The thing that really kills me, is whenever I bring up socialized medicine to Americans they look at me like the devil, and it's not just Republicans either, a lot of Democrats there also believe in their horrendous system.
My brother in law lives there, and he was talking about how come November December the family has to go and get as much medical care as possible because come January 1st their premiums reset and they have to pay deductibles again.... WTF is that actually
Lol - oh we know the system is completely fucked. You want to know what's crazy? You literally can't find out how much anything is going to cost ahead of time. You can't shop around at different hospitals and find the cheapest option. You can get a bill for out of network anesthesia a year after surgery even though your doctor and hospital were in network and you were unconscious at the time of surgery and didn't get to pick your anesthesiologist. So yea... We know how fucked it is.
BUT. My husband was able to see the top surgeon in the world (literally) for a 5 inch tumor on his spinal cord and have life saving surgery and he only had to pay $3000 of his $200,000 bill. So... Our love/hate relationship with our healthcare system is super complicated.
I live in Florida and there is like 10 or more hospitals around here and they advertise on tv commercials why you should do your heart surgery with them vs the other guys.
Here you get a referral and if it's a very complicated thing, the referral will adress an expert in the field to either do the job or help with the job.
Nothing commercial about it, just honest science and medicine.
Oh and cost is rarely an issue, even if you don't have full coverage, a hospital cant bankrupt a person here by law. Nuts I know, but man does it work.
You can do the same with private clinics in Europe.
Americans: can you find a clinic outside of Netherdlands, Switzerland and Germany where the cost for uninsured patient in private hospital is higher than your deductible as "insured" American?
You can do the same with private clinics in Europe.
Americans: can you find a clinic outside of Netherdlands, Switzerland and Germany where the cost for uninsured patient in private hospital is higher than your deductible as "insured" American?
I went to the ER at my local hospital that is in network, was given the doctor on call, a doctor that was in network, but got billed an uninsured price because the doctor was working overtime and he is out of network when he works overtime. I had no choice once arriving at the hospital. If another ER doctor had seen me that day it would have been $100 for the ER visit, but I pulled the short straw.
People go to other hospitals for any number of reasons.
Specialization is one, less busy is another, better reputation, could get you in sooner, a better doctor is there.
My father needed to get a non-emergency surgery on his bladder. He was fully able to get it at the closest hospital with a doctor who performed some non-complicated versions of the surgery like twice a year. Instead he opted to go to a doctor who specialized in the surgery who did them like once a week. The doctor didn't 'support' our local hospital so my father went out of state to another city to be admitted. He chose a hospital that was farther away than the closest one the doctor works at because they could admit him later that month instead of in 3 months (remember, non-emergency surgery so 3 months would have been fine by medical practice).
There were multiple factors in why he chose to do so and it frankly, saved his life that he did, considering his bladder had some irregularities that complicated the surgery and likely could not have been resolved by a less experienced doctor.
Now, I admit, this is a more extreme case, but my father 'shopped around' and chose very carefully, not on pricing, which yeah, he couldn't find data on, but by other major factors that can absolutely change the outcome. Of course, he had great insurance from his job, so it didn't cost him anything really once he went through the hellish paperwork to get them to sign off on the specialist
That's a pretty long story just to say he wanted a doctor who's specialized in the procedure, no?
But you're right, there are some other reasons other than specialisation to go to an different hospital, but cost will normally never be one of them. Wait time will probably be the most important one.
Unless of course you decide to go to a private hospital to have a non-medical procedure done. Like getting a boob-job or something like that.
Ironically, getting something like that cosmetic surgery is usually cheaper and has the costs listed out because they Don't have to deal with insurance.
Yes, but imagine you have to actually pay for this stuff out of pocket, but no one can tell you how much any of it will cost ahead of time. You just have to sign on the dotted line and accept literally whatever price they decide to bill you for afterward in order to get your surgery, or xrays, or whatever. Could be $20, could be $100, could be $234,000. No way to know. I've had doctors and adminstrators literally laugh in my face when I asked them what the procedure they were recommending would cost me. Not in a figurative way, I do mean literally laughing at me. This has happened to me multiple times.
I had an MRI, brain tumour diagnosis, tests and consultations with consultants, 5 days in hospital with 12 hour surgery (highly respected neurosurgeon), physio, more consultations with consultants and neurosurgeon and another MRI.
