First pay your utility bill, they will cut off your power, hospitals won't. Next these are representative of the highest costs individuals, not representative. Third charity and go fund me can cover some if not all of these costs. More highly biased reporting to stir up the people.
1
@vulcanalex
"charity and go fund me can cover some if not all of these costs."
Everybody - please read this - in a nutshell it is the Republican healthcare policy.
1
@vulcanalex Charity and Go Fund Me? Am I reading this right?
@vulcanalex Your solution is a GoFundMe campaign? A 2017 investigation found that 70% of GoFundMe campaigns are for medical expenses, and that the average campaign garnered less than $2700. Research published in the American Journal of Medicine reported that medical expenses are the leading cause of bankruptcy in the US - approximately 60% of bankruptcies in 2007, and increasing steadily since. Your suggestion is idiotic, short-sighted and fundamentally unworkable - not to mention that it does nothing to solve the underlying, systemic dysfunctions of the financial part of the health care system in this country.
7
1495 Americans out of 330,000,000. And from this limited case data commenters feel justified to make sweeping (and often nasty) comments about the whole of the USA health-care system, and what a horrid country the USA is. Seriously. This sort of article and comment section is similar to social-media propaganda and negativity as far as I can determine, and it is not helpful to a reasonable social discussion. at. all.
1
@j
It is a statistical sample with enough cases to validate the correlational coefficient to 99%.
Before you make comments like this, which show a lack of knowledge regarding surveys and statistics, try learning about them first. This article presents facts, you call it propaganda. It would seem when you see some article citing a study with a result you do not like, you call it propaganda. The people that do these studies have their facts and methods reviewed by others who are experts in the field before they are published.
So whom should we believe, the people who do these kinds of studies, or you who criticize them? Take a first level graduate course called Research Design then make your criticism based on the method and statistics used.
16
@ This is the root of many American problems. Someone who has no knowledge or understanding of scientific methods (but who probably believes every anecdote the Rump spews) believes that facts are propaganda.
4
We will never be a civilized society until you fix the following problems: healthcare, education and retirement. Replace the vulture-capitalist systems currently in place for those three with government-based programs, like every other civilized country in the world does.
In addition, if you want to be competitive, invest in infrastructure.
In case any of you centrists feel oh-so-smart by asking "oh, how are you going to pay for it?" I don't really care about what you think, because you seem to have supported every other government bankrupting idea like the Iraq war, other wars and an obscene DoD and war budget among other inane ideas. I ask that you folks open and actually try being smart, instead of pretending to be.
296
@FurthBurner I want to hear national-level Democrats talking big-picture ideas like these—now. Otherwise, if we were to take back Congress, we will lose way too much time debating the options.
3
@FurthBurner Re "In case any of you centrists feel oh-so-smart by asking 'oh, how are you going to pay for it?'," there's a simple answer:
With money, just like we pay for it now. The only difference will be the tremendous savings that will accrue from restructuring many redundant, idiosyncratic and wasteful systems into single, comprehensive systems backed by the power of Uncle Sam. If that doesn't work, tell them that the savings will provide additional funds for their beloved wars and other inane ideas.
4
@FurthBurner
We pay for it thru increased human misery, premature death, and financial destruction before you go. After all you cant take it with you, so might as well hand it over now.
Its part of corporate americas strategy to socialize losses and privatize gains, a strategy that turned much of YOUR money into THEIR money during the great recession.
2
The men and women in health insurance companies need to understand that they are at a crossroads. If they continue to stand in the way of care, hiring lobbyists to protect their own interests over the interests of Americans - they will be laid off in a government takeover of their business as we go to Single Payer.
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Pharmaceutical companies and healthcare providers, too. Pharmaceutical company employees need to seek therapy for their greed. The people who bill for providers need to learn some honesty. If they don’t, they, too, will find themselves jobless in a Single
payer system.
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Believe it or not, I am not a huge proponent of Single Payer on principle, but I’ve dealt with the realities of our healthcare system. Just Monday I found myself in a blood draw with a girl who told me it wasn’t covered by my insurance but couldn’t tell me what the tests would cost out of pocket. Before that my doctor had written a prescription only for my insurance to decide - after a two week wait - not to cover it. And none of that comes close to the time I went back and forth with a provider for 7 (seven) months just trying to get a straight answer on what a procedure would cost out of pocket.
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I really want a hybrid system. All Americans should have basic government coverage run by Medicare. We should be able to buy more coverage as we want. But this only works if the people in insurance companies, pharmaceuticals, and the billing end of providers reform themselves.
According to a 2009 study, 45,000 sure each year due to lack of health insurance. This started in the 1970's when Wall Street decided that getting sick or injured was a hot profit item. Time to take Wall St. out of health care.
No insurance company covers the $1500.00, 3-mile ambulance rides in Fort Worth, Texas.
ER doctors cost nearly 100 times what a visit to my own doctor. These people consider patients an exciting opportunity to do tests that have nothing to do with stabilizing your condition. For that reason, I'm going to wear a sign around my neck that says:
"You do not have permission to try to figure out what my illness is. Do not do ANY tests unrelated to stabilizing my condition. Just get me temporarily patched up and throw me out; or bury me."
I, for one, do not plan on taking any extreme measures should I fall ill. I am in my sixties and there will be no expensive operations or medications. I will not beggar my family with hospital bills and medication costs for what might only make my life a few years longer. I will not inflict a long, slow decline on my loved ones. That strikes me as the height of selfishness. The quality of my life is what is important, not the length of it.
We have been taught that life must be maintained at all cost. This ethic has fueled an elder care industry that warehouses the elderly at a huge cost and profit. It is fueled by the pharmaceutical industry which makes enormous profits on the backs of the sick. It is fueled by fear of death taught in most religions.
Who wants to live forever?
3
A "gatekeeper" physician working for Kaiser Permanente denied my husband, who had had two heart bypass surgeries, a referral to a cardiologist back in 1997. He died of a heart attack two weeks later. In 21 years, NOTHING has gotten better. The people who defend and sustain this country's unholy for-profit medical-industrial complex deserve to watch their loved ones die terrible deaths.
4
ObamaCare hasn’t made this much worse because of the latitude insurance companies were given to increase copays and deductibles. At my job, a large Midwestern academic health system which is self insuring, my deductible went from $0 to $2000 in 5 years. The amount of uncollectible debt has substantially increased as patients are unable to pay ever rising out of pocket costs. Most affected are the middle and lower middle class - poor people and the working poor are shielded from this by Medicaid expansions and other program she (depending on the state - my state aggressively covers these groups of patients). Bankruptcies with medical debts have increased, not decreased. The disruption of the insurance markets and changes in the traditional safety net haven’t been a positive and have cost trillions of dollar to implement and subsidize. The give aways to insurance companies have made them and their investors wealthy. It’s a disaster and desperately needs revision.
@Me
Has made this worse - I hate autocomplete!
@Me
We humans should not try to alter that which only The Almighty Market should decide.
#1 - Ban sale of tobacco products.
#2 - Medicare for all adults(leave CHIP alone).
#3 - All the employees shift from Artha, Cigna, United, etc to Medicare/Medicaid jobs to capitalize on their skill set.
Simple - the only barrier is our congressmen/women and K-Steet.
We are an embarrassment plain and simple.
7
Because of my job, I have near gold standard health insurance. I still worry. I'm still afraid. For myself and for family members who don't have what I have.
5
@sjs
If I need any healthy organs for a transplant, can I come see you?
Even in 1993 I remember joking about this. That was a quarter-century ago, and every attempt to improve our country has been blocked by the rich.
The rich. I want their organs...in me.
1
Khurram Nasir, an associate professor of medicine at Yale, has ...he realized many of his cardiac patients were struggling to pay for care and making tough choices like skipping pills or cutting back on food.
“When I started realizing this, I took it upon myself as a responsibility to talk to my patients about these issues,” he said. “It was very hard for patients to bring this topic to our attention.”
Dr. Nasir sounds like a great physician. Yes, of course financial pressures have a strong negative impact on those who are sick. This is something that must be very difficult for caring doctors to be aware of. Just to have the issue acknowledged by one's physician is truly of help.
Dr. Nasir
2
What is the difference between the guy who says:”How much is it worth to you for me not to break your knees?” And the the guy who says: “How much is it worth to you for me to fix your broken knees?” They both have the same business model: extortion. Anyone who believes the unfettered free market is the answer to the high cost of health care should reflect on Rousseau: “It is by dint of seeing death and suffering that priests and doctors become pitiless.”
5
It's a relatively small population of people under the age of eligibility for Medicare and with complex expensive health care needs that traditional insurance does not cover. They could be dealt with by a slight expansion in Obamacare. We certainly don't need a wholesale overhaul of this country's health care system like Medicare for All.
This article, if anything, understates the brutal reality of anyone who becomes chronically ill in America. I was disabled with a progressive, degenerative, incurable disease in my early 40s. At that time I was well educated and employed a in professional position with a six figure salary, excellent health insurance, disability insurance and substantial assets. Someone who was presumably in a better position then most people to deal with this setback. Initially, I was able to avoid to mitigate, the effect of my illness on my life. However as time passed. I went through hundreds of thousands of dollars, litigation with my disability insurance carrier and ended up living with relatives until I was able to structure a new life for myself. Not counting the effect of my illness along the the loss of my lifestyle, my profession and expected future income. This is the brutal reality to becoming sick and disabled in America. And I was one of the "lucky" ones.
10
I have never understood why spouses and family members are expected to become caregivers. My father was chronically ill and my mother, a homemaker, was not, so that system worked for them. But it didn’t work so well after his death when she became ill. I had the financial and job security to spend some time on her care, but it cost me a promotion and I lived in a different state, with my husband and school age children. Visiting nurses cost less than hospital care but it’s nearly impossible to use Medicare or employer health insurance to pay for it. Expecting every patient to have a family member with the wherewithal to provide unpaid regular care is absurd, but that’s how the system works.
9
Interesting read. In my experience, the whole point of health insurance is to make sure that I receive the best care without worrying about whether I can afford the Doctor, or the test, or the hospitalization, or the physical and occupational therapy. I am alive because of the miracles of modern medicine. I am also bankrupt from the costs of saving my life -- disabled at the apex of my career. The New York Health Act is a splendid piece of legislation, vetted by the centric Rand Corporation and health care experts, and provides affordable, universal, cost savings, and cost effective for every New Yorker. So that people can rest assured that they will receive the care they need, without financial ruin. Get Smart. NYHCampaign.org Do the right thing and Vote
7
Margot Sanger-Katz is wrong to say:
"The whole point of health insurance is protection from financial ruin in case of catastrophic, costly health problems."
No, no, no. The point of health insurance is to make sure you can get the care you need without worrying about it's affordability.
There are a few ways to avoid financial ruin including not getting necessary treatment. Cynical politicians who tell people that they shouldn't be "forced" to buy health insurance if they think they have better things to do with their money are suggesting exactly that. There is only one way to for most Americans to get the healthcare they need without worrying about it's affordability. And that is to have it subsidized by healthier and wealthier people.
6
October 20, 2018
The New York Times
To the Editor,
Re “1,495 Americans Describe the Financial Reality of Being Really Sick” (The Upshot, October 17):
The financial effects of ‘being sick’ are more than financial.
The emotional stress involved and the hardships suffered by having to scrimp on personal needs like care repairs, clothes, and food—just to name a few—are things that most individuals and families are too embarrassed to mention.
