A study by researchers at the Brown University School of Public Health found that avoidable mortality rose across all U.S. states from 2009 to 2021, while it declined in most other high-income countries.
I’m curious, how much is a typical doctor’s visit in the U.S. without insurance of any kind? Just a straight out of pocket sort of expense. $50, $100, $250, $500, $1000? I assume that it scales based on more complicated procedures or longer visits, but what about the basics, like going in for what you think is a bad cold or the flue, maybe a rash or something along those lines?
A bad cold or flu you probably wouldn’t go to a doctor, just an urgent care clinic for some antibiotics or whatever. Probably run $100-$150 + cost of meds (hopefully generic).
If urgent care can’t help, an out of pocket visit to primary care provider will be closer to $300 just to step in the door. Hospitals will put you on a payment plan if you can’t front it.
Ah, yes I’ve heard that about stateside hospitals. Apparently there’s an entire department alongside accounting that deals with remediation of accounts payable. Less than ideal, but it sounds as though it costs a lot less that I’d been assuming this whole time.
I’ll stress that’s just to get in the door. Usually if you’re going to the doctor they’ll want to run xrays, CT scans, MRIs, blood tests, whatever diagnostics and it starts escalating fast.
But this is stuff people can plan for. Emergency visits are much worse in my experience, suffering from appendicitis would have put us $40k in the hole overnight without insurance.
"Rogozov had intended to use a mirror to help him operate but he found its inverted view too much of a hindrance so he ended up working by touch, without gloves.
As he reached the final and hardest part of the operation, he almost lost consciousness. He began to fear he would fail at the final hurdle.
‘The bleeding is quite heavy, but I take my time… Opening the peritoneum, I injured the blind gut and had to sew it up,’ Rogozov wrote. ‘I grow weaker and weaker, my head starts to spin. Every four to five minutes I rest for 20 - 25 seconds.’
‘Finally here it is, the cursed appendage! With horror I notice the dark stain at its base. That means just a day longer and it would have burst… My heart seized up and noticeably slowed, my hands felt like rubber. Well, I thought, it’s going to end badly and all that was left was removing the appendix.’
But he didn’t fail. After nearly two hours he had completed the operation, down to the final stitch."
That story about Dr. Rogozov always struck me as something superhuman. I’ve only ever managed to perform very minor surgeries on myself, I just can’t imagine a major operation on internal organs - with or without the mirror for extra complication.
"That story about Dr. Rogozov always struck me as something superhuman. "
It actually says near the end of the article that Rogozov and Gagarin (who flew 16 days later) both served as models for the Soviet superhumans mentioned in propoganda. It’s also probably why some countries now make appendectomies compulsory prior to visiting Antarctica.
Huh, I never knew that. I suppose that someone who could operate on themselves with an assistant holding a mirror definitely qualifies as superhuman, but the propaganda is news to me.
Pretty much the fastest way to be penniless in the US medical bills. Hence why we have such shit outcomes, we tend to wait until the last damn second for anything medical.
And frankly, the $1000 winning the lottery is with insurance as well.
Christ, not a good state of affairs. I’d say that the U.S. healthcare system should have been overhauled decades ago, but the resistance to improving it seems almost insurmountable when the way that money affects the setup is taken into account. It might not change for the better for a long time yet.
Oh it might change if the the GOP gets their way. They want to strip out out the ACA or “Obamacare.”
Then we get to go back to where insurance dropped parents insurance on kids at 18 instead of until 26, back to limits on lifetime and annual coverage, and where you could be denied coverage due to pre-existing conditions.
This was a state of affairs within my lifetime. You think it’s bleak now, it can in fact get much much worse.
I don’t envy Americans this scenario. Hopefully the system can be restored to an acceptable, if not ideal, state of affairs once the Trump administration ends.
I hope so too. However between Trumps Executive Order on voting and the way the people of my state and surrounding states are acting on this (they’re loving it) I’m not holding my breath.
It’ll probably be a good idea to steer clear of the US for a while (decades). I’d say pray for those of us that are trapped and want the hell out, but with the GOP we’ve got plenty of “thoughts and prayers” already.
