The US is the most expensive nation in which to have a baby

It is obviously an insane way to run healthcare. But for the majority of US citizens, they've never experienced anything else. So this insanity is considered totally normal to them. Medical bankruptcy isn't just a thing, it's an expected outcome of any major illness -- medical bills are the most common reason for bankruptcy in the US.

If the US just switched to a proper universal national healthcare system (like say, a clone of UK's NHS), for even just one month, America would never go back to the way it is today. Not suggesting that UK's system is perfect, but it's so much objectively better than the US system that there would riots in the streets, if anyone suggested going back to today's US system.

Which is why we see so much lying about how terrible socialized medicine is, and so much money/time poured into preventing Americans from learning/experiencing it in any way.

I have a preferred doctor who doesnt have an xray machine. Obviously getting an xray image is the first step before even talking to the doctor. An xray of your hand is a _very_ basic procedure. My plan was to get my own image from a conveniently close facility of my choice and bring it to the doctor.

This is an open commercial market right? I decided to play a quick game with this and ask all my in-network local providers what their charge would be for just an x-ray of my left hand.

A car mechanic should be able to quickly give you an up-front estimate for common procedures, why not an imaging facility?

If youve read this far youre probably not surprised I called 4 different facilities, followed up with a series of requests over multiple days and failed to receive even one straight answer except "come in and we will see what we can do".

It makes me realize how soul-crushing the experience can be in this so-called "open market" to find the best possible treatment when you have a more complicated problem. The amount of leg-work, scheduling, waiting for doctors and getting opinions all while in pain would break the spirit of most anyone.

Is it really that much simpler in other countries to connect with the proper provider? I was under the impression countries like canada handle simple problems like mine much more gracefully but serious issues remain problematic.

What you do with those, is you burst them open to relief the pressure, clear the liquid inside (white cells and such) and put some disinfectant. In my (Western European) country it's a trivial 10 seconds operation every pharmacy is authorized to do.

So I go asked at a pharmacy/drugstore for that (probably a Walgreens) -- and they said they weren't allowed to do it and that I should ask at a clinic. I asked how much it would cost for this, if I went at one, and they told me about $150.

Yeah, right.

I just went on and bought a regular clothespin from that pharmacy, burned it with a lighter to disinfect it, and burst the cyst myself...

(And it's not about government mandated insurance vs "really free market" and such. We have mandatory insurance were we are, and the prices for all kinds of operations, both with and without insurance coverage, are still way lower).

That's largely a product of people trying a lot harder to with much earlier premature births than other countries, not a fault in care provided.

There's a lot of ways to frame how the US healthcare system fails people, this one's a canard.

It does, and it's shit like this that makes me absolutely convinced that US is a 3rd world country, where people have to weight their own health vs the financial cost. There's plenty of people saying they don't want to call an ambulance because they are worried what their bill would be. That people would risk their lives and that of their new born baby because there is a financial cost associated with staying at the hospital for another day is beyond absurd, it's like bad fiction about some distant society where things have gone horribly wrong, except that this is real and calls itself the greatest country in the world.

You don't know how much for them 1500 wad nor how high the risk nor whether coming back from home was that much dangerous in case that bacteria happened.

That's an entirely artificial problem created by the AMA (or BMA in the UK) to keep wages high. What if everyone who had the academic ability could train, rather than having to compete for a restricted number of slots? It's how every other discipline does it (they defer competing for places until the job market).

That is a thing called a direct entry medical program. It gets you the the end of medical school in 6 years instead of 8 by dispensing with the undergraduate degree. The extra two years cover the sciences and how to learn at medical school speeds.

It shaves two years off, but at the cost of pinning the student into a rigid track. The number of high school seniors who think they want to be doctors and change their mind during an undergraduate is pretty high.

that's the first thing that should happen. Especially the free market people should want it.

Yes, but also there is the fact that there is an artificial cap placed on total US residency class size, meaning there is a pretty effective bottleneck on actually becoming a medical doctor.

Or the woman dies.

Medicare would oppose this tooth and nail. The lack of pricing transparency enables them to keep reimbursing less than cost, because they can expect private insurers to be forced to pay the difference.

The country where Obamacare was copied from, Switzerland, also outlawed group insurance so (a) you didn't get health insurance from work and (b) EVERYONE was in the same risk pool.

The current situation, you have group policies that are actually affordable because...people with good jobs to provide it typically are lower health risks. Everyone else is stuck a shitty individual pool with lots of high risk individuals. As long as the group pools siphon off all of the low risk, Obamacare won't work.

