# What happens in the US when an uninsured person needs health care? **URL:** \ **Category:** Factual Questions\ **Created:** [September 9, 2011, 10:06am UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711 "2011-09-09T10:06:50Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Capitaine\_Zombie](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@Capitaine\_Zombie](https://boards.straightdope.com/u/Capitaine_Zombie)\ **Post date:** [September 9, 2011, 1:31pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/21 "2011-09-09T13:31:46Z")
> [@Mosier](#): > > It is very common to attempt to collect damages from an “at fault” party. If the at fault party has insurance, their insurance company will be liable to pay for the injured person’s medical expenses. This may end up costing more than the policy is worth, at which point the policy holder is on the hook for the rest. This could result in the at fault party having a court judgement against them, which he may or may not be able to pay. I believe bankruptcy in this case will not absolve him of his debt to the injured party. I’m sorry but what the fuck is the use of an insurance where when expenses encoured are higher than the policy, you’ve got to pay the rest? ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [September 9, 2011, 1:32pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/22 "2011-09-09T13:32:44Z")
> [@Maastricht](#): > > How often do people decide against treatment, just walk out of the hospital and hope for the best? I know a guy who collapsed at the grocery store and woke up in a hospital. Diagnosis was diverticulitis with complications, and the plan was to remove much intestine and perform a colostomy. The guy had no insurance, so he dressed and left. The hospital/doctor called him repeatedly warning that he was going to be dead in days/weeks without surgery. After hearing his story, I didn’t see or hear from him for months. I assumed he died. When next I saw him it was around 18 months after the hospitalization and he was doing great. He said that for a month or so he just laid around awaiting death. Then his condition began to improve. N=1. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [September 9, 2011, 1:34pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/23 "2011-09-09T13:34:04Z")
> [@Wendell\_Wagner](#): > > Fear Itself, am I invisible? Like a ninja. Sorry. ---
**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\ **Post date:** [September 9, 2011, 1:37pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/24 "2011-09-09T13:37:13Z")
> [@Capitaine\_Zombie](#): > > I’m sorry but what the fuck is the use of an insurance where when expenses encoured are higher than the policy, you’ve got to pay the rest? Aren’t car insurance policies like that too? If you’re only insured for a certain amount and you destroy someone else’s really expensive car, you might be screwed? That’s why they have certain levels of what you can pay for, and more insurance coverage means higher premiums. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [September 9, 2011, 1:37pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/25 "2011-09-09T13:37:28Z")
Hmm… I recall over a decade ago, a woman came to visit Canada from Europe. She went into labour, had her baby and ended up owing the provincial health care about $20,000C. I don’t recall if complications were mentioned; I suspect US hospitals are more expensive. I know a relative in the USA mentioned her son and his wife had to start saving as soon as they found out she was pregnant. I also recall one US doctor mentioning in the paper that he was legally obligated to charge patients without insurance full price. He had a contract with a health insurance company that fixed his rate with them as lower than what he charged anyone else; if he gave any other patient a deal, the insurance company would sue to have all their payments reduced below that rate and past overpayments refunded. So what would something like a broken arm or leg cost for an ER visit? ---
**Author:** ![Annie-Xmas](https://avatars.discourse-cdn.com/v4/letter/a/ecc23a/32.png) [@Annie-Xmas](https://boards.straightdope.com/u/Annie-Xmas)\ **Post date:** [September 9, 2011, 1:38pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/26 "2011-09-09T13:38:20Z")
When I broke my wrist, I went to the emergency room and got the minimal treatment of X-rays and a cast. No tests, nothing else, nothing extra to pad an insurance bill. It was great. ---
