Health Care and your experiences

[Philos]

Folks,

Some Americans used to talk about 'death panels' in UK healthcare. What they missed out is that we have always had private healthcare for those that can afford it. We have both private and public healthcare. I've used both myself.

Just the same as in the US, except that they don't have the choices we have.

Alex.

 

[DrZoidberg]

Folks,

Some Americans used to talk about 'death panels' in UK healthcare. What they missed out is that we have always had private healthcare for those that can afford it. We have both private and public healthcare. I've used both myself.

Just the same as in the US, except that they don't have the choices we have.

Alex.

Isn't triage death panels?

 

[Playball40]

Sort of. I'm opposed to a single-payer system because that leads to the sort of thing that Bilby considers normal: The acceptance of the suffering of those with non-fatal conditions. When the same agency does it and sets the standards for doing it you have problems.

However, I would favor something along the lines of taking the ACA, making the minimum plan Gold and have the government pay the cost of the cheapest plan in your zip code.



I would be complaining to the insurance commissioner as they aren't providing medically acceptable access.

I do not consider normal, nor acceptable, the suffering of patients with non-fatal conditions; nor do the UHC systems in either of my countries of citizenship.

You appear to be yet again more invested in propaganda that allows you to dismiss the obvious, than you are in actual reality.

Non-urgent patients can wait. Patients who are experiencing unmanaged pain are not considered non-urgent; Not by me, nor by clinicians in the U.K. or Australia.

This remains true even if you are able to find a handful of instances where a patient has not received the care that should have been provided - a circumstance that occasionally and regrettably occurs under any system - there are examples of people in the US system who have been failed in this way despite having the ability to pay (and countless examples of people in the US system who are currently suffering due to being completely disregarded by the system for the crime of being poor, uninsured, or underinsured).

You are attempting to defend the indefensible. I would thank you not to do so by misrepresenting my position.

However, they define what is "non-urgent" don't they? I've heard that is not always in the best interest of the patient (with respect to mental health issues), specifically for youngsters. Again, ALL systems have issues and overall, the US is the worst, IMO but I have heard the stories of some of the parents in the UK and Australia trying to navigate and get care for their kids and have had trouble. (The difference is, once they get the help, they won't go bankrupt for it like here in the US).

 

[bilby]

I do not consider normal, nor acceptable, the suffering of patients with non-fatal conditions; nor do the UHC systems in either of my countries of citizenship.

You appear to be yet again more invested in propaganda that allows you to dismiss the obvious, than you are in actual reality.

Non-urgent patients can wait. Patients who are experiencing unmanaged pain are not considered non-urgent; Not by me, nor by clinicians in the U.K. or Australia.

This remains true even if you are able to find a handful of instances where a patient has not received the care that should have been provided - a circumstance that occasionally and regrettably occurs under any system - there are examples of people in the US system who have been failed in this way despite having the ability to pay (and countless examples of people in the US system who are currently suffering due to being completely disregarded by the system for the crime of being poor, uninsured, or underinsured).

You are attempting to defend the indefensible. I would thank you not to do so by misrepresenting my position.

However, they define what is "non-urgent" don't they? I've heard that is not always in the best interest of the patient (with respect to mental health issues), specifically for youngsters. Again, ALL systems have issues and overall, the US is the worst, IMO but I have heard the stories of some of the parents in the UK and Australia trying to navigate and get care for their kids and have had trouble. (The difference is, once they get the help, they won't go bankrupt for it like here in the US).

You have heard these things only because you live in a place where there is a massive anti-UHC lobby spreading this crap around.

Nobody in actual UHC nations has 'heard of' this nonsense.

It's amazing how negatively something can be portrayed by wealthy interests who wish it not to happen, by reference to things that have been 'heard'. Donald Trump might be able to get elected on the back of innuendo and hearsay; but if you want to persuade people who are smarter than Trump supporters, you will need more than "I'm hearing this - from good people, really smart people are saying it, the best, the smartest people".

The difference in a UHC system is not what choices are made regarding who gets treatment. The difference is who makes those choices. Under UHC, they are made by doctors. In the for-profit insurance system, they are made by accountants and insurance company executives.

