United Healthcare is quitting ACA policies

[TechWife]

Um, no, I meant that some providers refusing state insurance would go away if that was what everyone had.

 

Gotcha! Sorry about that! 

[Audrey]

Quality of care issues would go away if everyone had the same insurance? No, there would still be good providers and crappy providers. 

 

Agreeing.... Of course.  There are good doctors and crappy doctors.  I've had mostly good doctors here, but I've also had a couple of stinkers.  Their personalities were about that of a blackfly, too.   I think you'll find that no matter where you are.  But, that's a completely different issue than access and affordability.

Edited June 24, 2016 by Audrey

[TranquilMind]

Here is a total thread derail, but us healthcare is so overpriced. I don't even get it. My ds4 broke his arm recently and we just got the bill from the surgeon-$1530. It was pretty much a no complication break (it was buckling a little so it needed reduction). The surgeon was with us for maybe 5-10 minutes and it definitely wasn't a surgery. The bill wasn't even for the hospital visit or X Ray. We have really good insurance and it pays 100% for accidental injuries, but no wonder insurance is so expensive. The insurance paid over $1300 for that. I know we pay for the surgeon's knowledge, but $1500 for a run of the mill broken arm still seems ridiculous.

 

ETA: I see the insurance company made billions in profits. I guess $1500 broken arms mY not be hurting them that much

Yes I is absolutely outrageous. The only ER trip we had here turned out to be a "go see the doctor" kind of thing. NOTHING was done except the patient was given Advil. Cost: $1400

[lovinmyboys]

If I'm understanding it correctly though, aren't these the kinds of issues would be the ones that would go away if everyone was covered under the same insurer?

Perhaps. I may be wrong, but I think providers are supposed to take tricare. I haven't found any that don't take tricare. I have found a lot that are not accepting new patients with tricare. I believe that tricare pays providers similar to Medicare and my understanding is that it is less than private insurers. So most providers (or at least some) have a cap on how many tricare patients they see. I guess my concern is that affordable insurance means nothing if doctors aren't accepting new patients with that affordable insurance. It seems like one of the reasons it is affordable is because it pays providers less. The pediatrician that I did find told me that they are lucky to break even with tricare patients. I have no reason to not believe him, but I have no way to know if that is true.

 

But, on the other hand, see my pp about the $1500 charge for my son's broken arm. Our insurance paid $1380 for that (which I thought was a ridiculous amount of money). I would be interested in what tricare would have paid. Maybe it is a more reasonable amount. I just don't know how we will have affordable insurance if a 5 minute consult costs $1500.

[Murphy101]

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

What the what.

 

We don't have 6 month waits bc those who can't afford just die doing without.

 

My husband had a lengthy waitlist to get into his endo even as an established patient. He finally gave up and went to the ER to renew his insulin prescription. Which he bought from London bc there's no way we can afford to buy it here.

 

Thank god he doesn't have a suspicious lump somewhere he needs to go to a new dr who then has to schedule a biopsy who then has to pay to have it examined and then has to pay for someone to maybe treat it.

 

So many people do without basic care in the states that would prevent the need for a specialist entirely and greatly reduce the urgency for one when it might be too late to do any good.

[Bluegoat]

Perhaps. I may be wrong, but I think providers are supposed to take tricare. I haven't found any that don't take tricare. I have found a lot that are not accepting new patients with tricare. I believe that tricare pays providers similar to Medicare and my understanding is that it is less than private insurers. So most providers (or at least some) have a cap on how many tricare patients they see. I guess my concern is that affordable insurance means nothing if doctors aren't accepting new patients with that affordable insurance. It seems like one of the reasons it is affordable is because it pays providers less. The pediatrician that I did find told me that they are lucky to break even with tricare patients. I have no reason to not believe him, but I have no way to know if that is true.

 

But, on the other hand, see my pp about the $1500 charge for my son's broken arm. Our insurance paid $1380 for that (which I thought was a ridiculous amount of money). I would be interested in what tricare would have paid. Maybe it is a more reasonable amount. I just don't know how we will have affordable insurance if a 5 minute consult costs $1500.

 

 

I think though that what people were thinking of was a universal insurance program.  There are a few ways to set that up, but what it would mean is that all insurance coverage would offer the same rates for the same services. 