Regarding universal healthcare, we have a unique viewpoint because we've actually lived universal healthcare in the military.

Long wait times for appointments, crappy doctors that you have no choice but to go see (or have fun paying out of pocket at a civilian doctor), an employer with 100% insight into your medical situation, the loving kindness of a DMV clerk surrounding you while going through the wonder of childbirth for the first time... Ah, those days don't come back.

What are your thoughts on universal (or single-payer) healthcare?

Not picking a fight here, just curious: another person commented on my original post noting that when I said my first birth didn't cost us anything, that wasn't true - my wife's employer paid a fair amount for her insurance.

Are your taxes broken out in the UK? Do you know how much you pay a year for healthcare?

My wife is open to a birthing center, unlike my home-birth overtones which she summarily rejected :)

> So whatever choice you make, tell your wife to listen to her body.

Thank you for this.

In other words, I bought a bronze plan because it fit best with my family situation and my budget, but was I selfish doing so? Should I have purchased a gold plan and therefore put more money in the system which would hopefully help more people?

I think there are a lot of potential solutions to the healthcare issue; either market-based or single-payer, if well-implemented, would be better than what we're doing now.

Practically, it's hard to think like that. I don't know what her employer was paying the insurance company for premium subsidies or the care we received.

I'm wondering where the other poster thinks they would save money vs insurance that covers things like child birth, hospitalization, emergency room visits, etc.

https://imgur.com/a/I0NYI

The box itself is great, but the reason that Finnish mortality rate for babies fell so sharply after the box was introduced was because to qualify for one you had to visit a doctor early in your pregnancy.

Having early contact with healthcare, when pregnant, means you're more likely to do well. The doctors/nurses/midwifes/assistants can frown at you, tell you to eat your vitamins, stop smoking/drinking, etc.

For what it is worth healthcare is not free in Finland, but we paid about €300 for mother, father, and baby to stay in a private room for 3-5 days. (Just over a year ago, I can no longer remember that period. I just remember in the 3-5 days I drank a full bottle of whisky, and smoked a cigar in the car-park, in subzero temperatures. Finland, remember?)

With the experience of a midwife, you are less likely to panic or do something dumb, and you'll have somebody to tell you if there actually is a serious issue.

By being away from pressure for intervention, you will avoid life-altering surgery. If it turns out that you like having kids, you might want more... but this can turn out badly if there are big nasty scars from surgery. To properly consider the hazards of surgery, it is important to consider not merely the present birth, but also all future births.

The delivery, 10 hour surgery, 3w stay in hospital with 3 says in ICU etc was paid for by single payer thank god.

Lots of my friends have had horrid hospital experiences. One had a doctor brutally cut her with a scissors, from her vagina almost to her anus, cutting across all sorts of tendons and meaty bits. (this can cause anal incontinence) She later learned that he was trying to get out of there to not miss his golf tee time. My wife had a similar situation due to the doctor wanting to deal with his flooding house; thus we did our later births elsewhere. Doctors are definitely humans with their own priorities.

Was chatting with the doc during our second birth, the admins had just pulled a bait and switch on the practitioners. Instead of better equipment and surgery rooms, they were getting a few hundred more beds. Beds are easy to bill for. Surgery and actual care are way less profitable.

It’s probably easier to improve training and inexpensive emergency equipment at a birthing center than for a hospital to significantly decrease its cost. If high cost affects quality of healthcare provided, it might be better to fix birthing center edge cases than to avoid them.

https://www.washingtonpost.com/news/wonk/wp/2014/09/29/our-i...

As an aside, Indian private hospitals are far from altruistic when it comes to cost, as recent incidents[1] have shown.

1. https://timesofindia.indiatimes.com/india/fortis-dengue-deat...

The bill turned out to be legitimate, in that the doctor was a "traveling anesthesiologist" and was never an employee of the hospital. And they billed separately, and were never given my insurance information. The whole case ended up relying on my wife's signature on a long legal form that she signed while she was dilated to an 8. All the contact information (address, phone, company name) on the documentation led to people who could not confirm any details on the bill. The hospital told me that they have had a lot of reports of doctors who do their own billing not sending bills for months because they're not very organized.

Eventually the anesthesiologist billed it to my insurance correctly and I paid 10% of it. I later found out I could sue the debt collector for not providing details fast enough, but the statute of limitations on their violation had expired.

Subsequent children were under an HMO, and we never saw a bill.

It’s like car sales people showing fake papers about how much the car cost them. “They are selling to you at cost”.

There is absolutely no way a simple hand X-ray costs multiples of thousands of dollars.

Those were great times.