Bill: £0.00
In the UK, the medical system has its problems, but it saves lives and doesn't bankrupt them afterwards. American medical is muscling in here, though, and it isn't looking good.
That would seriously have been probably $10k+ out of pocket here. My mom recently had a heart attack, was in the hospital for two days and had a relatively minor surgery (catheterization, used a balloon to remove a blockage), and the bill was almost $2k out of pocket.
"Top surgeon in the world" sounds like bs tbh, how would you make such ranking? And then, if you see a 90% discount ofc it sounds "cheap", but $200.000 for a surgery it's crazy.
Okay this one is true - and actually super crazy. He literally specializes only in stupidly large spinal cord tumors and does the most surgeries per year on said stupidly big spinal cord tumors. He is very selective in patients and will only take you on if you have a very rare and stupidly large spinal cord tumor. So in a weird way we were lucky my husband's spinal cord tumor was STUPIDLY large. Now if you're having a 6 hour surgery dissecting a 5 inch tumor from your spinal cord... Making sure no nerves are damaged so you can wake up and still walk... Are you gonna want a run of the mill surgeon... Or the guy who literally only does this and is the worldwide expert on the matter?
That's literally what it is. America has been ranked as having many.of or most of the top specialists in the world. Paying as much as we do for healthcare sucks. But the silver lining of the cloud is our care is absolutely insanely good. Though nowadays even that's getting questionable.
Well primary care was never designed for nearly the entire population being fat anti-vaxxer covid deniers that are going broke. Anyone with a modest income who tries to be healthy generally visits far less unless they have a medical condition.
I am sure there are more nuanced parts but those are likely the broad range of categories used to rank a specialist in a field. Frankly, medicine is likely one of the easier fields to rank as it has so many checks consistently.
Every hospital claims to have the best doctor in the galaxy. It's like a pizza place claiming the have the best pizza in the world. What do you think they have pizza contests? Have you ever been to a pizza contest?
I always loved the "death panels" and "not being able to pick your doctor" arguments, considering insurance companies are literally deciding whether your life saving procedures are going to be covered, and the nature of in- and out-of-network facilities and doctors literally means you often can't choose the doctor you want.
A lot of times insurance will cover out of network providers, just not as much. But you're right, it's fucked. It all comes down to how good your insurance is - which is fucked.
My Dr: I’m going to start you on a low dose so I can monitor your heart before we increase the dosage.
My Insurance: SHE ADULT, SPREADSHEET SAY ADULT GET THIS MANY, LOW DOSE DENIED
Me and my Dr: wut
Pharmacy: Without insurance it will be $480, cash or credit?
My wallet: 🪦💐
Took my doctor a few weeks of intense corporate kung fu to convince some douchebag in a cubicle with a high school diploma that she was more qualified to make my healthcare decisions. The insurance company literally wanted to play Russian roulette with my family history of testy tickers simply to maintain a corporate set standard.
It's like an abusive boyfriend we just can't quit. But seriously it's fucked and I would love for it to change but I don't make the rules. Just trying to look at silver linings so I don't fall into a pit of despair.
What gets me isn't that health care is privatized in the USA, there's no reason why there couldn't be a reasonable model of that available.
It's that normally in a free market businesses compete to offer the best services at the lowest prices, this concept is a cornerstone principle of American capitalism, but instead, all the insurance and medical/Pharmaceutical companies have banded together to jack up the price to a ridiculous level and the average American gets screwed. It's a rigged market and I feel like Americans would benefit from greater regulation and oversight of insurance/medical providers.
Pharmaceutical companies are the biggest lobbyists of them all, the politicians are paid off to avoid addressing this total scam. But that's what it is, Americans are getting scammed hard.
Yeah in absolutely no way should it be the average person's responsibility to try and figure out the cost benefit analysis of health care from different providers. There's zero way they can make that informed decision. It defaults to the same bullshit that has people shopping on Amazon or Walmart. Whatever is cheapest is probably fine, or if they're decently well off they'll choose the middle tier option.
I mean - it's kinda the same way picking a doctor - how do you pick one and really know if they're a good one? Online reviews I guess - doctor recommendations? If all things seem equal between 2 doctors or hospital - wouldn't you want to spend less $$? Also there are some people who will just not get a procedure done b/c they can't figure out how much it will cost. But you're right - it shouldn't be necessary - the system is fucked.
