The Continued Downfall of American Healthcare

[jhtalisman]

Is it just me, or has the American Healthcare system become even more greedy, for-profit, than before?

I ask this because, I had to make a decision in late December, whether or not to go to the ER, or wait for a GP/FP to see me due to abdominal pain that worsened shortly before Christmas. Being so close to the new year, with fresh deductibles, copays, and out of pocket maxes come 1/1/23, having barely used any of those for 2022, I chose to wait until 2023 to begin my expedition to find the source of said pain.

It is a sad, sad state when an individual has to make this choice, as either their health takes a backburner to cost due to poor timing of their illness/expenses or they have to accept that they essentially could pay 2x as much because of calendar year and carryover.

Ridiculous.

The US is the only country out of countless others that doesn't have some sort of UHC or single payer system. The high deductibles/out of pocket maxes are literally killing people, either financially or actuality.

Thoughts?

 

[AugieTN]

 

[Dannydet]

I'm in the US, and I had a CT scan, and then a Colonoscopy and a upper gastrointestinal endoscopy because of pain in the abdomen.

My deductible is $3000 for the year, health insurance through my employer.

I'm now paying most of my deductible on this, which breaks it down to high payments per month!

My wife is on Medicare because she is disabled and she's got bills even higher than mine.

Healthcare today is a moniker.

You have to have it, but what does it actually cover?

Back in the 80s and 90s we never paid for such bills...

 

[jhtalisman]

Last year, including employer portion, $17,500 was paid in healthcare premiums for my family of 5.

There is an individual deductible of $3,000/OOP-Max of $6850. Double those for the family amount.

I had surgery less than a week ago. Total out of pocket cost so far is about $4500. That is after a 20% discount at the hospital for pre-paying which amounted to $1000.

Also an ultrasound, 3 doctor's visits, and a trip to urgent care totalled another $320.

Luckily I/we had enough saved to cover these costs. If not then would have a payment arrangement that would have to be budgeted for.

The only saving grace for some is that medical debt is looked at differently now for credit score purposes.

I'm thinking of going ahead and finding out anything else that's wrong with me since I am so close to hitting OOP-Max already and getting a full restoration.

 

[mikedt]

Is it just me, or has the American Healthcare system become even more greedy, for-profit, than before?

<trimmed>

The US is the only country out of countless others that doesn't have some sort of UHC or single payer system. The high deductibles/out of pocket maxes are literally killing people, either financially or actuality.

Thoughts?

As I understand things in America, unless you've got medical insurance or can pay for the hospital fees by credit car or cash, it's good luck, and they might leave you dying in the street if you can't pay. Fortunately many other countries are not like that.

I'm originally from the UK which has the NHS, and China where I live has a basic govt healthcare system for citizens.

BTW last year I had a myocardial infarction and needed emergency angioplasty, with three stents inserted, but fortunately my employer's insurance covered the hospital fees.

 

[Dannydet]

Canada also pays health insurance for all Canadians.
I'm thinking about hopping over the Detroit River and becoming a Canadian soon.

 

[svim]

I don't think the American healthcare has become more greedy, it's been that way for decades. It's always been based on over-priced services that weren't so obvious back when Federal and state governments paid to make full coverage a non-issue even for those who weren't taken care of by solid, steady employment. But now that the conservative movement has forced austerity to be a standard, municipal funding has dried up and private businesses no longer just automatically provide robust health care for all its employees. I recall that back in the 80's when applying for a job health care coverage was a given, even for lower categories. Now it's no longer an obligation, a job may or may not include health care and when it does, there's a nutty number of 'health plans' with bizarre selections of coverage and deductibles, and we have to sort through to pick the one that works out best, hopefully.

 

[Milo Williamson]

I switched over to a different company, thank goodness I did, saved my root canal surgery I got a spell ago from plumping up, from 2,000 to around 899, afterwards went to the store to pick my medication up, was around oh 12 dollars, not bad for sinus pressure I got it done barely a few weeks ago.

 

[AugieTN]

Dental insurance really ticked me off a few years ago. I needed a root canal and I was told $375, my insurance was to pay 50% ($187.50). I get a note from the insurance company saying something like average cost for this procedure on this molar is $250, so all they are going pay is $125.

