To be appalled at people dying in the USA because of the cost of insulin

[WeBuiltThisBuffetOnSausageRoll]

A 27yo man in Virginia, who had type 1 diabetes, died last month because he couldn't afford to pay for the insulin that he needed to keep him alive and healthy.

Up to the age of 25, he was covered on his step-father's medical insurance, but once he turned 26, he was on his own. He was in a low-paying job which didn't come with adequate health insurance, so he saw no alternative but to buy the much less effective (and much less suitable for his needs) cheap variant over-the-counter at Walmart and then ration it to eke it out as much as he could.

I saw a report today suggesting that this is far from the norm. One family has a child whose insulin costs them £1,200 a month. It's their biggest single family outgoing and they sometimes have to sit in the dark or the mother go without food herself to be able to afford it. Of course, as he grows, he will be needing to eat more food and therefore need more insulin. Whatever would the family do if they had another child who developed T1D?

At best, it seems that ordinary people can find themselves very limited in their job/career choices and will often have to take any job based on what insurance cover it comes with, rather than one based on their skills, abilities, qualifications, experience, interests etc. At worst, the poorest, most vulnerable and/or least educated will not be able to get into any job that comes with the cover they or their families need.

It's much, much cheaper in Canada, so Americans who live anywhere near the northern border travel over and stock up there whenever they're able to; but the USA is a huge country, so this will not be a feasible option for the vast majority.

We see and hear all of the heartbreaking reports and appeals from poor countries in Africa, Asia and eastern Europe, but THE USA?!?!

I know our NHS is far from perfect, but we have an immense amount to be grateful for.

How do American MNers manage to deal with this; or indeed, people from anywhere without an NHS or similar public set-up? Are these the full, true facts? Are people in the richest country on Earth really just tossed into the trash so easily and left to die for getting ill?

No, their monthly premium will not go up, but there are extra co-pays for everything you end up needing.

I was specifically asking about insurance premiums tho, which saltinesandcoffeecups did a good job of answering (Thanks!)

It's definitely a good thing that using the insurance doesn't make it go up. I had expected it would.

In terms of co-pays, I guess this is just an amplified version of the fact that glasses-wearers in the UK have to pay for sight checks, glasses, contact lenses etc when those of good vision don't have the same financial burden.

I am still shocked that ome Americans think their system is ok

@housemdwaswrong

Here are the costs if you had my health insurance (in $)

That's without the extras which in the past 6 months include 2 MRI scans ($250 each) , 3x antibiotics ($24 total) 3x consultant appts ($150), 6x blood tests ($75 each). It hasn't been a particularly difficult 6 months, just the ups and downs of a chronic health condition.

Monthly premium for self only = $153.40

If I were you, I’d pay $ 423.90 per month average.

John Oliver did a good show on this. Everything costs so much more because they don’t have buying groups negotiating prices with suppliers, not even on a state level.

I took my under 1yo to an ER as she had a high fever I couldn’t bring down and very sleepy etc... she had the flu. While I was there they said oh she sounds a bit croupy too, we’ll do a neck X-ray. Ok I thought the must have to do it. All part of the upselling. The bill was 3k which insurance said no to paying as they deemed it wasn’t a life threatening emergency and I’d gone to an ER. We fought that and they did end up paying towards it.

When she hit her head falling off a chair and cut it I went to an urgent care and they said oh if she needs a CT you’ll have to go somewhere else. I was a bit more wise
Then and said no, she’d not lost consciousness, not vomiting and was behaving normally. Cleaned scalp and 3 staples later $400

I had a massive DVT a few years back and joined some FB groups to get more info. Lots of Americans on there had the exact treatment I had at an average cost of 150 thousand dollars! Then a lot couldn't afford the blood thinners needed. I've never taken our NHS for granted since and it annoys me when I hear anyone complaining, we are so lucky!

God bless America

In a Facebook group about brexit prepping I saw two posts in one day:

“I received a letter from my GP saying that they won’t prescribe my moisturising cream anymore. Now I’m going to have to pay £11 every 4 weeks for it” with lots of people commenting saying how atrocious it was and that the NHS was going down the pan, and it’s rubbish

Then the same day, a different person posts “I’ve received a letter saying that my hip replacement has been put back again as I’m considered a low priority and due to cost cuts they are down a surgeon etc” cue a load of people piling on saying that the NHS should prioritise operations etc and that it’s going down the pan etc.

If the NHS didn’t have to pay through the nose for your bloody moisturiser and hay fever tablets and paracetamol then perhaps it would go someway to paying for other more important things. Some people are stupid they just can’t see the link. You can’t moan about the nhs not paying for hay fever tablets, then expect them to find money to magically reduce a waiting list!