**Author:** ![Capitaine\_Zombie](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@Capitaine\_Zombie](https://boards.straightdope.com/u/Capitaine_Zombie)\ **Post date:** [September 9, 2011, 1:42pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/27 "2011-09-09T13:42:33Z")
> [@Ferret\_Herder](#): > > Aren’t car insurance policies like that too? If you’re only insured for a certain amount and you destroy someone else’s really expensive car, you might be screwed? That’s why they have certain levels of what you can pay for, and more insurance coverage means higher premiums. Can’t tell. But arent care insurances mandatory in the US? That means that you have to pay no matter what. But in the case of a private insurance, where you chose to have one or not, what 's the point of putting money in a pool if you’re the only one filling the pool? You might as well avoid paying the policy’s monthly fees. There’s no service provided by the insurance company there. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [September 9, 2011, 1:43pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/28 "2011-09-09T13:43:15Z")
> [@Capitaine\_Zombie](#): > > I’m sorry but what the fuck is the use of an insurance where when expenses encoured are higher than the policy, you’ve got to pay the rest? If your house or car insurance has one million dollars liability - do you think the insurance company will pay once the victim’s brain surgery, hosiptal stay and rehab go beyond $1M? Do you think that some awards in the US courts exceed $1M? Do you think you could reach $1M of costs with 6 months in the hospital and multiple surgeries? What’s the limit for liability on \*\*\*your \*\*\*house or car insurance? Currently IIRC you can get $5M or more but it costs money. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [September 9, 2011, 1:45pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/29 "2011-09-09T13:45:34Z")
> [@md2000](#): > > So what would something like a broken arm or leg cost for an ER visit? [$8,094.](http://www.washingtonpost.com/wp-dyn/content/graphic/2006/04/07/GR2006040700882.html) And that is five years ago. That is a lot more than going to your doctor’s office, but he is not obligated to treat you if you cannot pay. All services at an ER are more expensive than comparable services at a non-emergent care facility. When uninsured people use the ER as their primary care, it increases the cost of medicine that is passed on to other patients and insurance companies. ---
**Author:** ![Capitaine\_Zombie](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@Capitaine\_Zombie](https://boards.straightdope.com/u/Capitaine_Zombie)\ **Post date:** [September 9, 2011, 1:47pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/30 "2011-09-09T13:47:54Z")
> [@md2000](#): > > If your house or car insurance has one million dollars liability - do you think the insurance company will pay once the victim’s brain surgery, hosiptal stay and rehab go beyond $1M? Do you think that some awards in the US courts exceed $1M? Do you think you could reach $1M of costs with 6 months in the hospital and multiple surgeries? > > What’s the limit for liability on \*\*\*your \*\*\*house or car insurance? Currently IIRC you can get $5M or more but it costs money. I’m not sure I understand your question, but an insurance that covers up to one million dollars of damage doesnt require you to first give them one million dollars. Ain’t the point of an insurance to redistribute the costs among all the other insured that havent suffered any damage? ---
**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\ **Post date:** [September 9, 2011, 1:55pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/31 "2011-09-09T13:55:50Z")
> [@Capitaine\_Zombie](#): > > Can’t tell. But arent care insurances mandatory in the US? That means that you have to pay no matter what. But in the case of a private insurance, where you chose to have one or not, what 's the point of putting money in a pool if you’re the only one filling the pool? You might as well avoid paying the policy’s monthly fees. There’s no service provided by the insurance company there. All states but New Hampshire require some level of bodily injury and property damage coverage, but the levels required as a minimum vary wildly. DC seems to be the lowest, requiring at least $10K bodily injury coverage for one person ($25K total per accident) and $5K for property damage. Maine and Alaska are on the other end, requiring at least $50k bodily injury coverage per person ($100k per accident) and $25k in property coverage. My husband and I opted for much higher coverage levels in our own policy. Edit: figures taken from the Wiki article on “United States auto insurance.” ---
**Author:** ![Maastricht](https://avatars.discourse-cdn.com/v4/letter/m/a88e57/32.png) [@Maastricht](https://boards.straightdope.com/u/Maastricht)\ **Post date:** [September 9, 2011, 2:20pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/32 "2011-09-09T14:20:08Z")
People, can we keep this on topic about health insurance? I still want to know how much of an financial disaster gettting sick without insurance is. I’ve heard figures from 800 for a broken wrist to 20000 for a natural delivery. What I don’t know is what the average American makes net in a month. That would tell me how much of a dent such costs make. ---
