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?

Nearly every country in the world has a maternal mortality rate that is falling (as you would hope). It may be falling from a very high rate, i.e. in Sierra Leone it is 1,120 per 100,000 live births, but falling.

One of the few countries in the world where maternal mortality is increasing is the US. CDC info here and comparative info here - worth saying that some of the increase may be due to improved reporting, and that Germany's rate has also increased in the last few years.

One major factor seems to be a lack of midwives and particularly a lack of equitable access to primary care, so women are coming into contact with the health service in pregnancy with untreated underlying conditions because they can't afford a GP.

No hospital uses gas and air, it seems very old-fashioned (and ineffective).

Gas and air is f*cking excellent!

I had it with my kids 40 years ago and they had to prise the mask out of my hand (joke!). You feel stuff, but you don't give a monkey's!

@RuggeryBuggery
They’ll claim they’re for the “big society” thing. Same a David Cameron tried to sell us. Charity stepping in to fill the gap as the Conservative party (Conserve what? I always love the irony in that name) rip up and self off every not for profit public service in the country.
People in the UK love voting for it though. Unfortunately it takes a lot longer to build something - libraries, universes healthcare, decent schools, etc etc, than to tear it down.

I read something online ages ago about a woman who had a c section and she was billed for holding her baby. There was a picture of the invoice too.

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.

Where’s your evidence base that this offers any benefits to women? Insurance based systems have a tendency to over-investigate and over-treat. It’s easy money for insurance companies and doctors and women risk unnecessary and harmful interventions.

I have two exes who worked in American hospitals. One an orthopaedic surgeon, the other a cardiac surgeon.

Both enjoyed the world-leading, amazing facilities in their respective hospitals (each had worked in more than one).

Both hated having shifts when they were working with the ER because there would be patients brought in who didn't have insurance/the right insurance. The protocol was they would have whatever was essential (the minimum), life saving surgery, then they'd be shipped off to a hospital they could afford.

Neither ex came from the U.K. so they were both familiar with private health systems. They found this aspect of the US barbaric. It was one of the reasons each of them stopped working there.

The French healthcare system is closer to NHS but everyone pays social charges until the state retirement age. So early retirees still pay.
The french healthcare system is covered 70% by the state and then you can opt to pay for a mutuelle.
Most French citizens pay the basic mutuelle to cover the hospital bed, as this is not covered by the 70%. If you know you are in need of extra care then you can pay for a more expensive mutuelle cover and after 1 year you can pay the lower amount once more if you don’t need the extra cover.
Where people get caught out is when they use a doctor who charges more than the French base on which the 70% is applied.
So if a procedure is €10k, €7k is paid by the state.
But if that particular doctor charges €12k the state still pays back €7k.
For this reason you can take out 150% or 200% cover.

All illnesses of long duration, ms, diabetes, cancer etc are fully covered by the state.
Poorer people get cmu so everything is paid for.
French healthcare is usually very good but can be low on dignity. I know someone who had to strip completely for a smear test and your feet are always put in stirrups!

@SchadenfreudePersonified

No hospital uses gas and air, it seems very old-fashioned (and ineffective).

Gas and air is f*cking excellent!

I had it with my kids 40 years ago and they had to prise the mask out of my hand (joke!). You feel stuff, but you don't give a monkey's!

Yes, quite. If gas & air is sufficient for you why on earth would you choose an epidural?

@PandoraVox

Fair enough, *@SchadenfreudePersonified*. It took the financial challenge of getting sick in a dog-eat-dog capitalistic system to expand his horizons as a chemist, then go on to become a capitalist par excellence.

We can agree on that. And FWIW, I think it was the new zest for life he gained from finding out how very good he was, and how very much he could control his own destiny (having spent a life being crushed by other people's expectations go him as a "nice guy") that actually gave his body the energy to fight and defeat the cancer that was killing him.

(Not that I blame people for the severity of their own illnesses - of course I don't - but in this particular fiction this was the impression I felt was being pushed.)

"the government paid for my bodyworn hearing aids for school (I am not allowed to take it home"

Even if you have insurance you often have to pay 10 or 20%. I have 2 friends who we bankrupted due to medical bills, with decent jobs etc. There's free clinics in major cities offering walk in services and public clinics for childhood vaccinations (where I lived at least). My pregnancy and DD's birth cost $27,000 (standard delivery no pain relief, one night stay) my insurance paid all but $100 but my friend had to pay 20% different plan.

