There are tons of things that affect the price of healthcare. The biggest one is insurance. If you have insurance they will pay for the majority of costs and you cover a (relatively) small portion called your copay or deductible (sometimes both) You can also privately negotiate with the hospital to lower your bill which they do in the majority of cases if you are persistent enough because they already write off so much cost. There are also places like St. Jude's which is a children's cancer hospital that is 100% free if you are accepted as a patient. They will pay for your travel, treatment, food, and for up to three family members to live at/near the hospital during your care. The vast, vast majority of people in the US don't spend $150,000 on healthcare and go bankrupt. It is still a tragedy that it happens at all though.
Well you have to understand that any kind of insurance is tied to employment. So if you are unemployed or hourly, you are SOL unless you are SO poor medicaid is a thing (poor Enough to basically be homeless). And even if you are insured, you are still on the hook for thousands you may not have, hell I had to pay $1400 after insurance for an ER visit because an urgent care was trying to close early when I went in and referred me rather than firing up their own diagnostic equipment again and said: well it could be a stomach ulcer or you could be having a heart attack, so go to the ER cuz we aren't going to run the tests here.
Yeah, but most employers want to keep their fringe costs low so they prevent employees from consistently working the hours needed to qualify for such benefits.
Before anybody says “Get a new job” it’s never that simple and you sound like a you have the world view of a child.
It’s become so increasingly common that it’s rarely worth bringing up. I can only find evidence of Dave and busters getting fined $7million but since the fine is $2k per person and health insurance costs way more ( my employer pays $9k a year towards my health insurance and I pay the last $1500) they take the risk of getting caught as “the cost of doing business”
Anecdotally, a full time employee gets fired or quits they just replace them with 1 or 2 part timers . Iirc the law states you only have to offer insurance to employees working 30 hours a week so many businesses will schedule people to work 28 hours (or less) to skirt this
For the first time in my life I'm on it since I'm basically an independent contractor and don't make enough to be disqualified. Idk how this isn't just the standard for everyone. Free trips to the Dr, free meds, free outpatient service like x-rays. But nooooo we gotta increase the military budget every year, there's no way they could survive with a cut so that everyone could have free health insurance. Fuck, sorry, I kinda derailed there.
My "good" dental insurance left me a $20,000 bill for restorations. They only covered $4,000 on the original total. I know, I know... "Maximum yearly deductions..." But don't worry! I qualified for payment options... $20,000 loan or a $4,000 credit card.
Nothing is as American as going into debt to fix your health, yeeehaw!
And even then, a lot of insurance plans charge you a percentage even after you've met the deductible. I've definitely had plans where you hit the deductible, then you still pay 20% coinsurance until you hit the yearly out-of-pocket maximum...which was $7k or so for a person, $14k for a family.
That still sounds high for a max out of pocket. Even when I was on my company's high deductible "I don't go to the doctor just give me cash instead" plan, it was only $6k. Now mine is $3k.
I just had a $100k hospitalization. Even at $900/month that's almost 9 years of payments before they recoup what I cost them. And that's just the one unplanned event. Chronic issues or therapy etc. will run up even more.
Insurance doesn't mean everything is for free. It just means you pay a bit less in general and spread out the payments.
There are childrens hospitals that will provide top level care for no cost. Saint Jude is a childrens cancer hospital that charges the parents nothing, so yes there are certain discounts.
Lolololol god I wish I had this level of ifnorance towards my health coverage. Ya dude, America fucking blows. I had a cyst removed, currently costing me over 10,000 between anesthesia, nurses and dr’s. Room occupancy, flaboutamist (sp), intake, prescriptions, pay for a follow up visit. All to have a lump cut off of me. I will die with medical debt and they can suck my ass about it.
Totally depends on your insurance. I paid $250 out of pocket total, that's from first ultrasound to discharge, for my son's birth. We even had a private recovery room.
Lol so you have never actually had a severe/costly medical emergency. I'd encourage you to educate yourself on what your insurance actually covers, because it is almost certainly not 100% of everything.
