Clarification.
US health is great if you are employed, have a good income or are retired and on medicare. If you don't fall into those categories it is pretty tough
US health is great if you are employed, have a good income or are retired and on medicare. If you don't fall into those categories it is pretty tough
We have a terrible, stupid, inefficient system. It's drowning in its own chaos and bureaucracy.
Healthcare insurance doesn't get to dictate your healthcare directly. They aren't doctors, and open themselves up to liability if we don't push back.
[0] https://www.healthcare.gov/appeal-insurance-company-decision...
Life isn't always easy or fair, but standing up for yourself is important as you are your best advocate.
I don't think "do it out of pocket and try and claw the money out of them after the fact" was ever on our list of options. I wouldn't consider that unless the lawyers suggested it. We were looking into going overseas to have to done, which honestly its another big indictment of this system.
The point still stands about how insanely inefficient this whole system is at the macro level. The fact that lawyers are getting involved in routine medical procedures or doctors are suggesting what they know is incorrect treatment is a sign of deep inefficiencies. We aren't an outlier either. It is profitable for the insurance companies to jerk you around, fight you, try and sneak past denials were they can.
https://www.healthcare.gov/appeal-insurance-company-decision...
But I appreciate that it's a tough topic and not engage further. Good luck with it.
They aren't supposed to, but in reality, of course they do. They just have an on staff doctor who rubber stamps the decision.
With expensive procedures, they have a financial incentive to find a way to say no.
My wife probably burned 10+ hours of her life making phone calls that amount to "No no, I've already called the insurance company and they say the record is wrong on your side! I have to call your other office? No, I already called them! Why am I still getting a bill when it must be covered by the insurance ...!!!"
And none in our family is even badly sick. Don't want to imagine what will happen if one of us actually gets sick.
US healthcare system fucking sucks.
This is also usually necessary to find out if something will be covered.
Some of these change when you're truly end of life and in the ICU, and otherwise there are brief flashes of doctors actually giving you attention. But for the most part trying to receive healthcare in the US is like squeezing blood from a stone, independent of the soul crushing billing shakedowns.
It's more like you can imagine US healthcare is great if you don't need it, or don't proactively think about what needs to be done. Of course that's a great way for something to go unaddressed and kicked down the road until the next appointment (or ER visit).
I can't speak to other country's failings, but I can say this bogeyman narrative about "government run health care" is utterly fallacious. We already have the equivalent in the form of corporate-bureaucracy-first health care.
It's mid-tier all the way around except for cost, where it far exceeds any other system in the world.
Never being able to access the healthcare you're paying for because you can't afford the insane deductibles is even worse than not having healthcare at all, because when you DO have an emergency that you need to see a doctor for, your rates would often be lower out of pocket with the money you could have saved.
I can point you to several people who have great jobs, great insurance, and tens of thousands of dollars in medical expenses. Nowhere else in the civilized world does this happen.
Every other developed country has a better system than ours. Every one.
And for those who say "oh, well wait times are so much higher" - well you can get supplemental insurance in many of those countries as well - so the baseline isn't abysmal, but wealthy can get even better.
But if you purchase, or negotiate excellent coverage you can get excellent care. (You still have to do some research to find the best providers)