I’m in no rush, although routing options to go around a country so large are a bit of a pain in the ass to arrange. At least there’s the Caribbean for North-South travel, and Canada/Mexico for Pacific-Atlantic transfers…
If we wait until an injury or condition is imminently life-threatening then the hospital is legally obliged to treat regardless of an ability to pay and that’s one reason people wait. Also, insurance often penalizes (by paying less) for ER visits that turn out not to be emergencies. The thinking is that you should have gone to your doctor who’s booked-up six weeks out instead.
That tracks with a lot of what I’m hearing. Risking adverse outcomes by waiting until a condition becomes life threatening is a bit like playing Russian roulette, and with acute conditions it’s even worse. It’s maybe a bad analogy, but dentistry comes to mind - waiting until a cavity or tooth infection becomes severe can kill, even if it’s solved with surgery. It’s serious as serious can be, as much as people can’t afford the treatment, they can’t afford to walk a tightrope line where falling kills them.
Well, that’s the problem, due to changes passed with the Affordable Care Act (aka Obamacare), annual routine screenings are free including women wellness. A lot of people do not know this.
The problem is when they find something wrong. Going to a specialist can easily push from hundreds to thousands.
To add on: it has to be coded correctly for insurance. A “yearly physical” is its own special thing which does not require a copay, and if coded correctly covers like a basic metabolic panel, lipid panel, maybe something less common if family history suggests it. It has to be billed as a “preventative service” for something on this list of what falls under the “free” stuff, if you don’t want a nasty bill. I know a full lab workup for me is billed at around $1600 before insurance, and a primary care visit would be around $300.
Interesting, it’s no wonder that so many Americans have a difficult time with medical bills. I was also under the impression that the Affordable Care Act had been dismantled, it’s a bit tough to catch all of the headlines with so much going on all the time.
It’s still counter-intuitive to me, the thought that any country/state would try to save money by rolling back coverage for immunizations. The total loss to GDP from chronic and acute health problems is nothing to shake a stick at, denying coverage for immunization is like a country shooting itself in the foot (assuming that they can cover the cost to begin with).
I’ve been hearing that for a while (and it was said for a long time before my time), but they’re still keeping afloat somehow, despite several generations of getting railed by the conservative politicians, lawmakers & industry that they love. The math just doesn’t check out, how long can people hang onto a ledge by their fingertips while cheering for someone who spits in their face?
Yeah, I don’t understand it either. Immunization has always been such a huge benefit, such a huge return on investment, such a huge positive, that I just don’t understand how even the most self-serving, manipulative liar with no morals would try to cut it
So far as I can gather, it all comes down to vaccine hesitancy. The (dis)information coming down the line has led to some people calling themselves “Pure Bloods” in recognition of their common unvaccinated status, with the belief that there’s some kind of high-handed conspiracy to monkey with people’s DNA via immunization shots. It’s a bit of a headfull, and makes for weird reading, but they’ve really dug their heels in about the issue, believing that their lives are on the line ironically enough. This is going to be one complicated ball of yarn to untangle…
A lot of people think that it was gutted, but it’s actually the reason we have a health insurance marketplace and why you can no longer get denied for preexisting conditions. Before it existed, you were just SOL.
Not that it’s cheap, but my employer charges about the same rate for a high deductible plan. If you are low income, you can get cheaper plans.
Healthcare in America isn’t that BAD if you are relatively healthy, but it is nearly impossible to navigate… by design. Now, if you are actually sick, YMMV.
That does make sense, and although I guess it’s good that there are ultra low-cost options available, there’s that old adage about “getting what you pay for” to a certain extent.
That is exorbitant for most people for a basic doctor’s visit. Federal minimum wage is $7.25/hr. Takes an entire work week for a minimum wage worker to afford a doctor’s visit.
As other’s have explained to you, that is just a visit. It covers nothing else. No medication, no tests, no referrals. Just to talk to the Nurse Practitioner for 15 minutes. You will not be talking to the doctor.
Just brutal, I can’t imagine losing my job and home because I got sick. It’s been the case for many thousands of years typically, but it just seems so arbitrarily cruel to know that there’s a better system that’s been adapted (matter of opinion, I know), but strike it from consideration altogether because of the business model surrounding American healthcare. Paying higher taxes kind of sucks, but at least I’ve never had to remortgage for serious injuries.
