ISF Logo   IS Forum
Forum Index Register Members List Events Mark Forums Read Help

Go Back   International Skeptics Forum » General Topics » Social Issues & Current Events
 


Welcome to the International Skeptics Forum, where we discuss skepticism, critical thinking, the paranormal and science in a friendly but lively way. You are currently viewing the forum as a guest, which means you are missing out on discussing matters that are of interest to you. Please consider registering so you can gain full use of the forum features and interact with other Members. Registration is simple, fast and free! Click here to register today.
Reply
Old 16th December 2019, 01:07 AM   #1
El Greco
Summer worshipper
 
El Greco's Avatar
 
Join Date: Nov 2003
Posts: 16,260
British People Attempt To Guess The Cost Of American Health Care

I just want to know if the costs mentioned are real and how much they vary depending on whether you are insured and the kind of insurance you have.

YouTube Video This video is not hosted by the ISF. The ISF can not be held responsible for the suitability or legality of this material. By clicking the link below you agree to view content from an external website.
I AGREE
__________________
"Robbing a bank is no crime compared to owning one" - Bertolt Brecht

El Greco is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 05:56 AM   #2
Seismosaurus
Philosopher
 
Seismosaurus's Avatar
 
Join Date: Mar 2003
Posts: 6,082
"Shut the fridge!" has got to be one of the best expressions of incredulity ever.
__________________
Promise of diamonds in eyes of coal
She carries beauty in her soul
Seismosaurus is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 06:05 AM   #3
SuburbanTurkey
Master Poster
 
SuburbanTurkey's Avatar
 
Join Date: Apr 2018
Location: Boston suburbs, USA
Posts: 2,965
The problem is that for-profit health care is pretty complicated, with the various health insurance schemes, that someone in the NHS probably doesn't really understand how things work here.

I have a pretty common high deductible health care plan. My spouse and I have a combined deductible of $6,000. That means our plan doesn't cover any non-preventative care until I've spent $6,000. Unless something serious happens, the plan that costs hundreds of dollars a month covers preventative care and nothing else, because I don't exceed my deductible while in good health.

After that, I have coinsurance of 20% until I hit my out of pocket maximum of $12,000. This resets every year. If I were to become seriously ill, I could be paying $12,000 a year on medical expenses while "covered" by insurance. Assuming, that is, I remain healthy enough to stay employed. Should I get seriously ill for long enough to get layed off, I'm uninsured.

If uninsured, I can receive emergency care and be sent the bill later, which will be astronomical and end up going to debt collection. Non-emergency treatment (like chemotherapy) will be denied without proof of insurance or an ability to pay.

This is all assuming that I manage to stay "in network" and don't accidentally receive medical care from an unauthorized doctor, in which case my deductible and out of pocket max double.

Also, teeth are luxury bones and aren't covered. I have a separate dental insurance plan which also sucks.

Seriously Brits, the NHS is probably one of the pinnacles of human achievement. Cherish it.
__________________
Gobble gobble

Last edited by SuburbanTurkey; 16th December 2019 at 06:08 AM.
SuburbanTurkey is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 11:19 AM   #4
ArchSas
Critical Thinker
 
Join Date: Mar 2014
Posts: 274
I'd guess most Americans wouldn't be able to guess healthcare costs, either. Like SuburbanTurkey said, the system is complicated, and highly dependent on what your exact plan is. In many ways, the American healthcare system works on the premise that no one really knows how much they're going to pay for anything, because the expectation is that you have insurance, and the final cost to you will depend on whatever plan you have, and what deal the insurance company worked out with the healthcare provider.

