92 percent of US adults are not going to the doctor – too expensive | Hacker News Reader

92 percent of US adults are not going to the doctor – too expensive

independent.co.uk

44 pointstesting2232131 comments

It's not just that it's too expensive. It's the uncertainty. No one knows how much anything costs until you get the bill several months afterwards. Every time you go to the doctor, you're giving them a blank check.

There is a story of my aunt who got bitten by a snake when camping.

She was foolish enough not to take out travel insurance. There was no way she was getting a medevac so a park ranger watched over her for a few days while her body was fighting death.

This is why you should always have travel insurance because outside of Europe the first thing a doctor asks for is a credit card.

Not true.

Doctors and hospitals in Australia dont ask for a credit card before or after you leave.

There are many other countries around the world who dont ask, not really fair to paint the world that way.

I think "outside of the US" would be a more accurate summary of the situation.

If something happens to me here I go to the hospital, fill out the intake form, get treated, and maybe get given a followup appointment with my GP. That's all, there's no payment required.

In a lot of the developing world it's quite reasonable - you pay like $80 or something and that's it. Nowhere else is it as financially scary as the US.

I don’t believe the headline, full stop. More than 8% of people go to the doctor. I don’t care how they defined “not going to the doctor”, if someone has a painful infection or trouble breathing, they’re going to the doctor.

What counts for the purposes of ‘medical treatment’? Does getting a quote for plastic surgery and not doing it count as ‘delaying care’?

Whatever polling was done is so broad that it’s meaningless, you might as well claim 100% of people forego medical care.

I'm skeptical of the 92% figure as well (I'd guess that 60-70% of people have forgone advisable medical care at least once), but there's no question that a large percentage of people in the US avoid getting medical care because of the cost.

> if someone has a painful infection or trouble breathing, they’re going to the doctor.

That's not a given at all. I know people who have avoided going to the doctor for painful infections because of the cost. I've done the same myself.

"Trouble breathing" is an interesting thing, because there have been more than one instance in my city of people who didn't avoid going to the doctor but did die because they couldn't afford the ongoing care their conditions required.

The headline is safe to ignore, as are most headlines. In the survey results it's 92% of insured adults delay (not avoid, delay) going to the doctor.

https://www.jgwentworth.com/resources/medical-emergency

Pfft. My buddy separated his shoulder snowboarding. Never went to a doctor. 20 years later it’s still janky

Given that 20% of Americans have a net worth above $1M, all of the stats in this article seem way too high.

For example, it says that 85% of Americans have medical debt. I probably owe a copay or two that gets lost in the mail and I eventually pay. Do I count in that 85%?

> Given that 20% of Americans have a net worth above $1M, all of the stats in this article seem way too high.

Net worth includes retirement accounts and equity in homes. There are a lot of people in this group who are "house rich, cash poor". They may have a $500k home and $500k in their 401k, but they don't have $1 million in cash on hand. That's something you might access for an emergency or to cover costs for serious health issues, but it's not the sort of capital you dip into for much less than that.

Medical care in the US is insanely expensive, but also -- at least in some parts of the country -- it can be difficult to get at any price. Good luck finding a doctor that is taking new patients at all in my part of the country.

It's also a really weird two-tier system, private practice and everything else. When I worked in the US I just went to the local community health place like I would have done back home and... it was pretty shocking. It was literally like clinics I've been to in Africa, junk piled up everywhere, grubby and run-down, a few hugely overworked and most likely criminally underpaid staff trying to cope. And this was in (well-off) Westchester County in New York, not some holler somewhere.

This number sounds implausibly high to me, and I can’t find any information on the exact survey question. If someone has some muscle aches, but they don’t go to the doctor immediately because it’s probably nothing and they don’t want to pay the copay, is that counted as delaying medical care due to cost?

Given that would never happen in every other OECD country, yes, it does.

So essentially the stat claim is meaningless?

Not at all. As you said, someone has a medical concern, and they don’t go to the dr because of cost.

Exactly as the stat says

We should be concerned because somebody values the health care received less than a $30 copay?

In my experience, it is the blood tests, x-rays, ultrasounds, cat scans, and interpretations ordered by the physician. The labs, technicians, and interpretation may or may not be in network. Six months after the visit, I get a bill from a third party I never heard of.

There are many OECD countries where primary care appointments are not free. France, Switzerland, Japan, etc.

Countries that do make them free still have some sort of rationing mechanism that prevents primary care practitioners from being overwhelmed. In the UK, for example, appointment requests are triaged based on urgency and non-urgent appointments will often have to wait a while. In Canada, it's somewhat quicker to get appointments with your provider but much harder to find a provider if you don't already have one.

More generally, the goal of a functional healthcare system is to make sure everyone gets the care they need to achieve good health outcomes, not to ensure that everyone can have as much of a doctor's time as they'd like.

> the goal of a functional healthcare system is to make sure everyone gets the care they need to achieve good health outcomes

Which the US system fails at, miserably

Absolutely, but if you want to fix it you have to understand why and how it fails. If you think that 92% of Americans can't afford adequate care, you're going to be very confused by the shape of the debate. If the status quo is working for only 8% of Americans, how can it possibly be that we're not shaking things up?

The reliable polls I've seen (https://news.gallup.com/poll/654044/view-healthcare-quality-...) tell a very different story. Most Americans understand that the healthcare system has big problems, but the vast majority think that the care they personally receive is good, although there's been a slight downtrend since 2020. So it's hard for any reform proposal to gain traction without reassuring that majority that the healthcare they enjoy won't go away.

> the vast majority think that the care they personally receive is good

Which is actually the problem.

Americans have been propagandised for so many decades they are not well educated enough to have a clear understanding of where their country lags behind developed countries.

Reply on news.ycombinator.com