This is the story of civilization. You've been around for a blip and yet the Internet, flight, mobile phones, vaccines, civil rights, central heating etc. are all available to you.

You didn't contribute to any of that and yet you're the benefactor. For society to flourish it's necessary - within reason - to think beyond your own individual interests, and consider what type of society you want to live in and leave behind.

One in which people are financially ruined if they fall or give birth is surely not the best we can do.

The society you live in needs to replace its dying citizens with new citizens. The easiest way to do that is by existing citizens having children. If having children is too expensive such that the birth-rate shrinks below replacement levels, your society will shrink, and your economy will shrink. This is bad for you, regardless of you having children or not. Therefore, it's in your interest that society uses some of its pooled resources to ensure that the birth-rate is kept above replacement level, i.e. use your taxes to subsidize children.

Most countries have 'socialised roads' and 'socialised healthcare, but the US sees 'socialised roads' as something good but 'socialised healthcare' as something bad. Whereas most other countries, even the so-called 'poor' countries can afford their single-payer 'socialised healhcare', the US finds that too difficult.

Eh, what? Isn't continuation of the human species our number one priority? What's the point with all of this if there are no children to continue. We all will be dust one day, and if there are no children we totally, and completely seize to exist.

Continuation of the species is not a lifestyle choice. Children are not a lifestyle choice. They are necessary.

You can't seriously discuss children in the same context as you would describe any service, investment or consumer goods.

Yes. Because those population strata, not only in the US but across the world, produce the bulk of population with no education, high ecological impact, and scarred by social depravation. It doesn't advance humanity toward an 22nd century-appropriate standard of living to raise a vast population of people who are to become even more utterly worthless in the face of automation and extreme competition even among the elite of the 1st world.

It is beyond me how humanists can support unlimited population growth/"self expression of the individual/right to give birth" when that populuation growth is going to drive countries and continents toward a demographic and social catastrophe. Then again, my personal opinion is we are already on track and about to arrive there on schedule, so what gives.

Not if it was configured appropriately. In Sweden for example if you pay a fine for bad driving, it's not a fixed amount but a percentage of your income.

Nope, not harsh at all, and that's exactly what happened in China with their one-child policy (now a two child policy).

If you were rich, you could just have more kids and pay the requisite fine. If you were poor, well then, abortion for you.

Well, if the human race doesn't solve it voluntarily, Mother Nature will solve it for us, at a time and by a means not of our choosing.

Money is just a token of exchange. What if a certain amount the baby tax was hypothecated to planting trees, to offset the extra CO2 that that individual would produce? You can quite literally figure out how many trees/how much land you need, get the prices and work backwards from there to arrive at a cash amount.

I'm certain victims of mass shootings will beg to differ. Individuals also have a right to not be deceased or live in fear of mass shooters whom you are right, has been addressed with individual right to carry.

Having laws that favor one side heavily is not a standard for 'addressed'. Take a look at Australia, that is proper 'addressing' the issue.

is raising the safety net for the citizens of a rich country that other poorer country have such an existential and threatening notion?

you used the term, plea to describe such safety nets, which is a request made in an urgent and emotional manner. So you recognize that these are the voices of desperate people but still deny their rights.

I can confirm this is the case for both Italy and Spain.

But I have to say that sometimes, even if the National Health Service does provide for free[1] a given cure or analysis (or assistance to birth), in some cases they may be not fast enough (not for the actual delivery, but for some exams/tests) and there are private services (hospitals, diagnostic clinics, etc.) where sometimes you need to go, paying out cash (or - it is now becoming more common - having a dedicated insurance).

In my experience these - though not actually "cheap" - are anyway a fraction of the costs they I have seen mentioned about the US.

While the average income in Italy and Spain is lower than the US, the cost of these services is proportionally much, much lower.

A problem - common enough - has been in recent years the increase in the number of Ceasarian sections, even when there wasn't any need for it, allegedly (but it has not been actually proven) to increase the reimburse to the hospital by the NHS (SSN in italian) or by the insurance company, or to limit the legal responsibility of the doctor in case of complications.

[1] Actually almost for free, there is a complicated system where depending on your income level you may pay a part of the cost.

In some other European countries (e.g. the PIIGS) with the budget cuts, all social care/benefits have worsened dramatically.

"Crony capitalism is an economy in which businesses thrive not as a result of risk taken for them, but rather, as a return on money amassed through a nexus between a business class and the political class."

https://en.wikipedia.org/wiki/Crony_capitalism

(exactly what I explained in a separate comment on this thread :-))

But it is capitalism like it turns out in practice when the population fears "socialism" and caps on corporate greed.