To think it is terrible that Americans with health insurance have such high deductibles

[crunchymint]

I have been reading this article about American healthcare.

www.motherjones.com/politics/2018/01/go-fund-yourself-health-care-popularity-contest/

It says -

"With health care costs and high-deductible plans on the rise for more than a decade, medical expenses are the largest single cause of bankruptcies nationwide. Despite Obamacare’s efforts to rein in costs, the average deductible on a typical plan under the Affordable Care Act is $2,550—nearly as much as the entire monthly take-home pay of the average American worker. President Donald Trump’s efforts to destabilize Obamacare have already raised premiums, and experts predict the cost of a deductible under some versions of Republican health care legislation would rise to an average of at least $4,100."

Basically when someone has health insurance, they still have to pay a certain amount out of their own pocket. Typically they have to pay a certain amount to visit a Dr and for any treatment - with insurance covering the rest. So even someone with insurance who has a chronic or serious illness, still has to pay a substantial amount of money out on top of their insurance premiums.

Germany has a pretty good system unless you are self employed. If you are self employed then health insurance is very expensive and it isn't charged on a sliding scale of income so you'd pay the same if you were earning 10k pa or 40k pa. Tbf all taxes and insurances here are way higher if you are self employed. There's no perfect system IMO.

Also, I've found that here, if you have a broken leg or something they are brilliant. It's still hard to see specialists for particular chronic illnesses.

The costs for identical surgery in the US with no overnight stay was in the region of $100,000. I was horrified (as were they when they heard my price!)

That would be the hospital's list price for the surgery. Insurance companies negotiate much lower prices.

en.wikipedia.org/wiki/Chargemaster

When you look at that life expectancy chart on Worldometer, it is pretty shocking that the US scores lower than eg Puerto Rico (where more than 40% of the population lives below the poverty line).

We do pay a high price, but we also have a faster response. My 18 year-old son went to the doctor after three bad stomach aches/cramps/nausea in two week period. Called doctor on day 1, got appointment on day 2. Doctor recommended sonogram and scheduled at hospital on day 5. Sonogram done and results back to doctor by day 8. Surgery recommended so off to specialist on day 9, gallbladder out on day 12. Done as an outpatient and home in evening.
Less than two weeks from first visit to surgery. Cost $28, 650 total.
Cost after insurance paid $2,865 with 12 month payment plan of $225/mo.
NHS is free, but is it that fast?

@oneglassandpuzzled

I have a friend whose child is studying to become a doctor in the UK and I am shocked at how much easier it is in every way to become a physician in your country than ours. It takes fewer years, and the residencies are much less grueling. In the US, it is incredibly competitive and serious. I was really not impressed with what I saw. Doctors from other countries have to retrain to become doctors here.

Gosh, in the UK any old person can become a doctor. Just roll up and they'll hand you a scalpel.

Wow what an exaggeration & watering down of the training that UK dr's undergo. I think you'll find the qualified dr's will explain how competitive it is to get a place to study & that any old person definitely CANNOT roll up and become a Dr.

@CraftyGin Who's gloating? I'm certainly not with a $6K deductible to pay every year, plus the monthly insurance premiums!

What I'm saying is that you need serious money to access good healthcare and if DH and I lost our jobs, we'd be in immediate trouble.

I'd much rather be under the NHS as I was in the UK, despite the problems it currently faces. It's horrific that good healthcare is tied to wealth in the US.

@GeorgiaGirl52

We do pay a high price, but we also have a faster response. My 18 year-old son went to the doctor after three bad stomach aches/cramps/nausea in two week period. Called doctor on day 1, got appointment on day 2. Doctor recommended sonogram and scheduled at hospital on day 5. Sonogram done and results back to doctor by day 8. Surgery recommended so off to specialist on day 9, gallbladder out on day 12. Done as an outpatient and home in evening. Less than two weeks from first visit to surgery. Cost $28, 650 total. Cost after insurance paid $2,865 with 12 month payment plan of $225/mo. NHS is free, but is it that fast?

If it was life threatening, it might be faster. The NHS reacts fast and well to anything life threatening. The slower areas tend to be things that aren't going to matter if they are delayed a bit.

For comparison, my relative had a (single) very bad long-lasting headache when she was 11. Within hours she had a CAT scan showing a bleed on the brain. She was immediately admitted to hospital and they operated as soon as it was safe to do so (think a day or two later as soon as the bleed was stable - they had treated her to stop the bleed). She was in hospital for about three to four weeks, received intensive care and made a full recovery.

Cost £0.

I think you missed the sarcasm @NurseButtercup. My daughter is a UK medical student. She has exemplary academics and works extremely hard.

