Health

How does American healthcare actually work?

Ericsson / Engrawr🙈🙉
Mar 2

Tired of seeing all this BS on the news. Can some people actually inform me on it? Is it really as bad as they say? I want to hear your opinions. Thanks everyone :)

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  • Facebook public2
    If you are rich it is the best in the world, else it's unaffordable and or non existant. One political party wants to add insurance for all, the other wants to remove it. That's basically it.
    Mar 21
    • Apple / EngJCmS82
      Yeah, huge disparity based on means.
      Mar 2
  • Microsoft PizzaMan
    It’s not bad if you have money or work at a good company (tech)
    Mar 210
    • Ericsson / Engrawr🙈🙉
      OP
      What happens when you retire though? Or if you get fired?
      Mar 2
    • Microsoft FCTT57
      Even then it's shit. Went to the ER for something somewhat minor (ER was justified but it took 30mim to fix). "Oh, your insurance covers everything in this hospital except that specific doctor who is outside your network and we couldn't tell you beforehand, $4k please". WTF
      Mar 2
    • Amazon wFOC46
      Medicare/Cobra. Medicare is for people that legitimately can't afford healthcare, cobra lets you pay out of pocket while changing jobs.
      Mar 2
    • Microsoft PizzaMan
      Also, this is why 401k and HSA is super important for retirement
      Mar 2
    • New / Eng👄 𓂸.
      After age of 65 Medicare covers your medical expenses.
      Mar 2
    • Microsoft DangerRngr
      Yep. It is “ok” if you are in the 5% upper bracket and fine with having 95% of your fellows being screwed over.
      Mar 2
    • Oracle tamatar
      Sounds like the 'survival of the fittest' argument, except richest aren't (biologically) the fittest anyway, especially the techies!
      Mar 2
    • KLA-Tencor Ajdp17
      Until couple of centuries ago, the physical attributes dominated the definition of "fittest" but it is now the intelligence that dominates the definition of"fittest". Take for example neanderthals and humans - although neanderthals were relatively huge, they didn't survive colder climate. So it's a misnomer to use fit which many people would mistake it to mean physical fitness. It should be renamed "survival of the best"
      Mar 2
    • Oracle tamatar
      I had expected that someone would raise that point, and that's why I said "biologically".The way techies work, neither does that reflect the highest intelligence, nor will they live long enough and propagate their genes in high enough numbers for the survival of the fittest to play out.
      Mar 2
    • Amazon Jefe bejos
      Fitness is determined by a function relating the survival probabilities of given genotypes/phenotypes in a population to their frequencies in the population. If those with more intelligent phenotypes have a better probability of survival then they are more fit. If access to Medicare makes this so then they are still by definition, more fit
      Mar 3
  • Microsoft DangerRngr
    It is just a business as any other except that the “free” (😂) market is completely rigged by corporate money holding politicians hands.
    The US healthcare system does not work and is totally inefficient if you look at the spendings per capita and life expectancy.

    It is a manifestation of capitalism’s monstrous late stage.
    Mar 25
    • PayPal / MgmtaSpy
      Health care is not a free market and not intended to be.
      Mar 2
    • Microsoft DangerRngr
      Absolutely! The problem is that it is only “regulated” to take advantage of the people.

      It would just be a joke if it was not for the deadly consequences
      Mar 2
    • Oracle tamatar
      Let the doctors compete for our cash, without the in-between entities. That would be a real free-market. Then costs would come down and the poor could then be covered like in other programs.
      Mar 2
    • New / Eng👄 𓂸.
      Biggest rigging is artificial cap on number of doctors graduating per year in US. That creates a shortage of doctors increasing prices.
      Mar 2
    • OpenTable Meliodas
      Healthcare is not close to being a free market.

      The bulk of medical costs are not the doctors’ fees. It’s the rest of the leaches in the industry without a medical degree.
      Mar 2
  • Amazon / Eng
    HveP82

    AmazonEng

    PRE
    Amazon
    HveP82more
    I'm from Italy, and one of the most disgusting things here is that people are scared to go to do hospital because of the bill. Like people felling and hurting themselves badly, saying "let's wait to go to the hospital, maybe it'll get better" un fucking believable! It should be a no brainer, you get hurt, you go to the fucking hospital. In Italy, we don't have the best ospitals, but they'll never let you die, if you get cancer you know you'll get the best treatments for free. Here people usually end up homeless. Good shit
    Mar 21
    • Microsoft DangerRngr
      Yep! This! That is a fucking disgrace and we can’t even comprehend to what extent we are being fucked by the health industry!

