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What We Learned from a Year of Americans ‘Risking It’ Without Insurance

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Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#51

Post by bigpoo »

jmalicki wrote: post #13
SolaceQuantum wrote: post #7

I've tried to understand the circumstances preventing socialized medicine in america. I understand there are arguments against socialized medicine, but they make no sense to me on their face (eg. the idea that long wait times would occur, when wait times for USA and wait times for other first world countries with socialized medicine isn't very differe. The idea that socialized medicine would cause less medicine resea…

What do you mean by socialized medicine? If you mean government required and subsidized, like the systems of France and Germany, which have great healthcare systems, that sounds wonderful . If you mean single-payer healthcare, like Canada and the UK, screw that disaster.

If you mean disaster as in people not going bankrupt because of medical bills.

Or maybe you mean the disaster of there not being upwards of 40,000 deaths a year due to not being able to receive basic health care.

...

Oh wait that is all problems they don't have in Canada and the UK but we do have in America.

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#52

Post by maxxxxx »

standerman wrote: post #28
SolaceQuantum wrote: post #7

I've tried to understand the circumstances preventing socialized medicine in america. I understand there are arguments against socialized medicine, but they make no sense to me on their face (eg. the idea that long wait times would occur, when wait times for USA and wait times for other first world countries with socialized medicine isn't very differe. The idea that socialized medicine would cause less medicine resea…

The people that own insurance companies would become less wealthy. The industries (the 6 companies that own the majority of the media industry https://www.morriscreative.com/6-corporations-control-90-of-... ) that rely on the revenue from all the insurance ads would suffer. There's a decent amount of jobs created by all the inefficiency. Overall it's a boost to the US economy, but at the cost of immense suffering fro…

By that logic you could just impose more busy work on the economy and it would get a boost. Let's say we mandate that every employee needs to have someone that follows them every day and boom, we have doubled up the number of jobs.

The money for these inefficiencies has to come from somewhere and that area will suffer.

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#53

Post by CptFribble »

The problem I see is that even if ACA was "working as intended," it would still be an incomplete solution.

We buy off our state marketplace, but can only afford bronze tier plans with the subsidy. All plans are the same at low tiers, and all make you pay the deductible before the insurance company pays a dime (not counting "negotiated discounts," which are completely invisible until after the bill is generated)

That means we're not really signing up to be able to go the doctor, but to not go bankrupt in case of major illness. We buy insurance only to cap our risk at the annual out-of-pocket max. That we get a "free" physical is just a consolation prize.

I think a lot of people don't see it that way. As others said, most people see it as money wasted if they don't get sick. And that's a problem.

I don't blame the ACA for our issues in the USA, I blame everyone in the government who worked tirelessly to ensure insurance companies can continue to tax our doctor visits for shareholder returns.

We need Medicare For All. No one should have to skip going to the doctor because the insurance requires $6k-$8k of blood money before they start performing their function and paying for healthcare, or even let us pay "just" a co-pay.

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#54

Post by veddox »

devereaux wrote: post #40
NicoJuicy wrote: post #16

Wow, being used to Belgian healthcare... This article really makes America look primitive. We pay a lot of taxes, but at least I don't have to worry about money, if i would get severely sick. Eg. - A checkup at the doctor ( blood) costs 2€, results within 24 hours. - Additional costs are required upfront by law. If I'm not mistaken, you can't even get an estimate on the US.

What's the cost of a checkup at the doctor for a foreign tourist? (who I assume will get results also within 24h, and be informed about upfront costs if it's the law) What's the medican income in Belgium? In the US? I just don't understand how people in HN of all place complain about the costs of healthcare. I believe America has a better system, especially if you are in the hacker mindset (and with IT salaries!). Ju…

That is assuming you have the choice. Many people simply can't afford to "take their business elsewhere". The American system may be great if you have the money - but a society is measured by how it treats its weakest members, not its strongest.

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#55

Post by josho »

yodsanklai wrote: post #37
NicoJuicy wrote: post #16

Wow, being used to Belgian healthcare... This article really makes America look primitive. We pay a lot of taxes, but at least I don't have to worry about money, if i would get severely sick. Eg. - A checkup at the doctor ( blood) costs 2€, results within 24 hours. - Additional costs are required upfront by law. If I'm not mistaken, you can't even get an estimate on the US.

My European point of view is that on many social issues America is primitive, not only healthcare. I didn't realize it before I lived there. Although some people would argue that it's a feature and not a bug, in the sense that Americans pay lower taxes and are free not to spend on healthcare if they don't want too.

