I’m curious about details. Price seems low even with high-deductible and no existing conditions. What about someone like myself, with a history of heart failure?
This is fascinating. Actually, while our system is bad, not many illnesses are going to cost even $1,000,000 for them, considering that you’d probably want to be repatriated as quickly as possible. $10,000,000 is probably not going to cost them anything, since I doubt they’d ever see a claim that big.
They do it because of the anchoring effect. When you compute the perceived value of this insurance, you’ll anchor on to the $10,000,000 value, and your estimate of its worth to you will be a lot higher if they put the limit at $1,000,000. So they will sell more, and probably won’t have to pay out any more.
This effect is very strong. My daughter and I teach a behavioral economics tutorial for engineers, and we do an anchoring experiment in the class. The effect is statistically significant even with only 20 people in the group. That’s strong!
How much is the deductible, btw. I bet most people in England don’t even consider deductibles, since you don’t have any. I suspect that they pay more for trip cancellation claims than for health claims.
I just checked for medical insurance for a month in the USA for one person- $361. That is with a $100 excess. That is for unlimited medical, and about what I expected.
I know that my Credit Cards supply insurance if I use them to buy the ticket. I tried to claim once and it was a nightmare- to the extent I didn’t pursue the claim.
For the OP, I believe you are talking of the USA model of Health Insurance so my thoughts may not be applicable. Even though we have free hospital care in Australia, I have always had private health insurance so if something needs to be done- and it is not an emergency- I don’t have to go into a queue.
Also, currently, we have a Govt policy whereby your health insurance payments are a ta deduction. That is due to change shortly.
I was wondeirng about this as well. I’m approaching 20 years, and so is my wife, and neither of us has ever filed a claim.
There are many things wrong with health care in the USA, and I find it to be unfortunate that so very much of the attention is focused on how to pay for it rather than how to fix the structure that makes paying for it so expensive.
I do think that medical savings accounts with insurance as a disaster cap makes conceptual sense, but in practice the costs in the system would make pretty much any medical event into a disaster.
Case in point: I’m a motorcyclist. A bit over a year ago, I crashed a bike by hitting a car. I wasn’t doing anything wrong, or taking chances or anything of the sort; I simply misread a traffic situation and it was totally my fault…a simple accident.
I landed on my head (helmeted) and was unconscious on the road for about 1/2 hour. I woke up gradually as I was being loaded into the ambulance. A paramedic said to me: “We can’t find anything wrong with you, but we’re taking you in because you were unconscious for awhile.”
So, I was wheeled into the ER, inspected physically, questioned about how I felt, given a skull MRI and an X-ray of my left thumb, then told I was fine and released.
So, ambulance ride, treated and released. The bill? A shade under $19,000 dollars. Not only that, I received a letter from a law firm a few weeks later informing me that the hospital was claiming a lien on any money I might collect on any lawsuit I filed regarding this crash - a perfectly moot point for me, but nonetheless evidence that the grasping medical establishment was going to get as far into my pocket as possible.
Now, what I want to know is this. Howinthehell is it even possible to rack up $1900 in ambulance charges plus about $16,500 on a treated and released case??? How can that be???
And, given that these ARE the costs in this country, how could a medical savings account/disaster cap plan EVER work?
There is much wrong with our system. It is badly broken. But it seems to me that we’d be doing much better to discuss how to bring the costs under control and make them reasonable an rational, rather than all this debate about how to pay the extortionists their blackmail.
What is it that strikes you as implausible about this?
Well, to make more explicit a point that I had thought was explicit enough, if everything is a disaster, then a disaster cap is meaningless. It is just insurance.
And if treated and released can exceed $18K, then everything beyond scheduled office visits is a disaster.
It wasn’t explicit at all, so I appreciate the clarification.
I do agree with you that in the US, ‘disaster insurance’ is usually a misnomer when applied to medical insurance.
Those are probably the “Full Retail” prices, not the volume discount prices the insurance companies pay. Individuals paying cash must haggle like you are in a bazaar.
Typically “Million Dollar” patients are those with cancer or other long term illnesses that require long inpatient stays and/or expensive medication. If you somehow get diagnosed with cancer on a trip you’re unlikely to stay in the US for the duration of treatment if you’re from an other western country. check the travel insurance there might even be an exclusion for “non-emergency” medical care. As another poster pointed, slipping and banging your head on a trip in the US can cost close to 20K, enough to cause a real headache so to speak unless you have insurance, but it doesn’t make a difference whether the lifetime max is $1,000,000 or $10,000,000.
You are entitled to a fully itemized bill. If this was less than a year ago, and I presume you haven’t paid the whole thing yet - request it and look. I’d love to see what the major costs were to add up to that much.
