It's also telling when the hospital gives you different bills depending on if you're insured or not. If you're insured they charge waaay more. They give you a more "realistic" bill if you are uninsured.
It's a ridiculous system.
It's a ridiculous system.
The doctor then demanded full payment for his non-discounted rate-- 6x the insurance reimbursement rate.
To my mind, acceptance of the "deal" was done when the doctor took me on as a patient and agreed to perform the procedure. At that time the practice had full knowledge of what the reimbursement rate would be. I see the doctor's "windfall" of demanding the non-discounted rate as being fraudulent.
He made an argument (that I considered specious) about "fairness" to other patients and problems he'd had in the past with patients mistreating the office staff because of perceived "unfairness" in his offering discounts.
My attorney advised me that I'd likely spend more money fighting the doctor than just paying him. Because I care (probably more deeply than I should) about my credit rating I opted to pay the doctor and put the whole mess behind me. I also ditched my pre-ACA insurance that carried this never-expiring pre-existing condition waiver and moved to an ACA plan with no such waivers.
The surgery center that was involved in the ordeal was much more reasonable, BTW. They charged me the amount my insurance company would have reimbursed them. When I brought this up to the doctor (who is also a partner in the surgery center business) he simply stated that his office's policies differed from those of the surgery center, and that his policy was to receive his full fee.
I've often thought this could be solved by legislation (something like the uninsured cannot pay more than the lowest insurance + copay amount), but lots of folks are against such price controls.
As long as Americans can't stomach the idea of turning away people who cannot pay for emergency care to die we have socialized medicine. I don't understand why we can't, as a society, have a "grown up" conversation about this fact.
Instead of this perverse system of "shadow" socialized medicine, fraud, and over-billing, why not just make it come out of everyone's taxes? That way everyone pays a very modest amount in tax and no one has to be financially ruined by flukes of nature.
Also kills a huge amount of overhead in the billing departments, collection agencies, insurance companies, etc.
(No system is perfect; there is always room for improvement and trade offs)
Just two weeks ago, my wife had an emergency appendectomy. She went to the free clinic first thing Sunday morning as she had terrible pains all night. They immediately referred to the local hospital. She had the ultrasound in the afternoon and Surgery at 3:00pm. She's been off work (more or less) for 2 week recovering. The only thing we paid for is parking.
This[1] redditor in the US has the same surgery and it cost $55,000 dollars, which insurance covered a lot of but still left him with an $11,000 bill. That's just one simple surgery and that's not a small amount of money.
[1] http://www.cbsnews.com/news/cost-of-an-appendectomy-reddit-u...
longer wait times for non-emergency treatment and (most of the time) not being able to pay cash and get the procedure done without the wait. personally know ppl in Canada (Toronto, so not some little town in the boonies) who had to wait few months to get an MRI.
on the US side - takes 2 weeks or so to get the insurance company's approval (they do this dance with a mandatory x-ray and electromyogram appointment before approving) or $500 or so gets you in like tomorrow.
the kicker of course is they will charge the insurance company $3k.
that said - the current US system needs a major overhaul, no doubt. both Obamacare and the not-there-yet "Trumpcare" are lipstick on a pig solutions though.
On the other hand, my experience with the US is that the service is great. They'll even send you for unnecessary tests just because. And it's all pretty fast. But then you have so many people who get nothing at all. And then many of those who do get something are totally bankrupt.
There is no system that can give anyone health care and not have a triage system. So you might have to give up some comfort so your neighbors can live.
I remember reading in the news they were considering charging a nominal fee, like $5 to cut down on these types of visits. On the US side you'd pay around $50 for one of those visits (unless you go to your doc) - wait time is like 10 min.
I actually wouldn't mind something similar to a Canadian system - if they can manage that without tax increases :) - plus a private "network" someone who can afford paying for a private insurance (or using straight up cash) can use.
Actually making an appointment with your family doctor is also free. You don't have to go to a walk in clinic.
I really want to see actual studies on this. We Americans LOVE to throw this in the face of the countries with single-payer, yet we conveniently gloss over the fact that many Americans PUT OFF health care procedures because they can't afford them. I've done it and I know many, many others that have as well. Oh, this is going to be 1500$ out of pocket and doesn't need to be done today? Great let's schedule it for 2 months out.
Additionally, Americans also have wait times for non-emergency procedures. Colon cancer runs heavily in my family and so all of the older members get regular colonoscopies. I have several anecdotes of family members having to wait 6 months before they can get it and get theirs done.
AMERICANS ARE NOT ANY BETTER WHEN IT COMES TO WAIT TIMES. However, the onus is typically not on the provider, it's on the patient. So we describe the situation differently even though it's the same outcome, the patient has to wait for treatment.
In comparison, e.g. most European countries use a combined two-tier approach, where the role of the government is to ensure universal basic coverage and affordability of that coverage, but not to replace private insurance entirely.
Source: lived in US for 20 years.
They just don't want to give their money to a bunch of bureaucrats, who spend it mostly on themselves, and seem to multiply like rabbits.
[NB I'm just out of a UK NHS hospital so therefore feeling very warm and fuzzy about our favourite chunk of socialism].
You won't find many conversatives in other countries who want to give up their socialized medical system.
Americans aren't generous. Americans are preoccupied with moving money. The more it moves, the faster it accumulates to the top of the economic pyramid.
In fact, a single payer system would sharply reduce the number of jobs for health care administrators -- to the point that I've seen a blog post somewhere pointing out that these people would need income support and retraining. The economies of several small cities depend heavily on these jobs.
As someone who just had a few days in an NHS hospital I'm pretty much delighted with the experience. When was money mentioned? Not once, not once.
Seems a tad callous even by my standards as a staunch classical liberal; may be all other medical services but not emergency services.
The "conservatives" who bellyached that the ACA created "socialized medicine" willfully ignored (or were ignorant of) the fact that the mandate to treat emergency patients regardless of ability to pay "socialized" medicine when it was passed (by "conservative" stalwart Ronald Regan) in the EMTALA[1] in 1986.
[1] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...