Ten years ago I was spending at least half that amount, and what kills me is that I'm a single guy — if I was paying for a spouse or a family plan it would be about double the cost. And the sad thing is that my coverage from ten years ago actually gave me more coverage.
I'm happy to pay for coverage and be responsible, but the insurance companies at this point are pretty much on the level of racketeering mobsters. I had hopes for healthcare reform: But without a public option or killing the insurance companies I don't see much changing any time soon. I really hope that more pressure builds and people demand a real change.
As an aside, what you need to look up Medicare rates are the HCPCPS codes (call them "hick pick" codes on the phone so you sound like you know what you're doing). Just call your hospital and ask for them. They'll give them to you; they just mail you a new form separate from your actual bill. Then, just plug those codes in here:
(use a "specific locality" to get the rates in your area). Then you're ready to negotiate! But... good luck with that...
I'm with Anthem Blue Cross in California. In 2011 they spent 79.9% of premiums on actual medical expenses and due to law changes had to issue a refund for 0.1% This year they raised premiums by 22%.
Various administrative expenses are hidden all over the place. eg the cost of an appendectomy also includes the cost of recovering the money charged.
The problem with the US healthcare system isn't any one part. Every single part is broken in some way, with the interoperations between them compounding to make the problem worse.
Not the insurance companies as the entity which takes all that money, no, everyone here knows that.
It is the insurance companies in the sense that the insurance companies are in no way brake on costs, they are an accelerator. They take a cut of the whole and have an incentive to keep the whole high.
And what is wrong with this exactly? We all get old eventually, so this subsidy is actually fair.
> You'll be paying significantly more, with no direct benefit.
Only true if you don't plan on getting old.
Of course, that's an average covering every man, woman, child, pensioner etc. People in paid employment are paying at least double that (in tax). It's not far from your $10000 figure.
Of course, on the up side the NHS is hassle-free. I don't have to worry about co-pays, or money at all. I just go when I need it.
Source for budget: http://en.wikipedia.org/wiki/National_Health_Service#Funding
Source for population: https://www.cia.gov/library/publications/the-world-factbook/...
Of course, that's an average covering every man, woman,
child, pensioner etc. People in paid employment are
paying at least double that (in tax).
I currently have awesome coverage (by USA standards) and still have to pay ~20% of visit out of pocket.
Actually, that last part I'm guessing. Because of the back and forth game played between insurers and providers, I get confused, and haven't expended the effort to figure out the actual monies exchanged.
Low premium usually means high deductible. GP's premium is probably high because his he's buying as individual or small company. Meaning he has little negotiating power.
The major costs here are two-fold:
1) old people
2) doctors and hospitals (those huge, beautiful new buildings aren't free: http://www.feinberg.northwestern.edu/gfx/news/2012-year-revi...)
This is not "free", far from it, but, first, by taking no margins and then having tougher cost review for infrastructure/equipment purchase help reduce the cost. Then using generics drugs instead of branded ones by default also help. Remember, many hospital and doctors have official or under the table deal with private providers.
Then there are side benefits. People live longer and healthier. Their kids don't have to live in fear of having to spend 100k$ if their parent felt ill. My grand mother (91 years old) broke her arm and pelvic bone a few weeks ago. Of course, at her age, it wont heal, so it had to be replaced. How much would it cost in the US? 200 big ones (including a month or so of hospitalizations, the 2 surgery, the drugs and follow up). How much stress would it put on my family on top of the accident?
At some point, even for those who can pay, some level of social security, both health and monetary one reduce uncertainty and reduce crime rate. To some point, I understand US mentality on this. I tried to create startups a few times, it seem a lot harder here than everywhere else. It is not even socially acceptable to both succeed and fail. If you succeed, then you are a greedy asshole and if you fail you are a loser. But even giving that, I still think having universal health care and the other "big government" goodies is a good thing.
They definitely are. Doctors in the U.S. make more money. Drugs are more expensive, partially because the U.S. subsidizes R&D for everyone else. Hospital construction in the U.S. is insane in the major systems. They're "spare no expense" affairs, very different from the utilitarian facilities you used to find in the U.S. in say the 1970's and which you still find in the U.S. today.
No, not really. My american, pediatrician drove a beat up Subaru. Doctors is a pretty big field that covers GPs (PCPs in the US), surgeons, anaesthesiologist, etc. Surgeons make a lot of money in the US and everywhere, but your typical GP is not ballin'. I'd even say doctors in other western countries make more because no student loans and no malpractice insurance means their take home pay is higher.
Drugs are more expensive, partially because the U.S. subsidizes R&D for everyone else.
This list http://en.wikipedia.org/wiki/List_of_pharmaceutical_companie... has the top 2 drug companies being in the US and 3rd, 4th, and 5th are european. The US does subsidize the worlds R&D in erectile dysfunction research ;-). There are plenty of drugs that have been approved elsewhere that haven't been seen in the US.
(US GPs make sharply more than those in Europe).
The problem is US health care is for-profit and the "American way" is that there is absolutely no limit on that profit, so they charge whatever they want.
