Is US healthcare really this bad?

[PhilJ]

Hi all, I know most of you are US based so can answer this question. In the UK we are hearing a lot of horror stories about the US healthcare system, things like the quote below which was posted on social media:

“It’s awful, Mark. We get along fine as we’re in decent health with no chronic conditions, but comfortable as we are we both know it’s just luck. Unless you’re extremely wealthy you’re only one bad accident or illness from bankruptcy here. And Mike used to work pharmacy in Orange County, he regularly saw millionaires go bankrupt and had to turn people away who couldn’t afford their prescriptions for desperately needed life saving drugs (which again, can cost hundreds/thousands per month depending on the drug). He found it so depressing that he quit that career path. Anyone who tries to paint you a rosy picture of healthcare in America is either ignorant of the truth or lying.”

Is it really that bad? Do people really go bankrupt or die because they can’t afford their prescriptions?

 

[DisorientingSneeze]

People’s answers will vary widely based on the quality of the insurance policies available through their employers.

It has been very difficult. Things are extremely expensive, but worst of all seems the total lack of transparency about how much something is going to cost. Different people are charged differently and you have no way of knowing in a lot of cases until after you’ve been treated.

 

[0Scarlett_nidiyilii]

Dangerous short staffing in hospitals and nursing homes.

 

[Tis_Bearself]

Is it really that bad? Do people really go bankrupt or die because they can’t afford their prescriptions?

In most cases, no. In some cases, it can be a big problem. A lot depends on what exactly is being prescribed, what health coverage the person has, and what options are available to them, like can they get a generic version or not.

I do have a friend who needs certain stuff for diabetes and while he’s working, insured, and not anywhere near bankruptcy or death, he occasionally has problems affording the items he needs. I’ve noticed there is a little private “market” in diabetes-related supplies where people will sell or trade them on social media or by putting up posters on phone poles.
There have also been a few cases of certain items that suddenly increased astronomically in price due to manufacturer decisions and it created a big issue for people who regularly use those items.

But many people, like my parents and in-laws, have not had problems with their long-term prescriptions and have had almost everything covered by insurance, which was good because none of them were well off.

 

[PhilJ]

Thanks for your replies. I will pray for you. I think people in the UK don’t realise how good we’ve got it with the NHS. I’m diabetic myself so I was issued with a medical exemption certificate which means I never have to pay towards a prescription again. All British citizens can see a GP or receive hospital treatment for no charge. Yes it’s understaffed and underfunded, and there can be waiting times for certain medical procedures but we don’t realise how fortunate we are to have it.

 

[jvickers]

I teach at a University, so the benefits, especially prescription cost are really good. My co-payments are reasonable.

Some others might not have it so well. As Scarlett said, there are short staffing in hospitals. You have people working on critical care unit floors who aren’t really qualified. (My wife has her doctorate in Nursing Practice and works in a hospital, and that’s where I get that information.)

Many doctors are worried more about RVUs (a metric by which patients are billed), so they want high patient turnaround times to increase their daily RVUs. Quality for patient care suffers in that respect.

I’m not sure how our health care system compares to other countries, though, so I don’t know how bad of a state we are in. I’m sure there are better countries and I’m sure there are worse countries. You cannot always trust social media.

I think those people who are going bankrupt might have serious medical concerns and had a little money (maybe not that much) to start with. You can’t really go bankrupt if you’re already poor…

 

[PhilJ]

Thanks jvickers. I am naturally skeptical of social media which is why I am attempting to verify what I’ve heard on here. I’ve heard people claiming that if you need to have a Caesarian section it can cost $60,000 even with insurance. That if you get diagnosed with certain cancers, your insurance company can refuse to pay because the cost of treatment is too expensive. I can scarcely believe these claims as I’m used to all healthcare being free at the point of service (paid for out of taxes of course), so I’m attempting to verify the validity of what people are saying. The potential loss of the NHS is a big issue in the forthcoming UK elections so it’s proponents are spreading a lot of scare stories about the US system. I’m just trying to understand how accurate they are.

 

[jvickers]

PhilJ, personally, I would be concerned about the loss of your NHS. I’m no economist, but I would say that the privatization of anything can easily result in inflated costs, and healthcare is no exception. If you do not have insurance in the U.S. and make too much money to be on Medicaid, you can easily go broke, I think, from healthcare costs from what I understand.

I’ve had the luxury of being employed full-time in some field of education - whether as a classroom teacher or as a professor - for the past 26 years, so I cannot really speak about what people without health insurance have to spend out of pocket. Plus, I rarely get ill. My insurance fully covers my cholesterol medicine, and I spend something like $4 on blood pressure medication per month. However, I take a few other medicines I know I could not afford were it not for my insurance benefits. I am probably more fortunate than I realize.

So, if you have a voice in your political system, exercise it. Personally, I’d be voting for the person or people endorsing the NHS if you want to keep the NHS in place.

That’s just my two cents, though… I don’t know what other things the NHS proponents might be endorsing. You might be facing a conundrum.

 

[DisorientingSneeze]

I’ve heard people claiming that if you need to have a Caesarian section it can cost $60,000 even with insurance.

I’ve had 4. The hospital billed around $16,000 dollars each time. The amount we paid of that 16 ranged anywhere from 3k to 8k depending on the policies we had at the time. That’s just the hospital bill and does not include the separate bills you recieve for your OB, Anesthesiologist, and hospital pediatrician.