And see my later post 🙂

@GeorgiaGirl52

We do pay a high price, but we also have a faster response. My 18 year-old son went to the doctor after three bad stomach aches/cramps/nausea in two week period. Called doctor on day 1, got appointment on day 2. Doctor recommended sonogram and scheduled at hospital on day 5. Sonogram done and results back to doctor by day 8. Surgery recommended so off to specialist on day 9, gallbladder out on day 12. Done as an outpatient and home in evening. Less than two weeks from first visit to surgery. Cost $28, 650 total. Cost after insurance paid $2,865 with 12 month payment plan of $225/mo. NHS is free, but is it that fast?

Yes, the NHS can be that fast for emergency & life threatening cases.

If someone presents to A&E with severe stomach ache/ cramps & nausea, priority is to manage the pain, & investigate source of the pain. Typically they are sent for ultrasound, x-ray & possibly an MRI. Depending upon the results that person could have surgery within 24-48hrs of having the scans/initially attending A&E.

@oneglassandpuzzled

I think you missed the sarcasm *@NurseButtercup*. My daughter is a UK medical student. She has exemplary academics and works extremely hard.

I'm sorry, I definitely missed your sarcasm....

I'm fed up of people slagging off the NHS calling it a 2nd rate service but, continuing to access the service and abuse the admin & health care professionals.

I don't understand why this thread was restarted comparing NHS to USA where you have to pay upfront. And you can choose your consultant or which hospital you go to under the nhs patient choice framework. The model of care in USA is completely different to the UK.

However, the model of care in the NHS is undergoing a massive change. It was proposed in the NHS long term plan www.longtermplan.nhs.uk/online-version/overview-and-summary/
. Initially there was lots of resistance, but stakeholder buy-in & acceptance was accelerated during the pandemic. The Health and Care Bill 2021 that is currently being debated in parliament will formalise the changes.

I wish more people would read & understand how the NHS is changing. Here is a relevant extract:

"...The longstanding aim has been to prevent as much illness as possible. Then illness which cannot be prevented should where possible be treated in community and primary care. If care is required at hospital, its goal is treatment without having to stay in as an inpatient wherever possible. And, when people no longer need to be in a hospital bed, they should then receive good health and social care support to go home."

Hospital is for emergency care, planned treatment (& diagnostics) - as soon as you are stable/medically fit go home to recover. The ongoing care and majority of care & support will be in primary care & the community. NOT in hospital.

There is still an expectation to come into hospital and stay for months. Those days are long gone.

sorry I've gone off on a rant & long tangent....I'll be quiet now I've got that off my chest.

American here as well, living in the UK. I have a kid with a rare, degenerative eye condition. We were able to get vision saving surgery with the NHS. It did in fairness take a few weeks to organise as it had only recently been approved by NICE. In that time I was desperately researching the same, groundbreaking, treatment in the US. It was available in 2 hospitals in America. It wasnt yet approved on most insurance plans, the actual surgery cost hundreds of thousands before you factored in the cost of the hospital stay etc.

If we had still lived in the US my son would be blind by now.

One glass and puzzledU.S. doctors study for eight years, not five. They study longer if they want to become specialists in a field. Then they have their residencies. UK residencies are longer, but far less intense. The US does not have one single national test such as the A-levels to measure proficiency, and different states have different standards. But it is home to most of the world's top universities, so clearly many students enter university with a decent education. I am not saying that UK doctors aren't gooda lot of doctoring is about intuition and humanity--but there is a big difference in training.

@GalesThisMorning. Your story demonstrates how amazing the NHS can be, despite its problems. Of course, I didn't fully appreciate it until I left the UK. I just that hope the US can work out a better system one day and stop making healthcare such a partisan issue, it makes me so angry.

Well, in the UK I had to pay for the NHS through my national insurance (which was over 5k a year) AND private health insurance (at a cost of about 1.5k a year) because the NHS was fucking useless. I lived in the UK for 14 years and not once did I ever manage to get the help I needed on the NHS. I now have a severely disabled relative in the UK - we're paying thousands for carers because the NHS keep fucking up and would let her literally starve because no else is around on a daily basis to pick up the pieces.

I now live in a country with no free health care. Everyone is obligated to have private insurance. And you know what? I can see a GP tomorrow morning if I wanted and a specialist within hours as well. If you're employed, your employer will pay at least part of your insurance. If you're extremely poor, the state will still pick up the pieces. Yes, I have an excess and I have to co-pay. It's peanuts in comparison to how great the quality of the care really is.

The NHS is not fit for purpose. We all need to get used to paying more for healthcare. That's the price you pay for the fact that most of us now live well into our 80s.

Every system has its good side and bad side. I do wish our system was more like U.K.'s system, except for the fact that your system is going bankrupt. So not completely like your system. The fact is, healthcare is never free. Somebody has to pay for it. And there are different costs and benefits in any system.