 

Here in Canada for example, each province has its own insurance mechanism, which every person in the province is covered by.  The insurer negotiates every few years with doctors (through their professional body) for a new contract where fees for service are decided.  Those are the same for every doctor.

 

So - no one is going to refuse patients because they aren't paying the same rate - there is only one rate. 

 

ETA: costs for services are particularly high in the US.  It actually tends to go down under a universal system, not only the agreed cost, but the actual cost of providing the service is less.  So - an estimate I found of cost to the system, in the Yukon, for a broken arm, was just over $100.  That is in an expensive area because it is so thinly populated.

Edited June 24, 2016 by Bluegoat

[TechWife]

Yes I is absolutely outrageous. The only ER trip we had here turned out to be a "go see the doctor" kind of thing. NOTHING was done except the patient was given Advil. Cost: $1400

 

Well, in all honestly, it probably wasn't an ED problem. ED's are designed for emergent situations. As non trained medical personnel, we sometimes don't know what's emergent and what isn't, but the fact remains that emergent and non-emergent situations incur the same base cost to the hospital when it comes to caring for someone in the ED. As consumers, we really shouldn't be surprised that we are charged for accessing emergent care, whether or not we need it, After all, we wouldn't purchase a Mercedes and expect to pay the same cost as a Chevrolet because we only need a Chevrolet. The fact is, we are buying a Mercedes and we should expect to pay Mercedes' prices.  

 

ED's treat routine illnesses all the time - but it is expensive to do so. It often happens because the person can't access health care otherwise (so many reasons - cost and availability being the top two). The same doctor that is treating someone for an ear infection is qualified to treat someone for a heart attack and they get paid more because they can treat the heart attack, not because they can treat the ear infection. The patients use the same hospital resources while they are there, no matter what the reason. Doctors, nurses (triage and treatment), exam rooms, lighting, heat, medical records, security, cleaning - all of these costs are fixed no matter the diagnosis of the patient. 

 

Urgent Care Centers can take some of the burden off of the ED, but the fact remains that they aren't located everywhere and when they are, they certainly don't have 24/7 availability, which has been my biggest frustration with that model. 

[Laura Corin]

Well, in all honestly, it probably wasn't an ED problem. ED's are designed for emergent situations. As non trained medical personnel, we sometimes don't know what's emergent and what isn't, but the fact remains that emergent and non-emergent situations incur the same base cost to the hospital when it comes to caring for someone in the ED. As consumers, we really shouldn't be surprised that we are charged for accessing emergent care, whether or not we need it, After all, we wouldn't purchase a Mercedes and expect to pay the same cost as a Chevrolet because we only need a Chevrolet. The fact is, we are buying a Mercedes and we should expect to pay Mercedes' prices.  

 

 

One time I was visiting a friend in Pennsylvania and I tried to get treatment for a urinary infection.  No local doctor would see me because I wasn't an existing patient with a US insurance plan (I had fully comprehensive insurance from a UK travel firm - I would have been putting care on my credit card and getting reimbursed).  I ended up apologetically turning up at the ER, because no one else would see me.

 

I'm sure that the equivalent must happen to US citizens.

[Laura Corin]

 

 

Here is an article I read this past weekend when I was at my in-laws house about kidney  dialysis and undocumented workers. I don't know what the answer is. 

http://www.houstonchronicle.com/news/houston-texas/houston/article/Undocumented-immigrants-in-Houston-desperately-8311380.php

 

You won't want to hear this, but the answer is that if anyone who is paying taxes contributes to the healthcare system, then the charges for those who can't contribute are spread widely.  In my house, Husband and I pay taxes; the rest of the family (two dependent children and ancient parent) get the same healthcare and don't pay.

[purplejackmama]

I'm not saying that at all!! The ACA got rid of pre-existing conditions so we now CAN buy an outside policy. Before the ACA, we were stuck with whatever plan DH's work offered. Great plan but $2k a month!! Insane!! At least with my crappy ACA policy, I'm saving $1k/month.

Wow! That's awesome. We pay $2400/m!

 

To clarify: I meant the $12,000 savings is good. We are paying $12,000 more.

 

Sorry the coverage is crap. Ours is too. I just pray we don't need to find out how crappy it really is. :/

Edited June 24, 2016 by purplejackmama

[TechWife]

One time I was visiting a friend in Pennsylvania and I tried to get treatment for a urinary infection.  No local doctor would see me because I wasn't an existing patient with a US insurance plan (I had fully comprehensive insurance from a UK travel firm - I would have been putting care on my credit card and getting reimbursed).  I ended up apologetically turning up at the ER, because no one else would see me.

