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Old 21st August 2019, 06:34 AM   #1
Seismosaurus
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Medical costs

So I'm a UKer, and this thread isn't to boast on the NHS or anything, but I'm kind of curious because I'm a fairly heavy user of medical services and I wanted to get an idea of the costs of the services I do get, if I lived somewhere like the US. Obviously it's going to be difficult to give exact numbers, but just a rough idea is fine.

So most recently, I got a rash. Thought it would go away, it didn't. Turned out to be bigger than expected, too, and came with a persistent headache, so I rang the docs. Got a same day appointment (admittedly this is lucky, usually have to wait a week or two) with a nurse practitioner.

Spent about 30 mins with her. Turned out I had shingles. Yay. She consulted a doctor and put me on two meds, Flucloxacillin and Aciclovir... both of which probably won't do much because I waited too long to go in, but she gave them to me anyway to be on the safe side and hopefully prevent any further spread.

Total cost to me, £0.

So, one nurse visit, one GP consult, couple of boxes of pills. If I'd been American, or other places without an NHS equivalent, and assume no health insurance, what kind of cost would you be looking at for that? Hundreds? Thousands? More?
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Old 21st August 2019, 06:42 AM   #2
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I'd estimate a couple of hundred, definitely more than one hundred but probably less than three hundred. The drug costs are the real wildcards but you might get generic equivalents if they're super pricy. You didn't have any lab tests, those would tack on another hundred or so easily.
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Old 21st August 2019, 07:19 AM   #3
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Doesn't your own government report the amount of money it's spending on your healthcare?

Total cost to you was $0 (not counting the taxes you've paid into the system over the years). But there was a cost. Somebody is paying the doctor to show up and look at you. Somebody is paying the drug company and the parcel service to get you your medicine. As I understand it, that somebody is your government. And as I understand it, they're paying for it with your money. Why not ask them how much your shingles cost?
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Old 21st August 2019, 07:34 AM   #4
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Originally Posted by theprestige View Post
Doesn't your own government report the amount of money it's spending on your healthcare?

Total cost to you was $0 (not counting the taxes you've paid into the system over the years). But there was a cost. Somebody is paying the doctor to show up and look at you. Somebody is paying the drug company and the parcel service to get you your medicine. As I understand it, that somebody is your government. And as I understand it, they're paying for it with your money. Why not ask them how much your shingles cost?
Because he is expressly not in the least bit interested in how much it costs the NHS and wonders how much it would cost in backward countries that do not have universal health care, free of charge, at source. Look;

Originally Posted by Seismosaurus View Post
...snip...I wanted to get an idea of the costs of the services I do get, if I lived somewhere like the US. Obviously it's going to be difficult to give exact numbers, but just a rough idea is fine...snip...

Why are you directing him back to the UK with his completely harmless query?

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Old 21st August 2019, 07:34 AM   #5
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Originally Posted by theprestige View Post
Doesn't your own government report the amount of money it's spending on your healthcare?

Total cost to you was $0 (not counting the taxes you've paid into the system over the years). But there was a cost. Somebody is paying the doctor to show up and look at you. Somebody is paying the drug company and the parcel service to get you your medicine. As I understand it, that somebody is your government. And as I understand it, they're paying for it with your money. Why not ask them how much your shingles cost?
One of the key cost savings of the NHS, as I understand it, is that, although it asks questions like that in general terms, it doesn't need to employ the army of accountants required to drill down to the level of specificity required to answer them for an individual patient. Rather, it determines what treatments are cost-effective, on a basis of statistical outcomes over large numbers of patients and overall costs, and offers those treatments freely. The overall result appears to be a very substantial cost saving, in return for considerable uncertainty as to the fine detail.

Dave
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Old 21st August 2019, 07:43 AM   #6
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Originally Posted by Dave Rogers View Post
One of the key cost savings of the NHS, as I understand it, is that, although it asks questions like that in general terms, it doesn't need to employ the army of accountants required to drill down to the level of specificity required to answer them for an individual patient. Rather, it determines what treatments are cost-effective, on a basis of statistical outcomes over large numbers of patients and overall costs, and offers those treatments freely. The overall result appears to be a very substantial cost saving, in return for considerable uncertainty as to the fine detail.