      Best part is - when you try to explain than 90+ countries have universal healthcare: “oh yeah.. but we can’t afford it!” Or “and who is gonna pay for that?”

      Fucking pathetic
      Mar 2
  • Compass / Eng
    FUPayMe

    CompassEng

    PRE
    Google
    FUPayMemore
    It doesn’t.
    Mar 20
  • New / Datatc xor fo
    Its consciously designed to keep people working somewhere (corp). The moment you think of doing somethin by yourself, Bam!
    Mar 20
  • Amazon lolwhat
    Just wait until Bernie becomes the president, he'll make healthcare free for everyone like oxygen is.
    Mar 20
  • OpenTable Meliodas
    It is best in the world care for those that can afford it.

    Insurance is hit or miss depending on a variety of factors. Most people get insurance through their employer and are happy with it.

    Those without insurance face difficulties. While emergency rooms must treat everyone that comes in. Preventive medicine would lower costs to society.
    Mar 27
    • Oracle blahbl
      Treat everyone? How would a poor guy pay?
      Mar 2
    • OpenTable Meliodas
      They usually don’t.
      Mar 2
    • Google / EngAbLy47
      Oh Jesus most people who get insurance through their employer are happy with it?

      My mom makes a six figure salary but pays 500/mo for company health insurance which has a 10k deductible. She is not happy.

      I had company health insurance last year and they refused my claim after my wife ended up in psychiatric hospital trying to commit suicide. They didn't believe she needed the services so they denied it. I'm not very happy.
      Mar 2
    • OpenTable Meliodas
      Most >> 2

      If most people were unhappy, the system would change.
      Mar 2
    • Google / EngAbLy47
      I get that I just know a lot of people unhappy with the costs of their corporate insurance for what they get outside of tech world.
      Mar 2
    • Oracle blahbl
      So sorry to hear about your wife. How is she doing now?
      Mar 2
    • Google / EngAbLy47
      Doing better getting help she needs, thanks!
      Mar 2
  • Databricks Gjsmxs
    It works like any corrupt system run by cartels (e.g. hospitals, insurance, pharma, government, etc) that claim to not collude, but in reality collude immensely to make sure costs are high and everyone can make money.

    And that's not even discussing America's litigious nature or political misgivings resulting in very shady backroom deals that benefit only the worst, most powerful players.

    Plenty of great pieces have been written about the truly despondent state America's healthcare system is in, so I won't go further here.
    Mar 20
  • Xilinx / Mgmtpumpedup
    If you have a good PPO insurance, it's good. You'll get good care and max out of pocket per year is capped. It may run into a few thousand dollars per year.

    If no PPO, it sucks.

    Healthcare cost triggered bankruptcy is very high here.

    PS: fundamentally healthcare system has HMO and PPO. You (or employer) pay insurance premium for either and that insurance covers costs.
    There's ACA marketplace for buying insurance if you're not covered by employer.

    Then there's Medicare and Medicaid for elderly and poor.

    There HSA for saving pre tax dollars for health costs.
    You can also keep pre tax dollars in FSA for prescription and doctor visit copays upto a max limit per year.