As someone with insurance, it’s complicated? So I pay per paycheck on the plan I want. I’m allowed to change this plan once a year or change electives, which will higher what I pay per paycheck or lower based on the plan. I have a wife and 2 kids, and for the plan just under the top it costs me about $600 a month just to be covered (and this is considered really good, I think). If any of us go to our doctors, there is a copay of $30. This copay is based on the plan I picked and have access to. It could be less if I wanted a higher plan or more if I wanted a lower one. This also applies to “urgent care” which is just a quick way to see a doctor if you’re sick and can’t get to your doctor. On top of this, normally you’re allowed a few wellness visits per year with your doctor without copay since they are necessary. If you want to see a specialist the copay can be the same or slightly higher, all depends on your plan. The other kicker, you also need to make sure your doctor or the specialist is in network and takes your insurance. Otherwise, you pay more. Is this crazy yet or make sense?
Other things, hospital or emergency visits, will normally be $100 or way more because they don’t want you to just go to the ER all the time unless absolutely needed. Wildcards, sometimes you need to see people and have no idea what you will pay in the end since sometimes they will do work or use something that isn’t fully covered so you then get a bill a month later telling you insurance only covered this you owe the difference. It’s up to you to figure out if that’s correct or not then go down the path of fighting it. Normally, it’s like the visit is 1k but insurance only covered $950, so you’re now paying another $50 on top of the copay. This happens a lot and is frustrating because you really never know what you will pay in the end. If your married you both can have insurance and submit the remaining cost to the 2nd plan to see what they cover. On top of this, prescriptions have copays as well and have rates based on what the drug is. If you get generic brand it’s normally less, if they don’t have a generic brand you may be lucky and can get the name brand for the generic pricing because they don’t have it.
This is just scratching the surface, I guess to answer your question it’s $30 per visit, but that can change based off above. Also, is it really $30 if I’m also paying $600 per month? Another thing, you can’t just not have insurance. If you don’t, you will have to pay a penalty on your taxes for the time not covered. If you don’t have a job your still required to get a plan and from what I’ve heard those plans can be 1k or more a month for someone who doesn’t even have a job which makes total sense!
“Wildcards, sometimes you need to see people and have no idea what you will pay in the end since sometimes they will do work or use something that isn’t fully covered so you then get a bill a month later telling you insurance only covered this you owe the difference. It’s up to you to figure out if that’s correct or not then go down the path of fighting it.”
This alone would get my hackles up, let alone paying $600+/month for uncertain coverage of treatments and prescriptions. Moreso, it would rub me the wrong way to have someone in my life who was unable to pay in and left up the creek with no paddle. The bit about a tax penalty for absence of coverage is a bit much, does the government really need to kick someone when they’re down? Best of luck to you, it sounds as though you have it well in hand, but I don’t envy you the task.
The bit about a tax penalty for absence of coverage is a bit much, does the government really need to kick someone when they’re down?
This was struck down in court years ago.
The “stick” was to encourage people to get coverage ahead of time or face the penalty. If they decided not to, the extra tax could help cover unpaid ER visits where they must be treated whether or not they can pay.
The “carrot” At the same time was reduced price insurance based on your income and expanded Medicaid coverage for people who couldn’t afford anything. This was paid for by the federal government but Medicaid is administered by the state: several Repugnancan states refused the money because their politicians were so set against providing free medical care
After the tax “stick” was struck down, coverage dropped without that penalty, and states where they refused the money left millions of lesser paid people without coverage . So yeah, we needed it
I’ll be damned, it was almost addressed by legislation in a similar way as car insurance then, if I’m understanding the broad strokes (penalty for non possession)? That being the case, was the penalty via taxes not routed in much the same way as simply paying taxes overall, except only as a means to cover some of the cost for those least able to afford it?
People are generally pissed about paying sales taxes which achieve much the same outcome minus the carrot-stick approach and penalties, how much more or less pissed were Americans about getting ‘nudged’ in the right direction with income tax penalties by comparison?
It’s hard to tell how pissed off people were about the tax penalty trying to nudge them in the right direction.
Clearly some people think they never need medical care, or that they can make that decision in the short term to save some much needed money. Statistics show they are very wrong, but everyone thinks they’re above average.
Clearly some people were vocal about complaining
but also very clearly a lot of it was partisanship, politicians stoking outrage to manipulate voters
I honestly don’t know how common it really was for people to be upset vs how common it was political shenanigans. As always, those shenanigans misrepresent and confuse the truth, so were those complainers even aware of what they’re complaining?
