This also varies greatly by state. I pay $250/month for a catastrophic policy with a $3500 deductible, 50% co-insurance and a $5000 out of pocket max. So, my yearly medical expenses would never be more than $3000 + $3500 + $1500 = $8000.
I am lucky to live where I am (WA) but cannot easily move to a different state. I’ll probably be paying about the same in a few years when I go on Medicare, but will be able to move without a big increase.
(my premiums have risen by 10% each of the last two years)
There are far, far too many variables to answer your question “How significant a hit is it if an uninsured person gets sick and needs health care?”
The answer depends on:
[ul]
[li]What the problem is, exactly (sick like a broken arm or steam scald from cooking, or sick like meningitis or breast cancer or HIV?).[/li]
[li]To what degree the problem exists (is your broken arm a simple or compound fracture? do you have HIV or AIDS? what stage is the cancer?).[/li]
[li]Where the person seeks health care (ER, hospital clinic walk-in, urgent care walk-in, community health center, regular doctor’s office?).[/li]
[li]How the person seeks health care (collapses at work and is rushed to ER by ambulance vs. decides to visit community health center under own power).[/li]
[li]The person’s income and/or ability to pay (an hourly worker whose job doesn’t offer health care who makes $19k/year, a salaried worker who opts out of his job’s health care coverage who makes $50k/year, someone who doesn’t work at all but has significant assets, a homeless man on the street with literally only what he can carry)[/li]
[li]The person’s willingness to ask for or negotiate discounts (see Broomstick’s post)[/li]
[li]Programs that may be available to help the person based on any of these factors or others that are available on a state-by-state, county-by-county, city-by-city or even hospital-by-hospital basis.[/li][/ul]
And probably some I’ve left out.
So if you want to try and define all those, then it may be possible to give you some ballpark figures. Until then it’s just anecdotes and guessing.
You might also be interested in listening to two one-hour shows that This American Life put together in 2009 regarding health care in the U.S.: Part 1: More is Less and Part 2: Someone Else’s Money.
FWIW, if you’re young and relatively healthy, catastrophic coverage is pretty cheap. Certainly far cheaper than almost any of the numbers that have been mentioned here (either numbers for getting coverage or numbers for costs of coverage).
To some degree, yes, but sometimes not to the degree that one might consider to be useful.
For example, in Florida, the minimum manditory car insurance is: $10,000 personal injury protection that goes toward covering you and your passengers if you or they are hurt in an MVA, $10,000 property damage liability that goes toward covering your or someone else’s property that was damaged in an MVA, and $0 bodily injury insurance liability that goes toward covering the people you crash into. Florida Insurance Requirements - Florida Department of Highway Safety and Motor Vehicles
In other words, the minimum required insurance in Florida is the next best thing to useless.
When I landed in the hospital about, oh, four years ago, after having a seizure, I was damned lucky, because I qualified for temporary Medicaid. I was only approved for as long as it took me to pay off of the bills, and that was it. And now even if I could afford insurance, I most likely couldn’t get it, because I have a “pre-existing condition”.
The other really fucked up thing I’ve found lately is that some doctors are no longer accepting people without insurance, period. Even if you pay out of pocket. I was recently dropped by my neurologist because they no longer take self-pay, which I only found out when I called to make an appointment. (You should have HEARD the words coming out of my mouth when I hung up the phone)
FORTUNATELY, I’ve been seizure free for almost two years (knock on wood), but that doesn’t mean anything, and I’m lucky right now because my regular doctor writes my scrips. But epilepsy is an unpredictable disease, so if I start having seizures again (knock on wood), I don’t know what I’m going to do. It’ll be a pain in the ass to find another doctor who DOES take self-pay. It’s gotten so that any time I make a doctor’s appointment now that’s the first thing I ask.
A couple months ago, my ex-husband (prior to being an ex), broke his ankle in the middle of the night. He has no insurance at all but the pain was so bad and it was swelling so much we decided to go to the ER. We were admitted with no problem but made to sign essentially an agreement saying that WE were responsible for the bills since he had no insurance. They saw him, gave him a temporary cast, took some xrays, popped some vicadin in for good measure and sent us on our way. Took about 3 hours total with 2 of those being just waiting.
Once we got out of the hospital, we received a total of 3 bills. One bill from the hospital itself for $900 for the privilege of using their building I assume. Another bill for $900 from the actual doctor who saw him (for a total of 10 minutes) and a final bill for $100 from the X-Ray technician who took the x-rays. So within a span of a few hours we were in debt $2000. That didn’t even include all the subsequent follow up visits with an orthopedic specialist that was required because of the position of the break.
