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Americans Are Skipping Doctor Visits Due to Costs

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Re: Americans Are Skipping Doctor Visits Due to Costs

#31

Post by carbocation »

wrp wrote: post #22
carbocation wrote: post #12

As a patient, post-2020 I find even basics like appointment scheduling to be hard. (I'm also an MD, which makes all of this easier for me, and yet it's still a morass of scheduling hell, too many phone calls, too many logins/reauthentications, etc.)

Although access got much worse in 2020, my impression is things are back to about what they were in 2019, which is still bad. My memory is that scheduling first became a serious issue when many doctors took early retirement to avoid dealing with the effects of the ACA. If you ignore the COVID bump, how would you describe the changes in accessibility from about 2014 until now?

People who had to deal with a lot of health care in 2014 may have had a worse experience, but my limited experience was that scheduling was pretty simple and clinics were more proactive, if that makes sense.

(I was also younger, so had fewer things to talk to my doctors about...)

Re: Americans Are Skipping Doctor Visits Due to Costs

#32

Post by frumper »

c_o_n_v_e_x wrote: post #28

My parents (both in late 60s) live in the US and I'm alarmed by what they tell me. Their old GP retired and sold his clinic to a "concierge" system/network (I don't know the terminology, been overseas for over 10 years so I'm not familiar with any of this.) You have to pay upfront a few thousand per year to get into the system. The US system sounds totally broken compared to my experiences within the Singapore and Au…

They should just find a new office. If theirs retired anyway, they’re getting a new doctor. They’d be on Medicare and the participation rate for doctors with Medicare is in the high 90s.

Re: Americans Are Skipping Doctor Visits Due to Costs

#33

Post by tppiotrowski »

I had a virtual care plan from Kaiser Permanente. What I liked:

- you can email a photo to the dermatologist and get a diagnosis for free. I used this for moles and rashes. Saved me a visit and $$

- you can email the doctor for free and chat with a nurse for free and if they refer you for labs or vaccines you just go directly to the lab and get your results online. No time with doctor required.

I am young and have no major health issues. I found this a drastic improvement over going to see a doctor in person, being told to take Tylenol + rest then getting a $700 bill for that advice.

Re: Americans Are Skipping Doctor Visits Due to Costs

#34

Post by solardev »

str3wer wrote: post #15
solardev wrote: post #14

Earlier quoted context omitted.

What happened in 2020?

a global pandemic?

Ohhhh yeah, lol. I always forget that really took off in 2020 (since it's called COVID-19). What even is time anymore =/

Anecdotally, though, it seemed like a lot of healthcare providers at the time moved to having better online appointment systems and remote visits, which made scheduling a lot easier for me. Probably a heavily YMMV situation though.

Re: Americans Are Skipping Doctor Visits Due to Costs

#35

Post by solardev »

nielsbot wrote: post #27
solardev wrote: post #11

We can't even get people to pay $14/mo for YouTube without ads, and you expect them to pay for healthcare?!

I don't understand this comment--what do you mean?

I just mean that people will be cheap and complain endlessly about small trivial things that they use all the time (like YouTube, or Netflix, or an IDE) rather than paying for it. And those things are like $20/mo and have an immediately visible benefit.

Meanwhile, a doctor's visit can cost anywhere from $50/visit (with good insurance and a copay) to hundreds of dollars, more for special procedures, and more for prescriptions, etc. Much of the time you walk away with the problem not really solved, requiring multiple referrals and specialist visits. It's really easy to want to put it off till later, especially when money's tight. Yes, the situation gets worse over time, but it's one of the easiest things to procrastinate on.

It's part of the reason I hate for-profit healthcare... it discourages routine preventative care that could help a lot of people and prevent more expensive treatments later, instead of just making them put it off until an ER visit is needed.

Making people pay for their healthcare like this just means few people are going to use it routinely, instead waiting for their condition to worsen and fester. Especially teeth, yeesh, where even good insurance doesn't get you much.

Re: Americans Are Skipping Doctor Visits Due to Costs

#36

Post by danans »

c_o_n_v_e_x wrote: post #28

My parents (both in late 60s) live in the US and I'm alarmed by what they tell me. Their old GP retired and sold his clinic to a "concierge" system/network (I don't know the terminology, been overseas for over 10 years so I'm not familiar with any of this.) You have to pay upfront a few thousand per year to get into the system. The US system sounds totally broken compared to my experiences within the Singapore and Au…

> Their old GP retired and sold his clinic to a "concierge" system/network

Concierge medicine is a luxury service where you pay an annual out of pocket membership fee to have a doctor always on call, including home visits. Its popular among the very wealthy, but not affordable for most people.

Re: Americans Are Skipping Doctor Visits Due to Costs

#37

Post by otikik »

kube-system wrote: post #10
mynameisnoone wrote: post #2

I de facto require semaglutide due to the side-effects of the only anti-depressant I'm able to tolerate (I've titrated up and down on 17+). Unfortunately, I currently don't have health insurance and hovering at 35% excess weight. There's no point in my going to a doctor when all of their recommendations are "window shopping". The only way this shit stops is not Medicare for all, which is a red herring with third-clas…

> The ultimate solution is [...] making for-profit health insurance illegal. > Every other free country in the world has [...] ... and most also have private health insurance too. Some have a higher percentage of people with private health insurance than even the US does, often in a supplementary role.

Well we do know how much we are going to get charged by private hospitals, at least.

Re: Americans Are Skipping Doctor Visits Due to Costs

#38

Post by jonex »

frumper wrote: post #29
SnorkelTan wrote: post #9

Earlier quoted context omitted.

Gastric bypass? Has the benefit of being a onetime payment instead of in perpetuity.

I’m sure some people have, but of the half dozen people I know to have gotten a gastric bypass, all of them were about where they started no more than 5 years later.

Weight gain does often happen a few years post treatment. Even then it's beneficial compared to no intervention, which would most likely have them be even worse off five years later. Long term health outcomes are better for those who get treatment than those who don't.

Re: Americans Are Skipping Doctor Visits Due to Costs

#39

Post by genocidicbunny »

modeless wrote: post #18
carbocation wrote: post #12

As a patient, post-2020 I find even basics like appointment scheduling to be hard. (I'm also an MD, which makes all of this easier for me, and yet it's still a morass of scheduling hell, too many phone calls, too many logins/reauthentications, etc.)

Appointment scheduling is beyond awful these days. We're getting specialist appointments scheduled literally a year out, or just outright rejected because they're too full. It's de facto rationing.

My PCP retired over a year ago and I have been trying to find a new one. The few even taking new patients would either schedule the 'first meet' appointment several months out (and then go 'whoops, the doctor is not in the office on that day, can we reschedule for another 4 months out?'), or I would basically just get the cold shoulder when they found out what insurance I have.

I actually ended up finding a new PCP in the next state over. It's a 10hr drive one way to see them, but when adding up the time, travel costs and other expenses, it's still cheaper than most of the concierge health services in my area.

Re: Americans Are Skipping Doctor Visits Due to Costs

#40

Post by modeless »

wrp wrote: post #24
modeless wrote: post #18

Earlier quoted context omitted.

Appointment scheduling is beyond awful these days. We're getting specialist appointments scheduled literally a year out, or just outright rejected because they're too full. It's de facto rationing.

Experiencing that, too. Are these long waits due to anything other than a shortage of specialists? If not, why is there a shortage? I thought more doctors wanted to be specialists because of better hours and pay.

There is a shortage of every kind of doctor engineered by the AMA, which is essentially a labor union.
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