Of course, when the question is 'does this patient really need this particular treatment?' sometimes doctors get the answer wrong. But the idea that accountants and insurance executives (or even, if they can afford to pay directly, patients) will get the answers right more often than doctors do is crazy.

This is the real thing that is hidden under the bullshit. The choice is between asking doctors what is medically necessary, vs asking non-doctors that question. There's ALWAYS a 'death panel'. The question is, will doctors be the ones who sit on that panel; or will it be staffed by people with no medical training whose job is to keep costs as low as possible to keep profits up?

 

[Opoponax]

One night my daughter hurt her knee. She also has asthma. So I took her to urgent care, which was going to be open for another hour because the ER is way more expensive and the deductible on her plan still had another $3500 to go before coverage kicked in. While at urgent care, her asthma flared up. Both of us being experienced with this, it sounded worse than it was. The doctor suggested a breathing treatment. I asked my daughter if she wanted one and she said no, that she was okay. But the doc pushed for it. I asked my daughter again, and she said she was fine. So again, I politely told the doc no. Then he got mad and looked at me like I was a neglectful SOB. He said something along the lines of how I should care about my daughter, to which I said, in a rather classy way, "Oh really, are you going to fucking pay for it?"

And there's the bullshit. The breathing treatment would've been around $800-$900. I knew my kid was okay, and she would have taken the treatment if she wasn't. But under the pressure the doc put on me to do it, if that cost didn't exist, I would have made her do it, which would've spared me the humiliation of having to make that decision in the first place. Oh, and the fight with my girlfriend at the time, who was an RN (they have way too much reverence for doctors). She was mortified at what I said.

At the same time, I couldn't help but wonder what was in it for the doctor. What would his cut have been; $400-$500 for giving an unnecessary treatment that he wouldn't have actually administered?

The American healthcare system is a fucking disaster. What I will die never understanding is why so many Americans are against UHC. It's utterly baffling. I don't care how much misinformation is thrown at us about it. To have to make the choice to live in pain or die/die early or go bankrupt... I can't believe that anyone finds that acceptable, much less that they vote in favor of it.

 

[T.G.G. Moogly]

One night my daughter hurt her knee. She also has asthma. So I took her to urgent care, which was going to be open for another hour because the ER is way more expensive and the deductible on her plan still had another $3500 to go before coverage kicked in. While at urgent care, her asthma flared up. Both of us being experienced with this, it sounded worse than it was. The doctor suggested a breathing treatment. I asked my daughter if she wanted one and she said no, that she was okay. But the doc pushed for it. I asked my daughter again, and she said she was fine. So again, I politely told the doc no. Then he got mad and looked at me like I was a neglectful SOB. He said something along the lines of how I should care about my daughter, to which I said, in a rather classy way, "Oh really, are you going to fucking pay for it?"

And there's the bullshit. The breathing treatment would've been around $800-$900. I knew my kid was okay, and she would have taken the treatment if she wasn't. But under the pressure the doc put on me to do it, if that cost didn't exist, I would have made her do it, which would've spared me the humiliation of having to make that decision in the first place. Oh, and the fight with my girlfriend at the time, who was an RN (they have way too much reverence for doctors). She was mortified at what I said.

At the same time, I couldn't help but wonder what was in it for the doctor. What would his cut have been; $400-$500 for giving an unnecessary treatment that he wouldn't have actually administered?

The American healthcare system is a fucking disaster. What I will die never understanding is why so many Americans are against UHC. It's utterly baffling. I don't care how much misinformation is thrown at us about it. To have to make the choice to live in pain or die/die early or go bankrupt... I can't believe that anyone finds that acceptable, much less that they vote in favor of it.

There is nothing "systematic" about medical insurance in the U.S. except perhaps that it systematically gouges the patient. If there is any silver lining it might be that it is forcing people to make informed decisions when they obtain medical care, owing largely to the increasing deductible and premium costs.

The problem with making informed decisions, however, is that everything is so hidden. You can call a given provider at three different times in a week and get three different answers to how much a chest x ray will cost, if they will even tell you.