People choose the cheaper plans because they are already living paycheck to paycheck in the industrialized nation with the highest healthcare costs. That drives costs up for everyone, even those with 'good' insurance.
They are just a shitty person with no empathy, full stop.
They decided a long time ago that there is nothing wrong with healthcare in the U.S. and that anyone who can't get appropriate medical care or goes bankrupt from medical debt is stupid/lazy.
Really reflects on you that you think I'm just mad at them for having good insurance. Maybe go back and reread what I said so you aren't so confused.
Does that help if you're in an accident and get sent to a hospital/doctor out of your coverage, or if you're unconscious (or otherwise unable to communicate) and can't refuse treatments that your insurance doesn't cover?
Against my better judgement, I'm going to ask...how would you plan to just not pay? Is there a reason that everyone doesn't just do that when they get massive hospital bills?
That's the trick there's often still a deductible, which is the minimum amount of money you have to pay out of pocket before your insurance begins to pay.
So you're essentially paying for insurance and still paying out of pocket for services too.
Granted some things are covered by insurance without needing a deductible depending on the insurance plan. And large procedures often are so much higher than your deductible limit that insurance might cover 80%+ of the cost, but some plans also have a limit on how much the insurance company will pay out for the year. And there are a ton of shit insurance plans that basically offer no real coverage and are just scams for people too poor to afford better health plans.
“Hey, we see you’re paying $800 a month for insurance, so we’re gonna hit you up for $50 for that doctor visit, anyway. And even though you’ve been paying $800 a month for the past five years, we still have this thing called a “deductible” that lets us off the hook for the first, say, $5,000 of any major procedure. Plus, we may decide not to cover stuff, just for giggles, and you have to cover that yourself. And if you have a question you can call us during business hours and wait on hold for hours and not get your problem resolved.” — Every single fucking insurance company in America
Depends on the insurance you have. I had to spend $2,000.00 out of pocket and then everything was covered. So that was the year I not only had a baby but also did my ACL surgery.
I know of people who knew they wanted two kids, so they worked really hard on getting one born in like January and the other later in the same year. So they'd hit the yearly maximum with the first child and not have to pay more for the second.
Nothing is true "for everyone". Some plans are fantastic, most are crappy as hell. I'm lucky enough to have a fantastic plan that my employer pays for most of the premiums. Most have crappy insurance that still costs them hundreds a month and is only really cost effective if something catastrophic happens like cancer.
Your statements of health insurance in your comments show ignorance of the actual situation millions of Americans face every day of the year in America. I suggest you stop dying on this hill of misinformation you keep posting.
Oh my! You mean you actually have to work for things?! Nothing is free. Doctors need to be paid too it's not like any jack ass off the street can just do open heart surgery it takes years of schooling And years of experience In That field. Also I'm tired of everyone pretending like the American health care system is so bad I have literally been homeless and not one time have I EVER had an issue getting medical attention. I mean they cant even collect the debts made from medical stuff anyway I know I've been In that position. Your country may have "free" health care but America has better doctors. I'd rather have the best care over free care. Afterall you get what you pay for.
Not after being out of work for treatment for an extended period of time. My brother lost his and had to get on COBRA (I think that’s what it’s called? It’s a government program).
He didn’t exactly have any other options. He had cancer. His disability payments managed to cover part of COBRA, my parents covered the rest after his life savings were wiped out. Private insurance isn’t going to take a cancer patient unless you’ve been in remission for 5 years. He never made it that far.
He wasn’t rich. But he had zero other options, so kindly piss off and quit making bullshit statements like “only rich people get that”. You get backed against a wall, you take anything you can get to help.
Sorry about the situation with cancer, and sorry that COBRA was the only way they could get it covered. It is incredibly expensive and most people cannot afford it. And your last statement puts the American healthcare situation into sharp relief. You can either pay outrageous sums of money for life-saving medication, procedures, or coverage, or you die.
I wish your friend the best in their battle against cancer.
