Literally most people I know would say this is cause and effect. The US is rich because if you’re not rich here, you will suffer deprivation of basic needs.
Let me pile in too.
I live in a European country. I pay zero for private health insurance, but I pay some 35-ish percent of my gross income in tax plus health dues plus college savings (our public unis have no tuition charge for citizens). I’m above the median income in my country (median is some 50-70 kUSD), so those who are worse off than I am pay less. Me, I’m good with that.
Some years ago, I went down with appendicitis. Total cost: zero, plus the parking fees for my spouse when they visited me in the hospital.
Some years ago, my spouse went down with a medical issue. They got it on a business trip to the US. We would’nt have been bankrupted if they were hospitalized over there, but we’d have to take out a second mortgage on our house if we’d have to pay their medical costs in the US. Since they managed to get back before being hospitalized, our total cost was zero plus my parking fees when visiting them plus my stress eating snacks.
One of our children is trans. While I thoroughly despise how transgendered people are treated over here, the total out of pocket cost for their treatment is zero. Because if you eventually (and painfully) get the diagnosis, the treatment is free for the individual.
I’m pretty convinced that being above median income I pay more into the system than I get out from it, but then I pay more into my insurances than I’ve ever gotten out from them. And I’m good with that, because when my dad was dying and we spent about two weeks at his deathbed 24/7, the cost was pocket money. We could’ve afforded a lot more, but not having to worry about the cost while emotionally handling my dad’s death was worth a lot to me.
That would explain a divide between the poor and rich, not the country being so wealthy overall.
(I know I’m preaching to the choir here and arguing with shadows, this isn’t your opinion. 
)
We have friends that are a couple probably making around very low 6 figures, 100K-150K/year, which isn’t a ton of money, but not bad in Georgia. I think they’re uninsured, and use a Christian “Medishare” plan, which isn’t real insurance. I think Obamacare would help them, but they hate Obamacare maybe because it’s named after a Democrat.
We have a house-maid that has insurance through the Obamacare exchanges. She used to be uninsured. She’s now able to get check-ups and treatments that she couldn’t get in the old days. I told her about the ACA after Biden came into office, and made the tax credits better. She’ll probably be in a bad spot if the enhanced Biden credits sunset in 2026.
The Insurance that people have probably works “OK to good” for about 75-80% of the population. They have some sort of coverage, and maybe some hassle, but they can afford what they need, and like what they have (I’m in that 80% group). But there’s 8% of the population that have nothing. Then, there’s some % of the people that have insurance, but can still go broke with co-pays in some instances. Only in America do medical bankruptcies occur. It’s insane.
Someone posted here a few years ago about needing medical care while visiting the UK. The doctor who treated him said that his care wasn’t covered under the National Health, but it was too much of an administrative hassle to try and bill him separately, so no charge.
In Soviet UK, bureaucracy is hassled by YOU!
The NHS is supposed to identify and bill such cases, but in many instances they give up on it, either because they are ideologally opposed to the idea, or it’s too much trouble to get the money out of patients who are not positively willing to pay.
Welp, I am in billing hell now too.
I made the dire mistake of paying the hospital what they said was my share of the fee for a test I had done last month. The insurance company ended up paying more of the bill than expected – like $500 more.
So I asked for that money back. Riiiiight …
I was told that while, yes, in fact there is a credit there on my account, there is another insurance claim pending and nothing will happen until that is resolved. This was news to me, so I checked and saw that the insurance company is withholding payment for an emergency room bill the hospital sent them back in November. The insurance company wants more documentation to justify the amount of a couple items on the bill.
So when I told the hospital billing folks that the ball was in fact in their court on this, they said they couldn’t send the insurance company anything that would change their mind – apparently the insurance company is doing something called an ‘ER downgrade program’ wherein they aren’t paying some ER charges.
Now, as far as I can tell, I’m not supposed to be held financially responsible for this little food fight they’re having, but apparently the hospital is going to hold my money, which I paid to them for a completely different service, hostage to this issue. Which is apparently unresolvable. Charming.
I have to go back to the hospital for another test on Tuesday. I’m sure they are going to want more money. And this time I’ll be telling them I’m going to wait until after they bill my insurance to pay whatever my share is going to be. This should be fun, as my former employer switched insurance companies at the end of 2024, so this will be going to a new company.
Fucking circus, it is.
Don’t worry, someone will be by soon to tell you how much tax you’re saving by not paying for the people who are recreational users of medical care.
If it was diagnostic imaging, you likely paid your $500.00 to some totally separate entity. For obscure accounting reasons in-hospital radiology departments are usually separate from the hospital itself, along with some other providers such as ER physician practice groups. I would check to see if the payment you made was to Stupid Hospital Health or to Stupid Health Radiology, and direct your ire accordingly.
