What do Americans do if they have no healthcare?

[summeriscomingsoon]

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?

Another key thing about the NHS is its ability to negotiate, as one body, when it comes to purchasing drugs etc. This isnt a perfect process by any means but it does help us pay much much less per dose for the same drug than US Healthcare providers (plus, you see competition over equipment, e.g. for ventilators in 2020 in the US that doesnt happen here). Not suprisingly a lot of US based drugs companies hate this and there is a lot of pressure for any US-UK trade bill to essentially prevent the NHS being able to negotiate in this way. This would be catastrophic for the NHS.

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.

It’s absolutely crazy not to include ambulance care in insurance - generally speaking if you’re in an ambulance you’re pretty unwell and unable to get to hospital under your own steam. It’s hardly a taxi service.

One of my friends lives in Virginia. Her little boy had a seizure. Instead of calling an ambulance they drove him there as they couldn't afford the extra costs (she was insured but only had basic insurance through work and they were living paycheque to paycheque.)

Before setting off in this emergency, she had to call her insurance provider to find out which hospital she could actually go to. It turned out to be one quite a few miles further away than the hospital near her home.

Her son was assessed when they arrived and the doctors, after checking her paperwork, told her he needed to go to a second hospital which provided better testing facilities for him. It was on their same insurance system and just a couple of blocks away. Fine. She went to take him but they told her he HAD to go by ambulance or his further treatment would not be covered. The ambulance ride took around 5 minutes and required him to just sit in the vehicle as a passenger. They gave him no medical treatment in the ambulance. It cost my friend over $500.

For a two block ride.

She still had to pay her co-pays or deductibles and whatever. It cost her (including the ambulance ride) well over $2000. All to find out her son had had a febrile seizure. He did get every test imaginable though.

The same woman had broken her foot when she was 19 or 20. She never had it treated as they were without adequate insurance. She limped for 15 years and because she couldn't afford the surgery required because it was preexisting and later, when insured thanks to ACA, couldn't afford the recovery time off work which supplied her insurance, she was simply proscribed strong pain relief for those 15 years. So many meds that the regular pain meds burned a hole through her stomach and also gave her gastroperisis. Now she has managed to have the surgery on her foot but cannot get help with her Gastroparesis (paralysis of the stomach basically) and ulcer pains because she's now labelled as a drug seeker due to her history of living on daily painkillers.

I hate her stories and it kills me that she has so many.

Take maternity care: you would never be denied epidurals, they would always do csection instead of riskier (for the mum) forceps as a cost-saving measure.

Well yeah- because the hospital get to charge for it!! Of course they won’t refuse it! It’s a cha ching in the cash cash register!

A shop won’t refuse to sell you their merchandise either. Shocker.

The other bad thing is it gives insurance based healthcare systems a bad name - most of the world including Europe operates on an insurance based system, with none of the problems the USA has. But as soon as there's any debate of changing from the NHS system in the UK, everyone panics and says 'but we'll end up like the US' so nothing gets changed. It really limits debate about the best way to fund a healthcare system in this country as no one wants the issues the US has, when actually there are many alternatives that function very well in between a full NHS and the failing US system.

If you haven't got 2 hrs, instead what a 20 min expose on healthcare by John Oliver (who is brilliant).

Why there is not a massive outcry, people on the streets etc? Access to healthcare should be to be a basic human right. For free!
because without basic things like universal healthcare people are too stressed and ill for protesting 😟

I know a couple who moved from the UK to New York. Both have good jobs with good insurance but even then, when one of their children was born with disabilities, they have to top up their insurance by around $300 per month. It will get worse when she's an adult. They have a friend with terminal cancer who is in the position of having good insurance through his job but who is unable to give up working despite being so ill. I just don't get why they love their system so much, or perhaps it's the case that we only get to hear those with the loudest voices on the subject.

I gave birth in the UK. Had my choice of pool room or birthing suite with balls and cushions and whatever else is supposed to help baby along. I had gas and air (dunno if it did anything but you'd have had to rip the breather out of my cold dead hands at the time) but epidurals were hugely discouraged. At no point did I ever think that it was to save cash. It's just more risky. End of. I didn't fancy the possibility of permanent back pain etc either.
After each baby was born there I always had my own en-suite room for as long as I needed to be there. No wards. No sharing rooms. My husband never got kicked out either. Even the hospital parking was free.

I was in a friendship group of 30 women online, all due to give birth around the same time. 20 Americans, 8 Brits, an Aussie and a Canadian. 18 of those American women somehow all needed to be taken for a Caesarian because it was taking too long or baby was getting distressed. They were all given Pitocin too. All 20 of them. We also sadly lost two of those babies. It broke the whole groups hearts. I always wondered why so many of them automatically needed the sections. Coincidence or over medicalisation. My Virginia friend had pre paid her last child's birth. She was made to pay hundreds of dollars to her physician at every check up to go into her "birth account". Crazy.

In an insurance based system the doctor is personally liable if they misdiagnose or miss something. Hence the barrage of tests, unnecessary antibiotics etc.
NHS protects the doctors more, so we have the other issue of not getting enough tests.

@thelegohooverer

One point that comes across strongly on this thread is that in the UK people look at the shambles that is the American system and feel more grateful for the NHS. In the US people look at the shambles that is the NHS and feel more grateful for the American system.