 

I'm sure that the equivalent must happen to US citizens.

 

It does happen to US citizens, which is a problem.  An urgent care center would have been able to handle a UTI, but they are not available everywhere and aren't open all the time.  

 

ETA: Urgent care centers are much less expensive than an ED. They are a bit more than an office visit with a primary care physician, but nowhere near approaching the cost of the ED. 

Edited June 24, 2016 by TechWife

[TechWife]

So what is the hospital supposed to do about losing all of the money.  As undocumented workers, none of them are paying income tax.  They are typically paid in cash so as not to leave a trail. 

 

Immigration reform.  :leaving:

[Lanny]

United Healthcare lost USD $500 million on the ACA policies it issued. It is a Corporation and the officers of a Corporation have a Fiduciary responsibility, to the Stockholders, to manage the company properly and make money, not lose money.  One of the issues with ACA, for insurers like United Healthcare, is that the percentage of policyholders who sign up for ACA policies who are much sicker and require much more medical care, is much higher than the Actuaries had anticipated, when ACA policies first went into effect several years ago.  That requires the Policyholders pay higher Premiums, for the same coverage, or, have higher deductibles and higher copays and continue paying the same premium.  No easy answers to complex problems. 

[goldberry]

It is a Corporation and the officers of a Corporation have a Fiduciary responsibility, to the Stockholders, to manage the company properly and make money, not lose money.   

 

The core of the problem with for-profit health care. 

 

Healthcare for those who are sicker than others should not be a "product" whose worth is only determined by its profitability.  There is a human element there - actual people who need healthcare even more so.

 

As shown previously, they are making money elsewhere and losing money on ACA policies.  They are still overall profitable.  That in itself proves that if it was all one giant pot, it would still be able to function profitably.  It's time to put it all in one pot.

[goldberry]

One of the issues with ACA, for insurers like United Healthcare, is that the percentage of policyholders who sign up for ACA policies who are much sicker and require much more medical care, is much higher than the Actuaries had anticipated, when ACA policies first went into effect several years ago.  

 

Yes, darn them!  Just because their conditions went on and on without them being able see a doctor, now they ALL want to see a doctor!  If they weren't so sick they wouldn't be costing everyone so much money.  Let's just go back to not covering them and then we can ignore the issue again.

 

(sorry... this line of thinking just sickens me...)

 

ETA, I am someone who was hurt and not helped by ACA.  But I don't begrudge all those with pre-existing conditions that now have healthcare and heaven forbid it's not profitable.  I want an answer that works for ALL of us, and I know it's possible because other countries are doing it.  

Edited June 24, 2016 by goldberry

[Laura Corin]

So what is the hospital supposed to do about losing all of the money. As undocumented workers, none of them are paying income tax. They are typically paid in cash so as not to leave a trail.

Under the UK system, the hospital is supported by tax payers. I as a tax payer consider all treatment of those in need who do not pay taxes a fulfilment of my human duty to others.

[Butter]

As far as why they charge so much for the ER:

 

You have 3 people that have insurance and can pay then you have 3 undocumented people or inmates or whatever that cannot.  So they charge the 1200 that they realize the insurance company will only pay 900 for.  So the hospital gets 2700 dollars that is really paying for the coverage for 6 people which is 450 dollars a person which is appropriate to pay for the staff that is needed for all emergencies, utilities, x-rays etc. 

 

You've got it partially correct.  There is another reason hospitals/doctors have to charge insurance companies so much.  The usual and customary rate is set based on a percentage of what the average charge in the area for specific services are.  I did insurance billing before I got married.  We had to raise our rates across the board $10/hr (therapist practice) in order to continue getting the same reimbursement from insurance companies.  Insurance companies are weird.

 

Also, a large number of people who cannot pay are not undocumented or inmates, but simply people who can't pay.  Many of these previously had no insurance (ACA was partially aimed at fixing that whether it actually did or not).  They'd wait until they were super sick and then go to the ER.  These are American citizens, many of whom are working full time.

 

So what is the hospital supposed to do about losing all of the money.  As undocumented workers, none of them are paying income tax.  They are typically paid in cash so as not to leave a trail. 