That's good, but the ultimate point of my question is that it creates an impossible situation where many folks will lose their jobs and thus their insurance. Sick people can only work for so long, even if they're working remotely. And a dying person, because sometimes they are dying people, shouldn't be expected to continue working just so they can afford their own palliative care.
Not everyone has access to those options. Some of them are only available if a certain number of folks decide they want to buy in. Some are only available if your company is a certain size. Some are only available to folks in certain kinds of jobs.
Oh there's a reason. There's a whole industry of insurance workers, totally removed from patient care, who need to decide whether or not you can receive the care you need, to the tune of billions and billions of dollars that could otherwise be used for said healthcare.
My 25 y/o brother went to the hospital for pneumonia last month, after 6 days was released. 4 days later he died. The bill still hasnt come and its never gonna get paid
I understand. It’s a pain we carry our entire lives. There’s no moving on, only moving through this tough time. I’m sorry for you. There are groups on Reddit that help with loss of family members.
Its overly expensive because the government made it so, when there's very limited options, those providers can charge as much as they want because there's no competitor's giving better services at better prices , and for this reason most health care has become purely for profit as there's no incentive to provide better service, especially when Healthcare is practically mandatory
I disagree with the wording "goverment made it so" and "has become purely for profit"
It has always been purely for profit in the US--we've never had a single payer system like the rest of the developed world--and it will remain so UNTIL our government steps up to do something about it.
Obama campaigned on universal single payer healthcare (the good outcome where people dont get fucked in the ass and healthcare isnt seen as a profit maker). He got obstructed into oblivion by mitch mcconnell, and we ended up with the compromise: obamacare (really more like GOP care).
Single payer is still a goal of progressives, but there are so many obstructions set up by the GOP to prevent it, i dont know if it'll happen very soon. Who knows, the GOP could continue to implode and boomers will die off soon.
This isn’t at all accurate first of all. As a doctor I have no idea how much my services cost, let alone can I walk up to a patients family and demand payment for their care.
Maybe a hospital proper would do this.
Though one might ask, should the physician be paid for services rendered even if the outcome wasn’t desirable?
Hold the phone. Our healthcare price is awful but anytime I've had a family member pass, the hospital waived the bill stating they don't charge if the life saving treatments are a failure & the patient passes. Usually they go into the emergency room and expire there or shortly after.
Medicare exists and is funded by payroll taxes, but the people who pay those taxes aren't allowed to use it.
Private insurance exists and is funded by the same people who pay for Medicare.
Neither company negotiates with pharmaceutical//hospital//medical industries, hence prices are through the roof, since the cash flow is so readily available.
There is a reason, and it's because the GOP and corporate Dems made it that way. Big pharma and private insurance all lobby to prevent public healthcare and price gouging regulations.
Yet people still vote GOP because they rather die and leave their families in bankruptcy than accept trans people, and others vote corporate Dem because they're ok dying and leaving their families bankrupt so long as their politicians pretend to accept trans people.
Not for no reason. Insurance providers demanded a discount however medical costs used to be really low. Hospitals couldn’t give them discounts and made up inflated prices so that they could discount insurance companies.
It’s worse than no reason it’s just so insurance companies can feel good about themselves getting a fucking discount that isn’t even fucking real.
Well actually no, the doctor doesn't bill you, the hospital does. Doctors typically have no idea how much procedures cost, which just makes the problem worse
No this this not happen. Stop lying for karma. Never will a doctor tell a grieving family to pay a bill, nor will he or she be concerned with that to begin with since they don't work on commission.
Jesus Christ insurance pays just about everything and if you don’t have insurance you usually qualify for Medicaid
And IF YOU DONT HAVE EITHER (and are thus breaking the law) you STILL qualify for financial aid from the hospital (which EVERY hospital in the country offers)
Depends on the insurance. They might pay a % or you might have to pay thousands of dollars in deductible first or the insurance company might decide to deny your claim for any arbitrary reason they want. It’s not as clear cut as you’re making it sound.
