I am Dutch, I do not worry about healthcare, though things can be improved in the Netherlands also.
Looking in from the outside and reading all the commentaries on this page, there are two things that clearly stand out: 1- the readership of the NYT seems to be massively in favor of Medicare for all, and 2- the fact that healthcare is such a bizarre rip off in the US is overwhelmingly blamed on the GOP.
Concerning 1: the people of the US have the power to change things by their vote. Well, go out there and make things better, you have the power. Concerning 2: the people of the US will keep their lamentable healthcare as long as they only blame the GOP for the pity state of their nation, most elected Democrats are servants of corporate greed also. Recently a Medicare for all proposal in the state of California was passed and then voted down by Democrat leadership and democratic ‘superdelegates’. When money is allowed to be the prime force in politics, there is no way forwards, whoever you vote for, because you as voters are allowed to choose a candidate, but the candidates offered are picked by the few.
25
This is just another indication of what is wrong with America.
I live in Queensland Australia and the ambulance is free, it is paid for by a small levy on citizens power bills.
There are three things that should be free and equal for all people .... health, justice and education but in America, the more money you have, the better their quality.
That is where the inequality lies ... you can live just as well with 10 million as with 10 billion but your country if the personification of greed, and to perpetuate that, you have the perfect president.
38
No employee should ever enjoy better benefits than the boss does; wouldn’t you Republicans agree?
Fine. Then, as the boss, I DEMAND the same health care plan my congresspersons have.
Problem solved.
18
The New York Times correctly observes the all-too common plight of someone injured who must choose between "getting by" or further suffering under the onslaught of medical expenses.
That health care is a complicated problem is perhaps the editorial understatement for the history books. Health care is the most urgent conversation in America today, where typical families routinely choose between food on the table and medical attention.
Of course it's complicated -- but that doesn't excuse the inaction and inertia around the issue. Our society is being held hostage by an escalation of health care expense and increasing proportion of our GDP -- with health outcomes far worse than any developed country.
Mr. Azar was brought to HHS to attack skyrocketing costs, yet meekly rubs his hands in distress -- we must be careful not to upset the apple cart. Funnily enough, ruthless mercenary credit and collection agencies do not hesitate to upset the apple cart -- and push many families to bankruptcy.
New Yorkers are progressive, and our state is fortunate to be amongst 26 states with Improved Medicare for All legislation pending. In New York, we call it the New York Health Act. Vetted by world-class health care economists, and ready to implement at once, NYHealth will save the state $45B annually by cutting the cancer of insurance company and hospital billing and insurance related administrative costs. Call your senators. Register -- and Vote! Find our more at nyhcampaign.org
11
I know my position on this subject will not be agreed with by many in my geographic area, but I think health care should be in the same category as police and fire protection. It's something we all pay for that all an benefit from. Yes, I can already hear the cries of socialism......the thing is, I pay for other people's health care already through taxes, so why can't I get in on that? My wife and I pay thousands of dollars every month in just income taxes, and don't get a damned thing back in comparison with the "baby daddy's and baby momma's" that get all their care for nearly free. I have to pay for my own health care in addition to the care of others...if I have to pay for others, why can't I augment that system with the private insurance that I have? People will say something about "death panels" with any sort of population-wide health care program.....but are insurance companies doing anything different than that? Seriously, I don't know the answer to fix everything....I wish someone smarter than me (not influenced by money or power) could figure it out:)
16
Here are some steps that we can all do to minimize out-of-pocket health care costs:
1. If diagnosed with an illness, do some online research and educate yourself on various treatment options. Often the treatment recommendation from your doctor is not the least expensive or most effective option. Look at PT journals (free online) and also review UK and other nations' practices. I was pleasantly surprised to discover when I was 35 and pregnant, that "advanced maternal age" is 37 in most European countries. Armed with that knowledge, I declined all the high-risk pregnancy services and had a relaxed, healthy, and much less expensive pregnancy.
2. If the doctor recommends certain tests, make sure that you have the risk factors to warrant such a test. Often doctors just prescribe the same tests across the board without tailoring to the patient. Also, ask the doctor how your treatment might change based on the results of the test. If the treatment options are the same, it might not be worth the time and money.
3. Always review your bills to ensure you are not being double-charged or charged for services covered by your insurance. I've found errors that totaled hundreds if not thousands of dollars.
4. Finally, (and this may be the hardest to do), take care of yourself. Turn off the TV and go for a walk. Choose veggies over snack foods. Stretch daily. Practice mindfulness. And vote for a kinder world.
12
My mother fell while in nursing home and required stitches to her head. The hospital was less than 5 minuets away a round trip was over $1200. That was just the ambulance. This is so wrong.
14
Our problem is basically one of Cost Shifting. People (especially the poor) go to the ER when sick and their costs are shifted to insurance companies, then to policy holders.
My best comparison was in the early years of the Century when I was going on business trips to Australia. My US insurance was $550 a month and my Australian policy (with far better coverage) was $88 a month.
Maybe the GOP politicians can study the Aussie system and then go to the Fortune 100 and ask them if they would like this type of savings. No one benefits more from the Aussie type system than employers.
8
Empower patients. Let them choose between expensive American doctors or cheaper, foreign doctors; between expensive, local pharmacies or cheaper, foreign pharmacies. Most exams can be done on Skype. This would force our medicine to compete with foreign medicine and bring costs down.
Don't we already force U.S. workers to compete with foreign workers in a global marketplace? Why can't labor be as unfettered as capital, and flow to countries where the cost of living is cheaper so that they can stay with a company when it moves its factories overseas? It seems that U.S. labor is over-regulated (as well as over-taxed). His housing costs are too expensive, and his educational and health care costs are crippling his global competitiveness. In the spirit of free enterprise, let's give labor the same freedoms we've given capital.
4
The reasons for our current predicament are well known and widely understood. To sell themselves to the public, political candidates, just like any other product, need to advertise. Advertising costs money. Hospital corporations, insurance companies, drug manufacturers and giant regional healthcare providers and have it, and spend it to control legislative outcomes--a wise investment for them; a disaster for the public.
Add to this the atomization of society and the belief, sown by the afroementioned interests and trumpeted by politicians, that any type of healthcare reform means the government will take away your money and give it to the (undeserving) poor. Mix in the Democrat's efforts to tax American citizens to provide free healthcare for the entire rest of the world should they transit, legally or otherwise, to U.S. soil, and you are left with little prospect for a reform consensus any time soon.
The current system is working brilliantly for the people it was designed to benefit.
3
Nu, so what's new? Conservatives, libertarians, et al. have long been telling us that if you can't afford it, you don't need it, can't have it and God doesn't love you anyway...
6
You can only lower the cost of health care in this country by not providing it, or lowering the overhead.....if you only knew how expensive it is to provide you would not be so quick to suggest that it can be provided cheaply.....every light, every machine going 24 hours per day in every hospital amounts to a lot of electricity....and....good service isn't cheap......cheap service isn't good......
1
Really?
In fact, UnitedHealth announced record-breaking profits in 2015, followed by an even better year this year. In July 2016, UnitedHealth celebrated revenues that quarter totaling $46.5 billion, an increase of $10 billion since the same time last year. And company filings show that UnitedHealth’s CEO Stephen J. Hemsley made over $20 million in 2015. To be fair, that is a pay cut. The previous year, in 2014, Hemsley took home $66 million in compensation.
Aetna, whose CEO Mark Bertolini reported to the Securities and Exchange Commission a $27.9 million compensation in 2015, has similarly celebrated sky-high profits. “In 2015, we reported annual operating revenue of over $60.3 billion, a record for the Company,” Aetna recently told investors.
All for being a middle man. With two hands out for money, and a maze to receive reimbursement or explanations, much less care. If you're lucky.
No Lucifer. It is only expensive here in the US.
Welcome to TrumpCare. Cheaper, better, winning! Now with less affordability or coverage! HOORAY!
12
France, Germany, Sweden, Canada (Canada!) does it cheaper and better. Try again.
15
"According to the Centers for Medicaid and Medicare the U.S. spent $3.2 trillion on health care in 2015. That's $10,035 per person."
You guys want healthcare for all- then tell me HOW ?? Are we willing to pay higher taxes? Are we willing to pay $6 dollars a gallon for gasoline? That's how other nations offset their costs- Are the Insurance and Medical lobbies even going to allow our Congress to discuss universal healthcare?
Don't get me wrong- It sounds great- people get excited- but as soon as you look at the economic and political hurdles involved - it quickly becomes a dicey and dangerous situation.
Are public and private sector unions- who have lifetime medical benefits as part of their retirement pension going to forego their private "Cadillac" health plans and replace it with socialized medicine..? Will illegal immigrants be entitled to universal healthcare? These are questions which need to be asked and answered...
Americans must wake up to the fact they are never ever going to get national health care for all. They will never get cheap medication. They will never get gun control. These are facts the rest of the world accepts. What seems to be the problem?
5
As long a profit comes before health care, it's not medicine being practiced - it is greed and stupidity. Essential services must be taken out of the realm of profit, it increases inequity and destroys lives.
12
I travel to the US for work a fair amount and whenever I ask about the situation regarding affordability of healthcare I almost always get the same response and that is that it is absolutely no problem. Most of the time the person I am asking knows I am from Canada and probably is aware of our universal health care coverage at "no cost" and so I always wonder whether that person is just being defensive about his country. I also wonder if their opinions will change when they get older and their health starts to deteriorate as it will for most of us. The most striking difference I've found in healthcare experience between the US and Canada is that in the US, seeing a healthcare provider feels more like a business transaction than anything else and it always sends a little chill down my spine because I can't help wondering about what happens to people who can't afford the needed services. I once experienced a slightly irregular heartbeat while working in Oak Ridge, TN and decided to visit the ER as I'd not had that before. It was US$500 just to walk through the ER doors and after a few perfunctory tests with plenty of waiting time in between them they pronounced me healthy and I then left. The total bill came close to US$800 (my work insurance paid). In Canada this would have cost the usual $0 although it would have taken much longer. Well, at least the pretty nurse turned on the TV over my bed for me as I waited for the next test.
7
Steven Brill's superb report in Time "Bitter Pill: Why Medical Bills are Killing Us" clearly explained why the US health care system is such a disgraceful disaster.
That was over 5 years ago (March 4,2013). Of course the report had little to no impact, the situation since then has worsened, and will only continue to deteriorate as the upcoming SCOTUS pick will likely tilt conservative, favoring the usual suspects: Big Pharma, Big Insurance, and Big Medicine.
Additionally, as Dr. Krugman has pointed out, Speaker Ryan and colleagues are pushing for cuts to Medicare, Medicaid and Social Security because of growing deficit concerns. (Never mind how the deficit got out of control)
So while affordable heath care for all is admirable, worthy, and should be an inalienable right, at this point it's a joke. How can we get Medicare for all when even simple CMS price negotiations are legally prohibited?
Yes I know - the answer ultimately is vote blue - but remember how the alt-right propagandized even the modest step forward ACA? Death panels, socialized medicine, budget-busting deficit spending to name a few.
Gotta hand it to the Medical Industrial Complex...getting millions of lower socioeconomic citizens to vote against their own best interests, literally with their lives on the line, to support the 1% plutocrat class is a pretty good trick.
10
Absolutely sad that this injured woman had to make such a choice, and shameful of this country's for-profit health care system. It is my sincere hope that this lady received care after such a horrific incident. This was an extreme example where the such a choice was made on the basis of possibly going into financial hardship. The story was shocking.
But the choices made in a less extreme example to either forgo a visit to the doctor or pay the rent or keep food on the table is no less serious. As a result, people here are sicker. In the richest country in the world where some members of the population who inhabit the highest income brackets are doing very well, and do not have to even give a thought to finance their health care, the vast majority has to pay high deductibles, copays, high hospital bills, and high prescription prices.
Our for-profit system is a sham. Every part of the healthcare chain profits: private ambulance companies, hospitals with their chargemasters, pharmaceutical companies claiming their high prices are justified by R&D, medical specialists, etc, etc. down the list. We need some form of a single-payer system, one not based on the for-profit system that places dividends paid to shareholders above the health of people. Until we have universal healthcare, that other developed nations have, these awful choices, such as the one illustrated in this article, will continue to be made.
8
I developed an ear infection on Sunday. It is the kind of scary looking infection that one would visit an ER for right away. I waited until yesterday and went to a clinic that covers the uninsured. It is an incredible service. The nurse practitioner was so alarmed that he gave me antibiotics and had me come in again today, and asked me to text him a photo tomorrow on the holiday to make sure it is healing. His parting words were, “If it goes south, it will happen quickly, and you must go to the ER.” My last visit to the ER was $8,000 plus a doctor’s bill of $1,500 for a five minute consultation. Keeping my fingers crossed. Happy 4th all.
11
Single-payer health care is the answer and does not need to be overly complicated. Many nations, most notably our neighbor Canada, have successful plans which could be duplicated here.
12
The reason and cause of the abysmal health care options in the United States is a 5 letter word. GREED! One thing is certain. As long as Donald Trump is occupying the White House and Mr. McConnell is leading the Senate NOTHING will be done to improve this health care options in this country. I urge all Americans to go to the polls and VOTE. VOTE against GREED.
13
UnitedHealth is one of the companies on the Dow Jones Industrial Average, along with companies like Apple, Coca-Cola and ExxonMobile. Their CEO made approximately $17 million in salary in 2017. Just ponder this for a moment. Insanity.
15
Keep it simple. Most people are on the side of life: they wish they could have more of it. They do not seek its end here, trying always to stave death off so long as life's delights and satisfactions endure.
What attacks life, unequivocally and directly (politics , economics, and Trumpism, excluded)?
Unnecessary pain, suffering, disease, anguish, anxiety, "accidents", poverty, murder, treacherous legalities, etc.
Many people can recover from the onslaughts of unnecessaries, given a little to a lot of help. Some countries provide it and others do not. High on the list of countries failing to fight against anti-life unnecessaries is the USA.
Why do we fail when other countries succeed in fighting against anti-life? We prefer to be on the side of death says the right..........against Life, that is. And they sort of control things, just now.
3
Keep it simple. Most people are on the side of life: they wish they could have more of it. They do not seek its end here, trying always to stave death off so long as life's delights and satisfactions endure.
What attacks life, unequivocally and directly (politics , economics, and Trumpism, excluded)?
Unnecessary pain, suffering, disease, anguish, anxiety, "accidents", poverty, murder, treacherous legalities, etc.
Many people can recover from the onslaughts of unnecessaries, given a little to a lot of help. Some countries provide it and others do not. High on the list of countries failing to fight agains ant-life unnecessaries is the USA.
Why do we fail when other countries succeed in fighting against anti-life? We prefer to be on the side of death says the right..........against Life, that is. And they sort of control things, just now.
I thought trump and the Republicans swore they had the absolute best health insurance/care program that this country had ever seen and they were going to make everyone healthy for free. Just as soon as you elect them. Then short term memory loss kicked in.
12
All that has been said so many times over and over again, yet nothing has changed, the nation elected a party and president, a Despot, (did we really ELECT them?) who moved heaven and hell to take even the little improvement of ACA away from the people. Normal governments know they are there to serve the people, to improve the general welfare of the people. Only Republicans don't think the government has certain responsibilities for the welfare of the people.
How could people get so duped by a conman and elect him to become the Despot of the nation? Cut taxes and increase the military budget and cut food stamps and reduce the deficit and start a trade war and the people swallowed it. How is that possible?
8
And thus to conclude: "Nothing will change until their fellow citizens step into the ballot box and insist on something better."
As Editorial Board fully understands, and as witnessed by all during citizens' EXCLUSION from manufacture of ACA legislation (not to mention further exclusion from any industry-protective alternative that might ever be offered under DJT-GOP regime), citizens at ballot box will NEVER be offered opportunity to choose any candidate not already vetted and suborned by the vampire healthcare cartel.
Back to your planning table, please, NYT Editorial Board; offer some better conclusion than such a patently mendacious bromide.
2
Approximately 85% of hospitals in the US are not-for-profit. And they bankrupt some of their patients. Imagine a homeless NFP or a financial counseling NFP doing the same. It's unthinkable. But we continue to call health care organizations businesses, and they apply the same mentality (e.g., profit and loss), under the philosophy that they need capital to invest. Except every new wing I've seen is named after a rich benefactor.
7
One very tough lady as physical pain was unequal to the perceived hurtfulness of deeper destitution and poverty. Awful circumstance and evil culture that despises poor people and hates everything about their inability to be financially secure. Nothing to be done until the USA returns to sanity and compassion.
6
Remember when Republicans blew a gasket over Alan Grayson saying that their healthcare plan was, "Don't get sick. And if do get sick, die quickly?" Truth hurts sometimes.
10
We don't need to "design" a universal system. We have one. Actually, we have two: Medicare and the VA health care system.
For non-veterans, open up Medicare to everyone. Watch the private insurers weep and go out of business (good riddance; you had your day). I don't want to say problem solved. But once most of the country is on the same medical care system, the problems that come with that will be much easier to deal with than the health care system problems we have now.
It's why I'm now a single-issue voter.
10
"Nothing will change until their fellow citizens step into the ballot box and insist on something better." We have a party that supports an affordable healthcare plan, but refuses to fight for it. We have another party that claims it can replace that healthcare plan with something terrific, but only undermines it. And, we have a people who voted for the latter party. Is it any wonder we don't have a reasonable healthcare policy in this country?
4
This all started with Ronald Reagan when he converted us from a cost savings based healthcare delivery system to one based upon profitability. We have been going downhill ever since and today we are in crisis with rising health care costs, increased bankruptcies due to insufficient medical cost coverages and people foregoing treatment including preventive measures. Republicans continue to whistle in the dark. Vote for change this November.
10
A few years ago, I fell down the stairs and crushed my knee and tore all the surrounding muscles. I scooted up the stairs, and my boyfriend carried me to the car all to avoid an ambulance. I have a pretty good job with benefits, but I knew the hospital bill would cost a fortune and be a financial hardship even without an ambulance.
I was right. I had 5 surgeries and months of rehab. I was fortunate to be allowed to work from home for six months, to have a boyfriend who could get me to my appointments, to have a manager who was supportive, and to have disability insurance in addition to health insurance. That said, money was still tight, and I worried constantly about losing my job.
I know that many - maybe most - people aren't near as lucky as I was. A health problem should never be catastrophic for a person who lives in a developed country like the U.S. I will never understand why people are so resistant to improving the health care system in this country.
15
This has been explained - there are just too many people who are afraid that “those people” will get some benefit, and so constantly vote for cutting - even if they themselves are hurt, in order to prevent black and Hispanic people from receiving any care provided with tax dollars.
6
Why are so many doctors dropping out? It’s because being a doctor just ain’t what it used to be. Doctors and nurses used to be in charge of hospital medical care quality. In the seventies I was sent to a quality of care meeting across the country by a hospital CEO to help keep his doctors/nurses up to date. The CEOs supplied the business means to support the medical ends. Doctors and nurses were at the center of the quality of care, as it should be. But year by year things changed and Hospitals became businesses first. Newsweek and Time announced the advent of “propriety medicine” during the same week In the 70’s. Hospitals merged and grew. Quality of care became less important than length of stay when charging by “diagnosis related groups” was introduced as a business decision. Ultimately and inevitably medicine was trumped by business. As the saying goes, follow the money.
8
A tiny suggestion to make lawmakers to do their jobs:
1. Tie each Congressional Representative’s and Senator’s salary to the median income of the area, district, or region he or she serves.
2. Require that each bear the total cost of health insurance from his or her own salary – no extra compensation at taxpayers’ expense.
3. Require that each select only the health insurance coverage available in his or her area, district, or region.
If Congressional salaries and health insurance were tied to the salaries and health insurance available in the areas they serve, then it would be incumbent upon them to better the lot of those they serve so that their own benefits would improve.
Let us stop the current state of affairs where a huge chunk of our taxes support those in Congress who are beholden to their 1-percent donors instead of being beholden to us. (And those 1-percenters probably don’t pay taxes because they have highly compensated lawyers and accountants to “save” them from the burden that the rest of us pay in taxes.)
Perhaps if the members of Congress have only the health insurance options open to their constituents – and have to pay for them out of their own pockets – they would begin to work for the 99-percent.
And maybe I’m just one small voice day dreaming a bit . . .
15
That’s how the USA is exceptional and unique.
5
Trump and the GOP believe that healthcare is not a right, but a privilege that only the wealthy should be able to afford. This women was not rich, so, she doesn't deserve to be treated in their eyes.
When faced with this woman's agony Trump and the GOP's response is an emphatic, "So what?! She can bleed to death for all we care!". Such are the morals of those who equated affordable healthcare with "death panels".
7
So, Mr. President. You start trade wars that kill jobs and increase consumer prices. You chastise allies because their military spending isn’t up to your expectations. You want to put troops into space. Yet, your own people can’t afford medical treatment. You know what that is? SAD!
14
Did we missed it .. the GOP and Presient Trump said lovingly to our citizens.. got hurt .. too bad .. now cough up the money or die ..!
4
Like The Onion says: ‘No Way To Prevent This,’ Says Only Nation Where This Regularly Happens
9
The anger at Trump administration members like Sarah Huckabee Sanders and Scott Pruitt and has now boiled to the point that they are being verbally confronted for their destructive behavior in public places. Perhaps the same treatment should be given to health insurance, pharmaceutical, and hospital executives, who truly should be ashamed of their unethical swindling in exchange for corporate profits. The last CEO of United Health took a one BILLION dollar severance package at retirement, while a woman with an injured leg in Boston can't afford an ambulance ride.
17
No voting or political changes will make a difference. As much as I hate to say this, things have gone too far that only two solutions can bring immediate transformation: an armed conflict/civil war or dissolution of the union into two or more countries.
4
"[F]ar too many of America's politicians plasce too little value on the well-being of its citizens."
Well, its human citizens, anyway. The corporations are certainly well-taken-care of. It does prompt you to wonder of what use is America's government? The first purpose of any government is the well-being of its human citizens. THAT is the sine qua non of a government.
10
The scourge of employer-based insurance is the high deductible healthcare plan (HDHP), which basically is catastrophic health insurance under a different name. When the injured woman in the article decried the $3K, she probably described the looming healthcare deductible waiting for her that her HSA or flex spending couldn’t cover. MA has mandated health insurance at the state level (Mitt Romney), that the ACA is based upon. This is both a blessing and a curse. Sure it expands healthcare coverage to lower income individuals, but leaves the middle class with employer-based in the mire of the HDHP, which has gained popularity as it meets the requirements of “essential health benefits” while cost-shifting to the individual, which leaves the individual/families unable to truly access healthcare. Meanwhile, resentment builds while lower income individuals receive subsidies or are on Medicaid (if you are lucky enough to reside in a state that participated in Medicaid Expansion). The really asinine aspect of HDHPs is that your prescription drugs are included in your deductible. Nothing quite like going to the pharmacy and facing a $100 copay for that branded generic. As the healthcare system hobbles, with the ranks of uninsured growing, I bet the drumbeat for single payor expands to suburbia. As the late/great Charles Krauthammer predicted on Fox News during the last ACA repeal mess, single payor will be a reality within 10 years because the middle class can’t access health care.
7
Americans can be such wonderful people. I've never been able to understand their willingness to let their neighbours suffer so long as they are persoanlly OK - or worse, the belief that the best of society should only be accessed by the most wealthy. The Canadian system is not perfect - none is - but we are looking out for one another as citizens and people dont have to live day to day wondering if a broken arm will break their entire family.
13
Crowdsourcing formalizes the "survival of the cutest" and is easily subject to fraud. We may approve of the first, but there's got to be a way to discourage the second.
5
My brother lives in British Columbia, Canada. He recently had major surgery, recovered, and eventually was discharged. As bending was painful, the hospital sent him home is an ambulance.
Cost? Fifty bucks. Period.
In Canadian dollars.
17
There are two basic reasons a proper healthcare fix is not likely to happen. The first is the extreme aversion of people at the very top of the income scale to paying higher taxes for anything that provides a benefit for the general population. One might think they'd be willing to take the trade-off, since they'd also get the benefit, and would save money on premiums and out-of-pocket expenses. But they've apparently determined that, overall, they end up paying less for their own care under the current system.
The second reason is that many people, including a lot of those aforementioned folks with a tax phobia, are actually making a lot of money from the current system. What a neutral dispassionate observer might see as fraud, waste, abuse, and price gouging, someone else sees as an opportunity to exploit the built-in inefficiency, complexity, and opacity for profit. For them, it's a feature, not a bug. And any changes that improve efficiency and reduce prices will mean the end of the gravy train.
14
Another example of why access and treatment aren't the same thing.
As long as we keep thinking that access to health care through insurance = receiving treatment for health related conditions, we will keep going around and around this same corner.
It is absolutely true that the definition of insanity is doing the same thing over again, and expecting a different result.
8
This is a nasty subject in today’s United States.
Really some of the comments just blows my mind.
Outright blatant robbery.
Gimme your money !
Gimme your money !
Gimme your money !
America, land of the healthcare racket !
6
The reason our healthcare is so expensive is because our Congress is bought by special interests.
Just so happens the reason we pay four times more for internet, twice as much for pharmaceuticals is also the same answer. Crooked Government.
8
I have lived overseas since I was in my late 20's. I am often asked by me relatives when I am moving back. I am so afraid of out of control medical costs in the US (even if insured -- priced at circa $15,000/year) if I get a serious illness that I can never contemplate moving back. The facts -- 1) anyone residing in the UK will receive adequate, if not world class, treatment for a serious or terminal illness without contemplating going bankrupt or draining their savings, 2) there is much job freedom and ability to be an entrepreneur because basic health needs are and will be covered (no one is reliant on an employer for health care).
a note: I have 1 sibling that has been declared bankrupt due to cancer treatment (and he was insured and had been with the same employer for more than 20 years). My only other sibling is paying off a hospital $20/month (probably for the rest of her life) for emergency treatment while she was working but not covered under the employer's insurance plan. This is something that others in first world nations simply do not have to worry about.
18
The Republican Party and Republican Donald Trump messed up, and screwed up the American healthcare system. Donald Trump "SABOTAGED AND MURDERED" Obamacare's subsidies killing it for 60 millions of children, low income- Americans, and families. Trump KILLED the Obamacare's mandate that made the Healthcare premium much less expensive for another 130 millions of Americans.
Trump and the Republican leaders are bloody murderers, criminals of the dying Americans with no healthcare or cannot afford it. America? It's the land of the abused now. Trump is beyond disgusting, he a real beast!
5
The Republicans want to treat health care as something that can be managed with a free market. Let the chips fall where they might. Of course if everybody were independently wealthy health care would be a whole lot easier to manage. One problem is the uninsured who drive the price of healthcare up and cause poor health to rise. Raising economic status is very difficult with income gap getting wider between the rich and everybody else. The US spends lots of money on the newest technology, that is vastly expensive, while not paying enough attention family health care. Private health insurance with its guiding principle the bottom line. So deductibles go higher and coverage has lessened in the putting tremendous strain on personal finance. With the opioid crisis and other on public health problems the cost of health care is ruinous with the present free market approach.
5
This is not a bug but the design feature and supported by roughly 40 percent of Americans if the rest don’t vote out the people who are fine with this situation then I guess we deserve what we have!
6
Get health through your employer or pay for it period. Do not saddle another financial entitlement onto U.S. taxpayers. It is not affordable just like democrat initiated social security and medicare.
1
You will change your tune when you get sick and can no longer work and lose your job and your health insurance and then your life savings. Or when your child is born with a heart defect or diabetes and you realize that he/she will never get health insurance as an adult.
18
I worked in private for-profit, private not-for-profit, and public non-profit healthcare for more than 40 years, I have watched the privatization and monetizing of every aspect of our healthcare system. Prior to Medicare, providers could deny services if you had no money. While most providers did not deny care, others did. Americans were dying from readily avoidable causes.
Medicare and Medicaid set “reasonable and customary” payments as a percentage of charges by guaranteeing prompt payment. Private providers increased charges resulting in increased profits. HMOs were born to control pricing by directing beneficiaries to specific “low cost” providers.” Providers, in turn, started cherry-picking high dollar & high coverage (Cadillac) plans. The payment model shifted to case rates regardless of charges. “Case Management” procedures, remarkably, were able to uniformly align length of stay with reimbursement. Now we in the midst of “value-based” reimbursement for clinical outcomes. I’m curious what work-around will be developed. Each evolutionary step did little to improve clinical care and outcomes but was highly successful at increasing individual and societal cost!
Absent EMTALA, STARK, Fraud & Abuse statutes, minimum licensing standards, et.al., inequitable access to care would devastate our shared social order. If you enjoy anarchy, that’s an option. I prefer single payer – it is more likely to assure access and reduce fraud.
6
We are watching as government of the people, by the people, and for the people is perishing from the earth. We are doing exactly what Putin and the Russians want us to do: destroy ourselves with internal bickering. The Russians got the right toady to do the job for them when they hired Trump to be our President. It’s nauseating to watch Trump demean himself and the United States for whatever Putin is paying him or extorting from him. As soon as Russia takes over America, it will be interesting to see how they treat their agent. What else can anyone say? We have lost our core and at long last will now atone for our crimes against humanity.
5
The woman in Boston who believed that she would be charged $3000 for an ambulance, an amount she couldn't afford was most likely mistaken. And this is because just about every city that charges for an ambulance does so on a sliding scale that is based on the person's income. It certainly sounds like the $3000 fee is the full fee, which is charged only to the highest income bracket.
And as far as deductibles go, what is indisputable is that the amount of deductibles skyrocketed as a direct result of the Affordable Health Care Act. That while before the act deductibles were in the hundreds, after the act was passed most deductibles went into many thousands.
And the reason for this is that insurance companies always offered different quality plans. There was gold, silver and bronze. Now before the act was passed it was up to the insurance companies to decide what type of coverage to include in each plan. So the insurance companies were able to sell different types of plans that went from gold, which provided allot more extensive coverage than bronze, and this was what differentiated the expensive plans from the cheaper ones.
However the Affordable Health Care Act required that all plans provide the exact type of coverage. As a result the only way to make some plans better and more expensive than others was by charging higher deductibles for the cheaper plans. And so it was only after the act was passed that we began to see deductibles in the thousands of dollars.
Michael, please cite your sources for your ‘sliding scale’ theory.
3
Health insurance has became something other than what "pure" insurance is supposed to be. Basic health insurance which only covers catastrophic type situations no longer exists in the US because of the ACA. I, as a single 37 year old male with no children should not have to pay for mandated things such as pediatric care, gynecologist services and all of the other things I will not ever use. I also should be responsible for paying for all of the preventable care such as routine check ups.
Unfortunately, health care has become a business. It started when congress revamped the Medicare system with DRG's (diagnostic related groups) in 1984. It was done to supposedly save a failing health care system, but was primarily done to cut costs and reduce length of stays for those over 65. The insurance companies adopted the same format in the 1990's with managed care. As a R.N. of 28 years, I have seen health care go from quality to quantity. The specific needs of the patient are not met. Get them in and get them out as quickly as possible is the mantra. No one addresses the specific needs of the patient. If you can stand up, then you can go home. PEOPLE: Money drives everything. This type of care is driven by insurance giants, big Pharma, and physician related medical groups that get paid by them. Wake up everyone! We are not making America great by keeping our heads in the sand. This is a long standing disaster that needs attention.
7
Here’s my Canadian story. I once got a small gash in my forehead that would require a few stitches. At the time, I didn’t think it was an emergency, but there was a lot of blood involved so others convinced my to take an ambulance to the hospital. Being young and naive, I had no idea the ambulance would require me to pay anything. I was actually quite annoyed when the bill came - a whopping $17.
11
The charge to you was $17. The cost was higher than that, which someone else had to cover. No one ever looks at the underlying or unseen cost of anything. In addition, at a charge of $17, there is no incentive to minimize the use of that service.
No "From Where I Sit" it was a cost that all Canadians covered. Not the ominous, hardworking, taken advantage of rich dude. Incentive bull.
Dear From Where I Sit of Gotham,
As long as there are people around driving cars and crashing them, incentives to minimize the use of any health service are moot.
I wish you had made an argument about preventative care and wellness, but you hadn't.
When I fell and broke my ankle two years ago, I called someone I worked with to drive me to the hospital as I was afraid of the ambulance bill. As it was, it might not have mattered. I eventually ended up having to have two surgeries and to stay overnight in the hospital and to have multiple follow up medical and physical therapy appointments. I met my deductible and the insurance kicked in, but I still have a bill I’ll be paying off for years. It annoys me that hospitals write off costs for some and other people do end up with essentially free medical care and I, with insurance premiums I’ve paid for years, was left in financial straits one of the few times I really needed to use it. And, yes, there are times I needed medical care and didn’t get it because of the deductible and the cost of medications. An ankle broken in three places wasn’t something I could treat myself.
6
Blame everyone who calls an ambulance or goes to the ER for the sniffles.
No, blame Republicans who won’t consider a single payer national health system.
10
If this is what American Exceptionalism is, count me out!!
9
Because the Democrats thought that they should be in charge of the healthcare industries, the rifdiculous PPACA was passed CLEARLY against the protests of the American people.
Remember, in 2009, 80% of Americans were ''Satisfied'' with their healthcare options. But Mr. Feckless Obama needed his name in the books, so now insurance and medical costs are much higher, and the middle class is much poorer because of the ravages of Democratic Party tinkering with things clearly left to the states and the people in our Bill of Rights.
This poor woman is yet another victim of Obama, Pelosi, and ''Real-Estate'' Reid.
I don't dispute the fact that health care costs in America are outrageous. But the story from the tweet doesn't seem ... right. Has any other reporter verified?
Every minute of every day there's someone in the US deciding to forego needed medical treatment because of the costs.
8
The Whited-House is teeming with White-Right racist Republicans who are proud of their bigotry.
These moral lepers insist that the government remain color-blind to Republican color prejudice.
The whole world knows that there are no racists quite so contemptible as Republican racists.
8
This is somewhat melodramatic. If you've been severely injured you get an ambulance and figure out everything else afterwards.
1
Maybe YOU do. That's privilege.
10
This is the result of conservative policies of the Republicans. All Republican policies are immoral. It is just a fact. They are a party of despicable, immoral people determined to hurt other people as much as possible who are poor or have a different skin color.
14
I agree that the majority of current GOP policies are immoral, unethical, and unraveling the fabric of our society. However, I think that the GOP are color blind when it comes to screwing law abiding citizens. It’s more about income level than race/ethnicity.
1
I grew up in apartheid South Africa. I am white. One day, walking home from school, I came across a homeless couple. They were black. The woman had a bleeding gash in her head, possibly inflicted by her drunk, belligerent partner. I called an ambulance. The call operator asked me the race of the person who was unwell. I refused to answer the question so the operator made an assumption, sending the lesser, slower service provided for black South Africans at that time. I waited close to the couple for over two hours before an ambulance finally arrived. By that time the woman was unconscious and foaming at the mouth. It is startling how closely American health care resembles the apartheid system.
