361–370 of 534 posts
Earlier quoted context omitted.
Taking a kid with fever to the ER is about as basic as you get.
Doesn't the US have out-of-hours pharmacies, or out of hours doctors, or urgent but not emergency treatment centres?
Earlier quoted context omitted.
$300 is a steal.
$300 [1] is more than I’ve spent on (non-dental) helthcare, in total, over my entire life. That includes one count of general anaesthetic and emergency surgery because of testicular torsion which happened while I wasn’t registered with any local doctor, one burned arm, one being knocked unconscious by a trampoline, and one being hit by a car. [1] “after premiums” is roughly the same as “after taxes”, right?
Earlier quoted context omitted.
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.
My host family father (anesthesiologist) works from 7am to about 3pm (works for Einstein medical center in Philly). He pulls weekend extra time (on-call) to make ~$1000/call on Saturdays (to support his hobbies like expensive bikes and lens for photography). Gets paid well above $400K/year until he retired in 2015.
My host mom works as at a quasi-private psychiatry treatment center where she manages about 20 in-house patients (almost always the same patients who she has been treating for many years). She goes to work just like any other 8-5 job. Very relaxed atmosphere. Gets paid very well (to the tune of more than $320K/year until she retired in 2016).
My gf and her fellow residents at the hospital do not have a lot of stuff going on during most part of the days. She is a bit luckier than average resident in that regard though because her hospital is in a suburban setting. Her friends who got into residency programs like in Brooklyn, Bronx or Queens (e.g., Elmhurst hospital in Queens) have to work harder in their first and second years (especially only the first year). But not as bad as like 80 hrs/week like what you read in exaggerated news articles. Sure they work more than 40 hours because of on-calls and night duties. But definitely around 60 hrs/week (never approaching more than 70).
All this is to say that the work hours of US doctors and medical residents (doctors in training) that we see in the news, I suspect, are a bit exaggerated (of course, they have to be bad/outliers in order to be in the news).
I'd like to add that my host parents practiced in the UK for almost 7 years, and decided to move to the US (practiced here for almost two decades) because in the UK, they made like a quarter of what they were able to make in the US.
Last but not least, all of them (my host parents and my gf) studied medicine in Burma (a third world country) for 5 years only (+2 years of residency). Certainly, the education one can get at Myanmar government-funded medical Universities isn't top-notch or state-of-the-art, but most med students learned on their own by supplementing with private classes, self-learning and practice (e.g., shadowing doctors). They (international medical graduates) score very well (usually better than their US peers--see chart #6, #7 in [1]). The point I'm trying to make is that we do NOT need 4 years of undergraduate education for wanna-be doctors (pre-med students) because that is not necessary and adds more debt burden to future doctors. This artificial barrier to entry is adding to the inflated healthcare price by making it very difficult for anyone to become a doctor in the US. We don't need 8 years of college and medical school education for most specialties; in the end, the garden-variety illnesses can be diagnosed by reading up references like [2], and it doesn't take 8 years of training to do that.
[1] http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outc... [2] https://www.uptodate.com/login
P.S. This rant is partly contributed by my experience when I got an ear infection (acute otitis media) last week and saw a doctor in New York, who charged me $200 for looking into my ears with otoscope for 10 seconds, and wrote up a prescription (the entire encounter lasted no more than 5 minutes). Since my deductible is high ($3K/yr), I had to pay $133 out of pocket. The oral pills (amoxicillin-variant and an antihistamine) for three days costs $30 (which I paid). The worst part is seeing the $283 price quote for ear drop (CIPRODEX). When I decided to not buy that and asked my doc for a more generic version, that costs $35. I asked my mom to buy the same generic version of ear drop from Myanmar as she is visiting me this week. The ear drop costs $15 a piece there; doctor consultation $40; oral pills $7 (for two weeks supply just in case I get the ear infection again in the near future).
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,…
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…
>It’s just that they pay it into a private insurance system that wastes large portions of it on rents and administrative redundancy. Would love to see a breakdown of real estate and admin costs for private insurance systems throughout the States to understand how much could be saved by eliminating redundancy. Not seeing this broken out in Anthem's Financials: https://ir.antheminc.com/static-files/73562e56-886c-4ff5-a…
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.
The profit margin is the amount by which revenue exceeds costs.
It's circular reasoning to point out that an industry with enormous redundant costs has low margins.
Earlier quoted context omitted.
Yeah, like did you know that 18 is the legal drinking age in the US? That's why 18 year old soldiers can drink alcohol in the military. BUT, if a state increases the drinking age to 21 in their state then they get sweet sweet federal highway funds. For a long time Louisiana was a holdout, so 18-21 year olds would go there to party for mardis gras, and the road quality showed it.
NB: in most states minors can drink alcohol if served by a parent. I'm not encouraging underage binge drinking, but if you want to have a quick pint with your high school senior, that's absolutely legal.
I live in Indiana. Lets shut down the interstates for non-Indiana citizens. Yes, that means the I69, I65, I70, I90 corridors.
The feds would have came to a 'deal', in new speak.
Earlier quoted context omitted.
According to the article, workers in Denmark see 26.7% of compensation go to "compulsory payments" including taxes and health care. Workers in US pay 43.2%. Why should I trust your figures over the article? Are you including the "employer contribution" toward your taxes and health care premiums?
Yeah, that's the thing. The true cost is somewhat hidden because of the employer part of the premium. And the costs you pay out of pocket when an actual health event happens. I imagine you can still pay $1000+ out of pocket to have a baby in a US hospital, even if you have great insurance. Also, the article talks "average", while I imagine US health costs are highly variable depending on whether you are young, old, s…
I just got that bill, in fact, and we have about the lowest deductible insurance you can buy, at a cost of about $1500/month. It was still $6500.
Earlier quoted context omitted.
For me it's the opposite. I moved from Denmark to the US, and I pay around $400 in health insurance premiums (health, eye, and dental) for a whole family. In Denmark, only health is covered, so for eye and dental many go out-of-country to get it cheap. The US is much cheaper for all health insurances, except if your poor. Obama tried to fix that, but made it worse and more expensive for everyone (socialism).
If you're employed and your employer is generous, then your insurance premiums can be inexpensive (low double digits per month if you're single, low triple digits if you have dependents) . My wild speculation is that most employers aren't as generous as they could be. If you're "poor", insurance is actually cheap, because that's when you get public insurance. However, if you're just middle income, health care is a no…
When I became a salaried employee in the Bay area I went to an urgent care recommended by Cigna and my allergy problems were resolved inside of 15 minutes with a $20 copay.
Obamacare is anything but cheap when you are poor.
Earlier quoted context omitted.
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 fa…
Lol. I wish. For me it was 5 digits. Closer to 6 than 4. And I had a $1,800/month premium for a family of 4. Spent multiple hours per week for months on end playing phone tag for the hospital and insurance company until it got resolved. Hospital billing also told me to not worry because nothing ever gets paid until both sides start suing eachother.
Yeah, this is peak efficiency. I just love taking up "resolving medical bills" as an unpaid part time job for the better part of a year.