Medicare for all—contrary to what its opponents say—and even though it won’t be without problems—is probably the best way to combat this problem.
Being over-powered by medical bills is a financial reality that no one in the richest country in the world—with concern for the common good— should ever have to face.
Edward Volpintesta MD
11
I’m a disabled 9/11 WTC attack survivor. I am in the WTC Health Program. I am certified through NIOSH as having WTC-related chronic rhinosinusitis, COPD, PTSD, GERD, and sleep apnea.
Two years ago, I developed pleurisy from a severe sinus infection and had to go to the ER. The WTC Health Program would not cover the cost of the ER visit, even though I am certified for WTC-related chronic rhinosinusitis and COPD. So, even though the pleurisy was caused by exacerbation of two certified conditions, I had to pay out of pocket. I asked the case manager at WTC Health what would happen to a first responder who had end-stage lung cancer who developed pneumonia; would they not pay to treat the pneumonia? Exactly right, they would not; it is not a certifiable condition.
This is the health care given to American “heroes”. The average working man or woman gets even less. We have the best doctors and equipment on earth—for the wealthy. For ordinary people, not so much. Shameful.
13
@BlueMountainMan
I sorry, it can be challenging to properly respond to comments when one can’t read the original whilst replying.
I re-read your comment & see you described developing pleurisy from a severe sinus infection (associated with chronic rhino-sinusitis) as well as from a COPD exacerbation.
Perhaps these two lead to a pneumonia that lead to pleurisy.
It’s incredibly awful that the WTC program won’t cover the consequences of the primary diseases they certify. I really don’t understand it, actually. You folks were there on ground zero. You’re our heroes & deserve far better.
Like you mentioned......Lung CA can lead to pneumonia (PNA) in various ways especially if tumor(s) block off distal airways permitting micro-organisms to more effectively grow there. Treatments for lung CA can lead to immunosuppression which increases PNA risk, etc.
This seems like a bad policy to me.
I also re-read that you are disabled so you should hopefully qualify for disability Medicare. I admit I’m not that knowledgeable, particularly re: disability Medicare, especially re: deductibles that might put the ER visit totally out of pocket.
Sorry, I received ZERO education re: insurance etc. Medical folk need to be aware of patients’ general financial situations to be mindful about affordability but hospitals etc must provide advisors to help in more depth as care providers can’t do it alone.
Thanks again, prayers & peace to you.
I’m sorry, but I don’t completely understand your situation. I’m not unsympathetic, just a bit lost.
The program you are describing does not sound like actual health insurance.
It sounds like it only pays for conditions that are decided to be completely secondary to WTC injuries/illnesses.
If you had to pay fully out of pocket for an ER visit for a condition not covered by this WTC program, then it sounds as if you either have no true insurance coverage or haven’t yet met your deductible for your insurance.
If you do not have any true health insurance, I do not quite understand that. It seems from all your health issues you would likely be disabled & qualify for Medicare. If not, are there no other choices, especially in NY? I thought they took the Medicaid expansion that was an option with the ACA.
Its a bit tough. I wasn’t aware that many with chronic rhinosinusitis develop pleurisy from it & proving that might be tough; I’ll have to look it up.
Im also not sure how WTC exposures, etc. lead to GERD per se in the absence of another WTC-associated illness/injury (eg. to the chest cavity/diaphragm, etc.) that itself can cause true GERD. Perhaps severe (especially bibasilar) COPD can cause GERD.
I wish I knew more. Next time, please include info about other insurance, or why there are no insurance options for you. Also, a link to a formal WTC illness guidelines/qualification would be very helpful. I’m very ignorant & feel I was potentially insulting. Thank you.
"the poor get poorer"
the poor have the best deal, particularly in ny state. they pay nothing.
after exhausting medicare the married elderly with some assets have to get medicaid divorces in order to stop the gov't from pauperizing (stealing) their last dime. call it a 100% tax rate courtesy of our government. as usual the middle class play the fools for both the rich and poor.
4
I am chronically ill. As a result (among other reasons), my feckless husband abandoned me two years ago and convinced my children that I am "to blame," despite his repeated affairs, secret drinking, and decades of Dark Triad behavior. Because our marriage "only" overlapped his active duty military career for 18.5 years instead of the required 20 years (though we were married 25+ years) I will lose Tricare military medical coverage, which is the Cadillac of coverage options in the US: low premiums, no limits of insurance, covers almost everything, etc.
I am absolutely terrified.
While a divorce court will likely require him to provide insurance for me, I don't image he has any idea at all what the costs will be. The deductibles, copays, and non-covered items will very likely beggar me! I don't have savings *to begin with* having been left with nearly nothing after an adult life of sacrificing my career to promote his, only to find myself discarded just as his took off.
6
I was a single-payer activist for a decade, after for-profit health insurance killed my late husband. Finally I realized that the rot was much more comprehensive than health care alone, and that reform had to be much more fundamental.
The only thing that will solve this problem is HJR-48, the "We the People Amendment" to the Constitution that will restrict constitutional rights to human persons only, and end the doctrine of money as speech. It already has a total of 66 co-sponsors in the U.S. House -- get your U.S. Senator to introduce companion legislation in the Senate, and if your Congress critter hasn't yet co-sponsored, make sure that he or she does so.
4
The fact is, insurance companies thrive when widgets are insured not people. Take the example of cars. Their will likely be some lemons in any production mode and here will likely be some victims of lousy drivers. These facts are predictable and can fit into a nice mathematical order from which rates can be devised. Some cars are so damaged they are written off as expendable.
If we treat the healthcare and health insurance the same as driving and cars why should we expect any different?
I'm a lemon. I had a brain tumor and radiation treatment (1984) only to relapse later with cancer all over my body. Upon reaching 18 I was told by health insurer after health insurer I could not receive coverage because I had a pre-existing condition - my cancer. Forget the fact I'd been cancer free for 5 years; forget the fact that up until the ACA I'd been cancer free for 25 years. I could only get heath insurance through an employer that offered it. I could not choose to be an artist, an entrepreneur or occupation needing individual health insurance.
The ototoxic nature of the chemotherapy dugs began to take their toll on my body as I aged. I became deaf. I had a stroke. I have had to spend thousands to take care of what cancer and the ensuing treatment did to my body. I'd apologize for getting cancer if that would lower some of the costs.
Before the current model of healthcare I was a write-off. With the ACA at least I'm now just a lemon.
We need an alternative for humans!
12
These days, most American citizens who are fortunate enough to have health insurance, spend (on average) approximately 1/3rd of their earnings for this "service". The only people who can truly afford it make much more money than the "average citizen". After almost 35 years of having healthcare insurance, I lost it in 2015. I am not alone; almost 20% of the people in this country don't have any health insurance. They simply cannot afford it. I sure can't, not anymore. It is a woefully rigged system which guarantees the rich to not only have the best healthcare insurance coverage, they make money by owning both the insurance companies and the providers of healthcare: hospitals, pharmacies, and most of all, the drug companies (aka "Big Pharma"). It is a win-win situation for the wealthy. The rich get richer, and the poor get poorer. Each year, the cost of coverage increases by double digits, and the benefits shrink. I know this extremely well because I co-founded a business from the ground up ("bootstrapped") in 1991 with a $10,000, 2 year loan, which my father had to co-sign. We built it into a business which grossed $2.5 to $3 million a year, and had up to 25 employees at the same time. We also had an excellent health insurance policy. In addition to having my own policy, I administered it for our company. This is how I know exactly how much they cost; how much annual increases are; and how much the benefits dwindle simultaneously. Each year we paid more for less benefits.
8
If "the whole point of health insurance is protection from financial ruin in case of catastrophic, costly health problems" than most people don't need it. They are already poor. Half the population shares about 1% of U.S. wealth.
Why not free prescription medication for all? It would be a good start to make sure that 95% of health issues are serviced. Nurse practitioners could provide inexpensive renewal and adjustments to medication.
Care provided by specialists and hospitals is the real reason health insurance is necessary. It is very expensive at the top of the medical pyramid.
With the government paying for medication, the taxpayers could reap the savings of medicinal advances and cures. Big Pharma needs to put people before profits.
4
This article should have something on the financial assistance policies that all not for profit hospitals/health systems must provide. In my state they are actually quite good. In my county the two major hospital providers have very generous policies. As an example, a family of four with an income in the neighborhood of $80,000/year has their entire out of pocket costs (that's deductibles and co-pays after insurance) completely written off! It applies a sliding scale for income over that amount. And of course if varies based on the number of members in a family. Also, patients are not expected to spend down their assets first; assets are not taken into account which I think is a state law in Washington state. Both of these hospitals are not for profits, one is Catholic and one is secular. Both hospitals provide all patients with notices of their policies and where they can get details on line or paper at their request. NYT, please do an article on these wonderful policies around the country. Your missing a big piece of the story.
7
Any American who doesn't vote for a single payer system is either mentally ill, stupid, or both. I say that as one who grew up in the UK within the National Health System. Everyone, sick or healthy, rich or poor, pays in to the system as soon as they get their first paycheck. And when they get sick (which, being mortal, all humans do at some point), money is not part of the conversation whatsoever.
Don't believe the scare-mongering you hear from people who oppose such a system, folks. (You'll hear them try to scare you with rubbish about waiting lists that people regularly die on, no doctor choice, and how having the benefits of such a system turns people into socialist robots.) Is it a perfect system? Of course not. You can find horror stories about any healthcare system, if you wish. But it is infinitely better than the for-profit, hodge-podge of (non-) care most Americans get.
As someone who now lives in the USA, I am sick of being held hostage by the above-mentioned stupid and/or mentally-ill people. If anyone is a mindless robot, they are, for having believed all the rubbish about the perils of single-payer systems. Pah!
25
@EB
https://www.theguardian.com/society/2017/jul/15/oxygen-patients-dying-un...
Some of the sickest patients that hospitals treat are dying unnecessarily because they receive poor care, blighted by shortages of staff and equipment, a new NHS inquiry has revealed.
A death rate of one in three among inpatients who need emergency help with breathing is already high by international standards, and is getting worse.
1
Bankruptcy due to medical expenses is not the worst alternative. Certainly it has a lot to do with where one finds themselves ( age, employment, assets etc.). Hit with $176k in medical expenses ,not covered by insurance, and at age 64 I filed bankruptcy. My attorney added my medical expenses plus all other non secured credit debt together and after the on line financial counseling required, I was granted $ 241k in bankruptcy relief. Kept my house, car, pension & one credit card. Never regretted it & feel great.Certainly can't apply for credit until I'm 74, but doubt I would have been applying for much credit between age 64 & 74. People should not worry about the 'stigma' of bankruptcy-it was created for a reason.
6
@Tollgate Valuable perspective: Bankruptcy and healthcare are now plausibly viewed as two sides of the same "not the worst" coin. Congratulations USA.
6
@Tollgate Very glad you were able to file for bankruptcy. And that you have a positive attitude. You also seem to be good at looking at the whole thing in a rational problem solving way.
If we had a system where money were pooled in a way that covered people who are sick and less went for profit, people wouldn't have to resort to this.
3
I could not find out what 3 of the 16 lab tests would cost from Kaiser; 13 cost $276, which put me over my $500 deductible, leaving 30% of remaining 3- but system could not tell Kaiser employee what final 3 cost to know what 30% of that would be. Lab bill was $550; 2x known amount (ie unknown tests >$900).