22
As seems to be common sense, the only way to actually reform our health care system is to take profit out of it. In a world where everything is about C-level execs and their salaries and bonuses, and about the shareholder, why in the world would healthcare be any different? OF COURSE their goal is to make as much money as possible, ie pay out as little as possible, ie deny claims and charge ridiculous amounts of money for everything. OF COURSE.
I'm self-employed, and pre-ACA the cost of my policy kept going up - and after I wound up with breast cancer, it went up to $820/month for just me. I was at the point of thinking I could no longer pay that (and of course couldn't get a different policy anywhere) when along came the ACA.
Now I pay $420 a month for insurance with a $6550 deductible, so no, I don't go to the doctor. I limped to the pharmacy counter a few weeks ago for my pricey prescription, and mentioned to the pharmacist that I'd had shooting/crippling pain in my right leg for over a month at that point, but having tests run would be too expensive. She looked at me in horror, but really, what else is a person suppose to do?
I don't blame the ACA - this is ALL on greedy insurance and health care companies who'll get their money anyway they can.
My blog post from pre-ACA times sums it up - things are basically the same. Greed is still good. Money is king. The people be damned. http://thethighmasterroutetokona.blogspot.com/2009/11/let-them-eat-cake....
10
The political and religious forces that are bent on banning abortions are also aligned in making health care less affordable and less available to those with limited means. Our times have become befuddled by a mixed-up morality that animates zealots against abortion while proudly working to deprive millions of health care benefits. The voices of outrage against this perverse morality cannot be sounded often enough or loudly enough to reset our country on the path to a more equitable and caring society, so that claims of being the greatest country in the world will stop sounding like sheer hypocrisy.
10
What would it be like if every American citizen could remove the terror of contemplating what they would do if they or a loved one were to become seriously injured or ill? To me, at times like these the thought of not being able to afford treatment that is readily available - or having to weigh whether or not to even seek treatment in the first place is tantamount to mental torture.
Other advanced societies realized this a long time ago and determined that only government controlled or supplied healthcare would avoid the terrible "Sophie's choice" of having to decide whether to go broke or try to live with the medical problem. Their citizens probably cannot even contemplate having to make decisions like this. They instead can simply concentrate on getting the needed healthcare as soon as possible and getting on with life.
8
..., the notion that healthcare isn’t a human right in a country as privileged as the United States of America, will forever be a mystery for most people, one ponders ...
18
Get the for-profit middlemen out of the game. It's inhumane that health insurance companies profit grotesque amounts on the backs sick and injured Americans. This has to stop.
9
When it comes to healthcare, we ARE the Third World.
14
Took an ambulance two blocks to the hospital. $2,000.
4
This woman did get medical care eventually. How ironic that in ground zero of the Medical Industrial Complex and the land of "Romneycare" (the blueprint for the ACA) that this woman should fear the cost of an ambulance which isn't $3k. It's fear of uncertainty of available health care which is paralyzing our country. Don't count on Trump or the Republicans to do anything about it.
4
France has a superior and cheaper healthcare system for all and a far better public transportation system. What do you know?!
10
A fine example of the predatory capitalism coupled with bureaucratic corruption citizens face all over America.
Where has the reason, common sense and care for one another gone?!
5
Now these insurance companies come up with cutesy terms like copay, coinsurance and deductible. Copay? Wait a minute. What was my premium for? Coinsurance? That’s just Orwellian.
And these high deductible plans hide the cost of the premium. I pay $340 a month for NOTHING. I’m not insured until I pay another $5,000 for that deductible.
When you sign up for insurance (my fourth insurance plan in four years) they ask you how many times you think you’ll see the doctor in a year. What?!
If I go through my employer, the cheapest plan is $800/month. So I have to settle for something that mitigates the damage if something catastrophic happens to me.
Thanks, Republicans, for blocking all legislation that would have given us a decent system. Instead we have a Romneycare. And that Republican plan is why it doesn’t work.
And people believe the lies about Europe’s abs Canada’s systems. What we have is god awful.
8
Nothing will happen unless we vote Republicans out of office. Ditto for assault weapons.
Be sure to vote in November 2018.
15
We support whole extra highly profitable industries, the lawyers and the pharma companies, in our healthcare establishment. It is in their interest that the laws make lawyers and big pharma necessary for healthcare. US citizens are so guillable and naive and they have had so much money that they have not fought all of this.
Maybe now they will (but probably not). For pharma, why would the US govt allow naturopathic (placebo) meds but still make big pharma spend billions to demonstrate efficacy? This makes the barrier for entry into the drug field so high that there is much less competition and much more price gouging.
How much extra in health care costs does it cost you dumb consumers to retain the right to sue any provider or ambulance or drug manufacturer for any perceived wrong and to seek $hundreds of millions in punitive damages even though your entire lifetime income is only $3 million? Jury selection as a moneymaking art by the lawyers!
By the way, there was such a thing as no fault auto insurance that would save everyone money, but the lawyers got that one thrown out as well 20 years ago, and the stupid American citizens did not realize that they were again being fleeced. Americans have to be focused and agressive to cut our costs, but we are not. We are dumb and easily fooled and distracted. So we get what we deserve.
4
A few years ago an acquaintance was headed to her brother's funeral and told me that he was whacked in the head by a garage door opener and made the fateful decision not to go to the emergency room because he was in between jobs and had no health insurance and didn't want a few thousands dollars of medical bills he could not afford. He correctly surmised that his skull was not fractured and decided to ride it out with Tylenol. Then his brain swelled up and he died. He was also a conservative and faithful Rush Limbaugh listener who trained him to believe that the health care systems like the ones in Canada and the UK and every other advanced countries are horrible. Had this happened in Canada or the UK he would likely be alive today.
Lack of health care kills and the crazy thing is, our system costs more, not less. Somebody is making money and likes things just the way they are here.
11
From the perspectives of most Americans, life in the U.S.A. is well on its way to becoming that of an underdeveloped third-world nation.
Trump and his Russia- Republican co-conspirators are determined to make the U.S.A. last in everything except racism and gun deaths.
8
Ambulance is free in Japan as it should be. America is the only country where going to a doctor puts you back $500 an office visit. With insurance, it’s more like ¥500 (or even less) in Japan, an equivalent of about $4.50. Without insurance, it’s a whopping ¥3,000. You do the math.
Having to worry about paying for care when you’re sick or injured is wrong and inhumane.
14
I used to work for an ambulance company's billing department when I was in high school, and it was absolutely heartbreaking and created a huge fear in me of ever having to take an ambulance. When I was in college, I fainted and got a concussion during my study abroad in Japan, and had to take an ambulance to their ER. When I woke up, I was terrified of the cost. I was 21, in a different country, and was so concussed I was having trouble understanding the language. My bill for the ambulance ride and ER came to a grand total of $35. That's it. The phone call to my parents to let them know what was going on cost more than that.
9
I suffered a stroke last year when visiting relatives in Poland. The hospital (3 days in intensive care, 7 days in neurological ward, all tests, medications, physical and cognitive therapy) came to $2500. Then I was transferred by ambulance to a rehabilitation facility (single room with bathroom, meals, more physical therapy, all medications) for 17 days - another $1500. My doctors in the US think that I have received an excellent treatment in Poland and were surprised at my progress.
4
I have it tattooed on my chest between the nipples.
“do not resuscitate”
What little I have I want to go to my children, not Aetna
8
"Medicare for all" is decidedly not the only other option. Germany has mandatory health insurance, but it is provided by some 200 private insurance companies. And it arguably works better than Britain's National Health Service (sort of a Medicare-for-all system).
Regardless of the system used, administrative efficiency and outcome-based payment to the hospitals/physicians is key to getting the cost down, not our system of ordering multiple, unnecessary test, and getting paid for it.
2
In Germany and the other single payer countries, government collects taxes to pay for health care, and then hires private companies to administer it. But the money comes from a single payer - government.
As for the UK, they're the only single payer country that has a health system like our VA, where government owns and runs the hospitals and clinics and directly employs all the medical personnel. That makes the system much more susceptible to budget cuts and the problems that result from that. Nevertheless, the UK's system is still superior to ours in many ways.
2
@Meg. No, that is incorrect. In Germany, the employer and the employee each pay half of the premium, transferred to the insurer directly by the employer (for those with statutory insurance). For those with private insurance (more costly, but more inclusive), at least in my case, my employer includes its share in my monthly salary, and it is up to me to then transfer the money to the insurance company.
I've never lived in the UK, so cannot speak from experience, but from what I've read, the Brits have a love/hate relationship with the NHS. Just like in Canada (again, from what I've read), there can be, and usually are, long wait times for surgeries, or even to get appointments. Of course, that is far superior to what we had, with almost 50 million Americans without any insurance.
Access to health care is as much a human right as is the right of every child to a public education, supported by the community and free at the school or hospital door. Americans will continue to see tragedies like this poor woman until we recognize our responsibility to become self-insured like we've done for seniors with Medicare. Doctors at trauma centers understand the cruelty in American health care as they save comatose patients knowing the care will probably bankrupt the patient like a friend of mine who had a stroke, and like the lady in the Boston subway, pleaded with first reponders to let him die rather than calling in a helicopter that fleeced whatever savings he had, putting him on the streets. Like Benjamin Franklin implored his colleagues, "I'd rather hang together than hang alone."
4
Romneycare / Obamacare was an attempt to create exchanges for standardized services so consumers could understand and compare them. The hope was that transparency and consumer choice would exert downward pressure on prices through competition. It was designed by Republicans and advanced by them as the best American solution until a Democrat implemented it, then suddenly they decide it is the worst possible system and do everything possible to tank it.
Well, the alternative is not the "let them eat cake" now favored by Republicans. Since they are determined to sabotage anything at all you might as well go for something you know works elsewhere: single payer. You have nothing to lose but your pains.
7
I have family who enjoy the benefits of the Canadian healthcare system and I also worked in that system. Having to hear the scaremongering fabrications of the GOP against the Canadian healthcare system is infuriating. These tactics simply play to the ignorance of the GOP electorate and shows the contempt the GOP have for their electorate. I also have an adult child who lives in the UK and is now a dual citizen. Had she been living in the US when her medical issues arose, my wife and I know with certainty we would have lost much of our life savings having to assist her with her bills from the type of care she desperately needs. No bills in the UK. The US healthcare system is a disaster for most and only benefits the few. I had breathed a sigh of relief when the ACA was passed as I felt the US was finally moving into the civilized world. What a disaster the current GOP administration has been!
17
Some commenters here and the GOP in general will continue to claim that government is always the problem and never part of the solution. This rant is useless as our private sector health care has no incentive to help a patient rather is slave only to profit.
The ACA was meant as a compromise that could engage both government and business in helping our medically needy people, but even this partial solution is attacked daily by the thoughtless GOP who have no answers and leave only destruction in their wake.
The situation of this suffering lady is not new, but something that I had hoped would fade with the ACA and eventual Medicare for all. Now it seems we are back to zero and the suffering will continue until we can get beyond the trashing of every possible solution.
8
Even municipally owned and operated ambulances charge these outrageous fees because to do otherwise would be "unfair competition" for private ambulance services, which are the natural outgrowth of the fee-for-service system of medical care we have in this country.
Ambulance rides could be free if they were funded the same as police and fire. Until we do that, people like that lady will continue to call an Uber for the ride to the hospital. This is a disgrace in a country that allegedly has such a great medical system.
3
No one in the US has the right to complain.
Republicans in Congress have voted more than 60 times since 2010 to repeal the affordable care act and they have only grown in majority positions as democrats have lost seats.
If you are concerned about healthcare then Stop voting for them!.
16
Compare this with Canada. My elderly neighbor had endovascular aortic surgery last week in the one of the biggest hospitals in Montreal. He chose the hospital and the surgeon. His procedure was in the morning and late in the afternoon he was talking to me in the garden. He was laughing commenting how an American friend was asking him how much that had cost. He told his friend: “It cost me a shake of hands, haha”.
I pay taxes happily to know that we have excellent affordable healthcare here and I don’t have to worry about going bankrupt if I fall sick.
And as the article says, Canada spends less per capita with healthcare than the US....
17
I have insurance. I opted to take an ambulance from mt Sinai Brooklyn. To my Sinai hospital Manhattan. 800$ later. No coverage. No fee explanation. I was possibly in need of emergency surgery. I should have called an Uber
7
The sad truth is that the US is likely the worst among the developed nations and among the worst even in less-developed nations for health care. This is simply because Americans repeatedly elect politicians who don't care about this problem... unless it's for themselves: members of Congress (and their employees) have a separate health care plan from the rest of Americans.
6
We were well on our way to a more sensible health care system. The ACA while far from perfect struck a good balance between the private and public sectors. Since accidents and illness affect everyone more or less randomly, it makes sense for everyone to have a stake in the collective health of the country. It is precisely the area where government should have a role to play. A healthier population will eventually lead to the competition that will bring down health care costs for all. The Trump admin could have had a hand in making that a reality with a few fixes and Trump selling the idea to his base. They would have bought it because his base has been a big beneficiary of the ACA. But Trump took the demagogue route and trashed the act and is working hard to undermine and destroy what's left of it. Now we have $3,000 ambulance rides and people deciding on their health or their home. Good work Trump.
4
This might not be relevant because it happened over 10 years ago.
I broke my foot in a household accident. The ambulance that took me to the ER (five minutes away) billed me for about $500. My insurance repeatedly declined to pay them, even though they covered all the medical care involved with the broken foot.
It took several weeks to figure out that the insurance deemed the ambulance ride as "non-emergency". This was because the call to 911 was made before midnight while all of the hospital care occurred after midnight. So the insurer's software labelled the ambulance ride as separate incident, unrelated to the hospital treatment. Hence the "non-emergency" categorization.
Eventually the issue was resolved, but only after the hospital re-filed all the claims with the date corresponding to that of the ambulance ride. Technically they should have done that in the first place, but what reasonable person would?
1
Health care is a business and the cost of the business keeps going up, not because of nurse and doctor salaries, but because of administrator salaries. That needs to stop!
5
The last time I looked up insurance company CEO salaries, the highest paid CEO made $68 million a year.
2
How about immunotherapy for cancer treatment or new drugs for cholesterol or new implants for knees and hips or the ability to save premature babies or surgical techniques less invasive than ever before? Don't these items also tell us something about the state of health care in America? the notion that a single tweet about the cost if an ambulance captures the state of health care in the US is beyond absurd.
1
Except that none of those innovations are financially accessible to many people in this country. "Available" does not mean "accessible" here.
11
What you describe is available in countries with socialized healthcare and when new treatments are available, they’re cheaper in those countries.
7
There are plenty of medical innovations taking place in countries with single payer. My husband had life-saving brain surgery that was developed in Belgium, then in France, then in Canada, before making its way belatedly to the US. It's simply US propaganda that makes people think the innovations all come from the US, and that the high prices are due strictly to research and development of drugs and medical procedures.
4
We as Americans need to help others. The hope for Medicare for all is clouding the issue I think. It's not a way forward, but one segment of the Democratic Party is using it as a cudgel against the other.
We need to fix Obamacare, and to do that we must win in 2018 and 2020. It's a long haul process. Let's stay focused.
A short discussion on M4A is here: https://wp.me/p2saZl-1n
4
My fairly recent experience--a fall at work (construction--no Workman's Comp, because that's the deal for gypsy labor these days). Packed up my gear myself, drove myself to the Emergency. Almost passed out walking in--no help from the Medical staff when I went in the wrong door.
Scans, unnecessary x-rays (areas that even I could tell were just bruised but I could not get them to stop doing multiple X-rays of these areas), cursory treatment by grumpy resident and absolutely no help getting dressed or out the door with my broken vertebrae and major bruising.
Oh, and a $25,000 bill, which wiped out nearly a years worth of part time labor.
Health care in the US is one step away from being a criminal enterprise.
21
In a country where almost half the voting public seemingly believes in alternate facts, it’s no surprise that the specious arguments against a national health single party payer system has so much traction. We already have a national healthcare system,in fact two, the VA and Medicare-Medicaid. The latter works ,and would work better with some polishing of its rough edges. The former would do well incorporated into the latter. We pay taxes for education,defense,both international and local, and for our major infrastructure, why not for universal health? A simple funding solution is to create a ‘highway fund ‘ type money source,untouchable by bureaucrats for anything other than health care,administered by the CMS. Cost controls could be more easily managed from hospital costs to individual care,to Pharma. If the Administration really cared about ‘we the people’ it would promote this scheme. Not doing so is buying into the myths fostered by those who benefit from the present system’s profits. The operant word here is ‘ profits’. Health care is a right of the citizens of an industrial country like ours. We are the only country in the world that lacks a true national health system.Its time is here.
17
The VA works, too, most of the time. It hurts when political appointees make unrealistic promises and then pressure the ranks to make it look like the promises are kept.
7
Not long ago, I left a hospital after 2 days, against doctor's advise, because I knew I couldn't afford the soaring 'deductable'. I had medicare. I continued to receive treatment at a local clinic. I'm sure it took longer than it needed to to clear up the problem - my legs had swollen to 3 times their normal size & were horribly painful. I'm sure I'm not alone in the decision to leave the hospital, against doctor's orders, for financial reasons.
13
The important thing to understand is that if this involved a member of Congress who continually votes against healthcare for Americans, they would get the best care.
20
Basic medical care in a wealthy first world country should be a right, not a privilege (as some politicians have come to believe). Why do all other "first world" and most "second world" counties have that right, except the US?
Many US politicians list examples like Canada - "oh longer lines for non-emergency surgeries such as knee surgery". Instead, why not look at successful examples such as Germany? It has combination of public and private insurance. Public is a right to all residents at 10 Euros a month! Private - at will basis for upper middle class. Difference? Slightly better treatment within the same system. For example, for open heart surgery - both patients would get it at the same hospital. However, for recovery, private insurance patient might have fully private (single) room, while public one shares a room with another patient. But no one would yell out "oh, this heart attack isn't so bad yet, don't call an ambulance". In fact, for any heart attack, a helicopter flies out for expedite transport.
14
It's a myth that single payer countries have long wait times. If that were the case, those countries wouldn't have life expectancies from 2 to 6 years longer than Americans. When my husband had to wait 120 days here in the US for hip replacement, unable to walk or work that whole time, I checked out the Canadian website that lists wait times for every major surgery for every hospital in Canada. It also lists an average - which was 90 days, a whole month LESS than my husband had to wait in the US.
2
Health care is expensive. But when the care is for an emergent situation, the injured party should not have to be further injured by this crass business model. This does not take anything away from First Responders who train and put their lives out there for us. Private ambulance companies should only be used for non- emergent situations. States can regulate the cost of these services- and it can be on a somewhat sliding scale dependent on how much a person can pay. States need to make this a singular priority which can be done without getting into any other healthcare debate which seems to stymie the works every time.
5
When I broke my femur ten years ago, my first thought was "Acceptance. I'm not getting up without help." My second thought: "I have no insurance: Who will care for me?" Luckily, California law requires first responders to take the injured to the nearest hospital, worry about finances later. Luckily too, I qualified for low-income aid. Had I been modestly successful, the $70,000-plus in bills would have ruined me.
I often recall the 2016 campaign when healthcare came up in one debate. Someone shouted: "Let 'em die!"
13
Yes, I remember this mantra. It was also the same mantra shouted back at a GOP debate in the Tampa Bay area in 2011. Wolf Blitzer posed the question to Ron Paul. Paraphrased, but basically quoted: "What if a healthy 30 year old does not have insurance, and suddenly he needs it, he goes into coma, what then?" Ron Paul said he should "assume responsibility for himself." and the audience shouted "LET HIM DIE."
5
I had a kidney stone four years ago. Once a year since then, the doctor has sent me for diagnostic imaging. Last week, the hospital sent a bill of $1,050 for the xray and the ultrasound. The insurance paid $190 and the hospital billed me $48. Without insurance, I would have declined the test - I can't afford $1,000. For the $48 dollar copay I'll do it. I probably would do if if the hospital charged me what they actually collect from the insurance - $190. What is the real price? How do I know that in advance?
I am confident that if the injured woman in this story had insurance they would not pay the ambulance company $3,000. Why is ok to charge the uninsurance some inflated price?
6
It's true that there's more administrative cost overhead in American health care but that's far from the whole reason why it's so much more expensive here. To understand the problem, we also need to compare what people in health care in this country and others earn, from hospital CEOs and surgeons to nurses and technicians. Are expensive diagnostic services like MRIs more available here? What is the national bill for malpractice insurance and settlements? Cheaper health care services in other countries isn't done by magic. Just attributing our higher cost to greedy insurance company executives is lazy thinking and won't solve anything.
1
Insurance companies add about 30% to the cost of our health care, and that doesn't count the major costs sto doctors and hospitals for billing clerks to deal with the hundreds of different insurance policies and forms.
2
An uncle of mine needed an MRI when he lived in West Palm Beach. At that time he had a "catastrophic" insurance plan that kicked in after the first 20k in medical bills. He called a local hospital and inquired about the cash price of an MRI and was quoted $1200. He agreed to this and had the MRI. A month later he received a bill for $7000 for the MRI. No explanation. He fought it for a year until they backed down. Nice people.
8
Not only will we need a revolution in health care in this country, which means "a social and political revolution" but we will need more of the love shown by the several people who helped her.
3
My wife had an accident on a recent trip overseas in Brussels. She fell face down on a train platform fracturing her orbital socket. The ambulance ride, emergency visit, doctor, CT scan and drugs cost a total of 370 euro. We flew home for the operation where our co-pay was $3000. The US has a health-profit industry, not health care.
20
My four hour visit to the ER with three x-rays taken resulted in a $21,000. bill to me even though both my car and the offending driver's car were insured and I have Medicare and was not to blame for the accident. No explanation or itemized list of charges has ever been provided to me by the hospital to justify this amount, and I continue to receive the demand on a regular basis. This huge fee and the cost to others in similar circumstances is one reason that Medicare for all is the hope of many. Hospital charges are outrageous. Cost matters to many of us, not just the uninsured.
16
I agree that Medicare for All is the only solution. Most people don't realize that Medicare covers all the oldest and sickest Americans for LESS than the insurance companies charge to cover their cherry picked younger and healthier population. The CBO says it would cost $20,500 to buy Medicare-equivalent insurance on the private market. Most Americans also think of Medicare for All as requiring higher taxes, without understanding that they'd no longer be paying up to $24,000 for a family insurance policy, or $13,000 deductibles or 20% to 30% co-pays, or more. It's estimated that it would save the average family $6000 a year.
I applaud the New York Times editorial board for citing the “nightmarish accident on the Boston transit system” as the “discord, between agony and arithmetic that has become America’s story too.” But there is a solution here in our state: The NY Health Act.
While twenty-six states are considering versions of single payer and, federal single-payer legislation has garnered 138 cosponsors, NY Health is the most robust legislation proposed, with years of rigorous review informing its language and solid econometrics to support its financing.
Paid for by a progressive payroll tax and taxes on taxable investment income, NYHA offers savings for 98% of New York residents, eliminating the wasted 30% dollars spent by private insurance that do not benefit anyone’s health. Business, labor and health professionals support the bill because it will reduce healthcare costs and stimulate the NYS economy, while improving public health, labor productivity, and labor recruitment to NYS.
How many more New Yorkers will face the same quandary the editorial board describes before The New York Times reports on this legislation?
10
I'm glad the Editorial Board stated that the reason we pay more in the US is not because we use more, but rather because it costs more for the same services in other countries. Think about that for a moment. That is not the fault of insurance companies. The provider industry of doctors, hospitals, and drug companies are primarily responsible. I'm not a big fan of government intervention, but why is it that prices are not regulated in health care like for example utility rate increases are? Price controls should be immediately imposed on the entire industry. At least freeze them for the foreseeable future. They'll squeal but what alternative do they have. It's not like they can get a better deal elsewhere.
3
Bill, actually it is partially the fault of the insurance companies.
The insurance companies are there to make a profit, they provide no medical services.
Simply get the insurance companies out of the loop and have single payer government funded healthcare.
3
I went to the doctor for a regular check-up once that was supposed to be 100% covered by my insurance. The MD asked how I as doing, I confided that I was having anxiety issues and she prescribed me medication. Come to find out I was charged $150 because the 5 minutes that we spent discussing anxiety warranted an extra "consultation" fee. I was horrified, called to complain, and they removed it from the bill. Only in America do you get a service and only find out what you pay after. The doctor should have disclosed she was going to code our appointment the way she did. I don't think people in America realize that in other countries you know what you're paying for before you are charged.
I was terrified to go to the doctor throughout my 20s because I never knew what they were going to charge me.
No communication, no transparency, you just get slapped with crazy bills after you receive the service, no matter how good it is, no matter if it actually helped you.
16
Don't use insurance. Say you'll pay out of pocket and you will know EXACTLY what you're about to pay.
My mother goes to the doctor on a regular basis. She is on Medicare. She has no medical issues requiring medication. She's elderly and has had Lyme Disease. She's had cataract surgery and some eye problems.
I have allergies, take the generic version of Zoloft for depression (a minimal dose), asthma, and am prone to sinus infections. I haven't seen a doctor in years. I need tetanus shot. Nearly 5 years ago I had a serious fall from my bike. I had a concussion and some bad bruising and cuts. I didn't even consider going to the doctor, the ER, or any walk in clinic. Why? I wasn't working and wouldn't have been able to afford the costs. I'm not working now and even though, thanks to the ACA, I'm covered by Medicaid, I still don't see the doctor.
My mother is 86. I will be 60 this November. I am not counting on living past 65. Why? Because America is no place for people who aren't rich before they retire or do not inherit a small fortune. And what America has become is not a place I want to live in: a place where riches determine the quality of care and life not decency and hard work.
10
My daughter passed out in school a couple of months ago. An ambulance was called to take her to the hospital - two blocks away. I received a bill from EMT. The cost was $1,300. I'm lucky, I have insurance which will cover the cost. But if I didn't, I can't even imagine.
9
Insurance pays what they negotiate with providers. Providers charge what insurance is willing to pay. Costs are not transparent because providers only know after insurance denies or accepts. Cost are arbitrary based on these negotiation.
Insurance makes you feel you save money. They don't want cost to go down, because who needs insurance if healthcare is affordable?
You get what you pay for. If a med student needs to pay $400,000 for his schooling and then another $500,000 to open his own office, the cost will be passed on to somebody. In most cases, people do not go into medicine to do charity work.
6
What does that have to do with the cost of medical services?
Do you honestly think that in other countries there is no cost to become a doctor and open a practice?
The issue in the US is that you've decided you would rather make insurance companies rich than provide universal healthcare at a much lower cost.
2
In many single payer countries, medical school is free or inexpensive. Doctors don't enter practice with a $200,000 or higher student loan to pay off.
Is there even one area of American society, culture, or economy — all of the routine of living — where conditions are improving for average Americans of any ethnicity? Education, health care, retirement, housing, food, life expectancy, transportation and infrastructure? Are living standards improving on any count for those of us who live average lives (or worse)?
Where do Trumpists or Republicans or right-wing Supreme Court justices imagine this leads? Where do Democrats who don't vote imagine it does? Go back 15 years, 20 years, go back to the Reagan years.... Did anybody imagine then that this was where we were headed?
12
Americans are finding MILLIONS of jobs that were not there from 2009-16. Americans are much more confident about life now, and our national security is much better now that every grasper and tyrant doesn't see our leader as some fool you can roll - like Iran, China, North Korea and Russia continued to roll Barack Obama.
THIS is why the November elections will not be friendly to the progressive Democrats and their violent hate-trainees across the country.
I am supposed to get an MRI for my lumbar but even with insurance I am putting off the test because my co-pay is $2000.00 and I cannot afford it. People cannot afford healthcare even with insurance. People cannot afford prescription medication even with insurance. People cannot afford tests even with insurance. So tell me - what good is insurance if you can't afford to use it?
19
It's no good.
In Canada I would pay for parking...
3
Chances are your lumbar could easily be treated with a few sessions of physical therapy. But it's much easier (and more profitable) for doctors to recommend expensive MRIs than to send you for a conservative and more effective treatment like PT.
I don't know what all these people are complaining about. The real crisis in America is that Germany, Canada, Norway and a couple other wealthy capitalist NATO members aren't spending enough of their GDP in taxes to build up their military and defend themselves. Instead of writing sharply worded letters to Cigna, Humana, and UnitedHealth about how much they charge in premiums for those high deductible policies too many hard-working Americans can't afford to buy, instead of telling pharmaceutical companies, "We're running out of patience with your unjustifiable prices and tricks to keep your patents protected from generic drugmakers who can slash the prices for consumers," instead of threatening to withdraw his administration's protection of the for-profit healthcare system and its multimillionaire CEOs, our president talks tough to our defense and trade partners. He demands all of them pay their "fair share" -- a percentage of their GDP -- for defense but cuts taxes on bigly profitable US corporations and the hyper-weatlhy so they have more disposable income to play with while mom-and-pop business owners. family farmers and gig workers pay more for their family's health insurance than they pay for their mortgages or rent. Why do ordinary Americans keep complaining about healthcare costs and inequities when our president has a world to run?
10
If a country does not have funding for adequate housing, healthcare, and education for its citizens, what is the over-inflated army there to defend?
It's same as insisting on putting bigger vault at a bank that has no cash left to store, claiming "well, we spend all the money on the vault, so there is nothing left for now to hold, but look we have this vault. Our neighbor didn't buy a vault, but occasionally uses ours".
3
Did you vote for Republicans? If so, SHUT UP!
12
This was my first thought as my co-workers called 911 for my heart attack. "Oh crap, I can't afford this."
17
An uninformed and feckless electorate is the root of most all American evils. Is what we get what we deserve? You couldn't pay most Americans enough to get them out regularly to vote.
8
Picturing this poor women sitting on the ground in a dark and dirty subway station unable to afford help compared to Melania Trump going to the Mayo Clinic, paid for by the tax payer, is really over the top. This is the stuff revolutions are made of, and tomorrow id July 4th!!!
17
I adopted 2 children from the foster care system. As such, they are entitled to Medicaid until age 18 (my state does not want the cost of healthcare to prevent people from adopting kids from the foster system). Medicaid pays for their therapies - occupational and psychological as well as the basics. Given the trauma they endured as children, they need therapy and as a parent, I need the support and advise of therapists to help my children heal the best I can. EVERY family should have this type of support and care for their children -- adopted or not -- without the risk of going bankrupt. It is a heck of a lot cheaper than supporting adults who are maladapted to society and unable to function/become contributing members of society.
15
This shocking story needs to go viral, and it needs to go to all the top Republicans including Trump himself. With photos, if there are any. This is a devastating indictment of those attempting to destroy the ACA. I would like to see this on the front page of every print newspaper and online paper in the country. Wake up, people, this is where we are headed.
8
It feels like this is how Republicans intend to "thin the human herd" and just as important stripping every last dollar and asset from the unfortunately people that have poor health or an accident. These same people reject Darwinism when it comes to biology but are all to happy to cruelly apply it to society.
13
I hate to sound like a broken record, but it is absolutely ridiculous that the richest nation on the planet can not provice national healthcare for ALL of its citizens. We all know that the real reason is that our government is corrupt to its core. We need to get money out of politics - they are nothing but legal bribes by special interests like the healthcare medical industry to keep the obscene money rolling in.
19
It’s happened to me.
2
Let her rub cake on it. MAGAing is hard work. Later. Time to play golf.
7
Medicare for all
12
If I had kids I would encourage them to leave the United States for this reason.
13
That's fine, but tell them not to complain about how expensive everything is. Food and consumer goods cost more in Canada because the price includes the taxes for the "free" health care.
When will Americans clue in????. You want good public education, healthcare etc EVERYONE HAS TO PAY TAXES! And not a few pennies.
Then you have to convince your Government to spend those taxes on social support instead of defense spending. Trump is ticked off because other NATO COUNTRIES DON'T SPEND enough on defence. That's because they choose to spend it on social support.
Healthcare is complicated worldwide and it's all about trade-offs.
So what are you willing to trade off for healthcare? Give up being a Republican and support a Democratic Socialist? Pay more for consumer goods? Pay more for transport?
My two oldest grandchildren plan to spend their adult lives outside the US. The oldest one has been doing so for 5 years and loves it. Her younger brother will follow suit in another year. I'll miss them, but I have to applaud their decisions. And no matter which country they choose, they;'ll likely have far superior and more afordable medical care.
1
Where my granddaughter lives, housing is a bit more expensive but other costs are in line with what things cost here in the Midwest. That is, except for healthcare, which is unbelievably inexpensive. She lives in a modern, high tech country that puts our infrastructure to shame. And unlike the US, it's a truly safe country. As a young woman, she can walk anywhere in a major city at any time of the day or night in perfect safety. Lose your wallet on the subway, and it shows up on your doorstep the next day, with money and credit cards intact.
What happened to the country I love?
7
Citizens United, Big Pharma, private insurance companies that carve up the healthcare market and whose CEOs are paid multimillion dollar compensation (in 2016 the CEO of Centene made $21,968,683; Humana CEO made $19,722,400), medial and healthcare lobbyists, 2 political parties spend their time fundraising and courting big donors (GOP is worst, but Dems legally bribed as well), The Republican Party, the imposition of the business model, privatization, and profits over people, a bloated military budget but no money for people, a preoccupied and conditioned citizenry who has no idea how healthcare is handled in other countries (the U.S. ranks 37 in quality of health care in the world but has the highest costs (ask why?)... and so it goes.
As Trump said, "The system is rigged." And he and the GOP are here to rig it for business and investors, and against public services for the citizenry (as Fox News and every GOP politician tells us, "That's socialism, and we don't want that do we?").
Add in an uninformed, stressed-out, fearful, very gullible populace who are thoroughly conditioned to ignore facts, data, and science and to believe every piece of advertising and propaganda they hear.
3
How does this article miss addressing the issue of $3000 for an ambulance to show up?
4
Think of it people. Being able to leave a job you dislike to pursue a dream...and not being tied to said job for the health insurance.
10
Americans are absurd. What's the point of being the richest nation in the world if half the population can't get easy access to the basics? Maybe slavery has left a cultural scar on the country where by it's accepted that some people will just suffer while others thrive.
Land of the free, I'm sure.
16
Poverty is a capital crime. That is the foundation of our country.
15
Iam grateful for Health Insurance and fear when its affordability ends..in a blink of an ...eye
Praying to finish my night shift. Deep breaths and pain, vomiting to lower pelvic area. Calculating pto and drove myself to er. Not good news but have affordable care act ins. Single hard working parent with disabled son with few safety nets. A 2nd surgery in 3yrs will pose a financial and work issue. Still thankful for what we have.
2
"The Republican Health Care Plan:
Don't get sick.
And if you do get sick - die quickly."
-Rep. Alan Grayson (D-FL) Sept 30, 2009
Still true, all these years later.
16
Wait a minute! Wasn't she supposed to call around to find the best price? Isn't that the way markets work? Jeesh!
17
Health care is very expensive. We can either provide it to all of our people or we can admit every charity case (otherwise known as a refugee or asylum seeker) as the left desires. Which do you pick?
