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?

What I don't understand is why the healthcare in the US is so expensive. We can opt in to private healthcare here and the cost if you compare like for like is world's apart.

Is it the private insurance model? Ie the insurers pay so the cost increases as "market rate" doesn't work anymore as the customer isn't paying.

We've seen similar in the U.K. with vets bills since pet insurance became a thing (and people became more emotional about their pets!).

It can be very hospital dependant. Some hospitals have charitable or religious trusts that aim to support and pay for the care of poor people in certain situations. Cancer care, emergency treatment, cardiovascular treatment, tend to be popular. Some hospitals with research goals will fund treatment for rare diseases for their own gain. In all fairness a lot of them have ways for children and pregnant women to get care for free or at huge discounts, but the issue is that many non-white families don’t get told about them.

@RavingAnnie

What I don't understand is why the healthcare in the US is so expensive. We can opt in to private healthcare here and the cost if you compare like for like is world's apart.

Is it the private insurance model? Ie the insurers pay so the cost increases as "market rate" doesn't work anymore as the customer isn't paying.

We've seen similar in the U.K. with vets bills since pet insurance became a thing (and people became more emotional about their pets!).

Probably more to do with most drugs and lifesaving equipment being developed there. Someone has to pay the real cost for these services and the US has decided it’s population will. This creates a strange situation where a US drug, with r&d funded and tested by the US population at full price, is then sold cheaply to other countries.

For the US population it would be better for their health if the US government created a more open market for drugs and treatments and turned certain drugs like insulin or metformin into an essential good that must be produced by all drug companies free of charge.

The US tax rates and revenues for healthcare are actually higher than the UK. So people in the US pay more than us for much crappier service. Except if they’re rich and can avoid paying tax at all.

Everytime myself or my family has used the NHS it has been absolutely shite. Poor care, mistakes made, just generally crap. Everytime we have used our private healthcare it has been great. There needs to be a middle ground between our shitty NHS and an American system where people cannot afford to be treated.

Probably more to do with most drugs and lifesaving equipment being developed there. Someone has to pay the real cost for these services and the US has decided it’s population will. This creates a strange situation where a US drug, with r&d funded and tested by the US population at full price, is then sold cheaply to other countries.

That couldn’t be further away from the mark if you tried.

It’s more the case of being pretty much a full cost recovery model as opposed to other models where it’s partial cost recovery with the remainder subsidised via Govnt using taxes.

So, use of a band-aid in the US may cost $50 in the breakdown of the bill. The band-aid doesn’t cost $50 but it’s the ‘bed cost’ associated with it - the time of the person needed to assess you needed the band-aid, the time of the person applying the band-aid, your portion of infrastructure and running cost for the time you sit there to get the band-aid on. The way other models work is you would just pay $1 for the band-aid and the ‘bed cost’ behind the band-aid is Hovnt subsidised through tax payers. That’s obviously a gross oversimplification and not real figures, and a lot more complexities behind it but that’s the general gist.

Is there really a direct correlation between people who complain about the NHS and the Royal family?

I think your NHS is great (I’m Australian and lived there for a while), always wondered why people complained about it.

But I don’t get the Royals thing at all. You don’t have to have a Royal family but universal healthcare is pretty bloody important IMO.

Certain sides of politics here have been trying to make our health system more like America’s for years, they also tend to be the Monarchist side of politics. So it is definitely the opposite here to what this post is saying.

So it surprises me that it would be the opposite there.

Gah, the post I was trying to quote didn’t show up for some reason. And now I can’t find it again. The one ranting about the Union Jack in amongst healthcare and Royals.

@SunshiningBetty

Everytime myself or my family has used the NHS it has been absolutely shite. Poor care, mistakes made, just generally crap. Everytime we have used our private healthcare it has been great. There needs to be a middle ground between our shitty NHS and an American system where people cannot afford to be treated.

That’s because in the UK private care doesn’t have much room for complexity. If you pay for private maternity and need lifesaving treatment or have complicating conditions you get sent to the nhs. I got rejected by several private maternity hospitals because I have a clotting disorder (risk of pph)

If you want to pay for private cancer treatment you might find yourself returned to the nhs if you have other complications. I know people who have needed to pay for private heart, brain, cancer specialists who then all decide to refer them back to the nhs when things became uncertain.

