Is American health-care amazing?

[foolsguinea]

No, it’s not great. If it were great, I think public funding would be more attractive. But who wants to be *forced *to pay for an unliked institution?

[Foxy40]

@sishoch

Here’s an example of the wonderful American health car system.

My doctor’s office exists to maximize profits for their investors. The doctors are scheduled weeks in advance, to maximize the throughput of the office. To get care, I have to call and schedule an appointment, typically 3 or more weeks in advance.

So if I need treatment right away, I am directed to the ER at the local hospital and I’m treated by the ER staff, that does not have access to my medical history. This is for any immediate treatment, even during office hours.

So any acute care costs me $150 for the ER plus $75 for each doctor I see, unless they are out of my PPO, in which I’m completely responsible. The cost to my insurance company is probably on the order of $1000 to $3000, depending upon the service.

So, if you feel sick in America, please have the courtesy of scheduling it well in advance.

The reason you have to schedule well in advance is because you are going to a physician that is in a network plan. In order to participate in such a plan, they agree to take huge discounts off of their regular fees. Therefore, they must see more patients within the same amount of time to meet overhead.

You’ll find much less wait times in private physician offices if you are willing to pay up front.
The BILL to your insurance company may be $1000-$3000 but the payment is probably about one tenth of that. I have been working in the industry for over 20 years and when I started answering phones as a receptionist while going to school, the doctor charged $60 for an office visit and the patient wrote a check. Now Medicare pays less than $40.00 for the same service. Your PPO probably doesn’t reimburse much better than that.

The reality is the doctors aren’t making the money. The insurance company executives are and that is what has to change. The people that provide the care need to be paid for it, not the people that REJECT the claims.

[Gaudere]

@QuanSu

To Admin: How can a “banned” account get to continue to post?

He was banned at some point after making that post. So no point continuing to talk to him, he can’t answer.

[Foxy40]

@Markxxx

This is because there is a lot of incentive to go for these goals and they can use the everyday procedures that make money to fund these experimental and “offbeat” researches.

The incentive is to make a profit. When you remove the financial incentive out of R and D will it still be as fierce and competitive to create that new wonder drug, procedure or test?

I don’t know but I am throwing it out there…

[gonzomax]

The World Health Organization's ranking of the world's health systems, by Rank The US has been down on the list of health care quality for a long time. I know senators, congressmen and the rich have access to great health care. The people not so much. People in rural areas have even more spotty coverage. We do not deliver very good care to the masses.
Drugs are researched in universities. and independent labs . When it looks promising the industry takes over. R & D is expensive ,but profits are incredible. Countries without stem cell banns have been grinding away trying to come up with the next big thing. Our politicians put us behind in that race.

[XT]

@gonzomax

The US has been down on the list of health care quality for a long time.

Well, you do realize that the WHO report you linked too was from 2000…right? Also, they rank based on a number of criteria. For instance, life expectancy is one of the things they base their ranking on. The US has one of the highest (if not THE highest) level of obesity in the world, which tends to bring our LE down. Flogging my memory from a thread on this from years ago, I also seem to recall that one of their ranking criteria is Financial Fairness, which brought down our over all score. IIRC though the US did very well on several (I believe we were number 1 in Responsiveness or something like that).

You have to take studies like that with a grain of salt gonzo…and you have to look at the methodology used and what criteria they are using to create their ranking system.

And actually if you look at your report, the WHO 1997 report had us ranked at 72…so, we actually came up quite a bit from there. I haven’t tried to find if they have a more recent ranking system as I think their rank system is flawed in any case. Feel free to do so if you like that…9 years is kind of a long time and we might have gone up or down since then.

I know senators, congressmen and the rich have access to great health care.

How are you defining ‘rich’ there exactly? I’m not saying that the plight of the uninsured isn’t a problem, but they are definitely in the minority, with the majority of citizens having access to good (if costly) health care through their employers. Unless you define ‘rich’ as ‘middle class and higher’.

We do not deliver very good care to the masses.

How are you defining ‘the masses’?

-XT

[sqweels]

How much does health insurance typically cost for someone who does not have an employer-provided plan? Let’s say a 40-year-old with no pre-existing conditions.

[Desert_Nomad]

@sqweels

How much does health insurance typically cost for someone who does not have an employer-provided plan? Let’s say a 40-year-old with no pre-existing conditions.

I am 37 and pay $190/mo for two people (my wife and I). I do have pre-existing conditions. Note that this insurance is from a private UK insurer and is valid everywhere in the world except the USA. I had to leave the USA to get it… and can’t return.