 

[Under the Rose]

Most of my experience with the medical profession has been as an observer and I must state that the immediate and emergency care in the Yukon is exceptional. Cancer and heart patients are immediately escalated and we have access to southern medical facilities as well by means of various agreements. For those dealing with chronic pain and in need of knee, hip and joint surgery, the wait list is quite long and we have a growing problem with continuing care for the aging, especially those with dementia. Additionally, many of our resources get used by those in crisis due to substance abuse which is another issue that our various levels of government are endeavoring to address, specifically the funding of such facilities and where to locate and how to staff same.

Fortunately my experiences with our health care system have all been very good, in spite of the difficulty for many of retaining a personal physician. I have, to date, only needed the health care system for trauma injuries (car accident when I was 21, fall from a horse a few years ago) and the annual female physical when I was younger. I last saw a doctor about two years ago and my vitals were good so I will next see one when I notice something awry. Mother and I do a lot of research and try to maintain our own health through good nutrition and exercise but there are circumstances beyond one's control including mishap and with advancing years often comes declining health. Hopefully the Yukon health care system will still be as vigorous when comes the time that I have need of it.

 

[Playball40]

However, they define what is "non-urgent" don't they? I've heard that is not always in the best interest of the patient (with respect to mental health issues), specifically for youngsters. Again, ALL systems have issues and overall, the US is the worst, IMO but I have heard the stories of some of the parents in the UK and Australia trying to navigate and get care for their kids and have had trouble. (The difference is, once they get the help, they won't go bankrupt for it like here in the US).

You have heard these things only because you live in a place where there is a massive anti-UHC lobby spreading this crap around.

Nobody in actual UHC nations has 'heard of' this nonsense.

It's amazing how negatively something can be portrayed by wealthy interests who wish it not to happen, by reference to things that have been 'heard'. Donald Trump might be able to get elected on the back of innuendo and hearsay; but if you want to persuade people who are smarter than Trump supporters, you will need more than "I'm hearing this - from good people, really smart people are saying it, the best, the smartest people".

The difference in a UHC system is not what choices are made regarding who gets treatment. The difference is who makes those choices. Under UHC, they are made by doctors. In the for-profit insurance system, they are made by accountants and insurance company executives.

Of course, when the question is 'does this patient really need this particular treatment?' sometimes doctors get the answer wrong. But the idea that accountants and insurance executives (or even, if they can afford to pay directly, patients) will get the answers right more often than doctors do is crazy.

This is the real thing that is hidden under the bullshit. The choice is between asking doctors what is medically necessary, vs asking non-doctors that question. There's ALWAYS a 'death panel'. The question is, will doctors be the ones who sit on that panel; or will it be staffed by people with no medical training whose job is to keep costs as low as possible to keep profits up?

Actually NO, that is NOT the case. I belong to an international support board for other parents/caregivers who have children that suffer from the same illness as my daughter. They do NOT have political motives. They are only motivated to get help for their children which is often denied based on an outdated set of standards. Again, NOT saying it's better in the US, but to imply any criticism to your UHC system is politically or economically motivated is rather presumptuous on your part.

 

[gmbteach]

I have recently experienced a few quirks with regards to our health system here.

As you know, I went private to have my knee fixed. I did this because to have it done under the public system would take forever, if it got done at all, because it isn't considered essential surgery. I got to choose my doctor, he charged me a co-payment of $300 for the surgery. Post op visits for a month are included. I paid a $250 excess on the hospital bill. I paid nothing for anaesthetic. All other costs were covered by Medicare and my private health fund. I reckon the premiums I have paid in this year have now been paid out twice over for this op alone.

Unfortunately, I developed some oozing and so, as per instructions, I presented to my local hospital. They contacted their orthopaedic registrar who refused to look at it because I had gone private and said they would have to contact my surgeon. My surgeon requested they give me the option of dressing it and giving me antibiotics and he would see me in the morning (this was Sunday afternoon) or go to the original private hospital and be admitted. Considering I had just left a trail of ooze on the hospital floor leading to and from the toilet, I chose Option B.

I found it interesting that the ortho at the public hospital wouldn't even look at me, or be the one to make the call to my doctor. But oh well.

So I presented back to my hospital and they admitted me immediately. No excess this time as I only pay it once a calendar year. My surgeon came to see me at about 8 pm on a Sunday night at no cost to me, and again at 7 am the next morning, again at no cost to me.