 

False.  Many undocumented workers do indeed pay taxes (and will never get them back because they can't file for a return if they are, for example, using a false SS# - it doesn't have to be valid to have taxes deducted, but it does need to be to file a return).  It's a myth that just won't go away that they don't pay any taxes (even those who don't pay income tax do pay property tax - directly through an owned home or indirectly through a rented home - and sales tax).

[Daria]

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

 

I've been waiting years to find a specialist for my child who is in network for my insurance.  Fortunately, I have the ability to pay hundreds of dollars a month out of pocket while we wait.  

 

Of course, that's mental health, which some people consider less important than cancer care.

[Daria]

So what is the hospital supposed to do about losing all of the money.  As undocumented workers, none of them are paying income tax.  They are typically paid in cash so as not to leave a trail. 

 

This simply isn't true.

[NoPlaceLikeHome]

What the what.

 

We don't have 6 month waits bc those who can't afford just die doing without.

 

My husband had a lengthy waitlist to get into his endo even as an established patient. He finally gave up and went to the ER to renew his insulin prescription. Which he bought from London bc there's no way we can afford to buy it here.

 

Thank god he doesn't have a suspicious lump somewhere he needs to go to a new dr who then has to schedule a biopsy who then has to pay to have it examined and then has to pay for someone to maybe treat it.

 

So many people do without basic care in the states that would prevent the need for a specialist entirely and greatly reduce the urgency for one when it might be too late to do any good.

Exactly. I think many think that it is OK if someone does not have insurance since they can always go to an emergency room or doctor. Well if your situation is not urgent like needing a hip replacement or needing gallbladder surgery (for non emergency gallbladder situation) or cancer then they do not have to treat you. Emergency rooms only stabilize you and they do not offer ongoing care that is not needed to stabilize your vital signs and condition.

 

Therefore, as happened to mom, you will probably be told if you cannot pay your bill for chemo or radiation, then no treatment. I saw a woman one day in my doctor's office who did not have health insurance and was told if she could not pay cost of visit (about $200.00) up front then no visit. Some doctor's charge much more.

 

So here in the US we have a lot of folks who cannot get care at all unless they have insurance or a lot of money which was a lot more people before the ACA law took effect.

[TechWife]

The core of the problem with for-profit health care.

 

Healthcare for those who are sicker than others should not be a "product" whose worth is only determined by its profitability. There is a human element there - actual people who need healthcare even more so.

 

As shown previously, they are making money elsewhere and losing money on ACA policies. They are still overall profitable. That in itself proves that if it was all one giant pot, it would still be able to function profitably. It's time to put it all in one pot.

One of the problems with ACA isn't for-profit healthcare. ACA is an insurance bill, not a healthcare bill. The problem is for-profit insurance companies. If more companies pull out, we will not work our way to a better for-profit model of health insurance where stockholders make less, nor will we work towards a not-for-profit health insurance model. It's more likely, IMO, that we will work our way to a single payer system.

[NoPlaceLikeHome]

As far as why they charge so much for the ER:

 

You have 3 people that have insurance and can pay then you have 3 undocumented people or inmates or whatever that cannot.  So they charge the 1200 that they realize the insurance company will only pay 900 for.  So the hospital gets 2700 dollars that is really paying for the coverage for 6 people which is 450 dollars a person which is appropriate to pay for the staff that is needed for all emergencies, utilities, x-rays etc. 

 

Here is an article I read this past weekend when I was at my in-laws house about kidney  dialysis and undocumented workers. I don't know what the answer is. 

http://www.houstonchronicle.com/news/houston-texas/houston/article/Undocumented-immigrants-in-Houston-desperately-8311380.php

IMHO I think it is offensive to assume that those without insurance are inmates or undocumented immigrants. My parents, both born and raised here and  are upstanding citizens could not afford health insurance for 3 years before they were eligible for medicare.

 

Also, prior to ACA, many hospitals were shutting down emergency rooms to due the huge amount of uninsured people. That number has dropped dramatically thanks to the ACA health care law. Additionally, many hospitals advocated for the ACA healthcare law and for expansion of medicaid that many states refused despite the ACA encouraging these states with financial incentives.

 

Lastly, prior to the ACA law, both my son and myself were turned down for health insurance by several companies for pre-exisitng conditions despite the fact that we had continuous health insurance with no breaks in coverage. We were in the private market at that point due to change in jobs. Also, my son and I were fairly healthy at the time with no devastating diseases which should always be covered anyway.