Health care costs in the US are terribly inflated. A cardiac surgeon in Quebec gets paid less than $2000 Canadian dollars to replace the mitral valve (one of the heart valves). In the US this procedure costs much more. Patients can choose their surgeons and do not have pay any money for this. They used to have to pay an amount to have a private room. Not anymore. All the hospitals have individual bedrooms now.
And the MDs in Quebec have very nice incomes. Some even demonstrated to have their salaries reduced...
6
Provide it to all.
You could provide healthcare for all for less money than you pay at present to cover some of the people.
All other western countries have done this, why does the US have such a hard time coming up with something everyone else has done?
3
Following my kid's birth, I tried to take some Advil that I had brought from home. The nurse told me I couldn't self-administer because they needed to keep track of what I was taking and how much. The charge for the hospital Advil? $10 a pill.
There is no reason health care needs to be this expensive. That is the point of this article and every other comment in this discussion.
2
Awful injustice; this, in a mighty rich country...but with profound inequalities; one of them is health care, the very issue Trump so cowardly tries to trample on. Are we this petty, no solidarity nor compassion?
7
According to the GOP-Evangelicals she had the freedom of choice to get the care she wanted....Hallelujah!
10
I'm a dual U.S. & Canadian citizen, born in the states, living in Canada for 48 years now. I served in the U.S. Navy and worked three years in a Naval Hospital. I understand something about health care. What I know best is that the U.S. system is not merely unfair, it is based upon a morality and a culture that holds the value of money above the value of good health, and calls this "freedom".
The U.S. is the richest country in the world, still, despite the vicious depredations of the present administration. It could afford a single payer system, reduce health care costs, increase longevity, decrease infant mortality, and provide for a healthier population. It chooses not to do so because those who can afford the best care are ideologically tuned to serving their own selfish interests. In doing so, they hoodwink the less well-off (the lies are spectacular!) into going along with their destructive notion of "freedom." To cadge a word from the orange-headed leader, "sad."
29
The genius of Michael Moore's 2007 film "Sicko" is that it wasn't about the horrifying fate of people without medical insurance in the U.S. -- it was about the suffering of people WITH insurance and their Kafkaesque experiences with insurers.
Every American can tell nightmarish stories about their HMO's bottom line conflicting with their doctor's advice -- right now I'm in the depths of red tape and paperwork trying to get our (top dollar) insurance to cover a $900 test my husband's cardiologist ordered. They denied the coverage after the test was already performed. It will probably take months too resolve and we still may end up paying it. Our choice? No choice at all. But apparently some paper pusher at the insurance company knows better than our doctor about what medical tests he needs.
We have a health care system based on making money for parasitic insurance companies. Patients' health has nothing to do with their priorities.
Unfortunately, Michael Moore has had a knack for getting to the heart of the matter and predicting when things will go from bad to worse in America. At the moment he's predicting Trump will declare himself President for life. Let's hope for once his predictive powers are failing him.
19
When I became ill in Nice an ambulance, provided for by the local fire department. Free of charge. When we arrived at the ER reception recorded my information which included my stateside address. After an examination and a series of blood tests (which revealed no underlying major issues) I was released. The bill, before health insurance coverage, came to 433 Euros far less than an ER visit with tests at an American hospital. And the ambulance ride was a free service provided by the local fire department. Thankfully my employee health insurance and traveler's insurance covered the bill but the big revelation is that I received excellent care at a considerably less cost. To France I say, Je vous remercie. And to America I say if we're so great why can't we do better in providing excellent affordable health care? Pourquoi?
17
A number of years ago a friend was working in
Slovenia when she was diagnosed with cancer. Weeks of cancer surgery and radiation treatment ended up costing a total of $450. She has been cancer free ever since.
2
The perverse outcome is that healthcare here isn't any better, except for the very rich, who receive opulent care. Countries with single-payer systems provide the same level of care as insured Americans, for a far lower price and cost, and they provide it to everyone. So, what's the catch? Only that it's not as profitable.
11
While the insurance situation in America is a nightmare, we as citizens must also admit that part of the reason that health care is insanely expensive is that Americans are incredibly unhealthy. We are sedentary, eat factory made foods, and abuse drugs at a far higher rate than most of the world. European healthcare is cheaper because the people there walk everywhere and eat better food. I think responsibility to fix these systems falls on everybody's shoulders.
2
That is true; Europeans bike or walk much more frequently than Americans. Their commute times to work are short and they have walkable towns and cities! WE only have that in some places.
Their obesity rate is not as high because they eat local and eat healthy.
They have regulations too! Their soybean crop is not sprayed with Round-up.
They also in enjoy more time off. Their average work week in 32 hours. They don't focus on stacking money. They take siestas, they spend time at local coffee shops, they talk to friends and family on a regular basis. This is the foundation of health and happiness.
Our values are skewed; results are evident. When you are the working poor in the U.S, what you buy in the store may be a box of mac and cheese and a package chemically laden hot dogs. Study the working poor in America. It's a tough life. A stellar book on the subject is "Nickel and DImed: On (NOT) Getting by in America" by Barbara Ehrenreich.
5
Mark in Tennessee: Possibly one reason Americans are more unhealthy is that we don't get needed medical care at the beginning of a problem because WE CAN'T AFFORD IT! So by the time we seek medical intervention, it is because we have no other choice, and then we become bankrupt and lose our homes.
5
My patients and I are profoundly grateful for Medicare. Still, there are gaps in coverage and some patients still struggle with healthcare costs. However, the fact that we can't even provide that level of coverage to all Americans is absolutely a shame in one of the richest nations in the world.
8
The 4th of July is tomorrow. And I will just say this up front: I am EMBARRASSED to be an American.
Totally aside from the fact that we have an unqualified, narcissistic lunatic in the White House, it is beyond shameful that we still do not have basic universal affordable health coverage in the U.S. It seems the single payer system approach is the way to go - but whatever method is best, it should have been implemented by now! We DO have the money for it. We simply do NOT have the political will.
Politicians (and many civilians) like to talk about this being "the greatest country on earth." Those who don't hop on the "America is the best!" bandwagon are labeled unpatriotic.
What would truly show a love of this country would be for Congress to push through health care for all - and push Trump OUT of office.
18
so why is Healthcare in the us more expensive?
2
Greed. lobbyists. Money. Our notion that we are superior to all other countries, and refuse to learn from these nations. We aren't curious enough to learn how their health care system system operates and thrives. We would rather stick with the false belief that other nations with universal health care wait for months and years to receive treatment, so we tell ourselves: "America's health care system is better."Somehow, that is our answer. We don't dig deep enough. Sound bytes work. Half-truths work. Lies work. We are hood-winked. But the solid and undeniable truth remains: We are all equal. We all matter. Health care is a human right for all people. That includes the U.S.and the U.S. territories.
3
Profit Uber Alles.
The politicians and Corp. they can buy.
The stupid, ignorant Americans that can't, won't change.
They rather see their children and loved ones die, than pay more in taxes. Even though it is proven to save them money, time and lawyer fees. With better, cheaper out comes and longevity.
3
Information assymetry. Monopoly power. Classic market failure.
I was at an international conference of psychologists several decades ago. A German social science researcher came up to me to chat. I taught psychology and social science courses at an academic medical center. Well into the conversation, he said, "Let me ask you something."
His face changed and he was disgusted. He shook his finger at me and challenged, "How can you Americans not provide healthcare for your citizens and how can you allow corporations to make profits out of people's illnesses and suffering. It is obscene! Health care isn't a political question; it is a moral question."
Exactly!
23
Tragedy heaped on tragedy.
In Europe, and most other places in the world, you would simply call an ambulance - no charge, ever. Nor would there be a cost for your treatment at point of care.
In the UK we pay per month for heathcare through our salaries; these are called 'National Health Contributions'.
And, if you do not earn enough to reach the threshold to start to pay, or you are jobless, then you receive completely free healthcare.
Any other system is downright inhumane. This poor woman, what a terrible decision she had to make.
America, sort it out.
15
Our health insurance system (because it's not health care- at all) is a barbaric monstrosity designed only to act as a extortion racket upon Americans in their hour of need. This situation is an inexcusable disgrace. It is inhumane that we allow ourselves to be endlessly victimized and shaken down by the bottomless greed of health insurance companies and pharmaceutical corporations.
Just this week, I went to re-fill a prescription that I have been on for a year. The usual co-pay is $60 per month. When I went to collect the re-fill, my insurance company has apparently refused to cover the medication. This was completely unbeknownst to me, until I got to the counter to pay. What was usually a $60 co-pay ratcheted up to $837. You read that right. Obviously I had to turn around and leave. I've spent the last few days under great stress jockeying with the insurance company trying to find a resolution. This is a daily medication and I'm down to one pill. This happens every day in our country.
We need Medicare for All. No excuses, no shenanigans, no watering down, no compromise. Universal Single Payer Health CARE. Period.
We can start by wiping the Republicans out of Congress at the ballot box in November.
30
Maximizing shareholder returns means minimizing that of everyone else. Simple. It then becomes a matter of power and right now corporates have most of the power.
Fight back by hitting them where it hurts. Avoid buying from large companies, buy directly from farmers, other individuals and small businesses, even if it costs a bit more. Save your money. Tie up their personnel by complaining when you are pushed around. Make it a game. Don't let these thieves win.
2
The solution is not universal healthcare, or single payer etc. The solution is to STOP THE GREED. How come a hospital bandaid cost $7 in the US, and mere cents in Europe? It is not that providers get paid any more. The winners are hospital and insurance company execs. Stop THEM. In any case, my family has left the US. We can sleep again at night.
5
The $10 aspirin and other outrageous prices are in part because of cost-shifting from the uninsured to those who can afford to pay. If we had Medicare for All, hospitals wouldn't find themselves having to jack up prices to compensate for those with no coverage.
1
If the transportation to the hospital requires an helicopter then you can be easily out of $ 75,000.
4
To specifically address ambulance costs, the Times should do an in depth study of those staggering emergency costs. Ambulance costs are often astronomical and typically far exceed what insurance pays, leaving the patient with debt for years. The victim of the accident that was described was likely prudent to look for alternative transportation to emergency services,
2
It is so painfully obvious the R's have gradually led us to runaway capitalism. The normal govt. checks on greed have been removed for the sake of giving the very rich more money on the backs of the poor.
We need a complete overhaul based on true democratic liberal concepts... Europe is very much ahead of us in this regard and it would do us well to lose the American hubris and learn from our European allies.
10
I agree, however you can look much closer than the EU, we're just a bit north of you.
2
My apologies and you're 100% correct and I didn't mean to slight our Canadian friends. I trust Canadian Govt to serve the people. If American govt could come along the progressive path like you all even only in health care, I'd be happy. Oh, also. Congrats on the legal cannabis legislation. 'bout time eh?
No need to fear for the livelihood of the ambulance companies, Board, I'm sure there are plenty of people with mangled legs who are willing to pay whatever they demand. Which is the problem.
3
There you have it in this article about a woman worried about not her leg or pain, but the prospect of paying for the ambulance ride. The hospital care and doctor's fees may have been covered by her insurance or some other manner. The idea in today's political climate of getting a "well-regulated single-payer health care system" seems so beyond the pale as to be foolish. How can a country be held by a 1%, or even less of a percentage, the wealthy, and allowed to control all that is public from health care (read about the original BlueCrossBlueShield) to education. We're fools to allow this and the majority of us suffer and will suffer from the blows to our idea of country and nation and ourselves as independent agents in our lives.
11
There was so much goodness in our country's policies once: the Marshall Plan, Medicare, the ADA, the ACA.
Now, we are a cruel nation.
Vote.
12
This illustrates once again the deficiencies in our health care system. I am self-employed, and available health insurance for myself & my spouse is a joke. Going to the marketplace generates mediocre policies with deductibles in excess of $12,000.00, and premiums of $1500.00 + per month. The end result is that my spouse works a job that she is really miserable in, solely for the "benefit" of having health insurance for us. Gee, that policy only has a $4000.00 deductible.
The conservation about health insurance presumes that everyone has coverage available through their employment in some form or fashion. That is simply a lie. When I have this conservation with other persons who are not attuned to these issues, the response I receive is that "you are just not looking hard enough for good coverage". The average person thinks that fantastic coverage is out there for a couple of hundred dollars a month, and that if you are going to the marketplace, you are a "loser", are "lazy", or just not working hard enough.
This is shameful in a developed country.
13
Two words will help bring down health care costs. TORT REFORM
Wait until the GOP Cruel Party eliminates Medicaid and Medicare next year if they keep the House. Imagine tens of millions of Americans dying in the gutters and in their beds all alone. Will the GOP finally be happy?
10
Health care or not, most Americans can NOT afford to have an accident outside the workplace! I thank God almost daily that when I broke my elbow it was at work; at least Worker's Comp will still cover all your expenses. I now can afford health insurance (and I also pay a little extra for a special accident insurance policy that's meant to help pay deductibles for any accident outside the workplace) but when this incident happened to me, I would have been taken to the cleaners if it occurred anywhere else!
5
ACA was meant to be a bridge to further advances in health insurance: hopefully all the way to a single payer system. It us not perfect but it *is* progress. To go back to millions more without insurance is an unconscionable choice -- one happily made by the GOP in order to give a massive tax break to the rich.
The OVERARCHING problem is wage stagnation and corporate welfare.
If wages had kept up, McDonald's workers would be making $24 an hour.
If wages kept up, neither Medicare nor Food Stamp, nor homeless programs would be as overused as they are.
We have a massive amount of working poor in this country. All while the rich get richer.
16
Back in the 90's, I was on a business trip in Japan and I totally messed up my back. I had already ruptured a disk in my lower back a month or two earlier and it flared up badly enough in Chiba that I passed out from the pain in the street.
I woke up in a taxi on the way to an orthopedic hospital. At the hospital I was interviewed by a back specialist, X-rayed, and given shots of muscle relaxant. I was then re-interviewed by the back specialist, given advice on how to take care of my back, a bottle of strong pain killers, and then sent back to my hotel.
In the US, even 30 years ago, the cost of similar diagnosis and treatment at an ER would have cost thousands of dollars. The Japanese hospital charged my credit card the equivalent of $120.
The current US health care system is, as this article points out, totally messed up. It costs more per capita than any other advanced country, millions of people have no health coverage at all, and the US health statistics compare unfavorably with any of our peers.
The ACA is undoubtedly flawed but it was a genuine attempt to improve health care for millions of Americans. All the Republicans have done is sabotage the ACA in every way they can through propaganda and sabotage at both the State and Federal level.
14
We need single-payer universal healthcare financed by a value added tax.
An ambulance could have been taken this woman to the hospital, and the bill would have been sent to the United States of America.
8
The problem is that if the US government were now billed, it's likely that a $3000 ambulance ride would become a $5000 ride. Or more.
That's not how economics works. Because the US govt is the only buyer, all ambulance companies will work to compete against each other to offer a lower price, not higher. It will be a buyer's market, not a seller's. The US govt will use its buying power to bring down the prices of all services and medicines.
Scott, that's incorrect.
As in all other western countries, the cost is much lower under the government run systems as there's economy of scale and no profit making from sick people.
The USA is the only western country that doesn't have universal healthcare, and it spends much more money on fewer people
The ambulance cost should be a non-issue. In Australia you can insure your family for ambulance costs , including air ambulance, for ninety dollars a year - unlimited call-outs. Concession patients are free.
If America cannot do at least as well as Australia, on something like this, bodies should be swinging from lamp-posts.
4
My father had a brain abscess in 1984. He thought it was one of his cluster headaches coming on. My mother took him to the ER that day but there weren't any signs of what was going on beyond a bad headache. We went to bed that night and the next morning he was unconscious and unresponsive. We called the police who sent an ambulance. The first question we asked then was if we could afford the care. It's been 34 years and people continue to ask that question. But now they ask it for every type of care, not just what happened to my father.
My father recovered and we didn't go bankrupt. He was in the ICU for at least one month, a general ward for another, and then spent 2 months in rehab. Today with the high deductibles and narrow networks plus the surprise charges that are tacked on we'd probably lose the house and all the savings.
It's wonderful to hear we have the best medical care in the world. It means nothing if we can't afford it.
18
For everyone calling for single payer:
That's fine, but please keep in mind that the developed countries with single payer systems have value added taxes of 15-25% on everything they buy. If we go to single payer, we'll need something similar, so make sure you're okay with everything costing 15-25% more. We can't pay for it with taxes only on "the rich."
Keep in mind that the premiums that most people and their employers pay to insurance company will come back into our pockets.
My insurance comes via the Georgia state employee system and the cost to my husband and the state for the high deductible plan is roughly 20% of my husband's salary. (employee and employer funds together)
The current insurance system isn't free and costs all but the highest earners a significant portion of their salaries. A single payer tax would at most be a few per cent, not 15-20.
6
Not a chance. If other countries need 15-25%, so do we.
Completely incorrect.
You can have single payer system coverage system for far less than you pay now, for every person.
Do a quick internet search on the cost of healthcare in other countries.
In Tennessee, a 70-mile trip by ambulance cost about $70 in 1975. Now, the same trip costs $1,500. There is no way ambulance services can justify such an increase. In 1975, Tennessee ambulances were carrying the same equipment they take now.
6
Don’t bring up Obamacare which solidified outrageous, unaffordable deductibles and out of pocket costs. The liberal press bends over backwards not to criticize the man, even calling him tranformational. Either Roosevelt would have fought like hell to get their Supreme Court pick through the Senate. And a great president does not cave to a greedy healthcare industry.
3
I am personally quite furious at Obama for not telling us about Russia's electoral misconduct DIRECTLY, and for not suing Congress to force them to hold a hearing in Garland. Major failings of his Administration.
I am not mad at him for getting further towards single payer care than any other president has. Bernie has great intentions, but even he knows that single payer has the longest odds ever of passing. Compromising to move forward is what the adults in the room have to do sometimes in order to be able to come back and fight another day. Ask Angela Merkel.
2
As a citizen of Canada I am only one of millions of other Canadians who receive top notch medical care despite all the naysayers usually proclaiming how our universal health care has problems. These people are always from the USA and they oppose the kind of system we as Canadians enjoy.
I truly believe that south of our border your American Dream which is really all about making as much money as possible and to hell with your fellow citizens who lag behind you in this endeavour is the major cause of your lack of affordable health care. In Canada there is the sense of "we are our brothers' keepers" whereas in your country it is "every man for himself."
37
A large number of patients can no longer afford essential medicines and cut in half their insulin or blood pressure medications to make it to the next paycheck. The cost of not taking such medicines is huge. However it will end up being a random event who amongst these people get to suffer the big slam consequences - and in most cases those people will simply go bankrupt and Medicare/Medicaid will pay the cost. Stop this madness - we need single payer national health care.
17
Last weekend I marched across the Brooklyn Bridge to protest family separation policies. A woman in front of me collapsed from the heat. People surrounded her and offered various kinds of help. A medical person assigned to the march arrived and suggested an ambulance. She repeatedly said, “No”. Fortunately a doctor in the crowd was able to get her back on her feet and hydrated and she was helped off the bridge.
Ambulances should be 100% covered. Nobody should ever be in the position of refusing help they might need because of fears of not being able to pay later.
12
" ... hospital costs were 60 percent higher in the United States than in 12 other nations. And that cost is often passed on to patients ... " Scheming MBA's extorting money from our society via our health care system. "There is little correlation between CEO income and hospital quality—but there is between salary and excessive marketing." (The Atlantic)
11
I am Canadian and my wife worked for 30 years as an OR nurse. Years ago an American fisherman broke his leg in Ontario and required surgery and a few days of care in her hospital. He was billed for his care. A while later the orthopedic surgeon received a letter from the insurance provider asking if there had been a billing error because the cost of his cast removal in the US was more than the cost of the surgery in Canada!
17
The $3000 ambulance is a bargain compared to the medivac helicopters which cost about 10 times as much. Guess who gets stuck with the majority of that bill?
I certainly hope the injured party got proper treatment and is on the mend..
4
Who gets stuck with the bill? The patient, although I know you suggest it’s the taxpayers. Stop pushing your false narrative.
3
At this time our medical care is dominated by insurance companies and pharmaceutical companies. Doctors are being sidelined in health care, their decisions being formed by what the insurance will cover, while the cost of drugs is ridiculous – within the United States; the same drug in Canada or Mexico might be 10% of what it costs here. In this way greed has taken over our system of health care. Congress won’t do anything about it because they are afraid of losing wealthy donors from those mentioned above, while Trump golfs with his executive buddies from the system. I am a health care professional working in one of the areas that is, luckily, excluded from the system above because it is primarily funded by Medicare and Medicaid, but threatened reductions to these services because they are used by people who are less likely to influence votes are in the pipeline. So, simply said, our system of providing medical care and our way of funding it SUCKS!
21
We need single payer, bad.
I pay $650 a month for health insurance just for my son and I. We are both pretty healthy, but if either one of us gets sick, medical bills catapult into the 4-figure range seemingly instantly.
The reality is I'm in a major struggle every month just to make the payment so my kid will have insurance, but God forbid he uses it - if we go to the hospital for a few tests we still get a bill for $1,400.
It makes no sense. The only solution I've come up with make sure we receive proper medical care when needed is to just not pay for it until I'm good and ready. The hospital got money from my insurance company, if they want to max my "out of pocket," they'll have to wait for additional payment.
So, that's my crappy solution to this impossible mess: debt.
Republicans think private health care is the best, and it is! For medical collection companies, that is.
Vote democratic. We gotta fix this.
26
I completely agree that single payer is the only way to go.
That being said, $650 a month for two people is not that bad. Before I went on Medicare in 2008 I was paying $400 a month for just myself. And that was ten years ago.
4
My father-in-law needs corrective surgery on his back bone. For half day hospitalization, a commercial spinal surgery center told him that his surgery will be paid for by Medicaid/Medicare but half day use of the facility will cost him $16,000.
The medical care in the US is a blatant scam run by hospitals, pharma industry, doctors, insurance companies and lawyers. Each of the five lobbies are rich and powerful with politicians in their pockets. Victims are millions of middle and lower income class families.
26
I have Medicare in the States, but I live in Mexico where I can't use it. I had stitches at the local public hospital for a serious dog bite. Total cost, $76 pesos (about $4.00 USD).
I later had the stitches taken out at a private clinic. Total cost, $600 pesos (about $35 USD). That's what it usually costs to see a specialist here, but is barely a copay in the States.
For two serious operations over a course of three years I went back to the States, where my Medicare covered all but the copays. I could have gone to public hospitals in Mexico, but their system is overburdened by the tremendous number of poor people, and also I wanted to get some benefit from the Medicare I pay into every month.
Mexico has a system of virtually free care for everyone, but due to the demand and the poverty there are long waits and often less than optimum care. A rich country like the United States has no excuse for not having at least a similar system, with better results. No excuse.
28
I moved to France. The scene described in this editorial would never happen here because health care is not a for-profit industry. Health care is affordable and it is top quality. It is one of the top reasons that I will never move back to the United States.
37
I watch Doc Marin on PBS. I love that character, a brilliant physician with an unlimited encyclopedic knowledge of Medicine, but with a personality disorder that prevents him from having pleasant interactions with patients. One day I was watching and thought There is something I like about his practice. And then it dawned on me. There is never any mention of money, no doctor's fees, no anxiety about going by ambulance to the hospital, nothing. This is England. National Health. What a glorious luxury to be able to practice in that way.
43
Even more glorious is BBC's Call The Midwife, which takes place at the dawn of the national health system. The relief of so many of the patients on the show when the midwives remind them that the national health will pay for a badly needed surgery is beautiful. It makes me tear up Everytime and wonder why our system can't help people the way theirs does....
108
I love the NHS. Two of mu children were born on the NHS, I was attended by midwives who came to my house for their monthly checks. I saw a doctor once or twice throughout my pregnancies since I was healthy and low risk. My youngest was a C-section (breach) and that was done by a surgeon. The NHS also saved my youngest when he coded twice due to a respiratory infection at 3 weeks. I wish we had the system here and the guts to pay for it.
1
Once again we are reminded that as the richest country on earth we have made a collective decision that we would rather leave a woman agonizing in pain on a subway platform than provide basic healthcare coverage to all Americans.
We do this because too many American insist -- from NY Times journalists and their readers to our so-called representatives in Congress -- that we cannot possibly afford to provide healthcare to all Americans. Who will pay for it, they want to know.
And yet no one asks who will pay for the increased budgets for the military and the bombs we drop on other countries; who will pay for the subsidies we give to large corporations; who will pay for the tax cuts for the ultra rich; who will pay for incentives we give to sports teams to relocate to our cities; who will pay for incarcerating individuals for minor drug offenses; or who will pay for the trips multi-million dollar weekend trips our president takes to play golf.
Who will pay for basic healthcare indeed, until we get our priorities straight as a nation.
46
You nailed it perfectly.
4
We the people have to pay for health care in the present fashion because " the powers that be have decided that will happen"
There is always money for what they deem necessary.
1
Excellent questions!
1
This is definitely not a scene that you would see in impoverished countries. In an impoverished country like Mexico, it is possible that there are no ambulances, or decent medical services in many areas, but if there is an ambulance, there is no way that they will try to charge you $3000 for the services, or for the emergency room or for anything. Even in a banana republic people know that healthcare should NEVER be a business... even in those countries that we despise they know that access to healthcare is a human right... but we are somehow the civilized ones.
17
There are ambulances here in Mexico, and they come with no questions asked.
The public hospitals are not great, but they exist for everyone, which is no small feat, given how poor the country is.
6
Too bad the Democrats were so beholden to the donor class when they controlled Congress and the White House that all they could come up with was the industry friendly ACA. Remember, single payer supporters were thrown out of a Senate Finance Committee hearing to which not one single payer advocate had been invited. Now that then Committee chair Max Baucus is not longer in the Senate he's apparently on record as saying that single payer should be considered.
9
Actually I seem to remember that it was the republicans who wouldn't even entertain the idea of a public option or single-payer. And Lordy, how they've tried to undermine and repeal the ACA since then...The point of this piece is that "Health care" in America is broken. What's YOUR point? How about offering up a solution?
8
I've offered up a number of solutions in previous comments over the years and now limit my communications about that to legislators who are in a position to do something about it.
It wasn't just the Republicans who were opposed to single payer at the time the ACA was passed. You can look it up.
Bernie Sanders attempted to push single-payer health care in Washington, and was ousted from the Presidential race, even though he had the popular vote. Unfortunately, championing a sane and just cause in Washington affords you nothing. The system rigged and over-run by health care lobbyists and steam-rolled by big Pharma and health insurance giants. We are getting nowhere fast on this matter.
6
I have blood and bone marrow cancer and am on the ACA. I’m supposed to go to my doctor every three months, but I haven't seen him for over six months. With my insurance deductible as high as it is, I can't afford the cost of the office visit. All he does is look at my platelet counts (which he could do on his own, when I'm not there), and then we talk for a few minutes; then he drifts off. Luckily, all I need for now is 81-mg baby aspirin as a blood thinner. I actually get a prescription for it (it would cost about $2 per month off the shelf); and fortunately, he's not making me go in for a visit to get it renewed (which has to be done every year). I have the chewable but would prefer enteric coated; I need a new prescription for that, even though I could buy either one at Walmart on my own. (Peculiar how medical liability issues work?)
When I bring up the cost of my visits, the doctor and nurses look perplexed. After all, how is it *their* problem? So I don't go to see my doctor anymore. Right now it's just not worth it.
So let me get this straight. We should look to go to countries like England, France, Canada, Australia, and New Zealand? Tie up loose ends in the U.S. and move whatever money we have left overseas? Overstay a tourist visa and look for jobs in migrant farming, housekeeping, and landscaping?
And in return we get decent health care along with a chance to live?
Sounds like a simple plan and a good deal. I’m pretty much ready to go.
14
The author her is wrong in his opinion that the US does not use more health care than either the UK or Canada the US population in 2017 was 325.7 million people vs Canada with 36.29 million people and the UK with 65.64 million people. We are treating millions more people with 50% of them either unemployed or on Medicare/Medicaid. Making a comparative study is useless when taking into consideration the millions that are treated for free.
2
The gouging of patients and the health care system in the US is well documented. Our costs start out much higher for no reason than profit margins, then vary widely by region and further greed by an unregulated system. The cost of an MRI or a pill or a routine surgery can be a financial crisis in America like no where else.
9
Millions are treated for "free?"Because they're unemployed or are employed but not offered coverage. That analogy blows up in your face because it shows the folly of still tying health care insurance to employment. No other first-world country does that. Health Care is a right to all tax-paying citizens in those countries. Sorta makes better sense, doesn't it?
3
The column didn't say that the US doesn't use as much health care.
It said that the cost in the US is higher not because of more use but because it's a higher percentage of the GDP. Percentages take into account differences in population.
Only the completely indigent are treated for free, as are those on Medicaid.
Medicare patients pay a premium and copays.
2
UBER needs to figure out how to make a special group that can replace ambulance services. Better any ride VS $3K and comfort.
9
most useful comment here
1
In rural areas, the availability of Emergency Medical Services can be far more limited than in urban areas. If someone calls 9-1-1 and an ambulance arrives, the EMS often can not bill for anything except a one-way ride to the nearest Emergency Department. If the patient refuses transportation (or if the patient is dead), EMS gets nothing. Even if the EMS can bill for the transportation, the patient's insurance carrier (all too often Medicare or Medicaid) rarely pays the full amount leaving the rest for the patient. The amount paid by Medicare is pitifully inadequate. Either way, the EMS has to bill the patient for the balance which all too often is never paid.
2
"Health care is a complicated problem...."
Not when you factor in the obscene greed and corruption that is part of the American way of life.
A mile from me is a private health care facility. I will, on occasion, see three or four emergency vehicles (ambulances, fire fighting pumper trucks) parked there. I asked a friend of mine who's an EMS volunteer why they need so much equipment there for a one-story building.
His answer was very simple: the more equipment they send, the more they can bill Medicare or the private insurance company. So if an elderly person falls out of bed he can be sawed in half and sent in two ambulances to the hospital.
8
You might want to try an analysis with a larger sample. This is indeed a complex issue, involving the cost of medical education, the prohibition on Medicare against negotiating with pharmaceutical companies over drug prices which are less expensive throughout the world, and the historical opposition of physicians to universal health coverage. Among other things. Not as simple as you think.
The insurance company wouldn't pay for my ambulance to the ER because I hadn't used the "designated provider." That turned out to be the municipal ambulance service for a city 15 miles from mine. They only serve their own residents. So in effect, the insurance company offered no coverage for this service. Complaints to the state insurance commission and the insurance company went nowhere.
9
Couple years ago, at 2 am, alone in a tiny village in the foothills of the Ligurian Alps, an hour and a half from the nearest hospital: severe abdominal pain with vomiting. Finally, already dreading the final bill, I dialed 113 and crawled to the piazza. An hour and a half later two smiling young Italians stuffed me into an ambulance for the hairy, twisty, painful, 1.5 hour descent to San Remo. Exam, IVs, X-rays, pain meds and finally a shaky trip home late the next day in the care of helpful friends.
Many months later I got the bill: €92.
13
Health care providers in this country amount to a cartel. When an overnight stay in a hospital costs more than the price of a new car, when an ambulance ride costs more than a week's stay in a luxury health spa, when a fifteen minute visit with a doctor costs more than a month's rent, we can no longer pretend it's just the insurance companies. Time to reign in these thieving profiteers. Time for a well-regulated single-payer health care system.
35
All the ambulance costs mentioned here are simply appalling to me. A few years ago my husband had a heart attack and subsequent bypass surgery, with very attentive care and support thereafter during his recovery. He is monitored closely by a cardiologist to make certain he remains stable. During the entire ordeal and surgery, he had two ambulance rides - one to the local hospital, and from there to the heart specialists’ hospital for his surgery a few days later. The entire cost for this care, up until the present day, was two ambulance rides at $80.00 apiece. We never had a moment’s worry about the costs we were incurring, or our ability to pay. The GOP has managed to dupe a large segment of the population into believing that universal care is inherently evil. They are playing their voters for fools, and so far it’s working well for them.
21
This is what Republican want. The affluent will be fine. People lucky enough to have jobs that provide insurance might be okay, but everyone else will definitely not be okay. Thanks to the Republicans, the country is going backwards toward the old, failed healthcare status quo.
14
This editorial does what many pieces about health care do - conflates the cost of health care with how we pay for health care.
Nowhere in this article does it talk about why the ambulance costs $3000. It talks about how Americans pay more for the care they get, but then switches to talking about how we pay for it.
Talking about how we pay for it is important, but it's not the same as talking about how much things cost and those things too often get conflated in the media.
2
That woman is not alone. I went to the ER over the weekend with a bad infection. It required taking blood cultures and 2 antibiotic transfusions on Saturday and Sunday. Scrolling thru my health plan, I can't even tell if it will cover any of my visit. Was my condition deemed serious enough for emergency room care? Furthermore, my policy stated follow-up care in an ER setting wasn't covered. Does that mean I shouldn't have come back the next day as requested by the physician who saw me both days?
If this happened during the week, I could have seen my primary doctor and not worried. However, I have a history of cancer in the are of my infection and didn't want to wait.
Many of us Americans have to worry if our conditions are covered, as well as paying out of pocket until high deductibles are met. President Trump told us we'd have cheaper, better healthcare. Who's lying to whom?
15
As so many stories here demonstrate, what's at play is a horrible, disappointing, unnecessary intersection between economics and sheer luck. When I was 25, I had an unexpected, middle-of-the-night medical emergency--totally unclear what was happening, symptoms could have been a heart attack. I called everyone I knew; couldn't get a ride. Was in so much pain I couldn't think clearly, and finally called an ambulance after agonizing over that choice. After spending 20 minutes convincing the drivers that I did need to go to the hospital, I got there, was admitted. Given extreme painkillers and sedatives. Told I needed emergency gallbladder surgery, and scheduled for the next day. I had been given so many painkillers I would have agreed to anything; I had no primary physician to call (out-of-state grad student), no family in the area. The only people I spoke to were a surgeon and the hospital's insurance agent. Total cost, pre-insurance: $35k. Ambulance was just under $3k. What makes me so incredibly lucky in our healthcare system, though, is that I wasn't 26 yet: I was still able to use my parents' insurance, and so lucky they could even help. 8 months later and I would have been bankrupted, in massive debt. This is not uncommon.
26
And your safety net (age 26 coverage under parents plan) was a feature of the ACA (Obamacare.) Remember that.
3
Oh absolutely--without that ACA feature, I would have been one of the thousands and thousands of young people banking on good luck and good health, since paying for health insurance was out of the question on my income. And good luck runs out, in the middle of the night.
Last fall I had a short stay at the emergency room after a trip and fall. The stand-alone charge for Tylenol and Neosporin for a small cut was $124.00. Nothing more needs to be said.
19
Until we get the cost structure of our healthcare system down nothing will change. Even a universal care system will bankrupt us all - someone, yes, someone has to pay for it. Fix the cost structure first. There are no other options.
11
I disagree. It's the other way around.