Dave
They also don't need to have a massive billing department. They don't have patients default on money owed. They don't have problems exacerbated by people waiting until they're impossible to ignore because they couldn't afford care.

They don't have to pay a profit margin for an insurance company. Or a marketing department to compete with other insurance companies.

In the US, when I pay an insurance company or a doctor or the part of my taxes that funds healthcare, parts of it go to this massive list of costs that the UK system doesn't have to bear.

Market fetishists love to talk about the efficiency of markets, but private companies create all of these massive inefficiencies.
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Old 21st August 2019, 07:48 AM   #7
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I can only share what it would cost at my office if you were a self-pay patient:

Visit as a new, self pay patient: $95. Now, if you could demonstrate some kind of financial hardship, we may be able to reduce your cost. We even see some patients for free.

You likely would not have gotten a script at my office if the clinician didnít feel it would help much. But if you did, it almost surely would not have included the antibiotic. The antiviral would cost you $8 at the least expensive pharmacy option but about $15 on average.

So around $103 or less, depending.
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Old 21st August 2019, 07:53 AM   #8
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Originally Posted by bluesjnr View Post
Because he is expressly not in the least bit interested in how much it costs the NHS and wonders how much it would cost in backward countries that do not have universal health care, free of charge, at source.

Well maybe we should be interested in how much it cost the NHS to deliver that service, no? Thatís the only way you can make a meaningful comparison. $100 might sound like a crazy amount or might sound kind of cheap depending on what it costs the people of the U.K. to deliver that care.
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Old 21st August 2019, 08:06 AM   #9
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Originally Posted by xjx388 View Post
Well maybe we should be interested in how much it cost the NHS to deliver that service, no? Thatís the only way you can make a meaningful comparison. $100 might sound like a crazy amount or might sound kind of cheap depending on what it costs the people of the U.K. to deliver that care.
The problem is, the nature of the NHS means that it is unable to answer to that level of detail. We can compare overall cost of the health care system with overall effectiveness of the health care system, in which the NHS typically comes out as one of the best in the world; but it's the very features that make it so efficient that also make questions unanswerable at the level of individual patient case studies.

Dave
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Old 21st August 2019, 08:08 AM   #10
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Originally Posted by Dave Rogers View Post
One of the key cost savings of the NHS, as I understand it, is that, although it asks questions like that in general terms, it doesn't need to employ the army of accountants required to drill down to the level of specificity required to answer them for an individual patient. Rather, it determines what treatments are cost-effective, on a basis of statistical outcomes over large numbers of patients and overall costs, and offers those treatments freely. The overall result appears to be a very substantial cost saving, in return for considerable uncertainty as to the fine detail.
I'm not asking for that level of fine detail. But surely the NHS must have records of how much they pay their doctors. Even in general terms - "a doctor with X years of experience, practicing in Y specialty, is paid between L and M per annum" - it would still be a pretty good estimate of costs.

And I would be very surprised if NHS doesn't have a schedule of medicines and their costs worked out somewhere.

There's also something vaguely implausible about the premise that they're saving a lot of money by the strategy of not keeping track of what they're spending it on.
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Old 21st August 2019, 08:12 AM   #11
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Originally Posted by theprestige View Post
I'm not asking for that level of fine detail. But surely the NHS must have records of how much they pay their doctors. Even in general terms - "a doctor with X years of experience, practicing in Y specialty, is paid between L and M per annum" - it would still be a pretty good estimate of costs.

And I would be very surprised if NHS doesn't have a schedule of medicines and their costs worked out somewhere.
What we can compare, as I said, is the high level cost/benefit ratio of the NHS as a whole relative to other health care systems. Studies are fairly easy to find by a quick Google, and typically they show that the NHS is outstandingly good in terms of global value for money. ETA: Here's a starting point.

Originally Posted by theprestige View Post
There's also something vaguely implausible about the premise that they're saving a lot of money by the strategy of not keeping track of what they're spending it on.
It's more a conclusion than a premise.

Dave
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Old 21st August 2019, 08:31 AM   #12
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Originally Posted by Seismosaurus View Post
So I'm a UKer, and this thread isn't to boast on the NHS or anything, but I'm kind of curious because I'm a fairly heavy user of medical services and I wanted to get an idea of the costs of the services I do get, if I lived somewhere like the US. Obviously it's going to be difficult to give exact numbers, but just a rough idea is fine.

