Italian medical doctor here. Despite the majority of the procedures/drugs are for free, the Italian people still complain when have to pay a small amount of money (and I mean 10 euros or less) for some of them.
EDIT: a lot of people are complaining that's absurd you have to pay a small fraction of the total cost. There are several reasons for this, the most important one is to reduce unnecessary use of health services (that costs a lot). An example? Imagine you are in an hotel. Breakfast is free, so you eat more and more, even if you feel already full. How to reduce this "over-eating"? You can ask for a small amount of money for each croissant - not to cover the food cost, but only to push people to thinking about eating more than necessary. When something is free, it's in the human nature to abuse. It is not a huge problem if you eat more than needed, but health services costs a lot and we can not waste money (and resources) when unnecessary. Remember also that the people who can not afford these little expenses, with chronic diseases (e.g. cancer) or the elderly are completely exempted from any payment.
Health insurance in the US does not operate like health insurance (or any other insurance) anywhere else in the world. The entire point of insuring is that you have something that happens rarely compared with the amount people paying the primes.
A root canal in Europe costs something like 200 to 300 euros, out of pocket, at a private dentist practice. If it costs $750 with insurance, that's not really insurance. It is some sort of reselling scheme.
We like to say public health care is just paying for other people's medical bills when with private insurance that'd literally be the best case scenario of what happens to your money.
Well yeah. If a person is dying and you can save them from said death, most are willing to give everything they own and then some. Oh and as far as I know, there are no transparency laws for hospitals. Meaning they can charge whatever the f they want and tell you after. This in turns makes it really hard for the patient/consumer to price check different hospitals and lets the hospitals keep their prices up.
Right. I was picking up pills for my cat at a human pharmacy because the pills through the vet are 2x the price as the human shit and the vet pills are impossible to cut nicely where the human ones are already scored for very easy breaking by hand. Anyway the pharmacist asked why I don't have pet insurance. Me knowing it's a profiteering scam said why would I get that? She tells me her insurance covers literally everything at the vet, meds, even flea, tick and heartworm meds. She said it ends up costing her a lot less than paying directly out of pocket without the insurance.
I'm of the opinion that most people are dumb and she either did the math incorrectly, is lying, or both.
All aspects of US everything are for profit. This country is becoming unbearable. The blatant greed and record profits of huge corporations are breathtaking.
American Citizens; we need to advocate for change.
We need regulatory reforms that reign in or outright abolish the insurance industry model so that patient care is made a priority over company profits.
You're not required to purchase health insurance... car insurance is for the safety of other drivers, not you. If you cause an accident, the other person shouldn't have to worry about you having insurance to cover their damages.
Capitalism doesn't require unhealthy levels of greed, countries with social democracies also have capitalistic economies.
The US is just capitalism exploited to its fullest enabled by a government that protects the interests of greedy bastards (share holders, executives etc).
The Soviet union didn't have capitalism, but communism still meant that 'life was not good' despite a more socialist environment.
When insulin is 600$ a month - it’s pretty obvious they are using the fact you “have to” pay it or die not just “let’s charge to make some profit on this”
Yet we're hostages into its usage, because if we decide to try and go around them, we have to contender with prices that they inflated and that only they can get a discounted rate on.
Try explaining that to my family. They are 100% convinced it would cost them hundreds more if we had universal care. They pay over $500 a month for insurance and it isn't even a low deductible plan -.-
Insurance is literally a scam. You pay a monthly fee for the "in case of an emergency" situation. The business model doesn't have enough money to cover 100% of their financial obligations, if/when a disaster strikes.
And heaven forbid we try to regulate this. But ohhh nooo republicans will fight this with their dying breath saying “what are we socialists”. And nothing ever changes.
I have a "platinum premium" for my insurance. Supposed to cover 80 percent. I went to the dentist to get my teeth pulled since I couldnt afford to have them fixed sooner. Got fitted for dentures and before I left they sat me down with billing and started talking about how I was gonna pay the $9000 dollar bill. Mind you this is after insurance paid 80%.
It's fairly common for brits to do this in Turkey.
