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.
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.
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.