So most recently, I got a rash. Thought it would go away, it didn't. Turned out to be bigger than expected, too, and came with a persistent headache, so I rang the docs. Got a same day appointment (admittedly this is lucky, usually have to wait a week or two) with a nurse practitioner.

Spent about 30 mins with her. Turned out I had shingles. Yay. She consulted a doctor and put me on two meds, Flucloxacillin and Aciclovir... both of which probably won't do much because I waited too long to go in, but she gave them to me anyway to be on the safe side and hopefully prevent any further spread.

Total cost to me, £0.

So, one nurse visit, one GP consult, couple of boxes of pills. If I'd been American, or other places without an NHS equivalent, and assume no health insurance, what kind of cost would you be looking at for that? Hundreds? Thousands? More?
The nurse visit and the GP consult would cost up to a few $hundred, as already noted (post #2).

As also noted, the wild card is the ďcouple of boxes of pillsĒ. The two you name are, AFAIK, available as generics, so perhaps $10-30 each? But if you were somehow forced to buy brand name, then it could cost you very dearly.

Then thereís where ... here in the US, costs to the uninsured vary widely (or wildly)!
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Old 21st August 2019, 08:34 AM   #13
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Originally Posted by JeanTate View Post
Then thereís where ... here in the US, costs to the uninsured vary widely (or wildly)!


I see a lot of medical invoices from the USA.

We have them 'repriced'

The difference between the original invoices and the 'repriced' invoices would make your socks fall off.
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Old 21st August 2019, 08:40 AM   #14
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Originally Posted by Dave Rogers View Post
What we can compare, as I said, is the high level cost/benefit ratio of the NHS as a whole relative to other health care systems.
I'm not asking for a comparison, high level or otherwise. I'm asking if the British government keeps any records of how much it pays doctors employed by the NHS.
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Old 21st August 2019, 08:50 AM   #15
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Originally Posted by JeanTate View Post
Then thereís where ... here in the US, costs to the uninsured vary widely (or wildly)!
The self-pay paradox is that some uninsured get charged less by some providers, out of pity and reason, whereas other providers will charge the uninsured more because the insured are getting discounts negotiated by their insurers. So technically self-pay are simply not getting discounts rather than being charged extra, but the effect is the same.

The system may make business sense but that doesn't mean it makes medical sense. I've worked in healthcare for a while now, and the broad consensus on the provider side is we'd just like to earn decent livings and make enough business-wise to stay in operation and provide good healthcare to the patients. When I was on the insurer side the ideal was to make money, and if people got good healthcare that was a pleasant bonus.
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Old 21st August 2019, 08:57 AM   #16
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Originally Posted by TragicMonkey View Post
The self-pay paradox is that some uninsured get charged less by some providers, out of pity and reason, whereas other providers will charge the uninsured more because the insured are getting discounts negotiated by their insurers. So technically self-pay are simply not getting discounts rather than being charged extra, but the effect is the same.

The system may make business sense but that doesn't mean it makes medical sense. I've worked in healthcare for a while now, and the broad consensus on the provider side is we'd just like to earn decent livings and make enough business-wise to stay in operation and provide good healthcare to the patients. When I was on the insurer side the ideal was to make money, and if people got good healthcare that was a pleasant bonus.
A good summary.

Kaiser Health News seems to do a good job on reporting reality. Some of their reports on health care delivery in (some) rural districts make your blood boil, and also be amazed at some of the selflessness evident in the behavior of the local nurses and doctors.
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Old 21st August 2019, 09:05 AM   #17
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With my insurance, total cost would have been $36.

$20 for the appointment (HMO copay. No deductible.)
$8 for each prescription, assuming you get generics.
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Old 21st August 2019, 09:09 AM   #18
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Rural healthcare is depressing. I never realized how expensive it is to run a hospital until I started working for them. Sparsely populated areas just can't generate enough revenue to keep a hospital running, not without government subsidy. And with those subsidies shrinking or just ending completely rural hospitals have to either merge into larger chains or go under. The former is complicated by anti-monopoly regulations: a few years ago a couple of rural hospitals in trouble offered themselves to my employer. We had to decline because we already had as many hospitals as we are legally allowed to have in that area. So they closed, and if the people in that region need to go to the hospital they have to drive a couple of hours. But sadly even if my employer had been able to acquire them they would have operated at a loss, and we'd be using our city and suburban hospitals revenue to make it up. Even as a not-for-profit we still need to make enough to keep the bills paid.
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Old 21st August 2019, 09:13 AM   #19
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Originally Posted by TomB View Post
With my insurance, total cost would have been $36.