**Author:** ![Tom\_Tildrum](https://avatars.discourse-cdn.com/v4/letter/t/e95f7d/32.png) [@Tom\_Tildrum](https://boards.straightdope.com/u/Tom_Tildrum)\ **Post date:** [September 9, 2011, 2:23pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/33 "2011-09-09T14:23:57Z")
> [@Mosier](#): > > This is quite the opposite of what is typical. If you look at your hospital bill after insurance pays it, it explains the work done for you, the cost the hospital charged, and the negotiated cost the insurance company pays. Insurance typically settles medical payments for much, much lower than the hospital would have charged an uninsured person. The reason for this is that the insurance company has the power to negotiate, as it represents hundreds or thousands of potential customers for the hospital. The discount at a hospital is for insurance, not a lack of it! It’s more complicated than that. The hospital doesn’t really expect anyone to pay rack rate; rather, certain unusual Medicare payments are calculated on a complicated formula that relies on posted charges, so the hospitals raise them as much as that formula will tolerate, then discount them for their contracts with private insurers. For people with no insurance, they’ll send a bill, and they’ll typically pursue it if it’s ignored, but they’ll work out a discounted plan if the person requests it (and indeed can’t pay). [QUOTE=CNN Article] Bankruptcies due to medical bills increased by nearly 50 percent in a six-year period, from 46 percent in 2001 to 62 percent in 2007, and most of those who filed for bankruptcy were middle-class, well-educated homeowners, according to a report that will be published in the August issue of The American Journal of Medicine. [/QUOTE] Note that while the proportion increased as reported, the total number of bankruptcies dropped by half over that period (according to that study), so the absolute number of medical bankruptcies (using its definition) dropped by about a third. ---
**Author:** ![Wendell\_Wagner](https://avatars.discourse-cdn.com/v4/letter/w/8491ac/32.png) [@Wendell\_Wagner](https://boards.straightdope.com/u/Wendell_Wagner)\ **Post date:** [September 9, 2011, 2:28pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/34 "2011-09-09T14:28:39Z")
In 2008, the average family (not individual, but family) made $61,521: [http://www.census.gov/compendia/statab/2011/tables/11s0697.pdf](http://www.census.gov/compendia/statab/2011/tables/11s0697.pdf) ---
**Author:** ![Pixel\_Dent](https://avatars.discourse-cdn.com/v4/letter/p/bc8723/32.png) [@Pixel\_Dent](https://boards.straightdope.com/u/Pixel_Dent)\ **Post date:** [September 9, 2011, 2:39pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/35 "2011-09-09T14:39:15Z")
> [@Ferret\_Herder](#): > > Most non-profit hospitals have plans for those who do not have insurance. Where I work, at least 50% is discounted to start with. Then you can sit with a social worker at the hospital and talk about other options and payment plans. In my personal experience, even for profit hospitals have similar setups. About 10 years ago when I had just set up my own company and didn’t have insurance one of my kids needed minor surgery. We got a bill for about $3000 and were asked for our insurance. When I told them we didn’t have insurance and planned to pay ourselves the lady said, “Oh, this is just what we change insurance companies.” Without my asking she rewrote the bill for $500 and I paid with a credit card. We had a couple similar experiences at different medical facilities over the next couple of years before we bought insurance for ourselves. ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [September 9, 2011, 2:52pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/36 "2011-09-09T14:52:19Z")
About 10 years ago, I had minor surgery in the US which cost about $12,000. A similar surgery in the Czech Republic a few years ago cost $450. So for me, when I couldn’t get insurance in the US, I simply moved by business, home and family out of the USA. Since I am American it was hard to get legal permission to just move to another country, so for about 3 years I was officially a tourist… moving to a new country every 90 days to stay legal. That was a very difficult time - I felt like a refugee… and still do sometimes. Next year my visa will expire and I will have to find yet another country to live in as the rules have changed and I can’t renew the visa in this country. So I am selling my apartment here and moving again. My brother is an ER doc in the US and earns over $300K per year, so you can imagine what they have to charge patients to cover that. ---
