Over the past couple of days I’ve found it really interesting reading about US healthcare/health insurance, and have been enjoying Michael Moore’s ‘Sicko’. I’ve also enjoyed some episodes of ‘This American Life’ about it. Really fascinating, and at complete odds with the NHS. Something that I feel very lucky to have.
What’s your experience like with the American healthcare system? What’s your insurance like? Is it relatively easy to get your healthcare paid for my your insurance provider, or is it a real battle for them to help you out? Do you have any horror stories, people that don’t have insurance? Does the system work for you, or would you prefer something more akin to Universal Health Care?
Edit: I understand that most people probably would prefer Universal Health Care, but I’m really curious about the practicalities and administration of getting your healthcare provider to help you out. Does it take an age to fill all the forms out? Do these insurers want to help you out?
18 comments
I absolutely hate our health care system.
I’m ready to usher in the system where it’s free. The costs of it are so high you can’t possibly pay. And then there’s insurance, doesn’t cover somethings, have to find Dr in network, have to meet a deductible, have to pay every month, and if you need it you have to pay more. Uninsured people may need a surgery but can’t get it because no insurance, so basically they’ll die.
I’ve never had any problems with a doctor not accepting my insurance. The only problem I had was when they forgot to bill my insurance but I just called them with the info. I know people who’ve had nightmares before but usually it’s something that could’ve been avoided.
For all it’s flaws, it’s nowhere near as bad as people on the internet claim to be. The price of healthcare is only a single facet that goes into determining quality. The current system works relatively well for about 90+% of people. Could it be improved? Absolutely. The problem is that the system is complex and we have to come up with our own way of doing it.
As a country we are more diverse and larger than pretty much any other country in Europe. We have cities with more population than some countries. We have states with half the population of some countries but twice the size. The solutions that a lot of European countries have developed simply wouldn’t work for everyone. On top of it all, research showed that Obamacare, our last major push towards universal healthcare, caused the quality of service to drop for the average American. So it’s not as simple as “just take over the hospitals”. It’s trying to:
– find a solution that works for everyone from Alaska to NYC
– doesn’t decrease the quality of care for the average person
– affordable
– easy to navigate
It doesn’t help that pretty much the one pure form of universal healthcare that we have, the VA, has an awful reputation.
I don’t personally deal with the insurance company much. One of my kids needed pre approval before a non-urgent procedure last year, which the provider took care of, but other than that, we just go to the dr when necessary, i can make specialist appointments for myself and the kids without a referral from our gp, and there’s not really any “forms” involved. The only time I remember there being an issue with my bill was around the time I had my second kid (in 2014) and I had to make a bunch of calls to sort it out.
For reference, we have lived in 6 states and had different insurance plans in each one. My (3) kids have all had to make an ER trip, with two getting admitted overnight, and we use urgent care semi regularly, but we don’t have any major or chronic problems.
Insurance companies and pharma/medical equipment companies are screwing everyone and an alarmingly high number of people are completely apathetic or even ok with it.
I have insurance through my hospital now and most things are covered in network, but I would still very much prefer a universal system. Insurance companies are not on your side, they will do everything in their power to weasel out of paying for something potentially essential because it’ll hurt their bottom line. They’re there to make profit, not help people.
I have insurance, I’ve used it, and had to pay so much out of pocket money each time until that total added up to the deductible
I’ve never really had any issue with my insurance. Everything has been pretty straightforward.
I’ve had a few different types of insurance and insurance companies, all through my or my wife’s employer. I’ve never had any serious issues finding medical care that accepts my insurance or getting the insurance company to pay for treatment.
The only issue I ever had was when my daughter was born. My wife and I had different insurance at the time, and my daughter was going to be covered under my insurance. There was some confusion about exactly which services should be billed to which insurance company that it took a couple hours on the phone to sort out, but everything got taken care of in the end.