$20 for the appointment (HMO copay. No deductible.)
$8 for each prescription, assuming you get generics.
At the risk of asking a personal financial question, what sort of annual cost would that represent for medical insurance?

Dave
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Old 21st August 2019, 09:16 AM   #20
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Originally Posted by theprestige View Post
I'm not asking for a comparison, high level or otherwise. I'm asking if the British government keeps any records of how much it pays doctors employed by the NHS.
I would imagine so. I would imagine it also keeps a record of all the other costs associated with healthcare, such as buildings and infrastructure, services and utilities, capital depreciation and support staff costs, all of which and more would be needed to calculate the actual cost of a specific treatment to a specific patient. But I very much doubt it does that calculation to that level of detail.

I don't know many other ways to say "The information you're asking for probably doesn't exist," but if you insist I'll keep trying.

Dave
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Old 21st August 2019, 09:32 AM   #21
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My cost when I had shingles: charge for an office visit to my gp, s120. Medication, $37.50 (one prescription). Because I had not yet met the deductible for my health insurance, I was out of pocket $60.00 for the office visit. There was a $10.00 copay for the medication. My insurance premium that year was $400.00 a month, with a $500.00 deductible. Once the deductible was met, an office visit would be a $20.00 copay.

Recurrence of shingles is rare but does happen. I have better insurance now, but because of some other issues, my doctor strongly encouraged me to get the Shingrix shingles vaccinations (2 required). I am getting them, but my insurance pays zero. Cost to me: $320.00.

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Old 21st August 2019, 10:16 AM   #22
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Originally Posted by Dave Rogers View Post
I would imagine so. I would imagine it also keeps a record of all the other costs associated with healthcare, such as buildings and infrastructure, services and utilities, capital depreciation and support staff costs, all of which and more would be needed to calculate the actual cost of a specific treatment to a specific patient. But I very much doubt it does that calculation to that level of detail.

I don't know many other ways to say "The information you're asking for probably doesn't exist," but if you insist I'll keep trying.

Dave
I understand that the information does not currently exist and that the Government probably has not done the necessary calculations to come up with a cost per visit number. But they definitely have all the information they need to do the calculations and I would be very interested to know what it costs to provide different kinds of care in the UK. I'm a little shocked that the NHS is not really interested in that number.


ETA: As the manager for a medical office, I know exactly how much it costs us, on average per patient, to provide care and exactly how much revenue we get per patient. This seems like basic, essential information that would be necessary to be fiscally responsible.
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Old 21st August 2019, 10:16 AM   #23
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In California, based on low income and a disability, I qualify for a program that pays most Dr. visits, and I only pay a small co-pay for prescriptions.

I really don't know what I would do without it.
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Old 21st August 2019, 10:19 AM   #24
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Originally Posted by Seismosaurus View Post
...snip...
So, one nurse visit, one GP consult, couple of boxes of pills. If I'd been American, or other places without an NHS equivalent, and assume no health insurance, what kind of cost would you be looking at for that? Hundreds? Thousands? More?
You may have trouble finding a comparison to Americans without any health insurance. Given that the great majority have insurance, I suspect there may be few to none on the forum.

My most recent medical adventure was the result of an accident (fell out of tree) five ribs broken in eight places, punctured lung, tension pneumothorax, cracked vertebra, broken scapula. That resulted in an ambulance ride, a two week hospital stay with X-rays and NMRI, chest tube, drugs, etcetera.

I'm retired, covered by insurance from a former employer. $0.
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Old 21st August 2019, 10:24 AM   #25
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I didn't want to edit again but just to add . . .

