You can use the difference in comp to buy a Cadillac level plan with zero deductible, zero out of pocket max. You won’t be going bankrupt.
More importantly, it doesn't solve the real problem. You're still subject to the same system. Fighting for prior authorizations, staying in-network, and navigating all the other administrative friction.
More than likely they'd find a way to make you go bankrupt rather than pay up. That or deny till you die.
So high deductible it is! Only met the out of pocket max once and it was glorious.
Before Obama, the zero deductible plans were only slightly more expensive than the high deductible plans. (Just an observation)
Seems crazy I was able to make an appointment directly with a specialist and only pay the copay back then…
I’m on the cheapest plan my company negotiated and my premiums are basically zero, because I’m young enough that most years I don’t spend more than a thousand bucks on health care (for me and my kids). Couple years ago I did hit the out of pocket max, though, and they did indeed cover everything from that point at 100%. I would never have gone bankrupt.
You can pay a lot of money in premiums, have a $0 deductible, and now OoP maximum, and still end up having claims denied.
I realize some people are stuck with UHC. I’d turn down a job unless it was perfect in every other way and paid extremely well if they only had UHC plans.
Should everyone (anyone?) receive monoclonal antibodies, gene therapies, biologic medications? What criteria should be used to make these determinations?
Yes. Everything that they are trained and able to do here, is covered by the national insurance, at least where I live.
We never even have to explicitly ask them to approve anything, it's all automatic. You don't see the bill.
You might have to pay the difference for "nonessential upgrades", like a plastic cast instead of a normal one when you break your arm. Had to pay 5.00 EUR for that and it was the only time I had to pay out of pocket in my entire life.
This is exactly what happens in the US. It's just that in your case the nonessential upgrade is a $5 cast. Sometimes the nonessential upgrade is an expensive surgery. My grandfather had heart surgery at 86 shortly before he died. My relatives went to 3 surgeons who all refused to perform surgery on the grounds that he was too old and frail for the procedure. Then they went to a fourth who agreed to perform it. The first three doctors were right, and he died a few months later. The insurance company quite correctly denied the claim and my family ended up fighting them over a bill for open heart surgery north of $50,000.
Your government wouldn't (and shouldn't) have paid for that surgery either. I think the real difference is that since you have a government system, that in your country that unnecessary surgery just never would have happened in the first place. I will admit this is a more efficient system, but it is no different in that there is a cost benefit analysis being done over what gets paid for and what doesn't whether you see it happening or not.
Diagnostics aren't free, either: many (most?) countries do not have anything remotely resembling the private offerings that Quest Diagnostics and Labcorp provide (breadth of tests, 3+ different methodologies for some tests, etc.)
I had an MRI denied for a partial pectoral rupture. Which was a routine diagnostic as a precursor to open shoulder surgery to determine the extent and location of the rupture to figure out if surgery was absolutely necessary and to prep a viable surgical plan.
I had to fight the insurance company with the assistance of both my surgical and non-surgical sports medicine doctors.
The good news though appears to be that I imagined the entire thing, because denials for routine things never happen.
And from my personal experience with narcolepsy, AI is a much better doctor than most human doctors.
To give an example, about 60 to 80% of the time, when I visit the dentist for a regular cleaning the charge is denied and I have to submit additional paperwork to convince them to pay it. I can't think of any more simple and basic procedure than that.
I have no idea why your experience with healthcare in the US is so much better, but I can assure you that there are many people whose experience is more like mine.
Yes, if that's an indicated and effective treatment.
Do you think people should just be left to die if they can't pony up the dough in the hospital? Oh, your card's declined, no oncology ward for you?
What if they have a 99% likelihood of death, are unlimited funds expended in this case?
What if there's a shortage on drugs - who should get the limited supply available?
Which country with public health options pays for biologic medications or similar patient-tailored solutions?
It depends on what would be an effective and indicated treatment.
> What if they have a 99% likelihood of death, are unlimited funds expended in this case?
Then treatment would neither be effective nor indicated. But if it was your parent, your child, your granny, wouldn't you rather they at least try?
> What if there's a shortage on drugs - who should get the limited supply available?
The people for whom treatment is most likely to be effective
> Which country with public health options pays for biologic medications or similar patient-tailored solutions?
The UK, for a start.
We're not the customers of healthcare, insurance, mortgages, etc. The planet's wealthiest pensioners are. No difference in comp is going to make that work out best for you.
Also, the existence of Cadillac plans implies that someone in our government doesn't believe the population at large should be receiving world-class care. It's like when Senator Biden had two cranial aneurysms, had top surgeons flown in on taxpayer dime, then fought against universal healthcare.
We're all already paying for the best healthcare in the world, just not for us.