Then a neighbor told me the same thing happened to him and he asked the insurance company where he can get the work done for the pricing they are talking about. They gave him the name of a dentist who had a room in the basement of Sears with a dental chair. He said it was crazy

 

[Johngromitleia]

Is it just me, or has the American Healthcare system become even more greedy, for-profit, than before?

I ask this because, I had to make a decision in late December, whether or not to go to the ER, or wait for a GP/FP to see me due to abdominal pain that worsened shortly before Christmas. Being so close to the new year, with fresh deductibles, copays, and out of pocket maxes come 1/1/23, having barely used any of those for 2022, I chose to wait until 2023 to begin my expedition to find the source of said pain.

It is a sad, sad state when an individual has to make this choice, as either their health takes a backburner to cost due to poor timing of their illness/expenses or they have to accept that they essentially could pay 2x as much because of calendar year and carryover.

Ridiculous.

The US is the only country out of countless others that doesn't have some sort of UHC or single payer system. The high deductibles/out of pocket maxes are literally killing people, either financially or actuality.

Thoughts?

The American healthcare system is turning into a money-hungry monster, and it's really disheartening. Having to decide between ER and waiting for a GP/FP just because of costs is beyond frustrating. Health shouldn't be taking a backseat to expenses based on some calendar year shenanigans. And you're totally right, the US is the odd one out without a universal healthcare or single-payer system like so many other countries. Those crazy high deductibles and out-of-pocket maxes are wreaking havoc on people's lives, financially and even physically. It's time for some major changes, so everyone can get the care they deserve without getting bankrupt in the process.

 

[jhtalisman]

My saga continues.

Have to get a colonoscopy in just under 2 weeks. Went to the ER for excessive blood you know where. CT scan was inconclusive on that, but did find advanced degenerative disc disease for my L4 and L5 so now I get to see a spine specialist too.

The pharmacy benefits manager for my insurance also forced me to go online only for one of my maintenance medications, with zero notice, so I have been waiting for a week for it to be delivered.

Gotta love the beauracy of our insurance system.

 

[jhtalisman]

Colonoscopy yesterday found 4 polyps, 2 large, that were removed. Waiting on the results of the biopsies.

As I have hit my OOP max for the year, I am on a mission to get all my health issues resolved this year if possible. 5 months left to do so.

 

[jhtalisman]

Biopsy found that all 4 polyps were precancerous. Get to have another colonoscopy later this year.

Been doing physical therapy for my back the last 4 weeks without much improvement. It isn't even necessarily my back that usually bothers me, though I have had back pain for 20 years, but my sciatic nerve getting pinched causing pain down my left leg. MRI scheduled for Thursday to evaluate for the next course of action, either a steroid shot or surgery.

So far I'm up to $129,000 worth of healthcare before insurance discounts and such. I may update my spreadsheet sometime to figure out how much insurance actually paid out.

 

[ozonetrooper]

If you do not mind telling me, how old are you ?

I recently have had a Colonoscopy and was diagnosed with a rectal issue that required pills that cost over a thousand dollars a month, until "if" the condition improves ... Then they wanted to advance my care by having me come in for checkups at double the rate I was going, office visits were not inexpensive either, just to "talk" to someone ....

I am going to be 68 in a month, and can tell anyone who asks, getting old ain't for sissies !

 

[Mr. Lucky]

Is it just me, or has the American Healthcare system become even more greedy, for-profit, than before?

I'll answer that by telling about the email I received a few days ago from my prescription medication insurance (Medicare part-D) provider. It informed about a price hike for 2024. After doing the math, I realized that the increase amounted to 61.9% !! I know things don't usually go down in price (except for technology), but it's hard to believe that the increase can be justified by an increased cost of providing service.

 

[jhtalisman]

If you do not mind telling me, how old are you ?

I recently have had a Colonoscopy and was diagnosed with a rectal issue that required pills that cost over a thousand dollars a month, until "if" the condition improves ... Then they wanted to advance my care by having me come in for checkups at double the rate I was going, office visits were not inexpensive either, just to "talk" to someone ....

I am going to be 68 in a month, and can tell anyone who asks, getting old ain't for sissies !