I would wager that the biggest cost difference between the two countries is in the Hospital and Pharmaceutical sectors, not office-based primary care. Now that our office participates in an Accountable Care Organization and Medicare Shared Savings , this has become glaringly obvious. If we could find a way to lower those two cost areas, the US would spend so much less.
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Old 21st August 2019, 10:31 AM   #26
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Originally Posted by Seismosaurus View Post
….Total cost to me, £0.

So, one nurse visit, one GP consult, couple of boxes of pills. If I'd been American, or other places without an NHS equivalent, and assume no health insurance, what kind of cost would you be looking at for that? Hundreds? Thousands? More?
My HMO would cover it all at no cost to me. I live in the USA and pay $578/year for family coverage. I have to go to certain treat facilities though. If I go somewhere else, then I end up paying part of the bill which could be hundreds of dollars.

Ranb

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Old 21st August 2019, 10:51 AM   #27
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Originally Posted by theprestige View Post
I'm not asking for that level of fine detail. But surely the NHS must have records of how much they pay their doctors. Even in general terms - "a doctor with X years of experience, practicing in Y specialty, is paid between L and M per annum" - it would still be a pretty good estimate of costs.



And I would be very surprised if NHS doesn't have a schedule of medicines and their costs worked out somewhere.



There's also something vaguely implausible about the premise that they're saving a lot of money by the strategy of not keeping track of what they're spending it on.
You are right such costs are known, for instance for a NHS (England) GP visit the cost is about £30.
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Old 21st August 2019, 10:55 AM   #28
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Originally Posted by xjx388 View Post
I understand that the information does not currently exist and that the Government probably has not done the necessary calculations to come up with a cost per visit number. But they definitely have all the information they need to do the calculations and I would be very interested to know what it costs to provide different kinds of care in the UK. I'm a little shocked that the NHS is not really interested in that number.


ETA: As the manager for a medical office, I know exactly how much it costs us, on average per patient, to provide care and exactly how much revenue we get per patient. This seems like basic, essential information that would be necessary to be fiscally responsible.
Don't know what the rest of my UK citizens are on about. Of course the NHS knows these costs, it's one of the ways it makes sure it spends its money efficiently.
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Old 21st August 2019, 01:33 PM   #29
kellyb
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Originally Posted by Darat View Post
You are right such costs are known, for instance for a NHS (England) GP visit the cost is about £30.
That makes sense, for a 15 minute visit. The government often owns the building the GP uses, right? And maybe even pays the utility bill?

I know the malpractice insurance docs in other countries pay is lower than in the US, too, because those costs are "socialized".

And then there isn't the army of billing experts to be paid like in the US, where docs have to fight tooth and nail for payment from the third party payers.
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Old 21st August 2019, 01:40 PM   #30
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Taxes are theft or something.
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Old 21st August 2019, 01:46 PM   #31
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Exclamation

Without insurance, I would have paid $100 upfront for an office visit, plus meds which would probably come in between $10-30. Los Angeles area.

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Old 21st August 2019, 01:49 PM   #32
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Originally Posted by Dave Rogers View Post
One of the key cost savings of the NHS, as I understand it, is that, although it asks questions like that in general terms, it doesn't need to employ the army of accountants required to drill down to the level of specificity required to answer them for an individual patient. Rather, it determines what treatments are cost-effective, on a basis of statistical outcomes over large numbers of patients and overall costs, and offers those treatments freely. The overall result appears to be a very substantial cost saving, in return for considerable uncertainty as to the fine detail.

Dave
Yes,

When I have time, I might dig out my posts that referenced papers looking at the administrative and advertising costs in US healthcare - it was well over 30%
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Old 21st August 2019, 02:51 PM   #33
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Just gonna toss this in here:

I had an MRI at a county hospital. My insurance was billed.

$4500

I had a second MRI (same injury) a year later at a private clinic and I paid cash. More modern equipment too. Included diagnosis.

$515

$4500 vs $515 for the same exact procedure. I wonder if that's a problem.
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Old 21st August 2019, 03:03 PM   #34
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We have a NHS in Australia, but it’s different to the UK. If I went to a doctor who charged the scheduled fee (many, if not most, charge more) the visit would be free. The medication would cost though. If subsidised (and I’m certain shingles medication would be) it would be several dollars, if not it could be a lot more.