Just as an example, a week and a half ago, I cut myself pretty badly while processing firewood and had to get stitches. I still have no idea what I'm actually going to have to pay for them. The clinic I went to took my insurance card, but didn't mention any costs, didn't charge a copay, and hasn't sent me a bill yet. Because I haven't hit my deductible, I'm assuming I'll need to pay for the whole thing, but I also have some money is a flex-spending account (from pay deductions) that I'm hoping will take care of at least most of the cost. It really should, but medical costs are such a guessing game, I have no idea; according to google, it could cost me anywhere from $100-$1500. In fact, the situation overall is a pretty good example of why our system sucks so much. While bleeding profusely, I kept trying to rationalize against getting care - even though i have decent insurance - until it was obvious I was injured pretty badly. Then, my girlfriend had to look up a local urgent care (not sure if they have these in other countries - they're sort of like emergency rooms, but much less expensive), because even though I live very close to a hospital, I didn't want to risk the cost of the ER. When we found a few options, we had to start calling around to see which ones accepted my insurance, and when we finally got to one, it took three attempts to register my insurance information for some reason. When I was actually getting the stitches, the doctor put in several more than was originally expected, and I kind of freaked out because some places charge by the stitch (AFAIK mostly ERs, but it's not like anywhere breaks down costs before they treat you anyway, so I don't know if this place did or not), and that meant my bill potentially just doubled. And now I'm just waiting for a bill with a mystery amount to come in the mail at some point and hoping it doesn't cost more than a few hundred bucks for a very quick, basic procedure.

Last edited by ArchSas; 16th December 2019 at 12:12 PM.
ArchSas is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 11:33 AM   #5
Ranb
Penultimate Amazing
 
Ranb's Avatar
 
Join Date: Jul 2003
Location: WA USA
Posts: 10,036
I only know what my health care costs are when the Naval Hospital sends me or my wife to a civilian facility for care. We normally get a statement showing how much Tricare covers. It is typically about a 1/3 of what the outside clinics charge other insurance plans. I'm not on the hook for any of it though.

Ranb
Ranb is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 11:39 AM   #6
The Don
Penultimate Amazing
 
The Don's Avatar
 
Join Date: Nov 2002
Location: Sir Fynwy
Posts: 27,935
I think that we British should have to guess how much our treatments cost the NHS. Maybe we wouldn't abuse it to the extent that some people do.
The Don is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 11:52 AM   #7
SuburbanTurkey
Master Poster
 
SuburbanTurkey's Avatar
 
Join Date: Apr 2018
Location: Boston suburbs, USA
Posts: 2,965
Quote:
nearly 60 percent of people who have filed for bankruptcy said a medical expense “very much” or “somewhat” contributed to their bankruptcy.
https://www.theatlantic.com/health/a...ruptcy/584998/

Get sick, go broke. The American way!
__________________
Gobble gobble
SuburbanTurkey is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 11:57 AM   #8
grunion
Philosopher
 
grunion's Avatar
 
Join Date: Jul 2003
Posts: 8,425
Originally Posted by SuburbanTurkey View Post
The problem is that for-profit health care is pretty complicated, with the various health insurance schemes, that someone in the NHS probably doesn't really understand how things work here.

I have a pretty common high deductible health care plan. My spouse and I have a combined deductible of $6,000. That means our plan doesn't cover any non-preventative care until I've spent $6,000. Unless something serious happens, the plan that costs hundreds of dollars a month covers preventative care and nothing else, because I don't exceed my deductible while in good health.

After that, I have coinsurance of 20% until I hit my out of pocket maximum of $12,000. This resets every year. If I were to become seriously ill, I could be paying $12,000 a year on medical expenses while "covered" by insurance. Assuming, that is, I remain healthy enough to stay employed. Should I get seriously ill for long enough to get layed off, I'm uninsured.

If uninsured, I can receive emergency care and be sent the bill later, which will be astronomical and end up going to debt collection. Non-emergency treatment (like chemotherapy) will be denied without proof of insurance or an ability to pay.

This is all assuming that I manage to stay "in network" and don't accidentally receive medical care from an unauthorized doctor, in which case my deductible and out of pocket max double.

Also, teeth are luxury bones and aren't covered. I have a separate dental insurance plan which also sucks.

Seriously Brits, the NHS is probably one of the pinnacles of human achievement. Cherish it.
In addition, there are:
Co-pays - typically between $15 and $75 per visit
Out-of-network costs - this typically arises when a doctor consults on your case during a hospital visit that isn't in your plan's network, and frequently prescribes a follow-up visit. This can be hundreds.
Lifetime maximums - for covered "non-essential" costs, after you hit some lifetime number they will cut you off.
__________________
Of all the offspring of Time, Error is the most ancient, and is so old and familiar an acquaintance, that Truth, when discovered, comes upon most of us like an intruder, and meets the intruder's welcome.
― Charles Mackay, 1841 - Extraordinary Popular Delusions And The Madness Of Crowds
grunion is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 02:15 PM   #9
Planigale
Illuminator
 