There is almost more money in the US than can be counted. To claim that the nation cannot afford healthcare for all its people, even at current costs, is incorrect. A reallocation of priorities is all that is needed.
But the costs cannot be reduced without changing the delivery system. So that is what must come first.
A single payer system would immediately reduce costs by the amount of profit insurance companies make and a substantial amount of their overhead, conservatively a total of 10%.
And economies of scale in a single payer system would reduce costs far more. Even as things stand now, just look at the difference in what is billed by doctors and hospitals and what Medicare and Medicaid actually pay.
The argument that the US cannot afford universal healthcare is saying that many people must do without it. That's unacceptable.
9
Have you looked at your local medical center, lately?
Here in Cleveland we have an excellent medical "foundation". It pulls in more money (that sure look and act like profits) than many large corporations.
There's your "cost structure". That and the trillion dollars a year in profits our private insurance system generates.
Single payer would save money, not bankrupt us. And provide far better medial outcomes to boot.
6
As someone who has lived in two other countries, New Zealand and Australia, I would say the same goes for dental care in the US. I remember when I first came here being struck by the number of people with missing teeth...
11
I'm in Portland, Oregon, and the amount of people we have seen struggling with injuries on the street is alarming. I have never been to a place where at its worst, a whole road can look a scene from a post-armaggadon movie.
People have no idea. A dear friend who is 59 was on the cusp of retirement when just before Christmas he received the news that he has an aggressive and rare cancer that rarely strikes someone as young as him. He can now no longer retire as he needs the health insurance. He will likely have to keep dragging himself into work for the rest of his life just to try to save his life rather than spend the time he has left with his loved ones.
It gets worse. He works for a small company that is self insured. I asked whether the future of the company was at risk. He says they are self insured for normal expenses with catastrophic coverage for cases like his. This should protect the company but given his treatment will be $500k for the best hope treatment plus a whole lot more for the chemo leading up to it, it is probably not guaranteed that the company will be able to afford the insurance after the rates are put up. If not, how many other people will be affected?
Americans like to think they are the richest country in the world but somehow are the only ones who can't afford universal health care. My friend is one of you. Healthy, hardworking, and a responsible saver. If this could happen to him, it can happen to you.
28
Well I guess one example tells it all. The "famous" Epipen costs about 600$ in the US, here in Luxembourg you buy it for about 50€ without insurance coverage. With insurance coverage your out of pocket is about 50$ in the US and 10€ here in Luxembourg.
Considering that the minimum legal contribution towards healthcare insurance is about 100€ per month for full service I somehow feel that you get ripped off in the US.
15
Sooner or later, we will have to go to a single payer system to rein in the cost of health care. Medicare is the prime example of how a good single payer system can work, although I think the providers share too much of the burden when it comes to cost.
Over the years numerous types of plans attempting to resolve the cost crisis have been tried and mostly failed. The ACA could have worked but for the Republican opposition. Should single payer ever become a serious discussion in the political arena, we can expect the fear mongering from the GOP to increase.
One only has to look at the countries where health care is provided through a single payer system. Not only is it considerably cheaper, it covers everyone.
The only question remaining is how to pay for it.
10
One aspect of medical care in the US that has changed in the last 5 years is that ambulance service has been privatized. While an ambulance trip to the ER in Kaiser used to cost $75, the privatized company unconnected to Kaiser that now provides service charges $250. And the service they provide is unacceptable. A dozen people showed up. None of them seemed to know what they were doing. They were told to take my mother in law to Kaiser, 4 blocks away but instead took her miles away to a different hospital, not Kaiser. And then they refused to tell us where they took her. We thought she was dying and for over an hour had no idea where she was. In the end we had to travel to the most likely non Kaiser hospital to see if she was there. And this is service in our home community.
13
Our child, a high school athlete, had to have surgery & physical therapy for torn hip labrum. This is considered an outpatient procedure, less than 48h (only 1 night) in the hospital. Millions of HS athletes, thousands of injuries. Total billing, about $58k. Pity a child if the uninsured - they can just limp.
12
Consider this! Over 50% of Congress (Senators and Representatives) are millionaires. Those not millionaires still receive a darn good salary of about $175,000/year, plus a very good health plan with the premium being subsidized by about 75%. They just don't get it that some people live (exist?) on just their Social Security benefits which doesn't leave much room for co-pays. Scott Fitzgerald was right when he reputedly said to Ernest Hemingway, "The rich are different from you and me!" and as the story goes, Hemingway replied, "Yeah, they have more money!"
15
Of the $1150 I get in Social Security, the government takes $150 for Medicare. Then there are the deductibles, copay and my private healthcare. Now I have multiple myeloma, HIV and a hernia. Due to my brittle bones I broke my foot. Therefore I cannot work. But I worked my whole life, earned a PhD anbd was fired for being gay - which is just fine in the eyes of my GOP run state of Florida. Right now, at 71 I cannot work but as soon as my foot has healed I will go back to work - oh, yeah, and campaign against the GOP.
4
Yeah , but the 1% got their $800 billion tax cut so there is that to be happy about !
America , are you really no better than Trump & his vile abettors ?
4
It is not likely Congress (Senators and Representatives) have much of an understanding of health care, or any other personal financial difficulty. Consider this! Over 50% of the entire Congress are millionaires, and the ones who aren't millionaires receive a darn good income of around $175,000/year, plus a health insurance plan that is very good and the premiums subsidized by about 75%. Scott Fitzgerald was right when he reportedly said "The rich are different from you and me." Are they ever!
6
A conservative colleague went all in for an HSA - proud to take responsibility for his own health care etc. On January 4th, the first year of the plan, his 10 year old son fell and was screaming in agony, grasping his leg. He took his son to the emergency room rather than waiting to see if the child felt better. The X-Ray showed a broken leg. The ER doctor recommended a pediatric orthopedist. Rather than shop around for a cheaper doctor, they made an appointment. The specialist was concerned about the break and the possibility that the boy's leg would be shorter than the other. He requested more X-Rays which my colleague agreed too. The boy's leg was set and he was fine. The next month, my colleague got his first medical bill - $8,000. He didn't any money in his HSA. Fortunately for him, he makes a good salary and could pay it. I asked him what his assistant (who makes much less) would do if it happened to her son. Would she decline the pricier care despite the future impact on her son? How would she pay an $8,000 medical bill?
50
Did he answer your question?
2
Annette, had a similar situation about 22 years ago with my daughter. Broken leg, potential that if not treated properly would end up with one shorter than the other. Ended up having surgery the next day by an orthopaedic surgeon, two day stay in the hospital, three return visits for casting, second surgery to arrest growth in other leg to prevent imbalance, another overnight stay in the hospital. Total cost $50.00 for the tv in the room!
1
There are some principles that people should take as a starting point:
1) Insurance only works when the people who don't receive the benefits pay premiums for the people that do and,
2) Larger groups of people in the same risk pool mean lower premium costs.
Taken together, these principles lead to a single payer system that everyone is in. Shame on the people who have made a political weapon out of health care insurance.
53
that this is how our mandated car insurance works doesn't seem to occur to the people opposed to ACA
4
The sad part is that it could all be so easily fixed. When my parents got sick all their hospital bills were paid by medicare, they had paid into their whole life through pay role taxes and it took care of them in their old age.
Medicaid and Medicare are two systems already in place, just expand it. If people want to keep their own insurance, then fine, but if people want to opt into the government insurance then they should be allowed. You can begin by covering everyone over 50, and maybe single moms. Then slowly expand it. Taxes will have to be raised, and maybe the Rich will have to give back their tax cut, but it is doable, and will bring down medical expenses.
The sadder part is we could easily do this, but the red States who continue to send republicans to congress hold Back the blue states which would vote overwhelmingly for such a plan. The Red States and the republicans live by the decree that you are on your own and the government is not responsible for your health and welfare, that the government should not pay for your medical insurance. The craziest part is that the people they elect to block Universal health care , the congressmen and Senators are gifted the greatest health care plan in the World for life. Its absolute madness.
29
You have captured the insurance side of the problem but there is also the cost. Running health care as a for-profit industry is also killing us. In some cities, there is only one "health care" organization, resulting in a local monopoly. The cities even supply incentives to make them even larger and more profitable. That also is madness. I am not sure I want "government doctors" but the focus on maximizing profits cannot stand.
People are suffering and "health care" is no longer helping. I realize this is anecdotal but a neighbor fell ill in England last year and wound up spending a night in the hospital. He paid $50--end of story. We have to do better and stop the greed of hospitals, clinics and pharmaceutical companies. A start would be to forbid lobbying!
7
JTSomm your anecdote is appreciated. For an absurdly long time, since what 1930´s at least, the word "socialised" or "socialism" has been a dirty word in the US. Why - well because the mega rich may just have to share. USA is an outlier in what could be positive times in throwing its entire populace and system into the trash. Its suicide. Yes health care is better in Canada, UK, Mexico, Germany, France, Colombia, Spain, Trinidad & Tobago, Scandinavian countries and just about anywhere else outside of war zones. We are complete suckers to put up with it. Logical people would be marching in the streets, tearing down their reps offices, barring entry to hospital admins and insurance execs.
The difficult calculation is that you don't know whether you needed to go to the hospital until you get there. My husband fainted in a theater, and the manager called the paramedics. We sat in the lobby while they debated whether he needed to ride in the ambulance. They argued over whether he was having a heart attack. They asked me -- I had no idea. They decided the ambulance was necessary. The emergency room doctors and staff were wonderful. After we had been at the hospital most of the night, the doctors decided he didn't need to be admitted, which meant we would be responsible for the ambulance bill. Our out-of-pocket expenses were $3,000, including $1,000 for the ambulance. We were very grateful for the care and were just barely able to afford it. Many families could not.
22
Two years ago I scheduled an appointment with my local Dr. as I had a virus I could not get rid of. During the visit, he discovered I had an abdominal aneurysm. Two weeks later, I had surgery to repair it. Total cost for the surgery and a two and one half day hospital stay was $275,000.
Medicare paid the bill, not the total billed, but about $40,000.
4
Three thousand dollars for a ride and a consult. Gee, do they think they are an airline?
1
glad you could afford it. my ambulance ride in Canada cost me 75$ ??? My friend broke his hip last yr. as a senior his ride was 45$
today i am off to by bone density test and consult , cost 0$
1
The aging population is driving up the cost of all medical goods and services. New doctors and nurses cannot be trained fast enough to keep up with the ever increasing health care demands of older Americans. Debates about the administration, financing and management of health care are irrelevant.
Throw in the obese and sedentary who are age 15 to 65 and the demand for health care services is skyrocketing.
I will be expecting less from the health care system in the coming years and I advise others to do the same.
6
Dan
Every country on the planet is facing the same challenges, often successfully.
Well many are facing the challenges, others, like US, are trying to figure out how to monetize them.
"...administration, financing and management of health care" are exactly the point.
2
You are right that the population is aging, as are you by the way. However, today's elderly are not nearly as health compromised as the prior generation. Smoking reduction has lower the risks of lung and throat cancer as well as heart attacks. We are healthier, but our health service sector is not. It is bloated from greed at the top. Hospital executives and health insurance executives are compensated lavishly, not so much the people under them. Greed is a form of obesity. It fills our system with fat that clogs the arteries of care. Collectively, when a ride to the ER is a gateway to bankruptcy, our system is on life support. Get rid of the fat.
2
Countries with universal health care manage to take care of their older and younger citizens alike. You can’t blame the U.S. health care crisis on old people. The US could have the best single payer system in the world, if only it had the will. Keep drinking the GOP kool-aid and that will never happen.
The time is long gone when an impecunious young man could negotiate to have 4 impacted wisdom teeth pulled under nitrous oxide and novcaine anesthesia for $200. Now the insurance companies dictate what doctors charge, and it now costs $200n just to have an ear cleared of wax.
7
EMT services, just like the ER itself are quite expensive. This is because the personnel are there 24/7, they are constantly training, they are professional and expert. When you add up the actual costs to have these people at your behest it is not cheap. The sensible solution to the need to fund these services, if we agree they are needed, is to spread the cost over the entire population. You can call it socialized medicine, or universal medicare, or just common sense. If we, as a nation, cannot afford this care we are really a sad society.
21
Well, EMT personnel in other countries are also there 24/7 and are constantly training, they are also professional and expert. But an ambulance ride does not cost anything close to $3,000 - it's less than $1,000, if you happen to have to pay for it privately. Otherwise it is covered by univeral health care.
There is no reason why the country should have to afford such expensive care, because there is no reason (except for greed) for that care to be so expensive.
22
If you want affordable health care, take the profit out of health care. Pay the care givers a fair and competitive wage, but don't have businesses making money off of peoples' medical needs. That is why fiscal conservatives scream "socialism" every time someone says "medicare". Some things just shouldn't be for profit... like a person's health.
12
"There is no reason why the country should have to afford such expensive care,"
1/ It is a for profit regime.
2/ Cut the US DOD budget by 50% and bring on single payer affordable health care for ALL.
If you think private insurers are simply actuaries and accountants, think again. Insurance companies are all about SALESMANSHIP. Sell, sell, sell, not pay, pay, pay. Simple: Insurance 101.
17
In healthcare, one man's costs are another's income. I had a dental emergency in Wellington, New Zealand. For a same day 20 minute consult, X-ray, and antibiotics, I paid (at the maximum rate for an overseas visitor, not covered by any NZ health scheme) a total of USD102. And all this at a downtown facility, as well equipped as any I have used in the US, and with a fully qualified dentist (not dental assistant). The same problem would have cost > USD1,000 in the US.
29
$3,000 for an ambulance ride is not bad. My daughters ambulance ride was 4 miles after a riding in a cab that ran off the road in a 1 car accident. Ambulance time 35 minutes and the charge was $13,000. Eventually negotiated down to $7,000 by the insurance company and then we were balance billed $6,000 (illegally) by the ambulance company for 18 months. Luckily she was covered by my employer based health plan, so my high deductible of $3,000 was my total cost. The cab company ( Yellow Cab) self employed drivers carry a $25,000 3rd party and are judgement proof.My employer picked up the tab for the lot.
Basically healthcare and health insurance in the USA is a shell game .
Make America Great Again - how far back do we have to look to find greatness.?
26
All things considered, $3000 is still pretty bad. Remember, she hadn't been quoted that price. Your daughter was also massively overcharged.
And here is the huge problem: we hear numbers like $13,000 vs $3000, and think "I'll take the latter." These are both outrageous, but our perspective is way off. Exactly what are we being charged for in the ambulance?
We are being overcharged for all aspects of health care - and politicians, with their healthcare for life, need to understand this.
18
The problem is that looking back will not make America great again. We need to look forward and welcome the new ideas that will make America great and accessible for everyone.
1
I have a friend whose entire paid job is medical coding. That is, she sits in a multiple physician practice determining the appropriate procedure code to assign to the work done by the doctors in the requests for payment sent to insurers (including Medicare and Medicaid). She is pure overhead and would be unnnecessary in a single payer model where medical professionals and their staffs were overwhelmingl salaried. There are thousands like her sitting in doctors' offices, hospitals, clinics, etc. Then of course there are the gatekkeepers employed by insurance companies, some of whose jobs are to decide beforehand whether a procedure or medication will be "covered" and others who "crtique" my friend's work. These are only some of the most cut and dried examples of overhead that doesn't happpen in more rational health care systems.
33
Honestly, it's amazing that a so-called civilised country like the US would have such a lack of a health care system that people worry more about the financial matters of their health than about needed medical care. I can't think of any other country in the Western world with such a shameful approach to health. The ACA had tried to address the deplorable condition of health care in the US by introducing two essential elements: 1) preventing health care companies from discriminating against people with pre-existing conditions by charging unreasonable prices for such conditions or by refusing clients; 2) individual mandate. Clearly, demanding that everyone buys health care insurance is necessary to avoid that companies are forced to charge completely unaffordable prices to people with pre-existing conditions. But the Republicans are destroying the ACA piece by piece. Shame on them and on anyone who refuses to understand and acknowledge the reality of the link between individual mandate and protection for pre-existing conditions.
33
I'm not saying the health care system is perfect but based off of the description from this story it doesn't seem to me as if this woman even needed an ambulance. She needs to go to a hospital, but not necessarily in an ambulance. An ambulance is supposed to only be used in life threatening, time sensitive emergencies, not when people are medically stable like this woman. Granted her injury was bad but if she was able to lean on some guy, have water bottles placed on her leg, and have the wherewithal to communicate she didn't want an ambulance she most likely is not in life threatening danger and can get to the hospital another way. There's no mention in this story of any severe hemorrhage or limb fractures to make an ambulance necessary. And this is partially -NOT fully- why the cost of an ambulance is so high-people are using them in ways they are not supposed to. Same with ER visits. ERs are not PCPs and when they are treated as such, medical costs skyrocket. Americans utilize the health care system in a remarkably inefficient way that only increases costs to themselves.
3
Perhaps you are right, Henry, that what is needed is a massive reeducation program that teaches Americans how to use our inefficient system as efficiently as possible and then a bureaucratic system that forces them to do so. It might work, though I am skeptical since I'm still hearing the occasional fruit loop railing against mandated used of seat belts.
Maybe this woman needed an ambulance and maybe she didn't. I wasn't there and I'm not a doctor anyway. Deflecting the argument to the people who use the system in ways you don't think are reasonable does nothing to help us mold our system for the delivery of health care into something that's more equitable and more affordable.
12
You've got it precisely backwards, Americans use the health care system in the way that they do, because it is the only way that works for them. They go to the ER because they cannot afford to pay for appointments. They call an ambulance because they cannot afford a taxi. They don't know how to take care of themselves, because they can't afford a regular doctor. You are complaining about the symptoms.
1
So, how was she supposed to get to the hospital then especially given the situation she was in? She couldn't just go drive herself. She was, after all, using public transportation. Hail a taxi? Order Uber? Walk? Hitchhike? An injury can be serious, without being immediately life-threatening.
It is simple.
1. Cut out the middle-man (insurance companies) by switching to single-payer.
2. Corporate values & priorities are the exact opposite of human values. Profits over people is the exact opposite of the religious values that many claim to embrace.
3. Unregulated Capitalism is not compatible with Democracy.
4. Our massive spending on the military, and cutting of taxes for corporations and the wealthy, is not making our country safer, nor the lives of our people better.
5. Virtually every institution and system (government, healthcare, education, legal, media) has been corrupted by money.
There are many simple realities that are purposely obfuscated by those benefiting from the injustice. The solutions are generally quite simple.
Corporate & media repression of left-wing populism (due to it's critiques of money & power), inevitably leads to the right-wing populism (fascism) currently spreading globally.
24
Walking on an uneven sidewalk in a large city here in the US, I fell and broke my jaw. Blood was pouring from a large cut, and I was stanching it with a scarf. My daughter said, "I'm calling an ambulance." Through clenched teeth, because I could not open my mouth, I said "No that's too expensive. Call an Uber." The ER was only about 3 blocks away, and I promised the driver I would not bleed in his car. Then the insurance company wanted to know the address where I fell. I said it was a public sidewalk. But they wanted the address of the house, they needed to find a responsible party. I gave them city hall.
22
A responsible party? What -----. Outrageous.
5
Three words. Medicare for All. The rich will pay and won't even feel it, with the tax cuts, corporate windfalls, and the sweetheart deal on unearned income. The reasonable alternative to Obamacare.
24
The ACA passed without any Republican support. This means that it was a wholly Democratic bill. And as far as I can tell, Trump and the GOP were unable to fundamentally alter it.
Then this $3000 trip on an ambulance is the result of a wholly Democratic bill or RomneyCare. Why weren't they able to take care of such thing when they had the supermajority?
This is not a sarcastic question. I'm just curious.
1
Republicans were able to substantially undermine the ACA and the affordability of insurance by enabling and encouraging States to "opt out" of medicaid expansion. There were other wounds Republicans inflicted on the ACA - and my own health care availability, It would be nice for the Times to report again on the process of passing the ACA, the significant efforts to involve obstructionist Repubs to support what had been a Republican proposal, and the differences between what was originally passed, the what we have now after rulings by "activist judges" on Republican challenges and objections to affordable health care.
What is this "supermajority" you speak of anyway? The Democrats did get something passed then,unlike the Ruling Republicans in the two years of their rule - why haven't they done anything productive to improve the Health Care crisis - unable to repeal, and certainly unable to replace the ACA, they have been aggressive in efforts to gradually kill the implementation of the ACA and those of us dependent upon it. Trump promised not just to "repeal" the ACA, but to "replace" it with something bigger, better and less costly - he with his Party of puppets have broken this promise, maybe Mexico will pay for the wall and tariffs on Canadian imports will pay for promised health care.
6
RE: "The ACA passed without any Republican support."
Not for a lack of trying. That is the lie of omission that is most frequently made by Republicans in discussions of the ADA.
The Democrats tried to work with the Republicans on the ADA. They made a number of changes to the bill, most notably elimination anything that smelled of single payer, in the spirit of compromise to meet the Republican positions. After making these changes to the bill the Republicans said they needed to vote for it they refused to vote for it, for the stated reason to spite Obama. Thus the Democrats passed it, but with a number of comprises that they would never have included had they any idea that the Republicans were going to take their ball and go home. The end result is often a bill that criticized by Republicans for the things the they insisted be included in the bill. It would have been a better bill if the Democrats had just created a bill the they would have voted for from the start.
2
The bill wasn't designed to curb the outrageous medical costs in the US just try to make medical insurance more affordable. Hence the name Affordable Care Act. Here in the US the cost of the ambulance isn't based on the actual service rendered which could be as simple as a transport to as extensive as treating an auto accident victim but on what they ambulance companies think they can bill
As long as Americans have the attitude that "I'm not paying for someone else's health care", you guys will never have universal coverage. People say that they are proud to be Americans, but apparently they are just not that crazy about their fellow citizens.
97
Where did you get the idea that Americans have that attitude? We all (well, at least the educated) know that health insurance is a risk amortization system (it's taught in high school, or at least, was taught at my public high school) where healthier people pay into a fund that contributes to less healthier people. We also have Medicare, etc, which are ultimately funded by taxes and other government revenue systems.
2
Applying the concept of risk amortization to health care is one of the destructive fallacies that hamstrings this country.
Also, the concept of taxes funding anything is a suffocating fallacy. Rather, congressional appropriations fund everything, including our breakfast coffee. Taxes retrieve appropriated money, to control the money supply.
"Where did you get the idea that Americans have that attitude?"
Because that's the first thing you hear from Republicans, conservatives, and Trump supporters when you talk about a single payer
system.
The official unofficial motto of the Republican Party is "no one deserves anything they can't pay for themselves."
But they said the same thing about Social Security. Medicare. What about roads you never drive on? Parks you never use?
I continue to be stunned at the hubris that passes for informed opinions these days, particularly when it comes to health care:
"America has the best health care system on earth."
Demonstrably false, using nearly any set of statistics readily available.
"I don't want some government agency deciding whether I get the treatment I need."
Better to have a profit-motivated insurer making that decision? Seriously?
"I'm not paying for someone else's health care!"
Now we are getting to the heart of the matter. How tragic.
We're selling ourselves down the river for some ambiguous concept of free choice or self-sustainability. Every human in every society will need health care of some sort at some point in their lives - this is the obvious fact. And still we hear arguments about not paying for something we don't need.
At least some of us own stock in these profit-making health care companies - and those stocks are paying off handsomely.
So we can pay cash for our deluxe caskets.
51
Who cares about our fellow man? Not the rich, that's for sure, who benefited from one huge tax cut at the expense of the working class under Trump. When (not if) we get into another war, don't fight. Let the rich do the fighting. They have the most to lose from destruction of the status quo. The status quo only reenforces the boundaries between us and them; i.e., their property rights are more important than our human rights.
22
When someone recently our 6 year old daughter recently injured fingers on her right hand during a ball game, we debated whether to have a doctor check for fractures. We decided to take a risk and not go when we found out it would cost $400+. Growing up in Scandinavia with excellent free healthcare this was a trade-off our parents never had to consider.
25
In addition to the commentary in this article, consider the price of an air evacuation. This bill is frequently high enough to buy a car. In my area the cost is $24,000 for a 90 mile trip, and in areas adjacent to us, the cost is even higher.
9
a $15M piece of hardware, sitting there, which needs thousands of dollars of maintenance a month, whether or not it flies, 4 professionals each shift, each worth more than $100K/year, and you object to the bill. The problem isn't that Americans object to paying other people's bills, it's that they want a billion dollars of infrastructure and hundreds of people to work for them, but are unwilling to pay for it.
2
I've been told stories about this. It is often the first responders, who make the call. Yesterday there was a report of a local car accident, with two injured persons. One was taken by ambulance to a hospital about 8 miles away on local roads; the other was taken by helicopter to a Med Center which is about 13 miles away, via a major parkway. It was highly unlikely that the latter saved time. ( Google Drive time estimates are 20 minutes for the shorter trip, 15 minutes for the longer one) I wonder who is going to pay. ( reports indicated that neither person was in critical condition).
1
I wonder why I was under the impression that in Massachusetts, Romneycare (precursor to Obamacare) would pay the medical costs involved in an accident like this, including EMS transportation costs so the poor woman could get the medical help she so obviously needed.
2
This appalling situation continues because those in power allow it to continue.
15
Those in power don't have to worry about getting or paying for health care.
2
I went year's w/o insurance pre ACA. Many injuries in non-union construction. Scariest was getting tinnitus and researching to discover it could be hearing loss, but it could also be brain or ear cancer...couldn't go to audiologist for fear it would be an expensive precondition. The stress made the tinnitus worse. I was lucky and made it to the middle class and insurance with work, no cancer. America is a cruel place for too many. Domestic colonialism. Cannibalism. Not united.
20
I suffered a mental health crisis a week ago and my physician called 911 ...a gross misunderstanding, though I understand that she was following protocol. Protocol = big money. I didn’t need an ambulance, but I faced handcuffs if I didn’t comply. A trip of fewer than 2 miles cost $1700. We’ll see if my insurance pays. My “treatment” in the ER was tantamount to incarceration. I was treated like a criminal, but it’s the treatment and cost that are criminal. The monetization of misery and misfortune is a dark blot on what I would have called our country’s soul, but I don’t think it has one any longer.
12
The current governor of Florida is a Billionaire based on his investments in for profit hospitals, despite the fact that his corporation cheated on medicaid billing to the tune of millions of dollars. The fine his company paid was peanuts. Then there are the various doctors in the US Congress. All of them just happen to be Republicans, and they find being Representatives or Senators way more lucrative than being doctors, just like the former Cabinet member who resigned after it was pointed out that he made piles of money investing in medically related businesses on which he had promoted legislation. Here in the Good old USA greed rules. US should be printed as U$.
15
The GOP would throw people under the train, the Dems provide "then-let-them-eat-cake" healthcare that no one can afford. Maybe we need more populism, not less.
3
The ACA, while a good first step, has not made health care much more accessible. Premiums are high, and with deductibles as high as $6000, most people I know just don't go to the doctor at all, ever. How can we, as a supposed first-world country not have universal health care? Our representatives prioritize huge tax cuts for the rich - who can afford the very best health care already, and ignore the rest of us. One major accident or illness can literally bankrupt a family in America! When I hear people chanting USA! USA! at a sporting event I am sickened. We are not number one; we are not a country worth chanting proudly for. We can and should do better. The way a country treats it's children, poor, sick, and old tells you everything you need to know. USA indeed.
11
The ACA was a step backwards. It was a handout to the insurance industry, and has nothing at all to do with healthcare.
2
if i had a de-gloving injury like it sounds as though this woman had, i think my first worry would be surviving the injury. Further, literally every hospital system in this country would rather take $20 payments monthly, than never get paid at all -- generally you just have to call the billing office and make a plan with them (i've paid off child birth that way). My last point was if people stood around, watching, tweeting, etc. and didn't CALL RESCUE, then they should be ashamed. looking forward to updates on this.
4
I broke my leg several years ago when I was laid off from my job and had no healthcare. When the ambulance arrived they asked me if I owned my house. When I said yes, they told me not to got to the hospital. I went six months without having my leg fixed, until Obamacare kicked in. There was no mercy treatment for me unless I bankrupted myself. I had paid premiums for 27 years prior to that, but I could not afford 1200 a month for COBRA. I did eventually have surgery, then I sold my house and moved to Canada. I would love to live in the US, but without health care it is impossible. The Canadian system is far superior to the ridiculous system in the US and everyone is covered.
23
I am so incredibly sorry that that happened to you. Your story will stick in my head all day, I am sure.
Medicare and Plan F together, however, are affordable and excellent. I can even go straight to Johns Hopkins if I wanted without spending a penny except for the usual nominal premium.. It's the best socialized medical coverage in the world. Tax like they do in Europe, spend on defense like they do in Europe, and we could have Medicare + Plan F for everyone.
7
These comments are ungrateful. Neither the article nor the comments appear to realize that Americans have the best care available in the world and the best drugs. Yet these people whine that it all costs too much to actually use. That is besides the point. Those that can pay get the very best. As for the rest, they don’t count cuz they don’t matter. That my friends is laissez faire capitalism. So many of you like it you elected trump.
6
Unimaginatively horrible that such things can happen in such a rich country! Here the closest ambulance would have come and she would have been treated immediately. But then we have a national health service. And we hold it dear. And we pay taxes to support it. And it works for us. We debate how to make it even better but none of us would trade it in for your disastrous health mess.
12
Medical costs in this country are totally ridiculous. If the country is all that great, we could have universal health care like every other leading country in the world. Only the government has the clout to do anything about the problem. Unfortunately, we have the Republican Party to deal with and they oppose even a tepid little program like Obamacare. The voters are getting exactly what they asked for.
9
To the Editorial Board:
You failed to add that despite significantly higher costs than most other Countries, the medical outcomes in our Medical Industrial Complex, in terms of resulting morbidity and mortality, are middling at best.
When last I checked, communist Cuba has a slightly lower infant mortality rate than we do in the United States. ( Defined as 'infants surviving the first year of life')
13
Does it count as “winning” when a substantial portion of Americans no longer qualify for first-world problems?
7
How exceptional we are!
The richest nation the world has ever seen, and we REFUSE to provide affordable healthcare to all.
Because it is a conscious, deliberate refusal. We COULD do it; but,if we did, the Kochs, Mercers, Adelsons, Thiels, Waltons, Murdochs, and TRUMPS might have to pay their fair share in taxes. And, heaven knows, we can't have that!
Right?
14
Don't tell that to the riders of the world's most decrepit big city subway system. Look closely and the US is very shabby.
1
we'll never have single-payer as long as politicos take big bribes from big pharma and insurance providers.
15
Here in Idaho Falls it has become very difficult to find a physician who accepts Medicare as payment in full for office visits. I worked in hospital administration in California most of my adult working years, and have a family of physicians, dentists, nurses, hygienists etc. The changes since the 60's have been astounding. Physicians' and dentists' offices are a far cry from what they were years ago. They were always nice buildings, but now they are the most elaborate, expensive buildings in town. The whole medical/dental delivery system has gotten extremely expensive, and compared with other wealthy western nations the outcomes are not better. We desperately need Medicare For All!
17
It's true to say that the U.S. spends more on health care than any other country, and it's true to point out that all deliverables -- for example an ambulance ride, an IV, or a night in the hospital are all much more expensive here than in other countries.
But that leaves out the most important point, which is that for that enormous spend, the U.S. ranks **37th** in health care outcomes. We have higher infant mortality, lower life expectancy, and are less healthy while alive, than the citizens of Malta, or Morocco, or Colombia -- countries whose entire per capita GDP is less than Americans waste on profit-driven care.
In terms of bang-for-buck, the American way of health care ranks dead last.
27
Thanks for pointing out these gross insufficenties of our "great" country, Mark. Every time we go to the voting booth, we make a choice--defend the country or take care of our citizens. The corruption of the medical world and Washington compared with the war budget pie (USA 52%
of GDP compared with Russia's7% and China's 3% and the rest of the EU less than that) we determine where all those tax dollars go. Give me higher taxes any day for good health care for all, good infrastructure and good government.
8
Mental health in the US scores even worse.
5
Americans are brought up to conflate money and expertise. It's the reason we have DJT as president. And it's why we have a for-profit health care system. We refuse to believe a doctor from Cuba could be as well-trained as one who has spent hundreds of thousands on a US medical school. Country club memberships, expensive cars, big houses - they are proof to us that our doctors are experts - the best in the world, despite all the evidence to the contrary. We don't believe anything has real value unless we pay thru the nose for it. In that sense, we have the perfect health care system for out country.
14
The US even blocks doctors from fully informing patients about hazards like guns in the home.
5
I was in my doctor's office because I had had an episode of low blood pressure. They ran an EKG and found a tiny abnormality. He called an ambulance. I said I could drive to the hospital, very close. I refused the service, I still got billed.
I never went to the hospital. I drove home. That was a year ago, no more issues.
Despite being on Medicare Advantage program I was billed about $400, IIRC. As most ambulance services in the US are now part of the local or regional fire department, I do not understand why there are such high charges, let alone any at all. If I have a fire, they don't charge me, our taxes cover it.
My theory is Follow The Money. They get reimbursed from insurance or Medicaid, so they charge.
Goddess, I hate health care in America.
Lest one thinks Medicare is "free," besides paying for my parent's generation through payroll taxes for decades, it cost me about $2000 for a total knee replacement and physical therapy, the latter being the biggest share. Also about $2000 for two eyes having cataract surgery. Grateful, but keep things in perspective.
6
I was taken by ambulance to a hospital a few years ago...the total cost $100 i paid half out of pocket and my insurer, the Ontario government paid half. I have a hard time wrapping my head around anyone paying $3000 dollars for an ambulance...
13
I'm a freelancer in the arts, am lucky enough to make enough money to support myself and the only insurance available to me in this country is via the ACA. Because of the GOP, the rates have been going up and up. I don't qualify for a subsidy cause I make too much (too much, btw, is just enough to cover my expenses). If I had to go to a hospital ER, it would cost me about $7,150. My deductible is $5800 and $7150 is the most they will pay out of pocket. And no, I can't afford to pay that. I would be wiped out, financially. So the GOP members of Congress, who, btw, get free healthcare for LIFE once they're elected, feel I'm "living off the system" even though I get no subsidies and have no other options for healthcare. Many of my friends, in similar situations, have opted to not have health insurance. Welcome to healthcare in America.
16
I believe that's referred to as "American exceptionalism".
6
My son fell ill last year and wasn’t able to talk or walk. We thought he was having a stroke or seizure. My wife wasn’t able to carry him. I wasn’t home. She called the ambulance. We live 10 minutes from the hospital. They were able to lift him out and transport him to the hospital where his condition was treated and he was released.
Ten months later we got a bill from the ambulance company for $1200. Uber ride would have been $12-$15. 5 years earlier the same trip with the same treatments (monitoring vitals, bag of saline) for my wife cost $500. Insurance will reimburse $400, once I pay.