So this far, I have been private and public. And am out of pocket less than a grand for excellent care and this space agey device on my knee to suction out the ooze. I call it an electronic leech (and they said the leech couldn't be improved upon).

All in all, I see no difference between the two systems. I do see a strange relationship amongst the surgeons though. Surely they should work together for the good of the patient then worry about egos.

 

[RavenSky]

One night my daughter hurt her knee. She also has asthma. So I took her to urgent care, which was going to be open for another hour because the ER is way more expensive and the deductible on her plan still had another $3500 to go before coverage kicked in. While at urgent care, her asthma flared up. Both of us being experienced with this, it sounded worse than it was. The doctor suggested a breathing treatment. I asked my daughter if she wanted one and she said no, that she was okay. But the doc pushed for it. I asked my daughter again, and she said she was fine. So again, I politely told the doc no. Then he got mad and looked at me like I was a neglectful SOB. He said something along the lines of how I should care about my daughter, to which I said, in a rather classy way, "Oh really, are you going to fucking pay for it?"

And there's the bullshit. The breathing treatment would've been around $800-$900. I knew my kid was okay, and she would have taken the treatment if she wasn't. But under the pressure the doc put on me to do it, if that cost didn't exist, I would have made her do it, which would've spared me the humiliation of having to make that decision in the first place. Oh, and the fight with my girlfriend at the time, who was an RN (they have way too much reverence for doctors). She was mortified at what I said.

At the same time, I couldn't help but wonder what was in it for the doctor. What would his cut have been; $400-$500 for giving an unnecessary treatment that he wouldn't have actually administered?

The American healthcare system is a fucking disaster. What I will die never understanding is why so many Americans are against UHC. It's utterly baffling. I don't care how much misinformation is thrown at us about it. To have to make the choice to live in pain or die/die early or go bankrupt... I can't believe that anyone finds that acceptable, much less that they vote in favor of it.

There is nothing "systematic" about medical insurance in the U.S. except perhaps that it systematically gouges the patient. If there is any silver lining it might be that it is forcing people to make informed decisions when they obtain medical care, owing largely to the increasing deductible and premium costs.

The problem with making informed decisions, however, is that everything is so hidden. You can call a given provider at three different times in a week and get three different answers to how much a chest x ray will cost, if they will even tell you.

There is no such thing as being able to have an informed decision in U.S. medical care. The only possible exception would be in a completely voluntary non-illness related medical procedure such as cosmetic surgery.

As you noted, even if you have the time luxury of being able to compare prices for a chest x ray, the answer is always "it depends". It depends on whether you have insurance, which insurance company, which diagnostic center, etc. And if you have insurance, you probably won't get the option of choosing where you go to get the x ray.

And in a medical emergency, there is zero opportunity to shop around.

 

[T.G.G. Moogly]

There is nothing "systematic" about medical insurance in the U.S. except perhaps that it systematically gouges the patient. If there is any silver lining it might be that it is forcing people to make informed decisions when they obtain medical care, owing largely to the increasing deductible and premium costs.

The problem with making informed decisions, however, is that everything is so hidden. You can call a given provider at three different times in a week and get three different answers to how much a chest x ray will cost, if they will even tell you.

There is no such thing as being able to have an informed decision in U.S. medical care. The only possible exception would be in a completely voluntary non-illness related medical procedure such as cosmetic surgery.

As you noted, even if you have the time luxury of being able to compare prices for a chest x ray, the answer is always "it depends". It depends on whether you have insurance, which insurance company, which diagnostic center, etc. And if you have insurance, you probably won't get the option of choosing where you go to get the x ray.

And in a medical emergency, there is zero opportunity to shop around.

What I meant was the cost without insurance, telling them you have no insurance and will just pay for the service.

 

[DolphinDynasty]

There is nothing "systematic" about medical insurance in the U.S. except perhaps that it systematically gouges the patient. If there is any silver lining it might be that it is forcing people to make informed decisions when they obtain medical care, owing largely to the increasing deductible and premium costs.

The problem with making informed decisions, however, is that everything is so hidden. You can call a given provider at three different times in a week and get three different answers to how much a chest x ray will cost, if they will even tell you.