In the USA because of pre-existing conditions, I was told no amount of money would get me insurance as I was declined by every insurer in the state.

Most my self employed friends in the US pay about $700/mo.

[Rumor_Watkins]

@sqweels

How much does health insurance typically cost for someone who does not have an employer-provided plan? Let’s say a 40-year-old with no pre-existing conditions.

That is a near impossible question to answer. For someone in my age range, health insurance can range from 50-250 a month (i am in a very cheap-to-insure age band); it entirely depends on the deductible, co-insurance amount, out-of-pocket limit, if there are co-pay options for routine visits, if there is drug coverage

i shudder to know how many more people would be considered “underinsured” - those that have some base health insurance but with relatively high deductibles and/or poor coverages.

[Rumor_Watkins]

The other unsung issue regarding privately-insured healthcare is the sickening choices people are forced to make when determining their own care… it encourages you to accrue high-cost treatment-based medical services versus lower-cost preventative services

have a high deductible plan? maybe you shouldn’t get that stomach checked out until it’s really bad
petrified of getting diagnosed with something in case you wind up blackening your medical history so as to wind up with “prexisting conditions” limitations? yeah, don’t go see the doctor!

people shouldn’t have to manage their lives around their physical ailments - it constrains people and it makes you feel immesurably crappier about life (i’ve lived in a country with social medicine, and i live in the US)

this aspect of private insurance can not be mitigated - private insurers cannot form a risk pool large enough to insure everyone without selectively discriminating who they will insure.

[athelas]

@Rumor_Watkins

The other unsung issue regarding privately-insured healthcare is the sickening choices people are forced to make when determining their own care… it encourages you to accrue high-cost treatment-based medical services versus lower-cost preventative services.

This NYT article says preventative care isn’t the cost-saving cure-all that reformists wish:

The great hope of every health care reformer is that better care will mean cheaper care.

The theory goes like this: By practicing preventive medicine, doctors can keep many people from getting sick in the first place. Those who do end up with a chronic illness will be closely tracked so that fewer of them develop complications. These steps will result in less illness, which in turn will require less health care. With the savings, the country can then lower its medical bills or provide health insurance for the 40-odd million people who lack it — or maybe even both.

No one really knows whether preventive medicine will save money in the long run, let alone free up the billions of dollars a year needed to help pay for universal health insurance. In fact, studies have shown that preventive care — be it cancer screening, smoking cessation or plain old checkups — usually ends up costing money. It makes people healthier, but it’s not free.

“It’s a nice thing to think, and it seems like it should be true, but I don’t know of any evidence that preventive care actually saves money,” said Jonathan Gruber, an M.I.T. economist who helped design the universal-coverage plan in Massachusetts.

Any effort to promote health has its own costs. Doctors and nurses need to spend time with patients to persuade them to change their behavior. (Ever tried to get someone to stop smoking or drinking?) For a new program to work, it has to reach people who are not being helped by whatever exists now — and who thus will be among the most difficult and expensive patients to treat. The program would also have to treat a whole lot of people who never would have gotten sick.

As Dr. Mark R. Chassin, a former New York state health commissioner, says, preventive care “reduces costs, yes, for the individual who didn’t get sick. But that savings is overwhelmed by the cost of continuously treating everybody else.”

[Rumor_Watkins]

@athelas

This NYT article says preventative care isn’t the cost-saving cure-all that reformists wish:

no, i’m talking about not going to a doctor for a $200 consult because you’d have to pay out of pocket for it (because your deductible is $1000) and hoping that it heals itself. then it doesn’t, and you’re facing 5k worth of medical bills

[Cyberhwk]

@sqweels

How much does health insurance typically cost for someone who does not have an employer-provided plan? Let’s say a 40-year-old with no pre-existing conditions.

I’m a 26 year old non-smoker. Never had any serious conditions ever. In fact I spent about $700 this last year on medical treatment (apart from dental), and that’s easily more than I’ve spend in the last 5 years combined.

Only two plans on eHealthInsurance have deductibles that would have caused an insurance company to contribute a single cent of my premiums to my own care. One costs $145 a month, the other $281. If I want prescriptions covered at all, that would jump to at least $172 (after a $1000 deductible that I’ve never hit in 26 years :smack:).

So basically, I fork over $100-$150 a month and they’ll never pay a single cent in benefits unless I wrap my car around a tree. Catastrophic plans are marginally cheaper but then even wrapping my car around a TREE may not hit the deductible and I’m still in the hole $10,000+.