Planigale's Avatar
 
Join Date: Jul 2013
Posts: 3,569
Originally Posted by The Don View Post
I think that we British should have to guess how much our treatments cost the NHS. Maybe we wouldn't abuse it to the extent that some people do.
I think this is very true. I have seen a suggestion that people should get a 'bill' for NHS treatment; stamped paid by NHS. Now this would not need to be accurate, but the NHS does have average costs for procedures etc. So it should be possible to generate a very basic estimate of cost based on diagnosis etc on discharge. People hugely under estimate the cost of their routine drugs etc.
Planigale is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 02:42 PM   #10
Nessie
Penultimate Amazing
 
Nessie's Avatar
 
Join Date: Jun 2012
Posts: 12,518
Having phoned an ambulance in 1986 whilst living in Boston, to find it was $250 then, I had an idea it was expensive. A group of us got food poisoning from a take away meal and instead of an ambulance we were told just to be sick and try and drink lots of water.
__________________
Audiophile/biker/sceptic
Nessie is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 03:34 PM   #11
ahhell
Illuminator
 
Join Date: Feb 2017
Posts: 3,123
Originally Posted by ArchSas View Post
I'd guess most Americans wouldn't be able to guess healthcare costs, either. Like SuburbanTurkey said, the system is complicated, and highly dependent on what your exact plan is. In many ways, the American healthcare system works on the premise that no one really knows how much they're going to pay for anything, because the expectation is that you have insurance, and the final cost to you will depend on whatever plan you have, and what deal the insurance company worked out with the healthcare provider.
This, especially the bold bit. In my experience, doctor's don't even know what they're services cost or what they charge for them. The problem with the US is not that its free market, its that its a convoluted mess.

If all the US did was mandate that all insurers and care provider became non-profit, that wouldn't change anything, we'd still have convoluted mess, it would just be a non-profit convoluted mess.

Anecdotes:
I had a massive bike accident. I got a bill for the ambulance ride in excess of $10k. I did absolutely nothing for 6 months and got a new bill that was down to $1k because it was some kind of accounting error. I often wonder, what would have happened if I'd payed, likely the "accounting error" would never have been corrected.

I have toe nail fungus. I've had 3 doctors over a 10 year period look at and go, yep that's toenail fungus but we need to test a sample to be sure before giving you meds. I asked two other questions each time. How much does the test cost? and What else could it be?
The answer to the first, "you don't have to pay anything" I follow up with, that's not what I'm asking, how much does it actually cost. One guy couldn't even understand what I was asking, the others have no idea. The answer to the second question was "nothing". So, totally unnecessary test that they require and have no idea how much it actually costs to perform. In this case, it probably doesn't cost much but something like that is probably true through out our system.

Last edited by ahhell; 16th December 2019 at 03:43 PM.
ahhell is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 04:10 PM   #12
casebro
Penultimate Amazing
 
casebro's Avatar
 
Join Date: Jun 2005
Posts: 17,379
My bill for 2 weeks in ICU was initially $433,000. The HMO has "Medical Auditors", they are not just accountants but people who check to see if the care being billed for was "customary and reasonable". They cut the bill to $120k. (One thing on it was a bill for "room and board" at an out side facility- where I never left the hall, never had a meal.) Meantime I got put on the HMO's list of low income, and they waived my $3,400 co-pay. Net cost to me, $0.

One thing that needs to be done is for someone to look at experiences like my bill, and declare that soooo much of if is a lie that the whole bill should get thrown out as spurious.

I assume that there are commercial "Medical Auditors" for hire? Somebody to review your bill and check for the phony baloney charges? My sister did that job, but for an insurance company.
__________________
Great minds discuss ideas.
Medium minds discuss events.
Small minds spend all their time on U-Tube and Facebook.
casebro is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 04:22 PM   #13
TomB
Muse
 
Join Date: Oct 2014
Posts: 656
It's pretty variable. I'm at the opposite side of the spectrum from Suburban Turkey.

I get my insurance through my employer, who pays most of the premium. For my family plan, which covers myself, my wife and any children under 26 (currently my 21 year old married daughter is on the plan) I pay about $250/month as my part of the premium. It would be lower if I made less and higher if I made more.

I don't have a deductible.

There are copays: $20 for physician or urgent care, $30 for specialists.