[TechWife]

Yes, darn them! Just because their conditions went on and on without them being able see a doctor, now they ALL want to see a doctor! If they weren't so sick they wouldn't be costing everyone so much money. Let's just go back to not covering them and then we can ignore the issue again.

 

(sorry... this line of thinking just sickens me...)

 

ETA, I am someone who was hurt and not helped by ACA. But I don't begrudge all those with pre-existing conditions that now have healthcare and heaven forbid it's not profitable. I want an answer that works for ALL of us, and I know it's possible because other countries are doing it.

Yes, and never mind the fact that there are long term benefits to having insurance. I expect that the number of critically ill patients that need to be covered by any one insurance plan would decrease over time because, theoretically at least, preventative care and care for minor illnesses would be affordable., thus reducing risk of critical illnesses. Short term losses could result in long term savings, but shareholders don't want to hear that.

[zarabellesmom]

Here is a total thread derail, but us healthcare is so overpriced. I don't even get it. My ds4 broke his arm recently and we just got the bill from the surgeon-$1530. It was pretty much a no complication break (it was buckling a little so it needed reduction). The surgeon was with us for maybe 5-10 minutes and it definitely wasn't a surgery. The bill wasn't even for the hospital visit or X Ray. We have really good insurance and it pays 100% for accidental injuries, but no wonder insurance is so expensive. The insurance paid over $1300 for that. I know we pay for the surgeon's knowledge, but $1500 for a run of the mill broken arm still seems ridiculous.

 

ETA: I see the insurance company made billions in profits. I guess $1500 broken arms mY not be hurting them that much

My daughter's broken arm cost us four thousand and did not require surgery. EKG and simple bloodwork to ensure my oldest was healthy before starting ADHD medication...$2000. Health insurance for my family including company contribution monthly...$1600. It's disgusting.

 

ETA: Out of pocket.

Edited June 24, 2016 by ZaraBellesMom

[TechWife]

IMHO I think it is offensive to assume that those without insurance are inmates or undocumented immigrants. .

It certainly is! I have uninsured family members who are falling through the cracks because their state of residence didn't expand their Medicaid program and they can't afford an ACA policy.

 

In addition to that, inmates are not uninsured. If they become ill, they are treated in a prison clinic. If they require hospitalization or specialty care outside of the prison system, their bills are paid by the federal, state or local government responsible for their care while incarcerated. Hospitals do not go unpaid for care they provide to prisoners.

[Murphy101]

I'm thoroughly jaded that insurance is the answer. We have had insurance in the past and getting decent timely affordable care wasn't easy then either. It's gotten harder and more expensive, but the number one cause of bankruptcy was medical bills and iirc 80% of filers had insurance. I don't see that changing due to ACA bc a huge part of the problem is insurance itself.

 

And yes, it's insulting to presume that uninsured means degenerate people who don't work or who are here illegally.

 

My dh works. All three of my oldest grown children work. None have insurance.

 

Never mind how many have insurance they can't afford to use.

[zarabellesmom]

This is quite possibly the first step towards a single payer system. It will continue to be a bloody battle which will last for many more years to come and likely none of us will be entirely pleased with the result.

 

For all of you who think you can see a specialist quickly in the US: That is not true nationwide. Try to find a psychiatrist in many areas and you will be in for a big surprise. Don't even think about easy access to a psychiatric hospital for inpatient care - the beds simply aren't there. In some areas, the general practitioner is the only MD with hospital privileges. If you have a heart attack, you end up waiting at the local hospital for an ambulance to arrive from a city an hour or more away so that you can transfer to a cardiology unit. Maybe, just maybe, a cardiologist will come through your small town and see patients once a month. That's fine if you're stable, but if you're newly diagnosed, you're going to need to make many road trips to see a specialist.

 

My family has received excellent health are here, largely due to he fact that we live near many research hospitals. But, I by no means think that everyone has access to this level of care. In fact, it likely never occurred to my husband's parents that this level of care we receive even existed. The first time my MIL saw a cardiologist was when she needed bypass surgery. He estimated that she had previously had around ten heart attacks and over 50% of her heart muscle was "dead." She died at the age of 63.

 

Access to healthcare is inconsistent.

