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What do Americans do if they have no healthcare?

489 replies

summeriscomingsoon · 25/03/2021 22:43

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?

OP posts:
brokengate · 26/03/2021 04:24

@blisstwins
There is currently a debate among Facebook friends of mine where they are calling colleges mandating covid vaccines to return to campus fascism and are threatening lawsuits.

Are they charging for the majority of covid vaccines?

blisstwins · 26/03/2021 04:28

I do think most of not all states have very low cost or free insurance for children. I had a friend who laid $10 a month. Poor suits get Medicare and everyone over 65 gets Medicare.
I do think the thing that feels Americans out, including me, are the waits and lack of choice in other kinds of systems. I have insurance—expensive, but my salary is higher snd it is a cost I accept as part of life—and I could see any doctor for anything almost immediately.

How does private insurance work in England? Does there end up being a two-tiered system?

I do think there needs to be significant reform in the US. I just don’t know what it should be me I don’t want to lose my choices either. I live in a major city and my access to healthcare is wild.
One friend ha stage 4 colon cancer snd is on an immunosuppressed therapy that is $$$ but covered and she is doing very well, thank God. But if you are poor, don’t speak English, and can’t navigate the system I think it is easy to get lost in the system.

pollyglot · 26/03/2021 04:28

My oncologist DB ran a free clinic for cancer patients and his DIL does pro bono legal work for the disadvantaged. USA's attitude to the poor is appalling.

Interested in this thread?

Then you might like threads about this subject:

UsedUpUsername · 26/03/2021 04:32

@00100001

It's so weird that Americans object to universal health care on the idea that "why should we pay into a pot/pay for people who haven't contributed" etc.

Wtf do they think any insurance is?? Confused do they genuinely think that when they pay for (say) car insurance, they're paying into their own individual pot and not subsidising other customers?

I cannot get my head around the fact that one of the wealthiest and most powerful nations ok the planet has such an archai system where...if you're diabetic you have to choose between rent and food or LIFE SAVING MEDICATION.

It's batshit.

Thing is, the average American couldn’t handle NHS treatment, it’s too bare bones.

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.

I went private because I am horrified at the thought of shared wards. In the US, men would be able to stay in the rooms (usually an in-room couch or something they can sleep in) and I just preferred it that way.

In the US recovering mums usually get private rooms where Dad can stay, never hear anyone being turned away for early labour, always odd to hear someone turned down for csection because anesthesiologist isn’t there or the surgery theatre is full. Even the scan schedule is a bit ... sparse.

The epidural refusal thing is so maddening. No hospital uses gas and air, it seems very old-fashioned (and ineffective).
Hi
Honestly, British women put up with a lot and should expect (so to speak) better.

This is just maternity care, I wonder what the differences would be in other areas.

blisstwins · 26/03/2021 04:33

No. Opposition to the vaccine has nothing to do with cost. Insurance covers it or not is free. There are people saying they don’t want to give it to their kids until the DA approves/until there is more data on long-term effects and who are schools to DICTATE an unapproved vaccine be required to attend college.
And then that turns into a rich debate because those upset at being forced to vaccinate their kids for college are usually in the right. They then get angry that the left who are pro reproductive rights (my body, my choice) and would deny choice to those in the right over the vaccine. It is a false
Equivalency because one concerns individual rights and the other public safety, but it is extremely heated and exhausting. I try to avoid engaging in real life to be honest

MariposaLilly · 26/03/2021 04:36

I'm British and lived in the U.S my entire adult life. I was born and raised with the NHS, loved it back in the 50's, 60's 70's, but it sounds really over stretched now. Over the years keeping in touch with family in England and I have been sometimes appalled at the treatment they have received there, mostly the wait times for procedures and appointments. Other times I have been gobsmacked at the wonderful level of care from their GP. So mixed feelings.

The same here in the U.S. As long as you have good insurance the healthcare is fantastic. The best. No waiting about that's for sure. No gatekeepers for getting appointments. Although they will ask if all your insurance infos the same when you make an appointment to make sure you are still covered.

In the last almost 50 years I have had all kinds of health insurance from none, to medicaid for the very poor (my husband was a student and I was unemployed sickie) teamster (union) insurance, regular employee insurance, federal worker insurance, state worker insurance, self-employed, to finally medicare for us oldies.

I've have managed to get myself into a lot of pickles and had about 10 major surgeries, so it hasn't been plain sailing.