ER visits are $250. Each hospitalization is $250. That includes any tests or surgeries that happen during the admission. (If you go to the ER and are admitted, you are only charged one $250 copay.) Outpatient procedures not done during a normal office visit (like outpatient surgery) is $250.

There is no copay for lab or imaging. My wife had an MRI last month and we paid $0.

Dental is a separate police for which I pay about $19/month for the family. Routine preventative visits and cleaning are $100% covered. Then there is a $150 deductible for each person. After that, it's hard to say. My last fillings cost me nothing. (I'd used the deductible on something else.) It cost about $400 for my daughter's wisdom tooth extraction. But she chose complete sedation which is only covered when medically necessary. the dentist brought in an outside anesthesiologist who charges like $700 per half hour. So that cost about $1500. Had she elected for a pill sedation instead, it would have been like $20.

My stepson has a plan similar to Suburban Turkey's, but his employer also sets up a medical spending account and puts enough in to cover the deductibles. So the deductibles really aren't an issue for him. He's pretty happy with it even though he has a couple chronic health issues.

So it varies.
TomB is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 06:35 PM   #14
mgidm86
Philosopher
 
Join Date: Jan 2003
Posts: 5,976
Wow, people keep talking about health insurance for the poor being such an issue. I'm poor right now and I don't pay jack squat, not a dime. But I stay healthy so it's not costing the taxpayers much in my case

Before that I had Kaiser, but then the ACA passed and my monthly payment went up 90%. Now I have Medi-Cal.

It was easy for me to find out the actual costs of my treatments from years ago. All you gotta do is ask the hospital.

My MRI at the local county hospital cost the insurance company $4,500.

Few months later I paid cash at a private clinic for another MRI, complete with diagnosis. $515. That's 9 times cheaper.

That could be a problem, no?
__________________
Franklin understands certain kickbacks you obtain unfairly are legal liabilities; however, a risky deed's almost never detrimental despite extra external pressures.
mgidm86 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 07:02 PM   #15
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Posts: 42,083
Originally Posted by The Don View Post
I think that we British should have to guess how much our treatments cost the NHS. Maybe we wouldn't abuse it to the extent that some people do.
Also, is there a control group for the clip in the OP? How good are the Brits at guessing their own healthcare costs?

"Madam, how much would you say it costs to have your appendix out?"

"Well, it's free, innit?"

"Free at the point of treatment, yes, but there's still a cost involved. Would you like to hazard a guess?"

"... It's free, innit?"
theprestige is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 07:10 PM   #16
TragicMonkey
Poisoned Waffles
 
TragicMonkey's Avatar
 
Join Date: Jun 2004
Location: Monkey
Posts: 53,823
Originally Posted by theprestige View Post
Also, is there a control group for the clip in the OP? How good are the Brits at guessing their own healthcare costs?

"Madam, how much would you say it costs to have your appendix out?"

"Well, it's free, innit?"

"Free at the point of treatment, yes, but there's still a cost involved. Would you like to hazard a guess?"

"... It's free, innit?"

"Gorblimey, guv'nor, me happendix scarpered? Lumme, cor! That's tuppence ha'penny six farthings! You'll 'ave to catch me first!" [comical chase to Benny Hill theme]
__________________
You added nothing to that conversation, Barbara.
TragicMonkey is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 07:18 PM   #17
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Posts: 42,083
Originally Posted by TragicMonkey View Post
"Gorblimey, guv'nor, me happendix scarpered? Lumme, cor! That's tuppence ha'penny six farthings! You'll 'ave to catch me first!" [comical chase to Benny Hill theme]
Fun fact: NHS has kept health care costs down in part by nationalizing Yakety Sax.
theprestige is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 07:43 PM   #18
Venom
Illuminator
 
Join Date: Apr 2011
Location: United States
Posts: 3,995
Originally Posted by mgidm86 View Post
Wow, people keep talking about health insurance for the poor being such an issue. I'm poor right now and I don't pay jack squat, not a dime. But I stay healthy so it's not costing the taxpayers much in my case

Before that I had Kaiser, but then the ACA passed and my monthly payment went up 90%. Now I have Medi-Cal.

It was easy for me to find out the actual costs of my treatments from years ago. All you gotta do is ask the hospital.

My MRI at the local county hospital cost the insurance company $4,500.

Few months later I paid cash at a private clinic for another MRI, complete with diagnosis. $515. That's 9 times cheaper.

