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Outsiders look at the US healthcare "system"

snowflake said:
I watched Michael Moores 'Sicko' recently, its quite staggering how evil a system it is (US)...............I had some major surgery on the NHS of late, in the US my options would have been death or bankruptcy, but I suppose that serves me right for not being successful.

S
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You've missed out the third option. Or is chemistry not your thing?
 
Yank said:
Military service is one way to earn privilege.
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I get that vibe with many Americans with a military background, that I know.
The healthcare package bolsters the kudos of the forces with a "they will look after us" ethos that is less prevalent in many other countries including the UK.
 
Bananahead said:
This should be about fixing the US health care system instead of comparing it to that of other countries. There needs to be regulation of costs. Make insurance simple and affordable.
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One easy way of achieving that is to nationalise it.
 
chartz said:
Not sure about that.
My most recent experience was the A&E at St Thomas’s in London, for an infected appendicitis, that required urgent surgery.
Great staff (incredibly nice nurses), top surgeon, zero cost.
But that was before Brexit.
What now for European visitors?
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If my understanding is correct, anyone who happens to be in the country always gets emergency medical care free of charge. This has never been restricted to European citizens, so Brexit should have had no effect.
 
matt j said:
How common is decent health insurance amongst average workers, say for instance delivery drivers and nursery school teachers perhaps with a couple of kids? Not professionals just regular working folk, can they afford it?
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About half of all full time workers have comprehensive medical insurance. The rest have either a high-deductible plan, which only kicks in after you've paid up to $10k out of pocket in a calendar year, or no insurance. Part time workers rarely qualify for healthcare benefits - that's a key reason that some companies deliberately staff up with part time / hourly pay workers.

My annual deductible is $1500 per person or $3000 for the family - insurance pays once I hit those limits. Several years ago I was on a plan with $5k individual, 10k family deductibles and it makes you think twice. My daughter had a bad ear infection and two pediatrician trips plus antibiotics cost us over $500. We could afford it, but there's a big problem with "well insured" people avoiding seeking care or filling prescriptions because of the high, and often unpredictable out of pocket costs.

Bear in mind also that these are not cheap plans. The monthly premium for a health plan with a $5k/10k deductible is still around $1000-1500 per month. To get a traditional plan where you only pay copays (e.g. $30 to visit the doctor, $200 for ER etc) you're looking at around $2k per month.

And that's before we even get to out-of-network and balance billing. You can go to an ER at a hospital that is in your insurance network and unknowingly get treated there by a doctor who does not contract with your insurance company and that can add thousands to the bill - that your insurance won't pay and you'll have to pay out of pocket. The doctors are not required to disclose to you if they accept your insurance when they treat you.

It's all rather sh*tty, however you look at it.
 
mansr said:
One easy way of achieving that is to nationalise it.
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Obamacare has shown that whatever measures are put in place to try to create a universal private system, the providers and insurers will game it and seek loopholes so as to maximize their income. I think medicare for all is the ONLY way we'll solve the rampant greed and corruption within US healthcare, but I'm not optimistic it will ever happen because there are so many deep pockets aligned against it.
 
sean99 said:
About half of all full time workers have comprehensive medical insurance. The rest have either a high-deductible plan, which only kicks in after you've paid up to $10k out of pocket in a calendar year, or no insurance. Part time workers rarely qualify for healthcare benefits - that's a key reason that some companies deliberately staff up with part time / hourly pay workers.

My annual deductible is $1500 per person or $3000 for the family - insurance pays once I hit those limits. Several years ago I was on a plan with $5k individual, 10k family deductibles and it makes you think twice. My daughter had a bad ear infection and two pediatrician trips plus antibiotics cost us over $500. We could afford it, but there's a big problem with "well insured" people avoiding seeking care or filling prescriptions because of the high, and often unpredictable out of pocket costs.

Bear in mind also that these are not cheap plans. The monthly premium for a health plan with a $5k/10k deductible is still around $1000-1500 per month. To get a traditional plan where you only pay copays (e.g. $30 to visit the doctor, $200 for ER etc) you're looking at around $2k per month.

And that's before we even get to out-of-network and balance billing. You can go to an ER at a hospital that is in your insurance network and unknowingly get treated there by a doctor who does not contract with your insurance company and that can add thousands to the bill - that your insurance won't pay and you'll have to pay out of pocket. The doctors are not required to disclose to you if they accept your insurance when they treat you.

It's all rather sh*tty, however you look at it.
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Mind boggling. Thanks for filling in some blanks, certainly makes you realise how much stress is reduced out of your daily life living here. The NHS isn't perfect but I'd take it any day over the above.
 
sean99 said:
About half of all full time workers have comprehensive medical insurance. The rest have either a high-deductible plan, which only kicks in after you've paid up to $10k out of pocket in a calendar year, or no insurance. Part time workers rarely qualify for healthcare benefits - that's a key reason that some companies deliberately staff up with part time / hourly pay workers.

My annual deductible is $1500 per person or $3000 for the family - insurance pays once I hit those limits. Several years ago I was on a plan with $5k individual, 10k family deductibles and it makes you think twice. My daughter had a bad ear infection and two pediatrician trips plus antibiotics cost us over $500. We could afford it, but there's a big problem with "well insured" people avoiding seeking care or filling prescriptions because of the high, and often unpredictable out of pocket costs.