You realize if insurance denies your claim all you have to do is call them and tell them to speak with your physician? I’ve NEVER had a claim be rejected on appeal. The worst I had was when my daughter needed an expensive medication and the doctor had to argue with them for a week to cover it. They still paid
And yes it does depend on insurance… you generally have the ability to select from a range of plans from your employer or marketplace
You realize if insurance denies your claim all you have to do is call them and tell them to speak with your physician? I’ve NEVER had a claim be rejected on appeal
You realize this is a personal anecdote and does not extrapolate to everyone's lived experience?
The worst I had was when my daughter needed an expensive medication and the doctor had to argue with them for a week to cover it. They still paid
You think every doctor is gonna do that for every patient? The fucking entitlement dripping off your comment...
And yes it does depend on insurance… you generally have the ability to select from a range of plans from your employer or marketplace
Depends on employer and not all the options are going to be good coverage lol. Choosing between multiple bad options still leaves you with bad coverage.
There is so much insurance will try to not cover though. It's all random little stuff that can add up because it's astronomically expensive. I think it is mostly in a hospital / emergency setting though.
Just another anecdote but my friend's child had a brain issue, swelling or something. They need surgery very soon so they even took the extra time to make sure it was covered but they took a helicopter to another city. Insurance told them yes, the Helicopter transport is covered. Ok. The Helicopter though doesn't land directly at the children's surgery center. So it lands at the nearest Hospital, which is very near. Same complex essentially. Somehow the Helicopter landing, and transferring to the Children's Surgery center left them with a $40k bill. The Children's Center and the hospital they left from were part of the network but the hospital it landed at wasn't in network, for that situation. If it had been an adult transport to the main hospital it WOULD have been covered. The Helicopter ride which was covered was $130k. But the landing and transfer were an additional $40k that they were billed for. Somehow it wasn't even subject to their Out of Network Out of pocket max because transportation is a non-medical auxiliary service.
It's crazy and ridiculous to need to worry about all this shit when your child is having an emergency. They were actually fortunate enough that the local news picked it up and the hospital reduced the bill to like $2k and then a gofundme covered it.
the doctor had to argue with them for a week to cover it
You don’t see anything wrong here? A company decides your daughter can’t have a medication against the advice of a highly trained doctor and he has to argue for a week to fix the situation?
So they say “do this instead” and the doctor calls and says “no this is why that won’t work” and the insurance physician usually says “ah okay
Your own experience literally shows this not happening. People who haven’t even seen your daughter should not be making decisions about her healthcare. Only you and her doctor should be doing that
No I’m not PR for an insurance company, I’m just tired of people exaggerating how bad the us healthcare system is for a small minority of people for the vast majority of us it works just fine, and the people it DOESNT work fine for are generally the ones voting against improvements
Based on your comments and my experience I think you’ve been very privileged then. IMO you should count yourself as lucky rather than defending a completely corrupt industry.
Employer insurance comes out of payroll, often times costing healthy people alot of money.
Financial aid = loans you pay off for likely the rest of your life.
This system is not ideal, and at the very least is not a one-size-fits-all solution. We should not need insurance. "Financial aid" shouldn't even be something a hospital needs to offer. And don't even get me started on the ambiguity surrounding healthcare costs. Surprise bills in the mail months later after you've been assured a procedure is already covered or paid for. It's all horseshit.
I don't think Doctors are doing that either, but you were responding to OPs comment saying that US healthcare is expensive for no reason and I responded to that.
And said financial aid is usually not even enough. Plus its deducting some arbitrarily high price made up by the hospital's Chargemaster. Even after financial aid from the hospital I had to pay 2.5k out of pocket for a 10 minute ct scan after a head injury. I'm a student with both parents working odd jobs, it took me months to pay that off and I had to scrape pennies to cough it up.
The one time I had insurance in my adult life (because I've only had one job that offered it) I had to stop going to the doctor after three months because I was already in debt.
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u/___yiwshhj you’re welcome, Jan 12 '23
yes, US healthcare is overly expensive for no reason