How much do Americans actually pay for healthcare?
How much do Americans actually pay for healthcare?
Hey all, I'm British so I don't really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.
So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.
However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They're just some elaborate dance between insurance companies and hospitals. If you don't have insurance, the cost is lower or removed entirely. Supposedly.
So I'm just asking... How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.
How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?
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As you mentioned there is a dance between insurance companies and care providers. You should never pay a bill on the spot or upon first receiving it. Always wait until it says final warning. Often by then the bill has been reduced significantly.
There are many ways for the system to suck. When my wife and I were working it was less expensive for me to be covered by my company's insurance and her by hers because adding a spouse to one policy was more expensive. This is because when you are working for a company that has a plan (not all provide this) the company usually pitches in on the cost of the insurance. The amount the company pays relative to the employee has typically been shrinking over the years. Combined the two of us paid about $500/month. Now that we are retired it is about $1500/month and the deductible has doubled to about $700 (which as I understand it isn't too bad). There is also something called a co-pay, which is a small amount you pay for normal office visits regardless of anything else. Ours was $25. Now it is $50.
Coverages were all over the place. For a while we paid more to both be in the same insurance because my wife's insurance would not cover alternative forms of birth control. My wife could not take the pill because it caused her to get blood clots. Ironically they would have paid (way more) for the birth of a child.
When my wife had a major issue, we found that ambulance services do not negotiate prices with insurance the same way as doctors, if at all. She was airlifted for a cost of $55k. Insurance paid $11k for some reason. The hospital stay (approx. 5 days) was $120k. Her max out-of-pocket was $16k, which we paid. Despite this, the air ambulance service was insisting that we pay the $44k and the insurance company was not budging on this. We had the same problem with the ground ambulance for $1600. This went on for like 2 years while my wife acted as intermediary trying to get the ambulance service to lower their price and the insurance company to raise theirs, figuring that having hit our maximum out-of-pocket meant we were off the hook. Not so. We were expected to pay this. Ultimately we were saved in the end when my wife's employer paid those bills.
After that, assuming that because we had hit our max, it would be good for me to get my colonoscopy, we wound up paying the whole co-pay and deductible because I was not considered family. Yup, I'm a spouse. Apparently family means children. Why didn't they say this? Probably to get people to do what I did.
So one of the biggest problems I think is when people don't have insurance or they do have insurance but no real savings to speak of, they avoid getting health care for fear of the high cost.
In New York a while back there was a viral video of a woman who had her leg trapped between the subway train and the platform and all of the people on the platform teamed up to tilt the entire train a bit to free her. It is an awesome video of humans being kind. What wasn't as viral was the fact that the woman had just prior to that, pleaded with the people on the platform NOT to call for help because she couldn't afford it. Very sad for a country with so many resources.
That is completely terrifying. You must be spending a large part of your life desperately dealing with medical bills and trying to juggle the unreasonable requirements of the various parties.
And of course, having health insurance through an employer binds you to that employer, so you are less free to switch even if the conditions are otherwise deplorable.
You're exactly right and it gets so much worse. I had a friend who needed a new lens in his eye. There were 3 options. For lack of a better explanation, it was, normal, better and best. His insurance only covered normal. So unless he could cough up more money, he only had the one choice.
My sister-in-law got very sick. She was in the hospital for almost a month. In the end, she died. My brother-in-law who was the executor of her will told me he saw the bill. It was $3.2M. You can't force a dead person to pay and he was not responsible for her bills so it was pretty much just written off. But holy cow!
I think people in this country who think we have the greatest health care in the world, simply haven't used it.
yes, that's about right.