementation.

[Lord Antares]

No, no one can argue the system is bad and broken. There is no doubt about it.

I was just saying that some people believe if you get shot and rushed to the hospital in the US, that you would get left lying there if you have no money. That is just a bit extremist is all I'm saying.

[DrP]

QUOTE: post 20/Lord Antares: "..they wouldn't leave you lying there.."

 

.... no they wouldn't miss a chance like that! they'd treat you while you are unconscious and then bankrupt you with the bill when you wake up. lol ;-)

Edited January 19, 2017 by DrP

[CharonY]

No, no one can argue the system is bad and broken. There is no doubt about it.

I was just saying that some people believe if you get shot and rushed to the hospital in the US, that you would get left lying there if you have no money. That is just a bit extremist is all I'm saying.

 

Not in emergencies, no. But as a direct result of that ERs are often overcrowded and if not recogized, especially uninsured may spend too much time waiting or get sent home without proper diagnosis. There have been a few prominent (fatal) cases in the news.

One should also note that typically nurses and MDs do try to help anyone that gets put in front of them. However, the system can lead to the issues described above where the staff makes unfortunate decisions.

Edited January 19, 2017 by CharonY

[Lord Antares]

Yes but that's an unsolvable issue everywhere, not just in the US.

If the hospital is crowded, then whatever method they use to determine who is next on the list, there will still be people who they won't have time to treat properly.

 

However, there is a key difference. In my country, they will use the priority of the emergency (or time of arrival if there are no emergencies) to decide who is next. IF the US uses the insurance as a deciding factor, then I agree, that's a fatal flaw. Literally.

[CharonY]

Actually it is a bit different. In many countries, ER is indeed for emergencies. However, since uninsured may not be taken in by regular family physicians, some are forced to go to ER for non-emergency treatments . The reason is that by law they are required to provide service, even when reimbursement is not guaranteed. That contributes to crowding that you may not see in other countries.

Also, that may also lead to unfortunate decisions by misjudging the severity of a condition.

[Phi for All]

A big part of the unnecessary expense that doesn't get talked about is overcharging to compensate for cash flow. As part of the cost of doing business, US medical corporations have to build in extra charges because the insurance companies can take years to pay out on claims. Many doctors get into some serious cash-flow problems that can keep them from updating equipment, give raises to employees, and many other standard practices. Add to the equation that each office has to deal with multiple private insurance carriers, each with different paperwork and criteria, and it's a recipe for administrative and fiscal disaster.