That could be a problem, no?
I always love reading your no-nonsense, often amusing simple approach to things, but although costs need to come down somehow and I think some form of universal HC is needed in this country, programs to get people to stay healthy in the first place might be necessary.

Schools seem to cut costs by serving the same junk food every week, and there's a similar story among low income families.

Dementia is the most costly condition in the country. Can't do much about it I don't think.
Obesity we could totally do something about. Smoking came down from the 1990s, why can't fast food?
Venom is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 08:02 PM   #19
El Greco
Summer worshipper
 
El Greco's Avatar
 
Join Date: Nov 2003
Posts: 16,260
Originally Posted by theprestige View Post
Also, is there a control group for the clip in the OP? How good are the Brits at guessing their own healthcare costs?

"Madam, how much would you say it costs to have your appendix out?"

"Well, it's free, innit?"

"Free at the point of treatment, yes, but there's still a cost involved. Would you like to hazard a guess?"

"... It's free, innit?"
Well, the important thing for everyone is not how much it costs but how much it costs to them. Sure, it would be nice if they had a rough idea about the underlying costs, but:

1) They also don't know the costs of road maintenance, production and distribution of electricity, military operations and tons of other services that all people use, even those who may have never visited a doctor in their lives.

2) There's a huge assortment of medical procedures, drugs and materials that's impossible for any layman to know how much they cost. Even more if you include the cost of building and operating the healthcare facility in the first place. How is anyone expected to know all this ?

3) At least some costs would be rather easy for them to answer with a good accuracy. If the doctor is a public servant and you have a rough idea about the salaries of doctors in your country, then you can have a pretty good approximation about how much half of his working hour will cost to the public. If there are fixed hospital and retail prices for drugs, then you may easily find out how much a specific drug costs to the state.
__________________
"Robbing a bank is no crime compared to owning one" - Bertolt Brecht

El Greco is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 08:19 PM   #20
angrysoba
Philosophile
 
angrysoba's Avatar
 
Join Date: Dec 2009
Location: Osaka, Japan
Posts: 26,583
Originally Posted by The Don View Post
I think that we British should have to guess how much our treatments cost the NHS. Maybe we wouldn't abuse it to the extent that some people do.
Originally Posted by Planigale View Post
I think this is very true. I have seen a suggestion that people should get a 'bill' for NHS treatment; stamped paid by NHS. Now this would not need to be accurate, but the NHS does have average costs for procedures etc. So it should be possible to generate a very basic estimate of cost based on diagnosis etc on discharge. People hugely under estimate the cost of their routine drugs etc.
I think I remember Jeremy Hunt saying he wanted to put the price of the medicine on the bottle. The argument against is that people who are most conscientious are less likely to abuse the health care system anyway and may end up shamed into not getting the treatment they need. I dont want to burden the taxpayer with my chemotherapy....
__________________
"The thief and the murderer follow nature just as much as the philanthropist. Cosmic evolution may teach us how the good and the evil tendencies of man may have come about; but, in itself, it is incompetent to furnish any better reason why what we call good is preferable to what we call evil than we had before."

"Evolution and Ethics" T.H. Huxley (1893)
angrysoba is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 16th December 2019, 10:00 PM   #21
Minoosh
Penultimate Amazing
 
Minoosh's Avatar
 
Join Date: Jul 2011
Posts: 10,739
Originally Posted by casebro View Post
I assume that there are commercial "Medical Auditors" for hire? Somebody to review your bill and check for the phony baloney charges? My sister did that job, but for an insurance company.
That would be a pretty good idea to use if the U.S. makes a move for UHC/single payer. People now in the insurance industry could be transitioned to auditor-type jobs and could monitor medical billing to cut down on over-billing. I've also thought about having personal advocates for people who are unable to navigate the system, remember doctor's
orders etc.

It would probably take 10 years for a proper transition, with the ACA as a reasonable starting point since it was originally a conservative/Republican idea. I don't know if the U.S. can pull this off at all, though. Reverting to the pre-ACA status quo seems more likely. Ideally once you're bankrupt you can qualify for Medicaid. It doesn't sound like a great plan, but pushing through something better may be impossible.
Minoosh is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 01:11 AM   #22
The Don
Penultimate Amazing
 
The Don's Avatar
 
Join Date: Nov 2002
Location: Sir Fynwy
Posts: 27,935
Originally Posted by angrysoba View Post
I think I remember Jeremy Hunt saying he wanted to put the price of the medicine on the bottle. The argument against is that people who are most conscientious are less likely to abuse the health care system anyway and may end up shamed into not getting the treatment they need. I dont want to burden the taxpayer with my chemotherapy....
I suppose it's possible that some people might feel that way, I don't think that there would be too many of them though.