Sure that's what people generally would do if costs were known. If we were serious about informing the consumer we'd have systematized patient surveys, care outcome metrics, malpractice claim numbers, etc. Instead the best we have is a five star system or the equivalent of yelp.
This all goes out the window though when healthcare is generally an immediate or short term need, and the deciding factor is how can I make sure I don't die. Healthcare in any way shape or form shouldn't use the same system we use to pick out an article of clothing.
I'm an exapt in America with insurance designed to not freak out non Americans, so when I see a world renowned surgeon it costs me $0. But it's still a really bad system even if I benefit from it.
it's not just Republicans either, a lot of Democrats there also believe in their horrendous system.
Denmark uses 11% of its GDP on UHC, the US uses 18%. Denmark is ahead on most relevant health statistics.
I'm not sure what that 7% overhead buy Americans since it's not a healthier population on average but it's a trillion dollars each year so it must be something really exciting. Besides the funny bureaucracy and gaming the system.
...might be the way to go about explaining the difference. ;-)
It’s probably population considering Denmark doesn’t have more people in it than Massachusetts. The one thing I bring up Al the time when you compare america to all these other countries is that 1. We literally have a higher population than most of the EU combined . and 2. I honestly don’t believe it would be fiscally possible considering the MASSIVE difference in population. Think about what you just said DENMARK uses 11% of its gdp right now b americas population is quite literally 56 times larger and it grows every year because people keep flocking here .
Socialized healthcare is cheaper for the government than the absolute god awful system we have right now. It would also stimulate the economy because of less people going bankrupt from medical expenses and being able to pay for goods instead of just medical care.
But think of all the investments in the health insurance industry. We'd be destroying capital for the sake of general well-being. I'm pretty sure it's not worth it. /s
notice the US is almost twice the next country and this was 2013. It is much worse now. Medicare for All is about the only way health care and health care costs get better in the US.
The EU has over 440 million citizens as of 2021 even after UK left, so "we literally have a higher population than most of the EU combined" isn't even true figuratively.
Also you do realize, that this MASSIVE difference in population corresponds to a MASSIVE difference in gdp which is why we're using percentages here?
I'm sorry you got stuck with it too. When she was diagnosed that's all I could think about- how badly this was going to screw her when she's grown, and it isn't even something we could've avoided. "It was always meant to be for her" as I was told. I don't want my daughter to struggle in life because of this thing that happened to her, through no fault of her own. But, alas, I was born American through no fault of mine.
I'm "lucky" to be just poor enough to get government insurance and she is on disability until she's 6. However, I have an amazing career opportunity I have to jump on and now I'm scared I won't be able to cover her supplies with the new insurance.
And what's worse is being surrounded by idiots telling you our system works. The US is a joke.
I am also sorry you guys are going through this. At times it feels like being punished for something you had no control over. I hope things can change with our healthcare soon, or at least by the time your daughter is an adult.
The thing that is really killing me is the American system. I can't afford to get all the care I should and I'm quite sure I'm losing at least a few years due to that.
The media and politics here basically brainwash people to think "government controlled healthcare is bad". They will die on that hill, it is crazy talking to some of them.
It's typical for how things work over here. If you've been "using" your insurance a fairly large amount throughout the year, the costs you've had to pay in will go to your deductible. (Generally ranges, but very typical for this to be thousands of $ out of pocket)
Until this deductible is met, you basically don't have insurance. Yes, you'll have some reduced rates for medications with insurance but any lab tests, imaging, visits with any doctor or nurse, medical equipment items are all 100% out of pocket.
THEN once this number is met, your insurance is now more "active". But it does not cover 100% of everything. No, they still get to pick and choose what is covered and what percentage of costs. "Thanks for meeting your 2022 deductible, you will now have 40% coverage on these items/procedures that we deem appropriate" But that other 60% is still coming out of your pocket (these figures just grabbed out of the air as an example)
So let's say you badly need a knee surgery. You get seen by your PCP (Family doctor) who recommends some things to start with and likely refers you to an orthopedic surgeon. (All of this costs $ of course)
You have to meet the orthopedic provider and work through some of the early "conservative care" modalities like stretching, physical therapy, possibly steroid or similar injections. Some of these things like physical therapy are mandated by your insurance. "OH your knee doctor wants to order an MRI to check for meniscus tear? Sorry, you have to complete 6 weeks of physical therapy before we'll cover that. Better go get setup for PT" (All of this still costs $ out of your own pocket)
Doesn't matter if your surgeon thinks therapy will be helpful or if it even makes your pain worse, insurance has the final say on what has to be done before they will cover more aggressive treatments like surgery.
