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US Workers Are Highly Taxed If You Count Premiums

peoplespolicyproject.org

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Re: US Workers Are Highly Taxed If You Count Premiums

#341

Post by pmiller2 »

refurb wrote: post #234
FactolSarin wrote: post #89

Earlier quoted context omitted.

The greatest trick healthcare companies have pulled is convincing Americans that after hours visits for things like high fevers and broken bones isn't basic care. I'm 40, and my Mom was telling me about how my brother cut his head as a child, and the local small town doctor came in after hours to stitch it up. Different era.

That’s what urgent care is for. You shouldn’t be going to the ER for a typical fever or a cut requiring stitches.

What do you do when they’re closed? Guess how many urgent cares within 15 miles of where I live are open at 3:30 AM? I live in a major metro area, and the answer is ZERO.

Re: US Workers Are Highly Taxed If You Count Premiums

#342

Post by dragonwriter »

geggam wrote: post #339

One thing he missed. Only in the US can you be bankrupted with full coverage, a simple medivac helicopter ride would take care of most Americans.

You can't be bankrupted with full coverage (except by the cost of premiums), but very few, proportionately, Americans have anything like full coverage.

Re: US Workers Are Highly Taxed If You Count Premiums

#343

Post by maxxxxx »

Spooky23 wrote: post #305
vonmoltke wrote: post #68

Earlier quoted context omitted.

> In the US you can happy if your cost for seeing a doctor is less than 4 digits. My wife and I have never paid four figures for a doctor visit, despite having two surgeries (one oral), a calf strain, and a dislocated shoulder (with ER visit) between us. The state of medical care in the US is bad enough as it is; you don't need to make up hyperbolic bullshit to make it seem worse.

It happens with high deductible plans. When I had back surgery I was with a public employer PPO. Total out of pocket was like $300 for about $500k of procedures. Half the people in my recovery PT were selling cars and emptying 401ks to make the mortgage.

That’s the crazy thing about the US system. For a lot of people things work smoothly like it did for you. Then you have a significant number of other people who get totally screwed with out of network stuff, billing errors and the insurance declining payment for random things. These people now have to have to negotiate often for years, fight collection agencies and often end up owing thousands and tens of thousands of dollars. It’s a big gamble and there is pretty much nothing you can do to protect yourself.

Re: US Workers Are Highly Taxed If You Count Premiums

#344

Post by fre3k »

bzbarsky wrote: post #319
Delfino wrote: post #278

Earlier quoted context omitted.

Yeah, this has baffled me before. I remember learning in my Family & Consumer Sciences class about the importance of being an informed consumer. Then, in college I had to get a dental procedure done and I called around to try to find out the price from different dentists and no one could give me any actual numbers. I ultimately just had to pick a place based on reviews and found out the price after the fact with no k…

That's odd. Dentists, unlike doctors, will in my experience just give you a price if you ask for it... Maybe this varies state to state?

They used to but it's dwindling. A friend of mine is a dentist and he said when he first graduated from dental school some 15 years ago, his father and his practice dealt directly with the patient and had a list of all of their prices on their website and in their office. As customers increasingly wanted to have their insurance cover dental they had fewer and fewer people paying out of pocket and going through insurance. So prices went up due to increased complexity of the business.

Re: US Workers Are Highly Taxed If You Count Premiums

#345

Post by lhorie »

wolco wrote: post #327
lhorie wrote: post #228

Earlier quoted context omitted.

Technically I did, since my taxes pay for it. What I didn't pay for is the overhead of clerical work from two different corporations for mailing me letters informing me of how arbitrarily priced my doctor visit was.

You did pay for it. Half of the Ontario budget goes towards it. The fact that you would go without thought of the cost but in a similiar situation would avoid because of the direct costs shows why the Ontario system is a poor model. The costs are hidden so more services are used. If costs were direct paid for out of your Ontario fund (a yearly budget that if not used would be carried forwarded or removed from your ta…

My taxes pay for the doctor's time, the nurse's time, the receptionist's time, etc. And that is entirely fair. It does not pay for clerical workers in different companies to be sending paperwork back and forth to satisfy some systematically complicated pricing structure, because such a thing does not exist. And it certainly does not pay the salary for the CEO of CollectiveHealth or whatever your provider is.