I'm only 43. Not overweight and walk a minimum of 40 miles a week.

I do smoke but my health issues other than occasional bronchitis are not completely attributable to smoking. I am trying to quit anyways, however, as it's 1) expensive 2)obviously not good for my health and 3)my spine specialist says I have to quit if I do need surgery.

 

[Steven58]

Biopsy found that all 4 polyps were precancerous. Get to have another colonoscopy later this year.

Been doing physical therapy for my back the last 4 weeks without much improvement. It isn't even necessarily my back that usually bothers me, though I have had back pain for 20 years, but my sciatic nerve getting pinched causing pain down my left leg. MRI scheduled for Thursday to evaluate for the next course of action, either a steroid shot or surgery.

So far I'm up to $129,000 worth of healthcare before insurance discounts and such. I may update my spreadsheet sometime to figure out how much insurance actually paid out.

Best wishes to you and prayers. I hope things work out for you, bro.

 

[AugieTN]

I'll answer that by telling about the email I received a few days ago from my prescription medication insurance (Medicare part-D) provider. It informed about a price hike for 2024. After doing the math, I realized that the increase amounted to 61.9% !! I know things don't usually go down in price (except for technology), but it's hard to believe that the increase can be justified by an increased cost of providing service.

I read that the pharmaceutical companies were against medicare price negotiations. How stupid is that? It makes the pharmaceutical companies look look as bad as they are:
J&J sues in latest bid to halt Medicare drug price negotiations

 

[jhtalisman]

Steroid injection for now, scheduled for the 27th of this month and we will go from there. ‍

Been cigarette free for 1 day, 18 hours and 19 minutes.

 

[jhtalisman]

Well, I forgot to update over the last few months, but I had a microdiscectomy this morning. Cleaned up some bone and the disc that was bulging on my sciatic nerve.

So far, so good. Best of all it's cost me a total of $35 so far. Did have to travel to Tulsa due my employer's insurance choices and a 3rd party administrator but anything related to the surgery, food and travel is paid for.

 

[Steven58]

Well, I forgot to update over the last few months, but I had a microdiscectomy this morning. Cleaned up some bone and the disc that was bulging on my sciatic nerve.

So far, so good. Best of all it's cost me a total of $35 so far. Did have to travel to Tulsa due my employer's insurance choices and a 3rd party administrator but anything related to the surgery, food and travel is paid for.

surgery and you're online later? WOW! Do keep up informed. I hope it works for you!

 

[AugieTN]

Let us know if they reimburse you for travel and food and/or if they screw you on the reimbursement, i.e. we only allow travel and food if it's over 750 miles or it's $25 maximum pay out

 

[jhtalisman]

Let us know if they reimburse you for travel and food and/or if they screw you on the reimbursement, i.e. we only allow travel and food if it's over 750 miles or it's $25 maximum pay out

There is nothing out of pocket with anything directly related. I have a prepaid debit card for food and hotel, the 3rd party administrator booked my flights. The only things they aren't paying for is alcohol (lol) or anything I forgot to pack.

 

[jhtalisman]

surgery and you're online later? WOW! Do keep up informed. I hope it works for you!

Yeah, I actually feel pretty damn good all things considered. Just sore but that's to be expected.

Now if the hospital could have found my personal belongings promptly after the surgery it would have been a breeze, it took them 2 and a half hours to find them - still in the locker where they put them before the surgery. I was starting to get irate.

 

[jhtalisman]

Well back home as of yesterday afternoon. $100 OOP or so, not too bad.

I feel SO much better. Walked 5.5 miles each of the last 2 days. Walking through the airports yesterday I made most of the other travelers look like snails. Not quite 100%, still have some minor pain and discomfort, but I am not noticing anything signifcant like I was prior to surgery. I used to have to stop in the middle of doing things to stretch or sit down. Haven't had to do that since the day after.

Luckily the 3rd party administrator required a 2nd opinion before surgery, otherwise I probably would have ended up with a full spinal fusion with months of recovery. I should only have about 6 weeks or so time for full recovery and specific weight and movement restrictions until cleared. Fusion I basically would not have been able to do anything for quite awhile.