Also this month (not in April due to letter glitch), IRS asked me to complete an 8962 form to reconcile predicted income with my actual income to check if subsidy given based on estimate was correct for 2017. If it IS off by a certain amount, I will either owe or get an additional refund. I mailed it in yesterday, not actually sure if had completed correctly, so difficult & convoluted was the form/instructions to calculate the numbers to see if fit within allotted estimate zone for subsidy-- & I aced the logic portion of the LSAT exam. I have no idea how the average American required to do this task fares.
How are these connected? Because in 2017 I was dropped from a single payer type system in my state & had to get individual coverage in the marketplace for final 4 month of the year.
No idea if I'll have to repeat the absurdity of an 8962 form every year. I imagine that the bill estimate debacle is standard-- & Kaiser actually strives to be "member" (read: "consumer") oriented.
My entire adult life as a chronically ill "disabled" person has been burdened by trying to get & then navigate our absurd health insurance system. One reason why disability is a job in itself.
13
Its not only folks or loved ones who are in and out of the various hospitals or need multiple surgeries who find themselves or their families in horrible financial woes. Take the time to look at folks and/or family members who are homebound, mobility impaired, suffering from dementia and/or mental illness, etc., to see just how expensive medical or psychiatric care actually is.
Medicaid ought to be available to everyone who is financially encumbered by medical and/or psychiatric expenses. Medicare ought to be universal. Mrs. Clinton tried to procure medical care for all Americans, but she was vilified for her attempts. She did manage to protect children and their parents from the financial impact of special education for the autistic and other required care. Again, the empty heads cried about being 'pro-choice' while turning a blind eye to disabled babies & children.
President Obama got what he could for Americans to reduce the slings and arrows of outrageous fates and fortunes, occasioned by crossing the streets or slipping in a bathtub. Mr. Obama efforts have remained unappreciated while the empty heads, led by a Mitch McConnell mentality in this country scream that they don't need medical care. Repeal Obamacare, the empty heads scream. So I guess when the empty heads slip on that banana peel, we should watch them bleed out & die because we are not 'snow flakes'. America, what is wrong with you? Sickness happens to us all & is expensive for the well & sick as well.
12
Dementia care isn't covered at all. My father, with type 2 diabetes, was entitled to some care, but my mother, who needed it more than he did, got no care at all. It all had to come out of her savings.
3
Ah, but you see, "sickness" is seen as God's judgment on an ill-lived life, pardon the pun. The bargain is that if you live a perfect life and do not sin at all, "God will reward you with a long life, health and prosperity." Take one small step out of line, and you "deserve" to die diseased, broken, poor and alone. That's the harsh, hateful, unforgiving and anti-human legacy of our Puritan roots and everything else springs from this.
1
@Rita Harris I would like to reccommend this 300 times. Spot on.
I've been on Medicare for two years and it has been wonderful. Providing this program for all makes sense. Can't afford it? Maybe take the funds from the military budget including the absurd, never ending war in Afghanistan. What kind of health coverage could the nation have had if we took a pass on the criminal Iraq (and Vietnam) war? Wake up America!
25
It’s too bad that the NYT has too seldom or hardly at all provided an unbiased description of other countries healthcare systems. The US system does not provide universal coverage, a large percentage have substandard coverage, the jargon of deductibles, co-pays, co-insurance, donut holes, Part A, Part, B, Part D add to confusion and apprehension and not to any real value, our outcomes are universally worse, our individual and collective costs are way above the rest of the world, and longevity is decreasing relative to the other industrialized world. Our system is broken and non-sustainable. The core problem is that the medical-industrial complex can bribe politicians of both parties without a shred of conscience and we allow this legal corruption.
21
@Moses www.nytimes.com/2018/03/13/upshot/united-states-health-care-resembles-re...
www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the...
I am truly thankful to live in a country where this is never a problem.
15
Hospitals don't turn critically ill patents away. They treat them and bill them. If the bills don't get paid they go to collections. If the hospital still can't collect the bill will eventually be written off. This inevitably results in higher prices for those who can pay. If we pull several hundred billion dollars out of the healthcare system the cost for those who remain in the system will spiral out of control and only the supper wealthy will have healthcare.
2
Wanna live a long, happy life? Simple, give up your doctors and hospitals, pump iron twice a week, walk your dog(s) 5 times a week, drink three beers an evening, eat sandwiches and inhale cannabis daily, like President George Washington who distilled his own whiskey and grew his own pot. You're welcome.
4
My sister in law was healthy like this and got metastasized lung cancer anyway.
2
@Jim Dwyer and died at age 67
2
@K Flint and the average life expectancy was 50.
As a bankruptcy trustee, I see this all the time. Most Americans are one heart attack away from bankruptcy caused by medical bills and lost income.
29
They talk about the ACA going into a 'death spiral', which is not inevitable at all, but it could happen if certain things are not done. But I think that longer term, if we don't do Medicare for all, that the whole system will go into a death spiral. Some will be tempted to conclude that it is better to just go without insurance and forgo the medical system altogether.
8
The hospitals in my area have a solution.You are 80 years old and have a stroke? You lived a good life and it is your time to go.We will make you comfortable until you pass,
You have esophageal cancer? Hospice would be the best for you because in our experience this cancer is difficult to cure and leads to multiple surgeries with unknown outcomes.
You have diabetic dementia? The trip to the nursing home will only lead to readmissions in a never-ending cycle- better to make you comfortable in hospice until you pass from failure to thrive.
You have an aortic aneurysm? You are 80 years old and this is a very expensive heart surgery to install a graft, we will make you comfortable until you pass.
15
@Rick And what is their solution for a 47-year old with spina bifida?
7
@Rick End-of-life planning would be key, clearly. Unless it is overwhelmed by a FFS financing mechanism that overwhelms and silences it. A situation the USA favors, apparently.
2
@Dfkinjer
Although no longer in their health care suytem but still being treated in France my latest bill: 1 visit to a world renouned specialist, 12 specific blood tests+2 complete genetic tests......total $185.00 one hundred eighty five dollars! On the national heailth program the deal is: one payment/yr. ALl included visit testing and medication. YES America we can do this!
2
Can't afford to see a doctor ? You don't know how lucky you are.
https://well.blogs.nytimes.com/2016/05/03/medical-errors-may-cause-over-...
Medical Errors May Cause Over 250,000 Deaths a Year
If medical error were considered a disease, a new study has found, it would be the third leading cause of death in the United States, behind only heart disease and cancer.
7
The stories Margot Sanger-Katz describes so vividly here are only the tip of the iceberg. As Mitch McConnell prepares to meet the more than trillion dollar budget deficit caused by the Trump tax breaks for the wealthy with cuts to “entitlements” we will see even more disastrous consequences to our nation’s health.
Yet right in the home state of the Times, there is a bill passed overwhelmingly in the Assembly and stalled in the Senate for several years running. It will come up again in the spring. The New York Health Act (A4738, S4840) will provide universal, cost effective, comprehensive care for all twenty million of us at a savings over the monies we are now paying for a broken health care system. It will bring an end to the job lock, job loss, bankruptcies detailed in these stories at a savings over what we are now paying and create 180,000 new jobs in the State. The finances have been vetted by the conservative Rand corporation and found to be workable with long term care as well. Why don’t we talk about solutions that have all the econometrics worked out and that will show the nation how such a system can work?
39
@Barbara Estrin Why don't we talk about solutions? Ask that of the Republican controlled Senate in NY State. They're the ones who are holding up a solution.
3
This story can be even worse the more you know. After spending approximately $20,000/year on insurance premiums and medicines the past 20 years, I have reached age 65 when my disability income stops. I couldn't save because of the high cost of medicines and now have just social security to live on. The drugs I paid large sums for as my share after insurance kept me undetectable and no risk of transmitting hiv all this time. If nothing changes as my money runs out since my 65th birthday this year, I will no longer be able to afford to pay toward these medicines and will be forced to stop treatment. While the hiv industry is busy tryng to force testing on as many people as possible, here they have someone doing well on treatment and unable to pass the disease on because of that. But politics or money causes these hiv workers to concentrate on new case discovery and they are willing to force me to stop the successful hiv treatment I've paid for all these years. They know the risk of that is just as high for the community as it is for myself. The virus will rebound without treatment and my body will become contagious after all these years. There is something very wrong with this health system we pay so much for.
16
@Stephen7144 Will Medicaid D cover those drugs?
1
my husband, who tried Medicare Advantage for a year ended up with thousands of dollars in bills due to " out of network " tests- it took him months to sort it out ( many seniors would have given up and paid up but he fought it tooth and nail ). This shows that even with " secure " health care you can get in financial trouble .
He went back to traditional Medicare ( THIS IS THE BEST OPTION FOR SENIORS ) . Don't be lured in to Medicare Advantage - its a scam
36
@L. Finn-Smith I have experienced lots of "shady" billing practices as well. I would like to see an in depth analysis of traditional medicare vs. Advantage. I am paying more now for medication than I did before I was medicare eligible.
13
@GMP That is by design. For instance, a non medicare consumer can purchase many generic drugs for $4 at several retailers. If you have Part D coverage, federal law requires that medication be billed at FULL retail. That is was Part D is such a mess. If you do qualify for a cheaper drug, best to go to another drug store that does not have your Part D info.
1
The stories Margot Sanger-Katz describes so vividly here are only the tip of the iceberg. As Mitch McConnell prepares to meet the more than trillion dollar budget deficit caused by the Trump tax breaks for the wealthy with cuts to “entitlements,” we will see even more disastrous consequences to our nation’s health.
Yet right in the home state of the Times, there is a bill passed overwhelmingly in the Assembly and stalled in the Senate and will come up again in the spring. The New York Health Act will provide universal, cost effective, comprehensive care for all twenty million of us at a savings over the monies we are now paying for a broken health care system. It will bring an end to the job lock, job loss, bankruptcies detailed in these stories at a savings over what we are now paying and create 180,000 new jobs in the State. The finances have been vetted by the conservative Rand corporation and found to be workable with long term care as well. Why don’t we talk about solutions that have all the econometrics worked out and that will show the nation how such a system can work?
6
I am 10 months away from qualifying for Medicare (yes, I'm counting).
14
@Anne...I was in the same place...counting down the months til I turned 65. My Cobra had ended one year earlier and I HAD to have a very expensive drug so I couldn’t go without insurance. I applied for and was approved for Medicaid,which literally saved me until a few months ago when my Medicare kicked in. Be aware tho...only Part A is free. You will have $134 taken from your SS benefits if you are collecting it,for your Part B. This part covers dr visits,tests,etc.Get a supplement that will pick up that 20% and deductible that Medicare will not pay! And don’t be fooled by Medicare Advantage plans! You will be confused and frustrated by all the “rules” and fine print! Most people rush back to traditional Medicare after dealing w Advantage plans! C’mon 65! Best wishes!
6
I was a CPA for 15 years and always am shocked that the doctors never can or will not tell you how much a procedure is going cost. They always say to "ask the front desk". The medical model is a scam and the system is broken.
33
We don’t need health insurance. We need quality, affordable, accessible health care for all. Single payer, universal, Medicare for all
54
@Zane...Make that MEDICAID FOR ALL! Medicare coverage still ends up costing individuals about $300 a month, as only Part A is free. Part A covers hospital costs. You’ll probably want Part B, which covers 80% of allowable charges,leaving 20% unpaid,unless you sign up for and pay for a Medicare Supplement plan. Together these two pay for doctor visits,tests,etc. The cost of my Supplement plan is $142 a month. Then don’t forget you have to have. A plan for prescription coverage! Medicare costs me a bit over $300 a month! Medicaid is a government plan that is free.....so...MEDICAID for everyone!