The system has always worked okay for me, but I realize it doesn’t for a lot of people. My preference for the US would be a hybrid system like Germany uses. Based on the state of the VA healthcare system here, I would not want a totally government controlled healthcare system like the NHS in the US.
I can’t speak for everyone, but my experience with TRICARE has been largely positive for both myself and my family.
I go to my doctor. I see my doctor. I pay my copay.
There was one time that my insurance wouldn’t cover my medication. Turns out the doctor didn’t send them a form, he sent it and the issue was resolved in under two hours.
Don’t get me wrong. Improvements must be made…but don’t believe everything you see on reddit.
Usually you show up at your doctor, show your insurance card, then get treatment. After the visit you pay a copay.
Sometimes you get a bill in the mail for what the insurance didn’t cover. The bills range from legit (doctor double billed for the same procedure, insurance correctly refused second bill) to complete bullshit (only allowed one such visit per year and its only been 364 days, so its not covered).
There are services, like HealthAdvocate, that will argue with insurers, doctors, and hospitals on your behalf.
Uneventful. Most years, money comes out of my paycheck for insurance, I go to the doctor one or two times a year, give a $15 to $35 copay to the office, insurance pays the rest of my bill.
Once or twice a decade something happens and I end up in the hospital. Most recently a few months ago. I go, give them my insurance information (if I couldn’t, they’d treat me and get that later), get whatever treatment I need, and a few months later I get a bill (still waiting on the one from last winter). One time I had to dispute it, which was way more hours on the phone and headaches than anyone wants, but was ultimately resolved. My insurance has a high deductible, so I keep that much money as part of my emergency fund.
It’s not a great system, but the horror stories are the exception, not the norm. It mostly works well enough, just at a much higher cost than it ought.
I wouldn’t mind some form of universal health care where I didn’t have to constantly change insurance and where exactly what was covered was consistent, but whether I’d prefer it depends entirely on what it ended up looking like. If it meant increased wait times for important or urgent services, I’d honestly prefer our current mess to a new one.
It’s hell. The insurance companies are out for blood and never stop until they get paid.
> and have been enjoying Michael Moore’s ‘Sicko’
Oof. I’m not one to sing the praises of the current state of the healthcare system, but absolutely do not take everything in a Michael Moore “””””documentary”””” as gospel.
I have pretty good insurance. My wife, my children and I don’t have to think about it. We go to the doctor when we need/should. If we need medication we get it. I wish it were easier to process referrals for when we need specialists, but this is more of an inconvenience than a problem.
I generally check whether my doctor is in network before choosing them. I do not need referrals for specialists under my insurance, but some providers require a referral to take you on as a patient. I have had to change medications a couple times because of I changed insurance, and my meds were on a higher teir. I haven’t had any issues with insurance since my plan was discontinued when they passed ACA, and I was in a position to pay more money for a much higher deductible because the federal government decided maternity care was required coverage.
I strongly believe in universal basic medical insurance, especially for hospital care and long term chronic conditions.
That said, my current health insurance is pretty good. The main issue now I have is co-pays for one type of medication and ER visits, but even that is not horror story territory, more of an annoyance.
I did have a few issues with previous plans. And deductibles, in general, are fucking awful. I had, in the past, a high (at the time) deductible and it sucked. From what I understand, deductibles are even worse now.
Health insurance companies are complete ratfuckers, it’s total bullshit. If they were done away with or better regulated we’d have a decent system. I think a single-payer system makes more sense, but it seems private health insurance is too politically entrenched for the foreseeable future
I have good insurance through my job. I don’t think I’ve paid a single copay since I’ve had it. Recently went to the ER. That was also covered by insurance. It is a few hundred a month for my family. Rather than look at the cost, I think of it like taxes and and other paycheck deductions. I opted for the most expensive plan available since it covers pretty much everything.
When I was transitioning from college to my career, I had a period of time when I didn’t have Healthcare. I had to go to the ER. The bill was… big. I haven’t had any issues other than when I didn’t have insurance through work.