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] 1 points 4 months ago

When I used to live in the states my family would pay something like $2500/month for health insurance that covered all of us. Don’t know what the deductible was but apparently this was a very good plan. This was back around 2000.

[–] [email protected] 1 points 4 months ago (2 children)

idk, maybe im just fucking insane, but like, i can't run the numbers for insurance to make sense.

Unless the courts are LITERALLY broken, or the entire society will collapse without the presence of insurance, i don't think it makes much sense.

Healthcare maybe, if it worked, it doesn't though. Life insurance is fucking stupid unless you work in an dangerous job and have a family, it might be useful then, but only when you die. Car insurance is only legally required because people driving cars can't accept their own responsibility of owning a fucking car. (you could argue it's for the public good, but lets be honest, it's not) home/building insurance might make sense if you live in a suburban home and your contract doesn't change, or like actually covers what it should.

There are more insurances but i feel like you'd be a fucking dumbass to even consider those. Insurance for your business? My brother in christ this is why we invented LLCs.

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[–] [email protected] 1 points 4 months ago

Here's my anecdote. I have Kaiser through my employer and pay about $200 a month for the best plan offered. I pay $10 for a 30 day supply of generic medication. Video/phone visits are free. I recently had to get lab work done twice and paid $90 combined for both, but I was able to just drop by whenever was convenient for me and was in and out in 10 mins. I had a mental health crisis last year and went through weeks of intensive outpatient group therapy plus months of ACT/DBT therapy all for free. My individual therapist is covered and I pay nothing. I recently had a physical exam, it was covered. Now I do have an autoimmune disorder that I do feel a bit neglected a bit by them, but I could advocate for myself more.

So from a non major life threatening emergency perspective, I feel pretty satisfied with my insurance.

[–] [email protected] 1 points 4 months ago

I work at a large, private university health system.

Annual up front cost for insurance is $4967 for medical insurance and $609 for dental. Those cover me, my wife, and two of my three children. The insurance is a plan funded by my employer, but managed by Independence Blue Cross, AKA "Personal Choice".

There are three "tiers" of coverage.

First tier is for facilities that are part of my employer. Generally, for procedures performed at my employer's facility there is no additional charge. For a primary care provider who is part of my health system, there would be a $20 copay per visit. Specialist would also be $20, and an ER visit would be $200.

There is an "in network" tier, made up of external providers that accept personal choice. Primary care copay is $35, specialist is $50, ER $200.

The third tier is "out of network". If we see someone out of network, we would have to pay them directly, then try to get partial reimbursement from insurance.

There's also a prescription plan, but we get a discount by using the hospital's outpatient pharmacy.

Everyone always talks about the cost to give birth. All three of my kids were born at the hospital where I work, and none of the births cost us any additional money.

[–] [email protected] -1 points 4 months ago (1 children)

Going to make another post here, because I want to explain that American's aren't entirely irrational with our health care.

I spent time in the UK and the US, and I have to say that FOR ME, my personal, EXTREMELY privileged situation - The US healthcare system is better than the UK NHS. I say this knowing that if I lose my job, or I get a major illness, that could quickly change.

I pay a reasonable percentage of my paycheck for health insurance. I live in a mid sized town, in reasonable driving distance to several major cities, and the company I work is the single largest employer in the area, which means every doctor in this area is "in network" and I don't have to do any extra paperwork for medical billing.

If I need an MRI for a sports injury, I can get it within a day or two. If I need a CT scan because something unusual comes up on a test, I can get it the same day. If I need surgery for just about any injury, it'll be done within the week. If I need to talk to an expert, I can drive about 2 hours and get an appointment probably within a month (or less if it is an emergency.)

I will pay $0 additional out of pocket for any of the above.... AGAIN, ASSUMING MY SITUATION DOES NOT CHANGE.

My employer, who spends quite a bit on this insurance, very much enjoys this setup. They are the reason that I have this insurance, and I will lose it if I quit.

[–] [email protected] 1 points 4 months ago (4 children)

To be clear, I know there are serious problems with the NHS especially considering waiting times and mental health. I can imagine for a well off, lucky American the quality of care will be much higher than here in the UK.

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[–] [email protected] -2 points 4 months ago (1 children)

For me, I recently got a checkup and some blood work done. It came out to free, I didn't have to pay anything.

I also have pretty good health insurance.

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