Based on how much my little girl’s ICU admission cost,
https://kingsley.sh/posts/2021/two-weeks-in-the-icu-as-a-bab...
there is no way (in my mind) that their ICU admission will be free.
https://kingsley.sh/posts/2021/two-weeks-in-the-icu-as-a-bab...
there is no way (in my mind) that their ICU admission will be free.
The bill is eye-opening, thank you for sharing. I have no hard data, but I believe private medical care in the UK is so much cheaper, simply because there is the alternative of totally free health care from the state. It's not perfect, but any condition you have, they (eventually) do, and to a high level of professionalism (exceptions notwithstanding).
I know treating people requires highly trained, dedicated stuff, advanced technology and medication, and those aren't cheap, but I can't help but feel that something is broken in the US. One of the few things putting me off jumping across the pond.
I'm actually British, I moved to the US in 2016. Me/my family have used our fair share of the NHS - my mom suddenly died when I was 12, my dad is in remission from prostate cancer after treatment, I've had kidney stone surgeries, 8 years of orthodontics, major jaw surgery, broken bones, bad childhood asthma, etc. https://kingsley.sh/posts/2021/staggering-cost-of-surviving-...
I agree, I got world-class care, by world-class medical professionals, but, I also earn 2x than the average worker, I can afford to pay $700/m, the highest plan my employer offers. We still got a mistake $2.5 million dollar bill, we went to collections 3 times for less than $50, etc, etc.
The icing on the cake was my daughter being denied Medicaid because I earn too much. They skipped over HER 1-in-700m to 1-in-2b diagnosis, and her many disabilities, to deny me because I earned too much. I was told I'd need to spend the GoFundMe money (which ultimately paid for my baby's funeral), my 401k, any/all savings, and maybe even consider getting divorced (I'm here on a marriage green card). I like the good, but despise the bad.
How do people in the US who don’t have insurance get treatment for themselves or their family members in situations like this? It seems inconceivable to me that they or their kids are just expected to die?
https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
And generally, if you have nothing, the government will pay for you. However, quality and quantity of healthcare will likely not be as high.
The rough spot is in the middle when you have some assets, but not enough for a secure life, but do not have insurance, then you will have to forfeit your assets in order for the government aid to kick in, and then you are poor.
Is this the source of significant delay in diagnosis? Does it increase or decrease overall costs of treatment? Does it meaningfully alter expected prognosis of the middle income US patients etc
By law, annual out of of pocket expenses are capped:
https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...
However, based on the median income in the US, many Americans would have to think twice about scheduling a doctor’s appointment and being on the hook for an unexpected hundreds or thousands of dollars.
It is all a form of rationing healthcare, so having people think twice about going to the doctor at the expense of some people’s health is part of the system.
Which is where a lot of elderly people who need long term care end up.
Basically, yes. Hospitals are required by law to treat anyone who presents themselves to the emergency room (thus the ER is the primary entry point for many people, regardless of symptom) but they get triaged to the bottom of the queue. Hospital insurance administrators can and do intervene in doctor decisions on care.
Medical debt in the US was already a crisis before the pandemic. It can push people out of their homes and pretty much destroy them. Even some with insurance make gofundme pleas to try to cover their medical bills.
I can't find any evidence of this happening using Google. Do you have any?
Worse is the hospital revenue people intervening in care decisions. There was an expose about this in the NYT a few years ago; as far as I can tell nothing has since changed.
As far as "hospital revenue people intervening in care decisions," that doesn't mean people don't get care. It means they may not get super expensive treatments. That certainly may not be the best care, because, all the ER needs to do, legally, is ensure that the patient's condition is non-emergent before they discharge them, but it's completely unrelated to triage. It is, however, a predictable result of hospitals needing to make a profit.
Do you have any hints or keywords I could search to find the NYT article?
But everybody working in an ER knows this so surely you know someone you can ask who will be more authoritative than some rando like me on the net.