Ask Lemmy

I started a new job this week, in the US, and for a family of four I'm going to pay $30,000 per year in premiums....only premiums.

$896 per month in premiums, and about $18k out of pocket so far this year in addition. Me and two kids.

Let's put it this way, for most Americans it would be cheaper to fly to Cuba, stay in a hotel and have any medical work done there than it would be to pay for similar healthcare in the US.

You can get amazing world class healthcare in the US but you pay a similarly amazing world class price for it.

(Edit: Oh and by the way shitty healthcare also carries these world class prices, think of the shareholders!)

I injured my arm in 2016 while working on a trailer. The doctor sent me to get an X-ray. With my wife’s insurance (the highest tier her company offers) the X-ray was $650. A visit to the doctor was $65 last time I went (2016), and an Emergency Room visit is $75.

In late 2016 I broke my nose on a movie set and had to get stitches. Production did not file the paperwork so they refused to pay the $2700 bill (ER visit plus 3 stitches, the set medic set my nose for them). I finally found a copy of the paperwork the set medic gave me in case production pulled anything. They paid the bill the day I emailed the paperwork, but that was almost 2 years of fighting with them.

I have insurance. Just to give you perspective. I had a video call for some mental health diagnosis. I now have a bill of $568 dollars. Reminder, this is WITH insurance. I have to pay that out of pocket. And I even have to set up additional appointments. Which will be probably around the same price.

I also have an inhaler. I had a doctor's appointment to get a refill on my medication because I don't have to use the inhaler too much (meaning I don't have to refill often). I try to stay healthy and workout and only have to use it when working out/exercising. $300 dollars for the appointment. Another $212 for the actual medication that I picked up. In the last 30 days I have blown over a grand on medical. And I'm not even sick/unhealthy.

My wife on the other hand has very expensive monthly medication for a rare disease. She hits her max out of pocket every year which is 5k. Which we just have to pay forever. If I was on her healthcare plan, we would end up paying 10k every year just for healthcare.

I would say on a regular year. We pay around 7k in healthcare costs with our insurance (depending on how healthy I am throughout the year). On a light year 5.5k.

This last winter I was unemployed and I got sick enough to need antibiotics.

I couldn't prove that I didn't have a job, so the 'sliding scale clinic' charged me $586 to talk to someone (not a doctor). I knew what I needed. I was forced to take an unnecessary STD test ($180) and to promise I would go in for additional testing and scanning (undisclosed price, to be determined AFTER).

The meds were around $40 for a week of pills (15 pills).

I knew my issue, and just needed a prescription for the antibiotics.

I have a job now. They want about $200 a month for the basic coverage. I have on average, $20-$30 at the end of the pay period. So I could get insurance, but it means skipping more meals (I already skip several a week to save money).

So I just hope nothing ever goes wrong because if it does, I'll need to be close to death before I get help that will take me years to pay for.

My experience is pretty similar to others. Basically, if you have insurance (most people do, and there are lots of government subsidies to help afford it), and you're relatively healthy, it's predictable. If you get seriously ill, or have chronic health problems, the expenses can quickly bury you.

I'll add one thing about pharmacies. The same medication can be $300 at one place, and $40 next door. You just never know. There are also pharmacy discount programs that can radically reduce the price. I had one that was around $150 with the insurance, then the pharmacist performed some type of incantation on the computer, and suddenly it was about $16 without the insurance.

Vet here, so I get some shit covered by the VA... but as a full time surgical tech and part time student, I can't afford actual health insurance. Haven't any kind of check up since I was active duty.

Hopefully if I get sick or injured I'll be able to bullshit a reason for it being service connected and have the VA do it.

If it's something serious... idk... Just deal with it, medical tourism, or suicide?

That 27k bill will come out of your estate. So if you have a house, it will be sold to pay that bill before your children can inherit it, if they, for whatever reason, can't cover it.

Private Healthcare in this country is a nightmare. And with Covid slowly disabling everyone, it's only going to get worse. Saving the NHS is worth it.

America is a 2nd world country without universal health care. Just stick to your first world country.

I paid about $1750 in insurance premiums last year and an additional $9,000 in deductibles. This year should be a little more in premiums and hopefully, just $7500 in deductibles. (Wife was treated for cancer last year and had reconstructive surgery this year. I had a routine colonoscopy for the higher expense that I won't need again for a few years. )

My insurance is probably better than most since my employer is huge.

on the one hand - my wife and i didn't have insurance when my oldest was born, as i was doing contractor work overseas. Between one thing and another over the course of that year, we paid like $8k in medical expenses, including all the obgyn visits and the actual delivery, plus a hernia repair for me. The hospital was very easy to work with. Our income was very high so it was not exactly a burden. (8k was about 2% of total salary)

on the other hand - this year, with insurance we're going to pay about $6k in insurance premiums and $8k in medical expenses before we hit our deductible (~7% of total salary)

on the gripping hand - last year we had really excellent insurance. we paid a total of $1200 for the year in premiums, $50/pay period, and our deductible was only $2k. (~1% of total salary)

So it definitely varies a lot

I’ll give you some anecdotal evidence.