I hope you realize what he is talking about every single American deals with and I think you missed the part where he is fortunate and this is literally the best case scenario (outside of being rich enough to not give af.)
I do, yes. I’ve read reams and reams of accounts, comments, and articles about the hardships experienced under the current healthcare model in America over the past few decades. The exact costing metric was never addressed though, which is why I asked about it specifically. The whole enterprise of for-profit medicine as carried out under the current insurance model is criminal and immoral by any measure.
Wildcards, sometimes you need to see people and have no idea what you will pay in the end since sometimes they will do work or use something that isn’t fully covered so you then get a bill a month later telling you insurance only covered this you owe the difference.
You can request preauthorizations for an estimate.
I always try to request those.
Not always practical, however, especially when it’s urgent.
It’s up to you to figure out if that’s correct or not then go down the path of fighting it.
Fighting it is the worst.
It’s a 3-body problem—you, the insurance, the provider—and you’re caught in the middle.
You can’t just tell anyone in plain language “my insurance covers preventative care cost-free, so why am I being charged for this?”
They force you to do the detective work, and they don’t make it easy.
You basically have to know billing codes better than the billers and tell everyone to use correct ones.
The billing codes aren’t necessarily printed on billing statements or claims (mine didn’t have them).
Their meanings & provisions are unexplained.
The patient has no reason to understand them or know they exist.
Infuriating system.
This is just scratching the surface
You didn’t mention deductibles.
Before copay or coinsurance kicks in, your policy may require paying a deductible.
Cost sharing provisions vary by policy.
High deductible insurance plans come with a health savings account, which is completely tax-free (no taxes on contributions, their earnings, or eligible distributions) for health expenses including any type of cost share (deductible, copay, coinsurance).
As long as you pay health expenses with other funds & retain the receipts, it functions in practice as a smaller investment retirement account with less taxes than IRAs.
Somewhat interesting.
Health insurance typically doesn’t cover dental or vision: those need separate plans.
Another thing, you can’t just not have insurance. If you don’t, you will have to pay a penalty on your taxes for the time not covered.
Federally as of 2019 that was set to $0, so the amount ends up varying by state & could be $0.
You can make sure your doctor is in network, but if someone bills you for other services like an anaesthetists, radiologist or labwork, they may not be and you could get a surprise bill for thousands of dollars.
Oh, absolutely. When we had our kids both times we were hit with out of network anaesthesiologist bills. We fought it and won because we didn’t have a choice and when you have no choice it’s supposed to be covered. It took a few months to get an answer and is incredibly stressful and absolutely not something we should be worrying about after child birth, but welcome to America I guess… you hear about countries where the mother gets monthly care packages and at home wellness checkups on top of like 12 months off and I just get the extra stress of a 3k bill I may be held accountable for if I can’t complain hard enough on top of my wife having to go back to work in 1 month because you either don’t get paid or the few states that do takes over a month to get the first payment and it’s basically half of what you normally get. And that 1 month seems to be luckier than most since I’ve heard stories of people only allowed 1 to 2 weeks tops.
Honestly, if I wasn’t so established with life, career, friends, and also had financial freedom I really think if I had the ability to start over I would 100% be out of here… I know nowhere is perfect, but at least most don’t want to kick you when you’re down either.
I recently had a routine visit with my doctor. About ten minutes. The office sent me a bill. $179.00 Luckily for me it was sent to me in error and my ‘cadillac’ health insurance covered everything.
I’m curious, how much is a typical doctor’s visit in the U.S. without insurance of any kind? Just a straight out of pocket sort of expense. $50, $100, $250, $500, $1000? I assume that it scales based on more complicated procedures or longer visits, but what about the basics, like going in for what you think is a bad cold or the flue, maybe a rash or something along those lines?
A bad cold or flu you probably wouldn’t go to a doctor, just an urgent care clinic for some antibiotics or whatever. Probably run $100-$150 + cost of meds (hopefully generic).
If urgent care can’t help, an out of pocket visit to primary care provider will be closer to $300 just to step in the door. Hospitals will put you on a payment plan if you can’t front it.
My experience is that urgent care is significantly more expensive than primary care.
