What do Americans do if they have no healthcare?

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Seeing posts on Reddit about the costs of routine medical visits and the astronomical breakdown of figures charged, but I'm assuming these are all covered by health insurance.

But what if you have no insurance. What happens if you get cancer etc. Are you left to die?

@user1471439310
Sorry you’ve had such shit experiences
Where I am in the NW cancer services are excellent ..... One stop shop diagnosis for breast cancer....surgery within 3 to 4 weeks of diagnosis.... or if chemo first then starting chemo 2 to 3 weeks from diagnosis....some people who have initially gone private end up transferring back to the nhs because it’s quicker and more coordinated.

Neither dh or I have ever had a job where private med insurance was a benefit or even affordable, so I am very grateful for the NHS, for all its faults, and am happy to pay my share for a system that supports everyone.

I have experienced some of the negatives as I've needed mental health services and my children have been referred to CAMHS - both woefully underfunded services to the point of cruelty. But I'd like to see a better funded, better run NHS - the idea of not having free universal healthcare is a frightening prospect for me, and I'm not even poor, and my physical health is good.

This is an interesting article, although the stats are a few years old now. It's not surprising that the US spends more on healthcare as a whole as most of that is private, but what surprised me is that the government contribution per head is higher in the US than the UK.

@SchadenfreudePersonified

Thank goodness for the NHS - sadly half the country don’t know when we’re well off and the other half seem to want to undermine it at every opportunity.

Only the very elderly in this country (UK) remember what it was like before the NHS. Only they know the dread of having to call out a doctor to a sick child - putting it off, and putting it off because of the cost (which might mean that they actually had no food in the house for several days) until they HAD to call them out - and then it was often too late.

We have largely, as a nation, grown up with this wonderful service. Very few of us have ever had to make a harsh decision between paying the rent or calling the doctor. We always get treatment, though sometimes we may have to wait.

Health care is so much a part of our lives that it's like the air we breathe - we don't notice it any more, but if it wasn't there, my God we would suffer! I don't think many people realise how much under threat the NHS is from this government - they are dying to hike off the profitable parts and sell them off - and American pharmaceutical companies are the first in line to get their hands on them!

The health service isn't perfect (show me a service - any service - that is), but it has kept a lot of people alive when they would have died of comparatively minor ailments, and it has relieved a HUGE amount of chronic and acute suffering.

We would be idiots to let it go.

This^ My mum was 12 in 1948 when the nhs came into being....she had an eye test and was prescribed glasses and suddenly she could ‘see’ the world....she was amazed

@HoppingPavlova

You are very naive if you don;'t think we are in danger of this.

That’s hysterical rubbish. I’ve worked in a few systems and you won’t end up with a US system at all. It will be a system aligned with some European systems or the Australian system. No way will it be the US system. It’s not the only other system that exists.

Exactly, I love the concept and principles of the NHS but it is now long overdue reform...the alternatives are not “only” a US style system or the NHS...there are many other (successful!) ways in between.

@Diverami

People need to keep an eye on what is happening in the UK and use POLITICAL PRESSURE to enure that we do not get moved to a US system (ie vote socialist).

This - absolutely. The political theory seems to be "starve the NHS of funds so that it can't function property, then abolish it - "because it isn't functioning properly"

Sadly I know many americans in the same groups as me for chronic illness who are actually glad they don’t have our system despite the fact that their medical costs are crippling. They’ve been convinced that our system is dreadful, negligent, dirty, etc. Brainwashing basically. They’ll say “I don’t want to pay for other peoples healthcare” but this is precisely what health insurance is!

Really scarily, the American government spends more on healthcare per capita than we do - because they provide Medicare etc for those who qualify, within a privatised system that’s so much more expensive than ours. They could have a system better than ours for what they spend now. That’s mind boggling.

On holiday in New York I met a woman who was working in a shop and talking to her colleague on the till about whether she should go to the hospital. I asked her if she was okay and she said she’d burnt herself several days earlier, then she showed me - she had a very serious burn covering most of her forearm, no dressing, no treatment. She was at work like this. It was really awful.

Obviously there’s Michael Moore’s Sicko but everyone in that film actually has insurance, yet still many end up bankrupt, and they are absolutely tied to their jobs because it comes with insurance, so they’ll accept awful working conditions and terms as they have no other option. There are people in that film whose loved ones died because they were transferred to a hospital in their network, or because insurance found any way to get out of funding treatment.

@Pinksatin

I know of someone who moved to America. His wife who was pregnant with twins decided to give birth in England as it was cheaper.

Sorry but that's a fucking cheek.

I am hoping Brexit will stop this kind of health tourism. They're getting tougher with immigration now, and things like health tourism/trying to scam our system. And even though some think the Tories are EVIL with their new rules, it had to happen. Shit like THAT ^ proves that.