They are VERY persistent about paying but are willing to arrange payment plans. In our case, they said something about an ‘uninsured’ discount which essentially meant they’d cut 50% off the bill (the hospital and the doctor) if we paid it all in a lump sum. Unfortunately we weren’t in any financial situation to do so and thus were stuck with the entire bill. All I can say right now is I’m GLAD I got pregnant a couple years ago because that is the ONLY reason I have insurance right now. Got my foot in the door for state medical insurance that’s otherwise closed to new applicants. Basically unless you’re a kid, or in a situation like mine where you lucked out, you’re SOL for insurance (at least in my state) if your job doesn’t provide it.
Two years ago I went to the ER for what I thought was a nasty case of the flu. Turns out I had double bacterial pneumonia. I was in the regional/rural hospital for three days with no improvement, then taken by ambulance to the big city hospital where I was in ICU for three days and on the respiratory floor for six days.
Total bill for all of it (including ambulance and the two weeks of at home IV antibiotics and oxygen): $76,000.
I make about $18,000 per year.
11 days in the hospital plus two weeks treatment at home would have cost me 4 years of pay.
I had just gotten on my employer plan (thank you union) two weeks before this. They paid $37,000 and I owed $500 in copays.
If I hadn’t had insurance, I would either be paying on that bill for the rest of my life, or wound up in bankruptcy. Even $500 is tough on my small budget.
ETA: They wheeled me in a wheelchair and had to get attendants to put me on a gurney because I had passed out. As soo as I was back awake, the nurse handed me my purse and asked for an insurance card.
THEN you got the providers who don’t accept your insurance. So you get the Yellow Pages and call and call and call and call, to try to find a doctor who specializes in what you need, AND accepts your insurance.
The part that pisses me off is that the insurance they are refusing is TriCare. This is the coverage available to military retirees, and the dependents of active duty and retired. It seems to be unfashionably “unpatriotic” when doctors don’t accept the medical coverage of military and their dependents.
With the wholesale closure of military installations prior to 2001, there simply are not enough military hospitals to care for people entitled to coverage at a uniformed facility. I even had a billing clerk say, “Well, TriCare pays the lowest of all insurance.” SO WHAT? I certainly don’t have anything to do with the payments!
Yeah, National Health Insurance is DEFINITELY necessary in the US.
~VOW
In 2005 I moved from Nunavut (where I had full health coverage, I had to fill out a form and received a health care card in the mail) to Alberta, where I’m from, to go back to school. I did not think to procure/fill out the forms necessary to obtain Alberta health coverage (which I understand is one of the few provinces to require a monthly charge to maintain coverage).
Anyways, I managed to break some bones in my foot skateboarding during my break at work at the University of Alberta hospital. Because I did not have Alberta health coverage, they asked me during triage (and while I was in a considerable amount of pain, having walked on a broken foot for over two blocks) how I was going to be paying/who was insuring me, which I found to be quite tacky.
The long and short of it is that I ended up getting a bill from the Alberta government for $5000 or so to treat my broken foot. I was lucky in that I was able to forward this to the government of Nunavut, who kindly paid this for me because I was a student whose last permanent address was in Nunavut - apparently if you’re a student and in a different province, you still have ties somehow to your old province for health purposes. Whatever, they paid for it.
I now have almost a decade’s worth of experience working as a professional in the Canadian health care system and I have a hard time even believing that a system such as the one that exists in the US even exists…let alone that there are people who defend it! I go to conferences with American colleagues and am completely blown away by the stories they tell. I thank Og every day that I was born into a country with at least a semi-rational way of delivering health care and would not care to work in any other system.
I’ve been reading all stories and datapoints with interest, thank you all.
Here’s my Dutch data point:
I make 2740 euro a month before taxes. Of that, 200 euros go to my part of my health insurance. My employer also pays about that. But If I didnt’t have a job, my unemployment benefits or my welfare would pay for my health insurance. It would just be a more basic health plan, but it would still contain all the basics.
My luxury health plan pays for my psychotherapist, and my standard dental care, but not for my invisalign braces, which I think is fair.
If I get health problems, I can go to my GP and the hospital without a care in the world. I never even see a bill. If I had a basic health plan, that would also be the case.
From the point of view of the average Dutch person, we live in medical insurance paradise.
I keep trying to find downsides to our system compared to the US one. For instance, when the treshold for medical care is so low, there must be a lot of unnecessary medical treatments going on, right? Yet, that does not seem the case. I don’t really know why.
Maybe they had treated you as far as possible with what they had on the ambulance.
The thing with breathing problems is that you can die in a couple of seconds, if you haven’t been breathing well for a few minutes. So they’ll tend to hook you up to oxygen and such. Before I knew what was happening, I had one of those oxygen thingies up my nose and an IV in my arm.
