I think that the best GQ answer is that an uninsured person just has to negotiate with providers for payment options. As for how much of a hit that will be financially, well, it depends on how rich you are. As others have said, the last thing that a hospital wants to do is send you to collections. You can probably get away with paying as little as $50/month if that is truly all you can afford (depending on the size of the debt).
And again, keeping it GQ, I think that the US has the nightmare of a health care system that we have because of the complete opposite positions each party takes with regards to how it should be run. The left supports a single payer system and the right supports a market based payment system with catastrophic insurance. What you see as each party controls the Presidency and Congress is that bits of each have crept into our system giving us the worst of both worlds.
I’m personally for a market based system, but if I was President, I would have to compromise with the left and whatever got passed would be unacceptable to both. Unless one side or the other completely caves, there won’t be a change.
FWIW, the second part of the This American Life coverage on health care I posted on the last page has a pretty good rundown of how we got to where we are now (I believe it’s the one called “four easy steps” or something like that), regarding employer-based health care. Several of the other segments touch on the disincentives for various groups to make waves agitating for a change.
Shortly after I graduated college I had a trip to the ER for a really bad flu (which was necessary in every sense of the word - I was told if I had waited another six hours to come in they would have had to admit me instead of treat-and-release). They let me pay it off at $20/month.
Granted, that was over 20 years ago.
But the point that hospitals tend to accept almost any payment, even a ridiculously low one, over sending you to collections is a valid one.
Went to my local ER for an inflammed boil on my sternum. It was golf ball sized, and hot to the touch. Was evaluated by a nurse practitioner. Had an incision and drain procedure done. Got the bill one month later for 1900 dollars. No x-ray or antibiotic procedure done. Got cut on and streeted…and i was one week away from my insurance kicking in…
Oh, it hasn’t imroved. I haven’t read the whole thread, but will put my .02 cents in anyway. My wife’s ex-husband had a tragic motorcycle accident. He is now brain injured and a ward of the State. They had insurance, but the first week of care alone was almost $400K. They owned their own buisness and made great money, but couldn’t afford the medical bills. The insurance was quickly maxed out and they came after her for the rest. She has dillegently tried to pay when possible, but if you aren’t very wealthy there is no way to ever do so (she isn’t, she is a teacher). He was taken by helicopter to the hospital.
The cost was $20K for the ride alone and the insurance only covered a fraction of it. Why? Because the helicopter service that was used was not a “preffered provider”. How in the hell did she have a choice in what LifeFlight showed up at the accident scene? More than that how could she have known and do they think that she could have requested another one?
To top it off, her ex as I mentioned is now a ward of the State and they put him in a State run facility. He has Medicare, but has no income other than disability. This income from disability is used to pay for the facility that he is in, leaving no money for medical expenses. And the State guardian has actually denied him medical care (not life threatening mind you) because she says he doesn’t have the money to pay for it. The State declared him unfit, took him away and then says no medical care because you can’t afford it. Simply amazing. And we want government to control all our health care?
Bit of a hijack here, but would it blow your mind to hear about all the myriad ways people make major life choices around getting health care? Go to university here, instead of there, because you’ll be an in-state student and eligible for more benefits. Take this job, with the longer commute and worse hours, because they’ll accept your epileptic child on their health plan. Get married to have that surgery you can’t afford. Join the army.
Not that I’m complaining personally, my husband might still be my boyfriend if not for a spectacularly expensive trip to the ER for what turned out to be a thankfully minor problem.
On the edge of GQ… but why is it that when a non-US member posts a question like this, no one from outside the US pipes up with great success stories about market driven healthcare systems in other countries?
I’d be a lot more comfortable supporting it then. As it is, I fear leaving my family penniless even though I have saved diligently, watch my health and intend to pay my way since I have a catastrophic policy (which my ex-boss calls ‘Republican Healthcare’).
Not a hijack at all, that was exactly the info I was looking for. For you US guys, these things are so normal you don’t even bring them up, but for us…it is just not a factor. We bitch about other stuff, though.
So.. You mean your boyfriend married you to get you on his health plan when you had fallen ill?
To go back a day or so to this: Why did the paramedics in the ambulance have to ask which hospital you wanted to go to? Why would they not take you to the nearest one equipped to deal with you?
Sometimes there is more than one hospital that is nearby, and traffic would be about the same.
It probably varies with the situation. I’m guessing if someone is fixing to die, they don’t ask questions and go to the place they know is nearer.
I remember for my fracture, while I was claiming for drugs, they told me to calm down and tell them which of the two hospitals in town would they take me. They wouldn’t take me away until I’d decided on one vs the other. I was trying, at the time, to remember my insurance policy and see if one was accepted above the other (thankfully, no, both were covered). I picked one based on something as stupid as “I think this is likely to have less traffic that night”.
They also took as much of my insurance information as I could give at the moment while I was in the back of the ambulance (claiming for more drugs).
In addition to one hospital might take your insurance while the other one doesn’t, you might have gone to one hospital before, and been either impressed by it or appalled by it. Or your doctor might have privileges in one hospital and not another. Or one of your family or friends works in a certain hospital. Or one hospital might have better equipment for your problem, and you know this. Etc.
Or, if you’ve been to one hospital and not the other the one you’ve been to has your prior medical records which, particularly if you have a long-standing chronic illness, might be preferable from the standpoint of providing the best possible care.
In our case, I had the insurance and he had the illness. Yes, we’d have married eventually, neither of us was going to marry just for benefits. But a single minor skin infection that got suddenly and alarmingly worse landed him in the ER. The diagnosis included a simple blood test, one X-ray, a single shot of painkiller and we left with a script for antibiotics. Over $3500 after all the bills came due, and a sobering realization of his vulnerability.
So the talk about maybe we should go ahead and get married someday became suddenly more urgent and we began the wedding planning soon after.
It boggles my mind when people against national health care bitch and moan that “those people” without insurance should just get better jobs or pony up themselves. My husband had worked his entire adult life without insurance, pursuing and getting two university degrees, paying off student loans while supporting himself, paying his taxes and following the rules, and None of the jobs he ever held while doing those things offered him health care. Thankfully, he was healthy. Thankfully, nothing catastrophic happened. But the system sucks.
There’s also the question of whether your insurance will take the hospital.
The terms “in network” and “out of network” have been used in this thread, but perhaps not fully clarified. Basically, it refers to whether or not a provider is a “preferred” provider (in other words, whether he/she/it has accepted the insurer’s pricing schedule). Using an out of network provider usually means that the insurer will cover a smaller amount, with no assurance that the provider will waive the difference. With some insurers, however, it could mean that the procedure will not be covered at all (this is most likely to happen with an HMO).
Or the insurance company explains that the only hand surgeon they will reimburse to sew your finger back on is in a suburb 40 miles away that you have no way to get to.