The fee under discussion is in fact to the hospital - the fee for reading the test is a separate fee that we aren’t fighting about (yet).
We’re in much the same boat. Our health insurance is roughly the same as yours - we have a high dedictible plan, so we shell out close to 4K a year for me (before I hit the out of pocket limit, which I do every year and will likely do MUCH earlier this year), somewhat less for my husband as he usually doesn’t hit his OOP. We’ve been lucky in that we’ve largely paid our expenses out of pocket versus using the HSA, which has allowed us to save a lot of it for future use.
The insurance keeps dropping meds from coverage - MID YEAR sometimes, where we can’t exactly use that info to change our policy. In one case, the change forced me to an alternative asthma inhaler which quite literally gave me Type 2 diabetes. No joke: we noticed that my blood sugar was creeping up from the “keep an eye on it” through the “prediabetic range” and into full on T2DM. I’m the one who realized that the timing coincided with the inhaler change. Another switch, and the problem resolved (and then a couple months later they quietly added the original inhaler back to the formulary). To be fair, I did later develop T2DM for reals, which given my weight was no surprise - but just then, it made no sense - I was eating a little better, exercising a little more, and had lost a couple of pounds. And recently, they’ve basically said “Sorry, your policy doesn’t cover such-and-such, yes, we agree that it’s the best drug for you, but basically we’re hoping you die on someone else’s dime”.
I’ve cited a friend’s example regarding a kid being hospitalized while on a group trip to Europe. Appendicitis. Several days in the hospital. The parents were looking at an emergency credit limit increase to pay the bill… which turned out to be a whopping 600 dollars. Here in the good old US of A, that would get you paperwork and initial triage in the ER. Maybe.
Anesthesiologists, also.
Which leads to great fun when, say, the doctor and hospital are in-network but the anesthesiologist is not. Supposedly “balance billing” / “surprise bills” are no longer allowed in this scenario. I’m not holding my breath.
They do it anyway. I’ve had to get our states Attorney General’s office involved to get them to adjust the bill back to 4X what it would cost anywhere else in the world rather than 20X.
Their defense to a charge of bad faith is that the anesthesiologist is not affiliated with the hospital so not under their control.
Here’s one that worked out in my favor.
My kid used to get in home health services. My credit card on file with the provider expired shortly before we stopped service. For over a year they send me a bill every month or two, and I just put it off, because it’s $1600, and who wants to pay that?
Occasionally the bill is $2500, because some of the old services I’d long ago paid for get automatically added back to the bill. I email, they fix it, the bill goes back to $1600, and I don’t bother to pay.
Finally they said if I don’t pay it goes to collections, so I called to pay. Talked to someone to make sure none of these old phantom charges would come back, and she informed me that my insurance company had audited them (not surprising at all, as they’d double bill my insurance company sometimes), so all client copays from 2024 with my insurance company were being waived.
I only owed $450, not $1600. Also had her send me a letter saying that I was fully paid and owed $0.
Moral of the story is that medical billing is so completely fucked up that the people doing the billing can’t even get it right.
My every five year (I guess six and a half really) nightmare has returned.
I am scheduled for a colonoscopy in ten days. It was scheduled 14 months ago, because they are really backed up.
The facility that is going to perform it just sent me pages and pages of verbiage that amounts to “we do not guarantee that this will be covered by your insurance, it could be denied for these and other reasons” then goes on to list many, many, reasons why the claim could be denied. I should call my insurer and confirm that none of these apply.
I need to sign an agreement that I will pay what the insurance does not. How much? Impossible to say. Aren’t you legally required to say? We can, if you fax a request in. Turnaround time is three weeks. After the procedure? Yes. You can cancel the procedure but you’re within seven business days so there will be a cancellation fee. THAT we can tell you. $300.
Called the insurance company to see if this is covered. “We do not discuss pre authorization with the patient, only the providers”
Last time the colonoscopy that was supposed to be covered 100% cost me $700. I’m expecting it’s going to be over $1000 this time.
I’m expecting Max_S to come in and tell me:
- This is all perfectly normal, legal and expected
- It’s all my fault
I agree that’s bullshit. The provider and insurance company should be able to provide you with the exact amount that you are responsible for. This is a normal procedure.
Sorry, but that wording cracked me up.
And overall, yeah, a real pain in the rear!
Da Fuq?
Mr. Insurance Company… I AM YOUR FUCKING CUSTOMER, NOT THE SERVICE PROVIDER.
This is one of the essential problems with our system. We ask the patient to “have skin in the game”, to be financially responsible for care, when they are, by an order of magnitude, the least knowledgeable person of everyone involved. They know less about the service being provided, the medical options available, the obligations of their insurance coverage, and the cost, which is literally an agreement by the other two parties of the transaction, which the patient is not privy to.
My employer is their customer. I’m a nuisance.