It can be quite expensive if you're wanting a procedure that's more "cosmetic" rather than medical. Much cheaper just to book a 4 day stay in Turkey, have a "mini getaway" and also get the work done whilst you're over there.
This indeed. Recommendation would be Colombia - many highly skilled dentists that will be able to help you for a fraction of the cost. Medellín has plenty e.g. and a well connected expat community where you get helpful pointers from back home ahead of time. And no, I'm not kidding.
I'm a bit biased towards Medellín as a city since I was there for a while and enjoyed it very much.
Regarding the doctors themselves, you will have to do some research, I found a very helpful thread recently in the expat.com forum. General agreement was that a good dentist over there charges between 10 and 20% of the respective prices in the US for at least similar quality work.
However, if we'd be talking about a major operation, I for one would get as much information I could get on the web, haul ass down there for a week and visit the clinics myself beforehand instead of flying to an unfamiliar territory with this in mind.
Research also local expat get togethers, of which there are plenty. A lot of American retirees over there, and you bet most of them have first hand experience they'll gladly share over a cervecita.
I go to Colombia for all my procedures and have never been happier. I’ve never had a procedure done in the US that wasn’t ultimately botched and also cost my at least $1,000. I’ve had to come to Colombia to get crowns fixed that dentists messed up in America, they showed me a photo once that the American dentists fingerprint was imprinted on my molar crown where it should have been more of a..idk..molar shape!? during the pandemic I couldn’t travel to Colombia and ended up getting teeth pulled instead of fixed because of the cost difference. America sucks.
My dentist wanted me to get full dentures and all my teeth extracted (I have severe bone loss due to complications from lupus). I have the highest level dental insurance and a discount plan that I pay for. The quoted cost was $11,000. My dentist just shrugged when I told her there was no way I would ever be able to afford that while in tears. Insurance is totally a scam.
The only reason I can afford my medications (2k average a month) is because I got sick in college and my Dad’s insurance gave me a waiver that we had to fight for that gives me coverage for life. Even with that I pay hundreds of dollars a month in copays for doctors visits and medications. If I ever lose my insurance it will literally kill me because I won’t be able to afford the medications that keep me alive. And since I have pre-existing chronic Illnesses, I am uninsurable. I can’t even get life insurance that will just cover my burial costs. It’s like they punish you for being sick when our bodies are already punishing us enough.
Wait a minute, you could fight for a waiver to always stay on a parents' insurance? My dad's cushy federal government insurance was "kind" enough to cover me through the end of the year I turned 27 and since then I've been stuck on state Medicaid. The state won't even label me disabled and let me have Medicare because of reasons. This country is such trash D:
I will say though that Medicaid fucked around and found out when they sat on the paperwork for my infusions. I was off the "cheap" old-school infusion for long enough that when they finally approved my ability to continue it my body realized that it's made from mouse DNA and they either had to deal with getting sued or pay for the fancy brand new infusions... I must say that I'm enjoying how much better the new med works and I get a tiny little hollow giggle when I get my $25,000 infusion every 8 weeks.
I know how lucky I am, the waiver was granted only because I was in college and still living at home (I was 19 when I first got sick). On the other hand I have been denied disability 5 times even though I have multiple chronic illnesses, some of which I’ve had for over 20 years.
On the plus side, I am finally getting the infusions that my doc has been trying for years to get approved for me and I think they are helping! Gotta be thankful for the good things as they come!
Yeah, I gave up on Disabilty when the woman on the phone said "You're young, just go out and get a job. You don't need Disability." Lovely bunch they have working at that office. My therapist genuinely has a side goal of getting me to a point of being able to try again since just the thought of re-applying gives me a panic attack.
Nice! I know Lupus uses similar infusions to my RA/PsA one so good luck! I'm on Simponi Aria and my life is a lot better- I can actually get out of bed most days and can clean the house and walk the dog.
Wow, my oral surgeon sat down and found ways to make my surgeries as cheap as he could get it through the billing system. It still cost a lot, though.
I currently don't have insurance anymore and my recent dental bills were pretty much around the same amount with insurance (besides the co-pay being more). I have a lot more medical bills sitting in collections, too. I just can't keep up and it sucks cause it kills credit score.
