American health care

[JaiDee]

 So this young guy in California had an appendectomy recently.....not even the kind where it bursts and your life is in danger, just the typical, in and out in 24 hour deal.  55 grand.

.

 

But sure, we don't need any overhaul to our system whatsoever!

 

 

http://imgur.com/a/WIfeN

[pdogg]

Just like hotels I think hospitals have a "rack rate" and a negotiated rate that they pay to insurance companies.  The rack rate might be 10 times the negotiated rate.

 

So if you don't have insurance you get billed the rack rate.  But I suspect that they will settle for much less and then maybe then the hospital gets a tax write off.  And maybe the poor Joe gets his credit rating ruined.

 

I don't really have direct experience with this as I had a pretty good health insurance plan when I was working in the States.

 

What i am curious to hear about, is guy's actual experiences with Obama Care.  We hear so much political rhetoric form guys who are covered by their companies anyway but I'm talking about actual experiences.  Are you better off or worse off?

[JaiDee]

Yes, if you look closely at the bill the hospital submitted their EXTREMELY high-end rate to the kids' insurance company and the insurance company came back and said the true cost was 17K; which is still high for 24 hours.

 

Regardless, the kid is left with an 11K co-pay, which is ridiculous. And, keep in mind, he hasn't even seen the bill from the surgeons or the anesthesiologist yet, this is just the charges from the hospital; that will be at least another 15-20 grand for those guys.

 

  2,420 for the "pharmacy" ......which, lets face it, was probably a few IV drips and some aspirin/pain killers. Absurd.

[pacman]

I find all the news reports about Obamacare quite bewildering. From what I can gather the Administration has made such a cock-up of its introduction they should scrap it & start again. And I never could understand why nationalised public health had to be brought in with the involvement of private Health insurers. That alone seemed to condemn it before they started. If the public are going to get free treatment, give them free treatment, making them take out new insurance policies seems counter-productive to say the least.

 

As for this poor fellow who received a bill for 55,000 dollars for a simple appendix operation, that's one of the most outrageous things I have ever heard. Whether the cost was 55K or 17K, if the Australian public were told this would be the new normal, the citizenry would storm Parliament House, they would drag the politicians responsible out onto the street & put them out of their misery. They certainly would never be re-elected should they survive that. 

 

Is Obamacare destined to be repealed? Can they fix it? Will the US ever get a health care system like every other first world country provides? And lastly, why is there such silence from the American people? Others must be just as upset about these crazy charges yet they seem to accept it. What am I missing?

 

 

[JaiDee]

It won't be repealed......if anything, it will become more and more a fixture in American society once Hillary gets elected in 2016.  But she will improve it and make it a single payer system, same as she tried to do in 1994 when her husband was the Prez and she was shot down by the Repubs.

 

 That may make it easier for all,  but regardless the costs aren't going down, especially for the drug companies. Why would they cut into their profit margin even a little bit?

[mardhi]

WTF do you need a CAT scan to determine if you have appendicitis.  Talk about over doing it.   I sure never had one when I was a lad (not that they were around then) - its pretty damn easy to conclude what it is without a scan.    

 

Flip side of course is, the risk of being sued if it was NOT appendicitis, means I guess, they do all available tests just to cover their arses (whom someone else is paying for) and keep the Insurance company (for the doctor negligence) happy.      

[SiamSam]

My 2 cents:

 

Private health card is for the birds!!! Health care is as fundamental to the human condition as air and water. The best health care should never be denied anyone for lack of money. NEVER. 

 

But then again I'm Canadian…eh.

[rxpharm]

Pacman, the plan was never to make healthcare free to everyone! That's not the American way! The plan was to cover more of the estimated 15% of Americans that had no type of healthcare insurance. These uninsureds only went to the hospital ER whenever they were too sick to stand it anymore resulting in higher costs to finally treat them. They would have to go to medicaid hospitals which cannot turn away people who cannot pay.

 

I have been following some of the comments on the news sites from people and it is simply astonishing what approximately 1/2 of them post. It is the law of the jungle basically. Those opposed don't want these "poor" people to be subsidized by the healthy  - which is how health insurance works anyway. They see it as an infringement on their right to earn as much money as possible (believing rates will go up for them, in order to cover the formerly uninsured). They also see them as "freeloaders", leeches on society, and would be happy to see them die without proper medical care. It is astonishing to me that such a high percentage of Americans feel this way.

 

The plan had a lot of opposition from states that were governed by Republicans, which refused to open up the exchanges where the insurance companies had to offer their new policies. This put extra pressure on the federal gov't. However, due to a variety of factors, there was poor information being conveyed about the state of the system to upper administration (the climate of don't tell the boss bad news) and the roll out was messed up. However, the site has improved and they are getting much more people enrolled.