4
@Debbie
Medicaid is free? Really? No tax dollars needed to provide it?
1
best healthcare system in the world. and if there are any problems with it, a completely free market approach as the Republican Party advocates, would solve them.
1
@jbc Totally false, in every respect. Every other developed country in the world has a better system that produces better outcomes at a lower cost.
16
In 1989 Massachusetts General Hospital paid for their employee’s health insurance by 1992 Employee’s paid half of their health insurance. That is the beginning of the crisis in the USA.
Not the VA does not pay complete dental care.
1
It's funny that all the illnesses mentioned in the article apart from dementia are physical illness.
Imagine the problems the mentally ill have dealing with our current system. Any wonder that our healthcare system for all but the wealthy mentally ill is called prison.
16
@Steve, Mental Illness is the big skeleton in our healthcare closet. Why do you think we have a homeless problem? These young people are diagnosed in adolescence before they have sufficient work credits to qualify for either Medicare or SSD. So they get SSI and Medicaid, two restrictive programs that do not encourage young men and women to try working without penalty. It's disgraceful.
22
@Steve
To top it off, even if you have insurance and can afford treatment, you have to be experiencing a mental breakdown and considered a harm to yourself or other before they bat an eye. A bout of insomnia ignored by the doc, leading into untreated stress and depression to the point of disability and then full on psychotic episode. Self-medication is the stairway to hell.
How many times have you experienced an acute health problem and paid a medical professional for them to say, "Here's a script for some Advil, or oh that test result came back negative, you must not have a UTI, so good luck, etc."
4
Dementia / Alzheimer's are physical illnesses that, like cancer, lead to bodily disability and death - but most of the expenses for them are not covered.
3
@Holly You have hit the nail squarely on the head when you say "Our system creates sick people and then depletes them of every penny to treat their chronic illnesses." Whether chronic or acute, illness makes us vulnerable to the predatory yet commonly accepted practices of the US medical and insurance and pharmaceutical industries. That there are so many people willing to exploit the misfortunes of their fellow citizens is shocking and demoralizing. I wonder how long it will take for American voters to stop the immoral transfer of wealth from the sick and dying to the corporate tyrants and soulless apparatchiks of these so-called healthcare providers. How long?
24
@Maquis3857 Unfortunately, the corporate interests and the wealthy hold all the levers of power. And, they have no intention of giving up their profits and dividends to provide decent, affordable healthcare to the masses.
13
We learned this lesson with ObamaCare:
Americans desperately want the U.S. health care system to change.
But only if everything remains exactly the same.
6
"The whole point of health insurance is protection from financial ruin in case of catastrophic, costly health problems."
No! No! A thousand times no! No wonder America's health care bill is $3.5 trillion and almost twice that of the next advanced democracy. No wonder America's health care outcomes are ranked 37th in the world by the World Health Organization. We think of health insurance as equivalent to fire insurance! Bloody stupid with respect to cost-effective health policy, right? But better health outcomes really are not the goal of Wall Street, right? Timely, appropriate health maintenance and the early detection of illnesses are the bed rock of effective health policy. America will continue to come up short as long as Americans allow financial giants to extort hundreds of billions of dollars in wasteful layers of administration and profits, with Congressional permission, to perform a simple function. The thought of Democrats perpetuating the health insurance rip-off by repackaging Medicare Advantage health plans (which cost we taxpayers an average 18% more than is achieved with publicly-administered Medicare) as a "public option" is abhorrent to me. Everybody in, nobody out! Segmenting the group insurance pool into thousands of smaller groups, as for-profit insurance does, dilutes negotiating leverage. Almost 70% of America's $3.5 trillion health care tab has been paid for by a 3% payroll tax since 1965 and can guarantee health care for all.
12
@Walter Heath If I am not mistaken, Medicare Advantage came along under the Bush administration as a means of bringing the oh-so-efficient private sector onto the Medicare gravy train.
15
And we don’t want national healthcare because... Oh, right because the republicans say it’s bad for us.
35
There is simply no excuse or justification for disastrous healthcare delivery system in the US! None, nada, zip!
30
So, why do people put up with this? Doesn't make any sense.
13
@Steve Hunt Because "corporations are people, my friend" -- recent USA presidential candidate, unsmiling.
See:
Bitter Pill: Why Medical Bills Are Killing Us, S BRILL, TIME MAGAZINE 2013
Steven Brill Feb. 20, 2013
content.time.com/time/magazine/article/0,9171,2136864,00.html
2
Why do we put up with rich people not paying taxes, and being subsidized by poor people? And tax free churches? I'd fight a war against both.
3
@Steve Hunt Vote democratic.
No human being should accept Margot Sanger-Katz's characterization of the premise for having health insurance that is described in the very first sentence of her article. If health insurance is meant to be primarily used to cover catastrophic loss, then America's $3.5 trillion and ever-rising health care costs will continue to be, as Warren Buffet says, "the tapeworm in the gut of the American economy." Sensible health policy covers health maintenance and early detection of illnesses and saves other advanced democracies hundreds of billions of dollars. That's why every advanced democracy either strictly regulates for-profit health insurance or administrates a publicly-financed, not-for-profit health insurance plan similar to what Medicare used to be. It is sheer idiocy to continue subsidizing the vertically-integrated for-profit health-insurance oligopoly that literally cannot exist without government handouts. We in the provinces recognize the New York Times editorial bias towards the status quo and the lip service and posturing of liberals with respect to Medicare for All. We are not fooled. Democrats will continue to suffer electoral losses until they demonstrate greater leadership on this vital issue. Re-packaging the for-profit health insurance rip-off and calling it a "public option" will not cut it.
6
@Walter Heath You're right, but it's a mistake to blame the people's elected representatives. To change things, you need to convince the people, first, and then they will elect representatives who will effect that change
6
Here's something that isn't highlighted in the story, but that you can find out if you click through the link at the very end to access the survey report that's the subject of the story: On page 36 of the report, we learn that the majority of the respondents (57%) had some form of "public" insurance (Medicare, Medicaid, VA, Tricare). Only 21% had (presumably private) insurance through their or their spouse's employer or union; an additional 6% ourchased their own coverage. So, to the extent that people are reporting high amounts of un-covered medical costs, we have to understand that much of that is because plans like Medicare or Medicaid (and not just private insurance) aren't covering everything....
8
When people give me arguments against Universal Health Care I ask them how many people go bankrupt due to medical bills in Canada, UK, France, Japan etc. Of course the answer is no one. One recent report said that almost 650,000 Americans had medical bankruptcies last year.
While people complain about taxes, long lines, poor service the real problem is that our system does not insure millions while condemning even insured people to sudden financial ruin. Thanks for the article.
37
I’m going to get geeky and comment on the methodology of the survey the story is based on. (I followed the link at the very bottom of the story to access a copy of the survey report.) We’re told the survey involved "1,495 adults who either had a serious illness or were caring for someone who did." But we’re not told how those 1,495 adults were initially selected. They (the research team) had to have combed some kind of database of people who had multiple hospitalizations (and visited multiple medical providers) over the past three years-- which one? I’m hoping the story author is monitoring comments here and can provide an answer.
7
Health care should not be a business--except for the medical personnel providing it. Hospitals should not be profit-oriented. Insurance companies should not be allowed to make life-and-death decisions based on how much CEOs and others make. Medicare for all is the answer.
24
Excellent reporting. Once again documents how US health care and insurance is managed not to care for the population, but to profit. Health care costs are random and ever-changing—and anything but transparent. And health insurance is a shell game, constantly tinkering with ways to confuse and shift costs and coverage onto the patients—and those most at risk financially.
16
Our health, mental, physical and otherwise is of no concern to our government or the business community. We are viewed as replaceable identical units to be tossed aside as soon as we malfunction.
I used to have my asthma and allergies monitored on a regular basis. When I was downsized from a good job I couldn't afford that any longer. I still exercise. I still take the generic Zoloft and see the psychiatrist (as little as is ethically possible for her to accept) and pay for it out of my own pocket. I haven't had my eyes checked but hey, I can still see well enough to drive. It's been a year since I went to the dentist but that's fine as long as my teeth aren't falling out of my head.
When it comes to choosing when I'm unemployed and don't have any income coming in, I'll choose eating and having a roof over my head. Even if I were employed I've reached the point where dealing with our fragmented wealth care system is an exercise in frustration. All these narrow networks, co-pays, high deductibles, and other gotchas do is deprive Americans of the ability to receive timely medical care. America has become a country where you don't receive anything you need unless you can pay for it up front or are willing to risk bankruptcy.
21
I am disabled, although we are considered "upper-middle-class" we are at risk for losing our home and I have stopped seeing some of my doctors, or try to space out my appointments more than I should.
I worked in a well paying job for 26 years, and I thought I had a Long Term Disability plan through a major insurer to fall back on. Little did I know insurance companies will do everything in their power to deny legitimate long term disability claims. I have had to take this insurer to court, spending tens of thousands of dollars on an attorney, while this is simply the price of business for insurers.
We await the court's decision. My entire family's future depends on a favorable judgment. And this has only made me sicker.
46
@Chris I hope you have a good attorney.
7
Our family has been hit with one catastrophic illness after another - luck of the draw, or the genetic lottery. That said, when this began my husband and I were both employed and insured. We had the golden parachute of double health insurance. We were solid middle class. Yet we still found ourselves in a huge hole when our son was diagnosed with schizophrenia at age 24 and uninsured. This was just prior to the ACA. But still, we had more resources than most and paid for a lot of care privately. Fast forward 15 years. We are both on SSD probably more from stress than the long-term illnesses we face. We've exhausted our financial resources, house in foreclosure, facing bankruptcy and still have more than most. In addition to medical bill families face increased costs all around for everyday items one might normally save money on like cooking at home. Because really, who is going to bake a low cost lasagna to feed 5 after getting home from the hospital that's 2 hours away? And that young adult didn't have enough work credits for medicare or SSD so he gets SSI and medicaid. He lives at home because the housing situation is humiliating. Families like ours collapse under the pressure. It is really unkind out there and we have failed as a culture. So to "take away" at a time when there still isn't enough can only be considered a deliberate decision to foresake families in distress.
52
*When* are we going to include dental work in this discussion. I have and am spending another small fortune on it. I'm sure I'm not alone.
38
This is a compliment. I will be 70 years old soon (less than a month). I have cancer. I underwent both chemo & radiation at the same time! Medicare and insurance paid for nearly all of this. It cost me more to payoff others than the illness did!
3
I work for a large hospital system and our insurance has changed greatly the last couple of years. It has morphed from a PPO to a very tightly controlled HMO and from there has continually reduced what is covered and how much will be out of pocket.
One of the advantages of working in healthcare was high quality health insurance and it kind of offset the wage differential between the licensed health professions and other carers with similar education. That is gone for most employers in healthcare. What hospitals charge may be going up, but I assure you it is not going to wages or salary for Nurses, Respiratory Therapists, Radiologic Technologists, Lab Technicians, etc. in most of the country.