Then again, I'm not advocating what Jeremy Hunt proposed, merely that people should try to estimate how much various treatments cost the NHS.
The Don is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 04:15 AM   #23
TragicMonkey
Poisoned Waffles
 
TragicMonkey's Avatar
 
Join Date: Jun 2004
Location: Monkey
Posts: 53,823
Originally Posted by Minoosh View Post
That would be a pretty good idea to use if the U.S. makes a move for UHC/single payer. People now in the insurance industry could be transitioned to auditor-type jobs and could monitor medical billing to cut down on over-billing. I've also thought about having personal advocates for people who are unable to navigate the system, remember doctor's
orders etc.

It would probably take 10 years for a proper transition, with the ACA as a reasonable starting point since it was originally a conservative/Republican idea. I don't know if the U.S. can pull this off at all, though. Reverting to the pre-ACA status quo seems more likely. Ideally once you're bankrupt you can qualify for Medicaid. It doesn't sound like a great plan, but pushing through something better may be impossible.
"Once you're bankrupt you can qualify for Medicaid" would be a huge step forward for most states. In the current state of things, even with the ACA, merely having zero money doesn't qualify someone for Medicaid. In most states you have to be disabled, a child, or have dependent children to qualify for Medicaid. A childless adult can't get Medicaid. Full stop. We pay into a "safety net" that does not cover everybody. This is intentional because we wouldn't want "socialism".
__________________
You added nothing to that conversation, Barbara.
TragicMonkey is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 04:16 AM   #24
Rolfe
Anti-homeopathy illuminati member
 
Rolfe's Avatar
 
Join Date: Sep 2003
Location: NT 150 511
Posts: 44,515
I know how much these things cost for animals, as there is no NHS for animals. What routinely shocks me as regards US healthcare costs is how utterly astronomical the prices are compared to what I spent my career charging animal owners for the exact same thing.
__________________
"The way we vote will depend, ultimately, on whether we are persuaded to hope or to fear." - Aonghas MacNeacail, June 2012.
Rolfe is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 04:44 AM   #25
Wudang
BOFH
 
Wudang's Avatar
 
Join Date: Jun 2003
Location: People's Republic of South Yorkshire
Posts: 12,351
Originally Posted by Rolfe View Post
I know how much these things cost for animals, as there is no NHS for animals. What routinely shocks me as regards US healthcare costs is how utterly astronomical the prices are compared to what I spent my career charging animal owners for the exact same thing.
All those people working out why not to pay for someone's medical treatment don't work for free.
__________________
"Your deepest pools, like your deepest politicians and philosophers, often turn out more shallow than expected." Walter Scott.
Wudang is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 06:53 AM   #26
Matthew Best
Philosopher
 
Matthew Best's Avatar
 
Join Date: Jun 2006
Location: Leicester Square, London
Posts: 7,280
Originally Posted by theprestige View Post
Also, is there a control group for the clip in the OP? How good are the Brits at guessing their own healthcare costs?
Matthew Best is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 08:01 AM   #27
SuburbanTurkey
Master Poster
 
SuburbanTurkey's Avatar
 
Join Date: Apr 2018
Location: Boston suburbs, USA
Posts: 2,965
An anecdote about the wonders of the private bureaucracy.

Several years ago, I was in a motorcycle collision with a car. The car driver was found 100% at fault, as he had turned left from the opposing direction, violating my right of way. I had (mild) injuries, but was transported to the hospital via ambulance out of an abundance of caution. I was evaluated, x-rayed, and had three stitches put into my knee, then released the same night.

I had insurance through my work. I provided the information to the hospital. Of course, being not at fault, my health insurance pursued the driver's car insurance for payment of these bills. Much back and forth occurred through among them, while I received letters saying the debt had not been paid. Eventually the car insurance paid the bills. I considered the matter settled.