 

The upshot is that insurance companies have a huge lobby, and saw the potential for more profit with an expanded user base, so they supported the plan. If that were not the case, then this whole thing would have failed. With the current dismay about the situation and changing of the conditions by the administration (ie: catastrophic plans being accepted again, and people who had their plans cancelled being offered new plans similar to their old ones), are causing them to be worried. 

 

A single payer system would have simplified things a great deal and reduced costs - but I don't think that is going to happen. The Canadian system is better, but there are different problems with it, mainly due to the waiting lists.

[JaiDee]

 

 

Flip side of course is, the risk of being sued if it was NOT appendicitis, means I guess, they do all available tests just to cover their arses (whom someone else is paying for) and keep the Insurance company (for the doctor negligence) happy.      

 

   2 quick stories; in  2001 I went to a local hospital near Boston at about 8pm with an amazingly severe stomach ache. The Doc did some tests, turned out my white blood cells were fine, so he sent me home....but with a 'script for oxycodone to relieve the pain {why, if I am fine?}. 12 hours later I was right back in there, after my appendix had ruptured while I was sleeping and had filled my innards with bile, rushed into the emergency room and operated on.  Spent 12 days in hospital after that one and nearly checked out from this mortal coil; perhaps if the first Doc had done more tests he could have seen my appendix was indeed inflamed?

 

Who knows,  but being the typical American I am we tried to sue for negligence [my Mom was an RN and had recorded every step of the process]  but were told by lawyers we had no case;  it was the first Doctors "judgement" call.  BTW, if this guy's bill was 55K for 24 hours, can you even imagine what MINE was for 12 days?  Yikes, good thing I had 100% coverage at that time and didn't even see a co-payment.

 

   2nd.....was living in Canada in summer and fall of 2011, in the city of Montreal.  I had severe shortness of breath while exercising and a slight heart murmur, which scared me enough to go to a heart clinic, one of the best in all of Canada.  Was checked in, monitored and taken care of all night, stress tests and other tests in the morning, and discharged after about 24 hours. I remember leaving and no one was stopping me, I finally had to ask someone who worked there "Where is the billing department?"  She looks at me in all seriousness, really had no clue,  and says "That's a good question."  After 15 minutes I found some small office in the basement who handled billing, such as it is, and paid the bill;  1700 bucks, which I thought was pretty damn good. In the states that would have run me 5 grand, minimum. That's just one small example of the difference in health care between the 2 countries.

[pacman]

Pacman, the plan was never to make healthcare free to everyone! That's not the American way! 

 

Not free to everyone? What is a nationalised health service if it doesn't include everyone? If it is the wealthiest 10% who have to pay I can understand the logic but if it is families with kids who can expect a bill for $10,000 for a night in hospital, that's just stupid.

 

I have been following some of the comments on the news sites from people and it is simply astonishing what approximately 1/2 of them post. It is the law of the jungle basically. Those opposed don't want these "poor" people to be subsidized by the healthy  - which is how health insurance works anyway. They see it as an infringement on their right to earn as much money as possible (believing rates will go up for them, in order to cover the formerly uninsured). They also see them as "freeloaders", leeches on society, and would be happy to see them die without proper medical care. It is astonishing to me that such a high percentage of Americans feel this way.

 

 

 

When people can post anonymously never be surprised how nasty they can be. And when it comes to money matters some people will explode at the thought they might have to carry the less well off. RX, you're describing the ugly side of Capitalism, especially in America where there has always been a focus on every man for himself. Free healthcare cuts to the heart of that mentality. 

 

A single payer system would have simplified things a great deal and reduced costs - but I don't think that is going to happen. The Canadian system is better, but there are different problems with it, mainly due to the waiting lists.

 

 

From the comfort of my vantage point it appears that Obama has been blocked & frustrated at every step of the way. The compromises forced on him rendered the whole thing unworkable, or rather, workable in the least efficient way. I was hoping he would call out the Republicans & shame them into starting again. He still might have to. Or it might be the first item on Hillary's agenda once she's sworn in.

 

This morning here in Australia there was an announcement the government is considering introducing a fee to visit a doctor in order to stop some people abusing the system. It wouldn't apply to pensioners & those with a health care card but any move to charge for a basic right such as healthcare will have its critics. 

 

And the dreaded amount of this suggested impost on the public's private pocket?

 

FIVE DOLLARS. 

[SiamSam]

It's 30 baht in Thailand

[pacman]

30 baht is about the right ratio given the difference between the two countries respective incomes. And it's only a proposal at the moment, it may not pass the Senate.

[jmboy]

The American way is NOT to offer health care to its people? What the hell is the American way then? Damn glad I don't live there then!

[rxpharm]

The American way is NOT to offer health care to its people? What the hell is the American way then? Damn glad I don't live there then!

 

It seems for about 50% of the population the American way is every man for himself to become as rich as possible without gov't interference and to hell with anyone else who is unfortunate enough not to be successful. They are leeches and parasites on the system, dragging the successful down with requests for assistance.

