Shocked about the cost of childbirth in the US!

[somepeople2013]

mobile.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html?ei=4RfbUbuuGYnT0QWt8oCwDg&q=usa%20cost%20of%20birth&oq=usa%20cost%20birth&gs_l=mobile-gws-serp.1.0.0i7i30j0i8i30j0i8i13i30l2j0i8i30.12337.13925.0.16114.5.5.0.0.0.0.273.1140.0j1j4.5.0....0...1c.1j4.19.mobile-gws-serp.fO2SvOKOoE0&=&

Always knew that health care was expensive over there.....but saw this and am just

[pointythings]

One word: Litigation.

[somepeople2013]

True. Am just utterly shocked....I just can't get my head round their health care system I guess!

[DalekInAFestiveJumper]

The US health care system is bonkers. I can't blame you for not being able to understand it, somepeople. I've lived with it my whole life and I still struggle with the ins and outs of it every time I have to change insurance. One job my DH had renegotiated the insurance setup every single year, with a new set of rules and fees and having to change doctors and all.

We've moved to a new state recently, and I've the whole mess to sort through all over again. I'm paying through the nose for insurance that I can barely use because of the restrictions!

[somepeople2013]

It seems crazy....definitely makes me appreciate the nhs that's for sure.

[Lighthousekeeping]

What happens if you have a premature baby?

[pointythings]

Lighthouse let's just say that 25% of all bankruptcies in the US are related to medical bills.

[DalekInAFestiveJumper]

Lighthouse, a co-worker of mine had a premature baby several years ago. She had insurance, but it was not very good. As a result of the bills, her family lost their home.

My friend's husband got cancer. Again, insured, but because of loopholes in the system, they are still paying a significant chunk of money every month towards the bills they incurred at the time. This was more than a decade ago!

[Ponders]

I am shocked by that too. DD1 was born in NY 30 years ago, by CS - I believe the bill for surgery & staying in hospital for a week was c $2000, but anyway it was covered 100% by our insurance (which we'd had for 2 years. It was a HMI scheme though, which works kind of like the NHS, so more inclusive)

A friend of ours in his 60s had a severe stroke earlier this year & is currently in a rehab centre at a local hospital. The centre is a lovely place, quite new, lots of facilities, & all free of course.

DH recently wondered how a case like this would be managed in the US if you didn't have massive insurance; I mentioned this to DD1 & she told me about a friend of hers in NY whose father died when he was quite young, because he had cancer, & they couldn't afford the treatment, which is appalling in a supposedly civilised society

Our friend was resuscitated, repeatedly, by paramedics, then treated in hospital for weeks, then sent to one treatment centre for assessment, then on to the one where he is now. In the US, not being wealthy with massive insurance cover, he would probably just have died from the stroke.

I don't understand how the current Govt apparently can't see what a huge benefit to our society the NHS is

[Ponders]

\link{http://en.wikipedia.org/wiki/Health_maintenance_organization\HMO}, not HMI, sorry

[FamiliesShareGerms]

This is exactly why, even though it's not perfect, the thought of losing the NHS and / or creeping privatisation scares and saddens me in equal measure

[Beamur]

My Mum is about to undergo what could be an extremely expensive set of surgery/treatment and thanks to the NHS she won't have to sell her house in order to try and stay alive.
If you find yourself in need of the NHS is makes you bloody grateful for it!

[DalekInAFestiveJumper]

Where I grew up, it was not uncommon for small children to rarely go to the doctor at all. We simply couldn't afford it. Short of breaking a bone, you just went with it and hoped for the best. My parents were both teachers, with fairly decent coverage for the area, and even I only went in case of dire emergency. Adults went to the doctor even less.

You can imagine the horror stories that result.

These days, I have good insurance, but even that requires me to spend hours on the phone jumping through hoops to convince the insurance company to actually pay for things. Doctors will often start out conversations about treatment by asking who your insurer is. It doesn't matter what the best option for treating a problem is, if insurance won't cover it. And there's a lot they won't cover!

[Ponders]

from that piece linked in the OP

$20 or so for the splash of gentian violet used as a disinfectant on the umbilical cord (Walgreens? price per bottle: $2.59)

it's not just down to litigation - this is pure profiteering

[PoppyWearer]

Even with good insurance, friends of ours paid $1000 for a trip to the emergency room for their DC after a head bump.

I've never heard of a child in the UK being given a CAT or MRI scan for a run-of-the-mill bumped head, but that is what happened over there. At great cost to them and their insurance company.