My friend is American. She fell pregnant, but unfortunately had a stillbirth at term. This wasn’t covered by her package and she had to pay £10,000 for it.... meaning she had to wait years and years before trying again for another child as she was paying that off first. Horrific

It was one of the reasons we returned to the U.K. as dd has sn

@RuggeryBuggery

Can anyone explain this - I might be being simplistic but I think Republican Party are generally against universal healthcare? And Republican Party have a large proportion of Christians? I just don’t see how they can align Christian values of compassion and care for the poor with not being in favour of helping people, and improving access to healthcare for all? I know it’s not that simple and of course those aren’t just Christian values, but I really don’t get that mismatch.

Republican values are not Christian values. The evangelicals are merely a noisy wing of the party

@SchadenfreudePersonified

No hospital uses gas and air, it seems very old-fashioned (and ineffective).

Gas and air is f*cking excellent!

I had it with my kids 40 years ago and they had to prise the mask out of my hand (joke!). You feel stuff, but you don't give a monkey's!

I used it for one delivery after being refused an epidural (a shocking concept to folks back home) and it didn’t do shit. I felt like I was literally going to die.

Second time I had the epidural and it was amazing.

Been thinking about this three all night. Another major source of opposition to single payer is the fee that end-of-life care will be rationed. I don’t have the statistics and am too tired to look them up, but we spend a lot of money buying a few extra months for people with advanced cancers. We keep people on ventilators, etc. etc. that kind of care is $$$$$. But thisnis highly
Emotional and political (proliferation forces) and there is fear that there will be pressure to limit care , especially end of life care, if we went to a single payer model.

@IDontDrinkTea

My friend is American. She fell pregnant, but unfortunately had a stillbirth at term. This wasn’t covered by her package and she had to pay £10,000 for it.... meaning she had to wait years and years before trying again for another child as she was paying that off first. Horrific

Jesus, that's horrific.

@sylbunny

we don't pay for our healthcare form our tax, it's from national insurance which is much lower.

That is incorrect.

Total NI collected is less than the NHS costs alone (never mind that it's not intended to pay for the NHS anyway).

To be fair there are a lot of misconceptions about the NHS and its funding, though.

@WiseUpJanetWeiss

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.

Where’s your evidence base that this offers any benefits to women? Insurance based systems have a tendency to over-investigate and over-treat. It’s easy money for insurance companies and doctors and women risk unnecessary and harmful interventions.

This is interesting. Before my hysterectomy I spent hours online researching experiences and I found a lot of anti-hysterectomy sentiment on US forums and formed the impression hysterectomies were performed much more readily there, leading some women to regret the procedure later. Mine was an excellent choice but it wasn't easy to get it; however I really did need it.

I know of someone in their early 20s who broke their ankle in America with no healthcare. Fairly mild break from tripping over a step, I think.

The doctor x-rayed it and bandaged it like you might do at home for a mild sprain here. Sent her home with a huge bill and instructions (she lived on her own) not to try and stand on it for 6 weeks or she'd be permanently disabled.
Luckily for her she had some friends who raised enough money for her to buy a supportive boot after about 3 weeks, which helped.
She'll have permanent pain in that foot and won't walk without a limp again.

That's disgraceful.

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

The prosperity gospel is such a small slice of American Protestantism.

Healthcare and college are both service industries that have skyrocketed in cost and the people getting fat have no incentive to change. Admin in both sectors are overpaid and underworked imo but at least doctors get amazing pay for it, unlike professors.

The proliferation of urgent care centres where routine care can be had at a cheap cost is definitely a good move in the US, hope to see more of that. Keeps them from crowding ERs.

If you want to know how Americans cope with no health insurance or want to know what happens if illness strikes a family, read
Lionel Shriver's
So Much For That

It's fiction but it is chilling that it could and probably does happen to countless American families.
Its also one if the best books I've read.
(same author as We need to talk about Kevin)

Watch Michael Moore documentary Sicko for what healthcare is like.
Things have changed a bit since Obamams Affordable healthcare bill.
A lot of people still live with the old Pioneer attitude where we lived and don't want to pay out for something they may not use, and say they'll take care of themselves, but that will bite them in the arse one day.
Our local hospital was a Catholic charity one, they accepted most insurances, but if you had no ins, they would still admit and treat you, and set up payment plans you could afford, but many still would go bankrupt.

A close relative, an orthopaedic surgeon, worked in the US for a while. He and his family loved living there but he couldn’t cope with turning people away/giving only very basic treatment/discharging people early from his (Catholic run) hospital, so he returned to the UK.

We have doctors in the family in the US. Crikey they earn $$$$$$.