[azza33]

It seems for about 50% of the population the American way is every man for himself to become as rich as possible without gov't interference and to hell with anyone else who is unfortunate enough not to be successful. They are leeches and parasites on the system, dragging the successful down with requests for assistance.

The real parasites are the rich who exploit the ridiculously low paid people in their own country.

Minimum wage levels are disgusting in the US.

[jmboy]

They have rich people in the Scandinavian countries yet the gap between rich and poor is nowhere near as excessive as in the US. Is that socialism? It doesn't matter what it is called, it comes down to a basic caring of humans really - as above something that is lacking

[Jimslim]

The real parasites are the rich who exploit the ridiculously low paid people in their own country.

Minimum wage levels are disgusting in the US.

 

 For the first time in my forum life I find myself agreeing with Azza , this is the cause of real inequality .

 

They have rich people in the Scandinavian countries yet the gap between rich and poor is nowhere near as excessive as in the US. Is that socialism? It doesn't matter what it is called, it comes down to a basic caring of humans really - as above something that is lacking

 

Exactly it comes down to humans caring for one another .

 

Don't lets forget we are talking about the wealthiest country in the world , the right to free healthcare should be a given .

 

Rich or poor working or not that should not come into the equation everyone should have free healthcare in a society more than rich enough to provide it .

 

This is the finest example of what is wrong in this world .

[azza33]

30 baht is about the right ratio given the difference between the two countries respective incomes. And it's only a proposal at the moment, it may not pass the Senate.

Funny how they waste time on such a silly measure. Private health care is inefficient and inflationary.

Current wages paid to gp for a 15min chat is crazy.

Bout time the whole system was reinvented. Having to spend $50+ to get a script is insanity.

Say i want ciprofloxacin when I'm sick in Thailand. Costs me 100 baht - $3.5. In oz all up it'll hit $70. 20x the cost for the same end result. Madness!!!!

[pacman]

Say i want ciprofloxacin when I'm sick in Thailand. Costs me 100 baht - $3.5. In oz all up it'll hit $70. 20x the cost for the same end result. Madness!!!!

 

You don't mention that if someone needs that script & goes to a doctor who bulk bills, the doctor appointment costs nothing & if they qualify for a health care card, that script costs about $5. 

 

But the biggest point of difference between the Thai medical system & Australia's is that here if we go to a pharmacy to buy antibiotics, we will get it. Many Thai pharmacies sell fake medication, especially antibiotics. In Pattaya there are over 100 pharmacies, according to the Bangkok Pattaya Hospital only 6 of them could be trusted to sell genuine drugs. 

[azza33]

You don't mention that if someone needs that script & goes to a doctor who bulk bills, the doctor appointment costs nothing & if they qualify for a health care card, that script costs about $5.

... Still the taxpayer has funded the other $65. The cost either way is real and is a burden to everyone. $60 wasted. $10 maximum real cost. Add another $20 on the weekends and it gets worse!

Multiply that by millions of prescriptions....We are talking of saving billions via fixing this stupid process.

On the same issue, i gather the same stupid process is in place in Ireland as a i read a sad story of a girl who died in the street because the pharmacist refused to supply a "prescription" medicine to counter a peanut allergy.

As for Thailand selling fake medicine.... Im skeptical of a 5% trustworthy rate. My experience has been good over a 10+ yr timeframe.

[pacman]

The real driver of costs in any health care system is the demand by the health care professionals for very high wages. Exorbitantly high in many cases. I don't deny they have the right to earn a good living but I never ceased to be amazed by the expectations from some they should be paid 10 times more than the Prime Minister earns. 

 

re: fake medication - in China in 2010, it's estimated nearly 1 million people died from fake antibiotics. China is where the medicines are copied along with the logos on the boxes & is sold all over Asia. Large amounts of it have also been discovered in the UK with the fear that more is out there. There are many unscrupulous vendors in Thailand who think nothing of selling a tourist fake medication. How many times do we hear about someone coming home with a problem who goes to the doctor to get treated. They usually say they took something in Thailand but it didn't work. Of course it didn't work, it was fake.

[deepthroat]

The real driver of costs in any health care system is the demand by the health care professionals for very high wages. Exorbitantly high in many cases.

 

In the USA the driver is not the medical professional (doctor, nurse, etc.) but the ridiculous margins earned by the insurance companies and hospital administration.

[SiamSam]

In the USA the driver is not the medical professional (doctor, nurse, etc.) but the ridiculous margins earned by the insurance companies and hospital administration.

 

Yeah yeah...

[JaiDee]

Not surprisingly, this story has now gone viral;

 

 

         http://www.viralnova.com/hospital-bill/

[Lefty]

It seems for about 50% of the population the American way is every man for himself to become as rich as possible without gov't interference and to hell with anyone else who is unfortunate enough not to be successful. They are leeches and parasites on the system, dragging the successful down with requests for assistance.

“The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness.”

 John Kenneth Galbraith