• systemglitch@lemmy.world
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    1 year ago

    Man do I feel bad for you Americans when I see this shit.

    So many Americans justify it as well… I can mention it on reddit and I’ll get viciously attacked defending that shit healthcare system.

    It’s hands down, the worst in western civilization.

  • whitepawn@reddthat.com
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    1 year ago

    Had a relative in a car accident. They climbed out the vehicle, walked to the ambulance, and took their suggestion to get looked over at the ED.

    Nothing needed but an X-ray then a CT to make sure the spine was fine. Doc saw them for all of 10min. Most of the time was spent doing nothing, alone, waiting for a ride in a mostly empty rural ED.

    Bill comes. $15k.

    I did charges in the 2000s as part of my ED tech duties. Back then the stroke/heart attack go to ICU or get prepped for life flight charge, the most acute of 5 tiers of service was ~$2.5k. The lowest, say getting a ring cut off, was less than $200.

    I know costs have risen in the last 20 yrs but how the fuck do you go from what is at a very generous at most a tier 3 for ~$1k to $15k. AND that CT scan, 90% of what happened there, was billed separate.

    AFTER Medicare, the ED bill is $1.8k. Imaging is $800, and the ambulance ride, that didn’t even put in an IV, is $1.9k.

    So an elderly person on a fixed social security income is getting billed almost $5k for a ride, a glorified wait for my ride room, and a CT.

    One non displaced broken rib btw, that’s it.

    $15k. Is ring removal in ED now $15k a pop? I just don’t know. Or is a remote, empty ED soaking anyone who goes because they don’t have lines out the door and around the block like city EDs do?

    Either way, that’s several months of social security to pay for it while not buying groceries or driving.

  • FReddit@lemmy.world
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    1 year ago

    I have cancer and diabetes, and aside from the premiums insurance costs me a minimum of $4,250 every fucking year, plus stuff they refuse to cover.

    And I found out the hard way that you’re better off dead than getting air medivacced, a delightful experience I’ve had twice.

    The first time I told the ER head to just let me die. The cost of a hundred mile flight was over $80,000.

    The second time, this February was over $143,000, but by then I had gotten air transport insurance. Which of course initially denied the claim.

    In the U.S. you are just meat that is harvested for money.

    • Furbag@lemmy.world
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      1 year ago

      by then I had gotten air transport insurance. Which of course initially denied the claim.

      Leave it to the ridiculous American insurance system to invent an insurance package for something so obscure and specialized that almost nobody would ever need it, collect your premiums, and have them still refuse to pay out a claim when someone does try to actually use it.

      • Gestrid@lemmy.ca
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        1 year ago

        “Well, he probably didn’t need to be airlifted because of… what was it again?”

        “His car was hit by a car and went down the side of a mountain into an area that they couldn’t get to by road.”

        “Right, he probably didn’t need to be airlifted because of that. He just chose to get airlifted.”

        — air transport insurance, probably

    • protput@lemmy.world
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      1 year ago

      For that kind of money I would start a new life in a normal country and have decent healthcare.

      • x4740N@lemmy.world
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        1 year ago

        Back when I was on reddit I had seen few people who had left america for other countries mainly in the Europe region because america is a shithole

        • ℛ𝒶𝓋ℯ𝓃@pawb.social
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          1 year ago

          I’m seriously considering it when I finish university. I love the idea of freedom etc, but the reality of such a system is hell on earth.

  • ChamrsDeluxe@lemmy.world
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    1 year ago

    Good insurance won’t, but the problem is, most companies don’t provide “good” insurance. In most cases you are better off without it.

    One company I worked for had the worst insurance I’ve ever seen.

    I paid like $180 per paycheck JUST FOR ME! and I had no co-pay woooooHhhOoooo! Well anytime I’d go to the doctor i’d be fucked, with one visit really sticking out in particular: I went in knowing I had strep throat and just needed a doctors note. Doc took one look (didn’t do any tests or anything because it was really obvious) said "yep, you’ve got strep. " gave me my note, and I was oit of there in like 5 minutes… A week later? A $200 bill…. What…. The…. FUUUUUUUUUUUUUUCK!? Yeah bad insurance will ruin you.