If I thought it an emergence I could have gone to a public hospital for free treatment but a several hour wait in A & E. Or I could have gone to a private hospital with a short wait and maybe a $200 fee.

The real problem in Australia is surgery. Waiting periods for serious, but non-emergency surgery (like hip replacement) in public hospitals can be years. This is why I and around half of Australians have private health insurance, which effectively buys access to non emergency treatment.

Occasionally a conservative politician comes up with a plan to abolish our NHS and the idea is not stupid. It usually involves allocating NHS money direct to hospitals and let the market sort things out (this pretty much how our school system works). But any party that takes a plan like this to an election will be wiped out. Our NHS is here to stay.
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Old 21st August 2019, 03:17 PM   #35
The Norseman
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Originally Posted by Seismosaurus View Post
So I'm a UKer, and this thread isn't to boast on the NHS or anything, but I'm kind of curious because I'm a fairly heavy user of medical services and I wanted to get an idea of the costs of the services I do get, if I lived somewhere like the US. Obviously it's going to be difficult to give exact numbers, but just a rough idea is fine.

So most recently, I got a rash. Thought it would go away, it didn't. Turned out to be bigger than expected, too, and came with a persistent headache, so I rang the docs. Got a same day appointment (admittedly this is lucky, usually have to wait a week or two) with a nurse practitioner.

Spent about 30 mins with her. Turned out I had shingles. Yay. She consulted a doctor and put me on two meds, Flucloxacillin and Aciclovir... both of which probably won't do much because I waited too long to go in, but she gave them to me anyway to be on the safe side and hopefully prevent any further spread.

Total cost to me, £0.

So, one nurse visit, one GP consult, couple of boxes of pills. If I'd been American, or other places without an NHS equivalent, and assume no health insurance, what kind of cost would you be looking at for that? Hundreds? Thousands? More?
Okay!

So my daughter (age 23) and I (age irrelevant ) recently went on a week-long cruise to Alaska.

Second day, she got quite ill and was basically bed-ridden for 20-something hours before I decided she should see the on-board doctor. The hesitation was, of course, due to financial reasons.

We went and she got checked out. I questioned every procedure first and made it quite clear we were having to pay out of pocket. The doc showed the evidence and suspected my daughter of having appendicitis. They couldn't do much, but with her temperature, complaints of abdominal pain, absence of other symptoms and somewhat high WBC... the doc insisted that we be disembarked in the next town to be seen in the ED. The next morning. In the meantime, she was given some IV antibiotics on the ship; the first bag leaked all over the bed before they realized it and no one could say how much medicine she got; the doc decided it wouldn't hurt to give a second full bag. The nurse on the ship was massively (in my mind) incompetent and had to stick her three times to get a good vein for the IV line.

So, she spent the night on board and claimed feeling better the next morning but once again the doc insisted. With no real choice, we had to leave.

In the Ketchikan hospital, she had an ultrasound and CT and was given fluids. After about five hours, we were cleared to rejoin the ship.

Total bill from all agents involved: about three thousand dollars.
My daughter's mother was able to get a month's coverage through COBRA, but still had a $1,500 deductible which would have to be paid out of pocket regardless.

The ship bill was around $1,200; she was charged for the two attempted sticks at about $18 a piece as well as the first bag of antibiotics which had drained onto the gurney. We were also charged $250 for the fees for disembarkation.

The CT was something like $800 as was the ultrasound. Other charges too I don't recall.

Turns out that she wasn't suffering from anything other than probable food poisoning or a similar malady.

The whole time we were massively pressured to having all these tests, most especially the "oh this is standard" pregnancy test which my daughter and I both refused at first until finally relenting in the ED. Oh, it looked like we were charged for the pregnancy test by the ship-board doc, even though they pushed it there and we both flatly said no. It was a urinalysis so it was pretty easy to figure out if it were actually done or not, so I'm quite confident it was just another ******** charge that they hope to sneak by in the moment and make it much harder to fight later on.