Several months later, I receive a notice from the state tax agency that about $100 dollars was being withheld from my tax return for that year, because I had neglected to pay a debt related to this treatment. This was the first time I had heard of such debt, and to this day I never know where this came from. It was too small a sum of money to spend time trying to chase it down, and since I only became aware of it months after the fact and well after I had received my settlement to my injury claim from the offending party's insurance, I was likely without recourse. I just took the loss.

Private insurance requires massive bureaucracy. And since there are multiple insurance companies, each negotiating their own rates and contracts, there is massive redundancy. Often medical providers have no idea how much care will cost a customer because it depends on which plan for which provider and what billing code and what contract and what negotiated rates and blah blah blah. It's a disaster.
__________________
Gobble gobble

Last edited by SuburbanTurkey; 17th December 2019 at 08:02 AM.
SuburbanTurkey is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 09:17 AM   #28
Rolfe
Anti-homeopathy illuminati member
 
Rolfe's Avatar
 
Join Date: Sep 2003
Location: NT 150 511
Posts: 44,515
Originally Posted by Wudang View Post
All those people working out why not to pay for someone's medical treatment don't work for free.

I had figured that out, but that's a really good way of putting it.
__________________
"The way we vote will depend, ultimately, on whether we are persuaded to hope or to fear." - Aonghas MacNeacail, June 2012.
Rolfe is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 09:27 AM   #29
Donal
Illuminator
 
Donal's Avatar
 
Join Date: Sep 2006
Posts: 4,190
Originally Posted by mgidm86 View Post
Wow, people keep talking about health insurance for the poor being such an issue. I'm poor right now and I don't pay jack squat, not a dime. But I stay healthy so it's not costing the taxpayers much in my case

Before that I had Kaiser, but then the ACA passed and my monthly payment went up 90%. Now I have Medi-Cal.

It was easy for me to find out the actual costs of my treatments from years ago. All you gotta do is ask the hospital.

My MRI at the local county hospital cost the insurance company $4,500.

Few months later I paid cash at a private clinic for another MRI, complete with diagnosis. $515. That's 9 times cheaper.

That could be a problem, no?
One of the provisions of the ACA was that hospitals had to make their charge book public.

Also, the reason the charge book price is different than your up front cash price is because hospitals and insurance companies are doing a dance. Because insurance companies save money by refusing to pay for services, the hospital quotes a crazy high price. The insurance company refuses to pay and offers a counter price. They negotiate down until they reach a price that is still higher than what you paid in cash.

Because private companies are soooo much more efficient.
__________________
SuburbanNerd A blog for making tech make sense
Donal is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 09:31 AM   #30
Dave Rogers
Bandaged ice that stampedes inexpensively through a scribbled morning waving necessary ankles
 
Dave Rogers's Avatar
 
Join Date: Jan 2007
Location: Cair Paravel, according to XKCD
Posts: 30,303
Originally Posted by Matthew Best View Post
I looked at that and thought "46p a click, that's a bit pricey for a website, by the time I've found anything useful I'd probably have been better off going to the doctor." I'm not sure that was the intended message.

Dave
__________________
Inspiring discussion of Sharknado is not a good sign for the audience expectations of your new high-concept SF movie sequel.

- Myriad
Dave Rogers is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 09:33 AM   #31
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Posts: 42,083
Originally Posted by Rolfe View Post
I know how much these things cost for animals, as there is no NHS for animals. What routinely shocks me as regards US healthcare costs is how utterly astronomical the prices are compared to what I spent my career charging animal owners for the exact same thing.
The fact that it's humans and not animals means it's not even remotely the same thing. Just to start, I bet a doctor pays a lot more insurance than a vet. Because, you know, human lives.
theprestige is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 09:34 AM   #32
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Posts: 42,083
Originally Posted by Matthew Best View Post
The existence of such a "cheat sheet" suggests that Brits are abysmal at guessing the cost of healthcare.
theprestige is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 09:36 AM   #33
Matthew Best
Philosopher
 
Matthew Best's Avatar
 
Join Date: Jun 2006
Location: Leicester Square, London
Posts: 7,280
Yes, we wouldn't have a clue, not generally having a reason to know the cost.

I, too, was surprised it costs 46p to click on a website. No wonder JREF got rid of this place.
Matthew Best is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 09:56 AM   #34
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Posts: 42,083
Originally Posted by Matthew Best View Post
Yes, we wouldn't have a clue, not generally having a reason to know the cost.