    • bustrpoindextr@lemmy.world
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      1 year ago

      If you had no co pay you wouldn’t have had a $200 bill ( unless you went out of network and then fuck you for wanting to have a choice)

      • abraxas@sh.itjust.works
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        1 year ago

        Found the European (or just someone young who doesn’t know much about typical insurance shell-gaming).

        You have no copay, but most insurance plans include any non-preventative visit in the deductable. That means you are responsible for 100% of the bill until your $1500/yr deductible (in as low deductible-plan, a LOT higher in most plans) is reached. To look like they’re actually doing something, they treat the negotiated rate from the doctor’s MSRP as a “discount” (the doctor says $300, the insurance negotiates you to $200). The really ugly irony of that, is that if you were uninsured, many offices would have given you an NP for $70, and some have an “uninsured rate” of like $150.

          • abraxas@sh.itjust.works
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            1 year ago

            And the irony is that anything not covered (like your responsibility on a coinsure) does not apply to the deductable. Nor do copays.

            Literally the only thing left is “Maximum Out of Pocket”, but they even have ways around that.

            • ChamrsDeluxe@lemmy.world
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              1 year ago

              With the insurance I have now through my company, I already met tge deductible and haven’t been charged extra for anything. It’s really nice!

          • abraxas@sh.itjust.works
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            1 year ago

            No copay means no copay, what you’re describing is not no copay.

            Yes, “no copay means no copay”. Most insurance plans have BOTH a copay and a deductable on a large number of higher-end services like inpatient surgery and the diagnostics like CT. And I have had, and helped family shop for, healthcare plans that have no copay, but still have a deductable. Further, there’s a lot of PPO variants that have no copay or deductable, but have a coinsurance for everything.

            In my adult life, I have never seen a plan where your “typical” out of pocket for anything other than Primary Care or Teledoc was anywhere near zero, even if those plans approach $3000/mo.

            And you’re right. What I was describing was not a copay, but a deductable (please check the words I used, as I called it a deductable :) ). For a patient, money going out feels the same as money going out. Especially in large quantities.

            • bustrpoindextr@lemmy.world
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              1 year ago

              And you’re right. What I was describing was not a copay, but a deductable (please check the words I used, as I called it a deductable :) ).

              Sure but the conversation was about copay ;)

              • abraxas@sh.itjust.works
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                1 year ago

                Sometimes conversations get confused pretty quickly in thread format. I never understood why, but it IS hard to keep context in Lemmy. Let me reopen with what I was replying to:

                If you had no co pay you wouldn’t have had a $200 bill

                That’s what you opened with. The person above you didn’t use the word “copay” at all. They just complained about being charged $200 to get a note. Your reply was the quote above. My reply was “but most insurance plans have a … deductible”.

                The conversation was really about money out of pocket. I think you inadvertently thought it was about copays. It happens :)

    • Wogi@lemmy.world
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      1 year ago

      The only time you’re better off without insurance is if you never use it.

      The insurance company isn’t only paying part of the bill, even if it’s ridiculously expensive and pays laughably little of the bill.

      They’re also negotiating the price down. Without insurance you’re pretty much bare assed to the healthcare industry, who can and will charge you whatever they want. They’ll charge you for every individual wet wipe at hilariously inflated prices. They’ll charge you for the presence of a tray in your room to set a drink down on. When a nurse pops her head in for 30 seconds suddenly you’re billed for an hour of her time. And you’re stuck with that bill, no matter what, without insurance.

      The insurance company will require them to verify the hours billed, they’ll reject charges for shit they shouldn’t be billing for, and negotiate down the price of stuff they can bill for.

      The difference even for simple visits can but several thousand dollars. For more serious visits the sky is the limit.

      • dragonflyteaparty@lemmy.world
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        1 year ago

        This isn’t necessarily true. I’ve seen and heard of multiple doctors who had a lower price for those without insurance.