Blatant profiteering on a parent's concern, surely? And wouldn't you think twice about taking your child if it was going to cost that?

Of course all children bump their heads, and I took my own DCs into the GP/A&E after some nasty ones in the UK, but at that cost I may well not have done. $1000

[bico]

Not surprised in the slightest.

Many many years ago I spent time working as a lawyer in the US. I had one case where I was local counsel on a products liability case (my job was to assist the out of state counsel of a drug company). The drug company was one of over a dozen defendants being sued because a child had been given too much of a particular drug that caused brain damage. There was absolutely no evidence to support the our client drug company's medicine had been used. There were other drug companies supplying the same drug to the hospital. It was a pretty clear medical malpractice case and nothing to do with our client's drug other than a drug of the same type had been administered incorrectly to this poor child.

The case against our client was thrown out after a year of depositions, endless case conferences etc. The litigation cost to our client was over US$1m.

This was one of the reasons why I moved back to the UK.

[Lighthousekeeping]

I was watching Modern Family this week and the granny was in a nursing home with lakes and white picket fences. Does insurance pay for that kind of care? I know it's a tv show

My friends granny had cancer in New York and she had to pay four different specialities for her care when in this country she would have just been on a palliative pathway but they squeezed every drop out of the family. It's disgusting. And the care is no better than here. God, we are so bloody lucky.

[DalekInAFestiveJumper]

It depends on the insurance. But generally, if someone is in a nice-ish nursing home, odds are they either had money saved up or (more usually in my experience) their kids are paying a substantial sum.

One of the theatre groups I teach regularly performs at the lower cost sort of nursing facilities. They are grim. We can't take the youngest groups of performers anymore, because these places are so dire that it gives the kids nightmares. Hell, they give me nightmares.

[Lighthousekeeping]

Abit like here then

I always think of American ones to be like the Notebook!

[bico]

The thing you find in the US which we don't seem to have hear thank heavens is consultants having a share of an associated business. For example it is common practice to go to the GP and he'll suggest that you have a blood test. He has shares in the lab that does the blood test. They are mostly not needed but it is an income generator for the GP. Same for having shares in MRI machines etc.

[DalekInAFestiveJumper]

The US insurance system is heavily tied to employers as well. So whatever insurance scheme your employer has is (as a general rule) what you're stuck with. If it doesn't meet your needs, more often than not, you have to find a new job. There are ways to get add on insurance, but it costs the moon.

And if you lose your job, you lose your insurance. People sometimes have to put up with horrifying treatment from bosses, because they can't afford to lose their insurance.

[Lighthousekeeping]

If you worked for the government like nursing or policing would you get good insurance?

[DalekInAFestiveJumper]

It depends on which government. City/State/Federal varies a good bit, and then benefits vary within each. My parents worked for the state government as high school teachers, and we had awful insurance. When I first got married, I worked for the same state, but for a University. My insurance was not good, but it was better than my parents.

I have taught secondary school myself, for a different state, and that was some of the best insurance I've ever had. Much better than the stuff I've got now, even though I am currently far wealthier than I was back then!

Nursing is not generally a government job. Police tend to have good insurance, because they have unions.

[lalalonglegs]

It's bloody awful. It's one of the reasons that US pregnancy- and birth-related deaths are relatively high compared to most other developed countries.

My American SIL's mother worked (in a hospital but not as medical staff) well into her 70s to pay for the insurance that covered the care of her disabled daughter. It is scandalous.

[itsatiggerday]

It's interesting too from a medic's perspective.

DH had a run in over the phone when he worked in A&E with a parent of a student who fell off his bike and bumped his head.

Guy came in, was reviewed as per normal procedure, kept in for a while to see (can you tell I'm not a medic and know no specifics!) and after a few hours they were happy to discharge him. Cue call from his Dad in the middle of the night US time (was by now early am in UK) to rant about how his son had a head trauma and needed a CAT, MRI, full bloods and possibly ultrasounds. He could not see his son but had spoken to him (conscious, fully functioning) had no actual symptoms that hadn't been dealt with but thought that was simply required for any kind of bump to the head. DH could not get rid of him, just kept phoning back and ranting. Eventually the consultant got fed up because he would not listen and said that he was satisfied son was fine and if there was a complaint here were the PAL details.

DH actually said he'd hate to practise in the US as it would massively reduce the value of being the dr other than to have learnt how to read a load of test results. No diagnostic capability at all. He said it wasn't even a close call, the guy just didn't need all the tests and given that there are side effects and potential implications of many of them, it's not just financially that you wouldn't want to make them routine.