> free not to spend on healthcare if they don't want too

At an individual level that is correct. But at the macro level it is wrong because when a person gets sick those costs are realized in the economy (eg. instead of cheap preventive care up front avoidance of early treatment means some percent will end up in much more expensive ER services that will cost more than if all those individuals saw a family physician).

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#56

Post by devereaux »

onychomys wrote: post #25
devereaux wrote: post #12

I have the best insurance money can buy: a plane ticket to %anycountry (business class if needed) Cost of emergency endoscopic shoulder surgery in a private for-profit hospital in France, when totally uninsured, and paying by credit card: 1900 Eur - including anesthesiologist fee, surgeon fee, facility fee, radiology, drugs, private room etc. So around $2200 total, done the same day, after being arranged by phone. It…

It's going to be rough on you if you're hit by a car in Chicago and you only have insurance in France. There's a world of difference between emergency endoscopic surgery and a trip to the ED (or ER, or A&E, or whatever your country calls it).

My spouse had a trip to the ER at one of the most expansive hospital in Spain: 700 Eur, so about $900, all inclusive (radiology + seeing 2 doctors + bandages + the various fees they sprinkle the bill with). Top service. No delay. No hassle. They even provide a translator to follow you around in the hospital and make sure you get a great experience and come back again.

Considering the medican income in Spain in around $1100, I understand why they like clients who can pay $900 no question asked.

We are now investigating getting coverage in some European or Asian country, where they sell insurance for non residents + world coverage + air repatriation (in case of a serious condition, like getting hit by a car in Chicago) at a decent price.

Best we've found so far is around $120 month, with something around a $1000 all-inclusive medevac fee (that gets you in a plane, with a doctor and everything needed)

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#57

Post by olyjohn »

devereaux wrote: post #40
NicoJuicy wrote: post #16

Wow, being used to Belgian healthcare... This article really makes America look primitive. We pay a lot of taxes, but at least I don't have to worry about money, if i would get severely sick. Eg. - A checkup at the doctor ( blood) costs 2€, results within 24 hours. - Additional costs are required upfront by law. If I'm not mistaken, you can't even get an estimate on the US.

What's the cost of a checkup at the doctor for a foreign tourist? (who I assume will get results also within 24h, and be informed about upfront costs if it's the law) What's the medican income in Belgium? In the US? I just don't understand how people in HN of all place complain about the costs of healthcare. I believe America has a better system, especially if you are in the hacker mindset (and with IT salaries!). Ju…

Maybe because we care about people who aren't making IT wages and can't afford to fly around and take weeks off at the drop of a hat.

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#58

Post by devereaux »

TheLuddite wrote: post #46
devereaux wrote: post #24

Earlier quoted context omitted.

Not travelling because of some pain? Painkillers + business class. Not travelling because I'm unconscious or in a critical condition? Foreign insurance + air repatriation. Some countries do sell that, even to non residents. Just get world coverage - it's a bit more than $70, but if something bad happen, you get med evac'ed to that country and treated there. I'm exploring that option as I discover the wonder of medica…

Thanks, that's really surprising...not the stiff upper lip...but the repatriation. I thought it's only for people with residence + VIP client in a bank or something.

My suggestion next time you do some tourism: ask. Get quotes. Read the whole contract.

You will be surprised what some places offer.

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#59

Post by hathawsh »

chillwaves wrote: post #45
hathawsh wrote: post #18

Earlier quoted context omitted.

I think people are holding on to the hope that competition in the marketplace will control prices and bring them back to reasonable levels. I know I held on to that hope for a long time, but it's becoming clear that mere competition among insurance providers isn't a strong enough force. Medical prices are so high now that I think people are ready to consider drastic change.

How can there be competition when there is no price transparency? No ability for the consumer to shop around? How does anything about the way medical care is administered in the US work in the context of the mythical "free market"?

Chargemasters may be going online as early as next week:

https://www.healthleadersmedia.com/finance/put-chargemaster-...

It's not clear that this will have the intended effect (since insurance always pays a heavily discounted price), but I think it's a step in the right direction.

Re: What We Learned from a Year of Americans ‘Risking It’ Without Insurance

#60

Post by chillwaves »

devereaux wrote: post #12

I have the best insurance money can buy: a plane ticket to %anycountry (business class if needed) Cost of emergency endoscopic shoulder surgery in a private for-profit hospital in France, when totally uninsured, and paying by credit card: 1900 Eur - including anesthesiologist fee, surgeon fee, facility fee, radiology, drugs, private room etc. So around $2200 total, done the same day, after being arranged by phone. It…

Do you know what the actual costs associated with common accidents and hospital trips are? I got in a car accident and had 3 surgeries and a one week stay in the hospital.

The bill was over $120,000. And I was not in any condition to reject treatment or shop around, as you seem to do in your fantasy scenario.

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