There is no such thing as being able to have an informed decision in U.S. medical care. The only possible exception would be in a completely voluntary non-illness related medical procedure such as cosmetic surgery.

As you noted, even if you have the time luxury of being able to compare prices for a chest x ray, the answer is always "it depends". It depends on whether you have insurance, which insurance company, which diagnostic center, etc. And if you have insurance, you probably won't get the option of choosing where you go to get the x ray.

And in a medical emergency, there is zero opportunity to shop around.

Making confirmed decisions is why doctors, types of therapists, an nurses in the U.S. despise me, because I do my research, and have worked in health care and nutrition for years so I know their jobs and how they o them as well as how often they'll skirt or falsify data when talking to a patient. They don't get to do that with me or not tell me results, prognosis, diagnosis and relative outcomes pursuant to the various types of treatment nor do they get to push what they want as I've have genetic and CBC level testing one to see what my body responds to best an what it doesn't in terms of various types and levels of medicine.

There will be less regulation than there already is for the checks and balances and ethics committees to watch over physicians and patients alike, if the current administration has its way. So it certainly has been politicized and economized to not benefit those who rely on or have need of healthcare in the US.

Add the social stigmas related to a persistent majority of those in charge misunderstanding illness/injury, need versus elective, even going so far down as not understanding what is emergent and what can wait until there's an opening or space for the procedure but is still needed to return mobility or increase overall health to keep the patient on their feet, or under their own power in another way and independent plus financially solvent enough that they are not a burden. So of course most of the country will treat those who are not well as a plague deserving of the least quality treatment and compassion, which simply adds to overall discontent and revilement.

I was trying to avoid this thread for much of the week cuz I know too much about healthcare from both sides of the line in he US. The end result though is that it will never be fully about securing good health and safe practices for as many as possible here, nt as long as the same lack of understanding and lack of empathy plus attention put more towards profit and politicking in order to force untested and unproven beliefs of the leaders onto their constituents, as if that somehow does not breed both intolerance and criminal assault under the shadowed guise of "helping".

We would have had a bit of a better system several years ago had not half the politico types not decimated the ACA before it was even enacted because they thought it would then be too "easy" for people to get healthy without punishing them for needing it in the first place, no matter what the reason for the medical need is/was. Then to punish a portion of them again for being poor or uninsured or under-insured, when that same sector of politicians were the reason it became so expensive for patients in the first place, all because insurance companies and politicians want to "rein in" cost, instead of look for companies that don't play the insurance pay-off game to restrict care but charge for service based on time an labor instead of high profit, like those companies that can 3-D print prosthetic limbs for a fraction of the cost of what an insurance company will TELL you that you get (3-D printed limb, about 300-500 dollars, and the shittier and / or non-usable prosthetic an insurance company will TELL you they cover a pportion of, as much as $10,000 or more - but the same ins company saying that will balk and stutter and refuse when asked to pay the cost of the 3-D printed one, then tell you to call a number for their quality assurance office who will tell you to call your congress who will tell you that's the way it is and that's how it will stay in future)


I'm better off making as many of my own medical fixes and doing my best to take course work that will give the knowledge I need to care for myself under my own means as much as possible. It really doesn't matter if I end up dying in the attempt either, as long as it gets done according to how a physician would do it and I don't have to deal with the shit dragged out by stupid people who have no business dictating medicine or treatment nor in telling anyone what they can and cannot have for their health.

 

[braces_for_impact]

However, they define what is "non-urgent" don't they? I've heard that is not always in the best interest of the patient (with respect to mental health issues), specifically for youngsters. Again, ALL systems have issues and overall, the US is the worst, IMO but I have heard the stories of some of the parents in the UK and Australia trying to navigate and get care for their kids and have had trouble. (The difference is, once they get the help, they won't go bankrupt for it like here in the US).

You have heard these things only because you live in a place where there is a massive anti-UHC lobby spreading this crap around.

Nobody in actual UHC nations has 'heard of' this nonsense.

It's amazing how negatively something can be portrayed by wealthy interests who wish it not to happen, by reference to things that have been 'heard'. Donald Trump might be able to get elected on the back of innuendo and hearsay; but if you want to persuade people who are smarter than Trump supporters, you will need more than "I'm hearing this - from good people, really smart people are saying it, the best, the smartest people".