        • TurtleJoe@lemmy.world
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          1 year ago

          That could be true for a GP or something like that, but not for a serious issue where you need tests for a diagnosis, a hospitalization, or ER visit.

          • abraxas@sh.itjust.works
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            1 year ago

            Nah, a lot of hospitals do that.

            Hospital margins are razor thin because of the constant battling with insurance companies (and the high payscale for doctors and surgeons, high cost of equipment, etc, obviously). They will often negotiate reasonable rates for uninsured people.

            I was recently in the ER. Insured. I received a $2000 bill, “negotiated down” from $2,500. $1,800 of it was for 5 minutes with a doctor.

            I had a friend recently (regularly… she’s a hypochondriac) in the ER. Uninsured. $500. Same ER. Same complaints. Same tests. Same treatment.

            • braxy29@lemmy.world
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              1 year ago

              so is it better not to have insurance?

              i just got a job with insurance for the first time in my life, now covering myself and two kids - pay is just enough to take them off state insurance. the high deductable plan still REALLY hurts to pay the premiums. but not having had insurance in my adult life, i can’t tell if it’s worth it or not - i have never gone to doctors i couldn’t pay for out of pocket at the time of service (so almost never).

              • abraxas@sh.itjust.works
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                1 year ago

                I didn’t say that. Ignoring tax benefits, it’s better not to have insurance “9 years out of 10”. The tax benefits (employer insurance is paid is pre-tax) changes the equation a lot.

                Admittedly, it also matters about what your doctors charge, and what your medical conditions are.

                Heaven forbid, if you have a major critical event that puts you in the hospital for a month or two (happened to a friend this year), then insurance is the only way to maybe not be bankrupt, assuming they even treat you at all (past keeping you from coding) knowing you won’t pay.

      • abraxas@sh.itjust.works
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        1 year ago

        The only time you’re better off without insurance is if you never use it.

        This is absolutely not true. I have a high-risk, high-expense family member on my plan. Most years, we reach her deductible at the very end of the year and we’re ultimately paying all that money for “a rate plan”. Of the years we crossed the deductible and the insurance covered much of anything, it was still less than the $12,000 we shelled out that year in all but one case. In that one case, we saved about $5000, still a bit less than the overall money they’ve made off us. Literal cancer wasn’t enough to make health insurance a good investment.

        We still need it for three reasons. First, “what if you end up needing $100,000 or more in medical procedures”. Second “the doctor won’t be able to see you for 6 months unless you’re insured” (though this sometimes goes the other way). And finally, it’s a lot less of a financial drain through my employer as a pre-tax expense. Napkin math makes it $3-4000/yr saved in taxes.

        They’re also negotiating the price down. Without insurance you’re pretty much bare assed to the healthcare industry, who can and will charge you whatever they want

        This might surprise you, but many offices have “uninsured rates” because hitting someone with a $2000 bill for 5 minutes of time is a great way to have someone in collections for years and not actually see the money. They often do that alongside inferior service like an NP instead of a Doctor, but I’ve never found an office or hospital group who didn’t do something for uninsured folks. And you’re missing that they charge these things for insured folks much of the time to leverage their negotiated rates with hospitals.

        The insurance company will require them to verify the hours billed, they’ll reject charges for shit they shouldn’t be billing for, and negotiate down the price of stuff they can bill for.

        Oh, you’re not talking about usual hospital bullshit? You’re talking about fraud? Yeah. You call them on it once and that disappears from an entire bill. Most hospitals around here don’t do it anymore because there’s too much attention on them. TBH, the same hospitals you’re talking about are are often getting away with coding fraud, which is still reaching the patient’s wallet.

        The difference even for simple visits can but several thousand dollars. For more serious visits the sky is the limit.

        The “sky is the limit” is basically the only time insurance is cheaper than not being insured. And why the government really needs to become a singlepayer for healthcare costs.