@PrincessNutella

One glass and puzzledU.S. doctors study for eight years, not five. They study longer if they want to become specialists in a field. Then they have their residencies. UK residencies are longer, but far less intense. The US does not have one single national test such as the A-levels to measure proficiency, and different states have different standards. But it is home to most of the world's top universities, so clearly many students enter university with a decent education. I am not saying that UK doctors aren't gooda lot of doctoring is about intuition and humanity--but there is a big difference in training.

The first two years of Doctors career are still considered student years before they start their specialty training. All Drs are considered to be “junior” until they become Consultants.

A UK nurse does not need to retrain, they just need to pass the nclex exam.

Americans pay a lot, but then they don’t have to suffer in agony and get the treatment

If you have no or inadequate insurance you do!

The story of 78-year-old Roger Curry is a sad one, but it is an extreme case of an all-too common phenomenon in the US: “granny dumping”. It's estimated that about 100,000 elderly Americans are abandoned every year, by relatives who are unable or unwilling to help look after them or pay for their care.2 May 2019
inews.co.uk › news › health

I am in a fb group for parents of asthmatic children and it’s scary the amount of people who post about the cost of their children’s inhalers or not being able to have the one the Doctor prescribed because the insurance company won’t pay for it.

The NHS is far from perfect but give me that over the American system any day!

@Cameleongirl totally agree. The NHS is actually amazing. It's underfunded and we need to pay more into it, but it is amazing.

To the poster who said Americans don't need to suffer in agony - they most certainly do. My poor sister had an infected horrible abcess in a very hard to reach location. She had no insurance, she couldn't afford it. She got treated at a public hospital as an emergency walk in but they wouldnt dress the wound daily or deal with the resulting infected mess, or the underlying cause. She was in agony and couldn't get help because she didn't have enough money. She was a waitress serving ridiculously prices lattes but couldn't afford basic medical care.

Americans who claim the American health care system works, are lying. What they mean is it works for them, and they have probably had access to some of the best medical care the world can provide. Some people in America can access quick, reliable, world class health care at a price that they can afford. Plenty can't. As a system it is unjust, broken, and ultimately leads to poorer outcomes for all, not just the under or uninsured.

It does make you think how much of the NHS is wasted on people who abuse the service. Those who could help themselves choose not too, for example if you get drunk and fall and break a bone, how much you’d have to pay verses ‘free’?

PP stated the NHS is free, I have news for you, it isn’t, we all pay our taxes to contribute, even those with private health care still pay into the system, so effectively pay twice.

I know the cost when I had a C-section was around £30,000 to the NHS, I then had twins, I have no idea what the cost was for them in a UK hospital.

If people ha for pay they would think twice about abusing the system!

Well, no matter what system we're in, we still get screwed over by the gender idealogues, whether it's the medical students in the US who aren't being taught that there's a difference between females and males or the poor women on UK hospital wards who have to put up with transgender sexual offenders. :(

The system there is broken. Even our family members with cast iron medical through military service and government jobs pay more in deductibles and things that aren't covered than I have ever paid for just private medical in the UK. And they're STILL suspicious of the NHS! They can understand why it's so 'cheap' here when the reality is their medical stuff is massively overcharged.
My 26 year old cousin is a newly qualified ER doc, being paid $250k +, his insurance is covered and the hospital is paying off his student loan.
The family are SO proud of him, as he's going to be a millionaire soon but THEY are the ones paying for these nonsensical salaries and the system.
It's rotten to the core.

@GeorgiaGirl52. Yes, it IS that fast. The NHS is exemplary in urgent/emergency care and free to anyone who needs it.
'Cost $28, 650 total. ' for gallbladder surgery?? Can you not see how insane that is??

DD 5 was wheezing ( has viral induced wheezes). Bit worrying but not an emergency. It was a Sunday so I called the NHS non-emergency number, they asked a few questions and said they'd send a paramedic over. Within 20 minutes a paramedic in a jeep arrived. Assessed her and decided her oxygen was a bit low so took us to the children's hospital ER. She went downhill there and was immediately admitted to a room in the paedatric ICU, she was having a massive asthma attack.
She was there for 3 days with a dedicated nurse, doctor and asthma specialist in a private room. we slept beside her on a parents bed.
She had everything she needed and more, staff, medication, treatment, specialist equipment.
At no point did we have to worry about cost, or make decisions based in whether or not we could afford the treatment or if insurance would cover that cost.It was a the NHS.

3 years later she had an asthma attack in the USA when we went to see grandparents. The cost of an overnight stay in the kids hospital to monitor her, give her oxygen cost $10, 700. She had no other treatment.

Luckily our travel insurance covered it but when we were in the ER with her she was held for HOURS in triage until we could show that insurance would pay for the hospital room. Only then was she allocated a bed. The US hospital was no different from the UK - same qualified staff, same teddy bear oxygen masks, same bright colours, same treatment, same medication.

It's insane to think that the richest nation on earth can't or won't provide proper healthcare to it's citizens.