Ah, yes I’ve heard that about stateside hospitals. Apparently there’s an entire department alongside accounting that deals with remediation of accounts payable. Less than ideal, but it sounds as though it costs a lot less that I’d been assuming this whole time.
I’ll stress that’s just to get in the door. Usually if you’re going to the doctor they’ll want to run xrays, CT scans, MRIs, blood tests, whatever diagnostics and it starts escalating fast.
But this is stuff people can plan for. Emergency visits are much worse in my experience, suffering from appendicitis would have put us $40k in the hole overnight without insurance.
Holy shit, that’s daunting. I think that I might try cutting it out myself rather than go bankrupt.
You can do it!!!
https://www.bbc.com/news/magazine-32481442
"Rogozov had intended to use a mirror to help him operate but he found its inverted view too much of a hindrance so he ended up working by touch, without gloves.
As he reached the final and hardest part of the operation, he almost lost consciousness. He began to fear he would fail at the final hurdle.
‘The bleeding is quite heavy, but I take my time… Opening the peritoneum, I injured the blind gut and had to sew it up,’ Rogozov wrote. ‘I grow weaker and weaker, my head starts to spin. Every four to five minutes I rest for 20 - 25 seconds.’
‘Finally here it is, the cursed appendage! With horror I notice the dark stain at its base. That means just a day longer and it would have burst… My heart seized up and noticeably slowed, my hands felt like rubber. Well, I thought, it’s going to end badly and all that was left was removing the appendix.’
But he didn’t fail. After nearly two hours he had completed the operation, down to the final stitch."
That story about Dr. Rogozov always struck me as something superhuman. I’ve only ever managed to perform very minor surgeries on myself, I just can’t imagine a major operation on internal organs - with or without the mirror for extra complication.
It actually says near the end of the article that Rogozov and Gagarin (who flew 16 days later) both served as models for the Soviet superhumans mentioned in propoganda. It’s also probably why some countries now make appendectomies compulsory prior to visiting Antarctica.
Huh, I never knew that. I suppose that someone who could operate on themselves with an assistant holding a mirror definitely qualifies as superhuman, but the propaganda is news to me.
Oh, I quite agree. Reading through it (again) I had many mental pauses saying to myself, “That’s where I’d die.” An incredible feat for sure.
If you have to go to the Emergency Department, $1000 is you won the lottery.
Holy shit, yeah, that’s not good. With so many just barely squeaking by month to month, even that could be ruinous…
Pretty much the fastest way to be penniless in the US medical bills. Hence why we have such shit outcomes, we tend to wait until the last damn second for anything medical.
And frankly, the $1000 winning the lottery is with insurance as well.
Christ, not a good state of affairs. I’d say that the U.S. healthcare system should have been overhauled decades ago, but the resistance to improving it seems almost insurmountable when the way that money affects the setup is taken into account. It might not change for the better for a long time yet.
Oh it might change if the the GOP gets their way. They want to strip out out the ACA or “Obamacare.”
Then we get to go back to where insurance dropped parents insurance on kids at 18 instead of until 26, back to limits on lifetime and annual coverage, and where you could be denied coverage due to pre-existing conditions.
This was a state of affairs within my lifetime. You think it’s bleak now, it can in fact get much much worse.
I don’t envy Americans this scenario. Hopefully the system can be restored to an acceptable, if not ideal, state of affairs once the Trump administration ends.
I hope so too. However between Trumps Executive Order on voting and the way the people of my state and surrounding states are acting on this (they’re loving it) I’m not holding my breath.
It’ll probably be a good idea to steer clear of the US for a while (decades). I’d say pray for those of us that are trapped and want the hell out, but with the GOP we’ve got plenty of “thoughts and prayers” already.
I’m in no rush, although routing options to go around a country so large are a bit of a pain in the ass to arrange. At least there’s the Caribbean for North-South travel, and Canada/Mexico for Pacific-Atlantic transfers…
If we wait until an injury or condition is imminently life-threatening then the hospital is legally obliged to treat regardless of an ability to pay and that’s one reason people wait. Also, insurance often penalizes (by paying less) for ER visits that turn out not to be emergencies. The thinking is that you should have gone to your doctor who’s booked-up six weeks out instead.