And that, in a nutshell, is the typical and standard method of healthcare in the US.
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Old 21st August 2019, 03:22 PM   #36
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Originally Posted by Ranb View Post
My HMO would cover it all at no cost to me. I live in the USA and pay $578/year for family coverage. I have to go to certain treat facilities though. If I go somewhere else, then I end up paying part of the bill which could be hundreds of dollars.
At that rate I assume your health care costs are being heavily subsidized by your employer. I pay more than $700/mo. for one individual. (Stupid thing is I don't even use health care and am way overdue for all kinds of tests). Hang on 5 years and I'll qualify for Medicare, but that also generally carries a monthly premium (of $300 or so?) plus a $1,000 or so deductible per hospitalization.

I don't think $578 per person, much less per family, would even cover the cost of a thorough annual physical - a reasonable amount of blood work, and whatever screening tests are recommended. Never mind getting sick or being hospitalized.

Part of the problem with answering the OP question is that health-care prices in the U.S. are not terribly transparent. Prices vary wildly between facilities. I've heard of an emergency appendectomy being billed at $7,000 to an insurance company vs. $35,000 to an uninsured patient.
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Old 21st August 2019, 03:47 PM   #37
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Originally Posted by theprestige View Post
Doesn't your own government report the amount of money it's spending on your healthcare?
Me personally? No, it doesn't. I've never seen or been given a bill or costing of any kind.

Quote:
Total cost to you was $0 (not counting the taxes you've paid into the system over the years). But there was a cost. Somebody is paying the doctor to show up and look at you. Somebody is paying the drug company and the parcel service to get you your medicine. As I understand it, that somebody is your government. And as I understand it, they're paying for it with your money. Why not ask them how much your shingles cost?
I made the thread because I'm curious about what it costs elsewhere. Asking my government (and who would I even ask? Boris?) what it cost here doesn't really further that end, does it?
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Old 21st August 2019, 04:02 PM   #38
Minoosh
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Originally Posted by The Norseman View Post
Total bill from all agents involved: about three thousand dollars. ...

... Turns out that she wasn't suffering from anything other than probable food poisoning or a similar malady.
Providers are scared they'll miss something and get sued. I had similar at her age with salmonella. In retrospect I needed IV fluids and with a few injections for pain, but by the time the results were in I'd had the whole radioactive milkshake/enema treatment.

With a lot of machines to pay off and a real fear of liability, plus I'm sure some degree of greed, $3,000 sounds ... about right. But it's very difficult to know upfront what the charges are going to be.

Quote:
And that, in a nutshell, is the typical and standard method of healthcare in the US.
It can be kind of terrifying.
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Old 21st August 2019, 04:21 PM   #39
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Okay, general thoughts.

Seems like it would be on the order of $100-several hundred or so, which is actually less than I'd expected.

Other random thoughts from reading through the thread...

Yeah, obviously there are going to be advantages and disadvantages to any system. I hadn't considered how much the US system must spend just because it is about money, but that's sure to be a significant cost. And sure, there's a motivation there for doctors to press patients into unnecessary procedures.

But then with the NHS, overall funding is a matter of politics - which doesn't necessarily align with 'what's best for the patient' either.

From talking to people the biggest obvious advantage of the US system over the NHS seems to be the speed. For example, my dad just got an eye test recently. He's a stroke victim, and has compromised vision as a result. They found an issue and referred him to his GP, who referred him to an eye specialist. Total time from initial test to his appointment with the specialist is 122 days. It's a non-urgent thing, so it's not like he's going blind as he waits or anything; it's an inconvenience is all. But, again, on anecdotal evidence, this kind of thing goes way faster in the US.

My overall impression is that US healthcare is great... if you have good medical insurance, and/or are rich. And awful if you don't/aren't. NHS care is damn good, but slow, and the same for everyone.

Of course in the UK there's nothing to stop you paying out for private medical insurance or private healthcare if you want to skip those NHS waiting lists. Though you don't get a break on your national insurance costs if you do that, so you essentially pay double.

Thanks for the responses, all, it's been an interesting read so far.
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Old 21st August 2019, 04:23 PM   #40
Minoosh
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Originally Posted by mgidm86 View Post
$4500 vs $515 for the same exact procedure. I wonder if that's a problem.
I'm gonna say yes, it's a problem. Lack of transparency means that even if you chose to forgo insurance, you'd have a terrible time budgeting for a potential emergency.

It's as expensive as hell, but I can budget for $8K a year in health care premiums plus co-pays, deductibles etc. I can't budget for something so open-ended it might as well be infinite.
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