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Comment by stouset | Hacker News Reader

Counterpoint.

I have an Aetna PPO and experienced a stroke last year. $100,000+ hospital stay and insurance just… covered it. I paid $1,100 out of pocket.

I had a $100,000+ surgery a few weeks ago to repair a heart issue that may have led to it. They just covered it. No fuss, no hassle. I paid $3,300, which was the remainder of my total annual out-of-pocket, and now I will pay $0 for healthcare for the rest of the year.

For the surgery, I called in advance to double check that it was covered and after five minutes on the phone with a concierge they confirmed that it would be covered.

Obviously I am only a single data point and I can’t speak towards other conditions or procedures. But Aetna has done right by me, at least from within the perspective of our insane for-profit healthcare system.

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I'm glad you had such a good experience. Not a counterpoint, though.

Healthcare is like running water, bridges, or banking systems - a high-volume system with extremely high stakes. We need many nines of consistency as protection against preventable harm.

There are around ~35M hospital admissions in the US every year. Even if 9/10 patient experiences are like yours, that means more than 3.5 million people had a sub-par experience that year - that's the entire population of LA. We need to strive for a much higher bar of quality and consistency.

I’m not defending the current system at all.

I was simply trying to say that, within the confines of the current system, this particular actor has not gone out of their way to fuck me over in the same way that I hear about so many other actors.

I have no idea if my experience with Aetna is common or an outlier. My hope was that by posting this, it would provide a data point for people forced to choose a private health insurance provider in the future. I also hoped to hear from others who had experiences either mirroring or opposite my own.

If I could, I would dismantle our current system in a heartbeat and replace it with some form of single-payer. I can’t, so I tried to provide information about one player within the incredibly fucked up system Americans are forced to operate within.

My father had a stroke here in Ontario at the beginning of COVID. Total out of pocket costs: $0. This includes 2 ambulance transfers between hospitals because our local hospital didn't have the correct facilities for diagnostic imaging. The only real downside of the system in Canada is that medications aren't covered, but most people get some amount of drug coverage in their employee benefits.

> I paid $3,300, which was the remainder of my total annual out-of-pocket

So with insurance you paid more than a European without insurance would, and you call that a counterpoint?

Sure, if GP is in the US and the European is paying 2-3x the income tax rate & earning half the salary.

Depends on the demographic. Moving away from the rich (relatively) HN-er data point is the american in an average earning job much richer than the european after salary difference and tax?

I personally don't understand where these numbers come from. When I moved to Europe, my total tax outlay went down, not up. Aggregating costs across a large pool (everyone in the country) means that I paid less than I did in the US.

Right, and also the actual cost of the insurance which is about $20k per family of four per year. That cost will be born by the employer, partly by the employee, or by the taxpayer via aca subsidies.

Yes. I would gladly prefer to live in Europe and benefit from a sane healthcare model.

I don’t and neither do the hundreds of millions of others who remain in the US. So for those people, I wanted to provide a data point that might help them when they, like me, are forced to make decisions about their healthcare in this system.

And the cost of your Aetna PPO per year?

Also this is anecdotal. I too have an Aetna PPO and can tell you of horrid stories and countless hours on repeated phone calls with them.

Not saying you just did this (you obv did not) but as a whole in this country we need to start dropping the “it didn’t happen to me so something must be wrong with you” mentality. It is pervasive in the healthcare topic and unfortunately in many other facets of American life.

Germans in WWII that enjoyed the fruits of the regime have sang its praises - that didn’t mean the war machine on the whole wasn’t decimating the people and their country. We shouldn’t lose focus of how our country is being decimated by our collective ineptitude.

> Also this is anecdotal. I too have an Aetna PPO and can tell you of horrid stories and countless hours on repeated phone calls with them

Please do!

My point was simply to say that this option is one that has done right by me so far. If there is significant evidence this is an outlier experience, I (and I’m sure others) would benefit from knowing so.

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