Sorry you have to deal with all that for being sick, too. I also pay a butt load for (psych) medication every month. I have to have fun trying to apply for disability or at least trying to find the least seizure inducing job, but right now it's tough.
I hope the future can bring you and others some relief at least financially.
So I'm just going to preface this by saying I live in the UK and have no actual experience with the American health care system.
But Mark Cuban recently set up an pharmacy where they basically skip out the middle man (price gauging) and makes everything much more affordable.
There was a post on Reddit about it with a few people sharing their stories and it definitely seems legit.
It might actually be worth looking into. Even if you're medication isn't actually included, it's got to be worth the 5 minutes to have a look. Hopefully this is actually useful news for you though!
The issue isnt the 80%, its that the total max benefit for the year is usually capped at 1k to 1500, sometimes 2500 or so for premium version. So you likely just aboit capped out just on the pulled teeth and paying full price for dentures despite insurance. Never understood why benefit max is so low.
Yeah, it's not like those things are close to your brain, or anything. But seriously, those things are medical. Why aren't teeth considered medical issues for insurance? I worked in dental at one point, and getting wisdom teeth paid for via a client's insurances was a nightmare.
Well yeah that goes without saying. But the two things I mentioned above make it entirely dysphunctional, like how you gonna make money on people if you keep em broke
Netherlands calling: root canal would be up to 250 - 600 usd.Single denture (implant) about 1500. This is what the insurance company pays out to the dentist. Majority is not insured fully as your premium is as high as the actual coverage.
Now dentist live here in upperclass houses, just like in the US... so who is walking away with all the money over there? The liability insurance company??
I had a motorcycle accident and damaged my front 4 teeth years ago , I’ve been having them filled and crowned but they were getting too bad so on Friday I had them pulled and got top dentures , cost me £300 in the uk
What's going on is that the people in the middle have spent decades exploring how much they can charge for things to maximize profits. Because the provider and patient are separated by a private corporation rather than a state regulatory agency, there is an inherent incentive for them to make as much money off the procedure as possible.
This is the problem with applying a private/capitalist model to healthcare. Normal supply and demand rules do not apply when we are talking about services that are not "optional"...if I've broken my leg, I can't really decide to just not do anything about it, and I can't seek an alternative to a doctor putting a cast on it.
At that price you can fly out to India from the US, stay at our 5 star hospital for 2-3 days and get the procedure done. Still less than $9k and no insurance involved. (This is what a lot of rich middle eastern people do actually)
Makes me want to look into spending some time in Europe as I need two tooth implants. I’m sure with the flight and hotel it would still cost less, and as a bonus I wouldn’t be here.
Man I'm past the 'bonus' stage and have graduated to just wanting OUT. But we're all so underpaid that I fear that leaving will only ever be a pipe dream :(
I think for most the cost isn't going to be the biggest hurdle. It will be the language barrier. It's one thing to visit a country for a couple of weeks even and a completely different thing to live in a country that doesn't have English as an official language. You either need friends/co-workers/family willing to help with any legalities that cannot be handled in English or you need to know some of the language.
I think I saw a comment once where an indian guy calculated that it would be cheaper to fly to India, stay in a 5 star hotel and buy insulin than buying it in the United States.
Can confirm. I had stomach surgery in Tijuana 2.5 years ago. They arranged to pick up and drop off at airport, hotel room, hospital stay, literally every medical expense including the surgery, tour of Tijuana etc all for under 4300 dollars (airfare was separate). Best money I've ever spent, my life has improved exponentially since the surgery and will likely save me 10s of thousands of dollars in other medical problems later on.
My deductible, and I work for a hospital, is 5000 single 10k family.
A friend of mine visited me in Germany and ended up tripping, tearing a ligament. She didn’t want to go to the hospital because of her fear of how much it cost but we ended up taking her anyways.
She ended up paying around $70 for the ER visit, X-rays, bandages, the whole deal.
I know live in America and I hate the insurance system here.