28
@David Gregory
If you are in Charlotte you'd know that all the money our two major hospital corporations make is going to expand into not only other North Carolina regions but other states. They are buying one medical practice after another as well as other smaller hospitals. It costs a lot of money to build a hospital and staff it. It takes years before it is financially self sustaining and each new hospital is a drain on the other older hospitals.
3
Work full-time as a registered nurse in a local hospital. Subscribe to their top-of-the-line insurance plan. Go to their doctors. Go to their facilities. And yet there are endless co-pays and deductibles that no one bothers to warn you about e.g., $300+ co-pay for a pulmonary function test).
27
I live in Germany. Health insurance premiums are relative to what people earn. They are 15% of the net income, and with employees the employing company pays half.
Denmark has an interesting system. They have a higher VAT and pay the whole health system with that, so no premiums at all. Whichever system you chose, it is based on solidarity. The rich ones pay more, the poor one pay less.
The US problem is solidarity is non-existent, on the contrary it is defamed as socialism. It is a huge offense to ask from the rich to pay the same percentage as the poor. With that attitude you'll never reach a payable system for all, I'm afraid.
69
@Dean I am an expat living in Germany and I get into a rage when I hear about the plight of my fellow US citizens. Medical treatment here is great I even have dental coverage and NO German wants to adopt the US healthcare delivery system. Nein, danke.
22
I still don't understand how the wealthiest country in the history of the world can't supply healthcare as a right rather than a privilege in contrast to all the other industrialized countries in the world.
Perhaps Paul Krugman, a Nobel Prize winning economist, can answer this as throughout the 2016 primary campaign he said the country couldn't afford Bernie Sanders' Medicare for all plan.
Over 80 years ago Senator Robert Wagner introduced a national healthcare insurance plan. Since that time we have won the largest war in the history of the world, traveled to the moon, conquered once terrifying scourges like polio and tuberculosis, invented television and the internet and yet we still can't figure out how to give our inhabitants freedom from fear of the financial costs of becoming ill.
57
@Steve Indeed, Steve, that's sth. nobody living on this side of the pond can understand. Maybe the term 'solidarity' will become more acceptible to US citizens now that POTUS is on such excellent terms with strong communist leaders like Mr. P. and Mr. KJU.
7
@Steve-
Why is heathcare a privilege, not a right, in the wealthiest country in world history?
Because the wealthiest most-priviledged few in that country profit mightily off the existing arrangements. It enriches them further by impoverishing you.
Money being fungible, assume that the major investors in our heathcare-provision/health-insurance complex (a beast similar to Eisenhower’s fabled Military-Industrial Complex) are foreign billionaires and foreign goverments’ sovereign wealth funds, as well as uber-rich American private equity firms. Through registered lobbyists this complex controls healthcare legislation in Congress, especially any Republican-led Congress. It’s why the destruction of so-called “Obamacare” (whose broad outlines actually originated in a Republican-financed think tank), replacing it with nothing, is a priority bordering on obsession for them.
The American heathcare system is an extractive industry, like coal mining and oil pumping. The material extracted is ordinary Americans’ savings and investments redistributed to those who already own most everything. In this absurd inhumane arrangement unprivileged ordinary Americans were simply permitted to hold small slivers of wealth for a short time.
That’s why.
And since 35% of unprivileged ordinary Americans don’t bother to vote in our elections their negligent indifference dooms them to penury and misery in old age.
42
@Steve
We had Trillions loaned by the Fed (without the permission of Congress or the President)and Billions in TARP money to bail out the Banksters and even foreign central banks, we had unlimited money to fight George W Bush's wars of choice, the Republicans gave corporations and the wealthy a Trillion Dollar tax cut and are scheming for another.
The political reporters always ask how health care will be paid for but do not insist upon an answer when Republicans start cutting taxes. Funny how that works.
22
I work with international students and when I explain how our medical insurance system works the majority are shocked and their countries systems are much better.
And yet I speak with relatives who are convinced we have the best healthcare in the world and they have a few anecdotes about high taxes in the UK or someone from Canada who came to the US for a surgery due to a long wait.
Meanwhile, Americans are suffering, going broke and dying. And the rich get richer.
41
@lkos I love the long wait argument. I work in a large hospital in a suburban area. With "connections", I've been waiting 6+ months for a physical from my PCP after my last one retired early. Forget about any specialties in my area. You're looking at 18 months for a neurologist, dermatologist, etc. Genetic counseling is something you must go out of the area for... We are set up to fail in a failing system. God Bless America.
18
I realized the difficulties facing people with health problems in the USA and this article presents those difficulties in horrendous details.
I wonder why there is so many studies of the difficulties and none of the possible solutions ( leaving politics aside ); there are economic solutions implemented in many other countries.
7
@Puzzled Why are there no solutions ? In short because many politicians, mostly republicans have been paid to pretend that there is no better way by the companies who make huge profits from healthcare (pharma, insurance, private hospital companies). Additionally a large percentage of Americans are totally ignorant of how much better healthcare is in nearly every other advanced nation.
17
@Puzzled I suspect the possible solutions are suppressed as much as possible by the healthcare lobby. No doubt they're funding PACs and our representatives re-election coffers. That's the way our politicians choose who to listen to these days.
7
The real problem is that the hospital, insurance and pharma lobbyists hold the real power. That’s why the situations continue and will be hard to fix.. AARP should be lobbying for its members but it’s an insurance company too.
26
Besides, among voters, there is a lot of passion for a change, but not enough information. In this divided time, some decrease in misinformation would be a miracle.
10
@PhillyPerson AARP knows retirement funds are heavily invested in healthcare - check your retirement savings. It might hurt your retirement plans to have healthcare stocks go down. There's no guarantee your health care savings would offset that loss.
"Health insurance provided some protection against such outcomes — those in the survey who were uninsured were even more likely to face mounting bills and debts — but the insurance was generally not enough. The intensity of care increased the number of co-payments those surveyed faced, and it increased the chances of receiving the kind of treatment that their insurance denied. And they were most likely to get stuck paying insurance deductibles, which have been steadily rising over the last two decades."
Really, it's news to the NY Times that heath "insurance", which is really medical process insurance, doesn't cover a lot bills in the US medical process delivery system?
What world are the editors and reporters at the NY Times living in?
This "reporting" in 2018 underlines 30+ years of bad US medical insurance reporting in this paper.
No, ObamaCare (the ACA) is not like the Swiss and Dutch systems, those are highly regulated, and cover a great deal with nothing like the "deductibles" here in the USA. Then there's, France, the UK, Canada, Sweden...
But the likes of Paul Krugman claim with all seriousness that most US citizens are happy with employer provided medical insurance. He wrote this in 2018, not simply when attacking Bernie Sanders for Hillary Clinton in 2015/16.
10
@Yaj
I heard Elisabeth Rosenthal, the NYT reporter who wrote the long series on health care, why she (and the NYT) never mentioned single payer, when she could look in comments sections and see hundreds of readers writing, the solution is single payer. I didn't want her to advocate for single payer -- just report on it.
She said that single payer was not politically viable. She said that just as she ignored people who wanted to abolish Obamacare, she ignored people who wanted single payer, because they were both outside the mainstream of practical politics.
Then Bernie Sanders won 12 million votes in a primary race that included support for single payer. And the Senate failed to abolish Obamacare by one vote.
The NYT is like the mule in that joke. You have to hit him on the head with a sledgehammer to get his attention.
If you want to understand the NYT, I recommend you look up the Phil Ochs song, "Love Me, I'm a Liberal."
3
I really hate that the Republicans, with help from some Democrats, have turned this country into a business where profit is king.
24
@Ann
absolutely, we need to start over, but only after we get rid of trump and his ilk.
3
Our healthcare system is a national disgrace. Like other things, it only works for the rich. We give just enough crumbs to keep people passified in their ignorance. The educated and the politicians are supposed to look after the less educated and the less fortunate. Instead, they are bought and paid for the the rich who design a system where they are the only beneficiaries.
Add in the Fox News propaganda machine that blames straw men (i.e. libertards, regulation etc.) and you get our dysfunctional system.
27
@alan Do we have a healthcare system? Are the decisions to allocate healthcare resources and services driven by health policy goals or by what will make money? For most of the people who live in rural, red-state America a 100-mile drive to the nearest hospital is common. Deaths of mothers during childbirth in America occur more frequently than in some countries that are developing modern economies. Liberal and conservative politicians are invested in the political theater we see playing out on Fox News and on MSNBC. Accept no substitutes for one, publicly-financed health plan that does not make an operating profit. Keep on pushing until we get there. Looking for an issue that rises above the tribalism that besets our country and its people who no longer recognize what we've become? This is it. Guaranteed health care for all. Health care, not health coverage. Almost 70% of our nation's health care bill has been paid by a 3% payroll tax since 1965. It's called Medicare/Medicaid, a single payer of health care expenses for our most vulnerable populations. Single payer for everyone now!
14
Stop the whining. The voters voted in these politicians. We can all vote. This is the system we’ve elected. Kick the bums out of office if you’re not satisfied. Until then, stop whining.
12
@Frank. I post the same sentiment or fact all the time. Mitch McConnell was fairly elected and sent to the Senate term after term by the Kentucky citizens who stood to lose it all with medical expenses. Mitch used to be right of center but navaigated to the fringe and hard right after Citizens United and the election of President Obama.
9
@Frank. I definitely don't call this whining. I see it as educating everyone about the realities of the greedy insurance industry as it exists in America today. Keeping this reality hidden is exactly what the CEO's of the insurance industry want . Knowledge is power, and only the 1% want to have power over the rest of us.
7
Last year Blue cross/Shield sent us a bill for five months of missed payments even though those payments were set up with automatic/electronic payments.
Blue cross had mistakenly withdrawn those missing payments from SOMEONE ELSE S ACCOUNT !
... but Blue Cross claimed it “was your fault” because we hadn’t monitored our bank account to confirm our “AUTOMATIC” payments had been made !
The Gaul! The Hubris! The incompetency is staggering, even dystopian!
For gods sake , please give us Single payer health care!
32
“You sit there every month trying to figure out what bill to pay: Do you pay the hospital bill or do you pay the utility bill?” he said.
It makes me so sad or so mad I don't know which. It is so unnecessary. I know because I was born and raised in Calif. and was lucky enough to be healthy while I was young. Now I live in Sweden and have been chronically ill for 25 years. I pay about 20 dollars per visit. No matter if it is a checkup or CAT scans or emergency room treatment. 20 dollars. I have to pay up to 300 dollars a year for my medications. Everything over that is covered. My wife's cancer surgery and treatment 20 dollars. So when I read about fellow Americans losing everything becasue they are trying to pay their medical bills ......words fail me. It dosn't have to be this way. But folks, you have to stop listening to the people with the money. They have nothing in common with you and they do not care about you. Vote for Democrats that promise single payer health care. That is all. Believe me I have been there in both systems. I wouldn't be able to afford to move back to the U.S. even if I wanted to. I couldn't get health care with my pre-conditions. Vote for Democrats that promise single payer health care. Your life might well depend on it.
69
@kevo Most conservatives think they can escape the crowds. They feels they should not have to pay for others without realizing that others may pay for them in their time of need. This is pure selfishness and stupidity. That is why the rich can fool them so easily. Very SAD!
3
And, Mitch McConnell wants to decrease funding for Medicare and Social Security!! How horrific is that. All the healthcare funding for his ingrown toenails, to laryngitis from talking too much in the Senate, is paid for by us. It is easy to cut healthcare funding when it is not for yourself. What a shameful reality we are facing in this country due to these greedy oligarchs.