10
If you were self-employed before the ACA, you either went without insurance or paid for an expensive high deductible plan that was basically catastrophic insurance. Nothing new in this editorial. The truth is that if someone else pays, insurance companies here, prices will rise as high as the players can push it. Same reason why college tuitions have become so exorbitant compared to 30, 40, 50 years ago. It's not because of the great salaries professors earn; it's because the student loan program (banks) gave out money galore, albeit with a nice rate of return for them, so colleges just kept taking in more and more. As always, follow the money and ask yourself, "Who profits?"
8
The population of the US has grown 2.7 times since 1929, but the amount of money we are forced to spend on healthcare has grown 946 times. Get the picture? I'm a retire physician. In 1929, physicians received 1/4 of those monies, but today we receive 1/14. Guess where all that money goes in a Capitalist for-profit Healthcare System? We need a single payer healthcare system. Wait a minute, didn't some old Vermont Senator already say that? Stress R Us
38
For such a rich country, America has the poorest excuse for a healthcare system. There is an expectation that hospital costs will be exorbitant and doctors deserve to drive expensive sports cars. If it has to do with medical costs, it's expensive. We're a long way from universal healthcare, but in a way we already have it. Hospitals have to treat whoever comes through the doors; it's just a matter who pays for it. As it is now, it's other patients - either personally or through their insurance. If we went to a universal system, that cost would be spread among all taxpayers, not just other patents. Think about it.
See: RevolutionOfReason.com
15
Physicians are among the most educated professionals in the country. Leave them out of this. Physicians are being abused by the Insurance/Pharmaceutical Industrial complex as well. Their income is not a part of the problem and is severely tempered by the cost of education and years of indentured servitude where they are paid less than most professionals, in their 4-7 years of post-graduate training.
8
The problem is not insurance companies, per se. Insurers do not assume risk - they merely distribute it. Yes, they take a piece for administration and profit, and providers incur costs at the other end, but at the end of the day the real culprit is simply the fact that we pay more for everything related to health care than any other country in the world. Every device, every prescription, every ER, physician and hospital visit costs more. Prices and reimbursement are negotiated in secret and non-disclosure agreements make a mockery of the concept of price transparency. Politicians constantly tout the magic of "the market", but it is impossible for normal market dynamics to work in such a system, and the truth is that too many people are benefiting from the status quo for it to change any time soon.
12
Please don't try to say insurers are our friends-they get much more than admin and profit. They are a big part of the problem.
7
Another problem I have with the obscene costs of health care in America is its lack of transparency. It is difficult to determine how much services will cost prior to receiving them, sometimes resulting in an unwelcome shock - that is, if you decide to go through with receiving care in the first place. This fear of how much care will cost results in people denying themselves services that they might need and might even be able to afford, if they were able to determine how much the services even were. Along with that, patients are vulnerable to fee-for-service models that encourages physicians to provide more treatments in order to make more money. It is easy to say that people could just deny the "extra" services, but that idea neglects the power dynamic of doctor-patient and does not address patients who cannot speak English, an already vulnerable population. Of course, it is likely that most doctors would act morally and not push unnecessary services on their patients, but they may not have much choice, depending on where they work. Even if you do know how much your healthcare services will cost, pharmaceutical prices are equally as daunting.
The funny thing about the whole debate around "Medicare for all" is that it would not be necessary if we invested more in eradicating systemic problems (such as lack of housing, lack of access to quality food etc.) that lead to poor health, and yet typically the same people who denounce the former do the same to the latter.
12
As the late lamented health economist Uwe Reinhardt pointed out about 15 years ago. "It's the costs, stupid."
6
Has anyone done a breakdown of where each dollar spent on healthcare goes in the US, compared to other nations? Not only where each insurance premium dollar goes--part will be purely profit taken by the insurer--but where each dollar actually paid to a provider goes.
That we have the most costly health care in the world is one of the most-cited statistics, but explanations of those higher costs start getting muddy.
5
Actually there are ton of studies out there. Insurers stop loss ratios are about 18% but the real problem is the cost of treatment.
4
Insurers make too much profit. Something has never added up in the MLR calculations
"America’s politicians have placed too little value on the well-being of its citizens." –– This is not only the healthcare issue, it is the state of governance in this country across the board. It is true of every issue that faces this nation. Our leaders place far too little value on the well-being of our people and far too much on that of the vested interests who fund their campaigns. This is not helped by the unfortunate additional fact that America's citizens place far too little value on each other: individualism and loss of social capital exacerbate the healthcare issue and every issue.
40
We have a lot of citizens who vote for these politicians because their attitude is that this woman's injury is no concern of theirs and the election of these politicians and the politicians' focus reflects that lack of empathy. We live in an America that says your misfortune is not my concern and most importantly is a possible expense to me that should not be my expense. That was the sum total of the anti-universal health care arguments from Libertarians and Republicans. Remember Ron Paul's campaign manager who died without healthcare insurance leaving behind a very large bill for medical care. Ron Paul's position had always been if you have no insurance you "voluntarily" and deservedly take the risk of getting no care, no one, specifically not government should be responsible to provide assistance.
We have come to the future of this argument.
17
As an elderly Englishman living abroad I read about America with amazement.
This was a country I used to watch on the screen symbolised by the lack of fences around peoples gardens,where everyone was invited to a barbecue at the weekend Of course one knew about American individualism the ^Go west young man^ spirit ....but today...reading leading American papers...the level of disinterest ...of greedy money grabbing by the rich is truly insane..
The basic simple fact is that America was unchallenged top of the world from 1914 through to 1970 or a bit later due almost entirely to it avoiding most of the destruction of two world wars and becoming the only country standing at their end
Other countries and the EU etc have risen up to challenge its quality of life and America has responded with becoming even more individualistic and self centred instead of moving the other way towards a socialistic attitude.
There are recent signs...Bernie Sanders...etc that at last people are realising that hanging on to the coat tails of the ever increasingly super rich gets the people nowhere.
Welcome Jeff Bezos Bill Gates etc but with 200 Billion between them?
Wouldnt 1 billion or less be enough without dampening Americas entrepeneurial spirit?
The selfish greed at the heart of America will reduce its people to those in an Asian slum....
1
When I was in a rural area of the state of Oaxaca a couple of years ago with my elderly mother-in-law, she suffered a medical emergency and needed to be taken to the nearest hospital, which was located 15 kilometers away. We called the local emergency number for an ambulance, which arrived within 15 minutes, staffed by two medics who skillfully got her out the door and to the hospital. The cost: nothing whatsoever (except for the tip in cash that we gave the medics in sheer gratitude).
If a poor Third World jurisdiction can provide this service to anyone who has a medical emergency within its borders, why can’t the far wealthier United States manage to do it?
67
I have a British son with cancer. My research (and visits) show that he is getting the same care and treatment as he would at a major medical center here. The difference? He will never get a bill.
54
My daughter received world-class care for her thyroid cancer on the NHS.
At the time she was a student and part-time barista. All her care was free at the point of service.
19
Until Americans start realizing the corporations and the Republican Party is not working in their best interest we will have this disparity. We will see an attack on Medicare and Medicaid further reduced. Healthcare access will be privileged.
24
My husband and I are upper middle class with "excellent" health care through his employer. We also have 2 healthy boys under 18. We were able to cover my medical expenses after 5 spine surgeries but were knocked out by a recent, serious autoimmune diagnosis. We simply can not afford my health care. I have put off doctor's visits, tests, and am looking for ways to cut back on medicines.
And don't think for a second that I am not keenly aware of who benefited from Trump's tax bill.
64
Don't blame me, I voted for Bernie Sanders. The vast majority of our elected Democrats and Republicans are nothing but corporate lackeys. The get monetary rewards for throwing our best interests under the bus to maximize corporate profits and they call this "democracy in action".
1
I work for the State of CT which means my health insurance is great. But I'm still afraid. The co-pay on one of my pills just went from $10 to $84. And members of my family and friends worry about their health insurance plans all the time. The companies are making it harder and harder. I fear that soon only members of Congress will have good health care.
37
As I read this shameful story, I am reminded the OECD also ranks America as the second least taxed nation in the world -- as the rich continue their fantasy of "it is my money, I made it all by myself" to push for even more tax cuts? We have the lowest expenditures on a social safety net -- yet the right wants to abolish what little is left and has waged war on the poor. We have among the lowest school test scores outside (of the wealthy suburban gated-communities) -- yet the right wants to starve them even more by pitting parents against each other in a cruel lottery for vouchers. As the richest nation in the world, we have shameful levels of infant mortality and rising death rates that are starting compare with the poorest nations -- yet being poor is considered a lifestyle choice by many. And at a political convention not so long ago, the right cheered that people who can't afford health insurance should die.
How much suffering and cruelty do we need to inflict before the right finally acknowledges that "you should" does not work as policy prescriptions? How much longer do we allow the wealthy to absolve themselves for any responsibility to the nation that gave them their wealth?
How far must we go as a nation to reclaim our humanity as a nation and not just for "me and mine."
102
I suppose we should ask those who keep voting for it.
2
As each of us reads about what are descriptions as well as explanations of "well-being-woes" the time is long overdue for more than words! Choosing to give the time and energy that it will take to make needed changes in our pathologically infected health care system. Which each of US enables.Produced and protected by national policymakers. Individuals, of whatever party, gender, gender-identity, skin color, religiosity, ETC., etc., whose comprehensive government health insurance enables them to sleep restfully. Through the night. Which many of US do not! And these policymakers awaken, again, to say and to do whatever their ideological agendas and needs direct them towards. Whatever the political weather. Whether or not these are harmful words and deeds- all too often- or helpful ones. Also irrelevant ones to well-being. They know that they can live another day being personally unaccountable! Each of US enables daily challenges to our wellbeing. Passively or actively. By our complacency. By silent complicity. This upsetting Boston example exemplifies a toxic, infectious, endemic-pathological-policy with "immunity" for very, very selected-few.
6
Necessaries of life (housing, education, medicine, and food) are increasing their price relative to wages. Or viceversa, wages are stagnant relative to the growing cost of the basic needs to live compared to 4 decades ago.
However, in this same paper people argue against “socialist” candidates that precisely want to address that situation. When people are deprived of the necessary means to live, it is hypocritical to blame socialists who want to socialize the means of production.
Health care corporations have already done that. They already monopolize medicine and small practices and clinics are becoming extinct. This consolidation and concentration of capital in medicine won’t bring relief to those who suffer accidents and require medical care.
18
Three thousand dollars for an ambulance trip? Actually sounds kinda cheap. In some parts of the country that trip will cost you a year's wages. Need an X-ray or CT? Do the words "indentured servitude" sound appealing? That will be your fate when the bills arrive.
Do you think that health care should be your right? So do the pharmaceutical companies. Their extortion is of the velvet glove type. And to think that the colonists revolted against a government imposed monopoly on tea. No one died because of a lack of tea.
Tea party patriots, show us your stuff.
31
In my student days, I encountered an item of graffiti that read "if voting really changed anything it would be banned"!
This is particularly true in America. Too many democrat politicians have financial connections to the "health" industry for a simple party vote to change anything. If you want change you will have to carefully select and support candidates not parties.
You will also have to outlaw the practices of the lobbying industry; perhaps even destroy that industry. While there are billions of dollars to be made from sickness and suffering the "health" industry's lobbyist will subborn politicians to maintain the status quo. And worse, to spread the "infection" across the world.
31
SCOTUS ruled some years ago that (unlimited) lobbying is equivalent to free speech. We have the best gov't that money can buy. And it just keeps getting better and better.
9
One thing that this anecdote misses is that Medicare for all is not the solution. Medicare has co-pays that keep people from seeking care. It also has monthly premiums that may be well over 20% of income for many elderly. Only a zero premium, zero co-pay system will optimize care.
12
That's why you have to complement Medicare with one of the government-regulated plans. Plan F, for example, is about $165 a month and covers everything Medicare doesn't--no co-pays and no deductibles. It's a small premium to pay. The medicare premium of about $105 is deducted from Social Security so you simply don't feel it, or at least notice it.
8
Medicare premiums this year are $134.
Except that periodic increases in Medicare premiums tend to totally consume any increase in Social Security benefits, meaning that there is nothing left from the COLA increase in SS to cover the inflation increases in non-medical costs.
8
For most Americans, the Affordable Care Act has made health coverage less affordable. Since the implementation of Obamacare, my deductibles and premiums have doubled, presumably because I must now pay for coverage I do not need, including birth control and my adult children (who have their own coverage any way). My insurance policy has become effectively a very expensive catastrophic health insurance policy, because of the high deductibles.
9
This aspect of the ACA could be improved, but the GOP will not do it because they can use the rising cost of premiums and deductibles as an issue to help destroy the Program.
22
In the absence of the Affordable Care Act, your premiums and deductibles would have been higher. And now, with the GOP sabotage of the ACA, there will be no cap on how high your premiums will go. If you are diagnosed with an illness, your insurance company can now drop you thanks to the GOP - you will be forced to pay for everything directly.
1
Charles. Comprehensive insurance has always paid benefits to all ages and genders. The ACA just made it come clean about not ducking payments for things it felt essential to the healthcare of our citizens. Why would a 20 something pay for your statins or your cardiac stress test or PSA screening or colonoscopy if they are too young to need such things? On balance, the aging population needs more medicine, btw, so be quiet! As for premium increases, part of that is Trump meddling and the rest is the stubborn refusal of Republicans To EVER accept that affordable health care is a good idea and work across the aisle. This is the same party that has hated Social Security and Medicare from the inception but has always been glad to dump billions into a lot of things that do nothing for the common good. Last, would ask if you ever tried to buy insurance off the exchange? Just go price it. You are in for massive sticker shock.
2
Every other "developed" country has a health care system designed to provide health care for patients. The United States uniquely lacks a health care system. Instead, it has a medical-industrial complex that maximizes the wealth of executives and shareholders of its corporations.
Providing health care to patients is called "medical loss," as it steals money from those executives and shareholders. To avoid medical loss, the corporations deploy a constantly-changing labyrinth of exclusions, deductibles, copays, coinsurance, networks, formularies, and prior authorization. They also employ armies of gatekeeping clerks to stonewall, delay, or deny care, forcing doctors (who have been demoted to "providers") to spend countless hours arguing with gatekeepers and figuring out appropriate codes to unlock the gates.
Our medical-industrial complex serves executives and shareholders extremely well. But it too often fails patients, including forcing them into bankruptcy. The unfortunate woman in Boston is but one of numerous failures that happen so routinely that they're normally not newsworthy. She perhaps exemplifies why every other country has rejected our capitalist approach to health care.
Any discussion of health care must begin with the simple question of whether we want wealth care for corporate executives and investors, or health care for people. The medical-industrial complex does everything they can to prevent that question from being asked, as they know the answer.
100
To all of the GOP supporters out there -- a single, simple question. Just what is it about your world view which makes a decent and affordable system of public health care, accessible to all, a "bad" thing? It's certainly not about difficulty or expense -- every other industrial democracy in the world has something of the sort. And they all spend less per capita, with better results.
As for everyone else -- put the same question to the GOP candidates in the coming elections. At the very least, it will be fun to watch them squirm.
46
The problem is that the "centerist" Democrats -- Obama, Rahm Emanuel, and both Clintons -- were just as bad at rejecting single payer. Obamacare was the Heritage Foundation plan.
The only hope now is for democratic socialists, like Bernie Sanders and Alexndria Ocasio-Cortez, to take over the Democratic Party.
3
It would be nice if we had universal Medicare. And I'm sure that the pharmaceutical companies would love to have an endless transfusion of taxpayer cash for their monopolies.
Maybe if there was a monopoly on tea...
5
One of the saddest aspects of this article is that it thinks Medicaid is a good thing. It's not. To get it, someone has to go through the humiliating process of proving they're poor. And many doctors won't accept it because it underpays, if it pays at all. Often it doesn't pay anything because of bureaurocratic problems the doctor has no control over. I know this from 11 years of managing a family medicine practice.
Well, I guess it's better than nothing for the poor. Here, in a very rich country, we'll settle, I guess, for giving the poor next to nothing in healthcare insurance.
The real twist in the touting of Medicaid is that its expansion is supposed to the high point of the ACA. What does that say about the ACA if its greatest virtue is expanding the use of one of the worst insurances out there?
I wonder how many people -- with their Blue Cross / Blue Shield / United Healthcare insurances -- who think Medicaid is great idea ever had to use it or had any contact with it.
In those 11 years of managing a family medicine practice, I had no problems with Medicare in being promptly paid and paid fairly. Our practice would have welcomed the expansion of Medicare into Medicare for All, to replace Medicaid and all the many private insurances we had to deal with.
18
If all patients had Medicaid, doctors would have to accept it.
7
TH,
The fundamental problem with Medicaid is that it's managed by the individual states. Some states manage it well, I guess, and I know some states manage it poorly, handing management off to some contractor. And usually the criterion for finding that contractor is to find the cheapest one. But you get what you pay for.
Not only quality but also coverage can vary from state to state.
When I was managing the medical practice, Idaho Medicaid did not cover abortions. I doubt that's changed. If there's any group that needs the ability to consider an abortion, it is poor women. Idaho Medicaid effectively prevented that.
We don't need 50 different medical insurances across the nation. How are you then insured when you travel? We need one affordable, simple to use insurance that covers everybody everywhere. Medicare for All does that.
1
I haven't had Medicaid myself, but my children had MassHealth for about 3 years when we were going through a rough patch. The care was excellent. In fact, they continued to use the pediatrician and practice that they had used with the Blue Cross/Blue Shield HMO that they had prior to MassHealth. And now that they are no longer eligible for MassHealth (due to a salary increase), they're back on BC/BS and STILL using that same pediatrician and practice.
In other words, from the point of view of my children and their doctor, nothing changed at all over the last five years though they went from BlueCross to MassHealth and back to BlueCross. Only 3 people really know that the kids' health insurance changed (myself, the HR person at my workplace and the billing/insurance specialist at my kids' pediatric practice).
The biggest difference is that I was paying a very low premium, no deductible, and small co-pays. Now, I am back to a high premium, huge deductible & larger co-pays. It is nice to no longer have to jump through the annual paperwork hoops that came with MassHealth. And obviously, "self-sufficiency" feels less "shameful" than relying on a state-subsidized program. But the salary increase has been swallowed by the higher cost of health care. Of course, we avoid the doctor as much as possible. We've opted out of the epiphysiodesis that my son needs because the deductible is terrifying. With MassHealth, the surgery would be covered entirely at Boston Children's Hospital.
Just today, I had to try to convince my older son to see a dentist for a painful wisdom tooth. I spent hours on trying to arrange approvals, insurance, referrals, etc. for another son who needs surgery, but still have not gotten it settled. I spent more time submitting paperwork for denied claims on my FSA account, a couple of hours of work. I need medication that I can't afford, so I take half the dose that I should and have symptoms every day. My older son's insurance got canceled because of a billing issue that we can't seem to get to the bottom of despite many phone calls. How much time and energy and pain and emotion and productivity are we willing to waste on private insurance just to please the 1% who don't want to help out the other 99% with access to healthcare?
67
You have my sympathy. The same happens in physicians offices, where they may, for instance, have to pay for 10 hours of nursing time to get a MRI approved for an ill patient. And all of the conversations are with poorly trained, minimally knowledgeable, nonmusical insurance staff. And difficulty and delay getting services approved, despite great effort on the part of physicians' offices, can drive a wedge in the doctor-patient relationship.
16
The wealthy cannot possibly relate to a woman who just suffered an agonizingly painful accident while still having the mindfulness to calculate the greater pain of affordability of the resultant healthcare.
Why is it the wealthy hate socialized medicine they can afford not to partake in? They will always have their catered medical services that will cost them a trivial amount. At least socialized medicine for all is better than none or medicine that will bankrupt us. Why are they so intent on taking away our health care - do they really need the additional wealth? Is greed enough to sacrifice the health and the lives of millions of their fellow citizens?
60
If the cost of health was a burden of those who should be solving the issue, then we all would benefit. If politicians, CEOs and money managers were paying 30% to 80% of their income for health care our heads would spin on how fast the issue is addressed. Maybe there should be a law that politicians CEOs and money managers have to match the highest percentage of income spent by the middle class for health care. They'll either solve the issue or there would be a huge influx of cash into the system making healthcare more affordable for those who are barely eking by.
22
Why not highest percentage the poor pay (instead of middle class)?....because that is a death sentence.
I don't know if the ambulance actually would have cost the woman $3,000 but the figure doesn't really matter. Shouldn't basic health care be like the services of the police and the first department and the military? Fundamental and so available as needed?
The ACA was a step in the right direction. It couldn't make fundamental changes to the role of the private insurance sector because if that had been tried then that political behemoth would have crushed the project at the starting line. So instead it worked within that structure, making more people participants in the risk sharing pool. The important thing to do first was to get uninsured people access to care - kind of like stopping the bleeding and THEN worrying about the broken bones. It was pragmatic and I think the assumption, quite rational, was that once that first phase was stabilized then the government could start working on changing the structure of how money flows through the health care process. At the time, they had no reason to anticipate a malevolent child-man with an irrational, emotional compulsion to rip out the whole, partially-grown thing and throw it in the gutter to die.
Seems to me, you take the helm of a company or a country, you ask "how can I build on the hard work of my predecessors?" At least, you do if you're more interested in getting results for others than in getting cheers for yourself at rallies.
35
I tripped crossing the street to the Colosseum in Rome, and my forehead smacked forcefully on a metal railing. There was lots of blood, and a waiter ran out from a nearby restaurant with napkins to staunch the flow. Three Italian passersby stopped to help me up and all said that I needed an ambulance.
My first-second-and-third reaction was to say No, as I too was aware of the huge expense of ambulance service and emergency room service--in the US. They insisted, and an ambulance was called.
I later realized that what they could see, that I could not, was bone, not simply a surface wound.
At the ER I eventually had my wound sutured in multiple layers and I left the hospital with no bill at all.
I knew this would absolutely not happen in the US, and I completely understand the fear of the woman described in the Boston subway accident.
143
We need to VOTE out the Republicans who have allowed Trump to destroy all progress in America. America is being run into the ground by a cult of personality led by an ignorant con man. Organize, resit and vote.
54
True story: A young, vibrant woman somewhere in America had a urinary blockage over Christmas holiday; her insurance didn't kick in until January 1. She waited; she felt she couldn't afford to go to the doctor without insurance. She arrived at the ER January 1. She died January 1.
45
From the outside looking in, most of the western world looks awfully communist if health care for all is considered to be part of the so called left's agenda...But then, when Trump meets Putin, maybe he should discuss it with the former KGB guy...
13
And until the government steps on to control This monopoly ( which they have both a right and an obligation to do)... it will only get worse...
Meanwhile ... insurances company CEOs ... doctors... legislators and pharma will keep getting richer off us!!
No free markets ... no price constraints
Economics 101!!!
7
As a retired RN, I say, if you think doctors in private practice are the problem, you're wrong. Many can no longer afford it and are selling their practices to hospital systems. Malpractice premiums are skyrocketing, and insurance companies and gatekeepers call all the shots.
26
BMUS,
As someone who managed a private medical practice for 11 years, I can say, you are absolutely right.
If the public wants to keep a place in the system for the small private practice in which the doctor owns the business, and not some hospital or some other huge enterprise owning it, then we better implement Medicare for All, which would greatly reduce the overhead for small private practices, and would allow doctors to accept anybody who needs healthcare and wants to come to them.
As it stands now, in order to survive, the doctor in a small private practice has to screen possible patients for their ability to pay. It's a degrading system.
1
Steve C,
I completely agree. I watched this happen to my own doctor. I’ll stick with him because of who he is, one of the most positive upbeat doctors I’ve ever had who still manages to deliver top-notch care within this idiotic health delivery system. He hasn’t reached the disillusionment stage yet. That day will come, unfortunately.
The Affordable Care Act as originally intended was the best chance we had for achieving healthcare access for all. I don’t think we’ll see Medicare for all in my lifetime, especially now that republicans intend to gut it as well in their new budget.
The health care "system" in the U.S. is a most appalling experiment in Spencerian Darwinism. Those who can afford it live well into old age, procreate, and pass their healthy advantage onto future generations. Those who cannot afford it get sick and die. I suspect those who fight hardest against a more equitable system understand this all too well.
9
I would defend Darwinism from Herbert Spencer's mistaken version.
Darwin (and Peter Kropotkin) knew that the "fittest" were not the strongest or most brutal, but the ones who would cooperate.
A rat will aid a fellow rat in need. http://www.sciencemag.org/news/2015/05/rats-forsake-chocolate-save-drown...
Our Republican and neo-liberal Democratic representatives don't have the compassion of a rat.
I've dealt with rats and I've dealt with health insurance companies.
I prefer rats. A rat never denied me the health care that I've been paying for.
"But the trade-offs that everyday people are being asked to make,..... suggest that far too many of America’s politicians have placed too little value on the well-being of its citizens."
And that statement right there illustrates where the priorities of the GOP lie. Their small government philosophy ( zealotry ) leaves the common citizen to fend for him or herself while showering the wealthy elite with benefits and privileges - as if that elite class doesn't have enough already. But the ever increasing demands of this greedy gilded class hobbles the nation as the debt and deficit continue to grow. So, their only answer is to cut the legs out from under the very programs and policies that help the common citizen in times of distress. That level of greed has reached the level of mania for far too long already. And now it controls the government. Dislodging the grip of that maniacal greed will be a monumental task as the Roberts court is poised to strike down any forays against the privileges of the wealthy.
15
American health is all about wealth—for individual providers chasing it as well as big business corporations, e.g. health care systems, big pharma, medical device makers and all manner of administrative and benefits consultants. America cares first about business and has an outdated fantasy about the goodness of doctors. Get over it. Our health care crisis, our bloated heath care spending, is manufactured—only to make a few, fake elite-class wealthy.
8
Since health care is essential for life and the well being that makes anything else worthwhile, the health care industry is positioned to force a large amount of consumer spending its way, and is doing so with great if covert gusto. The other consumer sectors of the economy can continue to allow the health care sector to exploit its natural advantage and thereby diminish the amount consumers have available to spend on their products and services. This approach preserves the unfettered free market. Orthey can unite with their customers to liberate some customer money from health care so it will be available for them.
4
Whenever anyone proposes something that advances The General Welfare (the Constitution's words. not mine) the cry from the right goes up "we can't afford it".
The money is there, but more and more of the wealthy aren't paying their dues. It's not that "we can't afford" medicare-for-all, it's "we refuse to afford it".
America - the Exceptional Nation, indeed.
34
If my general welfare or pursuit of happiness conflicts with your general welfare or pursuit of happiness then the one of us who is higher in standing should prevail. There are many examples of this throughout life. If my pay impacts my employers profits, guess who prevails. If my use of public facilities costs more than someone wealthier is willing to spend, then guess who goes without. That’s only natural. It’s the competitive nature of capitalism.
1
It is hardly mentioned in articles like this that healthcare costs in the US are so much higher partly due to the profit taken out of the system, compared to other countries.
"An oft-cited study by Harvard Medical School and the Canadian Institute for Health Information determined that some 31% of U.S. health care dollars, or more than $1,000 per person per year, went to health care administrative costs, nearly double the administrative overhead in Canada, on a percentage basis."
"According to the insurance industry group America's Health Insurance Plans, administrative costs for private health insurance plans have averaged approximately 12% of premiums over the last 40 years."
"One study of the billing and insurance-related (BIR) costs borne not only by insurers but also by physicians and hospitals found that BIR among insurers, physicians, and hospitals in California represented 20–22% of privately insured spending in California acute care settings."
https://en.wikipedia.org/wiki/Health_care_in_the_United_States#Administr...
Why do you put up with this?
24
If the government decides who can drive an ambulance, who can practice medicine, and what drugs can be manufactured and sold, then why isn’t everyone who lives under that government entitled to healthcare?
15
I get it. I have insurance, but how much longer - recession/depression is likely coming - it's the GOP specialty - each and every time. It's the only thing GOP accomplishes. Once my insurance is gone b/c my job is gone (and the two should not be connected in the first place) pre-existing conditions kicks in. Two serious injuries, both requiring likely surgery, and I'm not going to get one diagnosed and treated - just so it won't be a pre-existing condition; I need the use of at least one of my limbs so I'll continue to limp in pain for god knows how many more months, years? I would not have had to do this when I knew President Obama's affordable healthcare act was in place. But under the Dump regime, one must again start strategically calculating and sacrificing one's health - even if in excruciating pain.
29
What a horror story. Who ARE we? We let people just bleed on the street (or platform)? Health care reform has been a major political battle for more than thirty years. Neither Republicans nor Democrats have been able to deal with it. Obviously, our political system is broken. The traditional Republican’s embrace of the Tea Party set them up for Trump’s hostile takeover. The Democratic Party is verging on following the same fate as Begins to pander to neo-Marxist radicals. However, there are now more registered independent and no party preference voters than there are members of both parties. Perhaps the best way for individuals to respond to this is to drop their party affiliation and register as independents. The party system is outdated, inefficient, and a huge obstacle to liberal democracy. Hamilton advised against them.
14
The Democrats are not pandering to neo-marxists, they are instead starting to embrace FDR's philosophy of caring for your fellow citizen.
1
We are for the most part an I society not a We society. Travel to Europe, Canada, Costa Rica, even Mexico and you will find some form of health care for all, from cradle to grave. And in too many minds Americans fear that because they think of Socialism, not health care for all, and in their minds that is to be avoided at all costs. Socialism is evil. We stand for ourselves, not the common good. Hopefully this will soon change.
24
"We stand for ourselves, not the common good. Hopefully this will soon change."
Ha ha ha. Never, it seems, and that chills my bones. I've been a Type 1 diabetic for 52 years, and I've had to pay those big ambulance bills a few times. We must get the "health-care industry" out of the hands of corporations with stockholders. The "free-market" conservatives have brainwashed far too many people who vote. I hope that one day, Americans will think of "us" before "I'm on my own, and so are you. I owe you nothing." But I'm not expecting it in my lifetime.
15
Why is disagreement with the liberal “free everything” mentality considered brainwashing. There is nothing stopping you and those with beliefs like yours from starting and funding a charity to support every cause you have concerns about. Why do you get to set the bar at your comfort level and demand that the rest of us fund it?
1
Don't give up. The over 65 Medicare crowd seem to have no trouble with it. It may come sooner than you think. VOTE!
My husband is Swiss, and two years ago I developed pneumonia while visiting our family there. We were staying in a fancy ski resort when I finally determined that I needed to see a doctor. When I arrived, they made me give my credit card since it was a private clinic, and I did not hold a Swiss insurance. To be sure, I was petrified by what the final cost would be. After two x-rays (one for the chest and one for the head), a thorough exam, one shot for amoxicillin and another of steroids, and finally two weeks wirth of drugs, the entire hill was $600. When my mother-in-lad heard she was outraged at the price, I was pleasantly surprised. That $600 bill would have been $4,000 in the U.S. without insurance.
25
Aubrey Mayo,
I’m glad to see much hasn’t changed. More than 30 years ago while moving into my Zürich flat I fell and dislocated my ankle. The ER visit, doctor, x-rays, reduction of the dislocation plus pain meds came to 40 CHF. At the exchange rate back then of 1USD to 2.5 CHF I paid 16USD. I still have the x-rays which they gave to me when I left along with the itemized bill.
Americans get price gouged for healthcare because our government allows it. The Affordable Care Act was a step in the right direction. It needed to be improved upon not gutted.
Americans should be embarrassed to call ourselves the greatest country on earth when someone with a grave injury that could claim her limb is afraid to call an ambulance because she could go into debt.
40
It is really too bad Republicans see Medicare for all as socialism. Maybe it is. I’m all for it. After all, we do have corporate socialism, and somehow, that’s okay.
44
The US spends vastly more on health care than any developed country in the world. The US also has far more mass shootings than any country in the world (developed or not) save for countries at war, like Yemen. With the Yemen type exception the US has more gun deaths per capita than any other country in the world. The US has far more guns per capita (no exception needed for Yemen) than any country in the world. All these facts are related in some intimate way, but it is not the second amendment, which does not prohibit reasonable restrictions on firearms, as even the late Justice Scalia noted in his "god-like" (for Trump and the NRA) Heller opinion.
I am not sure what relates all these facts, but it may have something to do with a pervasive and atavistic view in the US that the "wild west" still prevails. Everyone for his own. Kill or be killed. I just don't know.
12
How can healthcare ever become so frightening for the patient, it is beyond me. Is it because people of monetary wealth -far-distanced from the agony and pain of having to deal with financial ruin on top of illness or accident- make the policy decisions that matter? America “not the greatest” in my mind...
17
I would literally be dead without Obamacare. Because of the Medicaid expansion, I was completely covered when, at 46, my congenitally defective aortic valve finally broke for good and was replaced following the unexpected deaths of my partner, my cat, and my mother within two years time. Everyone else with a broken heart should be so lucky, no matter their income level.
53
It is not gridlock in Washington, it is gridlock by Republicans! Some of the best health care countries use Bismarck model (aka Obamacare), yet we can't make it work because Republicans, not Democrats, want it to fail. Blaming "Washington" just lets Republicans off the hook, allowing their mischief to go unpunished, or as the last election shows, rewarded.
23
I am very grateful to live in a country with universal healthcare for all. Everybody pays a percentage of their monthly gross paycheck to their healthcare provider, spouses and children until the age 24 are covered by your policy.
You get all the treatment and medication
you need when necessary.
Being lucky enough to never have had any major condition and just going for my semi-annual and annual check-ups, I nevertheless know that, if I ever needed major medical care, I would get it without having to worry about being financially ruined.
And my country is not the only European country with this type of universal healthcare.
The problem, of course, is that the "affordable care act" is, was, and always will be, a patent on obvious fraud. It was never designed to make health insurance or care "affordable"; it was designed to get taxpayers -- either today, with higher rates, or in the future, paying back accumulated debt -- to pay the bills.
And the progressives don't learn; they never do. They call for "Medicare for All" while Medicare for Some is like $40T in the hole. Leftists are great with promises of "free" stuff, but not so great with basic honesty about how to pay for those things. In a socialist country, they don't "tax the rich"; they tax everyone, at Denmark-style levels of 62% at a princely $50K.
We pay for both convenience and MDs' Mercedeses. No country compensates its physicians like we do. And Americans would never tolerate the kind of waiting periods other countries impose.
But there are some fixes; they won't do it all, but they can take positive steps:
(a) encourage HSAs; when people pay for things they want, they care about prices; relatedly
(b) insist on price transparency for non-emergency services;
(c) eliminate coverage mandates; let people buy the policies they want, not the policies Congress says they must have;
(d) divorce coverage from employment with credits for individual policies and no deductions for business policies.
Nothing will ever "solve" the problem. But we can address the problems government caused by eliminating those policies.
2
Uhm ... you're wrong. I am a Canadian in my late fifties. The problem of health care can be solved, and it was solved here decades ago. I have never in my life had to pay a single cent for medical treatment of any sort. Nor do I have to worry about whether or not the policy which I can "afford" is actually going to meet my future needs. I get sick or hurt -- I get treated. Period. And I know that it's pretty good treatment, because I also know that my life expectancy is somewhere between 5 to 10 years longer than that of my American counterparts.