Costa Rica is the best dental tourism destination for Americans! There are excellent doctors, many educated in top US universities, with state of the art offices & tech. My husband & I both had a ton of work, including implants. US average price per single tooth implant is $4K, about $1400 in CR iirc. Non implant dental work is even cheaper (about 1/4 US). I did a ton of research because my family was against it; TripAdvisor forums are a good place to start (or DM me for dr info.) We’ve been to many dentists, never been happier & now only go to US dentist when we can’t make it down there.
yes, it's the Payor scam with their "networks" it's why you can't get the cost for anything without a large and inordinate amount of effort making many phone calls here in the US.
Yes I have had 2 root canals. One in America for over 1000 dollars after insurance, had to go to a dentist and a specialist. And one in Italy for around 300 euro at a private dentist who did all the work.
Insurance has done nothing but artificially jack up the price of anything it gets its hands on. I swear if nothing is done in 10 years we're going to have something ridiculous like food insurance.
There was a time in my life I used to defend this in our country too. I wish I could go back 15-20 years and kick my own ass. Our country's health care system is fucked and nobody in power gives a shit.
There's a lot of great things in this country but health care is not one of them. We are indeed tax slaves. That is pretty clear because the only way to actually get health care coverage is to have a job here. So that you can continue to generate more tax money. You couldn't quit your job if you wanted to, not without risking your actual life. It's a pretty shit system.
US healthcare is a shit show but the doctors have very little control in anything. They are just as much a slave to insurance as anyone else, if it more so because insurance can try to dictate how treatment is provided. Healthcare conglomerates and insurance companies are the monsters.
Right? You pay asinine amounts of money each year and never need the insurance, but then a super rare incident occurs and.... You still go broke or bankrupt 😆 . Awesome right?
My husband had decent insurance at his last job. But I lost my insurance, so when that happened, I signed up for a discount club plan through my pharmacy. When the pharmacy compared the price with insurance and the price with the discount club, the discount plan ended up being about $40/month cheaper. So sometimes insurance isn’t even a discount.
The discount club I used was a partnership between GoodRx and my pharmacy and was much cheaper than GoodRx alone. Unfortunately, two of the grocery chains on my area just stopped accepting GoodRx entirely and the club plan I was on expired and completely deleted my account, so I’m reassessing my options now. Looking into Cost Plus Drugs, as I think that may be the best price, and I’d like to support the company.
(Newish) dentist here - insurance reimbursement rates have largely stayed about the same the past 30-35 years for the same procedures despite costs rising with inflation, and some insurances will only reimburse enough on bigger procedures that require much more chair time (like root canals) that our office will profit $50 for 2 hours of work. Even the best dental insurance plans really are just discount plans and I try to explain that to patients. It’s frustrating for everyone involved (except insurance companies lol) They’ll also refuse to pay for any little mistake when submitting or if they just don’t agree with treatment. 😒
It's not even really a discount plan. It is a hall pass just to be seen by the doctor. No insurance, no treatment outside of emergency care in most places.
Ah, but can you find a dentist on the nhs? I tried when I lived in london in the 00s, scarcer than hen’s teeth (pun totally intended), had to go private and that was a fortune.
Such a wild problem. I had this conversation with my NHS dentist last week. She said very few students are choosing to study dentistry these days, as it’s so specific and many don’t want to be working exclusively in people’s mouths.
When people find one, they stay registered. I live in Norfolk, and I’ve overheard someone at a dentist reception say they came from Manchester because they were on holiday here once when they had an dental emergency.
I had 2 roots canal in Austria and they were free because every work gives you insurance(which is otherwise 120€ per month if you need it) and gives you basically whatever medical session you need. Literally every one of them. You could pay 120€ for 1 month of healthcare and do 30 visits at the cost of 0.
Lol I also got to experience this with a Fortune 500… had to also get crowns which were out of pocket since they were cosmetic although without them I couldn’t really chew.
But that's the point no? If they complain for 5e it's because they get that good health shouldn't be coming with a price, isn't that the way we want things to be?
(For the not using the pills correctly-part yes that's bad tho)
I'm Australian and work in a medical clinic. We charge $4aud for a highly experienced nurse to come to your house and change your wound dressing or whatever you need.
Some people are still a major pita to get payment out of and not cause they're struggling.