I just had a major surgery, in a hospital in Baltimore, staying there for 4.5 days, with all kinds of equipment needed, procedures done and drugs used. Cost - $25K or so (I didn’t see the fully itemized bill yet). So yes, it would be interesting to see how they managed to do the $19K for you.
Oh, my insurance paid it. I had some deductible to pay but that was all. The final payment was negotiated down to something over $12K for the hospital and the full price for the ambulance. Total around $14K. Which is still well beyond absurd. And not what I personally was billed, not even close.
Now, on the other hand, I’d be fascinated to know how you managed “major surgery” and over 4 days stay for only $25K.
I am in the same situation as you - I get the bill, but it is not itemized and “NOT A BILL” - it just shows what they are sending off to insurance. But altogether it comes to about $25K (about $14K for the surgery itself, with a plethora of accompanying bills, I guess for hospital stay, anesthesiology, etc. etc).
That’s presuming that you’re accepted for that insurance. Any health issue you have can be considered (for the next 2 years under ACA, forever if ACA is mooted by SCOTUS) a pre-existing condition and can drive up the rate – including being overweight or obese (if obesity doesn’t disqualify a person entirely). Since the majority of Americans are overweight, the majority of us can never qualify for basic quoted health insurance rates on the individual market.
I can do you one better. A few months ago, I got an accident bonk in the forehead. A couple of days later, I had a lot of pain, a black eye, a couple of minor nosebleeds and sinus fluid was gushing down my throat. Those together are warnings for an injured frontal sinus, so I went to the ER.
I climbed out of my car at 10:03 and climbed back in at 10:29, still in pain and $1,003 poorer. I had four minutes with a physician’s assistant, and six minutes with the emergency physician. I had an exam consisting of looking up my nose with a penlight, making me follow that light with my eyes and pressing on my forehead and the bridge of my nose.
The doctor said I couldn’t possibly have a fracture and stand having my forehead pressed on, so I didn’t need an x-ray. He counseled ibuprofen and decongestant and it was done.
The doctor’s bill was $263. Which means his time bills out at $2630 an hour. (Lawyers are pikers, clearly.) The ER bill was $746. I had no tests, no equipment was used for me (not even gloves) and I sat on a chair so they didn’t even have sheets from a bed to wash.
If ten minutes of talking and minor touching is $746, anyone who seeks care in an ER for anything that actually requires serious diagnostics is screwed.
I think if you are going to use an ER for non emergent issues, you have to be prepared to pay more than you would going to your primary physician for an issue such as this. You are paying for their expertise, the staff time, the time taking up the room etc. So the cost would be the same for the triage treatment whether you had a bump on the head or a brain aneurysm.
Part of the problem is there’s only 5 codes an ER doctor can bill that span the range from someone with a sore throat to someone bleeding to death from massive trauma (In order of increasing severity 99281, 99282, 99283, 99284, and 99285) so a “less serious” 99281 gets billed the same as a more serious one. The codes are based on the perceived problem too not directly time spent with the patient, so a potential head injury might get bumped up even though it only took a couple of minutes. Assuming a 1 or 2, it does seem high but not totally out of line, especially as a billed charge and not an insurance allowed amount.
Also, it’s often not evident to a lay person when they should go to the ER as opposed to Urgent Care, or even waiting two weeks to see their primary physician. That’s why hospital based urgent care makes sense. You can present with anything from a sore throat to a gunshot wound and be directed to (and charged for) an appropriate level of care.
I must be in Oz. There are libertarians making a lot of sense in here. The simple fact, proven again and again, is that the market is far more efficient than a central monopoly power at allocating resources. Wealthy people from Canada, England and all over the world come to Johns Hopkins, Mayo Clinic and a host of health systems unmatched in their quality and skills.
The availability of American health care to the world brings dollars from abroad to the US. When the proponents of UHC add up what we spend on health care, they count what foreigners spend in American hospitals to make it seem as if we spend a lot.
Additionally, Washington DC with Medicare and Medicaid created two very large and wasteful systems that are rife with corruption. Congress looks the other way because the biggest scammers contribute to their campaigns. Medicare and Medicaid are just a way to funnel money to a guy that steals from the taxpayer to give the money to the re-elect so and so campaign.
Monopolies always kill innovation. The lack of competition is the same, whether run by Rockefeller, Castro or Washington DC.
And the rest of usgo to Mexico, Thailand and the Phillipines for affordable health care. Yes, we are in Oz.
cough cough Bell Labs. If you want great care for the rich and for the poor and the old to die, we’ve got an excellent system. If you want the best results for the population as a whole, not so much.
The fact, proven again and again, is that the market makes a big fucking mess out of healthcare. You might as well argue that the UK has the best motor industry because, hey, Rolls-Royce!