American Healthcare: How your system works

by Diogenesister 100 Replies latest social current

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  jhine

  Hi folks , I'm back . Sorry if it seemed that l done a disappearing act . I've just been really busy organising a local event .

  Anony Mous LUHE is perfectly correct in what he states. The government does not have anything to do with running the NHS .

  So some people say that part of the reason they go bankrupt is illness or accident. That has naff all to do with paying medical bills. We DO NOT GET THEM FROM THE NHS . Probably these people are are maxed out on credit cards or have loans that they now cannot pay .

  On the other hand Americans can still get huge bills for healthcare even if they have insurance.

  People over 80 are NOT denied treatment in the UK , there are NO death panels or covid concentration camps .

  You mention communists and l think that this is the problem. Some Americans are so petrified of communism that Republicans only have to breathe that word in the same sentence as universal healthcare and it becomes the devil's plaything.

  I like the system that my country has. It makes no odds to me how other countries do it . I do know that Americans who have fallen foul of the US system would swap in a heartbeat.

  LUHE l agree that the NHS does need an overhaul. I did misunderstand what you were saying , sorry . I feel that the calls that we get for more money to be injected in are misguided. The money that is handed over just needs to be used more efficiently.

  However the NHS doesn't have the problem of being ripped off by Big Pharma which American hospitals do

  Jan from Tam
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  peacefulpete

  The Affordable Care Act (disparagingly called Obama Care) is not an insurance program it is in part an exchange (website) where at people with lower income and no employer provided insurance can buy it. The insurance is identical to that sold by the same insurance companies outside the exchange. The premium is subsidized based upon income of the applicant. It works extremely well and has improved the situation for millions of Americans, including ourselves. The early snag was the unwillingness of some insurance providers to participate as the negotiated premiums cut into their profit.

  The ACA also has imposed new rules on the insurance providers, no longer can they drop sick people's coverage or deny coverage. Myself, with a history of cancer I would be uninsurable under the old system, or I could get a terrifically expensive policy that would deny coverage for anything they could relate to the cancer. Some years ago my friend got skin cancer and she was denied coverage because she had seen a doctor for acne as a teen. The ACA is not ideal as it still allows insurance companies to continue to disregard doctor direction (they today have taken ownership the majority of clinics and hospitals to enable them to dictate care).

  The stone-cold fact that must be addressed is that you cannot make money insuring sick and elderly people, it can't be done. The government has, as a consequence, needed to intervene and require them to cover these folks if they wanted to sell insurance in America. To make the system work well, everyone (universal) needed to be insured, thereby sharing the costs. Republicans successfully fought to remove the 'universal' care aspect hoping to bankrupt the system. Instead, because millions now had coverage they could never afford otherwise, it shifted the costs of the premium subsidies to the taxpayers. Now when an uninsured young person or whoever, requires care (emergency room) they cannot be denied care (Emergency Medical Treatment and Active Labor Act of 1986) but in the end often must resort to writing off the bill (and adding the costs to insured patients) or suing for payments that will bankrupt most people.

  In effect we already have universal healthcare, just really expensive, bloated with profiteering and inefficient due to multiplicity of actors.
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  littlerockguy

  Now when an uninsured young person (or millions of illegal aliens crossing our border requires care (emergency room) they cannot be denied care (Emergency Medical Treatment and Active Labor Act of 1986) but in the end the hospital has to deal with not enough revenue to keep the hospital open and sometimes have to close down.
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  SydBarrett

  "" If anyone can go in and get free healthcare, what reason would they have to take care of themselves?"
  

  
  So as not to get sick. Are you saying you just let yourself go because you have insurance? What a silly comment. I have insurance and I take care of myself because being healthy in a reward unto itself. Ideally, i'll never have to use my insurance for anything major. Why do you assume others would be different?
  
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  jhine

  Littlerockguy it's great that uninsured people can get treatment. Could you clarify what type of treatment please? Is it just emergency treatment? If an uninsured person needs expensive long term cancer treatment for instance would they get it ?

  If an uninsured person has a bad accident and needs an ambulance is that paid for ? If they are taken to the closest hospital which doesn't happen to accept non insured people would they be sent on to a hospital that does ?

  Jan from Tam
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  TonusOH

  Jan, emergency care is rarely not provided to those in need, regardless of insurance status. But a lot of non-emergency care, especially preventive care like check-ups, or important items like prescription medication, requires insurance or a cash payment. The system here is built around insurance, so it can be very difficult to even understand how much care actually costs, even before determining if it is affordable. This is exacerbated by an odd system wherein insurers are limited in terms of the regions they can serve with health insurance, a limitation not normally placed on other types.
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  peacefulpete

  How To Get Cancer Treatment Without Health Insurance (growingfamilybenefits.com)

  It is complicated, and specialists themselves are at liberty to get involved or not in many situations. My sister was in the middle of a bad divorce when she was diagnosed with a rare cancer. She had no insurance and no money. The hospital staff themselves assisted her to get emergency coverage using state programs and Medicaid. In the end (which was far too soon) her estate was left with bills that exceeded her assets anyway. It was shocking to me and family that none of the cancer specialists were willing to offer experimental treatments or even engage in studies. We strongly suspect it is due to the minimal nature of her coverage and the certainty of her inability to pay out of pocket for anything declined by Medicaid.

  In short things have much improved from the days not long ago when you simply would be turned away, but the system is clumsy and complicated. Knowing exactly who to ask for help and filling out the paperwork right the first time are essential.

  Interestingly, years ago when we returned to Miami from a self-funded missionary stint, I was not well (typhoid) and had concerns about some spots that looked suspiciously like skin cancer. I was broke and had no insurance of course. I went to the free clinic and was turned down because I was not an undocumented alien. It's complicated. The clinic was funded privately, and staff were volunteers, with immigrants in focus. I was told to apply for aid in my home state. Fortunately, I had a nurse friend who got me the help I needed.
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  jhine

  TonusH thank you for explaining that .

  Peacefulpete , sorry to hear that you lost your sister too young . It is just such an alien idea that someone can be left with huge debts for healthcare . Also that the hospital staff had to help her get funding. The last thing that you need when given such a devastating diagnosis is to have to fight bureaucracy.

  I had breast cancer and it was a trip to the GP who referred me to an oncologist . He prescribed a lumpectomy, then chemo and further surgery. All straightforward no forms to fill in , no worries about finances.

  Jan from Tam.
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  peacefulpete

  Thought I'd share a recent development. I had my annual checkup with my general physician last month. He spent 10 minutes glancing in my ears and eyes ( a nurse took my bp and pulse just before. I got the bill, just shy of $800. They billed for 2 office visits with the doctor. I assumed it was an error and called. The response came in the mail. the new game is to ask you if anything is bothering you and then can bill for a diagnostic visit. Or by simply reviewing the medical file they can bill for a consult. You have to laugh at the audacity.
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  smiddy3

  Here in Australia elderly people have access to My aged care packages and allotted different monies for different levels of care to help them live as normal a life as possible.

  It`s a great Govt. scheme and much appreciated by my wife and myself .