Everyone is setting the bar too low. We need to look at really good healthcare systems, think about how they could be even better, and work towards that.

Yes!

US health insurance can be good and bad, but it mainly depends on the deal your employer is offering. I had one employer that was extremely generous, non-contributory after six months' service, full Blue Cross/Blue Shield medical and dental cover including family members. Never used it at all.... because I was 26. As were most of the employees; the people who used it and needed it were middle-aged people, and as it was a magazine, there weren't many of them.

I think the NHS does the extraordinary brilliantly, and the routine pretty well but there will never be enough money to provide absolutely every treatment for absolutely everyone, especially as medical and life science is making such rapid strides. Several European and the Australian (no personal knowledge of this) systems seem to find a sensible balance.

@Teenageromance

What happens in the US when people retire? And no more work supported insurance?

They will get their retirement that they paid into the system over the years and Medicare. They will be ok

Homeless people who never worked in a day of their life probably will not

Absolutely fascinating thread. Thanks for starting it. Reading about personal experiences deapite knowing how awful access is in the US has been an eye opener.
Please could posters tell me the titles of documentaries to watch. I could t find the Louis Theroux one mentioned.

The US Gov has one of the highest spends in the world on healthcare, its citizens pay through the nose for fancy facilities and unnecessary treatments. For all of this expenditure they have lower life expectancies, and worse health outcomes than 36 other countries according to the WHO. The UK and the rest of Europe significantly and consistently outperform the US.

Choice is an illusion in the states. You can't make the best choices when placed in those financial situations.

A hidden cost of the US healthcare system is the huge admin burden it puts on families.
I lived in the US, had good health insurance with reasonable deductibles and copays. Luckily we were all generally in good health but I did have a couple of babies in the US.
You have no idea when the next bill will come in, who is it form ,what it is for. Suddenly your health insurance rejects it (and think of who is paying for the time of the people who are making decisions over what health care is included - that takes a LOT of time). Apparently one of the doctors was 'out of network' and not covered. You then protest and appeal (you know, being in labour and what not, I wasn't about to ask what network the anaesthetist was in). Eventually they agree to cover. But int he meantime you have wasted hours trying to get it sorted.
Or they make a mistake in spelling your name - rejected!
Or insurance decides you are not entitled to x procedure but should have had y procedure instead - rejected!
So much time and effort - this has a huge impact. Even more so when there is serious illness.
Give me any other system apart from the US one. It is the wost system of any developed counry and many developing ones (I'm in Thailand and it has a better system - less money obviously but everyone covered by govt health service). I'm not wed to the NHS, it has its pros and cons but as a SYSTEM, beats the US hands down on any objective measure you can think of.

I'm sure I saw something somewhere that to have a baby in USA is about $40 000. Here in Australia we have a system similar to the NHS (we have public Medicare plus private health insurance) and I am so grateful for it. I have had 3 babies and been in an Ambulance after a car crash and didn't have to pay a cent (other than the miniscule amount of tax I pay). I love much about USA but their health system is awful.

Judging by this thread the US healthcare system is primarily a means for healthcare companies to become very wealthy at the expense of the health of the American people?

And that's what our government wants; very wealthy companies, stressed impoverished unhealthy people🤷🏼‍♀️

This thread is interesting; I just don’t understand why a country that claims to be so great, is happy to let its citizens die or become bankrupt to fund health care.

The more healthy it’s citizens are the more able they are to work and earn money... to pay taxes. Nobody can pay taxes when they’re dead.

Scary thought isnt it? A friend of ours had problems in labour ,and needed a C section for a safe delivery .Had to produce evidence of Insurance before any treatment! I think we have such a wonderful system here .The Nurses/Doctors and so on work so hard and get precious little reward!(Nurses 1% a sick joke!)

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

We wouldn’t need any elements of the creeping privatisation if the Tories, and Blair’s version of Labour, hadn’t made and then reversed so many changes designed to introduce “competition” (aka divert cash to their mates and to companies they want to work for after finishing in politics) and stuffed the NHS full of badly performing managers.

We could also do so much more for the NHS if we stopped wasting money on white elephants like HS2, stopped spaffing cash on the big consultancy firms and finally realised that our “independent” nuclear deterrent a) isn’t independent and b) doesn’t deter anything

I remember a friends ds who has a host of Conditions. Cystic fibrosis being one of them.
She's been housed for months at a time for free, she has her transport costs reimbursed. When the hospital ran out of a specific drug he needs which only has a 24 hour lifespan they sent the hospital helicopter across the country to collect.
Doctors and nurses have stayed hours over when the should have been home. The doctor who was pushed through the hospital corridors on his bed resuscitating him when he collapsed as a baby didn't leave his side for 48 hours. He gave up his much needed days off because he wanted to know he'd be OK.

I can't even fathom to think how much that sort of care would have cost under a US system. In all honesty I don't think he'd be alive now.

The existence of the NHS also keeps the cost of private healthcare and insurance down in the UK. Privatisation is only beneficial to the consumer if the goods and services being provided are non-essential. If they are essential the providers can operate like cartels and hike the prices exponentially because the consumer has no alternative. Without the NHS the cost of private healthcare would rocket as the private companies would have us over a barrel.