Also, the ex-pats (from Britain) who went to Spain and Greece and so on, have been given the choice to move back here and LIVE here and pay their taxes here, and spend their money here, ... OR they can renounce their citizenship and stay where they are, without the luxury of using OUR health service and benefits system when it suits them.

There are a bunch of other things changing for ex-pats abroad too, now the UK has left the EU...

Shame. The Boomer's Marbella Party had to end sometime I guess.

I agree that there are lots of alternatives to the NHS other than the US system. Lots of countries in Europe, Germany in particular, have excellent health services. I do think sometimes people overemphasize how amazing it is, (I have still had to wait around ages for an appointment in Germany for example just as in the UK) but overall it is very good. However - people pay (per capita) a lot more than they do in the UK - especially in Germany. So, any move to that would mean that people (particularly higher earners) would have to spend more than they do now. The problem with this is, many people dont want to do that - and thats where the risk is that, on order to save money to the higher earners, the care becomes less comprehensive to all sections of society.

For what we spend on it the NHS is very good value.

I remember an American friend of mine (living in UK for years) saying once, 'I guess it depends if you'd rather wait or rather pay.' I know that doesn't apply to all kinds of illnesses or care, but it is an interesting and more pragmatic pov I think. We in the UK are pretty 'conditioned', if that's the right word, to believe that healthcare should be free at point of access; and so used to being taxed that we (well, some of us) don't even notice that we're paying for it.

I am pro-NHS, btw; just thought this was an interesting comment from someone who grew up and lived in a different society.

@Hoppinggreen

I just watched a totally fictional show where a man committed a crime to get sent to jail as he had cancer and would get free treatment. As I said it was fictional but it did make me wonder

I remember this storyline, but I can't remember the programme! It was several years ago.

So I am tired too of people scaremongering and stating that we will soon have the same system as the US. We wont but the NHS is in need of serious reform. Some part payment type scenario like the majority Europe would be a start.

@IntermittentParps

I remember an American friend of mine (living in UK for years) saying once, 'I guess it depends if you'd rather wait or rather pay.' I know that doesn't apply to all kinds of illnesses or care, but it is an interesting and more pragmatic pov I think. We in the UK are pretty 'conditioned', if that's the right word, to believe that healthcare should be free at point of access; and so used to being taxed that we (well, some of us) don't even notice that we're paying for it.

I am pro-NHS, btw; just thought this was an interesting comment from someone who grew up and lived in a different society.

But if you don’t want to wait you can pay, there is that option with going private.

I remember once me and a friend were at Gatwick Airport waiting to board a flight to Washington Dulles and I saw three women in the queue all on their own with newborn babies. I thought it was strange at the time but I wonder if they came over to the uk to give birth to save money.

I doubt it, you can't fly when heavily pregnant so you would need the means to support your self for a couple of months. Much easier to go to Mexico or Canada.

Watch "Srubs" on TV.
They constantly have story lines where the staff have to use various ploys to give treatment to patients w/o insurance.

Also New Amsterdam.

One patient was a child who'd had an organ transplant, the insurance paid for the transplant but not the drugs he needed afterwards.

But if his parents divorced mum and son were entitled to some form of insurance, possible Medicaid.

In another a bus full of ladies from a church have a crash and I'm unclear on the details but as the person hiring the car has taken out some form of supplemental insurance they can have medical treatment and surprise surprise they all have ailments they cannot normally afford to treat.

Actually any US drama in a hospital (such as ER) or involving a hospital has issues around insurance, things like friends and Rosanne which are comedies even have stories about not having insurance.

@littlepattilou In theory, people shouldnt be able to get health care free. For example, I having been ut of the UK for more than 5 years no longer qualify for free NHS care. If I become ill when visiting the UK however I am fine - my health insurance will cover it. Prior to Brexit if people were resident in the EU their EHIC cards would have ensured they got emergency care that would then be paid for by the host country/insurers etc (depending on the exact health care system in that country). However, because NHS care is free at the point of access a lot of hospitals arent set up to bill people/process payments. It isnt part of the culture/day to day practice of a lot of nurses/doctors to do this so in the past it was common for people presenting to A&E not to be asked for their health inurance details/EHIC cards or for these not to be followed up on for repayments. Nothing to do with sneaky immigrants/British expats trying to cheat the system. Everything to do with how processes are set up. Personally I think there were easier ways to fix this (fairly minor administrative problem) than the whole faff of Brexit but hey, thats a discussion for another day.

There are also people who travel back to the UK for planned healthcare (either from the US because its cheaper, or from elsewhere because its familiar) who are paying for that healthcare - there are procedures in place for this. But even when they are paying for it, it still works out cheaper than the US - so they arent cheating the NHS. It is just that healthcare in the US is a rip-off!

@littlepattilou Sorry... that should have said "those people" (meaning UK expats etc)

I took my son to the doctor's in the UK (before Brexit) and the doctor told us that she could claim the money back but it would actually be much quicker and easier for her just to see us (took 5 minutes) than work her way through all the paperwork.