    • Flying Squid@lemmy.world
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      1 year ago

      I went to see a gastrointestinal specialist two weeks ago and also had a five minute visit where he didn’t really listen to me about my issues and told me to call back in two weeks. I did, gave all my symptoms in detail to the nurse. A different nurse took two days to reply and the doctor still didn’t listen to my problem. Or I guess didn’t read it. And he’s the only gastrointestinal doctor in town. All the others within a 90 minute drive are either not taking new patients or won’t see me for 3 months, at which point, it will be too late. I haven’t eaten in 22 days. I’m basically fucked until I end up in a hospital.

      Please no medical advice. Thank you.

      • ChamrsDeluxe@lemmy.world
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        1 year ago

        Nope, when I ditched my insurance from that company and had to go to my regular doctor, it was $65 up front and I didn’t see another bill. It was the most bullshit thing I’ve experienced.

  • BlinkerFluid@lemmy.one
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    1 year ago

    I’ll never be able to finance a car over $15k and I’ll never be able to afford a home.

    What difference does it make? Might as well be free.

  • greavous@lemmy.world
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    1 year ago

    Have medical bills? Why not make and sell meth? The fact that breaking bad wasn’t satirical was a crime.

  • AProfessional@lemmy.world
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    1 year ago

    Obviously it’s a joke, but get insurance. Thanks to the affordable care act they have a maximum out of pocket cost (for what is covered) and will save you from ruin.

  • I Cast Fist@programming.dev
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    1 year ago

    No wonder the Brazilian universal healthcare system (SUS) is constantly bombarded and attacked from all sides, just think of all the profit$ being “lost”. It’s far from ideal and full of horror stories, but when you do manage to get medical attention, chances are good you’ll be well treated and cared for.

    • Powerpoint@lemmy.ca
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      1 year ago

      It’s Conservatives everywhere attacking those countries with public healthcare. Healthcare should be universal and freely covered without the fear of bankruptcy. American insurance companies are a scam and you can guarantee there’s some foreign meddling happening in your country by Americans.

    • computerscientistI@lemm.ee
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      1 year ago

      I gave my Brazilian friend quite a bit of money for a CT at a private clinic. The public clinic (hospital?) supposedly was totally overbooked for this kind of examination so they had some kind of lottery going on for appointments.

      Could of course also be that my friend scammed me, not sure.

      • I Cast Fist@programming.dev
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        1 year ago

        Unfortunately, it’s not uncommon for that kind of thing to happen. CT scanners aren’t common because they’re expensive as fuck, as is its maintenance. Not every public hospital has it and if it’s underfunded, that’s usually one of the first equipments to stop working, because that maintenance money will pay for higher priority materials.

        • computerscientistI@lemm.ee
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          1 year ago

          So chances are she actually didn’t lie and I invested into her health? If she doesn’t lie she might actually like me. And maybe even not only because I’m bankrolling that medical bill 😀

          • Scew@lemmy.world
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            1 year ago

            Keep a healthy amount of skepticism. Appearances are suggestive not informative.

            • Ew0@lemmy.sdf.org
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              1 year ago

              As someone who is too trusting of people, I’ve found this out the hard way.

  • blackn1ght
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    1 year ago

    The NHS has its problems but I’m so fucking grateful we don’t have to put up with this bullshit.

  • Rockyrikoko@lemm.ee
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    1 year ago

    I live in Germany and I just had hernia surgery. The entire procedure including appointments leading up to surgery a couple weeks ahead of time and post-op appointments over a couple weeks after came up to 905€, TOTAL… my copay was 45€. And I have the expensive private insurance that gives me access to single person hospital rooms and my procedure is done by the hospital chief surgeon

    • Jeredin@lemm.ee
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      1 year ago

      Oh, look at fancy angeben over here, gloating about his functional healthcare system that doesn’t bring his country to it’s knees, but instead strengthens it. Next your going to tell us that the education system is ausgezeichnet and doesn’t leave most students financially crippled. The nerve of some people. Now if you’ll excuse me, I need to go study up on which wealthy hyper-geriatric politician is going to represent my interests!

      PS: I totally didn’t have to google translation for those words because of my superior American education!