That tracks with a lot of what I’m hearing. Risking adverse outcomes by waiting until a condition becomes life threatening is a bit like playing Russian roulette, and with acute conditions it’s even worse. It’s maybe a bad analogy, but dentistry comes to mind - waiting until a cavity or tooth infection becomes severe can kill, even if it’s solved with surgery. It’s serious as serious can be, as much as people can’t afford the treatment, they can’t afford to walk a tightrope line where falling kills them.
What kind of Doctor? What kind of Visit?
Let’s say the family type, and a checkup for any of the more mundane things above.
Well, that’s the problem, due to changes passed with the Affordable Care Act (aka Obamacare), annual routine screenings are free including women wellness. A lot of people do not know this.
The problem is when they find something wrong. Going to a specialist can easily push from hundreds to thousands.
To add on: it has to be coded correctly for insurance. A “yearly physical” is its own special thing which does not require a copay, and if coded correctly covers like a basic metabolic panel, lipid panel, maybe something less common if family history suggests it. It has to be billed as a “preventative service” for something on this list of what falls under the “free” stuff, if you don’t want a nasty bill. I know a full lab workup for me is billed at around $1600 before insurance, and a primary care visit would be around $300.
Interesting, it’s no wonder that so many Americans have a difficult time with medical bills. I was also under the impression that the Affordable Care Act had been dismantled, it’s a bit tough to catch all of the headlines with so much going on all the time.
Affordable Care Act is mostly still there, but
Also the current administration is trying to
It’s still counter-intuitive to me, the thought that any country/state would try to save money by rolling back coverage for immunizations. The total loss to GDP from chronic and acute health problems is nothing to shake a stick at, denying coverage for immunization is like a country shooting itself in the foot (assuming that they can cover the cost to begin with).
Have you met Republicans? They like shooting themselves in the foot. They love guns.
And it is mostly the red states doing these counterintuitive measures. Unintended consequences going to catch up real fast.
I’ve been hearing that for a while (and it was said for a long time before my time), but they’re still keeping afloat somehow, despite several generations of getting railed by the conservative politicians, lawmakers & industry that they love. The math just doesn’t check out, how long can people hang onto a ledge by their fingertips while cheering for someone who spits in their face?
Yeah, I don’t understand it either. Immunization has always been such a huge benefit, such a huge return on investment, such a huge positive, that I just don’t understand how even the most self-serving, manipulative liar with no morals would try to cut it
So far as I can gather, it all comes down to vaccine hesitancy. The (dis)information coming down the line has led to some people calling themselves “Pure Bloods” in recognition of their common unvaccinated status, with the belief that there’s some kind of high-handed conspiracy to monkey with people’s DNA via immunization shots. It’s a bit of a headfull, and makes for weird reading, but they’ve really dug their heels in about the issue, believing that their lives are on the line ironically enough. This is going to be one complicated ball of yarn to untangle…
A lot of people think that it was gutted, but it’s actually the reason we have a health insurance marketplace and why you can no longer get denied for preexisting conditions. Before it existed, you were just SOL.
https://en.m.wikipedia.org/wiki/Affordable_Care_Act
Not that it’s cheap, but my employer charges about the same rate for a high deductible plan. If you are low income, you can get cheaper plans.
Healthcare in America isn’t that BAD if you are relatively healthy, but it is nearly impossible to navigate… by design. Now, if you are actually sick, YMMV.
Damn, good to know that the bit about pre-existing conditions hasn’t been struck down yet. I had to look up YMMV :(
Typically, out of pocket no insurance cost for primary care physician visit is around $200-300.
If you know the doctor, maybe $100 if he or she does a sliding scale.
That’s encouraging, at least. It’s not cheap per se, but definitely not as exorbitant as I assumed.
For most lower income Americans that can be cost prohibitive.
There are some lower cost options:
CVS and some other retailers have mini clinics where you see a nurse practitioner. Out of pocket these visits can be $50-100 out of pocket.
Some hospitals and health departments offer free clinics but they are often busy.
Online options have become more popular but they often are limited to very simple issues (e.g. sinus infections, allergies, etc).
This assumes you don’t need a prescription or labs.
From a prescription standpoint, Walmart still offers $4 prescriptions for very common drugs. Again out of pocket.
Labs your sort of SOL.
That does make sense, and although I guess it’s good that there are ultra low-cost options available, there’s that old adage about “getting what you pay for” to a certain extent.