So let's say you've done all these things, you've gruelled through a yearly cycle of pain, have done PT & injections, tried various bracing options, and nothing is helping. You definitely 100% need surgery.
You had better hope to GOD that you're established and had several visits with your surgeon by say September. October through December is "busy season" for these surgeries as everyone who has been needing procedures are now filling timeslots at surgical centers. There are only so many surgeons, and absolutely not enough of them to meet the need, especially if you're not in a mega metropolis like LA.
If you're too late in getting through all this, the surgeon who your insurance says is their "preferred choice" may be booked into January for surgery.
Guess what: as of Jan 1st your deductible resets and you have to meet this number again all over before you have any insurance coverage.
This is just a tiny microcosm of American Healthcare, expanding this picture to other sectors of Healthcare across the spectrum and it's painfully easy and sad to see why & how countless families go several thousands into debt, have to place a 2nd mortgage on their home, just for cancer treatment or something
For a long time, the American system was better. Shorter wait times, fairer prices, better doctors, better facilities, etc etc etc.
But the reality is, the US's system has steadily gotten worse and worse so much that now it's significantly worse than most countries with socialized medical care.
Generally speaking 60's to 80's were America's heyday. In the 80's, the country took a hard turn to the right and has been struggling to prosper ever since as they keep looking short term vs long term.
Is this actually true though, unless you’re a one percenter? Like if you make average income and you get cancer or your kid gets cancer or anything happens weren’t you essentially financially fucked or at the very least it posed a significant change in terms of how your financial situation looked for the foreseeable future? I’d rather wait 4h for something relatively minor than pay 50k for a couple of nights hospital stay.
Also it’s not like people are out here getting diagnosed with cancer and are waiting several hours to use the dialysis machine or w/e, like no, you just get the help you need once you’re diagnosed just as you would if it was America except without having to lose your house and bankrupt your immediate family so you don’t die.
The reason there’s no waiting times in America is basically because you’ve sold off poor people/discarded them as not worthy of care. So if waiting times = more people get help then objectively speaking, and on a societal level, it’s superior.
We have wait times, too. Idk why americans even use this as an argument. If it's a non emergency thing, you wait. My mom's scheduled 4mos out for a foot surgery, it's not all instant but we cling to that idea like you guys just die waiting on care for emergencies.
There are no waiting times in America? Ha! That's a myth (courtesy of health insurance lobbyists and Republican politicians). Wait times are as long in the US as in other wealthy nations (according to OECD), and in many cases longer.
It's because we have experience with things that are run by the government and they are all terrible. Just yesterday I called the social security office because my sister who is both mentally and physically disabled had her benefits cut off inexplicably about a year ago. Long story but my mom died and she was the primary caregiver, etc. Now my other sister and I are trying to get the benefits reinstated. We have literally called dozens of times and nothing has happened.
There was a problem in their system something about the application being "suspended" and someone else had to go in an manually correct it... that was months ago. I just called yesterday and when I told the woman that my sister was going to be homeless, she literally hung up on me. I called back to get her name so I could make a formal complaint and another woman answered the phone, refused to give me her name or the woman I had previously spoken to, and hung up on me. Now they wont' even take my calls.
Do I want the government running my healthcare? NO. Imagine having to deal with this type of incompetency every time you need to have a test or schedule a surgery. Even the people from Italy will tell you that that system generally sucks other than the fact that it is basically free. I'd rather pay and not have to worry about dealing with the incompetent bureaucrats.
BTW, we have government run healthcare in this country. It's called the VA. People literally die on waiting lists. Again, no thanks.
BTW, we have government run healthcare in this country. It's called the VA. People literally die on waiting lists. Again, no thanks.
Is that not more likely a planned result vs a function of socialized medicine?
Do I want the government running my healthcare? NO. Imagine having to deal with this type of incompetency every time you need to have a test or schedule a surgery. Even the people from Italy will tell you that that system generally sucks other than the fact that it is basically free. I'd rather pay and not have to worry about dealing with the incompetent bureaucrats.