I second the psychiatrist comment. We went onto a six month waiting list for Emory in nearby Atlanta for my daughter who was really suffering. After two months they called to tell me that they wouldn't be able to see us at all, they were just too booked. I could have spent that time on someone else's wait list. Three months later we were finally seen by someone else. This is for a child who could not be more than a foot from me, no longer slept at all, and had hands that were cracked and bleeding from constant OCD hand washing. Thank God we were homeschoolers because going to school would not have even been a possibility. There was one place we could have gotten in...a place that didn't take any insurance at all... Just cash at the door, $2000 for initial consultation alone. It was money I didn't have or we would have been all over it. Edited June 24, 2016 by ZaraBellesMom

[Kassia]

Never mind how many have insurance they can't afford to use.

 

That's us.  We pay so much in premiums ($13-14,000/yr) and then have a high deductible (I think it's $8,000.  If not, then it's more because I know it's not less than that).  So, we pay the high premiums and then don't go to the doctor unless it's an absolute emergency which scares me in case we have symptoms of something serious that could be treated if caught early, but we won't see a doctor because of the high costs.

[zarabellesmom]

This is simply not true. Additionally try get cancer treatment here in the US if you have no insurance or money to pay hundreds of thousands of dollars. My mom was told no chemo unless she could pay her bill despite having insurance (which we were grateful for since my parents went without insurance for 3 years and certainly could not afford to pay for health care out of pocket).

 

http://www.nytimes.com/2014/07/06/sunday-review/long-waits-for-doctors-appointments-have-become-the-norm.html

 

This article debunks what you have said:

 

http://www.pnhp.org/news/2012/june/5-myths-about-canada%E2%80%99s-health-care-system

My mother had to apply for a grant to receive radiation as palliative care for the stage 4 cancer that killed her. She was unable to afford insurance even though she was working full times before her condition prevented it.

[MooCow]

United is screwing over the employee offered as well. Our deductible is ridiculous and our coverage is a joke. The stuff they get out paying is amazing. One Dr's visit and boom what should be covered is not and now falls under our deductible . Meet the deductible and oops, so sorry, here's something else.

 

For the first time ever, we have real medical debt, and not for gosh forbid something serious.

 

Rant off now

[Murphy101]

United is screwing over the employee offered as well. Our deductible is ridiculous and our coverage is a joke. The stuff they get out paying is amazing. One Dr's visit and boom what should be covered is not and now falls under our deductible . Meet the deductible and oops, so sorry, here's something else.

 

For the first time ever, we have real medical debt, and not for gosh forbid something serious.

 

Rant off now

We repeatedly had that problem too. 10ish years ago when dh had to switch from regular injections to an insulin pump, we had to scramble to pay for the pump bc insurance wouldn't cover it or risk immediate health problems. Gee. That was "only" $6000. Eventually our numerous appeals netted the response that we'd get reimbursed. But the check never came.

 

So many stories like that from us and from so many other people.

[Kari C in SC]

DS6 is on a 10 month waiting list for a neuropsych. we have good insurance too. Just takes forever.

It took 4 months to get my dd into a specific GYN for an appt. Then it took 2 months to have surgery. The wait was worth it to us after a not great experience with a different practice. It took 6 months for me to get into a different GYN. And I now have a rheumatoid doc appt for December 22nd. The referral was made at the end of April. To be fair, I'm sure there are some doctors we could get into faster, but if you want a certain one... Be prepared to wait as a new patient.

[MSNative]

For reference: my 91 year old mother lives with me in Scotland, so I have a lot of experience of getting in to see specialists. The longest wait has been a couple of months for something that was uncomfortable but not life-threatening. A GP appointment for an urgent matter is same-day. For a non-urgent matter with a named GP it could be a week or two. It's fine.

My sister married a Brit and she and her family did not have that experience. They all lived in London. Earliest "emergency" appt to get treatment for a fast spreading cancer that has been the cause of death for several family members was over a year. We flew her back and got treatment here in the states in just weeks. Her MIL often had wait times of 9-12 months for specialists.

[Mom-ninja.]

One time I was visiting a friend in Pennsylvania and I tried to get treatment for a urinary infection.  No local doctor would see me because I wasn't an existing patient with a US insurance plan (I had fully comprehensive insurance from a UK travel firm - I would have been putting care on my credit card and getting reimbursed).  I ended up apologetically turning up at the ER, because no one else would see me.