Bear in mind also that these are not cheap plans. The monthly premium for a health plan with a $5k/10k deductible is still around $1000-1500 per month. To get a traditional plan where you only pay copays (e.g. $30 to visit the doctor, $200 for ER etc) you're looking at around $2k per month.

And that's before we even get to out-of-network and balance billing. You can go to an ER at a hospital that is in your insurance network and unknowingly get treated there by a doctor who does not contract with your insurance company and that can add thousands to the bill - that your insurance won't pay and you'll have to pay out of pocket. The doctors are not required to disclose to you if they accept your insurance when they treat you.

It's all rather sh*tty, however you look at it.
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I worked for and with Americans for years. The thing about losing their jobs which petrified them most was the loss of (a very good) healthcare plan. It certainly creates a corporate culture of compliance and employees who don’t dare step out of line, particularly with the lack of employment protection. Many people in the UK unaware of what happens elsewhere have absolutely no idea what a great deal we get.
 
Ponty said:
I worked for and with Americans for years. The thing about losing their jobs which petrified them most was the loss of (a very good) healthcare plan. It certainly creates a corporate culture of compliance and employees who don’t dare step out of line, particularly with the lack of employment protection. Many people in the UK unaware of what happens elsewhere have absolutely no idea what a great deal we get.
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The ACA (Obamacare) has taken some of the fear out of job loss, since you can sign up for health insurance without fear of being rejected for pre-existing conditions, and should you be out of work for a protracted period your insurance premiums will be quite heavily subsidized. It was absolutely awful prior to this - if anyone in your family had medical conditions and you lost your job you would have little choice but to be uninsured until you got another job. One accident or illness and you'd likely lose everything, since a week in hospital is an easy $100k. Bigger companies have to offer you the option to continue on the work insurance plan, but you must pay the premiums + 10%, which is usually > $2k per month for a family.

However there are still big gaps. You can be fired with no notice, and your health insurance can end that very day - you'll have to cancel any appointments, start the application for an ACA plan and wait 4-6 weeks until the ACA plan starts. Don't get sick or injured during that 4-6 weeks or, again, huge, life altering bills will roll in. Also if anyone in your family is receiving regular treatment (e.g. chemo) you'll have to put that on hold while you get insurance sorted out, and then possibly change doctors if the new insurance plan has a different doctor network.

Many Americans plan their lives (jobs, marriages) around health insurance - it's been that way for so long they regard it as normal.
 
Minio said:
I get that vibe with many Americans with a military background, that I know.
The healthcare package bolsters the kudos of the forces with a "they will look after us" ethos that is less prevalent in many other countries including the UK.
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It also gets you first in line for a job in government or with the police.
 
sean99 said:
The ACA (Obamacare) has taken some of the fear out of job loss, since you can sign up for health insurance without fear of being rejected for pre-existing conditions, and should you be out of work for a protracted period your insurance premiums will be quite heavily subsidized. It was absolutely awful prior to this - if anyone in your family had medical conditions and you lost your job you would have little choice but to be uninsured until you got another job. One accident or illness and you'd likely lose everything, since a week in hospital is an easy $100k. Bigger companies have to offer you the option to continue on the work insurance plan, but you must pay the premiums + 10%, which is usually > $2k per month for a family.

However there are still big gaps. You can be fired with no notice, and your health insurance can end that very day - you'll have to cancel any appointments, start the application for an ACA plan and wait 4-6 weeks until the ACA plan starts. Don't get sick or injured during that 4-6 weeks or, again, huge, life altering bills will roll in. Also if anyone in your family is receiving regular treatment (e.g. chemo) you'll have to put that on hold while you get insurance sorted out, and then possibly change doctors if the new insurance plan has a different doctor network.

Many Americans plan their lives (jobs, marriages) around health insurance - it's been that way for so long they regard it as normal.
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You're forgetting COBRA, which allows you to continue your existing coverage for up to 18 months (I think) after being canned, at your own expense, of course.
 
Bananahead said:
This should be about fixing the US health care system instead of comparing it to that of other countries. There needs to be regulation of costs. Make insurance simple and affordable.

As a side note, it is only when you leave the UK that you start to understand that the NHS is not that great.
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To where? All Western European countries have an NHS. And the UKs isn’t any better or worse... Middle of the table last time I looked.
 
If I shared that video on Facebook, I doubt anyone even would watch it. Most people only care about their health when it's too late.
 
gordon said:
You're forgetting COBRA, which allows you to continue your existing coverage for up to 18 months (I think) after being canned, at your own expense, of course.
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I think this only applies to companies with more than 20 full time employees, and the premiums are usually well north of $2000 a month. A useful stopgap if offered, though.
 
gordon said:
You're forgetting COBRA, which allows you to continue your existing coverage for up to 18 months (I think) after being canned, at your own expense, of course.
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"...at your own expense" being the key phrase here. That's a big bill for an unemployed person. Typically COBRA will be more than your unemployment check.
 
COBRA was about $800/month for me and my wife about 12 years ago. Expensive, yes, but not if you have cancer...or a broken bone. But, yes, it’s a stop-gap measure in a patchwork “system.”
 
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