My 14 month old son got a deaseae in the spine so he could not walk anymore.
We spent 4 weeks in the hospital. 1 week until it was diagnosed in the MRT, 3 weeks with 3 different antibiotic treatment and another two month antibiotics at home.
All this while my wife continued to study for her PHD so I stayed away from work and lived with my son in the hospital.
This whole experience did cost us around 200€ (incl. gasoline to drive to the hospital) while still getting full income from my employer.
My wife has sleep apnea, so during her normal annual checkup the doc wrote her a prescription for a CPAP.
She goes to the local vendor, they tell her to pick out whichever machine she'd like. She would rent it for a few months to make sure she liked it. The insurance company would pick up the bill.
Many months later we just got a bill for $500.
She calls them. They tell her that this is the balance owed on the machine. Now they've already billed the insurance company four thousand dollars for the machine. The insurance company paid about a quarter of that. Then she the rents on top of that. And now they want the balance. The bill came completely out of the blue.
They won't take it back. So she's thinking about selling it. Going online the machine is only worth 500 bucks brand new. They're basically selling the same machine three different times: once to the insurance company, once on a rent-to-own deal, and once as a bill coming from nowhere.
I don't know in what universe this is not considered plain old fraud. The billing situation in healthcare in the U.S. has become so byzantine and complicated that's it has basically turned into a shell game of screw-the-consumer.
I don't want to talk about why it happens. I don't want to talk about solutions. I will say that the politics of healthcare has led us here -- nothing else but that. And the more we argue the worst it will continue getting. I do want to note that it seems like every month or so there's some new horror story. It's so bad that the vast majority of the time nobody talks about it. It's an awful mess.
Ok, in the US we are one medical trip away from complete bankruptcy. Not too long ago there was an article saying the average person in America doesn't have $400 stashed away for an emergency.
So what do you do when you get this bill? You can't pay, you don't have the money. What do you do?
You contest what you can, and then you arrange a payment plan... also I believe the median surplus income (mean is higher) per month in America is ~$1k, most Americans just do something with it (leave it in checking account, invest it, or spend it) instead of putting it in a separate savings account.
Your general complaint about high medical costs is on point of course, but for most people in America they could pay off a dumb $18k bill over a period of time if they had to.
1k$ surplus income per month on a 18k$ bill means you'd have to forfeit all surplus income for 18 months.
If any other medical emergency happens and you have another 18k bill? Or a car accident (of which there are a lot)? Or car just breaks down? What if you get fired and spend a few months searching a new job?
This isn't exactly financial security with such a bill pending over your head plus numerous other bills being a possibility.
There is financial security for me. I don't have to worry about not being able to pay my hospital bill. I won't have to file for bankruptcy because I'm unable to pay because that doesn't happen.
So there is certainly some financial security for anyone in the world of what-ifs, atleast as far as medical coverage is concerned.
As I understand it, bankruptcy is often not necessary. In the US, public hospitals must provide service to patients who can not pay. So they typically forgive unpaid fees. But private hospitals and clinics are more likely to sell unpaid balances to collection agencies. And then bankruptcy is the only way out. Also, if they know that you won't be able to pay, they may do whatever's needed to keep you alive, and then transfer you to a public hospital.
One of the reasons I have basically given up my fantasy of moving to the USA is the russian roulette that you seem to have to play with your health and its insurance.
The article seems to be saying that in some cases the insurer assesses what the hospital is charging, decides it's too high, doesn't pay it all, and then you owe the hospital thousands of dollars despite being fully insured.
That was a travel insurance, "completely" different from the US healthcare insurance providers, where the issue is in-network and out-network providers, etc.
What happens if you get fired from your job suddenly? And if you happen to have pre-existing conditions, such as a type 1 diabetes, that is known for being very expensive to treat?
My mom lost her job with benefits, and a month later fell down some stairs and broke her arm. Eventually she was able to get an insurance plan (after getting a new job) for something like $200 or $300 per month (there are in fact cheaper ones depending on your need of coverage and state), while paying off the bills from the broken arm event.
Personally speaking, I have no fear of a similar event happening to me. If it happened, I'd figure something out, or die. Generally speaking, "what we think is unbearable proves to be bearable."
You left out a very important contraction from that quote, namely "I'd". The subject of the sentence changes its meaning entirely. As you quoted, it reads as an imperative, something I did not say.
I'm not defending the idiotic system that is US healthcare, but you can opt in to COBRA until you find something else. 2 main disadvantages are that it is time bound (i think max 12 months) and it is expensive, you have to pay both the employer contribution and your own.
Which makes me quite happy to just be in Germany. I will get all the required equipment to treat my diabetes, even if I lose my job. The insurance I have is going to be quite a lot cheaper when I have a lower income. I very much like the safety it provides and sadly it means I have to give my talent to the European markets.
Insurance won't cover everything... Sometimes there'll be an experimental thing that the insurance doesn't cover.
I tried this, when I lived in the US, even though it was a planned test nobody could give me a quote on what it would cost.
I had great insurance that covered everything. People next to me in the waiting room was paying extra fees to rent the facilities and stuff... Yet, even for a planned procedure neither my doctor or my insurance company would give me a quote or promise that the procedure was covered.
You can't know what the bill will be even for a planned procedure. Even if you ask 3-5 different entities multiple times.
For comparison, for your proportion of NHS costs to approach the lower end of that in the UK, you need to earn 2x-3x the national average salary. At $66k, in 2012, your and your employers contributions to the NHS over tax were around $300/month combined.