 

I'm sure that the equivalent must happen to US citizens.

In Germany on vacation my then 5 yr old suffered a head injury. My friend called her pediatrician and got my son an appointment an hour later. I was shocked. It was not a problem that he was not an established patient. It was not a problem that I didn't have insurance. The doctor saw my son right away. The visit cost me $50. The medication cost me $10. 

 

Let me just say that doctors in Germany aren't poor either. They make good money. Difference? They don't have crazy high student debt from med school and don't have crazy high liability insurance payments.  

[Splash]

I am sorry about your daughter but is this indeed really the fact about other countries? I have read many articles about other countries offer drugs that we have not even approved yet. Or how in many countries drugs are often way less expensive than here. When I need particular meds I saved thousands of dollars by ordering from Britain at the time. 

My daughter has an ultra rare disease (affecting less than 20 people per million) which currently has only one drug approved to work to keep disease activity at a minimum. (orphan drug)  It is made in US by US company.  Canada tried to get them to lower the costs but they said no, so not available there.  England it depends on where you live, some areas are yes, others no.  Australia just approved the medication for six months after kidney transplant, however the medication isn't a cure so it is needed forever for most patients, especially those who have had transplants.  Before this medication the mortality rate was 70% within three years of diagnosis with remainder in End Stage Renal Failure needing a transplant.  There are many new drugs in the making but that is a 3-5 year process.  We are hoping that it helps with the costs and also that there is a better way to administer the new drugs, currently she gets an infusion every 14 days.  One couple is in process of moving from India to America to get access to the drug for their child. I'm on several forums, groups that are worldwide that are trying to make the drugs available to all.  We also have yearly meetings about treatments, research, etc regarding the disease so I'm pretty up on things now.  The other countries do not have an alternative drug at this time.  They rely on plasma pharisees which almost killed my child when she was in the hospital.  People do this several times a week for years and years along with dialysis.  Their quality of life is very compromised compared to our 14 day infusions.  Most countries have just said it is too expensive. 

[LucyStoner]

I disagree. We are leading edge technology, particularly on genomics and cancer research. We have the funding AND the access. You don't end up on a six month waiting list here for cancer surgery. You do in state run systems. Ask people in Canada how long they have to wait to get into a specialist in many instances and how far out their surgeries are booked.

The United States does not get measurably better health outcomes. We just spend exponentially more. More expensive =\= better.

Edited June 25, 2016 by LucyStoner

[AmandaVT]

That's us.  We pay so much in premiums ($13-14,000/yr) and then have a high deductible (I think it's $8,000.  If not, then it's more because I know it's not less than that).  So, we pay the high premiums and then don't go to the doctor unless it's an absolute emergency which scares me in case we have symptoms of something serious that could be treated if caught early, but we won't see a doctor because of the high costs.

 

Yup - we pay $1500/month for crappy BCBS coverage. (BCBS is good, but we have a big $11,200 deductible) 

 

I am not going to the Dr for anything other than an annual physical (covered) and flu vaccine unless my arm falls off or something. 

 

DH had to go to urgent care one Saturday a couple of months ago. He had a nasty cold that was turning worse and settling in his chest and we had 3 different friends with pneumonia at the time. He went in to get checked and the bills are still rolling in. We're over $900 now for his 20 minute visit to an urgent care walk in clinic. 

[momof4inco]

I am totally shocked at what some of you are paying for insurance with a high deductible. I hear about it briefly on the news, but the cost of health insurance is not something I talk to people IRL about very often. I can now understand why many people would like to have universal coverage. I can also understand why some people decide to pay the penalty vs getting insurance.

 

The whole system sucks...

[Daria]

I second the psychiatrist comment. We went onto a six month waiting list for Emory in nearby Atlanta for my daughter who was really suffering. After two months they called to tell me that they wouldn't be able to see us at all, they were just too booked. I could have spent that time on someone else's wait list. Three months later we were finally seen by someone else. This is for a child who could not be more than a foot from me, no longer slept at all, and had hands that were cracked and bleeding from constant OCD hand washing. Thank God we were homeschoolers because going to school would not have even been a possibility. There was one place we could have gotten in...a place that didn't take any insurance at all... Just cash at the door, $2000 for initial consultation alone. It was money I didn't have or we would have been all over it.

 

Yep.