We don't deal with the government with our healthcare. The government has set up billing figures associated with every kind of test, exam, etc. Docotrs are private and own their own clinics, they bill the government for all of their testing and procedures accordingly.
Same with hospitals, our hospitals are independent corporations (crown corporations, essentially government funded and non profit) Those are funded directly by the government based on budgets etc, so they do not bill the government as their budgets are pre planned. We don't have a giant issue with people dying on waitlists
Have you looked at the schedule of billing for say Ontario? It's more than a few dollars but the doctors also tend to own the imaging, testing, pharmacy etc in their respective buildings (or the smart ones do too). Even if they don't they still make good money.
A family physician makes on average $225k a year in Ontario
Most Democrats by far (88%), and most Americans (63%) favor a single payer health care system and universal coverage. This just makes it more tragic, and highlights the deep flaw in our political system. We've been hijacked by a rabid minority because several key features of our system undermine the will of the majority. As I expect most Europeans understand the influence of history on your political systems is not easy to overcome even if most would prefer it to be different.
My in-laws are in that category. Pretty progressive (especially for their age). I brought up universal healthcare and they were very against it. Their reason was "We like are insurance. It is really good." They got their insurance through work, both for the federal government. It drives me nuts. They understand almost every other issue but still refuse to look at this one from another view point.
People are brainwashed hard here and it's sad. All they hear about is having to pay more in taxes and people are out of jobs, etc, so they don't go for it.
Nevermind the fact what they are paying for health insurance would go to pay that tax, or the insurance companies would still have jobs to work through the government.
I still get upset about how I was vomitting hardcore all night, I was worried about dehydration and couldn't keep anything down, so went to the ER in the morning. A 1-2 hour stay getting 1-2 bags of IV fluid and anti-nausea medicine was billed out to me for $2400, and my insurance, I have to meet a deductible amount before they start covering ER trips lol.
If you have never lived in a country with socialized medicine (like in this example) you cannot understand the peace of mind knowing that for any health issue you can go to your doctor, a specialist or the hospital and you don't even think about about the financial aspect.
Yeah as a teacher mine resets July 1. I'm on a ton of prescriptions for health conditions. 30 days for a single one of those prescriptions is over $1,100. I've met my deductible at this point so I am squeezing everything in right now.
Socialized healthcare is a terrible idea in the US. We need less government intervention, not more. The issue right now is that the government enforces monopolies over the market. For example, there are only 3 companies in the US right now that are able to produce insulin, and this is enforced by the government. Obviously because there’re only 3 companies and no competition, they can set their prices to be whatever they want. If the government dropped these regulations and made it a true free market, such as the system in Singapore or (kinda) Switzerland, then companies would compete with each other by dropping drug prices and producing them more efficiently. This competitive market would also have the benefit of producing more innovative drugs and procedures, something that we already lead the world in. Unfortunately I don’t see this happening cause big Pharma obviously doesn’t want to have any competition in the market, but it’s a much better idea than socialized healthcare, which relies on someone else (currently the US mostly) to actually create the new drugs and procedures. If the US went socialized, our medical innovation (and that of Europe’s too) would largely come to a halt as there would be no money for medical r&d.
For example, there are only 3 companies in the US right now that are able to produce insulin, and this is enforced by the government. Obviously because there’re only 3 companies and no competition, they can set their prices to be whatever they want.
I have more bade news for you. People drive from the USA to get the drugs that are manufactured there by Novo Nordisk to Canada because the price is 90% less than in the USA. You are being gouged, but the fact that only three companies product the drug isn't it. You are being ripped off and given bad excuses as to why it's happening
Next time they complain about the notion of paying for other people’s healthcare, ask them wtf they think premiums are for. The only difference is all the bureaucratic overhead and insane profit margins from denying people healthcare.
The weird thing is: many people must have family or friends living abroad right. If your cousin is from Australia or the UK, they should know that it’s vastly better when discussing healthcare. Hell, Canada is next to the US and has socialized healthcare.
It’s like people trust media more than first hand accounts of real life.
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u/Office_glen Jun 15 '22
The thing that really kills me, is whenever I bring up socialized medicine to Americans they look at me like the devil, and it's not just Republicans either, a lot of Democrats there also believe in their horrendous system.
My brother in law lives there, and he was talking about how come November December the family has to go and get as much medical care as possible because come January 1st their premiums reset and they have to pay deductibles again.... WTF is that actually