The difference in a UHC system is not what choices are made regarding who gets treatment. The difference is who makes those choices. Under UHC, they are made by doctors. In the for-profit insurance system, they are made by accountants and insurance company executives.

Of course, when the question is 'does this patient really need this particular treatment?' sometimes doctors get the answer wrong. But the idea that accountants and insurance executives (or even, if they can afford to pay directly, patients) will get the answers right more often than doctors do is crazy.

This is the real thing that is hidden under the bullshit. The choice is between asking doctors what is medically necessary, vs asking non-doctors that question. There's ALWAYS a 'death panel'. The question is, will doctors be the ones who sit on that panel; or will it be staffed by people with no medical training whose job is to keep costs as low as possible to keep profits up?

In most countries health care is bureaucratic, and/or a government run service. People are bound to complain, and people here and there will have red tape problems or something similar. No system is perfect. I've have a lot of conversations and seen a lot of polls, and the bottom line is this. People in their respective countries tend to complain about their health system. Yet, when asked if they'd like to switch places and have the US model of care, the answer is almost always a resounding NO. That should be a clue.

 

[Toni]

There is nothing "systematic" about medical insurance in the U.S. except perhaps that it systematically gouges the patient. If there is any silver lining it might be that it is forcing people to make informed decisions when they obtain medical care, owing largely to the increasing deductible and premium costs.

The problem with making informed decisions, however, is that everything is so hidden. You can call a given provider at three different times in a week and get three different answers to how much a chest x ray will cost, if they will even tell you.

[Bold]There is no such thing as being able to have an informed decision in U.S. medical care.[/bold]

This is not true.

Unfortunately, both my husband and I have had surgery for cancer. I was with my husband as he met with his doctors to discuss treatment options, which included doing nothing/watchful waiting . Because of my background and because of the type of person I am, I had already done a lot of research and knew what treatment options would be likely offered, relative success rates, risks of complications and of recurrences before the appointment and talked with my husband about each before the dr. Appointment where we would hear him
present treatment options. The doctor was extremely open, extremely thorough and extremely open to considering various treatment plans. He even suggested getting another opinion or two, with surgeons specialized in various treatment options. My husband chose the option he felt most comfortable with and had an excellent outcome.

I argued a bit with my doctor and then surgeon but ultimately, got what I wanted, given the circumstances.

No, there was no discussion of price. We are fortunate to be in the position of having excellent medical coverage--coverage everyone should have.

 

[DolphinDynasty]

[Bold]There is no such thing as being able to have an informed decision in U.S. medical care.[/bold]

This is not true.

Unfortunately, both my husband and I have had surgery for cancer. I was with my husband as he met with his doctors to discuss treatment options, which included doing nothing/watchful waiting . Because of my background and because of the type of person I am, I had already done a lot of research and knew what treatment options would be likely offered, relative success rates, risks of complications and of recurrences before the appointment and talked with my husband about each before the dr. Appointment where we would hear him
present treatment options. The doctor was extremely open, extremely thorough and extremely open to considering various treatment plans. He even suggested getting another opinion or two, with surgeons specialized in various treatment options. My husband chose the option he felt most comfortable with and had an excellent outcome.

I argued a bit with my doctor and then surgeon but ultimately, got what I wanted, given the circumstances.

No, there was no discussion of price. We are fortunate to be in the position of having excellent medical coverage--coverage everyone should have.

I think the main point most people on here are tied up with is that in too many places, including the supposedly most free and beneficial country on earth, supposedly, is that in the case of adequate let alone the best possible care/outcome when ill or injured is fat too often too high a cost for people to afford, so then they have to choose between something like a decent shelter, or medical care, or food or medical care, or no medical because even without a place to live or food for a month it would still be too costly to afford.

I have been with or working at an office where a doctor or two and a couple nurses were thorough and knowledgeable, had no problem making certain that patients understood fully what a treatment plan entailed, plus what the illness or injury with and without treatment would result in. But they are still too few in this country, and far between, some far too expensive if it is out of network but the right field and competency. And then there are the scores of physicians and nurses I've met who took away patient's choices by not informing them of all options, or tried forcing them to take a treatment they had already refused, or those that simply respond with, "if you want information on the treatment or illness, google it", kinda bullshit.