 

For teenage boys (and maybe girls, I just didn't look for the statistics on girls since I don't have one) suicide is the second leading cause of death.  Only automobile accidents kills more teenagers.  Mental illness kills more teenagers than any kind of cancer, or heart disease, or anything else.

 

And yet, because of stigma in our country, and because of the way our healthcare system works or doesn't work, many many teenagers and young adults go without psychiatric care.  People talk about the mythical waiting lists for cancer treatments in Canada, or for knee replacements in England, but children die in the U.S. due to lack of appropriate mental health care.  

[Kassia]

Yup - we pay $1500/month for crappy BCBS coverage. (BCBS is good, but we have a big $11,200 deductible) 

 

I am not going to the Dr for anything other than an annual physical (covered) and flu vaccine unless my arm falls off or something. 

 

DH had to go to urgent care one Saturday a couple of months ago. He had a nasty cold that was turning worse and settling in his chest and we had 3 different friends with pneumonia at the time. He went in to get checked and the bills are still rolling in. We're over $900 now for his 20 minute visit to an urgent care walk in clinic. 

 

We also have BCBS and, like you, say we don't go to the doctor unless a limb is falling off.  It's scary.

[kiana]

Yup - we pay $1500/month for crappy BCBS coverage. (BCBS is good, but we have a big $11,200 deductible) 

 

I am not going to the Dr for anything other than an annual physical (covered) and flu vaccine unless my arm falls off or something. 

 

DH had to go to urgent care one Saturday a couple of months ago. He had a nasty cold that was turning worse and settling in his chest and we had 3 different friends with pneumonia at the time. He went in to get checked and the bills are still rolling in. We're over $900 now for his 20 minute visit to an urgent care walk in clinic. 

 

Indeed. And this is so frustratingly counterproductive, because going to urgent care before it turns into pneumonia is exactly what a system that is overall concerned with saving money and keeping people healthy would want to encourage people to do. Not to gamble and hope it goes away.

 

I have a friend who's on partial disability because of complications from a bacterial infection. He was self-employed and, as you say, didn't go to the doctor until the limb was falling off. He's only barely in his 50s and cannot ever hold down more than a part-time job again, plus the cost of care to fix it has been astronomical. As he is now disabled, the continuing care he needs is paid for by the gov't, but the earlier bills were only solved by bankruptcy.

 

Who the hell does this benefit besides health insurance companies? Not him, not the hospital, not the taxpayers, that's for sure. 

[LisaKinVA]

Keep in mind, when you are comparing US health care to "European" health care, you can't paint all of Europe with a broad brush and say it's better.  Yes, certain parts of Europe experience much better health care than certain parts of the US.  But, there are also places in Europe that have worse care than places in the US.  Depending upon the country, and even within those countries with excellent care, you can have a wide variance of experiences.  Single payer is unlikely to remove the issues with the quality and access to various types of care in the U.S.  It will be available, but the extent of what is available where will vary greatly.

 

Currently, the USNH in Naples (and I believe the Army hospital in Vicenza as well) are being shuttered.  Pretty much, all you will be able to get on-base is an urgent care, standard check-ups and vaccinations. Everything else will have to be run on the economy.   It does have people stationed here planning to exit (people who would otherwise have stayed).  The hospitals here are not pretty.  They are usually pretty dirty (I've been to 4 different ones).  They are overcrowded. You may get seen, but you may not be diagnosed well (when Boo had appendicitis, the first doctor who agreed to see her (we drove to two others who refused to even look at her) said it was just a tummy ache and to bring her back in 3 days if it didn't get better -- she had already had the ache for 3 days, and it had intensified to the point she could not walk, and the pain had localized, we finally had to take her to the base hospital and get transferred to another Italian hospital that confirmed and treated appendicitis).  The doctors here do not listen to their patients - especially women. There is a huge bias against pain management (think, sure you just had a C-section, but you've been sewn up, remove the epidural, and here's a Tylenol for your trouble).   Yes, we were not charged to be seen, or for the treatment.  But it was hardly a stress-free experience -- and that's not even counting the huge language barrier.

 

There are huge problems with access to and costs of American Health Care -- Single payer may address one part of the equation, but it will not answer the second part for everyone.  

 

 

[MomtoCandJ]

We have ACA insurance but we can't really afford to use it... $13,000 is what we have to pay per year before anything kicks in