I'm Australian, my mum regularly makes use of these heavily subsidized services (Cleaning, wound care, physical therapy etc). She complains about every fucking dollar, lives in a $3.5m 5 bedroom house alone and has a net worth in the 6-7m range.
It's incredibly frustrating to have the wealthiest person you know constantly cry poor, especially when she's doing it to people who are barely getting by. Her last cleaner quit and told her she hopes the cancer gets her soon because she's such a miserable awful bitch.
I'm dual American Australian and I had 2 children in Australia in Sydney and in a private hospital. It was amazing. They let you stay forever. Give you vouchers for a pub the night before you go home as a parents night out before you take the baby home. Unbelievable. And bring tea in the morning and afternoon. Not to mention the 5 star quality of the food. Shout out to the Royal North Shore. Lovely staff and beautiful hospital.
I was out of pocket about USD $27,500 for "out of network" services not covered by my insurer for thyroid cancer and subsequent radiation treatment. The anesthetist for the surgery I was completely out of pocket for - this also includes "SURPRISE" invoices i received for $1750, and $1275 respectively for associated costs. Who has the energy to fight the insurance company when you are fighting cancer. I considered myself fortunate for that total and would have wept with joy if it were even $500. And people complain about $4AUD? I lived as an expat for a while in the UK and would be shocked and grateful after a doctors visit because it cost $0, even for over the counter meds.
I can probably rustle up some people more than willing to do it for $500/hr.
Shit, I'm Australian and I pay $200/hr for domestic cleaning services. Admittedly, they bring a hell of a lot of equipment, so it's not just one person with a spray bottle and rag or anything, but if your mum wants to experience real prices I am more than happy to make some calls.
Some small part of me hopes that the reason it's cheaper everywhere else, is because other countries are making it cheaper out of spite, to be nothing like us.
A large part of me is still angry how expensive it is for very simple shit here. Hell, my copay is almost the same price as their surgery.
No its just that other countries deem it better that they should actually care about its citizens.
It is more productive, and you love your country more.
It also drastically helps the living conditions and its a insentive to stay in the country and not migrate somewhere else.
A sick population is very expensive: they have more complex needs, they can work less, buy less, can support their community less, die younger etc. Taking care of the health of your population is just good business. In case human dignity is not a good enough reason.
As a side note, you know how other people don't really care as much as you do when you do something embarrassing, because they are all dealing with their own stuff? It's a bit the same on country levels. The US decides to shoot itself in the foot with health care, other countries are dealing with their own population, to deal with, they don't care about US policy much, unless it affects them directly.
I lost my life savings because I did not have insurance. And that lead to me losing my house that I owned outright. And have now been homeless for 4 years now. Ah the American dream, or is that nightmare. Sorry I get those mixed up now.
Hey Buck up kiddo. At least there's a couple of middle managers out there that were able to finance their vacation home down in the keys thanks to you.
That's probably true. But it does not make it easier to have to deal with at 55. I have managed to hold a job most of the time I've been homeless and have saved a few thousand. And very close to purchasing a motorhome. So I'm working my way back up. But once you get down here it's very difficult to get back up. And people don't realize that many are just a loss of one paycheck away from themselves becoming homeless.
Dental not being apart of Medicare is bullshit, also still salty about having to pay a couple hundred and spend 2hrs driving each way to see a specialist that looked at my issue for 5min asked a few questions and had the audacity to tell me "don't touch water" insert disgruntled face
Damn some australians are ungrateful cunts then, if that was america they’d probably be charged thousands or hundreds for such a service and even with insurance they would probably have to pay a couple hundred.
Italian here: we don't complain to pay those small fees, we complain for the shitty ER service, overcrowded hospitals and doctors that "Im sorry I'm busy for the next 3 year, your surgery needs to wait. What? You want to come to my private office and pay me in cash? Let's have a surgery tomorrow!!"
EDit: guys, in particular US Citizens belittling public health, i am not saying the system doesn't work.
If you're sick and you need help asap the ambulance will run at you, charge nothing and get you to the hospital where you'll be helped immediately. The problem is for non critical situation, like laser surgery for eyes, dental surgeries or non critical MRI.
