21% of Americans put off a Drs visit because of money

[brasty]

I have just been reading research into the finances of US citizens. It is a massive piece of research, with few surprises. But I was surprised at how many people said they had put off a Drs visit because of money. Either because they had no insurance to cover it, or could not afford the co pay.
Now some of these visits would have been for routine things that were fine to put off. But some may have been for early indicators of illnesses such as cancer, and putting off a visit may have major consequences.

Well I know a uk GP who says on average 35% of appointments dont even turn up. And 35% who do go have absolutely fuck All wrong with them. I know others in different locations who largely concur

I think we should charge for visits and if you need medication then its free.

35% don't turn up. That is way above the UK average, sounds like that GP needs to look at her own practice.

Interesting viewpoint OP. How on earth can it be the GP's fault?

The way the appointment system works for a start.

How does it work? You ring up, get an appointment with a time to attend - then attend at that time don't you?

Easy, JeReviens, people won't go to a GP they don't like. And most practices won't let you pick who you see unless you have ongoing problems, so they just won't turn up if they dislike the doctor. Perhaps the GP should look into their practice.

No, it is not as simple as that. I actually know what I am talking about here as my DP works in healthcare and they have over the past few years drastically reduced the number of people who do not turn up for appointments.
If the numbers who do not turn up are way above the average, then yes you do need to look at what you are doing. There are many ways to manage appointments that the patient does not necessarily see.

Mine have got rid of booking appointments in advance. You have to ring in the morning and book it for the same day. A hassle, especially working 9 to 5 but according to the practice, it has cut down a lot on people not showing up as nobody really wants to wake up early to book an appointment they have no intention of going to.

Oh and also if you do it 3 times without valid reasons then you can't book anymore

Also DP is coming across an increasing number of people not taking medication, because they can not afford their prescriptions.

jCo I always pick the GP I want at mine! Theres a few who I will never see because I think they're crap.

I have a debilitating pain, the treatment causes my bones to be stripped. I've had to stop having the treatment as I cant afford the bone scan. Which isn't covered by the NHS.

It already happens in the uk we are so lucky with the NHS

My initial thought was that 21% was lower than I thought, considering the costs involved I mean. I imagined it would be higher.

Different GPs do it differently with how they manage emergency appointments, routine appointments, cancellations. Those with higher than average cancellation rates need to learn from those with lower rates. DP actually works in a practice for students, which traditionally have notoriously high rates of no show. If they can get it way below the national average, anyone can.

I never ONCE didn't turn up for an appointment when I lived in the UK (Great system the NHS, never, ever knock it, you might end up with a system like in my country where it costs 50 euro to go to the doctor). I'm so poor I can go for free lucky me but I certainly don't abuse it. I only go if I'm really sick.

The American system is shocking though. The INsurance companies won't pay for the drugs that the doctors know would work the best, so your treatment is decided for you by an insurance company!!!!!

I have missed GP appointments when I was really ill. For a few years I had a GP appointment, hospital appointment, test or hospital stay nearly every week. My illness also made me confused. So I did miss a few appointments. Only time in my life I have.

This is why Americans spend more IN TAXES on healthcare than we do. They ALSO have to pay for it.

Here, I get a cough, go to my GP, get told off for time-wasting and feel a bit silly. But one of maybe hundreds of those people like me have something worse. Let's say TB. They get caught and treated early. They don't infect others. The GP can talk to some of the others about smoking cessation or something preventative.

In the US, half of those coughs don't see a doctor. The one that was serious has TB but didn't see the doctor. They infect a bunch of other poor people. They don't get treated until it's really bad and they go to emerg. Because even the US won't put up with people just dropping dead on the streets, there are emergs that will see you. But that's tax money. And instead of relatively cheap treatment, now it's bad. Some of the others have drug-resistance. Oops, now we have to pay to isolate people, that's really expensive. Some are 'illegal' and don't see a doctor because they are scared...

That's why even stupid people should support the NHS, unless they have a vested interest in making money making people poorer.

Yes true. And true about talking to them about preventative healthcare like stopping smoking. I know people who have changed their lifestyle when their health starts to be minorly affected, and the GP has frightened them.

This is older but good

I have to pay €50 every time I need to see my GP, if I need bloods done at that appointment its €75. Same for my kids that are over 6.
Have to pay for prescriptions too unless they are over €125.

I usually wait it out for a few days before making doctors appointment.

SoENFJ this is more or less what a lot of Americans think about the NHS, that it won't pay for the most effective drugs/treatments/diagnostics. To a certain extent both views are correct.

OP have you read this New Yorker article (I found it fascinating): www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

What are your findings re Medicare/Medicaid? My understanding is that most people who struggle are those whose incomes are slightly too high to qualify but not high enough to be able to afford insurance.

My mum was a teacher in the US for over 30 years and has excellent lifelong health insurance. For a very low copay she was recently able to have world-class breast cancer treatment incl two surgeries, radiation, chemo, endless follow-up appointments etc. (Maybe too much treatment to be fair, this is a risk with private health care.) But I know some of her colleagues who joined the education system later have more typical (ie worse) insurance.

No I haven't read that article, thanks for linking

It doesn't surprise me at all. I live in Ireland. It costs €60 to go to the GP. Just this week I've been diagnosed with anaemia resulting from a pretty severe iron deficiency. I've had symptoms for at least three years, but I've been putting off a GP visit. I'm lucky that I can afford it, but it's a huge chunk of money, especially for something as vague as chronic fatigue. I have small children as well so I kept convincing myself it was only normal to be tired, even though I really knew it went beyond that.

In the last two weeks I've had two GP visits, a blood test and a prescription for the medication I need. All in all about €200. A huge chunk of our budget for the month. Again, we can afford it, as a once off, but it does have an impact. Once I decided I was going to get myself checked out I actually put it off for another month so we could budget for the inevitable costs.

We pay NI here too, by the way. And as a family we have private insurance sponsored by DHs job, so I might get some money back, but it'll be less than half and I still have to pay for everything upfront first.

I have an American friend and she says their system is chaos.

They have good insurance through her DH's job however still insurance only covers 90%, so they still end up paying out loads. She has a chronic condition.
She said it costs $300 before you even walk into an ER.
And with what Trump is doing or trying to do that people will die. Insurance won't cover any pre-existing conditions so if you or your child are/get sick (cancer for example) and are poor, you will die.
She said the insurance will take your house if you happen to own it to cover the enormous medical bills.

I would never live in America, how privileged that we live in Europe and can get healthcare. America's fucked.

The can't book in advance/ phone in the morning for an appointment system also has its flaws.

My old GP had this system and the phone was constantly engaged first thing (8:30 opening). If you managed to get through any later than 8:45 no appointments left - call back tomorrow. I remember once calling every day for 4 days with no luck and eventually had to visit the OOH drop in clinic as (what I thought was a bad urine infection) was actually a bad kidney infection. They said if I had left it any longer it might have required a hospital stay.

I did say at time of calling the GP what I suspected was wrong with me but was told it wasn't in the criteria to get an emergency appointment.

I would actually say the American statistics sounds about right - maybe even a little low - I would have thought it would be closer to 30%. I know I would put off a GP visit for something non urgent if I couldn't really afford it.

For example a slight change in a mole - most likely nothing but could be a sign of skin cancer. Or a lingering cough. Again could be a sign of something serious or require antibiotics. I think I would perhaps hope it clears up on its own eventually and leave it longer than I should if I was facing a bill that I couldn't afford.

I suspect a lot of people in the US do similar things - It will probably be nothing or clear up on its own so why waste money I can't really afford going to the DR?

Makes me really appreciate our NHS (flaws and all).