The secret is having insurance. The very poor can get treatment. Hospitals can't turn people away. There are free or sliding-scale clinics

We have kept ourselves insured and so we've been okay. We even have medical helicopter/plane insurance and that paid off when my husband was in a very bad accident. We live about 80 miles from a trauma center and so the cost of the airlift would have been well over $100,000.

I find it disturbing UK women see a nurse for a pap smear. Here a pap smear comes with a full pelvic exam from a gynecologist. I've never heard of a nurse doing that! Also you don't have to go to a crowded hospital for blood work and waiting for hours. Your doctors practice does that. There are many labs, MRI's etc.

I've been reading here on mums net how babies and toddlers have been refused appointments with doctors. That is frightening. It sounds as if the ambulance service in the UK is used almost as a taxi service. We only use ambulances if we are in serious peril, such as heart attack or car crash etc. That's the difference between us - even though we have good coverage I wouldn't bother the local ambulance crew. What if there was a serious accident they were needed at?

What I have come to learn after so many years in the U.S is that there are millions of Americans who do not want to be 'looked after'. They don't expect it and don't want it. In the UK most people want to be looked after and expect government to do it. While my parents were still alive and I'd go home to visit, or reading mums-net, I clearly see the difference in the two cultures. For many years I didn't understand it, but I do now. For many of us it's about freedom, individuality and personal responsibly.

Given the choice of the US healthcare system or the NHS, I would stick with U.S healthcare system. I love it.

BTW, in the US there's different kinds of bankruptcy. Chapter 7, 11, 13 etc. So I don't think it's the same as in the UK where I believe if you go bankrupt you lose everything. Maybe someone else can explain it better, we just had an earthquake here as I was writing this.

PS. Look up what a nurse makes in the US.

brokengate · 26/03/2021 04:36

@blisstwins ah ok thank you.

Gosh this makes interesting reading. Different world really.

mathanxiety · 26/03/2021 04:37

Why do Americans think this system works? Sounds dreadful.

Because of the poison that is moralism.

Americans who are privileged believe that everyone gets what they deserve. The 'prosperity gospel' and its earlier incarnations have a lot to answer for.

Cokie3 · 26/03/2021 04:39

@GeorgiaGirl52

There are options for people with no insurance. St. Jude's Hospital treats children with cancer totally for free. Even provides housing for parents who bring the children there. Lion's Club International provides vision tests and glasses free for adults and children. They operate "Lighthouse for the Blind" to help with training newly blind in the use of braille, providing guide dogs, and in some cases providing employment for the blind. Veteran's Hospitals provide treatment for the servicemen/women. Shriners Hospitals for Children provides specialized care to children with orthopedic conditions, burns, spinal cord injuries, and cleft lip and palate. The American Cancer Society, American Kidney Foundation, and other charities provide funds for research and for treatments of patients. While we don't like the socialism idea, we are very willing to donate to charities. We just want to choose for ourselves, rather than let the government decide where our money goes.
@GeorgiaGirl52 It should not be left to charities to help poor people, the government should be doing that. And not everyone in America lives near those free hospitals/charities.

Americans have this obsession with 'socialism'. As if any and every thing that is remotely near 'socialist' is bad. Health care is a basic human right in all first world western countries, bar America. Choosing for yourself is ok if you have the means to, but what about others? The focus on the individual and I'm right fuck the rest of you is an indictment on America and why they are seen as weird and strange and uncivilised by the rest of the civilised first world. The government decides where money goes with roads, schools, and the military, yet you're all ok with that. So why not health care, which is arguable the MOST important thing of all?

Not every thing that benefits a community and society as a whole is 'socialist'. And if something is, it's irrational dogmatic ideology to reject something socialist simply out of ideology. Some things that are 'socialist' are superior, and if it works, THAT should be the deciding factor, not anti-socialism point blank no exceptions. America has this bizarre obsession with hating anything even remotely community-minded or to the left of far right ideology. So much so they will cut off their nose to spite their face. Even if the so-called 'socialist' option means people don't suffer and it's better, they are so driven by ideology to the extent it makes them irrational. I checked several years ago what the country health rankings were. From memory, Switzerland was ranked first. I think Japan was second. Australia was ranked 3rd. UK forth. Forget fifth but it was either Canada or New Zealand.
America, was 42. Yes, forty-second. If that doesn't make you wake up and feel deeply embarrassed and deeply and utterly ashamed at the 4th world state your backward and uncivilised country is in, nothing will. Iraq and other middle eastern 3rd and 4th world countries probably have better health care than America. Actually I do remember Lebanon ranked higher than America but I never registered the actual position just that it was before America.