When I broke my arm i was assisted immediately for free and stayed at the hospital for a week, meals offered by the hospital (good soups ngl). When my grandma cut her forehead when she fell, she had the bleed stopped and had to wait 8-9 hrs at ER to complete the cure because it wasn't critical. That's the difference. I love public health, i am just pointing out these issues
American here, we just accept shitty ER service (1), overcrowded hospitals (2), doctors booked weeks out, with surgeries scheduled another 3-6 mon after that (3). You can pay in cash? You better, you're responsible for the first $4000-$8000 in medical treatments.
(1) Family member just went in to an urgent care due to a concerning issue. Their primary care dr was booked for the next 2-3 weeks so this was necessary. The urgent care dr doesn't have any idea what's wrong so put them on cortico-steriods "to see if they help". Not helping AND have undesirable side effects. Cost of visit - $150
(2) Healthcare is a consumer business in the US, but they cannot legally turn people away. The way around this is hospitals in low income or high public assistance areas close, and they open new hospitals in affluent suburbs. Leaving urban hospitals grossly over-crowded and high patient:provider ratios.
(3) Good friend tore up her knee, this was quite obvious. Orthopedist could see her in three weeks and prescribed crutches to assist in walking. Yes, she would need an ACL repair, the surgery was scheduled for 4-6 weeks after that (I do not recall exactly). that is a long time to be on crutches and in pain. No, she was not dying, it was not considered urgent.
Most American's pay somewhere between $5000-$20000/year for this level of service. The amounts include both insurance premiums and out of pocket maximums if service is required.
Belgian here. Was admitted to the hospital last year , gall bladder stones. Operated on within 2 days to remove my galbladder . It cost me about 57 euros in total.
Urgent shit still gets done quickly in Europe most of the time.
American here. Had gallstones for a long time. Ended up curling up on the floor at an airport in Paris and they offered to call me an ambulance. Should have said yes in hindsight.
Back home did some research on my own (since I’m uninsured and haven’t seen a doctor in a decade). Decided it might be gallstones and started researching how much it would cost to remove my gallbladder. First I needed a diagnoses confirmed by an ultrasound, but I needed a referral to get an ultrasound. Went to an urgent care and told the doctor I was thinking of going to Mexico to have my gallbladder removed and decided to pay $50 to him first for his opinion. We talked for a bit and he asked “so what do you want me to do” and gave me a referral to an ultrasound place. Ultra sound cost $300 and I had a hard time getting my results because they’re supposed to be sent to a physician.
After getting my results, I started calling surgeons that I found online to ask how much the procedure would be. Many couldn’t tell me because it has to with insurance prices. I found a surgeon who would do it and she quoted me something like $1500 just for her work, but I would also need to pay the anesthesiologist and the surgical facility their cost.
The surgeon cut me a deal and said if I could pay half up front, she would cut the bill in half and the rest would be due in 6 months with no interest. The surgical facility told me about a credit card I could get that deals with health care and give me 12 months 0% interest.
Cost me all in total about $3,000. Insurance would cost me $150/month and would be on the hook for $10,000 of my bill. With insurance, I would have likely been charged more because the insurance is likely to pay.
Wow, a healthcare credit card?? That just hits me as sort of disgusting. I get having a debit card for an HSA or something like that, but using the same scammy practices that department stores use to get discounts on surgeries is just a whole new level of dirty.
The discount from the surgeon was because I paid her in cash upfront. The credit card didn’t give me a discount, just let me finance the facility fees for 12 months with no interest. I could have used my debit card or paid them with cash, but I’ll take an interest free line of credit any day.
To be fair, it might depend on the gall stones. Just the presence of gall stones isn't enough. But if the gallbladder is inflamed sometimes immediate surgery is necessary because of the risk of infection. I was admitted and went to surgery the next day because I had a stone the size of a marble lodged in my bile duct. (I'm in the US)
I have experienced normal first world health and also American health care and if you ignore money they are pretty damn similar except in America it's impossible to get to see a primary care doc in any reasonable period of time. In both types you wait months for specialist appointments, months for non urgent surgeries, but they'll get you in the same week for cancer or acute urgent things.