Some people don’t know how lucky they are with the NHS, and they moan about buying a cream for £11 a month!!
(Yes I know some people are skint, but that’s not the point, if we didn’t have the NHS they’d be fucked)

@FATEdestiny
Ok.
The co pays are important though because some of them count towards your deductible. The deductible is essentially the annual cap on certain out of pocket expenses. (Usually prescription drugs are excluded). Once you hit it, further costs are 100% covered by health insurance.

So say your yearly deductible is $7500(self only), if you end up in hospital and health insurance covers 80% of cost (you pay 20%), once your share exceeds $7500, health insurance starts covering the rest at 100%. If you’ve been having MRIs, tests, specialist visits the copayment all counts towards that $7500 figure.

Each new calendar year, the deductible resets. So if you were in hospital over Christmas/New Years you’re screwed.

Scary stories on here. Yes, we have to pay for GP visits and medication in Ireland but the Drug Payments Scheme means a family only has to pay the first €124 a month for medication, the HSE/government pays the rest...and it can be substantial as previous examples show. And that's regardless of how wealthy you are. And low income/medical card holders pay a lot less.

I’m American. How did I manage? I was lucky to meet my dh (who is British) and got the hell out. Everything you’ve described is spot on. That is in fact exactly how it is.

I once (when still living in the US) had an abnormal smear. I lost my health insurance shortly after (it was through my university and I’d graduated). My new job didn’t offer health insurance, which is typical of graduate level, part time, fixed term contracts. I had to wait 2 years wondering if I might have cervical cancer until I found a job with health insurance and could afford the colposcopy and biopsy. Even with insurance it still cost me $900.

My dh and I moved to the UK to get married and have our dc. If we had stayed there, health insurance for the two of us (pre dc) would have cost $1200 a month. You still have to pay for your dr visits, prescriptions and any tests and procedures on top of that.

I have a friend from school who recently developed a pulmonary embolism and had surgery and then got sepsis. She’s spent about a month in hospital really ill and had a total of 9 operations. I suspect her final bill will be close to $1 million or more. She’ll likely lose her house.

@JuniperBeer tbf my hayfever tablets are prescription only.
I totally agree with your other points though.

@doctorallcome

Let’s be careful about painting a false picture here...

Yes there are some very basic and low premium plans out there with high deductibles , but they would be inappropriate for someone to choose if they expected a to use a lot of health care, these plans are usually chosen by young, otherwise healthy people who are insuring against catastrophic accident and injury. In other words a 20 something who goes to the doctor maybe once a year, but wants to protect themselves in case of breaking their leg on a hiking trip.

The higher premium plans offer lower copays and lower annual deductibles, and these plans are better options for families and individuals with complex medical needs.

My deductible is $1500, my husband’s policy is $1000. We can choose which coverage we want to sign up for each year.

I could choose to have a higher deductible and a lower premium, but I choose not to, because I prefer to have the lower deductible and the better coverage. On the flip side we chose a very high deductible low premium plan for my husband at one time as a temporary measure before we were married and he was in between jobs due to a relocation. It was a calculated decision because he was healthy and we didn’t anticipate any major health issues, but wanted him to be covered for major illness or injury. (It was actually a very comprehensive policy and was about $150 a month that covered hospitalization, emergency treatment, and primary and specialist doctor visits with low copays.

Ironically, post ACA we would not be able to find as good of a policy because of the policy requirements like maternity coverage (which is obviously super helpful for a 30 yo man)

I work for an extremely large company so the risk is distributed over many employees. When my mother was alive, she worked for a company with 5 employees. When she got cancer, the next year, the insurance premiums went sky-high. The employer accepted some of it as lost profit and passed the rest on to the employees. My mom was fired before it came time to evaluate insurance premiums for the following year. At that point she could not get health insurance anywhere. Thankfully her state provided a high cost insurance plan for high risk patients so she purchased that until she was old enough to qualify for Medicare.

Before Obamacare, my US cousin's DH lost his job suddenly

(he had been Employee of the Year couple of years before, but came into work one day to find the entire division was being sacked that very day without compensation, to cut costs)

His health insurance for the family stopped that day too.
My cousin has chronic health conditions which require frequent treatment, including some hospital stays

In the 6 months or so until he was able to find another job with health insurance, that middle class family lost their entire life savings accumulated up to their late 40s, had to take out another mortgage on their house.
If he hadn't started that new job then, it would have been the DC college funds next.

It's many years later now, but their finances have still not recovered to where they were.