47
I'm 64 and retired. Both parties have been talking about cutting Social Security and Medicare since I was a little tyke. They won't, there will be riots in the streets. I did hear recently that the Senate voted cuts to it, but no way trump is going to sign anything that will hurt his base like that would. Maybe for future generations, but not current seniors. Republicans would lose both houses for sure if that happened. And I just heard SS was getting a 36 cent raise this winter. I would support Medicare for all, but don't know how we'd pay for it unless we taxed the 1%, that'll never happen either.
8
@P Green Fact is most Democrats are as bad as most Republicans with respect to keeping the money flowing to the health insurance oligopoly. Taxpayer premium-payment subsidies that directly flow to for-profit, shareholder-owned enterprises?!? That's the Affordable Care Act (ACA), Nancy Pelosi's crowning legislative achievement. And most Democrats in leadership positions still don't understand why many registered Democrats are unhappy. The ACA did very little to restrain escalating costs and many rural hospitals are still struggling. Expanding insurance coverage at the expense of the middle class is not the same as providing care. People need health care not coverage. the expansion of Medicaid is the only part of the ACA's 11,000 pages of regulations that is improving health outcomes. That should tell us all we need to know.
2
@Walter Heath Single payer was proposed when Congress considered healthcare reform, but there were not enough votes for it. PPACA passed the Senate with the minimum possible number of votes (all Democrats). PPACA was the best that could be achieved at the time, politics, as always, being "the art of the possible." The only way forward is to change the politicians.
First it was healthcare, then education, housing, and soon food that are just a revenue stream for the 1%. It is utterly disgusting if you compare todays society to that of the 50's. Where ethics, compassion, and community that were alive and well are now dead and buried. Greed and avarice is the only thing that counts today.
I say there is hope, and it starts on November 6
39
Sometimes I have to feel so smug, being a Canadian. my universal health care, my automatic old age pension, pharmacare, the embrace of refugees, and lack of guns.
And today, marijauna became legal.
In Canada we don't believe in living in fear.
54
@truth be told SHHH! You guys do a great job in fooling us into believing that we don't want the Canadian system because of the high taxes. Better for Americans to think that not paying taxes means more money for vactions and cars while not realizing that the necessities of life need to be paid some time. In you system, the high taxes pays for needs. It is not wasteful gov. spending as we are incessantly taught by the conservatives. It is enforced savings to cover you in your time of need.
8
@truth be told Congratulations on the legalization of marijuana! Yes, I pray we someday see the wisdom and practicality of universal health care.
3
But you live in a city with the nation's highest cost of living...
How many voted GOP?
12
I guess we need another NYT economic analysis telling us how great the economy is. It must be true, if you ignore the plight of actual people living in the real world.
27
@Donald
funny!
2
The “greatest” country cannot be the greatest when it cannot take care of its own. Period.
An MRI shouldn’t cost a paycheck. An epi-pen shouldn’t be more than your mortgage.
13
I remember a time when I could still get an epi-pen. And when Benadryl could still save you from a visit to a hospital (drug addicts used Benadryl; now the company sells a lamer version that doesn't work). Now if I have an allergic reaction, I guess I can just die. In this country, that's not such a bad thing. Better than growing old here.
I haven't read all the individual cases in Ms. Sanger-Katz's reporting, but I do want to say that (as a health care provider) I see a vast number of (naive) Americans suckered into believing they need care (particularly surgeries) that they actually do not. (And oftentimes leads to worse QOL than would have forgoing such medicines/procedures.) Such is the lot of our crooked, duplicitous driven-by-money health care system. Will I live long enough to see something more honest and in the real interest of suffering people?
12
To think of the overall net standard of living in this country for most people, the level of getting hosed is absolutely staggering. The effective tax rate is close to what it is in other advanced countries, but most of then cover almost all tuition and health care expenses.
I want to do a study on our NET standard of living. Let's just do the math and look at:
1) total tax burden including property tax
2) bloated cost of health services and drugs paid through premiums or out of pocket
3) cost of tuition PLUS interest, after-tax income,
5) cost of unfair and predatory city government civil, criminal, and court fees as exposed in the Department of Justice's report on Ferguson,
6) cost of lost productivity and unpaid labor incurred through hours spent navigating and fighting with insurance--doesn't exist under single payer,
7) The predatory cost of fees and interest paid by poor folks for "payday loans" not prevented through regulation.
We are getting fleeced so badly it is sad!
Democrats are you paying attention? What is your message? Are you doing a no-message Hillary 2.0?
17
My income of $69,000 a year ($11,000 in dividends) is less than $30,000 after taxes, health care and payroll deductions. Every penny of dividends and more is swallowed up by property taxes, more than half of which is school taxes. I have no children, and pay these taxes in NJ until I die. No break at age 65.
I find myself needing to know the makeup of the sample taken. Do they vote. Do they vote Democrat. If an individual does not answer yes to these two questions, then the crocodile tears of their Republican overlords are deserved. I can only sympathize with the Democrats.
This is not rocket science people. The rest of the industrialized world all do it better than we do. Here the lack of empathy is replaced with corruption and cynical mercantile interest by leaders such as Donald Trump and Ted Cruz.
12
@Thomas Williams
Lots of reporters have gone into the sections of hte country that voted for Trump and interviewed people who were too poor to afford health care, and yes, they voted for Trump. I think Vox had a good documentary, and Columbia Journalism Review had many stories about that.
One of their problems was that Obamacare, with all its premiums, deductibles and copayments, was still too expensive. They might pay $1,000 a year and have to pay a $3,000 deductible before Obamacare would even start to pay anything.
One woman acomplained to Hillary that her health insurance was so expensive she couldn't afford it. Hillary suggested that she shop around until she found a policy that was cheaper. That's when I realized that Trump might actually win.
The Democrats had eight years to come up with a health plan like everyplace else in the world. Instead they moved to the right -- what they call the "center" -- and compromised.
As Jim Hightower said, "There's nothing in the middle of the road but yellow stripes and dead armadillos."
15
Our “system” is such a failure but I almost can’t bring myself to read articles like this. It’s so painful knowing it doesn’t have to be this way and yet because this system makes some people very rich, and they pull all the strings in this country, it will never change.
12
only in america. healthcare controlled by corporations with profit as their sole goal.
You can work hard all your life and be bankrupt in your 60s because of a major illness. If your child is born with a major disability, you will spend the rest of your life dealing with its financial consequences.
No other developed country treats its citizens with such brutality. The stock market is up though and huge fortunes are being made in the healthcare "industry".
16
Single-payer:
Any condition, any doctor, any procedure, any medication, any time, preventative, emergency or ongoing, whenever needed.
No insurance company, no deductibles, no approvals or disapprovals. No longer enslaved to your job. No giving up savings or retirement funds.
Of the many, for the many: All in it together. Citizen health is an economic, cultural, and national security issue.
How to pay for it? Maybe the $3 billion needed could be reprioritized out of the $700 billion defense budget. Do you think $697 billion would still do it? Of course it would.
Priorities, America.
23
What percentage of respondents were seriously ill vs percentage of respondents who were speaking on behalf of seriously ill person? Important to disclose.
2
Since the questions were about facts easily obtained from bills, it doesn’t matter. The criteria were stated up front in the article. The respondents had to have been hospitalized twice in the past two years. If the person died, then the caregiver answered.
3
People vote but corporations rule and healthcare is the most egregious display of political, social and commercial asymmetry there is in America. You are not in control.
9
By reading lots of your comments I can see that this for profit healthcare system devastes the rich and the poor, liberals and conservatives and if I was running for office it’ll be my first priority to explain why Universal healthcare is the only long term solution.
3
Our health care system is evil if you get sick or you have to care for a family member that has a long-term care medical issue.
I am too exhausted to write about my challenges since my mom's stroke in 1992 and my son's brain injury in 2001.
13
Americans are so afraid of the term "socialized medicine" (because theyve been brainwashed for decades to be so) that they'd rather die or go into bankruptcy than support what is an obvious good for everyone.
39
Please don't anybody forget that bankruptcy is a constitutional right. Please obtain competent, disinterested debtor's rights advice.
3
Bankruptcy is not a constitutional right. And thanks to Congress it is now very difficult to discharge medical debt, even from bankruptcy.
8
@Liz What does this mean? Is this sarcasm or straightforward advice? I've lost all my assets and had to declare. It took eleven years to recover and, once i did, another devastating medical issue arose. What has been SOLD to half the population is the myth that we are living in the greatest country in the world. Liberty, manifested as the right to suffer, is a core value that has been swallowed hook, line and sinker by the pathologically god-fearing, the idiots and the compassionless. Bankruptcy, a constitutional right? Dignity is a human right.
7
@Liz Why not ask students drowning in "educational debt" how bankruptcy has helped them.
Oh, wait, . . .
The ACA was not meant to be the final word, but a blueprint to improve upon, and a pretty darn good blueprint it was. Romneycare in Mass. is the same. It is working there and has worked for a long time. I don't see anyone trying to kill that plan that has worked so well.
But why would Republican's try to kill it instead of improve on it? Ready?....tax cuts for the wealthy. The party of no idea's strikes again. It feels malevolent and cruel to me to have people go broke for medical reason's the same way it used to be when i was a child in 1944. Republican's have shown they don't care about the common man/family, or seem to understand that a healthy country is a much happier and productive one. We've got to throw these fools out and give our citizens peace of mind. Their only concerned about the health of their donor class. Truly disgusting. Greed over people's well being. Better vote for a Democrat or kiss all of your healthcare goodbye. It's all up to you. Show up. Vote Democrat, unless you like that "crushed" feeling.
15
This is the United States in which the GOP wants to force us to live. Welcome to our sad new home.
13
Insurance companies and doctors are crooks. Just to get a routine blood work done, when there is a label attached for a precondition, it shoots up the cost. For the exact same test, if they dont put the label precondition, I dont need to pay extra. What kind of a money making unfair system is this?
4
As a “broke but breathing” survivor, am glad the corollary financial ramifications of extensive illness finally rising to the level of public discourse.
I had the best employer-provided health insurance on the planet, but the deductibles, co-pays, And capitations on types of Care (pre-ACA) in 6 figures for several years caused liquidation of all my financial assets, 401Ks and pension fund, sale of my house, and bankruptcy. One is not making the best money management decisions while desperately ill, but simply trying to survive. No other “civilized” country does this to its citizens. Unadulterated capitalism
23
Healthcare is a need not a frivolous luxury. We will all get sick and need to go to the doctor or hospital at some point in our lives.
It's time for the United States, the wealthiest nation, to join the rest of the world.
Democratic candidates should make healthcare the main focus of their campaigns. This is an issue that ordinary people in all parties agree on.
10
Two words: Medical Tourism. It is big business. Thailand, India, Canada, Costa Rica, Mexico. Millions of dollars a year are leaving this country even those with serious illnesses do make the journey.
7
@Lillies
Earlier this month, I had major abdominal surgery in Bulgaria. I was in the hospital for eight days. The bill came to €600 ($690 at today's exchange rate). What would $690 get me in the United States these days? A down-payment on a pap smear maybe?
3
Back in 2016 Hillary wanted to expand Medicare to people over 50.