And as for those intolerable wait times which you seem to believe have been "imposed" upon me -- well I've never actually experienced any such thing. Nor has anyone else in my immediate family. So the real question is this: what leads you to believe that such wait times actually exist? Other that GOP propaganda, that is?
11
Curious, this is the crux of the problem. I never understood how Americans in general could not see how other countries could deliver healthcare to their citizens universally without the massive out of pocket costs indeed in most cases no out of pocket costs at all. Also I also never thought in any way shape or form that America could vote for Donald Trump. What I failed to realize is that there is a small but significant sector of the US public that swallow the GOP freedom mantra even while they die due to lack of care, lose their job or go into bankruptcy. I suspect the original poster has never taken any time to look at healthcare systems in other industrialized nations and simply gobles up the GOP nonsense about socialist medicine etc.
1
Free/affordable healthcare for all should not be a luxury.
Politicians, US government, doctors, pharma, hospitals, lawyers, lobbyists and insurance companies all profit with human suffering, exploiting every piece of decency left in this world.
As long as we live in a for profit "health" system we are doomed to die in poverty and misery.
It was Mahatma Ghandi who said “A nation’s greatness is measured by how it treats its weakest members.”
29
Nothing is free. Someone is paying for it.
1
A civilized society recognizes that it's immoral to profit from a medical crisis. Capitalism puts profit before people. It doesn't have to be this way. Germany has provided socialized healthcare since the 19th century. What is wrong with us.
28
If something can’t be done for a profit, it isn’t worth doing.
1
This is America today. As long as it's someone else, or someone else's wife, child or parents — don't change anything. As long as I'm OK, who cares about anyone else. Oh, I feel sorry form them, but when it comes to spending money, no way, no how.
26
Precisely.
3
More than 30 years ago when I first came to the US I was hosting a dinner party in St Louis. As the guests left we noticed a man spreadeagled on the sidewalk, stabbed. We rushed over and he tried to crawl away to stop us calling for help. In those days the ambulance only cost a couple of hundred dollars. I was sickened then. I'm sickened now.
41
On a recent visit to the US, while enjoying a walk in a large park in Tennessee, I came upon a young woman having a grand mal seizure, her upset toddler son next to her. As an Emergency specialist I rendered first aid while someone else rang for an ambulance. When the seizure stopped, before she could even tell me her name, or that of her son, she asked how much the ambulance would cost, saying she didn’t have very good insurance. All I could think was how lucky I am to be Australian.
89
I am lucky to be Swedish... I think it should be a humane privilegium to have access to medical help when required. ...
10
We do not get value for our health care dollar. Health care costs more in this country than any other. The concept of 'free market' in health care now overrides the ethical standards that were inviolate decades ago. Doctors have no idea how much is being charged for their services or how much the tests and medications they order actually cost.
The patient is a mere widget that is used as a means of generating charges by the free market that is looking for profit (no such thing as a non-profit in health care-deception). No entity has the power or desire to reign costs in. The only solution is total breakdown of the system and the hope that someone will put it back together.
It is going to get much worse as the government continues cutting Medicaid payments to nursing homes and Republicans cut Medicare. A bumpy ride with no light at the end of the tunnel, only death and bankruptcy.
19
Before people whine about not wanting to pay higher taxes for a single-payer healthcare system like we get in Canada, Americans seem to not know how that system actually works, especially the tax part.
Here's a simplified breakdown of what a person who earns $40,000/yr, there are of course many factors that could play into this.
Federal Income Tax + Quebec Income Tax (15%): $6,000
Employment Insurance Plan (EI) (1.66%): $664
Quebec Parental Insurance Plan (QPIP) (0.548%): $219.20
Quebec Pension Plan (10.8%): $4,320
Total taxes (28%): $11,203.20
Net Income: $28,796
Employment Insurance (EI) is everything that covers maternity leave, sick leave, being laid off. More info here: https://www.canada.ca/en/services/benefits/ei.html
QPIP is the paid salary you get when you go on Maternity/Parental leave. From 55% to 70% of your weekly wages for up to a max of 50 weeks. The most generous of all provinces.
So yes, we're taxed a whole lot more, but look at the benefits you get. Prescription drugs are negotiated at the government level, so we pay very little at the pharmacy. Daycare in Quebec at $8/day as many places are subsidized. When you need to care for a loved one whether a sick child or adult, you can earn a reduced salary for a few months. No more cobbling together vacation and sick days to get paid time off, no more pressure on employers to provide healthcare solutions. It's not perfect, but it's much better than what Americans are getting.
83
The pension plan payment is essentially savings for you, too, not just “taxes.” I know it can’t be personally drawn on, but what a fine way to pay taxes.
3
Yes - we get it - if you're a net-taker of the benefits from high taxation life is good.
I don't have kids so why should I subsidize your free choice to have kinds in daycare at $8/day. Why should I subsidize your decision to have kids so you can enjoy a year off. If I employ you - what do I do while you are off for a year and I have to keep running a business.
If you hurt your knee - how long will you wait to get an MRI? I can get one within a week. Do you have a Dr? About a quarter of Canadians do not have a Dr. in a purportedly 'free' system.
If the wait times become too long on your region - where do the patients waiting treatment go - is it the USA?
"free" medical care is great - unless you have a good medical plan in the USA. The question is always - do you want average to poor care for everyone or amazing care for folks that work for a living?
"The question is always - do you want average to poor care for everyone or amazing care for folks that work for a living?"
That is the question for those who believe in the American version of individualism: Every man for himself and the devil take the hindmost.
Other Americans believe that there are some things that need to be done collectively because most individuals cannot afford to pay themselves. Health care is one of these.
I wish I had read this when I first saw it. I have a simple observation. I have long drawn a distinction between the US and the civilized countries, because I do not believe the US is, actually, one of the civilized countries. In my view, the civilized countries share, at least, three commonalities. They provide basic, quality health care to all citizens as a right; they have reasonable gun control that brings gun violence stats far below US numbers, and the civilized countries do not practice judicial murder: the death penalty. We are nowhere near qualifying as a civilized country. That is a big problem, considering the present political order.
112
For the life of me I don't understand why Americans allow themselves to be tortured and abused by the scam/racket that is called the U.S. health care system. You scold Europeans for not "paying their fair share for national defense" but you can't even offer your citizens a system that let's people visit the doctor without the fear of going bankrupt. What exactly is your military protecting? Why bother having a country?
Allow me to tell a brief story: I am back in the U.S. on temporary assignment. I am a dual citizen (Italian-U.S.) As a European, I have paid into the nationalized healthcare system and, for the most part, I've been very pleased with my doctor and my care. My Italian family, friends and colleagues (along with most European citizens) don't worry about going to the doctor. Almost everyone has access. So, today I had my first blood test for an upcoming physical; the first exam back in the "American system." The test will bill-out at $500 dollars. A simple blood test. So sorry, but that cost is absurd. No wonder Americans suffer from depression, anxiety and fear. And, you know, of course, there are many of your family, friends and neighbors who don't have insurance and simply cannot pay for this kind of extortion.
As I sat in the waiting room this morning, I had a mini-anxiety attack knowing that if one little mistake was made with my insurance coverage or if I accidentally went to a lab not covered by my plan, I could find myself living "the American Dream!"
126
Wasn't the ability of insurance companies to sell across state lines going to solve all this? That's what I heard during the last election.
18
Yes, and that there was going to be "beautiful" healthcare that would be much better and would cover everyone.
13
This issue is a little more complicated than you might think. Here in California, the cost of an ambulance ride is around about $3000 to people with no insurance. However, for Medicare patients, the cost is closer to $500. Obviously the cost of an ambulance call is the same, regardless of the age of the patient. The difference is that Medicare has a lot of negotiating power, while an individual without insurance has none. The ambulance business charges those kind of prices because they are a monopoly and they can get away with it. I think the real cost of the ambulance call is closer to $500 than $3000. I believe they are making a killing on private patients.
And, here in California, the state government lets them get away with it. The ambulance service is regulated and the prices are approved by the state government. You would think that Democrats would be upset by massive price gouging of injured people. You would be wrong.
Another issue here is the role of local fire departments. Fire trucks turn up for every 911 call, and they then bill the patient for the service provided. That means that 911 has become a significant revenue stream for fire departments, and therefore supports public employees who are generous contributors to state politicians. The fire department provides a slightly faster response, but for most 911 calls they are an unnecessary additional cost. Fast response is nice, but an ambulance service is no good to us if we can't afford to call it.
25
The hypocrisy of California Democrats is transparent.
My wife and I are retirement age, though not retired. I am a practitioner of Eastern medicine with thirty years experience running a clinic staffed with MDs. I can navigate both worlds fairly easily. We have both all but given up on the Western model - no blame to doctors, but to the system. Even with Medicare and supplemental insurance, our health care is way below standard. Many doctors in our large community no longer take Medicare based on poor reimbursement rates. This means drives of two hours on occasion. Absurd. We're both proactive, and have taken charge of our own health via our approach to eating. Mostly Paleo inspired, with no alcohol or processed foods, and definitely no sugar! Sounds grim but we feel terrific, and eating is still a pleasure. She runs and does weight resistance training. I swim. We count on nothing from this overburdened, expensive system. We've been fortunate. And healthy. But if cancer strikes, if I have stroke, God help us. Because this country will not.
23
My doctor thought I might be having a heart attack and called an ambulance to take me to the hospital 30 miles away. After my insurance paid (lucky me), I owed hundreds of dollars. I will never call an ambulance again unless I am certain I am near death. What is wrong with this country? Our sense of community seems to have nearly disappeared.
40
To all the comments about the awful situation, I say only this. We know how bad it is. We know it will only become worse while the same people are in power. Never mind the details right now. VOTE. Organize. Support progressives. Join an organization, or start one, and go door to door to get the vote out, remembering that power resides at the local and state levels as well as the federal level. VOTE.
34
We have turned into a mean nation. Getting rich is more important than compassion and humanity.
122
First they took health care away from the poor. But I wasn't poor, so I did nothing.
Then they took it from the self-employed, but I had a job, so I did nothing.
Then they announced Medicare needed "reform." But I was young, so I did nothing.
Then I got sick . . . and all the premiums I'd paid, all the taxes I'd paid . . . did nothing.
310
So awful. I live abroad and thank God everyday because an ambulance where I am would cost around $200 and people think that is expensive. I have no doubt an ambulance would cost $3k or more in the US.
23
TRUMP'S HISTORIC, GARGANTUAN TRANSFER OF WEALTH FROM THE 99% TO THE 1% Is going to come to haunt him. It's already happening. Trump added between $1.5 and $2.3 TRILLION to the national debt to give tax breaks to the 1%, paid for by the 99%. He's incapable of empathy and remorse. He's got his, so the rest of us can just go take a long walk off a short pier.
55
I agree with you 100% but until the Democrats start getting this out there on a 24/7 truth-is-truth/facts-are-facts basis, Trump's lies are going to be the only story in the town square and his base who are getting devastated by his policies will continue to think he walks on bad trump wine.
16
Thanks for your thoughtful comment. I agree with your fears. Still, my perception is that politics are so polarized in the US now that people no longer distinguish between fact and opinion. There are parallel universes, meaning that the GOPpers may NEVER follow the same news sources. Even more frightening is the fact that most people get their news from tweets from friends or from Facebook. Trump's father was arrested in 1924 for fighting with the police after a KKK rally. Such violence does not stop at the front door. So Trump was exposed to domestic violence. He learned how to get negative attention by starting food fights at birthday parties. That's still his MO. His life is one big food fight. Also, he shows signs of severe impairment in the language, memory and executive functions of his brain. Much of what he says is pure emotion with a minimum of fact in the mix. Hitler's chauffer reported that shortly before he shot him, Hitler said that the reason he failed was because Germany was not ready for his greatness. One of the most chilling lines I've read! But Trump is there too. If the US fails it will be because we were not ready for his "greatness." (I gag to write the words) Reality is no match for delusions and dementia. Truly, I wish you the best. And I wish that I could be more optimistic like you. I see no easy fix. Meanwhile, the coal museum in Kentucky is powered by solar panels. You'd think people would react to that. But they prefer Trump!
We will never have affordable healthcare as long as Trump voters are in power. That's right, I said Trump voters. Not the Republican Congress, and not Trump. Trump voters put these disgusting, unfit people in our nation's highest offices.
Our current health care system may well hurt Trump voters more than most. But they don't care. Trump voters will let their families die of treatable illnesses, as long as their "president" tells them that as whites, they are superior to the rest of us.
We need to disabuse our notion that all Americans want affordable health care. In fact, nearly half of our citizens clearly do not. Trump voters would gladly sustain bankruptcies to pay medical expenses, as long as he remains in power.
So understand this. Trump voters do very much vote their "interests". But their interests are not ours. Their interests are to see a Christian state imposed on the rest of us, where brown skinned people "know their place", and where women are nothing but forced birthing machines, even in the cases of rape and incest.
The rest of us, on the other hand, want affordable health care for all, want to keep a woman's Constitutional right to control her own body, and want a legal system that provides equal rights and opportunities for all.
We are now two separate nations. The fiction that we may somehow "come together" is just that - a fiction. We will not have affordable healthcare, or any other rights found in decent nations until we secede.
111
It’s not just Trump voters. Neoliberal Dems do not support Medicare for All.
No need to secede, Henry. I firmly believe that the good people of this country outnumber those whose fear, anger, and racism have led them to support Trump.
Let the Trump voters secede. I'm staying right here.
I remember when I used to say "America is better than this!" I have since held in abeyance my childish and myopic view until the midterms.
As my favorite carnival barker in public housing is fond of saying..."Wait and see...maybe something good will happen... maybe not!"
10
18 months in our White House, yes you, Trump, a Grand-Master of the Confidence Game, you conned tens of millions of unwitting foolish Americans into handing you complete power over their lives.
It must be difficult to not laugh uproariously; perhaps you do while tweeting.
From your entirely bereft of empathy perspective, you were/are magnificent, or as you might say - "Bigly Magnificent", and damn if you don't think, no, you believe, you are becoming a better and more effective conman, with every instance of turpitude, yes turpitude meaning, so you don't have to look it up, "vile, shameful, of base character; depravity itself", which you and the fawning acolytes you convince to follow you, truly are.
As a NYC landlord, you learned, to some degree in the trenches, not that you were physically there, but you did learn from the terrified managing agents you hired, and manipulated, the L&T lawyers you planned questionable deregulations with, and the brutalized tenant associations, and advocates, you beat down, and sometimes co-opted, to bend to your will, and you bring all of that brutal warfare, or as you believe, business acumen, (hilarious), into our White House, your new rent free Property Management Office, and from there you now use our tax receipts to fund and conduct the same kind of L&T, landlord/tenant warfare against the tens of millions of brutalized poor and middle-class Americans, you now consider to be tenants in Trumps America, tenants you are now regulating.
25
I have insurance but would still be bankrupted if I had any major medical issues. I barely make enough to cover copays. When I have labs ordered, I sometimes can't afford to do them all. GOP and conservatives blocking common sense single payer are freaking RIDICULOUS and I have them for making people like me suffer unnecessarily. I work three jobs and work my butt off. And now they're planning to cut SS and Medicare because they blew up the deficit (that's NOT FAKE NEWS).
41
My mom just died from colon cancer. It also killed my grandfather. I am way past the age where I should have had a colonoscopy. I am still putting it off because nobody can tell me how much I will have to pay for this screening that, according to ACA rules, is supposed to be "free or low-cost." I might have to pay 20% of the total cost if the facility is not a "doctor's office" and I might have to pay full price for, say, an out-of-network anesthesiologist. So the cost of a colonoscopy remains a mystery, unknown to doctors, billing departments or my insurance company.
For the four years that I have had ACA insurance, I've never seen a primary care physician because appointments are always at least 60 to 90 days out and by then, I am no longer sick. I've been to the ER twice and urgent care once. This year, in the Arizona ACA "marketplace," there was one silver and one gold plan available. My premiums are $200 and my deductible is $7,050. My urgent care copay is $100. None of this has anything whatsoever to do with healthcare. It's blackmail: buy this prohibitively expensive catastrophic insurance or you will either die or go bankrupt -- or maybe both.
41
I am sincerely sorry for your losses.
From working for the same employer for over 30 years,our premiums are $2,200 a month for private insurance. For 2 people. Our the doctor bills are higher than yours, and our copays for emergency room and doctor bills are just as high. We also wait the same, or longer, to get into a physician - for serious health issues.
I'm a former director of a health clinic group, former member and speaker at a state's board of health ethics, and I can tell you first hand as someone who also testified in Congress for health care reforms that worked for over 16,000 small businesses (no pre existing conditions, no penalties for utilization) - and the GOP killed that plan that had worked for years successfully - without a single subsidized cent or govt grant.
People complaining about the ACA should try our private, required by my husband's employer, insurance. Are you aware that people that go on to disability are unable to access Medicare for 2 and a 1/2 years? Prior to the ACA, even patients with cancer, severe spinal injuries etc. were unable to get chemo, surgery, any care at all until their Medicare kicked in 2 and a 1/2 years later. Now we have the ACA that covers that gap. And the ACA is a lot cheaper than COBRA.
Many more die without the ACA than with it. Without it, people have NO access whatsoever to health care - no access. I will most happily trade you our $2,200/mo. private insurance premium for your $200/ mo. ACA premium.
24
Before ACA, I had no health insurance for nearly 12 years. I was downsized, became self-employed, and after my COBRA coverage ran out, I could not find private insurance for any price, despite being in relatively good health. I will continue to tell the truth about ACA. Yes, it is better than nothing. If I get hit by a truck, I will probably be patched up and able to get back to work so that I can pay my deductibles and premiums and copays and the balance billing and the out-of-network and whatever else. Please don't lecture me on what the Democrats tried to do. They had both houses of congress AND the president and they took single payer off the table. They are cowards.
Here's the proper sequence:
1. Call an ambulance for three grand.
2. Sue the subway system to more than pay you back.
Of course, this requires having the ability to front the three grand plus lawyers' fees. If you can afford to do that, you probably already have insurance.
9
On the high cost of medical care in the US, there is only one question that needs to be asked.
Cui bono? Who benefits?
And the answer is what Dwight Eisenhower might be moved to describe as the Medical Industrial Complex--the immensely profitable (for those at the top) nexus hospitals, doctors centers, testing facilities, specialist physicians, and of course insurance companies. Why is this "business" profitable? Simple to answer. Princes for treatment are for the most part incredibly exorbitant, set by an unregulated "market" in which the buyer usually has not choice about accepting the price for services and--as most of us can attest--often has no idea about what she is being charged for and how the "amount to pay" is actually determined.
Cui malo? Who is harmed?
All of us. Our supposedly "world class" medical care is either denied to those unlucky enough to have no insurance, or unlucky enough to be unable to pay their often budget-busting, bankruptcy-inducing share.
Free market principles do NOT work for "products" that consumers must have regardless of the amount charged.
47
Good post. However in the Medical Industrial Complex you neglected to mention the medical device and supply dealers and Big Pharma
5
In 2009-2010, Democrats set about vastly improving access to 20% of our population who didn’t have easy access to health insurance, fully aware that they were going to need to seriously stick it to the 80% who didn’t need help but who wanted the curve in rising cost of their healthcare merely to be flattened; and to those who didn’t even purchase health insurance because they were young and healthy. Rational Republicans asked why we were seeking to transform our healthcare for 100% of our people, which basically worked for 80% of us but had become too expensive, in order to EXPERIMENT with a program to improve the lot of the 20%. Why not target a program specifically at the needs of the 20%, and leave the rest alone? They might even have spent some time figuring out how to REALLY “bend the cost curve” on the means of providing healthcare to the 80%.
Well, we all know what happened. Republicans rebelled against the sheer, runaway hubris of the Democratic attempts and, abetted by an Obama HHS that had become berserker-ideological, they lied, performed administrative shenanigans in the Senate and barely rammed a bill in the House, the ACA, of which even its Speaker, Nancy Pelosi, claimed that “We have to pass the bill so that you can find out what is in it.” Against unanimous Republican rejection, and the rejection of a majority of the people at the time. It turned out that Democrats had settled for a dreadful kludge of an experiment that couldn’t work.
Since then, …
1
… Democrats have persisted in claiming that ObamaCare was the best thing since sliced bread – we just needed to keep pouring billions and billions into it to keep it barely alive, shackling our people with “mandates” that were contrary to our traditions and creating yearly liabilities for them collected at the point of a knife; and adding largely to the inability of our states to invest in anything ELSE, such as education and infrastructure. And we have seen ALL parts of healthcare infested with the ACA’s failures – even dramatically INCREASING the cost to employers to insure the 80% of our people who didn’t need help, forcing them to off-load more and more of that rising cost to those employees.
It’s an immense, unaffordable mess that doesn’t work – certainly not when an ambulance ride in Boston costs $3000. Emotionally, liberal Democrats can’t accept their catastrophic failure and generate millions of words every year by pundits and others to defend it. But the people aren’t stupid: from 2010, when Dems lost the House, to 2014, when they lost the Senate, to 2016, when they lost the presidency and saw two-thirds of our governorships and partisan statehouse chambers go Republican, the ACA has been the central element that destroyed them. Yet STILL they defend it vitriolically from the political wilderness.
But once having granted an entitlement …
Since then, the Republicans have willfully torn down all the good that came from ACA and replaced it with the chaos of uncertain markets and allowed the costs to swell even more while taking away the beneficial protections of no preexisting conditions and no life time caps, things that allowed entrepreneurship and moving jobs for financial gain.
Republicans have done absolutely nothing to help and everything to hurt healthcare.
8
… and allowing a large constituency to become dependent on its benefits, you can’t just kill it – it’s not politically survivable, an observation Republicans should consider carefully. Now, we MUST transform our healthcare, to fix the mess Democrats created and to create a system that, among MANY other things, keeps ambulance rides in Boston affordable.
But why America would allow liberal Democrats within three galaxies of such a fix after THIS performance is a rational question to ask.
We need to get private insurance companies out of the business of paying for BASIC healthcare for ALL Americans – that will need to be a single-payer program paid for substantially by payroll taxes. Services above that basic level will need to be available on subsidized exchanges from private insurers chartered nationally, to increase risk pools. In return, we get rid of everything else – Medicare, Medicaid, the healthcare components of Social Security, Veteran’s Care, the ACA, state accretions, and the “basic” component of employer-provided.
We have a failed system for providing affordable healthcare to our people, which means we have a failed healthcare system. We didn’t once, but we do now. In order to fix it, we need to blow up the mess we have now and replace it completely. And both political realities and simple prudence dictate that it must be a REPUBLICAN solution.
1
Please advocate consistently. If you would like single payer or any other form of governmentally funded healthcare, help pay for it with not just other people’s money, but also your own. Advocate for a fully-broadened tax base - no exemptions or deductions at any low or high income level.
9
Actually, that's easy.
The money we pay to private insurance would go to a for pay Medicare option.
And we would save money.
8
Summer is speeding by; soon it will be autumn & the insurance companies will be setting their rates for 2019. Maybe I am missing something, but I can find no evidence that Congress or the Executive Branch are working on any helpful legislation related to health care access & costs. Republicans have recently pushed restrictions on Medicaid recipients. These restrictions are merely spiteful & punitive; they neither treat nor cure our country's sick health care system. Where is the "beautiful" health care system we were promised during the 2016 campaign, the one that will replace the ACA with something "much better".
73
I am 68 and last November I was admitted overnight to Danbury Hospital for apparent dehydration. I had been there previously for asthma treatment. While I was there they gave me an asthma inhaler which I didn't need and had'nt asked for. I have Medicare and a supplemental plan. A month later I got a bill for services not covered. One item was the inhaler which I was charged $1,154.00. This same inhaler cost about $30.00 at Costco. When I questioned the charge I was told"the charge is customary" I complained and 3 monthes later the charge was dropped. When are we as a country going to stop this blatant thievery?
520
They do it all the time. Last year I went to a cardiac appointment. I checked with my insurance company because the doctor was a specialist. After the appointment, I received a bill for $5000 for one appointment. It took 8 months for me to clear up, and I was reported to a creditor even though I made monthly payments.
Normal sick people cannot afford the American health care system. I read in a book by Christopher Reeve that HE could not afford the treatments after his accident. Superman. You can read it in the book "Still Me" about insurance caps.
Point is, it is utterly ridiculous, and being made worse by the Trump Administration and the DOJ. We need to stop talking about Russia-gate and start talking about this.
6
John,
After 68 years alive, which I am too, I know you know that this "kind of blatant thievery", has been occurring for much longer than our 68 years, and in fact, in this America I no longer recognize, this attempt to "legally" rip you off, is just the dot on the tip of the iceberg cruising in deadly silence beneath the surface of our American existence, driven by our corporate owned government whose singular goal is complete ownership of the wealth of our nation, including the wealth produced by the disenfranchised poor and middle-class.
The birth of the United Totalitarian States of America, has occurred, and instead of the first cry of a long awaited redeemer, on the evening of November 8, 2016, we heard a roar of primal fury and triumph, emanate from the salivating mouth of the rough beast which had long been slouching toward Bethlehem, to be born.
That rough beast is riding herd on America, as Independence Day, July 4 2018 approaches, and I for one am worried as never before.
Probably when Republicans are no longer bought and paid for by large pharmaceutical companies.
Don’t hold your breath, pardon the pun.
When Clinton was attempting to improve the health care sysyem, I had a friend living in Canada who was trying to understand the implications of a single payer system. He asked if our system was in fact a form of income redistribution - I told him yes, higher taxes paid by wealthier people effectively subsidized health care for poorer people, and that this was widely understood and supported. His response was that America would never accept this, as anatoginism to any policy clearly socialistic in concept and application was deeply embedded in the culture. It appears that he was right, and I think it a terrible shame that America consistently ignores the plight of its citizens by clinging to failed dogma.
115
But the American “culture” also accepted T.Roosevelts trustbusting, a once vibrant unionism, The New Deal, Aid to Dependent Families with Children, Medicare, Medicaid, Chip and S Chip, food stamps... one could go on. Socialistic policies are as American as apple pie. At its economic and geopolitical apex, 1950 to 1975, America’s success was largely due to the correct balance of capitalist and socialist policies. When the balance goes too far in either direction, everybody loses.
12
History has proven that when Reagan assumed the Presidency and more and more Americans started to buy into his famous "trickle down" economics theory and "government and taxes" were evil, the America you described started to crumble resulting in what exists today and the inequality, winner take all society in America started to take hold.
Add to that the enormous amount of money allowed to be injected into the campaigns of politicians created policies that started to serve the interests strictly those of the campaign donors and in favor of big business.
This has now become so entrenched in the American political system,the only way out is to start electing people who will reverse this heartless mess by not being beholden to corporate donors.
Never over-estimate the intelligence of the average U.S. voter.
Bernie Sanders was the only presidential candidate that has any knowledge and understanding of our complex healthcare system. Look at his record in the senate and his website.
If the NYT Editorial Board expects people to vote accordingly what's their excuse for sabotaging his campaign? Don't try to deny it. We all saw it.
34
Ironinc, isn't Max, that Bernie Sanders' Vermont chose to scrap their universal health care plans because of the extraordinary cost, a doubling of the taxes on their citizens...
And when California dabbled with the same issue, the crushing cost made the decidedly liberal state government, executive AND legilative, to give it a pass.
1
That is true, but without the entire country’s ability to check costs through transparency and negotiation, both state plans were doomed. You cannot do universal healthcare without price-checking the manufacturers of drugs & tech, the providers and the hospitals.
It has to be a wholesale revamp across the industry.
12
and thanks to folks like you, we have Trump.
how's that working out for you?
13
The rest of the world looks at America's insistence on the solution to everything is capitalism including basic public services like health care, and they think we are crazy. It's like insisting the solution to everything is Marxism. Both philosophies taken to their extremes are wrong.
94
Exactly so. Both my retirement and health plans are administered by Smith & Wesson. It's the American Way!
18
My husband and went through 7 years of medical hell. From a heart attack at age 47, a serious head injury while skiing into a fence, a grandparent who was moved against her will from a community hospital 90 miles to a tertiary fortress by an overzealous hospitalist, children denied care because the local hospital no longer sees patients under 16, lost tests, bad equipment, bad information, administrators who don’t transfer critically ill patients, the list goes on and on. Thousands and thousands of dollars later, we are still no better off. And, we are one family. What will happen to our childrens’ generation?
91
And then move into mental health and the calculation gets even worse. When it comes to children and mental health, the refrain is, "Get help" (for your kid). Um, where? Who is paying for it?
No insurance plan really covers mental health. A decent therapist costs $200 a visit and a psychiatrist costs $400. Who can afford that?
69
Those touting the virtues of the United Kingdom's National Health System really need to investigate the real-world conditions of that system...and the ever-rising costs to provide them.
The NHS is plagued with serious problems in their emergency and trauma units...not enough doctors, not enough beds, slow ambulance service, long waits to be seen.
The NHS is also crippled by the slow pace with which they handle the "optional" medical conditions of the nation's population. One has to wait weeks to get a knee or a hip replaced after waiting weeks to get the appointment to see the specialist. And you might have to wait months for other, more technical procedures like back or shoulder surgeries or getting arterial stents placed....
Sure, one doesn't have to pay a few years salaries for the services, but then again, an overwhelming majority of our 365 million people ARE covered by health insurance that makes paying tens of hundreds of thousands personally unnecessary...
Every healthcare system in the world has its intractable problems...It becomes a question of which problems are you willing to tolerate and which you will not.
3
Of the top 10 countries with the best rated health care systems England is last. The US ranks below England. Why on earth would you use England as a model for comparison? How about let's look at the best systems out there, figure out what works and fix ours.
34
FYI, I had a hip replacement in San Diego. I waited 4 months from my decision to move forward with surgery, after waiting 6 weeks on 2 different occasions for appointments with the orthopedic surgeon.
I've been waiting for a procedure to help cope with my back issues since January-my first appointment with the pain clinic. I'm finally scheduled in 2 weeks.
I'm not poor. Please don't bring "waiting" into the equation.
42
Sorry you had that experience...
I got in to see my knee surgeon on a weeks' notice and had the surgery the following week. My surgeon was one of the pioneers of the minimally invasive technique...
My spouse had the same experience... TWICE.
I got to see my hip surgeon on a week's notice and the surgery scheduled AT MY CONVENIENCE four weeks later. This surgeon is the head of the Joint Replacement Center at a hospital that his been in the top four of our nations' hospitals for DECADES.
I you are "waiting" then you need to find a better place to have your medical conditions addressed.
"Nothing will change until their fellow citizens step into the ballot box and insist on something better."
Don't hold your breath. Nothing will change.
9
Yes but Paul Ryan doesn't care.
53
Paul Ryan has extraordinaily good health insurance paid for by we the people. So, yes, of course he doesn't care.
34
Soylent Green is fast approaching ...
14
As I sees it: Sometime in the late 60s someone figured that if a third party could be inserted between medicos and the few health insurers back then (i.e.: Blue Cross-Blue Shield) that used "usual, customary and reasonable" as the guide for a claim payout, lots of money could be made by denying many claims and charging the medicos for that service. Employees transferred from the doc's office or hospital to the 3rd. party agency now were payed by the third party and billed back, along with all of the added overhead of the third party. Therefore if an earlier bill was $10. the new, 3rd. party (value added??) bill would be $30. Add that 3rd. party agent factor (layer) to the unregulated profiteering layer by big pharma and one might be able to figure out why healthcare costs are so high. Too many whole hands in the pie. And, our bodies are that pie. Icky-poo.
22
It is neither coincidence nor an unimportant fact that an ambulance ride in those countries with universal health care will not set one back three grand, and that's just the start of the billing along the health care continuum for emergency treatment.
There was a time, back when I entered the American health care system as a provider, that for-profit hospitals were a rarity, used primarily by those for whom the cost of medical treatment was as inconsequential as a penny dropped while feeding the parking meter. Over the past 30 years non-profits have been ascendant and community-owned health care centers have disappeared.
Health insurance is a for-profit enterprise. Out of the triad of corporate executives, shareholders and patients, guess who comes in third? Hospitals charge inflated prices that only those without insurance are forced to pay, because the insurers have dictated to the provider the price it will pay for each procedure, drug, or diagnostic test. Those who are uninsured and paying full freight support the bonuses, stock options and corner office views of the CEOs of AETNA, CIGNA, Anthem and others.
Medicare for all is feasible, doable, and a moral imperative.
The insurance premiums paid into the coffers of the the Big Ones, if directed into Medicare would cover costs and then some. The Medicare tax paid in by workers and employers to pay for health care when you retire is but a pittance, comparable to the spilled parking meter change mentioned above.
52
Every time I hear a story like this, and then hear the subsequent scoffing at it by people who hated the baby steps that the Affordable Care Act took to get this country started on the road to health care for all, I want to throw something. I am on Medicare. Even after having paid into the "system" for 50 years, I pay $134 monthly for Medicare Part B, plus another $122 per month for a Medicare Advantage Plan, plus co-pays for prescriptions and doctor visits. People assume that Medicare is "free medical are." It is not. Neither is the care people receive in Scandinavian countries. In those countries, people pay taxes in lieu of paying insurance premiums to finance their health care. So compare your monthly insurance premium with what your commensurate health tax would be. "Oh, we don't want the government to make decisions about our health care!" Who do you think is making decisions about your care now? It's insurance company staff. If you need a certain drug and it's not on their formulary, or you need an MRI, the doctor doesn't order it-the insurance co APPROVES or DENIES it. I worked in health care for 40 years; my husband's a retired family doctor. We both want universal health care. Medicare costs us each more than $2400/year. It's not free. We are willing to pay for care, but EVERYONE should have access to care. Medicare for all is what we need. What are we waiting for?
382
Medicare “Advantage” plans provide the advantage to the insurance companies. You sold yourself to an insurance company in exchange for what, the health club membership, a little dental benefit, and maybe eyeglasses? And a slight saving over a Medigap policy. I have Medicare, a Medigap F policy, and of course part B. I have had big sinus surgery, hearing testing, an ER visit after a bike accident complete with CT scan, allergy desensitization therapy and routine doctor visits, with no co-pays. None of it has cost me a dime. Reread that—- not a dime! None of my docs have to spend a half hour on the phone begging a prostitute out of state doctor for permission to test or treat me. Get out of medicare advantage now.
11
How much do you pay for your medigap policy? Is it free? Does your former employer underwrite the cost to lower premiums for their retirees? As more and more companies pull back their retiree benefits, the retiree ends up paying more out of pocket. Those with no employer pension programs to share costs are left to navigate a mess of a system alone with little explanation of what are their best options. A MedAdv plan can sound pretty good to someone with little knowledge or guidance.
4
We are waiting for a Congress that isn't owned by and beholden to Big Pharma, Big Medicine and Big Insurance.
In other words...when hell freezes over and pigs fly.
16
When healthcare is a for-profit industry with no accountability, this sort of thing is inevitable. Healthcare should be de-commoditized. There are certain aspect of society where you don’t want more demand: healthcare and prisons. It creates a perverse system. It is not “gridlock.” Both the GOP and Dems only want to tinker at the edges and the leadership of both parties doesn’t want to tackle the moneyed-interest behind healthcare costs because they donate lavishly to both parties.