**Author:** ![Maastricht](https://avatars.discourse-cdn.com/v4/letter/m/a88e57/32.png) [@Maastricht](https://boards.straightdope.com/u/Maastricht)\ **Post date:** [September 9, 2011, 2:57pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/37 "2011-09-09T14:57:34Z")
> [@Wendell\_Wagner](#): > > In 2008, the average family (not individual, but family) made $61,521: > > [http://www.census.gov/compendia/statab/2011/tables/11s0697.pdf](http://www.census.gov/compendia/statab/2011/tables/11s0697.pdf) Thanks. Oddly, I expected it to be much more. My idea of USA incomes was that you guys made more on average, but that you also had more costs so you needed to save more for a buffer. It seems that only the latter part is true. A typical Dutch family will have one parent working full time and one parttime, and they will jointly make about 45.000 euro’s net. A euro is about 1.3 USD, so the amounts are about the same. Yet, from that net Dutch income health insurance will already have been paid. If that is true, I must say it is somewhere between doable and terrifying to have to pay for medical costs without insurance. If I had to pay 800 bucks for a broklen wrist, that would mean no vacation that year (we have cheap vacations 🙂 But a debt of twenty thousand euro’s would mean that my entire working life’s savings would be gone, or the kids college fund, or both. ---
**Author:** ![AClockworkMelon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aclockworkmelon/32/10803_2.png) [@AClockworkMelon](https://boards.straightdope.com/u/AClockworkMelon)\ **Post date:** [September 9, 2011, 3:39pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/38 "2011-09-09T15:39:47Z")
[QUOTE=Maastricht] It also seems to me that under those circumstances, the average person will do anything to prevent getting in a hospital, and will also do anything to get out of the hospital as soon as possible, even when he is still sick. [/quote] This is exactly what happens. After trying to treat a great deal of dental pain at home for about a month or two I finally went into the ER when my lymph nodes starting swelling. I was in the ER for about ten minutes with the doctor (including waiting room I was only in the hospital for about twenty) who prescribed antibiotics and the doctor’s bill is $300. Still waiting on the hospital’s bill, no idea how much that’ll be. That doesn’t sound like a lot of money and I guess it isn’t. But it can be scary to be uninsured in the United States and a great many people are. ---
**Author:** ![Hello\_Again](https://avatars.discourse-cdn.com/v4/letter/h/85e7bf/32.png) [@Hello\_Again](https://boards.straightdope.com/u/Hello_Again)\ **Post date:** [September 9, 2011, 3:48pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/39 "2011-09-09T15:48:01Z")
> [@AClockworkMelon](#): > > This is exactly what happens. > > After trying to treat a great deal of dental pain at home for about a month or two I finally went into the ER when my lymph nodes starting swelling. I was in the ER for about ten minutes with the doctor (including waiting room I was only in the hospital for about twenty) who prescribed antibiotics and the doctor’s bill is $300. Still waiting on the hospital’s bill, no idea how much that’ll be. > > That doesn’t sound like a lot of money and I guess it isn’t. But it can be scary to be uninsured in the United States and a great many people are. You could have gone to “urgent care” (a doctor’s office that sees patients on a drop in basis for non-life threatening but immediate health needs) or a dentist, and gotten the same service for $100 or less. As many urged you to do. There’s a psychology to it though. You (generic you) feel you “can’t afford” dental care or a doctor’s visit, but, when you feel your life is threatened, will go to the emergency room, which is actually far more expensive than the more basic care you felt you couldn’t afford. . ---
**Author:** ![Maastricht](https://avatars.discourse-cdn.com/v4/letter/m/a88e57/32.png) [@Maastricht](https://boards.straightdope.com/u/Maastricht)\ **Post date:** [September 9, 2011, 3:50pm UTC](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711/40 "2011-09-09T15:50:22Z")
**AClockworkMelon** , did you know how high the costs would be going in? Do most people in teh USA have a fair estimate of the cost they are likely to incur, or do they just fear it will be “more then I can afford” ? [Previous page](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711.md?page=1) [Next page](https://boards.straightdope.com/t/what-happens-in-the-us-when-an-uninsured-person-needs-health-care/595711.md?page=3)