I can't really get to grips with is the idea of paying thousands in health insurance premiums, still having a bill for copay etc at best and at worst, having a bill for thousands of dollars being rejected by insurer after treatment. Or being rejected prior to life saving treatment and just being left to die

I don’t know what’s wrong with a copay. But no one is left to die, that’s completely absurd. Denied coverage is not the same as denied treatment

No one here get left to die. It’s actually illegal to refuse treatment because they do not have insurance. What they are left with is debts

To another poster, I said, "his nurse" which seems to have offended. People here will also say the doctors receptionist or his/her PA. He hired her and she's employed by him, not the government

It's your assumption that the doctor will be a MAN which is offensive.

There are many, many excellent women doctors.

(Also that the nurse will be a woman)

Everytime myself or my family has used the NHS it has been absolutely shite. Poor care, mistakes made, just generally crap. Everytime we have used our private healthcare it has been great.

I've never gone private - i've never needed to, The NHS has a aways been amazing when my family has needed them (and we have had a couple of very serious illnesses amongst us).

And as AGrumpyHoonMain says - you have the option to g private in the UK, but any complications that arise are back on the NHS.

Quite a lot of NHS money these days is spent repairing botched surgery by unscrupulous doctors - the sort who say "Come over here to Whereverland. Enjoy two weeks in the sun and have a face lift. Go home looking fabulous and your friends will never know why you look so good! Costs half the price of what it would in the UK", and then perform a slapdash surgery , often getting infected, frequently with an appalling cosmetic result as well, and then washing their hands of the patient, who then comes back and lands on the NHS.

I’ve twice paid for private healthcare when the condition wasn’t serious, the treatment was straightforward, I was in a hurry and I had enough money. I was happy with the care provided and outcomes were good.
I have frequently used NHS services for conditions serious and not so serious - I’m quite old - and on all but two occasions was happy with the care provided, and outcomes were good. One occasion I was dissatisfied was when I was messed around with appointments, the other was to do with an individual HCP.
Someone upthread mentioned care for older people. My parents had excellent care from the NHS in their later years, including treatment for heart disease, Parkinson’s, diabetes and cancer. As a result they remained happy and (relatively) healthy until a rapid, natural and unavoidable decline and death in their 80s.
The NHS, for all its faults, is a gem.

No woman here has to take her knickers off for her GP or his nurse. When we need birth control, pap smears, general reproductive health checks, breast exams etc we make an appointment with our gynecologist and/or obstetrician of our choice. We also select our GP and it is not based on where we live. I travel up to 100 miles to see my favorite doctor.

If you pay or have insurance you can do all of that here.

The reason you need to register with a GP who is local is because UK doctors make house calls.

About 10/12 years ago a lady from the ME travelled to the UK in the very final stages of pregnancy. She had had fertility treatment and was carrying 6 babies. It cost over £500,000.

You don't get to the 'final stages' of a pregnancy when you are carrying 6 babies. You are lucky to get to 30 weeks. Also the father's employer paid the bill.

www.thenorthernecho.co.uk/news/7097152.bosses-agree-pay-sextuplets-care/

Everytime myself or my family has used the NHS it has been absolutely shite. Poor care, mistakes made, just generally crap. Everytime we have used our private healthcare it has been great.

I worked for one of the best private hospitals in the country, I got my own care via the NHS.

Where do you think all those private hospital employees were trained?

Not saying staff in private healthcare are better trained. Just that bad attitudes and care are tolerated in the NHS because we ‘should be grateful’. That is not the case in the private healthcare sector as people can vote with their feet.

@SunshiningBetty

Everytime myself or my family has used the NHS it has been absolutely shite. Poor care, mistakes made, just generally crap. Everytime we have used our private healthcare it has been great. There needs to be a middle ground between our shitty NHS and an American system where people cannot afford to be treated.

I've always had a great service from the NHS. So reassuring to know it's there too. A real safety net of care.

@SunshiningBetty

Not saying staff in private healthcare are better trained. Just that bad attitudes and care are tolerated in the NHS because we ‘should be grateful’. That is not the case in the private healthcare sector as people can vote with their feet.

The NHS is a bit of a monopoly employer for Drs. They all train in the NHS. Private work opens up when they are fully qualified, ie when they are consultants. Which for most specialities takes 10+ years.

Very few are full time private and lots do no private at all. So that private consultant is also a NHS consultant.