That is exorbitant for most people for a basic doctor’s visit. Federal minimum wage is $7.25/hr. Takes an entire work week for a minimum wage worker to afford a doctor’s visit.
As other’s have explained to you, that is just a visit. It covers nothing else. No medication, no tests, no referrals. Just to talk to the Nurse Practitioner for 15 minutes. You will not be talking to the doctor.
Just brutal, I can’t imagine losing my job and home because I got sick. It’s been the case for many thousands of years typically, but it just seems so arbitrarily cruel to know that there’s a better system that’s been adapted (matter of opinion, I know), but strike it from consideration altogether because of the business model surrounding American healthcare. Paying higher taxes kind of sucks, but at least I’ve never had to remortgage for serious injuries.
A couple years ago I didn’t have a job or health insurance and the flu shot cost $37.
That’s not bad, I guess, but probably more than anyone would want to pay if they were out of work.
Pretty much, yeah
if any blood tests are involved then that alone can send it into the 1000’s. -I’ve had firsthand experience with that.
That’s insane, I can’t even begin to estimate the markup on those tests.
As someone with insurance, it’s complicated? So I pay per paycheck on the plan I want. I’m allowed to change this plan once a year or change electives, which will higher what I pay per paycheck or lower based on the plan. I have a wife and 2 kids, and for the plan just under the top it costs me about $600 a month just to be covered (and this is considered really good, I think). If any of us go to our doctors, there is a copay of $30. This copay is based on the plan I picked and have access to. It could be less if I wanted a higher plan or more if I wanted a lower one. This also applies to “urgent care” which is just a quick way to see a doctor if you’re sick and can’t get to your doctor. On top of this, normally you’re allowed a few wellness visits per year with your doctor without copay since they are necessary. If you want to see a specialist the copay can be the same or slightly higher, all depends on your plan. The other kicker, you also need to make sure your doctor or the specialist is in network and takes your insurance. Otherwise, you pay more. Is this crazy yet or make sense?
Other things, hospital or emergency visits, will normally be $100 or way more because they don’t want you to just go to the ER all the time unless absolutely needed. Wildcards, sometimes you need to see people and have no idea what you will pay in the end since sometimes they will do work or use something that isn’t fully covered so you then get a bill a month later telling you insurance only covered this you owe the difference. It’s up to you to figure out if that’s correct or not then go down the path of fighting it. Normally, it’s like the visit is 1k but insurance only covered $950, so you’re now paying another $50 on top of the copay. This happens a lot and is frustrating because you really never know what you will pay in the end. If your married you both can have insurance and submit the remaining cost to the 2nd plan to see what they cover. On top of this, prescriptions have copays as well and have rates based on what the drug is. If you get generic brand it’s normally less, if they don’t have a generic brand you may be lucky and can get the name brand for the generic pricing because they don’t have it.
This is just scratching the surface, I guess to answer your question it’s $30 per visit, but that can change based off above. Also, is it really $30 if I’m also paying $600 per month? Another thing, you can’t just not have insurance. If you don’t, you will have to pay a penalty on your taxes for the time not covered. If you don’t have a job your still required to get a plan and from what I’ve heard those plans can be 1k or more a month for someone who doesn’t even have a job which makes total sense!
This alone would get my hackles up, let alone paying $600+/month for uncertain coverage of treatments and prescriptions. Moreso, it would rub me the wrong way to have someone in my life who was unable to pay in and left up the creek with no paddle. The bit about a tax penalty for absence of coverage is a bit much, does the government really need to kick someone when they’re down? Best of luck to you, it sounds as though you have it well in hand, but I don’t envy you the task.
This was struck down in court years ago.
The “stick” was to encourage people to get coverage ahead of time or face the penalty. If they decided not to, the extra tax could help cover unpaid ER visits where they must be treated whether or not they can pay.
The “carrot” At the same time was reduced price insurance based on your income and expanded Medicaid coverage for people who couldn’t afford anything. This was paid for by the federal government but Medicaid is administered by the state: several Repugnancan states refused the money because their politicians were so set against providing free medical care
After the tax “stick” was struck down, coverage dropped without that penalty, and states where they refused the money left millions of lesser paid people without coverage . So yeah, we needed it
I’ll be damned, it was almost addressed by legislation in a similar way as car insurance then, if I’m understanding the broad strokes (penalty for non possession)? That being the case, was the penalty via taxes not routed in much the same way as simply paying taxes overall, except only as a means to cover some of the cost for those least able to afford it?
