I have really good insurance. I work at a great company with great healthcare benefits. My monthly cost is only about $60. Even with that, things are not always as they seem.
A few weeks ago I got sick. Really sick. I had a fever over 101. I was coughing, sweating, freezing, vomiting, had a headache, and just felt like crap. After a couple of days of my symptoms only getting worse, I went to the doctor. I didn’t have a primary care doctor (I know, irresponsible of me), so I went to a local clinic. $107 after my insurance paid its part. The prescription was another $15.
The next evening (a Friday), my temperature was on the rise. When it broke 102, we called the doctor I saw the day before. She said I needed to go to the hospital. $481. There is also a charge of $17 for tests. A follow up doctor visit (I had passed my deductible by this point) cost $8.
It turned out I had a nasty virus. They were not sure what kind. But that virus cost me $628. Good thing I have a good job.
But here is what makes me livid. What did it really cost for me to be sick. I paid $628 and my insurance company paid $3362 (glad I have insurance). So apparently being sick cost a total of $3990.
BUT WAIT! DOES IT REALLY COST $3990?
The doctors and hospital billed my insurance company for $5650. Apparently it costs $1660 more than I cost to be sick? That can’t be right. Can it? Why would it cost an uninsured person $5650 to be sick but only cost me $3990 to be sick? I would like to think I got the ‘good looking person’ discount, but no matter how attractive I am, I know that is not the case.
The fact of the matter is that we take advantage of people who do not have the financial insight or means to take care of themselves. If someone who can’t afford insurance walks in with the same problem as me, they are charged thousands more just because they don’t have insurance. That is disgusting, wrong, and should be illegal.
I don’t know why we allow this sort of atrocity to continue in this country. We are allegedly the most developed and powerful nation in the world, yet we can’t even take care of our own sick people without sending them into bankruptcy unless they are privileged enough to have insurance.
To me, going to the doctor is a human right, not a privilege for the wealthy. I usually try to keep politics to my personal blog, but I know that when I vote in 2012 and every year after, I will always vote for the person that thinks every single American deserves top quality healthcare no matter what.
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21 thoughts on “The Disgusting State of American Healthcare”
99% of the time, if the uninsured person will tell the provider **in advance** that they don’t have insurance, they will get the **real** price, which is some 25-50% of the price charged those who do have health insurance.
This has been borne out time and time again. Providers change the insurance companies a bunch more, so when the companies pay the “allowed” amount, it will be something close to what they originally intended to charge to start with.
I didn’t know that happened regularly. Interesting insight, I will have to read more about it.
Not only is it expensive, but how did you feel about the care? My wife is a RN and we are real picky what doctors we use. We are both extremely healthy, but regularly see our doctors. Unfortunately, young people do not. Health care needs to change, but no one is attacking the high cost . The answer is not a HMO.
What do you think we should do to improve our healthcare system in the US? I used to be on an HMO, but now I have a PPO plan.
Hi there. I think you under estimating quality of American health care.
Once we have to call to emergency for our little one and it arrived within 2 minutes.
This is truly miracle and i depends on insurance, ours cost us 20 dollars per visit – that is it.
Emergency call cost us nil, including trip to hospital.
You have to travel to third world to understand how grateful should you be for what you have at home.
That is a good point. I think we do have great doctors and great technology, I am more upset about the financial side of our healthcare industry.
In Canada, we still have to pay for our dental coverage. Usually patients with insurance are charged higher rates since the the dentists know that the insurance companies won’t investigate etc.
I’m thinking that maybe in your case, the doctors are charging more because they don’t believe that the patients will pay 100%. If a patient pays 50% or declares bankruptcy, the doctor will benefit to a much higher degree than if he had charged the uninsured patient the same rate as he did you.
I never thought about dental insurance in Canada. I always just figured it was included with the national medical system. Thanks for sharing.
and guess what, this time next year, every one of those charges will be 10% to 15% higher because that’s how hospitals do business. I have been in the systems end of hospital billing for 40 plus years and every year some exborbitant arbitrary rate increase gets decided to be applied across the board.
I have never sat on that side of the table, but it does not shock me to hear that charges go up every year. As the Governor of Montana discussed just this morning, doctors often focus on performing more services per patient to increase revenue. They should focus on the end health of the customer. Our insurance system pushes them to do that in a very unfortunate way.
agreed! That is why it is worth even having a low premium plan with minimal coverage. Insurance companies automatically get a discount. It just isn’t right.
I would rather have great coverage than a minimal plan, but anything is better than nothing. As you could probably tell, I am a fan of single payer national healthcare.
The state of healthcare in Canada is not the greatest, either. When I was suffering from constant headaches, I had to pay for a diagnostic test out of pocket otherwise I would have had to wait ONE YEAR before I could even get the test, let alone the results or any follow up.