I personally may be far too ill, and far too insolvent transport and finances wise to get the right treatment for any one of my illnesses, and it has drastically shortened my lifespan as a result, plus making what life I have left worth less in value by most in my home and my nation. I'm told it is how it should be, and that this is the price of "freedom" and "choice", and that if I want better or just adequate, competent treatment from anyone "I should leave country", or just "shut the fuck up".

But hey, we've got 50 different kinds of fruit and veg from all over the globe compared to some other countries, and about a hundred choices in terms of where to shop for clothes and shoes, get to listen to people snipe at those trying to improve perceptions, representations and education because they just can, and the growing crowd of irrational "helpful" activists who don't seem to help many others besides themselves, so I guess what I advocate for really does hold less merit.

Sometimes being a watcher of the world lets ya see jut how few of those options are "free for all to try for" and just how few "grand opportunities" there really are, ESPECIALLY in medical care, which should never have been a for profit business model, only available sometimes to those who are "allowed" by way of some physicians'/pharmacists personal belief system, and/or somebody has the money for the gross out of pocket cost for monthly premiums, per procedure/treatment co-payment, AND prescription costs all wrapped up.

Even a complete over-haul, tear down and rebuild, it would be done wrong here, because there's far too much of an allowance for politicians and insurance providers who get near daily approval to work solely off of their own self-interest, an/or private beliefs without much evidence to back them.

 

[J842P]

There is nothing "systematic" about medical insurance in the U.S. except perhaps that it systematically gouges the patient. If there is any silver lining it might be that it is forcing people to make informed decisions when they obtain medical care, owing largely to the increasing deductible and premium costs.

The problem with making informed decisions, however, is that everything is so hidden. You can call a given provider at three different times in a week and get three different answers to how much a chest x ray will cost, if they will even tell you.

There is no such thing as being able to have an informed decision in U.S. medical care. The only possible exception would be in a completely voluntary non-illness related medical procedure such as cosmetic surgery.

As you noted, even if you have the time luxury of being able to compare prices for a chest x ray, the answer is always "it depends". It depends on whether you have insurance, which insurance company, which diagnostic center, etc. And if you have insurance, you probably won't get the option of choosing where you go to get the x ray.

And in a medical emergency, there is zero opportunity to shop around.

There was this great article, I'll try to find it, where a doctor was going to have a baby, and she tried to find out what the costs were going to be, and not only did she find it almost impossible to get any answers, when she did, the prices would fluctuate wildly, even at the same providers. Estimates would be as low a few thousand to as high as 30k. At the same hospital, for the exact same thing, she would just ask on different days.

 

[Toni]

This is not true.

Unfortunately, both my husband and I have had surgery for cancer. I was with my husband as he met with his doctors to discuss treatment options, which included doing nothing/watchful waiting . Because of my background and because of the type of person I am, I had already done a lot of research and knew what treatment options would be likely offered, relative success rates, risks of complications and of recurrences before the appointment and talked with my husband about each before the dr. Appointment where we would hear him
present treatment options. The doctor was extremely open, extremely thorough and extremely open to considering various treatment plans. He even suggested getting another opinion or two, with surgeons specialized in various treatment options. My husband chose the option he felt most comfortable with and had an excellent outcome.

I argued a bit with my doctor and then surgeon but ultimately, got what I wanted, given the circumstances.

No, there was no discussion of price. We are fortunate to be in the position of having excellent medical coverage--coverage everyone should have.

I think the main point most people on here are tied up with is that in too many places, including the supposedly most free and beneficial country on earth, supposedly, is that in the case of adequate let alone the best possible care/outcome when ill or injured is fat too often too high a cost for people to afford, so then they have to choose between something like a decent shelter, or medical care, or food or medical care, or no medical because even without a place to live or food for a month it would still be too costly to afford.

I have been with or working at an office where a doctor or two and a couple nurses were thorough and knowledgeable, had no problem making certain that patients understood fully what a treatment plan entailed, plus what the illness or injury with and without treatment would result in. But they are still too few in this country, and far between, some far too expensive if it is out of network but the right field and competency. And then there are the scores of physicians and nurses I've met who took away patient's choices by not informing them of all options, or tried forcing them to take a treatment they had already refused, or those that simply respond with, "if you want information on the treatment or illness, google it", kinda bullshit.