24
The reality is that any single payer system will have to have a cost effectiveness filter in place when determining access to drugs. For example, NICE in the UK is famous for preventing access to cancer drugs because they don’t feel the NHS gets its bang for its pound. Personally, I am fine with our system if it means I get whatever drug my doctor thinks I should have vs what tallies up to acceptable on a socioeconomic ledger.
@QED: I had cancer. My doctors recommended the kinds of treatment I should get. But when the insurance company said, "No, too expensive," the doctors shrugged and told me, "Gee, too bad. Here are the cheap alternatives, but they won't work as well."
Someone else is always dictating what kind of healthcare average Americans get. Right now, it's the private, for-profit insurance companies. Having lived abroad for a decade, I know first-hand that even the worst government-run system beats what we've got now. If nothing else, with a non-profit system, you won't go bankrupt paying medical bills for the rest of your life.
574
And you think private insurers aren't already doing this? Guess again.
38
And thus the opioid epidemic was born...
There are far more effective treatments (think physical therapy) that are more costly to patients than medication. Under a single-payer system, these treatments become much more accessible.
24
When I worked for a private ambulance company in New Orleans around 1991 or '92 the charge for a simple, basic transport was $160 American dollars.
Today the private ambulance company that has the contract for service in Louisiana and Texas charges ten times that. Even if they are 5 minutes away, really, just 5 minutes, from a hospital emergency department, they will sit in front of a patient's house for twenty minutes starting an IV and other assorted "advanced" paramedic type procedures just to pad the bill by another $1000. It's standard practice. Everybody is in on this gold mine. The system has evolved to get as much money as possible. The insurance covers it. It's free money.
61
I had a stroke at work and the ambulance ride of 1.7 miles was 1650$. If I wasn’t double covered by TRICARE and my employer that would have all been on me. As it was TRICARE negotiated it down to 175$ for me out of pocket
6
GOP approach to addressing this health care issue: Don't get your leg caught between a subway train and the platform. Problem solved!
81
Democrats tried with ObamaCare to start the ball rolling toward a better and cheaper health care system, they were handed their heads on a plate the next election. American's don't want cheaper health care for all, they are happy with what they have. Anyone who tries to improve it is headed to their own demise at the ballot.
7
Obamacare didn't do anything to reduce the cost of health care. It just increased the victim pool. Nor did it do anything to address the very high levels of death by medical error.
4
Obamacare was a compromise due to the Republicans. And it did get people insurance and save lives.
The parasitical insurance indu$try is the root of this evil. It is literally killing people by robbing health care resources from the majority for the profit of a minority.
45
You offer no solutions, and walk away from the problem by only wringing your powerful bully pulpit hands by stating, "it's complicated". Get with it! MEDICARE FOR ALL.
23
Unless the woman meant "air ambulance", an ambulance ride does not set you back $3,000.
Secondly, the train operator and the train station where it happened may be liable for providing medical care.
Something is fishy about this story.
But the editors are willing to be fooled by such maudlin and silly stories or tweets. (Was the tweet verified to be true?)
5
Apparently, you have not had any hospital bills lately.
Ambulance ride plus hospital emergency treatment: I would not at all be surprised if the bill for that exceeded $3000.
12
Let me guess - the woman was a professional actor, the skin didn't really get ripped off her leg - that was special effects makeup. And you know all this because you were there?
Nothing beats an informed comment.
4
Uh--in Boston, that's what it would cost.
2
The Times is right. The problem isn't that the political hacks ignore how ineffective US health is when compared with other developed nations. It's that so many of the US citizens directly affected by its failures ignore them. They may, at some point, vote the hacks out. But only when it gets bad enough that they can no longer ignore it. Meantime they'll continue to play with their smart phones and assume they'll never be injured or sick.
18
This is precisely what most Americans don't seem to get about their own inefficient and expensive system, that calculations about cost are simply not an issue (or are, at most, an insignificant one) in just about any other developed country. That we seem to accept this travesty here as normal appears to be as much a symptom of our profound ignorance about the way health care works everywhere else as much as our susceptibility to Fox News type propaganda that our system is the best in the world.
I can definitely relate to the lady who caught her leg. If it weren't for the fact that I'm now on Medicare, I'd probably plead with people not to call an ambulance as well.
17
just today i went for the fitting of a back brace for my severe chronic back pain. the brace was a velcro wrap, with a hard plastic backside. i asked the cost of this device and was told it was $900. i went into literal shock. made in china, this item could not have cost more than $40 to make. i found out my co-pay would have been $200. i am always left to think of my son who lives in croatia where they have socialized healthcare, and where this medical device would have not cost the recipient a penny. our healthcare system is outrageous, cruel, exploitive and sheer profit-driven. a profit-driven system will have only one priority..........profit.
81
This editorial avers "Health care is a complicated problem, one exacerbated by the gridlock in Washington." It is even more exacerbated by cruelty in Washington.
Such cruelty is gratuitous. It is gleeful. It is arrogant. It is snide. It is mean. It is pathetically small-spirited. This is the tone of our national public messaging-turned-substance.
We have entered an era of boastfulness about our inhumanity toward our own fellow citizens. We are being urged to hate ourselves and we are taking the bait.
22
I can't help but believe that many Trump supporters find themselves in equally precarious situations: overpriced and inadequate health insurance. Where are their voices?
I saw a soy bean farmer and Trump supporter interviewed about the negative impact of tariffs on his income. The reporter asked the farmer if this affected his support of Trump, "Nope, he said. The reporter then asked the farmer what would it take for him to reconsider his support of Trump. The farmer pondered the question and said, "I guess if I went bankrupt." There is always Monsanto who could relieve the farmer of his land for pennies on the dollar.
How do you penetrate such a mentality?
Just as Trump is bankrupting our democracy and its institutions as well as our moral character, I feel our delayed reaction will simply be, too little too late. There is always the Koch Brothers.
28
health care reform is being derailed by a failure of both parties to understand the true nature of the health care market. both parties have conducted their debate based on the premise that the markets for health care are characterized by free market capitalist principles. this is absolutely not the case. instead the markets are based on 4 interlocking govt sanctioned monopolies. Doctors enjoy a govt protected monopoly to practice medicine, and a govt protected monopoly to decide who can obtain a medical license.Doctors also enjoy a govt protected monopoly on access to prescription medicine, and pharmacists a govt protected monopoly to dispense it. Insurance companies enjoy a government protected monopoly to sell insurance. US Pharmaceutical companies enjoy a govt protected monopoly to sell drugs in the US. to say that these govt granted monopolies exist is not advocating that they be removed. however it is essential to recognize them for what they are if the two main purposes of health care reform, cost containment and guaranteed access, are to be achieved. usually when govt provides an industry a protected monopoly as in the case of utilities it creates a commission to control prices and ensure quality of service.going to a single payer system would not solve these problems. the entire range of costs; doctor salaries, medical school fees, pharmaceutical costs, shared pharmaceutical development costs, will all have to be taken into consideration.
5
Do you hear that, I say, to the many do-called Christians who have railed against Obamacare for years? Do you get it now, or do you still think people who can't afford health insurance should be left to suffer and die or go bankrupt when life deals them something unplanned? Or is the extent of compassion limited to offering a shoulder to lean on and a water bottle pressed against a leg?
17
This will only get worse and worse as the Trump administration moves to privatize every thing the government does for our citizens.
Profit before people is the American way.
21
And yet, in Canada, she wouldn't have had to worry. Now, in addition to her injuries, she'll be further ruined by medical bills.
No wonder suicide is on the rise in this country.
50
Dems:
Stop calling to abolish ICE! The majority of America wants customs enforcement!
Focus, instead, on the skyrocketing costs of healthcare coverage and services! ALL America is worried about this.
And present a Democratic congressional SOLUTION to fix it...don't just complain about it.
20
Considering that many on the right already advocate letting people drop dead if they can’t afford care, let’s say we disconnect 911 in red parts of the country and THEN see how they feel.
9
US is no. 35 of Western countries as far as efficiency of health care and availability to all in a WHO study. Is it any wonder why??
Israel should be a model for the US with mandatory health care insurance for all; government subsidies for the poor; three or four competing HMO's to choose from; agovernment commission from different cabinets to set fees and keep costs within inflation. Care is equal or better than US; easy access to neighborhood clinics and some of the best hosp[itals in the world. Doctors and pharma have set fees and prices and do not earn astronomical amounts.
US healthcare goes by slogan- Making America healthcare unaffordablle again. Profit is the most important factor for healthcare in the US. SAD.
9
Six of us in our fifties sat around yesterday talking. In the main, we avoided politics, because, as we all agreed, it was too depressing. But then healthcare came up. And suddenly, we were back to politics.
All of us either own small businesses or are contract workers, which meant that not one of us has employer-paid health insurance. Everyone is either insured through the ACA - or not at all. Two of us have had cancer and have massive medical debt, one of has a kid with disabilities who depends on Medicaid, and the one without any insurance said that he just doesn't go to the doctor at all. Everyone at the table embraced alternative medicine -- acupuncture, chiropracty, massage therapy, homeopathy, etc., as well as diet and exercise. They are the cheapest ways of staying relatively healthy. And nobody would set foot in an ambulance willingly, merely because we know what it would cost us. We're all terrified of accidents. Things are getting so ridiculous here in this country that most of us agreed that we no longer want to live to be old. We read about science expanding lives, but have lost interest in living long lives, because who can afford it? Only the wealthy can survive in this country.
By the way, to all you politicians who oppose the ACA, Medicaid, and Medicare: we'll all be voting in November.
127
Nicely put.
I'm also independently employed. I have an ACA plan -- which is vastly better than what I had before Obamacare.
Yet, with the super high deductibles, I avoid checkups and ignore symptoms. We need something much better.
I have friends from Canada who don't live with this kind of mortal fear of illness and can't believe we put up with it.
I'll join you in voting for anyone who promises to move us in that direction. No excuses this time. We all have to show up.
25
Medicare for All is the only solution. ACA is for profit insurance and too many Americans can’t afford it.
1
Ironic that we, the American taxpayer, funds our representatives healthcare costs and they turn around and deny us the same coverage. Why? Because they are legally bribed not to create publicly funded healthcare for all. Meanwhile, we have a bloated, expensive and less effective healthcare system than the entire industrialized world. We're told were not allowed to have that 'pony'. Yet everyone else seems to have figured out how to have the 'pony'. Strange isn't it. But not so much when you realize that CEO's of healthcare organizations and insurance companies make over a hundred million dollars a year and the companies funnel a lot of 'campaign contributions' to our representatives in both parties.
39
In the RIchest Country The World Has Ever Seen. And then people wonder how we got, why we deserve, Trump. He was a brick through (and a middle finger at) the Establishment Window. Unfortunately he tturned out to be a styrofoam brick. But at least he was willing to pretend to be a brick. Hillary "(Single Payer) Will Never Ever Come to Pass!" Clinton wasn't even willing to lie.
The American People have had enough and we won't be duped again by another faux Obama/Trump populist. We will now insist on real populists who don't come pre-corrupted by corporate pac money. See Alexandria Ocasio-Cortez's "surprise" victory.
8
$3000 for an ambulance?! What a morally reprehensible, corrupt, selfish system. Disgustingly inhumane - that poor, poor woman. Why do a majority accept being treated with this cold cruelty?
21
A certain portion of America's population will reject medical care proposed by a black man. That's how far gone they are.
34
The elephant that remains unseen is the fact that market medicine does nothing but insure a flow of profits to corporations big and powerful enough to lobby/influence. People with chronic illness, debilitating disease that requires ongoing intervention, our sick society- is profitable only by extracting every possible dime from the system. Meanwhile exorbitant costs lead to more of the same-( to compete)- our lack of government balls to take on the big dogs and pass adequate legislation- is becuase we live in a time of vacuity- our politicians, leaders are for the most part not independent thinkers- neither one or the other!
9
American electorate has consistently voted to deprive health care from the poor and not to have price control on medical care. We deserve what we have, don't we?
7
When looking at why the U.S. health care system (?) it can have an analogy to a computer. What one experiences using the computer, images on a screen is minute compared to what is happening out of one's reach knowledge. Programs running in the background, an organization of files and functions, etc. With the health care system, there are programs running in the background that creates so many "fingers in the pie" so to speak that the average consumer is unaware of. An average visit to a doctor who appears to be in private practice is actually an employee. Her billing is done by another company. She may have a "patient portal" which gives the patient the impression that the doctor is just an email away. The prescription the patient receives is electronically sent to a pharmacy and the pharmacy goes through an approval process with the pharmaceutical manager of the patient's insurance company. If the patient is admitted into a hospital, it is not a free standing hospital but is owned by a company that owns many hospitals. It should not be a surprise that we have the most expensive healthcare with a lack of positive results commensurate with the cost.
18
Our problem is an ineffective legislature purposefully made that way by massive infusions of money from lobbyists to legislators. This was made possible by scotus landmark Citizens United decision that said money was free speech. So, the only voices heard are those from well monied corporations who's only goal is increased sales.
Ordinary people can't afford a voice.
30
The basic problem is that the Republican party believes that health care is not the responsibility of government at any level. They see government involvement in health care simply as a very expensive and do not want to have to support it with taxes. As a result they have no interest in exploring alternative ways to deal with health care. Sad.
31
I'm an American living in France and currently dealing with a health issue. I'm amazed every time I fill a prescription or get a hospital bill...literally pennies on the dollar compared to the US costs for such services. Even the cash prices (which I paid before I got enrolled in the health care system) are ridiculously cheap. Health care system contributions (*based on income*) and taxes pay for this system. The French make health care affordable for everyone--they treat it as a human right. How unreal that this woman's first thought, after confirming her leg was still attached, was about money.
138
France is civil the USA is not.
7
It's horrific to read this. But then I realized I have been making a similar calculation with my HSA in a high deductible health plan. Every year, I try pay out of pocket or sometimes basic care so I don't spend down my HSA. So in case I get cancer or something, I can meet the deductible each year until I die. Every year, I look at my HSA statement and say, I can live with cancer for 2 years, 3 years, 4 years. And hopefully I'll be dead before I spend down the HSA and can no longer meet the deductible.
29
You are fortunate and healthy enough to afford an HSA. Many , many are not.
6
I know. That’s why I put in the max and never use it. So I can pay for healthcare for a chronic illness if I need it. Unfortunately I am more likely to need it since I am putting off preventative care.
1
It is true that if you can take a taxi or Uber to the hospital, you will save thousands of dollars compared to an ambulance. Those thousands of dollars might be yours, or an insurance company’s, or the government’s, but somebody is paying. If you need an ambulance because you are having trouble breathing or are having a heart attack, then take an ambulance. But the highly trained technicians, equipment, and liability make an ambulance the most expensive form of transportation.
5
But Rick....are you saying that the technicians in other countries are not highly trained? That their equipment is bad? Because that's not true. What's true is that there are enormous excess profits being sucked out of the pockets of patients who receive less effective care, by almost every statistical measure. Are you really suggesting that the woman in this example shouldn't have gone to the hospital in an ambulance?
30
An ambulance is now essentially an emergency room on wheels. If you need that much high technology and highly trained experts, call an ambulance. But if you just need a ride, call a cab. The amount of money wasted by people calling an ambulance because the government picks up the $3,000 cost rather than taking a cab because the $10 comes out of their own pocket would blow your mind. Other countries control costs in other ways, by just sending a guy in a van or by rationing service. The American way is highly trained paramedics and the latest equipment in constant contact with emergency room doctors.
3
When you call 911 for an ambulance you get a bill afterward. Once upon a not too distant time the taxpayer would pay for it, but not anymore.
In the US, money trumps ANYTHING else. And the drug and insurance companies are making lots of it, and our politicians represent them - not us. And it ain't gonna change.
32
It isn't just health care costs that are soaring, so are insurance costs. I recently ran across some old paperwork from when my husband was hired 30 years ago. Good insurance for both of us cost his employer about $140 per month and we were charged $48 per month for my coverage. Jump ahead thirty years, we have lousy coverage his employer pays about $1400 a month for while the coverage for me runs us about $280 per month. And we're lucky to have it. When he retires, an even worse policy is going to cost us $2400 per month until medicare kicks in. People like to think voting against universal coverage only hurts the poor people of color who haven't "earned" it. They cannot imagine that two successful, employed, financially secure people will run into the twin buzzsaws of skyrocketing healthcare costs and soaring insurance premiums. Meanwhile, a congressman can serve one two year term and have benefits for life. Just who exactly is the free loader?
426
Your are the people the insurance company loves. Having assets that you need to protect such as financial investments, savings accounts, bonds, retirement accounts and physical assets like a house and property keeps you in their hip pocket. They know you have money and that you'll pay just about anything because to go without health insurance could jeopardize 40 years worth of hard work and savings.
Being self employed or retiring before you are Medicare eligible is an expensive proposition.
By the way, I hear what you said about those free loaders, also known as congressmen. And of course they haven't rolled back or limited their coverage and nobody running for office has proposed that their coverage be terminated after leaving office.
15
"Meanwhile, a congressman can serve one two year term and have benefits for life."
Sorry, not necessarily true. Per Snopes:
"Finally, upon separation from political life, Members of Congress may purchase FEHBP insurance if they are otherwise eligible for retirement and if they have had five years of continuous healthcare coverage under their DC SHOP plans."
(https://www.snopes.com/fact-check/members-congress-health-care/)
A single two year term doesn't make a Congressman eligible for government subsidized insurance.
2
Crafty in Montana: Your comment about your health care costs is certainly accurate and duplicated by a lot of people.
In the interest of accuracy though, your comment about a "congressman can serve one two year term and have benefits for life" is not accurate. A Representative serving only 1 2-year term doesn't receive a pension nor free health care benefits, and all Senators and Representatives retiring with health care benefits pay a premium, albeit subsidized up to 75% by the terms of their pension.
1
I'll tell you who doesn't see much of that $3000 lift to the hospital - the crew on the ambulance. EMTs have very tough training - very few who start end up finishing. And you have student debt. To make it to paramedic you've got more intensive training and more student debt. You are doing one of the hardest jobs in the medical care sector for less than $40k a year on average.
Care providers at all levels are not making bank in American healthcare. The insurance companies are.
Anthem turned a profit of $1 billion in the first quarter of 2017.
Read that again.
We are trapped between a rock and a hard place. We have a free-market economy here, and very powerful lobbyists for very rich corporate interests. But we absolutely need to regulate the cost of healthcare, which would be in direct opposition to shareholder interests.
125
I was an EMT for several years. I even progressed toward becoming a paramedic. It is not that tough. It's minimal training to teach responding public safety personnel how to avoid making an injured person worse by their efforts and basic first aid. Basic EMT consists of about 200 hours of training, total, 100 hours of that is classroom instruction, which takes 3-4 months. Paramedic training is more hours where they get to do stuff, like stick needles and tubes into people and play doctor, without the extensive university level preparation in science to allow them to understand what they are doing. Ultimately they are mostly firemen and cops who are taught by other firemen and cops and they hang out with firemen and cops.
If they assumed a lot of debt to get trained they were suckered. It's just as well there is a high failure rate, most of them don't belong in the profession, which is really just a job. The tough part is hauling 350-400 pound obese people down a flight of stairs and have the patient grab the handrail. It's easy to get crippled in that job.
4
Why be an EMT? In Los Angeles I found out that part time employees in the Department of Recreation make $17.50 and hour (and can earn benefits) after a certain probation period. That is right, $17.50 an hour pumping up basketballs.
5
It's true that EMTs are surprising low paid considering the importance of their jobs. The NYT had an article last year about private equity firms taking over all ambulance services in many rural areas. There are of course pension funds enlisting the services of these same PE firms in search of higher portfolio returns. We have met the enemy...
2
Start taking away politicians Health Care benefits, paid for by the taxpayers, and see how fast this travesty is changed.
134
Or at the very least make them ‘partake’ in the health care landscape they have crafted... I think it’s ridiculous that they make so much money (and kickbacks during and after their career) and get a ‘cadillac’ plan. But make decisions so that those who are just scraping by have to decide to eat or keep their health. SHAMEFUL (but as this president is aptly showing all politicians (on both sides) don’t seem to have the ability to be shamed)
10
The ballot box as a solution to our problems simply doesn't work, hasn't for decades. A good argument could be made that the last time our legislature did a good thing was the Clean Air and Clean Water Acts. 1972-ish.
Real political change is needed. An end to the two party system. A different way of voting. An end to the childish red/blue, liberal/conservative rhetoric. An end to political "contributions" of any sort.
Mostly, we need a way to make changes happen despite the incompetence of the political class.
37
One of my Mother's memories is checking out of the hospital after child birth watching my Dad paying the bill and wondering where on earth he got the money. I am a baby boomer, so we sure have not made much progress on healthcare.
Just horrible that in the US an injured women would be in agony and more worried about the bill than treatment.
15
Although I agree with the other comments here about our horrendous healthcare system, I am struck by this woman's intelligence and her astute financial planning, even when her leg has nearly been ripped clean off.
I would have done the same thing unless death was imminent.
We shouldn't have to do that. In our worst moments, bleeding out, gravely injured, having a heart attack, we should not have to lay there and think, "Am I dying? No. Am I REALLY dying? Am I SURE? If not, if there's a CHANCE I won't die if I can just get a taxi to the hospital, I'll take a taxi! I can't afford the ambulance!"
We are making those kinds of calculations, and we shouldn't have to. It's appalling. Europeans, Australians, Canadians, the Japanese, they don't worry like htis.
We cannot expect Trump, who has health insurance, and his low IQ'd comrades to do anything. They and their rich friends are fine, so all is well.
Every day, it's a new heartache in this country.
Every. Single. Day.
To the woman: You are very brave. I hope you heal quickly, I truly do. And I hope you were able to go to urgent care, or your regular doctor, because the ER bill will be enormous because hospitals like to gouge you when you are down. Good luck to you.
238
Your country is sad, really sad.
36
It's much worse than that; our entire corporate owned government is genuinely evil, capitalizing on misfortune not only here in the United States, but throughout the planet.
Don’t blame the messenger (hospital), blame the message (our healthcare system). Believe it or not, most community hospitals are barely able to be in the black as they are charging higher prices to those with insurance to offset the free care or nominal payment care provided to those without insurance. Welcome to the hidden perverseness of current health care system. We need single payer for all where we all know what we have to pay up front and what we are going to get for it.
1
This story brought to you by the Republican Party.
If you're hurt or ill, just go away and get better or die on your own if you don't have the money to pay the Health Care Extortion Industry.
62
The Democrats are just as responsible for the American healthcare fiasco as the Republicans. Both have been bought off and co-opted by the deep pockets of the American healthcare industry.
Barak Obama allowed the insurance industry to write the Affordable Care Act (ACA) which did so to ensure its own profitability, not to ensure availability of affordable healthcare to all Americans. The ACA based upon unsound assumptions and wishful thinking; was poorly designed; and is now collapsing in slow motion without Republican help.
Other countries have figured out to economically provide universal healthcare to their citizens. Some programs are single payer government run (e.g. the UK); some are single payer privately run (e.g. Canada); some are insurance managed privately run (e.g. Germany); still others use some combination of all of the above. What they all have in common is that the government sets the prices of goods and services. As long as this is done, all of the above systems can be made to work.
But this interferes with healthcare free markets!! There are no free markets in healthcare. When you need healthcare, you don’t have time to shop shop around. Even if you did have time, pricing is opaque, comparing outcomes and results is difficult, time consuming and confusing and it is in the in the interest of the healthcare industry to keep it that way. That is why it will fight ferociously to keep the government from settling prices.
Republican. Democrat. Doesn’t matter.
8
Ha ha! When I needed a PT, I put together a "request for proposals" to send to various providers, hoping to avoid the problem of having to switch providers down the road because the treatment was ineffective. I asked about similar cases that were treated and basic philosophy of causes and treatment plans, but I didn't receive any replies. Shouldn't I be able to get quotes like any other service provider?
Sadly, the people I talk with who most need affordable medical care because they have terrible health plans or none at all are the ones who start screaming OMG socialism! if you suggest a national health care system. Also in the mix are the so-called right-to-lifers who vote for Republicans because they only care about getting a fetus born and not a wit about health care for children and families...or don't see the connection between a living wage, health care, stability, and children thriving or babies that are wanted. Against such ignorance, I don't know how a sensible system can ever prevail.
143
" the ones who start screaming OMG socialism! if you suggest a national health care system."
Ask them if they'll decline Medicare coverage when they hit 65!
16
When my mother used to complain about how social security and medicare were bankrupting America, I'd remind her she could refuse her benefits and save the country. That always stopped the conversation. However, because she listened to conservative talk radio, the issue came up at least once a month for years. Rinse and repeat.
3
Here in New York I have several family and friends who work for the government and as such have high-quality taxpayer-funded health insurance. One acquaintance had her liposuction covered, and my sister-in-law is undergoing her second round of IVF. Meanwhile, my husband and I who have very expensive insurance and pay a lot of taxes can't even get a free physical.
I notice that people who have good healthcare think a single-payer system or Universal Health Care is socialism. I work in disability law. I see how quickly employer's cut off people's Insurance once they're sick and can no longer work. Once people can no longer afford medical care at the time they need it most, it's amazing how quickly they change their views on socialized medicine.
4
The simple truth is that American politicians act as though medical profits for corporations and practitioners are more important than medical care for all citizens. No other advanced nation follows this policy. Americans should be ashamed of themselves as supporters of greed before better health--and also simply stupid at great expense to themselves! The fact remains that having spent much more than any other advanced nation, Americans die at younger ages!
Andrew Biemiller
37
GOP Healthcare : Pay up, or DIE.
Period.
39
...or preferably, "Pay up, then die."
13
Or sell health plans which they can't even call "health insurance" like Iowa does which cover nothing!
8
Quietly - preferably.
The problem is not "exacerbated by gridlock in Washington". That implies some intractable disagreement on deciding on solutions.
But only one side of the aisle wants to find solutions.
33
It's been my feeling that those that speak out the loudest against insuring everyone are those that never had to worry about where their coverage came from in the first place. It's just too simple for a white collar worker or union member to say they are not in favor of ACA simply because their experience is that they aren't worried about coverage, since their employer supplies it. A couple of years ago the airwaves were saturated with stories of Americans who had the same attitude but found themselves on the wrong side of the unemployment window. I was amazed (well, maybe not) at just how quickly they changed their tune and supported ACA once they realized that they qualified for a plan that cost them next to nothing.
As far as healthcare costs are concerned and why we have the dubious honor have having the highest cost system in the world, I strike that one up to the good 'ol American profit motive.
31
The American Healthcare System is a patchwork of feudal fiefdoms (insurance companies, hospitals, HMOs, public, private, and non-profit entities) whose main goal is to make money. Healthcare is secondary. These entities are so wealthy and powerful that they are able to buy political influence and circumvent market forces. The workforce involved in the financial aspect of healthcare (billing, insurance, etc.) is as large as the workforce that provides and directly supports healthcare (physicians, nurses, technicians, assistants, etc). Think about how inefficient and wasteful that is.
For those of you who believe in healthcare markets, consider this: There is a persistent national shortage of about 175 basic but critical drugs such as morphine, IV fluids, commonly used antibiotics (e.g. cefazolin, cefepime), drugs used to control dangerous heart rhythms (amiodarone), drugs for Parkinson’s Disease, et, etc, etc. Sometimes a drug manufacturer will increase a price by 500%-1000% (e.g EpiPen) just because they can. If free markets truly existed in healthcare, shortages and price gouging like this would not happen.
Other developed countries have figured out how to provide high quality healthcare to ALL their citizens at a reasonable price. This *requires* that the government set prices for healthcare goods and services. Unless this happens, prices will remain opaque, markets will never work, greed will prevail, and Americans will not get the healthcare they need and deserve.
249
Yes, indeed. Meanwhile "113 heads of 70 of the largest U.S. health care companies in the last seven years have... cumulatively earned $9.8 billion since the ACA was first enacted."
https://www.npr.org/sections/health-shots/2017/07/26/539518682/as-cost-o...
3
I have a $7000 deductible. I don't go to the doctor anymore. A trip to the emergency room is totally out of the question. I'll call 911 if I think I'm dying. That's what it will take.
Most physicians now practice what is called "protocol medicine". That is when any person presents a certain set of symptoms, a battery of tests are automatically ordered regardless of the history and particulars of the individual. Instead of ordering what are the most likely necessary test(s), everyone is treated the same. It's like some kind of anti-discrimination policy. The play the "rule it out game". Well great, everyone is treated the same. Except those tests come out of my deductible. Forget it. If something doesn't feel right and it doesn't go away or get better as the days pass, I'll go to a doctor. Otherwise, I wont go because if I do, protocol medicine will eat up that deductible as soon as I walk through the front door.
So it's like this. Take two aspirin and call me when you are on Medicare and have decent coverage. I'll schedule any future illnesses or accidents after I turn 65. That is, if the Republicans haven't taken that away by then.
257
They are working on it.
7
As someone posted, we have to be informed:
1) Where is the nearest Urgent Care, what kinds of care do they cover? Tests? Some lab tests can be done separately by a lab and results given to a physician.
2) Is there a Planned Parenthood? They actually do a lot of great basic care.
3) Comparison shop hospitals -- are your doctors in network? And at which hospitals?
4) Which tests are covered? Which are not?
I know a patient's bill of rights is long over due. Sadly these days we need to research our care options and get costs in writing.
1
I'm confused... Can someone clear this up, for me? I thought Massachussetts was the leader in expanding health care coverage for its residents and had established near-universal health care coverage, by now. Is that not the case?
6
She may have had a plan with a high deductible and she was afraid that the ambulance ride would not be covered until she'd met her deductible.
23
We are the leader, but even Massachusetts does not have universal health care
14
Or possibly not a Mass resident
It didn't specify.
2
And this is the supposed famous "Greatest Country in The World." Outclassed by much poorer countries that somehow provide a modicum of universal care, but then those countries don't base every daily action on the net gain or loss of a dollar. 17% of GDP is ridiculous. Yet, so many are simply not, in their minds, going to pay for "those sick people". A pox on them. Justice would see them seriously ill and without care, a taste of their own medicine.
80
What is "better"? .... insurance coverage for an ambulance ride and doctors care for what we used to call a skinned leg, like I had a dozen times playing baseball and riding my bike. The cost $$$ gets dumped on the taxpayers and the other insurance pool participants . Do you think having insurance means free??? Free health insurance for all.... what is wrong with this picture.... it's the millionaire "providers" , corporate ambulance factories and the James Scarelli types who need controls.
2
Go somewhere that has a subway and take a look at the gap between most trains and the platform. I can guarantee you that the result of getting your leg caught in that space is far worse than anything that happened to you playing baseball or riding your bike as a kid. She needed medical attention but could afford it.
17
The story implied that the woman didn't simply "skin" her leg but that the injury was severe and down to the bone.
15
Thanks,
A sad comment on the current state of ....
13
Please Democrats, put healthcare back as a priority mid-term issue. Every American is impacted.
322
The neoliberals won’t support Medicare for All. They say “We can’t. “. Their pockets are lined with money from big insurance and big Pharma.
3
To start, I'm glad the woman sounds like she's okay, and I don't question that this sounds painful or injurious.
But using this as a poster child for health care reform is a bit dubious. The attached article is notably missing important facts involving broken bones, extensive bleeding requiring more than "water bottles" to staunch, and other serious symptoms. It sounds like a massive abrasion couple with a probable sprain and obviously some contusions.
If that was really the extent of the injuries, her request to hold off on the ambulance sounds reasonable. In fact, its one that I myself have made before, with similar logic: there is no need to spend money an ambulance ride when I can wait until my friend or my wife can get me there.
And I understand that's the point of the article. We should have the comfort in knowing easy, cheap, professional medical transportation exists.
But easy and cheap are not synonymous with "ambulance." The training and equipment for paramedics in an ambulance are incredibly expensive. Throw in insurance requirements for common carriers and medical professionals...
What this case does demonstrate is our need for non-emergent, low-care medical transportation. Urgent care clinics have replaced ERs for many common injuries and illnesses, to cheaper and quicker effect. What's to say the same can't be done with ambulances?
Then we also have a cheaper alternative to sell people on during our next push for single-payer...
7
This woman very well may not need advanced care but the point of the article is that the ability to pay should not be the first thought that goes through a sick or injured patient’s mind.
7
Why is it that something as basic as ambulance service is not a public good, ready to respond, and funded by taxes? Why is it paid for when one unfortunately needs the service? I feel the same way about hospitals. I should be paying all along so it will be there when and if I need it. It is a public good, a benefit to all, and we all depend on it. We have created this huge mess of friction to determine who deserves healthcare. What a waste! Why exactly does anyone believe this is a fair, efficient system? (Meanwhile the very wealthy are counting their tax cut bounty... again. I'm glad some folks are happy with the status quo.)
15
You mean Uber or Lyft?
5
This is what the GOP want and push for. This is freedom. Mean while hospital corporations charge what they want. AMA restricts the numbers of doctors and refuses to allow foreign doctors in to practice. We need a single payer system to cut the massive insurance overhead. We need to open up medical schools to more students. we need a clamp on drug pricing.
49
It's not just accidents, My brother had chest pains, and feared he was having a heart attack, on a Friday night and waited till Monday so he could see his family practitioner ($20 copay) rather than the emergency room doctors, who would have given him the tests he needed, but whose 50% copay would surely have added to finishing him off. We don't have a healthcare system if we can't access it for any reason. What we have is a "for profit" system and that ain't healthy.
494
It's not only not healthy—it's a human rights violation. Disgusting.
3
My son was a volunteer firefighting EMT in a rural area of California. He told me that a lot of people fought them when they arrived with an ambulance because they had no insurance and were worried about the cost. For years he organized fundraisers for people's healthcare expenses. After a few years he stopped doing it because it was a very right-wing area where they voted Republican and thought that universal healthcare was a socialist plot. He felt bad about not doing the fundraisers anymore, but he said they could organize their own fundraisers until they woke up and started voting for people who would work for their best interests.
593
Amazing story Carole. I do wonder why individuals vote against what is in their best interest. This fragile medical system is on the fast track to change. It may not be a single payer system, but a push from the aging boomers and population growth will be a big deal, plus the revenue loss from a generous tax plan Our measly Federal tax dollars cannot fund growing health care needs.
4
Amen, Carole. I'm convinced that in dealing with this hard-right movement, sometimes learning the hard way is the only way to learn.
8
Bill Maher was right. Americans are stupid.
7
A free market knows no compassion. What we do not see are millions of poor choosing between medicine and food every day.
The parable of Jesus feeding the crowds with two loaves and fishes says that when little is shared, it will be enough for all. But were greed prevails, many will perish.
68
Free markets may not know much compassion, but probably more than the one we've got, which is nothing remotely approaching a free market. If it were a free market, I would actually know what the heck I'm getting and what I'm going to pay for it! And I wouldn't be paying a third party to mediate every transaction with a provider. That's the biggest lie of all about the American healthcare system- that it's a "free market." Hear that free market idealogues?