In Australia we went to the doctor after my kid had an allergic reaction. They medicated him, had a nurse within 10 feet and kept him for 6 hours until symptons receded. Total cost - AUD$40.
The US systom is absolutely insane, expensive and delivers worse results.
I'm in Australia too, and I equally laud the system we have here.
But note that this article was about a Korean family travelling in the US.
A foreign family travelling in Australia won't be covered by Australian Medicare and will be at the mercy of the medical cover on their travel insurance, which is the real story here.
That's not to say that the charges for this visit weren't exorbitant, but your case isn't an apples with apples comparison.
Of course that was not the total cost. That was just the cost to you at that moment. The rest is paid by the society.
The real total is probably still a lot less than the cost in the US would have been.
This is no different than the way health insurance works, though. The mechanisms for collecting money and subsidies are different and for most places, there is a much larger pool of folks paying into the system.
Also, early treatment avoids really expensive later treatment. Wait too long with an allergic reaction, and you might end up calling the ambulance, invoking ICU and so on and so on. Instead of probably a couple of pills to reduce the immune systems response.
But it’s still easy to compare. Look up public medical expenditures per capita. The US’ ranks amongst the highest, while covering few people and quite poorly (the VA is... the VA).
By comparison, Australia spends about the same per capital and covers everybody, without everybody needing to fill out $1000/mo (like I do - for family of three)for insurance.
I am pretty sure $40 isn’t the cost of the exams. It is being subsidised by other tax payers. We can discuss the merits of this approach but it is not necessarily cheaper overall.
The US government pays more for healthcare in the US than many other countries. When you add in private insurance the US far outspends outher countries for healthcare. But they don't have better results. For example, the US has a shorter average lifespan than many countries.
It sounds like this "trauma activation", has replaced the triage system. Where a triage department will determine the severity of the emergency injury, and associate an appropriate medical response.
The triage activation assembles a team of experts that treats every emergency patient with the same high level response, similarly because doing so attracts a higher fee.
What's the long term stable state for American health care? Given the difference between the rate at which healthcare costs grow and the rate at which wages grow, it will only take a couple decades before the former is larger than the latter -- and at that point, only a few years until it starts becoming (large) integer multiples of the latter.
So what's the plan then? Obviously, nobody will actually be capable of paying those costs. Will people simply choose to die, or leave untreated most medical issues? Even in the case in the article's title, how could any non-billionaire justify paying such a cost? They don't even live here -- I could never imagine what sort of calculus would lead me to even pay a single dollar to someone requesting such an obscene price for so few services rendered.
US Healthcare costs are fake, hospitals don't really expect to get the whole sum after they apply discounts for insurance companies, so they make them appear bigger just to get what they intended. It's only people who don't have a strong insurance company to fight on their side who get ripped to shreds.
GP is probably referencing a meme in UK politics — there is a widespread beleif that health tourism is responsible for everything wrong with the NHS. (It isn’t yet responsible: was recently estimated to cost 0.3% of the NHS budget [1], and before anyone points out that future costs of this to the taxpayers don’t depend on current costs to the taxpayers, the NHS bills tourists [2] — however, it may still be good to be a health tourist from the USA, as even at the 150% rate for visitors without insurance I would expect it to be cheaper than the USA for many things).
US patients might in fact still find it cheaper to even fly out to use private UK hospitals in some instances, and many of those private hospitals in turn rent operating theatre capacity etc. from NHS as needed, even thought both the private hospital and the NHS is profiting on it.
Health tourism, or retired pensioners who moved there permanently?
(I’ll grant that some of the “some” who say this sort of thing seem to have difficulty drawing the right distinctions between such groups. At least two have angrily denied my examples of my brother and my girlfriend going from the UK to the Philippines and Hungary respectively for cheaper dental work).
Many countries have arranged to do just that because they make a profit from it. The popular medical tourism desitinations provide world class care at a fraction of the cost of the same or inferior care in the US. The medical tourists pay cash on delivery. The providers make handsome profits, despite charging substantially less. Lots of factors behind why it works. Mostly rooted in market forces.
Not for free, but the UK's NHS for example are allowed to operate private clinics and some NHS trusts derive substantial extra income from that as a means to alleviate funding shortfalls while making better use of spare capacity.
Not a huge loss for the US, but I will probably never go back due to this. Even if you have insurace, your life will be hell for a while due to having to fight your insurance company over a tremendous bill. I don't want to have to think twice if I should bring in my son to the hospital or not, and frankly, the US doesn't have anything unique enough to offer to offset that risk. I'm also doing my best to stay away from conferences, preferring instead Canada, European or Asian destinations.
Is this a case where having better insurance would protect you from the hospital? Not sure how insurance or billing in the US works, but in the article one person broke their ankle and their insurance negotiated the price with the hospital, and then the hospital still came after the person for the costs that the insurance company negotiated to not pay.
The hospitals are assembling a team of experts to deal with extreme injuries of patients. Patients then refuse to pay this bill but forget that if this team was not there they could have lost their life. Any trauma to the head is life threatening - people die from slipping in the bathroom.
That is near impossible, and still gives folks little to no choice in an emergency.
"to keep your child from possibly dying, you'll wind up paying at least $15,000, depending on the diagnosis"
Of course, that last bit was completely unknown upfront. It is hard enough to shop around for non-emergency gall bladder surgery, let alone actual emergencies.