I make okay money. Not great, but I’m not starving. Lower middle class, probably. But I’m a single man, so if I had a family I’d be lower class no question. (This all just to give you an idea of my income without sharing my personal data online, we’re all working class)

I tried getting insurance this year, and the cheapest plan I could find was $700/mo. That means I pay an insurance company $700 every month, whether I go to the doctor or not. Now, if I were going for a general checkup, I’d pay a “copay,” so a base cost for the office visit. Probably $40-$50.

Then, depending on what I get done, tests, lab work, medicine, I’d still probably pay at least a portion of that, the medicine is likely to be discounted.

But then there’s this thing called a “deductible.” That means I have to spend the amount of the deductible in the year out of my own pocket before the insurance company would be paying for anything major. My deductible for this $700/mo plan was something like $7,000. Something like that, $5-$7k. That’s my cost before the insurance company is obligated to pay for anything. Small stuff they’ll probably cover (depending on the doctor I went to…) but before I spend that $7k of my own money in this calendar year, they’re not gonna pay for much of anything, if really anything at all.

So before we get into the absurdity of how much medicinal care costs here, there’s all that insanely stupid system to pay off and figure out.

You either have a good job, or you have to choose between not getting medical attention or being chased around your entire life over medical debt. Be prepared to flee the country if the latter.

Consider that most Americans are pay 2x to 5x more in insurance premiums each month than folks in the 32 other developed nations with national healthcare coverage pay monthly in taxes for health care. Consider that Americans still pay deductibles and copays. Consider that insurance won't cover pre-existing conditions (which are many). Consider the insurance frequently denies claims and requests for further tests and specialists. Consider that most insurance only works within the limited network of the insurance companies designated healthcare providers.

I work a multinational company that has moved staff from Japan, Canada, and the UK to the USA for periods of work. All of these folks were shocked and horrified by the American insurance system.

We pay $500 a month for family "health care" because we're forced to. Every doctor visit I go to I get a $40 bill just for walking in the door, on top of paying for my medicine copays. It really sucks.

I had a two part visit, about 45 min each, to test to see if I had asthma. My out of pocket after insurance was about $1,200.

TL;DR: mine is $660/month for health, $42/month for dental

Most folks in the US aren’t aware of how much they pay for health insurance. I live in California, where law requires full time employees (>30 hrs a week, >130 hrs month) be provided some amount of health insurance. The type of coverage varies not just from job to job, but also within the same job the employee must often choose their own plan from several company selected options at varying price tiers and types/amount of coverage. Usually the employee only sees the amount of the monthly cost that THEY are responsible for, which is then automatically removed from their paycheck. What most folks are unaware of is that the employer is also paying some of the cost (which is the part that the law makes them do). The part that makes it extra frustrating to deal with an already broken and overly expensive system, is that the rate paid by employers is negotiated in bulk with the insurance providers. Larger employers (national corporations with hundreds of thousands of employees) are paying much less than an individual or small employer would. This is the one of the largest reasons becoming unemployed is so dangerous in the US. In addition to not having income for food or housing, people often forego health insurance due to the expense. If you lose (or leave) your job you’re eligible to keep your current insurance plan for 18-36 months with COBRA (Consolidated Omnibus Budget Reconciliation Act, which is such a ridiculous backronym that I had to google it just now). This is often the only time people realize the true cost of their insurance as the entirety of it is then passed on to them directly (at the employer negotiated rate) and it shows up as a new monthly bill.

I recently left my employer to start my own business and discovered that my true cost of insurance is ~$700/month ($660 Health/$42 Dental). Keep in mind, this doesn’t mean that I have zero medical bills should I actually visit a doctor or hospital. This is pretty good health insurance, but I still have to pay $5,000 out pocket (annually) before it kicks in at the full coverage amount. Since I had ear surgery earlier in the year and hit that limit, and wanted to be able to continue seeing the same doctors I had for already scheduled follow ups, I decided to keep the same insurance. That $5,000 isn’t the only expense that landed on my shoulders, there’s a bunch of rules that I honestly don’t fully understand and I’ve probably ended up paying somewhere between $7,500-$10,000 for the surgery I had (in addition to the monthly premium).

The main reason I keep paying insurance (in addition to the fact that you’ll now be charged a penalty on your taxes if you go uninsured for a month), is my fear that you mentioned in the original post. Having a car hit me while I’m walking down the street and ending up with a $50,000 visit to the emergency room is a very real possibility without health insurance. California recently limited ambulance rides to a maximum cost of $1,200, so that’s… good?

My father has had two heart attacks. The first was a pretty standard one by heart attack standards, required a stint to be put in and two days at the hospital. The cost was ~$40k and after insurance we were left with I think a $4-5k deductible (pretty good county employee insurance). His second one luckily (ha) happened while on the job and required another stint to be put in (he got amazingly lucky, as it was a widow maker of a heart attack) and was covered under his works insurance.

For reference, I'm healthy and in my late 20s, I pay ~$250 a month through my employer's health plan, $25 for an office visit, $500 to walk through the doors of the ER, with a $3k in network deductible ($6k out of network). Believe me when I say you are amazingly lucky to have the NHS.

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.