2
Good news, in November you have a choice between:
a) Democrats who, through the ACA and continued campaigning have made it clear that they want to get healthcare to as many Americans as possible
b) Republicans who have voted, what, 40 or 50 times to take away your healthcare and are actively sabotaging the ACA to ensure that healthcare is more expensive and harder to obtain.
The party that wants you to have healthcare or the party that wants to take it away from you. You get to choose America
1015
It's not that simple. The Democrats gave us Obamacare, which was literally the right-wing Heritage Foundation plan, which privatized health care and subcontracted it to the insurance companies, with government subsidies to make up for their inefficiency. Paul Krugman has explained this in many colums.
They called it the "Affordable" Care Act for the same reason Fox News calls itself "fair and balanced" -- because it's not affordable. You have to pay $3,000 out of pocket in deductibles before the plan kicks in -- and then you have to pay co-payments, until you reach a maximum of $8,500, in one scenario.
The Democrats -- Obama, Rahm Emanuel, Hillary Clinton -- have always opposed single payer, and favored "free market" solutions provided by their campaign contributions.
The time to vote for Democrats is in the primaries, and you shouldn't vote for a Democrat who doesn't support single payer. That means Democrats like Bernie Sanders and Alexandria Ocasio-Cortez.
1
Indeed, compared to GOP policy, the ACA is better. But even with single payer - never mind the ACA - from ambulances and band aids to x-rays, unless we target the cost side of this equation the with price controls, the resources extorted by monopoly pricing providers will prevail. And that means fewer resources available for every other business - private or public - with a payroll or a moral requirement to ameliorate citizen misery in this highly unequal economy . As detailed in the 'American Healthcare Paradox" US spending is opposite other OECD countries: Too much goes to a lucrative sector healthcare sector.
2
Corporate dems continue to vote against Medicare for all. What then? Both parties are trying to kill us. Or bankrupt us before they kill us. The duopoly that controls out wealthcare system doesn’t want a system that delivers healthcare to the people.
I'm a consumer healthcare advocate.
Our citizens have been raped, robbed and pillaged by our own government.
Who determines what will be covered by insurance? The insurance companies, who design algorithms to improperly deny claims and invent loopholes and conditions our clients who are Doctors can't figure out.
The ambulance? It used to be that communities managed that. Now that most are private, you'll pay more for a 1 mile ride than you would for a month in a five-star hotel. And you'd better hop that they drop you at a hospital in your network with ER doctors that are in your network. Otherwise, you're going to be in fiscal jeopardy.
Then comes the fun of the hospital and doctors "balance billing" (charging you the balance of the inflated pricing they didn't get from your insurance company). It's illegal in theory, but is common practice. When I've caught billing departments fudging their numbers (even the type of treatment that was received), the answer is always "Ooops, computer error". You couldn't take them to court for fraud if you had more money than Midas. (They'd drag it out so long you'd be in the hereafter before it was settled).
I hope and pray my business goes under because it was no longer necessary. I'm 100% behind Medicare for all. It will be the only way to get close to guaranteeing that people of all economic backgrounds can access quality, affordable care.
668
You are being raped, robbed and pillaged not by your own government, but by private corporations in a health system run via a nearly unchecked free market system. There should be managed and set profit limits for companies in markets with unlimited demand. It works in Germany.
The US has laws against war profiteering. The same should be on the books for health care.
6
CHris:
"You are being raped, robbed and pillaged not by your own government, but by private corporations"
In the US, the distinction is academic.
I wasn't aware of the term 'balance billing'. Way back in 96 a friend in Florida (with full insurance) spent a week in hospital and was then sent a bill for $64,000. My friend's wife called the hospital and challenged it, she was immediately (I was there) asked, "how does $4,200 sound?". She agreed and paid that amount which was probably more than they should have but they could afford it.
3
Going by ambulance to an ER is one of the costliest experiences an individual can endure. Even insurance can’t cover the various and exorbitant cost of simple things used by emergency personnel, like gauze, stitching, even a bedpan. I recently had to take a family member to the ER; total bill AFTER insurance deductible was $7,000 +. This was for a fall, but nothing broken.
What astounds me is that Americans, politicians and households like, seem inured to how truly ridiculous this situation is.
64
pain, suffering, and even an agonizing death itself is far better than having "socialized" medicine, a Commie plot to pollute our precious bodily fluids while preventing a small percentage of the population from growing extravagantly wealth on the misery and bad luck of the rest of us.
what do YOU vote for, and why?
18
in about 5 comments down or so, there will be someone who will state that no one has the right to health care, food, water, education, or anything else for that matter.
so no surprise this is the country we will in. I simply give up.
45
You forgot air.
13
A very similar accident happened to my daughter in NYC a few years back. She wound up limping to the nearest hospital, bleeding profusely. At least she was living in a blue state, in which healthcare is accessible and high quality (once you get to the hospital).
i'm feeling some despair at the thought of callous, cynical Republicans having control of all of our federal branches of government. Life expectancy is down by about five years among working class whites in red states, a number of which did not expand Medicaid under the ACA.
I hope the Democrats take control of the legislative branch this November, at least the House, so that we can bring some balance to our federal government.
It is hard to fathom the cruelty of politicians and voters who want to destroy the ACA, repeal our safety net, and overturn Roe v. Wade.
Why do they want to make life short, brutish and nasty for the ordinary American?
209
Why don’t ALL Democrats support Medicare for All?
4
In answer to this last question, simple. The more services you provide, the more you cut into profits. It's the new American motto: of profit, by profit, for profit!
3
US healthcare in a nutshell - to the winner all the spoils.
24
Welcome to Trump's America. Given the Democrats' fecklessness, this will remain Trump's America.
My late father used to say there were three things you should never do in America because only a Rockefeller could afford to do them: get old; get sick; get in trouble with the law. He's been gone nearly 45 years and nothing has changed.
30
This is tragic and it's shameful. But it isn't surprising. I can't be the only American who's just ignoring various ailments because I can't afford the monumental bills.
What a waste of life.
We have a lot to give, we Americans, yet we're reduced to this.
195
Or Americans who keep losing primary care doctors. My primary care doctors keep leaving the group practice and I keep having to call the office and switch to another doctor in the practice.
1
I don't understand why the Times doesn't do an in-depth comparisons of all the healthcare delivery systems in the major countries, distribute it to every major news organization including Faux News. Also give every member of Congress the report and demand a response. The money for the military is always found but the people can wait, hope and continue to suffer and die early!
51
This information should be a regular Dem talking point with insistence the Republicans address the poor standing of the US.
11
I agree! But sadly the Democrats are nowhere to be found these days. When you do hear about Democrats they are usually reacting to the latest baiting by Republicans on identity politics which doesn't resonate with the populace at large. The fall for it every election time and lose. I'm for humane immigration, bathrooms for trans-sexuals, etc. but for most people it's low down on the list of priorities. Let's up the ante om health care reform, education, consumer protection, and living wage jobs. Compare the Democrat versus Republican positions and push to sell the Democratic solutions which I'm sure average American really support.
@Robert Keller - I'd like to see the Times include in the article full disclosure of the amount of the defense spending that is a result of waste, fraud and unnecessary infrastructure.
1
I am a board certified Emergency Physician. In 2012 I was in a head on car accident and my seat belt and air bag saved me. I had no head injury or alcohol/drugs. When I refused the ambulance, the police hand cuffed me to the stretcher. When I refused treatment at the hospital, my wrists and ankles were cuffed to the gurney. The doctor did a superficial exam and ordered 5 CT scans which I refused. He sedated me because I kept refusing but never treated my severe pain, missing my broken wrist.
I got bills for $1500 from the ambulance, $5000 for the CTs and $13000 from the ER. When I threatened mail fraud, the billing nurse stopped calling me. I never saw a doctor for follow up, because I knew most injuries heal themselves.
37
I was charged $33,000 for an air ambulance flight and all I got was lousy fentanyl. Neither were covered by insurance.
9
Healthcare reform has been the number one legislative priority of mine for many years but I am past hope that my countrymen will ever produce a humane healthcare system as many other civilized countries have enjoyed for generations. All I can say is I am sorry for this woman's physical pain and her mental suffering about the cost of the care she needed. That's life in America.
19
Before Barack Obama and the Democrats successfully passed the ACA (Obamacare), health care bills were the number one cause of personal bankruptcy. Trump effectively killed Obamacare (pre-existing condition is back, no individual mandate), it’s now Trumpcare and this woman’s anguish will be echoed by middle-class people around the country.
19
All you rewriters of history who blame Obama for not having a magic wand and not encountering unified opposition, please cut it out.
We had a majority they couldn't overcome for almost 5 months in 2009, between the seating of Al Franken and the illness and death of Kennedy.
Do you think Republicans are going to let go of power for the next 187 days (until Democrats are seated on January 7)? Do you think they respect the minority the way we respect them?
Think again.
134
The sad thing is that it is Republicans who are in the minority, yet they ram their ideological purity down our throats gleefully, laughing while people suffer.
5
Medical care is now essential. As a physician I found patients listened eagerly as I explained how to improve their health: they followed advice and got better. Even the emphysema patient who was very doubtful about pulmonary rehab said: " I didn't think it would work and I only went because you wanted me to. And Now I can walk in the woods again." But the lack of knowledge was rather startling. Lots of medicine is really not terrible complicated. Lots of health promoting concepts are very understandable. We need much better education in our schools: mandated at junior high level before drop outs start and hormones rage. Yes we need universal health care but we also need to take care of ourselves. Prevention is relatively cheap.
Lots of risky behavior is caused by mental illness: prevent it by family planning: a planned baby has a much better chance in life
30
IN February I had an MI. Went to the hospital, was treated with angioplasty and stayed for two nights. 6 weeks later a second stent was installed and I spent one night in the hospital. The bill for both procedures was pegged (apparently by the "chargemaster") at over $100,000. Thankfully I have Medicare.
What about those folks without health insurance? Cruel and unusual punishment for them. Who in their right mind could support any Republican now or ever?
476
Only $100,000, you must live outside the NY metro area. I'm exaggerating but the numbers are mind-boggling.
Single-payer is the only sane approach.
26
Unfortunately, there are a lot of morons who vote against their interest because they can be distracted by shiny objects and scapegoating by Republicans.
16
Here's what it could be: A few years ago, I had a major health crisis that landed me in the hospital for a week. I had multiple x-rays, catscans, and other tests, as well as a procedure to reinflate my lung. I was seen by three specialists and multiple medical students. A few months later, my partner was diagnosed with cancer and had major surgery that also resulted in a hospital stay of several days. Both of us have had years of follow-up care with world-regarded specialists and thankfully are healthy and well.
The out-of-pocket costs for all this? $0.
It doesn't have to be this way. Vote!
7
I saw a very similar situation last year. I was riding my bike home from work and saw the woman in front of me fall. Several other riders stopped to help. Her wrist was bleeding and obviously broken, with her hand dangling at an awful angle. She pleaded with us to not call an ambulance, saying she was a student and couldn't afford it. Then she wrapped her wrist and arm in a sweatshirt and called an Uber to take her to the urgent care instead. It is pure insanity that making sure we can all access basic medical care when we need it is not a priority for us as a nation.
470
That’s Trump’s America. Can’t spend money for health insurance when the wealthy folk get massive tax cuts. Medicare and SS are on the chopping block to pay for those tax cuts.
21
She made the right choice.
No body needs luxury care, but everybody needs good basic care, as in the rest of the western world.
3
And the urgent care probably sent her to the ER because they could not deal with a serious fracture. Which is why we need universal health insurance - not every medical problem can be solved cheaply.
4
There are many of us that must weigh the decision of "Do I see the doctor or buy a prescription I need or eat this week". And yet we can give away billions in tax cuts to the already wealthy and big corporations. We can protect Big Pharma from having to negotiate prices. We can continue to feed the for profit medical system in this country or we can vote for a change in November.
405
MAny decades ago, I read a book-(possibly after riding the Orange Line ), , titled:" The Forever War"by Joe Haldmen about the possibilities of a "war" between two species, all but unknown to each other who must travel at sub light speeds to battle one another. This causes the hyperindustrialization of the Earth's economy in order to ensure it is protected from an "Alien enemy menace" .
The most horrible part of the novel is when the soldiers,now victorious, return from a "battle"(more a skirmish killing aliens who may have been innocent civilians), and are celebated . The earth is wildly different place-it is 70 odd years later-the soldiers are only 1 or 2 years older so-their families are mostly dead or much older. The antihero is considered a old timer-(the only living humans with combat experience are these college grads), his mother, is still alive, but ill.Earth refuses to treat her because she is not considered important to the military, . The vet uses much of the vast wealth of back pay he has to treat her with black market drugs-but it is hopeless. Ironically, decades later, I cared for my mother to her last breath-I couldn't reach her MD, anyway, as the HS dropouts on the phones couldn't understand me.
I might have killed myself had I known what the future held.
Read "Forever War" just to see how bad it can be.
7
No matter what is written in an article or op-ed discussing the cost of healthcare in the USA there is never a mention of the extravagant salaries for doctors.
An average doctor in France earns the equivalent of about $100,000. There isn't one doctor I know who admits to making less than $500,000 a year and several say they earn nearly $1,000,000. Yes, I've read some statistics that indicate the salaries are far less than that, but I wonder why then my acquaintances make more. They aren't social friends, just acquaintances and I've seen how they live and spend so I believe them.
And the hospitals and meds are grossly inflated also.
57
While no doubt US physician salaries are high, most countries provide medical education (with a service requirement) and don't require undergraduate liberal arts education so most physicians abroad are not in a deep financial hole prior to starting practice. And even with physicians the "proceduralists" (surgeons, scopes, and catheters) make much more than the "cognitive specialties" (your family docs, your internists and pediatricians).
That being said, physician salaries probably aren't the main driver of our increasing health care expenditures. It's real estate, it's patients requesting more (unnecessary) testing because patients feel that, "it would be good to know", it's imaging, and all the add-on rules and regulations and hiring of non-clinical staff to make sure all the rules and regulations are attended to, as well as all the high level administrators hired to make sure all the business aspects of medicine are attended to. It's electronic medical record systems.
3
please educate yourself. I know an oncologist, in private practice, in southern California that can't afford to live where his parents lived.
there aren't many doctors who make much more than 100-200K and that's at least what they have in student loans.
7
I don’t know what kind of friends you have, but I venture that they are not internists, endocrinologists, neurologists, rheumatologists, pediatricians or infectious disease specialists.
All of the “ cognitive “ specialists ie people that spend time talking to you in general make far far less than 500,000.
5
People keep asking "How can we afford a single-payer system?". How can you NOT?
Insurers standing between patients and their care have to extract profit as well as the cost of fighting the other insurers to see who is best at preventing treatment.
You just skip those steps with single-payer. That is why single-payer costs LESS and delivers better care.
706
The reality is that, as the article says, the US pays 60 to 100% more per capita for their health care than other nations with universal single-payer healthcare - the US only covers about 90% of the people while the other nations cover everyone. Outcomes are better in those other nations too.
Trump's statements that "everyone's going to be covered", that the healthcare will be cheaper and better were all lies.
November is our first chance to tell him what we think of his mendacity.
6
Fact: single-payer is in financial trouble, all across the world.
https://www.ft.com/content/dfd41b72-785b-11e8-bc55-50daf11b720d
It is government worker unions who are profiting from patients. Just ask SCOTUS.
Insurance companies add no value to the healthcare dollar. We need the For Profit companies out of our healthcare. Now.
8
Because of the high deductibles of most policies today, all health insurance is basically catastrophic insurance now, no matter the premium. A Bronze policy won't even pay for a doctor visit until the deductible is exhausted. Another way to view it is most policies are merely a front for shareholder profit.
346
I always say that Europeans see health care as an inevitable liability that needs to be funded whereas Americans see it as an opportunity to make a profit. Public policy in each place reflects those divergent views.
7
November is coming. I am optimistic both of our political parties are going to change and a responsible health care system will arrive here as it already has in the rest of the developed world.
22
Wow! I wish a had your optimism amidst this stronghold of Trumpism in AZ.
14
And how do you feel about the tooth fairy?
18
There'd have to be a mammoth "Blue Wave" to have any effect here. I live in +30 R country. Hasn't been a Democrat elected to county-wide office in years, and I don't see that changing anytime soon.
We need a base line of emergency, preventative, and maintenance medical care in this country. And we can afford it the same way we can afford an army, or public schools, or clean drinking water, or a thousand other things that go to making a healthy country. Note I said 'baseline', the government doesn't need to pay for cosmetic surgery or liver transplants for alcoholics, etc., that type of thing can be left to the individual to pay.
70
The four horsemen of the American middle-class apocalypse --healthcare, child care, housing, education--will continue to completely undermine any sense of stability and security in this country. The fallout from lack of hope is suicide and addiction. The epitaph for the late, great America has to include something about Pharisaical adherence to trivial morality and complete rejection of compassion and generosity.
695
Caring for neighbors need not be motivated by compassion. It also makes financial sense if you think long-term. The problem is not meanness so much as the need for every investment to pay off immediately. Tax cuts do not pay for themselves, but investing in people eventually does.
That is why we need governments to make choices that pay off only in the long-term. Public health and safety are examples of this; The odds of you needing a fire department or a surgeon in your lifetime are much higher than needing it at any particular moment. Municipal, State, Federal: They just operate at different scales, but taxes for them all make financial sense.
17
the 5th horse is senior care - for aging parents and then for ourselves, if we get to grow old and frail.
6
In Honolulu, the City & Country provides ambulance services for the entire island of Oahu. A recent study found that a significant portion of the ambulance calls were for the homeless who were then checked into the principal public hospital were they stayed. The bills NEVER get paid.
1
And your point is?
21
whats the answer? let them die?
18
Wow it's almost like it would be cheaper to address the root causes of poverty and homelessness.
Groundbreaking.
9
This is another case where Obama and the Democrats had a chance to deliver at least the Public Option or even Medicare for All when he arrived in office with a clear mandate and a super majority in Congress. Instead Obama chose to go with Romney-Care an Insurance and Health Care for Profit giveaway. He did not even use the Bully Pulpit to advocate for better alternatives to Romney-Care. The Democratic Party was then left to fight for Obama-Care as Romney-Care was then renamed. While better than nothing it left out millions of people and left many with high premiums and costs.
If Obama had advocated for Medicare for All he would have been pushed for a third term and the Democrats would have control of Congress now. Yet another reason to get corporate money out of the Democratic Party election process.
27
Not true. In 2009,the public option was not an option. Despite a majority in Congress, the Democrats simply did not have the votes for a public option or Medicare- for-all bill. Obama barely got the votes for what eventually became the ACA.
47
This is wrong.
We did not have a chance. We did advocate for Medicare for All. All this armchair criticism ignores a whole lot of facts.
29
Yes it was if Obama had decided to fight for it. Obama-Care ended up passing, needing a threshold of 50-votes. Health Care is important enough they should of gotten rid of the nuclear option and went back to the normal 50 votes, like the Republicans are doing now for example the Supreme Court.
It's quite simple really. Medicare for All.
763
It's not "really quite simple." Medicare for all is a solution, but not the only one. If it were really simple, we'd be there already.
Medicare requires that people have supplemental insurance or cover 20% of the cost. That could be more than the ambulance for a trip to the ER. And Medicare covers some services more than others. The formulary and drug plan is poor. Navigating supplemental and Medicare Advantage plans is complex and often beyond most people's comfort level. It is a great start, but not a panacea.
Fundamentally single payer can drive cost down, but we have not come to the point at which enough of us are wiling to have a central group determine both the standard of care and what we are willing to pay for. Most of us want top notch care, and most corporations and health systems will be out there lobbying that we get it. So the ambulance will still be too expensive for the system.
I like the idea of universal care, and I like the idea that either the state and federal employee systems or Medicare start as the base. But I don't believe the solution is even close to simple.
3
We currently cover people over 65 years of age via Medicare. Everyone pays in via a 1.45% tax coupled with a 1.45% tax on the employer. If we raised it to 5% for each we could provide basic care for all. Yes, many would want supplemental coverage and they could purchase those plans. For many others, a basic plan would be sufficient (think young people).
The fact that everyone receives basic coverage (including a necessary ambulance ride) via a tax is indeed, quite simple. The rest that you mention is no more complicated than what we have now.
1
Tr, that was voted on in Colorado. Defeated 79% to 21%.
Simple.
I am an American living in Germany and this woman's situation would be impossible here. Healthcare here is affordable, with much better coverage, low or no deductibles and don't bring up the old tired story of waiting times. Shame on the American government!
979
@Robert Keller
Just today an American friend living in Berlin stated she would like to move back to the US but says she would not be able to afford insurance. She is presently going through the invetro process......all covered by the German government. Something that costs tens of thousands of dollars in the US.
12
I live half the year in France and it's the same concept as Germany. Great service at no cost to a citizen and even for me who doesn't have French 'carte vitale' an office visit is 25 euros. I'd love to find a doctor in the States for less $150 for a non-insured visit.
Shame on the Republicans and the current miscreant in the WH.
37
Dual citizen, currently living in Oz. I had to visit a public ER once- out within 4 hours (thankfully!). Total cost $0. I pay a whopping 1.45% Medicare tax so I (and others) can use the public system. I was raised in the States, and one system is clearly superior and more efficient...
15
Obviously she was not informed that we have the most profitable health care system in the world - huge CEO pay and shareholder value!
Americans of all incomes are more than willing to sacrifice a little pain to keep the scheme...er I mean "the BEST SYSTEM "...going.
298
Yep!
https://www.npr.org/sections/health-shots/2017/07/26/539518682/as-cost-o...
1
Anyone who has lived overseas in countries like Australia, New Zealand or France can tell you that the care is excellent, cost is low, and no one ever goes bankrupt from medical costs. Sadly, most Americans can’t have that experience, as my family and I have, and therefore don’t know how bad we have it here.
422
I would add to your list Singapore, which has an inventive combination of for profit and non profit. The government subsidizes both. Health care is excellent. And even for-profit expenses are reasonable, probably 1/10 the cost of similar services here.
But, then again, Singapore wishes to have healthy and happy citizens and avoid unrest. We are headed in the latter direction in this country.
4
I was born here in the USA and lived in Australia with my family for several years, during which my youngest brother was born. The bill that my dad paid to the hospital was Au$8.00...for 3 days of cable TV.
3
Why do we tolerate this situation? I have lived and traveled overseas and have had medical care in many countries, even what we call "third world." Without exception the care has been equal to or superior to anything I have received in the USA---and AFFORDABLE as well. Americans need to grow a brain and think for themselves, not listen to those who have their own interests in mind.
296
Primarily because we are, as a country, addicted to the idea that laissez faire free market should determine availability and pricing. The price falls or rises based on demand, and will rest at whatever the market will bear. Likewise, what is available, is determined by gross profit margin, not need.
So we are aghast that people are rationing basic drugs like insulin (and sometimes dying as a result), and are alarmed when a woman in the middle of an accident is mentally calculating the affordability of calling an ambulance and going to the ER, but this is a natural and "desirable" feature of the market model with which we are besotted.
5
Right on target!
"even in [...] the 3rd world", yes an important point, as commentators in the US often compare this dreadful situation to "other western countries", "other industrialised countries", but the truth is you are very much unique... from Thailand to Cuba, countries simply "don't do that"...
1
This is what happens when you make health care a business. The only American Exceptionalism here is exceptionally stupid, as citizens of every other advanced economy with universal health care tell us every day. And this is why young aspiring politicos who advocate Medicare for all win Democratic primaries. Single payer would lower costs by allowing the government to negotiate prices while eliminating insurance companies and the vast bureaucracy now required to handle medical billing. Not a novel concept; easily done because we already have Medicare for the elderly and it WORKS.
302
Medicare treatment can also involve high deductibles. So the American Medicare, extended to
all, is not a panacea.
1
It may not be a panacea but it's better than what we have now. My husband's Medicare A recently paid a $399,000 hospital bill without asking for a single deductible. And another $150,000 for surgeons, doctors, labs, medications and X-rays only cost $2,000 in deductibles. Anywhere else in the civilized world those bills would have been less than a quarter of what was charged in our country. If you want open-heart surgery, go to India. The surgeons are all U.S.-trained and charge a 10th of what it costs here.
All correct. Except for the "single payer system." England has a single payer system. Germany does not. But not only medical community itself and its pricing, also the insurances, which ARE businesses in Germany, are government regulated. Pricing medical equipment and service is highly dependent on both political and market conditions. The WSJ recently carried an excellent article on manufacture and sale of the most advanced hospital beds in the post-communist Check Republic. The identical high-end hospital beds are sold to German and American hospitals. The price? For USA hospitals the manufacturer charges 10 times what he charges German hospitals. The WSJ reporter asked the manufacturer: What explains the difference? His reply: Because we can get the money in the USA, not in Germany. We have government regulation of other areas in USA life: traffic laws are only one example. Why not also regulate medical equipment, services and drugs in the USA? Doing so would serve those most profound American values, human dignity, right to life, and happiness and liberty. Besides: A healthier population is more productive. I have often wondered why the USA is so dogmatic in this area?
1
Healthcare is insanely expensive and many can't afford healthcare, which should be a human right in a first world country. I have just been told our insurance rate will be rising by 22% in 2019 for 'less' coverage. Where is Trump's "great healthcare plan" that would "cover everybody, be better and cost less"? Republicans have no plan for healthcare and neither does Trump. It's time to let the democrats run the gov't, because Trump and the republicans have been an utter disaster.
204
You think America is a first world country? Ha! Think again.
2
On Obama's watch, as I lost my primary income, my out-of-pocket cost for healthcare rose to nearly 20K a year. Single mother, head of household, I went to the emergency room last year, and paid a 1.5K co-pay. I haven't been to a doctor or hospital since and I have a chronic condition that is treated with pricey drugs I can no longer afford the co-pay and co-insurance, sometimes thousands a month for which my white male doctor gets a spiff every time I fill the tank. As such, I've stopped taking all my rx meds, using only holistic methods, maintaining my remission, with no medical aid or doctor supervision, probably getting worse. And I'm one of the lucky and few who can afford these insane out of pocket costs that are the toxic outflow of Obama care. I have to fly to other states, across the country to even get possible meds that support my condition. The ultimate gender tax on my seventy-nine cents on the dollar. It has to be awful for other poorer women. Do you really have to wonder why women are killing themselves? Better to do it yourself then wait to die because the Obama broke the US health care system and women can't afford to call an ambulance!
Women live in the service of society yet at every turn, we are being assaulted.
24
It wasn't the ACA that broke the U.S. health system, it was the Republican party.
9
Such BS.
Emergency rooms were insanely expensive before Obama, as were medications and doctor visits. And you can't blame Obama for the facts that you lost your job, are a single mother, and have a bad medical condition.
The current profit-based health care system has a 60-year history, and the trajectory of costs existed long before Obama. He attempted to do something about it, and even used a conservative plan, but he could only do so much. Conservatives disowned their own plan, and now are going back to that "pre-Obama golden age" you seem to miss. So don't blame Obama for the inherent greed among doctors, insurers, hospital corporations, ambulance operators, and big pharma.
1
We need to flip the math, so it's more profitable to keep people healthy. Fee for service and profit motivation are literally killing people.
Most people assume that single payer means a government will run the health care system. That is simply not the case, it just means that payments for services are coming from the government. See Japan, Germany and Canada as examples.
Finally the drug companies need to be reigned in. I just paid a 20% copay of $150 for insulin to treat my type 1 diabetes. I could get that for $90 retail (no insurance) in Australia. That is simply absurd.
142
If payment is coming from one source, the government, of course the government will control Health Care. The government will use money to control hospitals, doctors and other medical providers. Medical providers in essence will become employees of the government with none of the benefits. No vacation time, no sick days, no pensions, Etc.
If there is a single-payer system and the money is coming from the government, the government will also dictate what drugs, procedures, excetra it will pay for. This will not benefit patients. For example, a doctor may feel that in his opinion, a certain state-of-the-art drug is the best thing for the patient. If there is a single-payer system, all the government has to do is refuse to pay forward. The doctor and or the patient will be stuck.
I understand your concerns. However, the insurance companies are dictating and denying that coverage currently to needed individuals.
I don't know why Trump's rabid supporters haven't called him & the soul-less GOP out on their failure to ever even propose a semblance of 'better, beautiful' ' healthcare for "everyone" as PROMISED. With that tax cut for the 1%, you can bet we won't get a thing from them now.
Our healthcare system is obviously unsustainable. My glaucoma eyedrops without insurance are $700 a tiny 1 mo. supply! With insurance $148 -- in Mexico $40.
Canadians are horrified at what we pay and that we allow for-profit business to determine who gets medical care.
I'm 57 and have had good health insurance as a former executive and lawyer working for others. Now I have my own small business and have been uninsured for 4 years.
I ride a motorcycle in LA daily for work and will say the same thing as this woman, if need be, because one trip to the hospital will wipe out everything.
Thanks, GOP.
177
You know how the system works, yet your don't insure yourself, you ride around on a bike and then blame the GOP. You do realise that the Affordable Care Act is still law. If it isn't good enough, blame the Democrats who failed to pass comprehensive healthcare when they had big majorities in Washington.
An insider’s view...I’ve worked for the last 10 years as a medical speech pathologist in major metropolitan hospitals. I spend most of my time in the ICU or step down units, mostly seeing patients/families in the worst of life’s crisis - strokes, brain tumors, traumatic brain injury, head/neck cancer, etc.
One of the hardest aspects of my job is the limitations of our “medical system” in providing equitable, needed care and services. I grind my teeth, turning away the administrator with the financial responsibility paperwork to sign, explaining that my patient currently can no longer speak or read to handle such things. Our system pulls out all the stops to save many at the brink at enormous cost (sending many of my patients and families to certain bankruptcy) but often barely patches them up to be discharged to little to no follow-up or rehabilitation. An egregious example was the tragic 38 yr old mom who became a quadruple amputee after an extremely rare infection, only for our rehab team to learn her lack of insurance meant no prosthetics or rehabilitation upon discharge. I have hundreds more stories I could share of those being ground up by the system.
I have learned to put on the blinders and focus on what I can do for my patients/families in the moment. How else to live with the heartbreak this system often provides?
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A quadruple amputee with no rehab or prosthetics: horrible, but believable. Morally, this is unforgivable. We need to step up and voice our outrage as a community.
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Remember Michael Wolff's book "Fire and Fury: Inside the Trump White House"?
For me, its key revelation wasn't the administration infighting or the salacious hints at an affair.
It was a single quote, almost a throwaway line, spoken by Donald J. Trump during a meeting with aides on healthcare:
"Why can't Medicare simply cover everybody?"
Somehow, in the aftermath of that book's publication, I didn't see a single news piece about that quote.
The point is, even the President sees the insanity and inefficiency in this system. It is McConnell, Ryan and the other soulless, spineless, self-interested Republicans in Congress that are keeping Americans sick and poor while amassing great wealth for themselves and their corporate chums.
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"If you can’t take care of your sick in the country, forget it, it’s all over. ... I believe in universal healthcare," Trump told CNN’s Larry King in October 1999.
"I would put forth a comprehensive health care program and fund it with an increase in corporate taxes," Trump told The Advocate in February 2000.
"The Canadian plan also helps Canadians live longer and healthier than America. … We need, as a nation, to reexamine the single-payer plan, as many individual states are doing," Trump writes in his 2000 book The America We Deserve.
*Then he decided to become a conservative in order to win the republican nomination and the presidency.
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So why do Americans put up with the shameful situation of healthcare in the US?
Of course, government- paid health care as in every other first world country would certainly mean higher taxes!
Even though Canadians kick and scream at tax time, we consider universal health care as a right.
Although our health care system is not perfect, health stats in every category are better than in the US.
It's time for Americans to fight for this right, something Canadians did decades ago.
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I'm epileptic. In the past, I'd have a seizure every six months or so. I always dreaded the ambulance ride because of the bill. I know what will happen when I have a seizure: I wake up with a headache, a bitten tongue, and I go to sleep for the rest of the day and try to be more attentive to my medications and my sleep patterns.
An ambulance ride would tack another $1,000 to this - something that I could, in the past, afford, but still money that I would have rather spent elsewhere. In my current state (self-employment), I can't afford it, though as a disabled vet, I'm still able to receive free medical coverage.
The healthcare system's ridiculous, yet another tax on the poor and middle class so that the rich can buy that golden toilet seat they always wanted.
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I am an emergency physician in KY. A few weeks ago my son, who lives in D. C., sent me a text with a photo of his face asking me if he needed stitches for a small laceration to his lower lip. I couldn't really tell by the photo and suggested he go to an urgent care facility. He found no urgent care facility would treat facial lacerations. I told him he would have to go to an ER. As a facetious remark (no pun intended), I told him it might be cheaper AND faster if he just went to the DC airport, caught the next flight to KY and then let me see and treat him here in my kitchen and then he could fly back to DC. He laughed and went to a local ER. About 6 1/2 hours later, he called to report that he had finally gotten care (one stitch!) and after paying his $500 deductible he was back home. Turns out, my remark was just about spot on. Incredible.
We have gotten "used to" the high cost of medical care here in the US. In order to cut down on medical costs, SOMEONE or SOMETHING is going to have to accept getting less than they currently are. Will it be doctors?, nurses?, hospitals?, pharmacy companies?, administrators?, laboratories?, radiology?, insurance companies?, housekeeping?, security guards?. I have yet to see ANYONE broach this question.
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By getting the for-profit insurance companies out of the mix, we could pay a lot less for medical care for all. It works in the 34 industrialized countries (ALL of the industrialized countries except the US). The US pays almost double what other countries pay, while leaving many people without insurance or access to health care.
And the US is ranked #37 or 38 worldwide. We also lead the developed countries in infant and maternal deaths, ranking us down among developing countries.
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You forgot the most important, patients and their expectations and demand!
How much of the total healthcare is spent on the last several weeks/months of one's life? And for what kind of life? We hold that life should be "saved" at all costs. For oncologists, an extra week is a victory. The patients in other countries don't. This one cultural difference can explain a huge portion of the costs in the US v. those of other economies.
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Interested observer, can you provide citations for that? Also, even if other countries do provide heroic medical intervention at the end of life, they certainly do it much cheaper than the US does .
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Never forget that a Tea Party member, those people who gave us Trump and the GOP Congress, did this:
At a Q & A town hall when a GOP Congressman opposed to the ACA was asked if people should be allowed to die at a hospital door for lack of insurance, that person in the audience yelled "Yes! Let him die!"
And never forget Thomas Duncan who was turned away from a private Dallas hospital for lack of insurance and who was then allowed to possibly infect hundreds of people with Ebola. Yes. They let him die.
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Here is a huge joke. You can go abroad and purchase travel insurance for infinitely less than you can get it on the open market in the U.S. In addition, in many countries you will not be charged a penny for a medical emergency on their soil. It is advantageous for people with serious medical conditions to leave the United States in many situations! What kind of commentary is that on our government and our health care system?
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