I, too, was surprised it costs 46p to click on a website. No wonder JREF got rid of this place.
The only way it makes sense to me is if they're trying to say something like "the cost of having this website here for you to click on, divided evenly amongst all taxpayers (amongst all citizens?) works out to 46p each."

Sort of like the online version of "stepping into an A+E."
theprestige is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 10:02 AM   #35
Matthew Best
Philosopher
 
Matthew Best's Avatar
 
Join Date: Jun 2006
Location: Leicester Square, London
Posts: 7,280
But that would mean it would cost me 46p even if I didn't click on it.
Matthew Best is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 10:06 AM   #36
Dave Rogers
Bandaged ice that stampedes inexpensively through a scribbled morning waving necessary ankles
 
Dave Rogers's Avatar
 
Join Date: Jan 2007
Location: Cair Paravel, according to XKCD
Posts: 30,303
I think I've set us off on a perfect demonstration of Parkinson's Law of Triviality here.

Dave
__________________
Inspiring discussion of Sharknado is not a good sign for the audience expectations of your new high-concept SF movie sequel.

- Myriad
Dave Rogers is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 10:06 AM   #37
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Posts: 42,083
Originally Posted by Matthew Best View Post
But that would mean it would cost me 46p even if I didn't click on it.
Now you understand why Brits have so much trouble guessing the cost of healthcare.
theprestige is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 10:10 AM   #38
Matthew Best
Philosopher
 
Matthew Best's Avatar
 
Join Date: Jun 2006
Location: Leicester Square, London
Posts: 7,280
I've always understood why Brits have so much trouble guessing the cost of healthcare.
Matthew Best is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 10:17 AM   #39
lobosrul5
Graduate Poster
 
lobosrul5's Avatar
 
Join Date: Nov 2017
Posts: 1,910
Originally Posted by SuburbanTurkey View Post
The problem is that for-profit health care is pretty complicated, with the various health insurance schemes, that someone in the NHS probably doesn't really understand how things work here.

I have a pretty common high deductible health care plan. My spouse and I have a combined deductible of $6,000. That means our plan doesn't cover any non-preventative care until I've spent $6,000. Unless something serious happens, the plan that costs hundreds of dollars a month covers preventative care and nothing else, because I don't exceed my deductible while in good health.

After that, I have coinsurance of 20% until I hit my out of pocket maximum of $12,000. This resets every year. If I were to become seriously ill, I could be paying $12,000 a year on medical expenses while "covered" by insurance. Assuming, that is, I remain healthy enough to stay employed. Should I get seriously ill for long enough to get layed off, I'm uninsured.

If uninsured, I can receive emergency care and be sent the bill later, which will be astronomical and end up going to debt collection. Non-emergency treatment (like chemotherapy) will be denied without proof of insurance or an ability to pay.

This is all assuming that I manage to stay "in network" and don't accidentally receive medical care from an unauthorized doctor, in which case my deductible and out of pocket max double.


Also, teeth are luxury bones and aren't covered. I have a separate dental insurance plan which also sucks.

Seriously Brits, the NHS is probably one of the pinnacles of human achievement. Cherish it.
Yup my uncle's widow is faced with a $300,000 bill because the ambulance took him to the wrong hospital when he had a massive heart attack. Wonderful system we have here.
lobosrul5 is offline   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Old 17th December 2019, 10:31 AM   #40
theprestige
Penultimate Amazing
 
Join Date: Aug 2007
Posts: 42,083
Originally Posted by Matthew Best View Post
I've always understood why Brits have so much trouble guessing the cost of healthcare.
People who don't think they have to pay for stuff don't bother thinking about how much stuff costs?
theprestige is online now   Quote this post in a PM   Nominate this post for this month's language award Copy a direct link to this post Reply With Quote Back to Top
Reply

International Skeptics Forum » General Topics » Social Issues & Current Events

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump


All times are GMT -7. The time now is 12:04 PM.
Powered by vBulletin. Copyright ©2000 - 2020, Jelsoft Enterprises Ltd.

This forum began as part of the James Randi Education Foundation (JREF). However, the forum now exists as
an independent entity with no affiliation with or endorsement by the JREF, including the section in reference to "JREF" topics.

Disclaimer: Messages posted in the Forum are solely the opinion of their authors.