Healthcare in our country sucks

Two things happened today.


Earlier while going through old paperwork I found an EOB that I had purposely kept because of how outrageous it was.  An outpatient medical procedure was billed for over $150k.  Now because we have insurance and because they were in network, the bill was paid at less than $3,000 and we owed zero.   But what if we didn’t have insurance to negotiate the rate?  Sure, they probably wouldn’t have wanted us to pay $150,000 for it, but would have have “settled” for $5,000?  $10,000?  More?  Who knows, but basically we would have been at their mercy.  And this is not an isolated incident, how many times have we read about people without insurance fighting to lower the bills and still being expected to pay five or even ten times what insurance pays for the same procedure.

Which brings me to the second thing they happened today.  An in-law of my sister passed away.  She had been sick for awhile but put off seeing a doctor because she knew that if they found something serious she had zero ability to pay for tests and treatments.  She knew she was sick, but she also knew that being able to afford treatment was about as likely as being able to afford a Maserati.  And let’s be honest here, that is what healthcare is in this country, a luxury only for the rich.

People who claim we live in the greatest country in the world are either delusional or just sadistic.  Or maybe a bit of both.


Very tragic. I'm sorry about your siser-in-law. Its not the health care that's awful, its the lack of universal health care.


cubby said:

Very tragic. I'm sorry about your siser-in-law. Its not the health care that's awful, its the lack of universal health care.

 We spend more per capita on healthcare than other countries yet have worse outcomes.  


In part because of the immense insurance beauracracy.  It's just crazy.  Do we have the national will to fix it?


What do you expect:

No central system (CDC provides recommendations only).

Stand-alone for profit hospitals

Stand-alone for profit health care insurers

Individual lawyers specializing in health care claims

What can possibly go wrong?


I saw that Bernie won the Americans Abroad primary.  This is probably because Americans living anywhere else have access to free health care and medications and wonder why the US is so screwed up.


And where not totally free, way lower cost and readily accessible, unlike jumping through hoops here.


what about the quality of care?  is it better in other countries.  my docs have MISSED hypothyroid, hypertension, blindness in 1 eye, injury to knee, injury to arm and more.  At one point I listed all my doc appointments and calculated they were wrong 80% of the time, mostly due to attitude.  I even had a positive blood test for hypothyroid and doc blew it off.  When I had a traumatic brain injury, I never got good medical care.  One doc even said I couldn't be experiencing the symptoms of a TBI unless I had something like a stroke (acquired brain injury)....The 1st one said I was fine and could drive when I couldn't even see straight....with the arm injury, I went to urgent care and doc just assumed i was rug seeking and blew me off.  I couldn't even lift my arm....and already had narcotics that didn't help.

I had a friend go through prostate cancer....he went to about 5 different docs, they all insisted their treatment was the best...and it happened to be the one that they were financially vested in...


I wrote elsewhere that a routine free BreastScreen mammogram at end of July resulted in an indistinct pic. By the end of that week, I was called back to another location for ultrasounds and biopsy, and the following Wednesday given my diagnosis. The next morning my allergy doc (a teaching Professor at one of the local unis) gave me a series of printouts about my MAST cell condition that means I react to most medications and foods, as well as stuff in the environment even though my IgE tests seem to be ok. He also gave me instructions for anaesthetists, radiologists etc. The following week I met with my oncologists and breast care nurses. Surgery scheduled for early Oct. Free, public.  Top teaching campuses in Southern Hemisphere. (My niece was headhunted from Melbourne to Boston, to join a breast cancer research team several years ago; she was headhunted back to Sydney because of her work with killer cells)

My radiation therapy will be free. The herceptin2 will be free. The transport to and from, dedicated service for cancer patients, is $7/day if I have it. I have free mental health services; D has free carers’ support, support as a male carer, and will be paid a carer allowance by the federal govt.  I’m currently on ‘safety net’ for my other medications, meaning that I don’t pay for prescribed meds.

*It was announced last weekend that researchers just outside Melbourne, Victoria have discovered the active link in breast cancer in pregnant women, and how to safely switch it off. While the study was small, it’s being replicated elsewhere. 
https://www.abc.net.au/news/2020-08-29/breast-cancer-research-discovery-in-ballarat/12607310

*You might remember D’s bowel cancer journey years ago. He’s a 7 year survivor. That was all public and free. He’s still checked. We spent Friday in isolation in ER because he had severe pain; turns out he was passing a gall stone. Top treatment even during a pandemic, and even though a public patient in the middle of the night: ambulance, xrays, pathology (3 different sets), ultrasound, pain meds all free.

*Every 2 years, our federal health dept ensures I’m sent a free home test kit from the national Bowel Cancel Program, for early detection. 

*Our blood donors line up to volunteer regular donations; I only stopped donating because I’d had a head injury and they wouldn’t let me any more. Used to donate plasma every 6 weeks from the age of 18 to 29years. 

*Oh! I’m seeing my neurologist tomorrow re my chronic migraines. After the rebate from Medicare, I think I’ll have paid him $20 out of $400-ish.  I see him every 6 months. 

