this post was submitted on 13 Aug 2024
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Hey all, I'm British so I don't really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.

So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.

However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They're just some elaborate dance between insurance companies and hospitals. If you don't have insurance, the cost is lower or removed entirely. Supposedly.

So I'm just asking... How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.

How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?

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[–] [email protected] 4 points 4 months ago

Depends.

I pay $600/mo for insurance, mid-grade, without using it. Co-pays, medication, or any other medical procedures are all varying costs and extra out of our pockets. Some things are “free”, like vaccinations, and maybe some basic meds might be zero copay at the pharmacy, but it all comes out of the paycheck. Out of network doctor or specialist? Way more.

Things that are not covered are any extra insurance like long or short term disability. Long term care. Psych care. There are some things that cost extra, like ED visits, specialty treatments maybe like dental implants or hearing aids. We pay extra for some of these.

I have a good job, so does my spouse. The monthly costs are in the vicinity of $800 for a family of four, so $9,600 a year. They aren’t big costs, but nonetheless it’s money spent making some insurance company profitable gambling on my continued health. We also take money out of pay for what amounts to a pre-tax bank account that can be used for medical expenses only. You can pay for meds, dental visits, etc. with it. It’s pre-tax, so that’s great, but you don’t get to spend the money if you need it elsewhere.

It’s also all gone if I lose my job - the insurance is through my employer. Too sick to work? Gone. Injury and disabled? Gone. There’s no safety net except Medicare or -aid, and that’s a shitty plan that has all kinds of caveats like Medicaid can essentially take your home as “payment” in certain situations. Completely fucked up.

My insurance constantly gets more expensive and my services become more restricted every time my employer sees fit to reassess their insurance costs.

I would gladly pay a tax (or whatever they call it in countries that don’t call it a tax) in a more level paying field that isn’t tied to my job, that I have to choose what care or physicians I go to because of how much more it costs, or whether I should see a doctor, that doesn’t go to making some assholes rich based on whether or not I get a more costly or denied treatment.