The last one was pretty bad because our policy created a brand new deductible for the baby and gave her her own 3k bill in addition to mine. The baby…whose room and board is just to stay in the same room and be cared for and fed by me and my husband. And even if your hospital and doctor are in network you might get a random 4 thousand dollar bill from an out of network medical assistant who just happened to be there that night.

My sister has military insurance. She has paid 0 to 5 dollars for hers.

 

[phil3]

How much is taken out of a paycheck in taxes for the UK health system?

 

[DisorientingSneeze]

The potential loss of the NHS is a big issue in the forthcoming UK elections so it’s proponents are spreading a lot of scare stories about the US system.

On the other hand we get a lot of scare stories about the NHS here in the US. A friend of mine lived in London for a year. During that time her oldest child needed to see a speech therapist and even if willing to pay they couldn’t find anyone who would see him because the national standards had the suggested age as much higher than here. She had a csection while there and had no idea you have to bring all your own supplies, gauze and bandages and such. Then recovery was in a huge room full of other patients who had been seen for a host of other things, not a private or semi private room with other moms of babies.

 

[jvickers]

Then recovery was in a huge room full of other patients who had been seen for a host of other things, not a private or semi private room with other moms of babies.

This would prove problematic.

 

[Tis_Bearself]

I’ve heard people claiming that if you need to have a Caesarian section it can cost $60,000 even with insurance. That if you get diagnosed with certain cancers, your insurance company can refuse to pay because the cost of treatment is too expensive.

The key word is “can”. People tend to post scare stories on social media. It doesn’t mean that it happens to everyone or even that it happens frequently. As someone else said, it depends a great deal on what kind of coverage people have available through their employer. Also, some employers offer a choice of plan and people might choose the plan that has cheaper monthly payments but ends up not covering as much when they get sick. There have also been legal steps taken to try to prevent insurance companies from just deciding they’re not going to cover treating someone’s illness because it’s too expensive.

Up until a few years ago, the big problem was that a lot of people did not have any insurance at all because their employer didn’t offer it, or they didn’t have a steady job. I knew people who would work for a certain employer for X amount of months or years and just be on the verge of qualifying for insurance and then the employer would find some trumped-up reason to fire them so he would not have to give them insurance. It’s very hard to contest such a firing - one guy I knew in that situation had a father who was well-off and actually took the employer, some gas station, to court, and lost.

Things have improved in that area somewhat because the law allows young people to stay on their parents’ insurance longer, and also people can now purchase their own insurance off a website. It’s not perfect, but the idea is to make sure everybody gets some coverage, and from what my friends have said, it does help.

As for the NHS, I used to think it was super great and in some ways it is better than US options, but then I took a course on comparative welfare at Oxford and I expected the professor (British) to trash the US health care system and say the UK had a much better system. Instead he pointed out a lot of flaws in the NHS system (Including long wait times and other things) and talked about things the US system did better. He was some sort of international health care expert. I came away from the course with the impression that there are good and bad things about all health care systems.

 

[jvickers]

I came away from the course with the impression that there are good and bad things about all health care systems.

And this is the truth of the matter. We gain something in one system only to lose it in another. No system is perfect. Excellent points in your post.

 

[PhilJ]

How much is taken out of a paycheck in taxes for the UK health system?

I don’t know what proportion of income tax goes on healthcare or the exact tax bands, but they are something like this: The first £12,000 of earnings are tax free, then earnings over this up to £49,999 are taxed at 20%, anything £50,000 + is taxed at 40%.

So someone earning £60,000 per annum would pay 20% on £37,999 then 40% on £10,000.

Hope that makes sense.

 

[PhilJ]

Thank you for your detailed and informed answer.

 

[PhilJ]

She had a csection while there and had no idea you have to bring all your own supplies, gauze and bandages and such.

I’ve not heard of this I must say. My sister in law had a C-Section and I don’t recall her having to supply her own stuff. You do get put into a public ward though.

 

[DisorientingSneeze]

Her husband had to go to a pharmacy across the street to buy it. I kept wondering how they trust you to have provided sterile materials but I guess it was for aftercare and not for surgery.

 

[whatistrue]

I’ve heard people claiming that if you need to have a Caesarian section it can cost $60,000 even with insurance

I guess it is possible for an emergency section where both mother and baby required heroic measures and multiple specialists to survive, including some time in the ICU/NICU, to cost that much, but I can’t see a regular scheduled (or even a more “normal” unscheduled) section costing that much anywhere in the US except possibly at an exclusive high end boutique medical facility that catered specifically to the extremely wealthy.

 

[phil3]

Here is what my wife and I pay for our health care. $9000 yearly that is taken out of our checks. Then we have a $5000 deductible. After that we pay $0. So we pay a total of $14,000 a year. Some where I read in the UK you pay 12.5% of your income into the healthcare system. My wife and I earn a little over $180,000 a year. We would then pay almost $23000 a year. Why would I be so stupid as to pay 9000 more a year for the same service if not worse service?

You want to fix the health care system here? Remove the patient from the money payments. The hospital can only charge the insurance company and no other. Also, set the rate for any hospital charge the same a medicare/Medicaid rates. Set the cost of prescriptions to the same they pay in Canada.

If you really think the USA needs some form of government health care system, let people volunteer to pay another 12.5% into the medicare system. They get a card and can use it.

I have GREAT health care