That you think that people should have to resort to charities for HEALTH CARE says everything about your lack of values imo. That is such a foreign concept for compassionate, moral people in civilised countries, it's hard to even fathom your mindset.

There is a reason America has such a bad, barbaric, backward and uncivilised reputation. Maybe you need to re-examine your deeply entrenched obsession with left vs right, socialist vs conservative, and look at it based on what works and what doesn't. Not everything that is socialist is bad. A good, proper, compassionate, moral and civilised society will embrace what works, not what matches what ideology. A good, proper, compassionate, moral and civilised first world country will utilise a mix of socialism where it works and a mix of conservatism where it works. Not everything socialist is bad, there are good elements to it, just as there is to right wing. Not everything right wing is good, either. America's complete lack of a health care system while pretending to be a first world 'free' country proves this.

mathanxiety · 26/03/2021 04:39

For many of us it's about freedom, individuality and personal responsibly.

^^ That.

KickAssAngel · 26/03/2021 04:40

I'm aBrit living in America so have experienced both systems. The quality of care for people with insurance is significantly better in the US. Not just that waiting times are very low, but also how well doctors listen and pay attention. the NHS nearly killed me by not doing the right tests and giving me life saving medication. After I moved to the US my GP picked up in the problem and got me sorted out.

Having said that, of course it's a problem that there's a significant number of people who fall between medicaid and having insurance. those people are mainly self employed. Health cover for single people or a small family business is very expensive. There are options like insurance that covers accidents and terminal illnesses, but obviously that's very limited.

Many medical centers, both doctors and hospitals, will try to help out, e.g. Giving advice over the phone and not charging, or giving urgent care through a gp office which is cheaper than an ER visit.

As others have said, the situation isn't bad enough to lead to maSs protests and demand for change. It certainly doesn't make it good, and it is horribly unfair. I think most people just can't see how to make such a huge change. How do you deconstruct an entire industry? So they would rather see some small improvements as they worry about the impact of dramatic change. I live in a fairly liberal area where people do want to see better availability of health care, but they still worry what would happen if there was sudden dramatic change without good leadership

mathanxiety · 26/03/2021 04:45

do they genuinely think that when they pay for (say) car insurance, they're paying into their own individual pot and not subsidising other customers?

Yes, that is exactly what they believe. And there are not enough crayons to explain to them why they are dead wrong.

They also don't understand that American companies are competing against companies abroad which operate in societies where single payer/free at point of service healthcare is the norm, and companies themselves don't shoulder the burden of paying for health insurance. The so-called party of business, the GOP, is particularly opposed to 'socialised medicine'.

blisstwins · 26/03/2021 04:53

www.wnyc.org/?modal=queue-history

Interesting audio piece in small pox vaccine and American law on vaccines.

Travelledtheworld · 26/03/2021 04:54

Americans also want freedom of choice, to shop around for healthcare. And they don't believe that "Socialised" medicine offers this.

Pyewackect · 26/03/2021 04:56

Depends on the State where you live. I worked in the US on several medical contracts and cancer care was definitely covered as was dialysis. That said most people are on some sort of Health Plan and dentistry is almost a religion. The other side of this is medical professionals get well paid. I made $100k pa as a nurse and between myself and my husband we made enough to buy our house outright when we came home.

mathanxiety · 26/03/2021 04:56

[Medicaid] is not universally accepted but it is WIDELY accepted.

No, it's not.

Very few doctors accept Medicaid.

There are specific family practice groups which essentially bill the federal government per patient. That is their business model, and they depend for profitability on volume.

They act as gatekeepers, sending patients experiencing medical emergencies to surgeons or services which also accept Medicaid, and because there are not that many surgeons/physical therapists/dieticians/dentists accepting Medicaid, you sometimes have to wait for your medical/surgical/dental treatment or your therapy.

mathanxiety · 26/03/2021 04:57

Americans also want freedom of choice, to shop around for healthcare. And they don't believe that "Socialised" medicine offers this

Yet millions of them get their healthcare from HMOs, or Medicaid.

There is a level of cognitive dissonance in America around healthcare that needs to be examined closely.

Nancydrawn · 26/03/2021 04:58

If your family has under $37,000 for a family of four (or $19,000 for an individual), you qualify for Medicaid, or government insurance. Some states have expanded eligibility. Most red states rejected the expansion, even though the federal government would have paid for it for a long period of time, because of politics.