11
insurance companies make money in two ways -- by denying care and by lowering reimbursement. for-profit healthcare makes money from sick people. americans pay more and have worse outcomes than other countries. the american healthcare system is capitalism run amok: outright theft in the worst plans, widespread fraud, and thirty percent of the system devoted to pushing paper vs. delivering care. the multi million dollar salaries of insurance company executives are carved out of the flesh of patients.
14
Healthcare must be unlinked from employment. It would help patients. It would help employers. It would help the economy.
7
My insurance company cancelled my policy and left me with over 100,000 in med bills. We followed all the rules and always paid on time. They won't take responsibility. I can't get insurance now due to pre-existing conditions. For 4 years, docs said "Wait and See" I have a huge umbilical hernia, aneurysms, thyroid tumor, kidney tumor and many tumors around my neck and blood clots as a result of a transfusion. All "Wait and See" Now all of them have grown and spread and I can't get care. The docs in the ER said they won't help me with the hernia unless it strangulates, at which point I will be dead. I live 25 miles from the nearest hospital. I had no problems with ins until Trump took office. The ins co knows they are breaking the law and don't care, because they know poor people can't afford an attorney and court costs on top of med bills that are now in the hands of collection agencies.
14
I can't take it anymore. If there isn't some kind, any kind, of good news about our country, or in our country soon, I am seriously going to lose my mind.
And my insurance won't cover it.
19
A person who I love was recently diagnosed with MS. I will help him in any way I can but I will not marry him. 2 attorneys advised that if I did and he became debilitated and needed nursing home care, I would be left destitute. They would run through all he has and then come for my assets. I'm 61, worked all my life and planned to retire comfortably. Shame but I need to not be a burden on my own children.
24
@Debbie, Yes, I am about the same age, worked all my life, and am now ready to retire. I would never marry a person now. If I had to take on their medical debt it would be disabling for my financial health. Also, many men seem to want to marry women at least 10 years younger. Most guys in their 70-80s missed the self-care, exercise boom and are in horrible physical shape. Cha-ching goes the medical calculator......
2
This was disheartening to read. I was surprised that when you buy health insurance it does not state clearly what is excluded.
As a student in the US I always paid for student health insurance which was cheap at $ 75 pr. quarter. We were always warned about being uninsured in the US, as it's quite expensive in relation to other countries.
Now I am sick and luckily don't pay for anything as I live in a single payer country.
The US can afford this also......if it wants to.
11
Is it not interesting that we Americans always are being taught that we are the most powerful nation on earth BUT also the most civilized and we cannot even take care of those most vulnerable and sick. And now, we have McConnell and the rest of the GOP wanting to take away by slashing and burning, our Social Security and Medicare (which we working people have paid into) but also Medicaid!
Since when have we given them the right to choose who can live (and survive) and who will die (while they become destitute)?
I am having a very tough time recognizing the country that I was born and live in!
13
Scary to think one might become seriously ill and hospitalized, but its terrifying that treatment so often leaves one destitute or living on a knife's edge. Something is very, very wrong when this can still happen in such a rich nation as ours.
8
Great story, too bad it doesn't matter. The insurance industry, pharmaceutical industry and the oil & gas industry are running the country. With our corrupt campaign finance and lobby system these industries and the ultra wealthy are making their own rules with our government. We live in a plutocracy. So all of the complaints are falling on deaf ears. Don't vote for anyone that does not have campaign finance and lobby reform as their number one priority, if there is no one then don't vote at all.
11
I believe the American people can obtain universal coverage or Medicare for all, bringing them in line with Canada and every industrialized country on earth, by voting and electing those who support a single payer healthcare system.
Canadians do not face financial hardship due to illness. Period. We never even receive medical bills! I had a very serious medical condition that required immediate and major surgery, years of follow-up, countless scans, regular visits with doctors and specialists and I never received a single bill. Why Americans tolerate the immoral system they live under that lines the pockets of the very few, at the literal expense of everyone else and continue to elect those who support it is beyond comprehension.
31
Why we tolerate wars and rich people who pay no taxes is also beyond me.
Does anyone really believe that the insurance companies are providing a real product for American consumers? Our only way out is to stop buying insurance in favor of universal system. No one buys, they die, we live.
7
I work in Health Care. This survey is spot on. Nothing will change and I predict things will get much worse in the next 2 years if Trump and the Republicans control the White House and Congress.
Please VOTE. Vote Democrat and block the Republicans from bringing back Pre-Existing conditions and cutting Medicare, Medicaid and Social Security.
Vote because your life and your financial future are at stake.
18
I am a very healthy person, but about 6 mos. ago I was diagnosed with a kidney stone. I have insurance thru the ACA. Between the deductibles, doctors bills, tests, etc. I owe $6,000. That’s what my insurance didn’t cover. My premium is $900/mo. I’m so worried that I’ll get another stone but the insurance co. has denied coverage for the test to determine how I can change my diet to avoid another one. One of my Canadian friends asked me recently, “How can a country let this happen to their citizens?”
32
@Bosha Kantrovitz. Stay away from low to no carb diets. The very low carb diet was cited as possibly a cause for husband’s kidney stones. You can check out the relationship. There is nothing definite, but I’d suggest just eating healthfully from all food groups. Oh, and avoid calcium supplements. Lots of water, of course. Not a doctor, but my husband has been there with the stones.
4
@Bosha Kantrovitz, there are herbs that prevent kidney stones, look into chanca piedra, also called stonebreaker. It works well for many.
1
This story needs front page coverage on a daily basis. It is a problem that haunts everybody’s nightmares but troubles no one in Canada or advanced European countries.
We can do better. ACA was a first step. Medicare for all is the right answer to this problem , not someday, but NOW!
16
@JMT. You are right. Last night the ABC news with David Muir covered the media reaction to Daniel Craig’s (James Bond) carrying his newborn baby in a hands-free baby carrier. Seriously? Did anyone care? Meanwhile, stories such as this one are not given any attention.
4
The myth of self-sufficiency is blown away by catastrophic illness. Medicare for all is the most reasonable and necessary service our government can provide. We spend on defense because the wealthy cannot support their own armies. They can, however afford their own healthcare, so ... tell me which is more likely to happen to you - Vladimir Putin knocks on your door or Cancer does?
12
I'm always appalled and saddened when I see a post for a medical-expense related fundraiser. It's all due to inept policy - healthcare for all is badly needed. Sadly, many of those setting up bake sales, don't see the connection to their vote.
6
One aspect of the health care situation in the US that continues to stun me is that members of your Congress receive superior health care benefits but continually vote against reasonable benefits for everyday Americans.
20
If I said what I'd like to do to our politicians and to rich people in general, I'd be arrested.
Terrifying to me. I’ve already encountered some health issues and found out if I have to take a leave I get zero income. Fortunately I have days saved up to defray that outcome. But what about the next time? How can we as a nation fail one another so badly?
9
I pay $1,100 to Horizon Blue every month and yet I am still getting killed with the cost of certain meds that they won’t fully cover. Then there are co-pays to see a doctor. I wish we had never moved back here from England, where we lived for five years and never had to think about these costs.
12
It is with fear and trembling that I offer an added perspective here. I agree that people in the U. S. are suffering medically and financially due to our profit-driven healthcare. It needs to change-and fast. Single payer is the obvious answer, but is there enough money to cover the cost of known unhealthful behavior? Behaviors such as firing guns at people, eating to obesity, failing to exercise, ignoring safe sex practices, etc. When I think of countries where single payer works, the culture seems to encourage healthy behavior. Can the U.S. do the same? While individuals are responsible for themselves, how much harder is it when the media present temptations all day long? This is not written to shame anyone-I am obese like so many of us.
3
There are plenty of obese English people, and their govt takes care of them. PS: I'm fat, have great blood pressure and cholesterol levels - avoiding meat and eggs helps - I don't have diabetes or heart disease, either.
The crazy thing about Medicaid is that rules vary from state to state. So maybe Oklahoma made that woman spend-down her 401(k) so that her husband could get Medicaid. But another state will have a different rule and she won't have to spend-down her retirement savings. This is one reason why Medicare for all is so appealing. Same rules across the nation; wouldn't that be nice.
11
I have two rare, chronic health conditions. Both are physically painful. I have health insurance. I have paid almost $20K in health care expenses in the past two years, not including the monthly premiums. That is life in America if you are sick. Here is a note to all Americans --- my life can happen to you too. Not all chronic illnesses are caused by poor eating, smoking, or not exercising. Sometimes bad things just happen. And they can happen to you too. There was nothing I could do to prevent my diseases. And unless you hit the lottery, there is no way you can save up enough money to pay for chronic, expensive illnesses. I live in constant fear of the future now -- and I'm only 47.
16
As one suffering a series of illnesses that required many surgeries - and in 2013 led to a near-fatal Hospital Acquired Infection - I can assure readers that the issue is the way such illness and treatment saps the strength and diminishes earning power.
One does not simply "rebound" from serious illness.
It takes plenty of time.
And now some states have decided to impose work requirements in order for the neediest among the ill to receive financial assistance for healthcare. This only makes sense as a punitive measure. It is like demanding a starving person reduce calories in order to receive food.
I repeat: being ill diminishes earning power. There is no way around that.
The HAI which hit me - 6 months before the ACA made it illegal to bill the patient for treating any HAI - was the single most costly thing I ever experienced. I was lucky enough to be insured at the time, and I stopped adding up the bills for my lengthy hospital sojourn when they hit $300,000.
Yes, illness is a matter of life and death. And in America, paying for treatment is, alas, often also a matter of life and death.
We must stop this now.
I don't care who is 1/1,024th part Native American.
I don't care who is "an outsider" or an "insider".
I do care about promoting the general welfare, as the US Constitution demands.
Universal Healthcare should be considered a matter of national security.
I assure you, people without provisions for healthcare lead a most insecure life.
https://emcphd.wordpress.com
14
Only in America is someone considered a good catch for marriage if they have decent health/medical insurance available through their jobs. Seriously.
13
Health Care? That is overrated.
Don't worry. The Vichy GOP, the collaborators of the Reality Show Con Artist, plan to cut Social Security, Medicare and Medicaid and I'm sure that will help the situation.
Oh - and because of they will cut the pre-existing condition clause from the ACA, those who are sick won't be able to get ANY Health Care.
The Vichy GOP have a time worn method for treating the poor and the Middle Class that Dickens wrote about nearly 200 years ago.
Are there no prisons? Are there no workhouse? The Vichy GOP will make sure there are plenty to serve their useful purposes for the poor and the middle class.
Just remember the Speaker of the House said you got a Costco membership out of the Tax Cuts last year. Maybe they will offer Health Care and Social Security at some point.
8
It's not just the deductibles that are rising. The portion that insurance companies pay are rising. Health care costs are rising. Premiums either have to go up, we have to pay more out of pocket or providers and pharmaceutical companies have to get less.
Of course if we had a healthier society that needed less health care that would also contain costs. Better diets, more exercise, less miles driving, lower gun ownership, alcohol and drug abuse...
I'm for Universal health care. It's not just about political will, it's about personal responsibility and political will.
It's a national disgrace that we are fat and out of shape and pay the highest prices for pharmaceuticals and health care in the world.
Make America Great, vote for Universal Health care, go out and take a long brisk walk and eat a salad.
11
@HL Where is the corporate responsibility, which needs to happen along with the personal responsibility? Things do NOT go better with Coke.
2
"The whole point of health insurance is protection from financial ruin in case of catastrophic, costly health problems."