> The fact that you would go without thought of the cost but in a similar situation would avoid because of the direct costs shows why the Ontario system is a poor model

The pricing is hidden from me regardless, except that in one case people get the care they need and go on with their lives, and in the other I hear stories of people getting a surprise 4-digit bill in the mail three weeks later, after already paying through the nose for insurance.

When you look at international rankings of standard of living, the Ontario system is considered a good model (along with other similar healthcare systems such as those in nordic countries). The US model is poorer on several fronts, from pricing opaqueness to availability for low income people, and let's not even go into medical bankruptcies...

Re: US Workers Are Highly Taxed If You Count Premiums

#346

Post by cpach »

elliekelly wrote: post #325
mercutio2 wrote: post #273

Earlier quoted context omitted.

Agreed! The way countries with cheaper healthcare manage to spend less is by paying healthcare workers much less. Doctors and nurses in the US are high status. When they lobby against something, it’s hard to win. When I read people discussing cheaper healthcare, I always go looking for the part where they explain that healthcare professionals will make a significantly lower dollar per hour. I rarely find this discuss…

I wonder how the earnings of American doctors compare to European doctors once you've removed the high cost of an American education/all those student loans they're paying off.

Work hours could also be a factor. I’m quite sure US doctors work more than European doctors.

Re: US Workers Are Highly Taxed If You Count Premiums

#347

Post by refurb »

pmiller2 wrote: post #341
refurb wrote: post #234

Earlier quoted context omitted.

That’s what urgent care is for. You shouldn’t be going to the ER for a typical fever or a cut requiring stitches.

What do you do when they’re closed? Guess how many urgent cares within 15 miles of where I live are open at 3:30 AM? I live in a major metro area, and the answer is ZERO.

We have some 24 hr ones here, but yes, if it’s not an emergency, but you need immediate attention, the ER might be your only option.

Re: US Workers Are Highly Taxed If You Count Premiums

#348

Post by fucking_tragedy »

analog31 wrote: post #107
dnautics wrote: post #91

Earlier quoted context omitted.

Private healthcare insurance has margins well below most profitable companies, in the us. If anything I'd hazard that the poor treatment of consumers by these entities stems from being barely able to hold the line, not because of greed. Rising medical costs, I think, have the blame elsewhere, but insurance companies sure do make a good Boogeyman for politicians, because they are very poorly understood.

Somebody's gouging us. Who? Everybody cries poor and points the finger at everybody else. Nobody knows where the money is actually going.

> Somebody's gouging us. Who?

Owners, executives and shareholders. Look at who owns the hospitals, practices, labs, insurers, suppliers and associated facilities.

Re: US Workers Are Highly Taxed If You Count Premiums

#349

Post by glangdale »

Someone1234 wrote: post #19

I moved to the US from a country with socialised medicine. When you include premiums then taxes in both were roughly similar if not a little higher in the US (ignoring cost of living differences). But even that doesn't include the real sting on the tail of US medicine. You pay a fairly high health insurance premium, but if you actually need health services you then pay again through the nose even with insurance "disc…

Can confirm. Moved from US back to Australia. Had one child born in USA, one in Australia. Neither birth was super-complicated (both in maternity hospitals)... The most expensive thing about the Australian birth process was the parking - had to pay an exorbitant $24/night to park in an open lot. So the whole thing cost about $36 or so.

I forgot the fees on top of our insurance in the US (it being >16 years ago) but it was pretty steep.

Re: US Workers Are Highly Taxed If You Count Premiums

#350

Post by henrikschroder »

TallGuyShort wrote: post #216
Someone1234 wrote: post #19

I moved to the US from a country with socialised medicine. When you include premiums then taxes in both were roughly similar if not a little higher in the US (ignoring cost of living differences). But even that doesn't include the real sting on the tail of US medicine. You pay a fairly high health insurance premium, but if you actually need health services you then pay again through the nose even with insurance "disc…

Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, but it turns out their definition of a physical didn't include the doctor's definition, which included blood tests. So before I had my blood drawn, I asked them to tell me what the tests would cost if my insurance didn't cover it. "It depends on how it's coded,…

I was at the dentist today because I managed to chip a tooth yesterday, and needed it fixed. Before the procedure, they asked if I wanted an estimate, I said sure, and got one in a minute.

The dental industry works the same as the medical, I have a half-useless insurance that covers too little, and out-of-pocket expenses are always higher than you expect. But if they can do estimates before a procedure, why the hell can't the medical industry do the same?

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