And that was a comfortably off mc family, with main breadwinner a STEM grad.

We are so lucky in the UK.
My friend had a kidney transplant a few years ago. (UK)
To pay for his anti rejection meds he's bought a NHS prepayment certicate which costs £104 a year or you can pay it in 10 monthly direct debits at £10.04.

@Purpleartichoke just out of curiosity how much do you have to pay for your husband's anti rejection medication?
You don't have to answer.

And btw my friend isn't on a low wage. You have to earn under £17K in the UK & be in receipt of free prescriptions or on certain medications for certain conditions:

You can apply for a medical exemption certificate if you have one of the following medical conditions:

a permanent fistula (for example, caecostomy, colostomy, laryngostomy or ileostomy) which needs continuous surgical dressing or an appliance
a form of hypoadrenalism (for example, Addison’s Disease) for which specific substitution therapy is essential
diabetes insipidus and other forms of hypopituitarism
diabetes mellitus, except where treatment is by diet alone
hypoparathyroidism
myasthenia gravis
myxoedema (that is, hypothyroidism which needs thyroid hormone replacement)
epilepsy which needs continuous anticonvulsive therapy
a continuing physical disability which means you cannot go out without the help of another person
cancer and are undergoing treatment for either:
cancer
the effects of cancer
the effects of cancer treatment
These are the only conditions that entitle you to a medical exemption certificate. If you’re not sure about the name of your condition, speak to your doctor.

@saltinesandcoffeecups
Yes, you are right about the trade offs between high deductible plans versus lower deductible plans. I was just giving one example and did try and explain that there are many types of plans to choose from. I’m glad to added to the info because health insurance is very complex. I wasn’t sure if our U.K. friends had any idea about the variety of health insurance plans in existence. (And we haven’t even gotten into HSAs or tax deductions!)

It is important to note though that many workers cannot afford anything but a high deductible plan. They only have the $150/mo to put towards health insurance not the $1200/mo they maybe should pay even though they have complex health needs. Other workers are only offered high deductible plans by their employer because they are cheaper for the employer as a business cost.

It’s depressing, so many of us are one medical disaster away from poverty. The stories of people suffering just due to bad luck are the main reason why I wish we could get universal healthcare in the US.
It system only works if you are so rich that money is no object or incredibly lucky.
Don’t let Trump destroy your NHS U.K.

Hopefully & fingers crossed most of the NHS will be like Greenland - not for sale.

That’s the USA for you! All that land of the free stuff means fuck all when their government treats its citizens like rubbish, it is one of the most unbalanced countries in the world, run by a greedy , nasty government

Touch wood too.

We tend to compare ourselves to the US.

Different continent, different outlook.

Inspite of shared language, the UK is far more European in outlook (oh, the irony right now).

US has a view that govt intervention as socialist/communist (Europe and other countries view the terms socialist/communist as different things).

I’ve never understood the American dream. I view healthcare as one of the most important factors in a country’s development and output.

My DH is the cheapest in our family. About 100 a month on meds and 100 a month on lab work. He only has to see his specialist 2 times a year at 45 a visit.

Dd’s Asthma and my cancer survivor/autoimmune condition that caused the cancer in the first place are much more expensive to manage.

@DoctorAllcome

This is really why I’m posting. It’s like anything else you only typically hear the horror stories and very few stories of... I got sick/had an accident insurance paid. Just like Americans only hear the I waited 3 years for a hip replacement or they parked granny in the the hospital hall for 2 days stories of the NHS

I’ll never say that the American system is the best or without flaws, and as you’ve said it’s not great for a lot of people. But it does work and is liked by far more than it doesn’t or quite frankly it would have been replaced long ago.

I also think a lot things are blamed on healthcare cost that is either an exaggeration of the truth or just plain misinformed. Like the previous poster’s story of their cousin. Seems to me that the 6 months of reduced or no income would have far greater effect on their finances than their doctor’s bills. (I know I would deplete my savings if I didn’t have income for 6 months, as I’m sure most people). And the guy could have chosen to pay for continuing coverage at the full (and more expensive) rate, which may have been cheaper in the long run with a chronically ill family member.

Thanks Purple

And sorry to hear about your health too.

@JaimeBronde, fyi in Wales all prescriptions are free of charge and so is all hospital parking. We don't pay a thing at the point of delivery.

The US system seems utterly barbaric, particularly when seen side by side with US religiosity. How can people who claim to be religious and live by the Bible and love their neighbours etc allow their fellow citizens to suffer so appallingly?

The burning question is: Why are US citizens so afraid of social health care?

They had the fear of Reds under the bed hammered into them in the 50s and have never really got over it.