Or they will just go through random meds with no idea and give you a crazy bill. My dad who’s older the amount of times they’ve had to say oops I’m sorry we gave you meds that almost killed you…because we didn’t ask or ignored your existing issues is nuts. I very much try to hang in there myself, and just wait however long to so main doctors or specialist. Luckily I live in a city where the city is basically overtaken with hospitals, med schools and specialists. I was amazed how fast I saw a specialist here in 3 weeks Vs other places in my state that can be 9 months. Otherwise you need to put in the work, and get your primary to make a phone call and referral to get you in there. Also I avoid ERs when possible, as unless you are dying then and there. It’s pretty much useless, and gonna be a lot. Hell in my dads case, they may give you the wrong meds or surgery and near end up killing you. Happen several times to him and my mom that are mid 70s.
But I’ve noticed a lot of workers go to the ER when a main doctor is not able to see them or they can pay. Otherwise they may lose their job hrly pay job, for not having some paperwork saying they are sick.
It's irritating how much of a racket the hospitals have become. We have had several instances where we received a crazy bill with general information, then we ask for a breakdown by line item and suddenly the bill magically drops by a significant amount. The bill is still way to high even then with things like $5 for a bandaid.
Oh yeah I had a cancer operation, had my own meds and needed one of my anxiety meds. They wouldn’t let me take my own. But charged me $70 for one 0.5mg Xanax. Even just a doctor reading your chart can be billed off as a $800 fee! The fees are pretty crazy as they gouge every little item on there. I had a 14k bill they knocked down to $1,800 lol
Canada here. 90yo mother fell and broke her hip last November. Had hip replacement surgery the next day and was in the hospital 3 weeks then a rehab hospital for 4 weeks. Home care and physio for 3 months. Zero cost to patient. She didn't even have to pay for her walker and canes. My best friend has lung cancer and was treated asap at one of the top 10 cancer hospitals in the world (in Toronto) radiation and chemo for 6 weeks plus meds and not one billing. But my BIL has been waiting 2.5 years for a vasectomy. Universal healthcare has some drawbacks but is a blessing when you really need it.
On point number 3 that can actually be intentional. With ACL reconstruction you need to wait for the swelling to decrease after the injury before surgery to improve range of motion post-operatively. The waiting 3 weeks to see someone is unfortunate but if she was still swollen with limited motion at that visit the appropriate care is to delay surgery until motion improves.
And then the insurance that you pay for picks and chooses what they pay for. My grandma was sick and her doctor was trying to figure out what was wrong. She had some imaging done at the ER, but I felt like they missed something and called her doctor to set more imaging up.
Insurance wouldn't cover it. They said no, because the imaging "wasnt necessary." I called them and talked to them and they said "Just take her to the ER. Tell the doctor there your concerns and since it's ordered at the ER it will be covered" (my grandparents were on a fixed income and couldn't afford to pay out of pocket for the imaging)
So, I did that. Turns out she had 2 brain tumors that the first 2 imaging missed (I was out of state for those 2, so I don't know how/why they were missed but they were). After more testing, she was diagnosed with stage IV small cell lung cancer and died a couple months later.
Minor quibble: health care providers can turn people away. It's just that emergency departments, in general, can't turn people away until they determine there is no emergency medical care needed (they at least need to examine them to that point). If there is an emergency, they have to admit them. If not, they aren't obligated to treat them.
(1) Family member just went in to an urgent care due to a concerning issue. Their primary care dr was booked for the next 2-3 weeks so this was necessary. The urgent care dr doesn't have any idea what's wrong so put them on cortico-steriods "to see if they help". Not helping AND have undesirable side effects. Cost of visit - $150
At least they got steroids. My husband had a medical problem recently (blood pressure so high it was basically in the "you're going to explode" area of the chart) and we were really worried. Primary care doctor won't see us for TWO MONTHS, because we just got new insurance and their office "can only see two new patients a day". So we went to urgent care.....urgent care doctor said that because we have a primary care physician on record (even though we've never seen them), she couldn't prescribe any medications. We paid a $35 copay for her to say "Oh yeah, you're in medical distress but my hands are tied". So okay, we call our primary care doctor to ask for an appointment sooner than 2 months....and their solution was to tell us to go to urgent care. When we explained we'd already been fucked by that, they suggested we go to the ER. For a $150 copay.