My husband had dropped me off at the entrance, and then gone on to park the car. When he came in, I think that he gave them all the rest of the info, including how we planned to pay for everything. But if the ER staff thinks that you’re gonna keel over, they WILL try to prevent that.
Not many people enjoy receiving unnecessary medical treatments. Free movies, yes. Free dinners, yes. Free anal probes, not so much.
Regular attention to seemingly minor matters can catch them before they become major, so a little bit of money paid out early on by the system saves the system a lot of money later on. Which is why that here in Ontario, Kanukistan, the health system is actively encourgaging fellows to get free anal probes.
That could be it, Muffin. However, I’m sure that if I studied both systems more in-depth then I want to do now, I’d find more info on how each works out. It is true that even with no-treshhold medical care, many people here are reluctant to go see a doctor. They don’t have the time, or don’t want to consider having a serious problem. Yet, the government here, as wel as elsewhere, often complains about healthcare costs rising and rising. Yet others see that not as a sign of a sick socity, but as added wealth.
One more question. Since one sick family member can bankrupt the entire family, do sick people notice resentment from their family members or romantic partners? Would a sick uninsured person have a harder time finding a date or a spouse?
In the US, it’s not uncommon for divorces to occur during serious illness or after major accidents - and I’m sure financial stress is a factor. Having a chronically ill child is almost like taking a life-long vow of poverty in the US, so sadly, it’s not unusual for one parent to split and leave the other with the kid. And yeah, when one family member’s health is draining the family coffers, leaving everyone in poverty, of course there can be resentment.
And yes, people do sometimes avoid marriage specifically because of insurance concerns.
I did not post any falsehoods. The problem here seems to be a misunderstanding. I clarified that “ruin your life” was hyperbole in a literal sense, but not in the common usage sense. It is not incorrect to assert that uninsured (and often even insured) medical costs can bankrupt someone, and that bankruptcy typically erases a person’s financial progress and makes their life significantly more difficult, especially if you are sick.
What I think is interesting is that you countered what I said by saying that it makes life more expensive, not more difficult. I propose that those conditions are one and the same. You, on the other hand, are using a singular anecdote (your own bankruptcy) to extrapolate that bankruptcy in general is basically no big deal. That’s just not the case. Keep in mind the OP is asking for general information. Generalizations are not just allowed, they’re encouraged for questions like this.
I am very surprised to see some of the numbers being given here.
In 2002, my then girlfriend and current wife developed severe abdominal pain in the middle of the night. Turns out she had been hiding some recurring pain for a few weeks, and it had finally gotten the best of her.
An ambulance ride to the hospital. They asked which hospital, and I said the only one whose name I knew, which was not the State Hospital. Away we went.
Admission to the ER. Xrays, MRI, and then an emergency Appendectomy. Including a chat with the anesthesiologist while my girl was already drugged and being wheeled into the OR.
We had no insurance whatsoever. She worked, and I worked, but neither job had insurance.
Thankfully, the folks at the billing office gave us information on a state funded program to help with the situation, but until that kicked in (retroactively) we started getting bills.
Ambulance Ride.
ER admission.
Surgery
Anesthetic for surgery
Labs
Imaging
An overnight stay in the hospital itself.
Bills came to just over $250,000. Thanks to the state program, our out of pocket for this ended up being a couple hundred bucks, but without that, we would have been ruined.
It is crazy that, at the same time as struggling with illness and finding effective treatment, you also have to worry about having to pay for it. Get a grip you people!
To provide a UK perspective. Here are some of the health issues my wife and I have had, and the amount we were liable for (over and above our regular tax and national insurance contributions)
Broken nose - £0
Broken radius and ulna - £0
in-patient bone spur removal - £0
Two children, 5 days stay in total, natural delivery with epidural (plus full theatre prep for a C-section that wasn’t needed) - £0
2 laparoscopies - £0
1 laser treatment for endometriosis - £0
and the list goes on. I should say that for each of the above there may be a small (£7-8) charge for prescription medication as required (though not for the pregnant and new mothers)
Now I don’t know how much I actually pay out of my taxes each year to fund the NHS, but I do know that it is predictable, progressive and ensures that the only concern I have regarding illness is the discomfort and prognosis. ingrowing-toenail or stroke? financially it makes no difference.
UK v. US? You live longer, on a per capita basis you personally pay less and your government pays less, and as a portion of GDP your government pays less. Bottom line? Better health at less cost.
This is pretty typical when comparing first world nations that have socialized health care as against the USA. The problem is that ideology has trumped reality in the USA.