@SunshiningBetty

Not saying staff in private healthcare are better trained. Just that bad attitudes and care are tolerated in the NHS because we ‘should be grateful’. That is not the case in the private healthcare sector as people can vote with their feet.

Staff in independent sector are definitely not better trained. Most people report very high confidence and positive experiences of the NHS. National inpatient survey and FFT run at about 92% nationally. Somewhere the scale of the NHS cannot judged by anecdotal evidence. There is fantastic care going on, even during the pandemic.

@Happyhappyday

Wowwwweeee let’s do some America bashing here! The healthcare system isn’t universally bad, it’s just very variable & tied to employer. For me personally the cost of my health insurance plan is considerably less than the difference between the US taxes I pay (20%) & uk taxes we paid (top rate). However for that difference I can see MY dr same day, always, pretty much any specialist I need within a week or less & visits to things like PT aren’t limited. I pay $15 per visit or if I was to be an inpatient/have surgery etc it would be $15 per day. Facilities are literally a world away from the NHS facilities I experienced.

People over 65 are covered by Medicare, poor under a certain income threshold are covered by Medicaid & children are covered. It is not universally accepted but it is WIDELY accepted. Obamacare set out to provide affordable insurance for people who fall between poor & having employers who provide health insurance.

In a lot of cases you can choose your coverage, I could pay half as much into my plan but then have out of pocket costs at $10k, or I can do as I have and have basically no out of pocket costs because I know I’m likely to use a lot of healthcare. The US system gives people the option to choose how they want to spend their money.

I’m not saying it’s great and definitely not for everyon, for $$ spent, the outcomes are not enough better and the experience varies massively by state, a bit like the experience across Europe varies by country. It’s also appalling some people don’t have insurance, but for some of those people it would also have been a choice to pay less up front and cross their fingers they don’t get sick.

As long as you're OK eh? fuck everyone else! How can you possibly stand by a system that allows the least privileged, often due to no fault of their own, not have access to decent health care, to go bankrupt, diabetics not taking their insulin because they can't afford it, watching your loved ones die of conditions the other half like you can be treated for. Shame on you!

Everytime myself or my family has used the NHS it has been absolutely shite. Poor care, mistakes made, just generally crap. Everytime we have used our private healthcare it has been great. There needs to be a middle ground between our shitty NHS and an American system where people cannot afford to be treated.

I've had the very opposite experience. Every time myself or my family have used private healthcare (in the UK) it's been really shitty, the NHS, they've been excellent, even putting right the fucked up private treatment my mil had.

@RavingAnnie

What I don't understand is why the healthcare in the US is so expensive. We can opt in to private healthcare here and the cost if you compare like for like is world's apart.

Is it the private insurance model? Ie the insurers pay so the cost increases as "market rate" doesn't work anymore as the customer isn't paying.

We've seen similar in the U.K. with vets bills since pet insurance became a thing (and people became more emotional about their pets!).

Because in U.K. there is backup of NHS. It really is that simple. Most private hospitals have to dial 999 in an emergency and move patients to NHS hospital. Many private hospitals offer part of the care, not all of it. You might get your breast cancer private consultation in private hospital but need to go to NHS for diagnostics and surgery. You might then go to private hospital for chemo but any complications you go back to NHS - sepsis, DVT etc. You almost certainly would have radiotherapy via NHS.

The NHS has huge buying power. So a certain device may cost £500 each in the NHS, but a private patient may have to fork out £5000.

There is also a limit to what the market will pay. If the only option is private, you have to pay what they charge. If you have a state option as well, you can weigh up the cost of private now vs free next month. The more expensive the now option, the more likely people will wait.

Health finances are very complicated. I don't think your ability to pay should prevent you having access to treatment. Hence why I support the NHS.

@SunshiningBetty

Not saying staff in private healthcare are better trained. Just that bad attitudes and care are tolerated in the NHS because we ‘should be grateful’. That is not the case in the private healthcare sector as people can vote with their feet.

The majority of co sultanas who work privately also do NHS work.....so are you saying they do a shit job when they seeing their nhs patients and a good job when they see their private patients.....because I’m sure they would find that assumption very offensive

The majority of co sultanas who work privately also do NHS work.....so are you saying they do a shit job when they seeing their nhs patients and a good job when they see their private patients.....because I’m sure they would find that assumption very offensive

Maybe so. But I bet that GPs and dentists give more time to paying customers instead of whatever piddly amount the NHS offers. It would be unfair otherwise