When my grandmother needed to have surgery in order to correct a hernia that was impeding her from walking properly, it took the doctors over SIX MONTHS before she was finally admitted, and she never had a date, either — she had to keep harassing the doctors. I was also really not that impressed by the response when she had her stroke. I’m thankful she made a recovery, but it was in spite of the medical system.
Whenever I visit my family doctor, he always tries to get rid of me by saying “oh that’s normal” and pressuring me to leave if I take up more than 5 minutes of his time, even though I had to wait hours before seeing him. And, I’m one of the luckier ones because I do have a family doctor and I don’t have to wait 6+ hours in a clinic.
Let’s face it — in ANY system where there is a disconnect between doctor and patient, whether that disconnect is caused by a dysfunctional symbiotic relationship between insurance companies and government, or whether it is caused by a single payer system like we have here in Canada — the quality of service will decline, and the price will concomitantly increase. I figure that our household is paying more than $10,000 a year in health care via a combination of private insurance and public insurance, and I really don’t see the value.
That is also an interesting perspective that really makes you think about how things work. There are so many inputs and possible scenarios in health systems. Comparing the US to Canada and comparing our systems to the UK and Scandinavian countries gives a wide range of possibilities. Of course, the best care often comes with higher costs. Finding the sweet spot of good value is difficult.
About the insurance thing, my own experience is that things cost less for me as an uninsured person. When I was in school there was a time I wasn’t on the student insurance plan, and during that time I paid for my dental stuff out of pocket. The dental provider charged me about half the price that they would otherwise bill the insurance companies.
My personal opinion is that insurance is mostly a racket, including the public system here and including the private systems, too! Hundreds of dollars of “free” massages and stuff like that? Comeon! 🙂
The way we use it in health care it’s as if you used insurance to pay for your oil change or a minor ding on the door, or worse, as if you used insurance to pay for your car wash! Using insurance like this just drives up the costs, especially when we have an encylopaedia of regulations and red tape! Insurance should really be for protecting people from catastrophic loss, not creating a market for insurance companies to skim billions of dollars off the top.
In Canada many of the costs are in terms of waiting time, care that doesn’t exist, pushy doctors, higher taxes, and what not, so sure, it’s not as directly felt or seen, but that doesn’t mean that they don’t exist.
If we want people to be healthier it’s clear that neither the American system nor the Canadian system are models to follow. Maybe one way out of this mess would be devolving all responsibility for health down to the state level, and let different states try out different rules and regulation to see what works better in terms of delivering better health care and what doesn’t. It’s really hard to do that when you’re working at such a big and complex level and when you’re dealing with dictionaries of red tape — how do you analyze and compare?
Thanks for that detailed comment. This article has an interesting perspective an an interesting benchmark: http://www.factcheck.org/2009/08/cancer-rates-and-unjustified-conclusions/.
I think the long run answer is very complicated. My favorite system is a single payer national health system that encourages inefficiencies and protects everyone. That is, of course, easier said than done. Most government agencies have little oversight on efficiency outside of budgets. They should be encouraged to run like a business and produce the maximum result at the lowest cost.
At the end of the day, I just want everyone to be covered no matter what their financial situation. If you are rich and want to pay more for private insurance, that should be allowed just like private schools.
The natural, logical consequence of healthcare as a “right” is forcing doctors into the field and into necessary specialties. You can’t possibly have a right that requires someone else to actively do something, or you are intruding on their rights.
Having a right to live in peace and safety forces firefighters and police officers into action. Having a right to security forces soldiers into battle. People choose a profession, including medicine, because they believe in what they are doing. Doctors (at least in the future) would know what they are getting into.
Having a right to live in peace requires simply that bad guys leave you alone. Barring that, you have the absolute right to defend yourself.
You do NOT have a right to fire or police protection. I can cite court decisions from all levels and districts admitting that “serve and protect” is nothing but a marketing slogan. Castle Rock v Gonzalez, USC2005 is a prime example.
The UK has a huge medical brain drain because being a doctor used to bring prestige and wealth. Now, it brings paperwork nightmares and debt. We’ll get the same results. We will have fewer doctors the more that .gov regulates cost, price, and demand. The result is waiting periods and rationing, as proven by every government-run healthcare system in the world, including our own medicare and VA systems.
Salaried general practitioners in the UK earn between £53,781 to £81,158 a year plus extra for overtime and hours outside of the standard work day. I don’t think people making $83,000 and up are starving.
what he means by having health-care as a right, is having equality where health-care is concerned. So if no one gets any health care then so be it but when the wealthy have good health-care, i think the less wealthy deserve equally good care or at least decent care not refusal. I think the American health service is nothing more than absolutely disgusting. As far as im concerned your nation is not a great nation. How can it be called great when it doesn’t even provide for peoples basic needs. Its gross. People who do not care that other people are left without basic needs are gross.
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