People are generally pissed about paying sales taxes which achieve much the same outcome minus the carrot-stick approach and penalties, how much more or less pissed were Americans about getting ‘nudged’ in the right direction with income tax penalties by comparison?
I’m not sure about the routing
It’s hard to tell how pissed off people were about the tax penalty trying to nudge them in the right direction.
I honestly don’t know how common it really was for people to be upset vs how common it was political shenanigans. As always, those shenanigans misrepresent and confuse the truth, so were those complainers even aware of what they’re complaining?
Ah, par for the course then. There’s a lot of that going around on a pretty regular basis unfortunately.
I hope you realize what he is talking about every single American deals with and I think you missed the part where he is fortunate and this is literally the best case scenario (outside of being rich enough to not give af.)
I do, yes. I’ve read reams and reams of accounts, comments, and articles about the hardships experienced under the current healthcare model in America over the past few decades. The exact costing metric was never addressed though, which is why I asked about it specifically. The whole enterprise of for-profit medicine as carried out under the current insurance model is criminal and immoral by any measure.
You can request preauthorizations for an estimate. I always try to request those. Not always practical, however, especially when it’s urgent.
Fighting it is the worst. It’s a 3-body problem—you, the insurance, the provider—and you’re caught in the middle. You can’t just tell anyone in plain language “my insurance covers preventative care cost-free, so why am I being charged for this?” They force you to do the detective work, and they don’t make it easy. You basically have to know billing codes better than the billers and tell everyone to use correct ones. The billing codes aren’t necessarily printed on billing statements or claims (mine didn’t have them). Their meanings & provisions are unexplained. The patient has no reason to understand them or know they exist. Infuriating system.
You didn’t mention deductibles. Before copay or coinsurance kicks in, your policy may require paying a deductible. Cost sharing provisions vary by policy.
High deductible insurance plans come with a health savings account, which is completely tax-free (no taxes on contributions, their earnings, or eligible distributions) for health expenses including any type of cost share (deductible, copay, coinsurance). As long as you pay health expenses with other funds & retain the receipts, it functions in practice as a smaller investment retirement account with less taxes than IRAs. Somewhat interesting.
Health insurance typically doesn’t cover dental or vision: those need separate plans.
Federally as of 2019 that was set to $0, so the amount ends up varying by state & could be $0.
You can make sure your doctor is in network, but if someone bills you for other services like an anaesthetists, radiologist or labwork, they may not be and you could get a surprise bill for thousands of dollars.
Oh, absolutely. When we had our kids both times we were hit with out of network anaesthesiologist bills. We fought it and won because we didn’t have a choice and when you have no choice it’s supposed to be covered. It took a few months to get an answer and is incredibly stressful and absolutely not something we should be worrying about after child birth, but welcome to America I guess… you hear about countries where the mother gets monthly care packages and at home wellness checkups on top of like 12 months off and I just get the extra stress of a 3k bill I may be held accountable for if I can’t complain hard enough on top of my wife having to go back to work in 1 month because you either don’t get paid or the few states that do takes over a month to get the first payment and it’s basically half of what you normally get. And that 1 month seems to be luckier than most since I’ve heard stories of people only allowed 1 to 2 weeks tops.
Honestly, if I wasn’t so established with life, career, friends, and also had financial freedom I really think if I had the ability to start over I would 100% be out of here… I know nowhere is perfect, but at least most don’t want to kick you when you’re down either.
I recently had a routine visit with my doctor. About ten minutes. The office sent me a bill. $179.00 Luckily for me it was sent to me in error and my ‘cadillac’ health insurance covered everything.
Well, that’s something at least. How much does a “Cadillac” health plan’s coverage cost you though?
I got it through my job/union. I pay about $20.00 for a doctor’s visit out of pocket. Pretty much everything else is covered.
I wish everyone had coverage like mine.
That’s cheap AF compared to what I’ve been hearing so far. All day long, Union strong.
I lucked into a civil service job with a good Union. Ended up getting great benefits.
One reason Trump is trying to ruin the government is because rich folks hate the idea of employees having anything good.
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