I personally may be far too ill, and far too insolvent transport and finances wise to get the right treatment for any one of my illnesses, and it has drastically shortened my lifespan as a result, plus making what life I have left worth less in value by most in my home and my nation. I'm told it is how it should be, and that this is the price of "freedom" and "choice", and that if I want better or just adequate, competent treatment from anyone "I should leave country", or just "shut the fuck up".

But hey, we've got 50 different kinds of fruit and veg from all over the globe compared to some other countries, and about a hundred choices in terms of where to shop for clothes and shoes, get to listen to people snipe at those trying to improve perceptions, representations and education because they just can, and the growing crowd of irrational "helpful" activists who don't seem to help many others besides themselves, so I guess what I advocate for really does hold less merit.

Sometimes being a watcher of the world lets ya see jut how few of those options are "free for all to try for" and just how few "grand opportunities" there really are, ESPECIALLY in medical care, which should never have been a for profit business model, only available sometimes to those who are "allowed" by way of some physicians'/pharmacists personal belief system, and/or somebody has the money for the gross out of pocket cost for monthly premiums, per procedure/treatment co-payment, AND prescription costs all wrapped up.

Even a complete over-haul, tear down and rebuild, it would be done wrong here, because there's far too much of an allowance for politicians and insurance providers who get near daily approval to work solely off of their own self-interest, an/or private beliefs without much evidence to back them.

Everyone should have as good access to excellent care that I have.

I truly believe that we must push for that. Hard.

I also believe that nothing will eliminate the advantage that comes with a good education and money or access to money. Or the appearance of having both. I've also run into physicians who assumed I had less money than I did ( although it turns out I actually DID qualify for medical assistance) and ones who presumed a great deal more ignorance on my part as well as a certain level of passivity. I also know that I some places,the system is set up to foster those negative opinions. That also needs to be changed.

 

[T.G.G. Moogly]

There is no such thing as being able to have an informed decision in U.S. medical care. The only possible exception would be in a completely voluntary non-illness related medical procedure such as cosmetic surgery.

As you noted, even if you have the time luxury of being able to compare prices for a chest x ray, the answer is always "it depends". It depends on whether you have insurance, which insurance company, which diagnostic center, etc. And if you have insurance, you probably won't get the option of choosing where you go to get the x ray.

And in a medical emergency, there is zero opportunity to shop around.

There was this great article, I'll try to find it, where a doctor was going to have a baby, and she tried to find out what the costs were going to be, and not only did she find it almost impossible to get any answers, when she did, the prices would fluctuate wildly, even at the same providers. Estimates would be as low a few thousand to as high as 30k. At the same hospital, for the exact same thing, she would just ask on different days.

What you are saying is that no one knows what the actual costs are.

Think how fucked up getting food or buying a car or taking a vacation or going to a movie would be if those things and everything else worked the same way, and not to mention how much more expensive.

 

[EricB]

Well, I am a disabled veteran and have healthcare through the VA. Depending on the location, it can range from mediocre to yet another opportunity to give my life for my country - even if I just show up with a toothache. While I could supplement with outside insurance, generally the only medical issues I have are related to my time in service, so I pretty much get re-routed to the VA anyway.

 

[Toni]

There was this great article, I'll try to find it, where a doctor was going to have a baby, and she tried to find out what the costs were going to be, and not only did she find it almost impossible to get any answers, when she did, the prices would fluctuate wildly, even at the same providers. Estimates would be as low a few thousand to as high as 30k. At the same hospital, for the exact same thing, she would just ask on different days.

What you are saying is that no one knows what the actual costs are.

Think how fucked up getting food or buying a car or taking a vacation or going to a movie would be if those things and everything else worked the same way, and not to mention how much more expensive.

In the case of having a baby, there are many variables that will result in differences in costs. These include whether the delivery is a simple vaginal birth with no anesthesia to many levels of anesthesia and other medical intervention or treatment, whether the delivery is by c-section and type of anesthesia used, as well as amount, any complications for mother or child, whether a circumcision is performed, whether mom is in a private or semi private room and for how long--just off the top of my head.