If you have an employer policy, your deductible is usually capped. So you pay some each time, but there's a cap to it. If you're out of network, you can be very in debt.

If you aren't offered employer insurance, you can buy some on the exchange. It's far too expensive, often, but it's available. This is Obamacare and was a huge advancement.

If you're over 65, you qualify for healthcare through Medicare.

The system is appalling. But there is some safety net, however full of holes. And Obamacare made it much better, even though it was far from perfect legislation and full of awful compromises.

blisstwins · 26/03/2021 05:11

Also, if you get insurance through your employer it is tax deductible. I pay almost 20k a year for my insurance snd so my taxable income is x-the cost of my insurance premiums.

Tinpotdictator · 26/03/2021 05:19

Because the American system is profit based the hospitals are incentivised to charge extortionate fees for unnecessary tests. The U.K. system is about providing healthcare free at the point of service for the (cheapest amount possible). So only doing what is absolutely necessary.
A poster further up said about nurses doing smear tests over here in the U.K. instead of gynaecologists. I cannot think of any benefit to having a dr doing a routine smear test over a nurse.

Cokie3 · 26/03/2021 05:28

@Travelledtheworld

Americans also want freedom of choice, to shop around for healthcare. And they don't believe that "Socialised" medicine offers this.
@Travelledtheworld The thing is, 'socialised' medicine can and does coexist with private healthcare. For example, in Australia we have 'socialised' health care AND private health insurance. Everybody, regardless of their wealth can have free healthcare, BUT we also have the choice of going private and having private health insurance.

Socialised healthcare does not remove choice. On the contrary! It adds to the choice. It gives you more choices. So I don't understand Americans going on about freedom of choice, when they basically have NO choice in America. Their only 'choice' is pay thousands upon thousands for health care, plus thousands on top of it for what it doesn't cover - or go without. Hardly a 'choice'. Mortgage your house for healthcare or die. That's their 'choice'.

Countries with Universal Healthcare are the ones with the real choices. America's system gives you no choice at all.

Nothingyet · 26/03/2021 05:34

@summeriscomingsoon

Why do Americans think this system works? Sounds dreadful.

Thank god for our NHS

Plenty of relatively poor people in this country would like healthcare to be privatised. They think only of those who they see are getting something for nothing- immigrants, healthcare tourists, people with life-long illnesses, and it angers them that they are paying for it. They don't care they might be cutting off their noses to spite their faces.
AdamAntsBitofFluff · 26/03/2021 05:36

I have a few friends who have lived in US and needed hospital care.

Friend Shelly was living and working. She had a driver reverse into her while she was waiting at a bus shelter and the impact caused the shelter to crush her legs.
Driver had insufficient insurance to cover Shelly's extensive medical bills. She was advised to sue bus shelter manufacturer.
When Shelly was in court the judge berated her for running up 2 million dollars of health costs to save her legs....because artificial legs are cheaper. I was shocked but Shelly and her husband were so ground down by the 3 year process they just shrugged it off. She spend 5 months in hospital, 18 months in a hospital bed in their apartment as it was cheaper. As soon as she was allowed she returned home (Still has a huge limp and is registered disabled).

Friend Jill is working in US in medical field. She fainted at work (but not in a hospital). She had ambulance, MRI, Cat scans, night in hospital....$40,000 to find she had low blood pressure. Her view is that they find out you have good insurance and do the works. And she has had to pay $10k out of pocket.
Rubbish/no insurance? bare minimum and kick you out.

It has given me a massive amount of respect for NHS.

Tinpotdictator · 26/03/2021 05:46

@Nothingyet I don’t think any “relatively poor person” would bemoan health tourists using our services and then conclude that we should therefore all have a private healthcare.

KeepWashingThoseHands · 26/03/2021 05:58

On one trip to the UK my US colleague had a seizure and cut his head open on the fall. Here are all the things that amazed my US colleagues about the NHS:

  • off duty doctor came to assist whilst waiting for ambulance
  • colleague was permitted in the ambulance with the patient
  • no metal detector at the hospital
  • no one asked for proof of insurance before treatment (sure he was billed at some point)
  • treatment was fast in A&E
  • on realising colleague was international and staying alone in hotel room (they recommended obs due to the seizure) docs permitted he stay overnight at the hospital
  • provided fit to fly note several days later
  • clean, professional hospitals and staff

They’ve travelled here many times but never had to use the NHS and only had a perception before. These are high earners with very good medical coverage and raved about how good the NHS is.

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