*Out of my two recent cataract surgeries, and laser work for the back of both eyes (I had ‘encapsulation’?), so about 6 specialist visits around $350ish, and the surgeries around $3000 each plus $450 for the anaesthetist, I only paid for the surgeries and anaesthesia and got a healthy rebate on those. (I chose ‘intermediate’: public in a private setting. Very little waiting) Ophthalmologist picked up a couple of emerging issues (as you’d expect).  My new reading glasses come next week (I don’t need driving glasses any more), I’m set. 

Podiatry, exercise physiology, physio, dietitian, dentistry... we can juggle allied health as we need the support according to our most urgent needs. My local town Council supports active healthy ageing so I can join their aquarobics sessions and heart-health walking sessions for free/low cost if I’m out of referred supports.

Universal access to health is civilised. You don’t have to use it if you can afford not to.  Offering it to all ensures dignity and safety for all 24/7/365 wherever you are in the nation, whoever you are. It ensures the best training opportunities for all branches in the caring services, and it highlights those unsung workers who ‘keep turning up regardless’ because each day, in some way, some family’s day will be totally changed because THAT person was there to make the difference. Give caring workers that chance!


Some people use the excuse “it isn’t free, someone has to pay for it.”  I wonder if those people are against public education also.


@spontaneous,

There are so many things in our society that charge higher costs for the same service to the most vulnerable and disadvantaged. But just looking at the numbers... it's staggering.


My taxes paid for someone else’s better access to prompt medical attention, medicines and allied health when they needed it. And I’ve earned “credits” while being unemployed over the 11 months, by keeping to my commitments with my employment support provider. 
So this means that I can continue to volunteer, as I did yesterday - taking an elderly lady to the pharmacy and to the hairdresser - as well as remaining independent as much as possible. 
So I’m using the car, cleaning the house, weeding the garden, cooking...I’m studying to be job ready for next year. 
I'm not using my super, I’m still saving that. And when I’m working next year, my taxes will again help someone else. Meantime, I’m grateful for the safety blanket. 
It’s the same reason I’ve learnt First Aid since my early 20s.


I would not expect health care to be free.  I'll happily pay taxes for it, and pay co pays.  I assume my employer, freed of the health care burden, would pay me more to offset the increased taxes.  By eliminating so many of the middle layers we could curtail a good bit of the cost.


If healthcare wasn’t tied to employment then more people would be willing to try to start small businesses since they wouldn’t have to worry about buying a plan on their own.


And they'd be freer to move to potentially better jobs to advance their careers, or to change careers, not having to worry about coverage.

There are really zero positives to our current system. Except to the middlemen.

spontaneous said:

If healthcare wasn’t tied to employment then more people would be willing to try to start small businesses since they wouldn’t have to worry about buying a plan on their own.

 


What is really going to make it hard to change this is that those middlemen have become a huge part of the employed in this country.  In several states health care is the largest employer, and that's not doctors and nurses.


There is public and private health care in Hong Kong. The outcomes in the public system are better. The public system alone has been handling the Covid-19 crisis.


FilmCarp said:

What is really going to make it hard to change this is that those middlemen have become a huge part of the employed in this country.  In several states health care is the largest employer, and that's not doctors and nurses.

 There’s a valid place for aides, allied health, cooks, cleaners, maintenance, drivers, paramedics, ‘ordinary’ reception/admin and booking/accounts staff, groundskeepers, parking/security, childcare and training staff and so many more roles you wouldn’t usually think are related to the caring sectors  until you and think. You don’t need to study at fancy colleges for a decade and earn $500k+ in a slow year to be ‘essential’ to a hospital or community health centre.

(This morning, after my Heart Foundation walk, we were talking about the government program to check for polypharmacy: a (retired) pharmacist is allocated a specific region and all family doctors in that region request home visits for patients. The pharmacist checks all meds, supplements, lotions etc for compatibility, use by dates, storage conditions and whether the patient understands why they’re taking this/knows how to use it. A written report is sent to the doc, clarifying issues and simplifying prescriptions (important if the patient has several specialists or uses home remedies/alternative therapies). Better than Dr Google.)


FilmCarp said:

What is really going to make it hard to change this is that those middlemen have become a huge part of the employed in this country.  In several states health care is the largest employer, and that's not doctors and nurses.

 When Obamacare was debated, progressive push was for single payer. The strongest force against single payer was the insurance industry. Simple: They take 15% of your premium for nothing but pushing paper. They don't give you so much as a BandAid.

That's why the president of United Healthcare had his own private jet.


spontaneous said:

Some people use the excuse “it isn’t free, someone has to pay for it.”  I wonder if those people are against public education also.

 What? Don't you know any Republicans? Betsy DeVos does her best to find excuses to direct funding from public education to private schools.


Formerlyjerseyjack said:

FilmCarp said:

What is really going to make it hard to change this is that those middlemen have become a huge part of the employed in this country.  In several states health care is the largest employer, and that's not doctors and nurses.

 When Obamacare was debated, progressive push was for single payer. The strongest force against single payer was the insurance industry. Simple: They take 15% of your premium for nothing but pushing paper. They don't give you so much as a BandAid.

That's why the president of United Healthcare had his own private jet.

 You are right.  The big mistake with the ACA was that Obama got everyone into the room to work it out, and every group made sure that they could profit from it.  




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