    I'll add that raw cost of care is so expensive that except for the uber rich, no one can afford to pay by themselves. E.g pregnancy runs 20/30k, a week in hospital 30k, cancer easily a million bucks.. etc.
    Mar 20
  • Microsoft wfgyre
    No one knows. Not even the ones working in healthcare.
    Mar 20
  • Amazon hsysysvsbh
    It doesn't work!
    Mar 24
    • Apple / EngJCmS82
      Working well for me. I’d be dead if it weren’t for my doctor and surgeon.
      Mar 2
    • Oracle tamatar
      JCmS82: Glad for you. Could you please clarify whether you meant the doctor's and surgeon's skills or you actually meant the current American healthcare system?
      Mar 2
    • Apple / EngJCmS82
      Both but keep in mind I have the means to buy good insurance. Many people are not as fortunate.
      Mar 2
    • Oracle tamatar
      I think that's the point of the discussion. If someone could travel to India or Egypt or Mexico or Australia (these are random names) and get treated much cheaper, then it shows that the skills aren't what Americans are paying for.
      Mar 2
  • Oracle tamatar
    You pick up a prescription (in the US) of any medicine that's manufactured in India and compare its price in India with the price in the US. Make a similar comparison for any treatment/procedure - medical, dental, or vision. You'll know what everyone is complaining about.
    Mar 23
    • Oracle blahbl
      Medicines here are paid by insurance. In india you pay for themselves. Why even compare?
      Mar 2
    • Oracle tamatar
      You're getting closer, yes!
      Mar 2
    • New / Eng👄 𓂸.
      Insurance companies pay out of money they collect in premiums. So it's money you pay.
      Mar 2
  • Oracle blahbl
    If we choose PPO, what’s the maximum amount that an insurance provides? Would it provide millions of dollars if someone gets a cancer or something?
    Mar 22
    • Apple / EngJCmS82
      The ACA removes lifetime coverage caps so they will keep paying for covered services.
      Mar 2
    • Xilinx / Mgmtzen-
      At this point there are no caps thanks to ACA. But friendly neighborhood red politicians are hard at work to go back to the dark days before ACA - lifetime caps, no coverage for pre-existing conditions. Etc etc
      Mar 2
  • Microsoft BOVi42
    It's always fun to compare drug costs here and in my own country. Same drug same manufacturer produced in Japan. 40$ in my country and 350$ in usa. What the fuck?
    Mar 20
  • Oracle blahbl
    How does insurance companies make money? I pay UHC only 70$ a month and almost everyone uses gets more out of it than that amount.
    Mar 25
    • Oracle tamatar
      The doctors would gladly take what you contribute as copay as full payment if they could avoid dealing with insurance or government. Your entire premiums are practically funding the overheads and profits.
      Mar 2
    • OpenTable Meliodas
      Collectively, premiums exceed claims.

      You need to also factor in what your employer pays.
      Mar 2
    • Oracle blahbl
      How much does employer pay?
      Mar 2
    • OpenTable Meliodas
      It is listed on your pay stub.
      Mar 2
    • Apple / EngJCmS82
      Usually 80-90% of the actual cost.
      Mar 2
  • Amazon wFOC46
    If you have insurance and a little financial intelligence it's not bad. People like to quote that having a baby costs like $20k. That's how much the raw bill is. For 9 months of prenatal care, blood testing, ultrasounds, a birthing suite including a hospital bed and a separate bed for the spouse, jacuzzi tub, room service, etc it cost me $200 out of pocket. That was paid as a $50 copay during our prenatal visits.

    My plan was a PPO plan where I paid a higher premium up front and nearly everything was covered. There is also an option for a high deductible plan so you can pay a low premium and put the rest in to a tax advantaged savings account. If you get sick, you have the money. If you don't, you have retirement money.

    One of the biggest benefits of our system is the speed. I could go get an MRI today as a walk-in if I needed one. Places like Canada it can take many months to get on the list.
    Mar 23
    • Oracle blahbl
      But an appointment takes several weeks. I hate the delays here.

      How do you have for retirement in PPO? Do you have a HSA or something?
      Mar 2
    • Google / EngAbLy47
      I think he is saying with the cheaper policies. I use an HSA myself. I figure on average insurance companies make money so I'd rather have the higher deductable pay then less and save for rainy days.
      Mar 2
    • Amazon wFOC46
      That's correct. I chose PPO because my wife and I were planning on having children and I figured it would just be easier to prepay for the next couple years. I now have a high deductible plan and contribute to my HSA.
      Mar 2
  • Oracle Hun7?K
    Don’t be sick. You are good.
    Mar 20
  • Google / EngAbLy47
    The biggest problem with healthcare is that in order to meet demands for lower costs by insurance companies providers have raised the book cost of the service and charge essentially the same amount.

    Usually self insurance is cheaper if you have the money, but that isnt generally true with health insurance. There are so many health insurance companies negotiating rates none of them have a ton of leverage (Medicare keeps costs down much better with the largest insurance pool).
    Mar 20

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