The broken part is that they charge whatever they want and then stop anyone else from being able to charge less. If you do the first half, but not the second, its very much not the American way.
Where these exist (most states) you'll have a hard time opening a new facility whose purpose to charge less than the incumbents. (In theory they'd have to charge more to make up for the business you take away so you'll be raising prices.)
Heck in California (I don't know about other states) the sales tax is paid based on the purchaser address, not the address where the sale takes place like for other goods.
Or how foreigners aren't allowed to own more than 50% of an airline.
For a land of free business, there is an awful lot of protectionism going on.
If I needed 10k for a medical problem I'd be completely screwed. It's not like they will treat cancer in the emergency room.
The idea that poor people do not get top notch medical care in the US is largely a myth. It might not be quite as nice but it is often nearly as effective. A large part of the reason medical care is so expensive for average people is that they are subsidizing the healthcare of poor people. This is why the average survival rates for most cancers are higher in the US than anywhere else in the world; people that cannot afford it still get treated with the state of the art and the cost is passed on to people with insurance.
A poor person with cancer in the US with cancer has a much higher survival rate than the average person in the UK. Poor people may not have official insurance but that does not imply lack of healthcare in practice.
EMERGENCY CARE must be admitted, ie. loss of a finger - it most certainly is not free and that person will never be able to get credit for the rest of their life (unless they can somehow afford to repay it - but an ambulance flight in is at least $10k alone)
They are under no obligation to treat cancer. If you were bleeding out from the final stages, they might have to admit you. Otherwise it's not an emergency. You are free to die slowly.
If you don't catch the cancer early on and can get some federal assistance to get it treated, you are pretty much screwed. They pretty much know with cancer you aren't going to be paying them back for any services rendered, so none rendered.
If you are a step above federal poverty level yet still cannot afford to pay for medical or dental treatment in this country, you are screwed. Your entire income will be consumed as you get older by medical needs. If you get cancer, your best bet is to then make sure your income completely disappears and apply for all the assistance you can get, your job income then becomes a liability.
So you are calling parent a liar? That his story can't be true because someone without insurance but with liver cancer would just die under our heartless system?
> If you are a step above federal poverty level yet still cannot afford to pay for medical or dental treatment in this country, you are screwed.
You definitely have a problem, but I think you severely underestimate the amount of charity care that goes on in the US, which is why our hospitals charge so much anyways. You can go to the hospital, get treatment, they will bill you later, and...they won't run a credit check first.
> If you get cancer, your best bet is to then make sure your income completely disappears and apply for all the assistance you can get, your job income then becomes a liability.
You can get charity care without being on medicaid.
Do you have any references?
I have been able to find this
Global Cancer Statistics, 2002 DOI 10.3322/canjclin.55.2.74
That shows essentially the same survival between the US and western Europe. (Link to table http://i.imgur.com/UWPxDEx.png )
Which contradicts the claim
I think they worked hard on getting comparable data, but I find the discussion on where they come from somewhat lacking. There is some discussion on inconsistencies between diagnoses (when is something Cancer X?), but I could not find a discussion on QALy's (http://en.wikipedia.org/wiki/Quality-adjusted_life_year). I expect that can make a decent difference in 5 year survival rates (if you give patients the choice between 6 months in bed in hospital and 3 months at home, the last on bedridden, quite a few would choose the 3 months)
I suppose I generally consider that when US/UK cancer survival is brought up in this manner it inflates US medical treatment and uses the UK as a proxy for western rest of the world medical treatment - however this isn't true as Cuba, France, Canada and Australia for example hve essentially the same survival from that chart as US survival...
That person with stage 4 liver cancer? What if it were skin cancer - it looked funny, but they can't get it checked out. Until it is an emergency... and by then it could be too late. Even then, the emergency room will say it is too big to treat from there and refer to the normal doctor most times. This isn't top notch medical care. This is "suffer until it is dire, and maybe you'll wind up surviving in pain"
I'd much rather pay an insurance tax so everyone is covered. I doubt it would be much more than people pay now for insurance since everyone would be paying in.
We have universal healthcare coverage in the USA, the difference between the USA and everywhere else is we'll bankrupt you first in order for you to access it.
This is an incredibly inefficient, heartless, and needless way to run things, yet it's what we have. I see a few comments below you talk about no access to cancer or chronic care if you're poor but there are tons of programs, grants, etc. that you can access, except you must be genuinely poor. And spend a lot of time finding them, and filling out paperwork, and on and on and on. You'll get care, but it will be psychologically, financially and physically demanding for you and everyone around you.
That's more than a third of the median US individual income.
And that was just a routine pregnancy with no complications...
The same thing happened to me. Over a span of 10 years, I went from having HMO $30 copay and no deductible to $5000 deductible plus another $7500 out of my pocket for co-insurance and the monthly payment being 2X as high.
(and in the UK, where I live now, things are even easier...)
Sounds like quite a lot to me considering i would pay (here in Canada) ~66$ a month, ~$800 a year (0 co-pay i think its called), if my employer didn't pay my insurance fee for me. And prescription drugs are also mostly covered... 10K really sucks :(
That's a fucking shitload of money.