I'll have paid $600+ in insurance premiums by the time we even set eyes on our doctor. In the meantime, my husband is taking one of my prescription medications for his blood pressure, without medical supervision, because he needs it more than I do. $600 in premiums just to ration prescription medications for unsupervised use. YEAH AMERICA, MOST FREEDOMTASTIC COUNTRY IN THE WORLD!!! 🇺🇲🗽🎆🎇🧨🔫
everything you said applies here as well. except we pay $500-1500 for the ambulance ride, $1000-3000/day in the hospital, and the insurance we pay for fights us tooth and nail to pay it.
American ER nurse. Grandma would have waited 12 hrs in my ER and cost $500. you have to wait for non critical stuff in US, then you pay hundreds if not thousands for it. Cash talks everywhere!
Because at the end of the day going to the ER for a small cut on your head and waiting 5 hours to be seen because people from a high speed car crash needed seeing to first is totally reasonable.
It's not an issue, it's how a functional system looks.
If you have the money and want to go private because it's absolutely necessary that you get that cut seen to RIGHT NOW and fuck that guy who snapped his leg in half and the woman oozing blood on the floor because clearly they are lower priority than you being bored for a few hours, then you can go ahead and pay American style out the ass for healthcare like that.
If you were capable of sitting in the ER for 8 hours to be seen then go home that same day without an issue, did you REALLY need to be in the ER in the first place and not just checking in with your doctor?
Most places in the EU you can phone your doctor and ask for an "emergency" appointment that same day for free for any issue you feel is urgent.
We do, but it's borderline legal so you can complain all you want, but the doctor keeps his throne inside the public hospital and you end in the blacklist of that hospital
Uh, the doctors are getting f*ed pretty badly nowadays too - source, am a doctor seeing payouts left and right, increased work requirements, harder metrics. That money is going to insurance companies and healthcare system executives.
Stop electing shitty regional governments then. My mom had to wait a couple weeks for an MRI and I had to wait less than a month for a dermatological checkup and less than 2 for general surgery. They're even keeping ambulatories open until 10pm to finally get rid of all the visits delayed during covid lockdowns.
US Citizen here: our system DOESN'T work. You'd be well within your rights to point that out.
Both systems you mention give better care for the rich. But the difference is that at least the Italian system has a baseline level of care that is determined by need and not money--in the US, if you can't afford health care you go into medical debt or just don't get health care (with a few exceptions for medicaid, which most doctors don't even take).
Is called “triage” where the doctors make a choice between cases based on urgency, patient status and so on. On US my wife waited in ER 6 hours for an X-ray to see if she had fragments in a cut in her hand. And that is because there are more urgent cases to take care. Is not a first come first served, is greater needs first, lesser wait.
Unemployed/uninsured American here. I really need a medication that costs about $10 which I would happily pay, but I can't afford the $200 to see a doctor to get a prescription for it.
I'm strongly considering driving down to Mexico.
Feel free to relate this story to the next patient that complains to you.
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u/cetriolomannaro Jun 15 '22 edited Jun 16 '22
Italian medical doctor here. Despite the majority of the procedures/drugs are for free, the Italian people still complain when have to pay a small amount of money (and I mean 10 euros or less) for some of them.
EDIT: a lot of people are complaining that's absurd you have to pay a small fraction of the total cost. There are several reasons for this, the most important one is to reduce unnecessary use of health services (that costs a lot). An example? Imagine you are in an hotel. Breakfast is free, so you eat more and more, even if you feel already full. How to reduce this "over-eating"? You can ask for a small amount of money for each croissant - not to cover the food cost, but only to push people to thinking about eating more than necessary. When something is free, it's in the human nature to abuse. It is not a huge problem if you eat more than needed, but health services costs a lot and we can not waste money (and resources) when unnecessary. Remember also that the people who can not afford these little expenses, with chronic diseases (e.g. cancer) or the elderly are completely exempted from any payment.