Yes OP, they die.

Medical issues are the No. 1 cause of bankruptcy in the US.

I have a rare condition and am on a support group where ladies are predominantly from US with some UK like me, Canadian and Australian. It affects my airway. Standard treatment is to dilate airway as a daycase under general anaesthetic, it doesn’t last you may need it doing every few months. Ladies in US with insurance often have large co pays so put it off - resulting in emergency trachy or death (all deaths on group have been US ladies) There is also major surgery on airway as a possible option. In UK we tend to try less invasive for years then have major op if no other choice as it is very risky - risk of not speaking again, high risk of death) But in US they jump to that immediately and take risk as they can’t afford more cautious path. The treatment isn’t better in US the leading surgery was developed by a UK Team. I was fortunate to have everything on NHS - I only pay travel costs to London. When people knock NHS I wish they could see the stark contrast on the group. If your health care is linked to work yet you are ill and struggling to work it must be horrendous.

[quote Kitkat151]@user1471439310
Sorry you’ve had such shit experiences
Where I am in the NW cancer services are excellent ..... One stop shop diagnosis for breast cancer....surgery within 3 to 4 weeks of diagnosis.... or if chemo first then starting chemo 2 to 3 weeks from diagnosis....some people who have initially gone private end up transferring back to the nhs because it’s quicker and more coordinated.[/quote]
My dad was the same. He lived in the North West.
He was dizzy and uncoordinated on the Saturday. He saw his GP Monday morning, was having hospital scans by Monday dinner time and had the confirmation diagnosis of brain tumours the following day. Within 16 days he had brain surgery and was starting radiotherapy and then chemo at Manchester's Christie Hospital. The cost? Pretty much the petrol for his missus having to drive him there every day for the treatments. Even his parking was covered eventually. Sadly he did pass away after 10 months but the cancer was already too far along when discovered.
Thanks to the NHS my dad had 8 carers coming into his house each day, he had a hospital bed and any other equipment he needed. He spent his last weeks in a hospice then a nursing home. No one had to go bankrupt for it either. He died with as much dignity as anyone could and no worries about how everything would be funded.
Our family is now only suffering with grief, not homelessness on top of that.

WeIcomeToGilead I had my appendix out 18 months ago, admitted through ER, arrived at 6.30pm, had surgery and released at 9am next morning, 18 grand !!!
Im lucky, the state I live in has better mandatory insurance than other states, MA had mandatory insurance before obama care. It costs a lot though if you are working ( employers of less that 11 people dont have to offer insurance). There is a sliding scale for how much of a subsidy you can get and the cheapest option is very basic, basically catastrophic care coverage.
I have to pay the first $4000 of medical costs every year before my insurance kicks in. I have a separate health savings account through work to cover this cost. Its deducted pre tax from my wages, again not something everyone has available.
With medicare, the seniors health insurance, most need to also buy a private insurance as medicare doesnt cover everything. I dont know anyone who just has medicare, they all have a secondary plan.
Medicaid, at least in this state, doesnt pay well and a lot of doctors wont take patients who have it. In this state at least if you have a terminal illness you and your family can get medicaid. I have a friend in that position and she always says its a godsend.
As for ambulances, omg their collections people are like rabid dogs, will be calling demanding payment in 24- 48 hours. In all my years Ive never had a problem negotiating a payment plan with anyone but ambulance companies. They want the full amount then and there over the phone. I dont think they are routinely covered by insurance either Its no wonder people dont use them if they dont have to.

@UsedUpUsername The US has one of the highest maternal death rates in the developed world, so it clearly is not a system that is working for women. Shared room or not, I know where I'd rather have my baby.

I know the NHS can be shit.. I work in it.. but when I went to Boston which is a fairy affluent area of the US in general , I was truly shocked by the number of youngish disabled people who had conditions that are on the whole preventable. There were so many young blind adults, so many people who had had strokes in their 40s-50s , amputees with no prosthesis... I know these things happen in the UK but never in these numbers... never that overtly omnipresent.. this will mostly be untreated blood pressure and diabetes.. we haven't seen public health consequences like this in the UK for 50 + years..

Government starves NHS of funds.
People complain about the waiting times and other related issues.
People start saying the NHS needs serious reform.
People don’t kick up a fuss when services are gradually privatised.

It’s so transparent yet this strategy is working well.

People say there’s not enough money. Of course there is. There’s money for what you prioritise, and it’s not in this government’s interest to prioritise the NHS.

Privatised services cost more in the long run, so this is not about saving money.

If you want to learn about the US Healthcare system, I really recommend the Michael Moore documentary Sicko (the whole film is on youtube). Its frightening and absolutely horrifying that thousands of Americans each year declare bankruptcy over medical bills.