And no amount of calling dubious value-add for-profit 3rd party intermediated pre-payment plans "insurance" will make them so.
It's a maddening, vexacious topic. Google " KHIT Overcharged" for some of my blogging on the issues. If you're not confused, you've not been paying attention.
3
The republicans and Trump are responsible for this continuing problem. Obama caved to the Republicans with Obama care- but it was a beginning. We have health care only for the rich- and entitled- like congress and our president.
5
The truth of the matter is that nearly half the Americans would rather have their taxes used to pay for tax cuts for the wealthy or to fund unlimited wars THAN to pay for the healthcare of their fellow citizens. Think about it for a minute. What's more, these people would rather die than pay a dime towards someone else's healthcare. Sheer out of spite. That's how much we hate each other.
20
Sorry, I live in a blue state, so my taxes will be going up. That's why we call the Trump tax cuts for the rich a tax scam.
I just found out my very painful brain tumor has returned. It's only been 2 years since my brain surgery. Focused radiation this time around. Each radiation treatment will cost $75.
I found out I'm losing my vision due to something *else* going on in my brain.
I just found out the program paying my medical premiums (ACA; the premiums are going up neatly 18% for 2019) is ending.
I have no spouse to provide another source of income. If I'm sick, I can only work so much. If I go blind, I can't even.
I'm seriously considering ending my life soon. A body can only take so much.
16
@Theresa Jennings
I've never experienced what you are going through but I am so very sorry that you are feeling so despondent. Are there resources in your community that you might be able to turn to for help?
6
@Theresa Jennings I am sorry. I wish that I had a pot of gold to send you. I don't. Prayers won't cure the problem. What would help is real access to real medical care when and where a person needs it rather than when s/he can afford it.
2
More horror stories from life in the USA. If it is not about guns it is health care. One illness from total poverty, only in America. And Americans know that other nations have national health care and it works. But they have no hope against lobbyist who pay congress billions to get what they want. It is never going to change.
23
After more than 10 years in which I couldn't buy health insurance because of a pre-existing condition, followed by losing my home, bankruptcy and becoming disabled as a result - Obamacare saved me.
Many thanks Obama!
Now I finally qualify for Medicare - which is much better than nothing but it's no panacea. I recently saw my doctor for an ongoing worsening disability in my hand - swollen, finger becoming crooked, pain - and asked my doctor why he doesn't refer me to a rheumatologist.
He replied "because they would order a lot of tests you can't afford and then want to put you on medication you can't pay afford."
In the meantime, my Medicare deductible is $1000. For someone like me, that basically means I avoid getting care because I know I can't pay that.
When Trump and the GOP pushed thru that huge tax cut for the wealthy, they knew that the resulting deficit would mean they could try to make a case for reducing Medicare, Medicaid and Social Security. My disgust for the Republican party knows no bounds.
I lived for a time in the U.K. and Spain and if anything went wrong, I could walk into any hospital or clinic and be treated for free. Now, in my country, I have Medicare but avoid getting medical care because the deductible is too high. Medicare has already refused to pay one of my most necessary prescriptions.
Hey, is this country broken or what?
18
Medicare does not have a $1,000 deductible I think you must be confused. Medicare will generally pay 80% and you were responsible for the other 20% but you can buy Medigap plans to cover that 20%
3
@fast/furious Perhaps you have a Medicare Advantage Plan? Traditional Medicare does not have that high of a deductible! Make sure you understand your insurance plan so you don’t get caught up in unnecessary bills.
1
of course the US healthcare system sucks. It just sucks even more if you're uninsured. And the #1 reason is pricing (and the complete lack of visibility or competition around pricing). Whenever you visit a doctor and have a test done, you're simply waiting for the other shoe to drop: will I have to pay $5, $100 or $500? this is the Russian roulette equivalent of financial misery. Just look at any EOB - why would a provider bill the insurance a crazy amount of money to only get 10% or less from the insurance company? - is the provider trying to scam the insurance, is the provider artificially inflating the price because there is no market rate for the service? How is the consumer supposed to navigate the complexity of the system?
9
I had the great good fortune of being posted to Washington DC as a Canadian Army Liaison Officer in 2011 for three years. We loved the city and the people and see it as the highlight of our postings. What I never understood was the way Americans conducted their health care and why they continue to do so in the face of so much evidence that it is a dysfunctional mess. You pay twice more and receive less than the other first world democracies. The citizens are always at risk of financial catastrophe if something goes wrong medically.
After my return to Canada my mom suffered serious health crises and spent six months in hospital, including multiple surgeries and three weeks of ICU time. She received superb service by highly competent and caring staff. Money was never mentioned once. She recovered and went home in a much healthier state, and it did not cost her or our family a penny. I believe if Americans ever learned the truth about universal health care they would change their minds and adopt it. Anything else is madness.
26
Why is it that every article on healthcare costs omits mental health?
I was about to go on a well worn tirade regarding costs and the difficulty of finding treatment for complex cases, even on an outpatient basis. And dental care? Even those who have health insurance often don’t have dental. This is not a comparison of pain. However, we are whole human beings and deserve to be treated as such. Instead, we get sicker from the stress of being our own health care managers, while we drain our finances. That leads to loss of hope. And we wonder why the suicide rate has increased?
10
The UK's National Health Service has many defects, but is widely esteemed by Britons young and old, rich and poor. However, I have never read more compelling evidence of the value that the NHS provides than this survey evidence. "Socialised medicine" sounds unappealing, but structurally it delivers a better answer than the painful collision between humanity and profit that this survey relates.
10
I am MD, I am working in the health system. For me the question is How sound American private insurance system. There is clearly reckoning day is coming.
One way or another in this country we are going to deal with the critical and inevitable question, healthcare for all.
Then what will be the true solution, going entirely Medicare or private insurers based system Obama care but wider coverage , to be honest private insurance corporation doesn't have any heart , if the system become nationwide , they cannot cope with that business type.
Then medicare for all , the problem with that republican party will drag this as long as possible.
The reality about healthcare is In USA and in our condition , it will be very pricey and no other way to adress it.
We do not have good primary care system nationwide , it needs to be rebuilt.
7
Until the mid-1980s, health insurance by federal law had to be non-profit as were many community hospitals. A couple of years ago my SIL almost died while on vacation in Australia but because they put people - even those visiting - before profit, they saved her life. She spent 3 weeks in ICU. Her medical records were immaculate so said her Drs when she returned to the US. However the US medical system murdered her on Christmas Day by giving her a medication mandated by her insurance even though her family begged them not to. She bled to death and while she was doing so, her insurance denied a life flight. We make it a point to not spend any money on holidays.
11
My husband had a heart attack in 2003 and had to have the stints replaced in 2010. Two days after getting home from the hospital he received a letter from Blue Cross who informed him they may not pay for the stint replacement because it was a pre existing condition. This was at the same time Obama care started and his bill was paid. The bill as over $100,000.
11
I am not "really sick", and I have what used to be consideed "good health care", for which a big, huge chunk of money has come out of the paycheck every month (my premiums have gone up exponentially.)
Now I have a tear in my shoulder that requires surgery. (yeah, I could live with it - if I am OK with limited mobility, inability to swim, and living on advil and alleve at night.)
Imagine my suprise when I learned that. depsite the fact that I have paid over 20 years of increasing premiums (and never reallly been sick) I now have an $800 'surgical deductible' and a $30 co-pay 2x a week (for 25 weeks . ouch)
I guess I am lucky ?
6
A few years ago I was laid off and my job and had to choose between paying my mortgage or COBRA. I opted for the mortgage, because I had always been healthy and always employed, so I knew I would find a job quickly. In around 5 seconds my life changed forever, when I fell and broke my leg and shattered a knee. When the ambulance arrived they asked me if I owned my home and when I said yes, they told me not to go to the hospital. Best advice I ever had. I did not get my leg fixed for 6 months, and only then was able to because of Obamacare excluded pre-existing conditions. In five seconds, I lost everything I had worked 30 years to achieve. I ended up having to sell my house anyway and now I am facing a retirement without savings. I returned to my own country of Canada. I don't love the weather, and I miss my beloved NYC, but I don't miss the idea that you can do everything right, work, pay taxes, raise decent productive kids and still be left with nothing if you trip and fall. My children also now make their home in Canada, simply because of the health care. There is a big weight off your shoulders, when you don't have to worry. Last year, I was diagnosed with an ovarian tumor, I was in and out of the hospital within a week, the tumor was removed and turned out to be benign, but had it been cancer I would have been treated. I currently pay approximately $30.00 US a month. My adult American/Canadian children recently told me, they will never go back.
49
I wouldn't miss this country for two minutes. The only reason I don't emigrate is because of the quarantine on pets.
Yet just yesterday this newspaper reported the GOP wants to reduce Medicare, Medicaid and Social Security. It is fine to allow the wealthy multiple loopholes to avoid paying taxes, but it is their sacred duty to assure the average American cannot survive a serious illness. I frankly consider these people rather evil. One of the BASIC responsibilities of a modern society should be to assure a basic level of health care for all citizens, and to have in place a system so that someone suffering due to no fault of their own doesn't fact financial ruin due to illness. Other nations have achieved this - why is it so difficult for us? Because policy makers are a captive of the "health care industry". Consumers of health care have no power because we cannot find out what care costs. Most insurance policies are opaque. Middle men drive up the cost of prescription drugs -to no benefit of the consumer. Unfortunately millions of people continue to vote for a party that doesn't care about them. I've never been able to understand it.
53
I vote Democrat and they don't care for me, either. For both parties it's all about how much money they can redistribute to the rich. The irony of blue states is that we all have to move to red states in order to survive. The Dems didn't give us single payer either. Time for a third party.
The GOP war on Medicare, Medicaid, and Social Security will continue full throttle if they remain in control of Congress. The Majority Leader has stated that "entitlements" (read help for those less fortunate than the 1%) will be a target to reduce the deficit. Meanwhile they GOP will consider more tax breaks for those that really don't need anymore breaks while those like my 92 year old mom will have to pay taxes on the money she and my late date lent the federal government when they took out savings bonds. The general population just can't catch a break.
53
The system is designed such that no one dies with any assets to their name. The 'insurance' companies, healthcare providers, medical device makers, drug companies, and associated businesses have rigged the system, and bought off the politicians, so they end up with all the money. Only the 0.1 percent might have enough to pay for end of life care and have anything left to pass on.
33
My mother's dementia ate up much of her savings and inheritance and estate taxes ate up another big chunk.
Actually several of the many doctors who have treated me in the last few years, have obliquely addressed the cost of a potential treatment they would like to prescribe. They ask “How good is your insurance?” When I hear that phrase I know the treatment is expensive.
13
@mwm Agreed. And this is how we ration care in America. Sometimes doctors have changed their treatment recommendations based on my insurance coverage. While I appreciate the effort to work within my financial situation, this is rationing of health care and we should be honest about it.
18
"The whole point of health insurance is protection from financial ruin in case of catastrophic, costly health problems."
That statement is so not true. All insurance exists for insurance companies to make money. Pure and simple. People pay their unbelievably high premiums for the privilege, when they are hospitalized, of paying an enormous deductible and a significant percentage of the basic costs. It's just plain legalized robbery.
The only reason medical testing, doctors and hospital costs are so high is that the hospital is in league with the insurance companies. They frequently are the same company.
I recently had a TIA (temporary) stroke. I was in the hospital one day and a half. The combined bill (ambulance, hospital and doctors) was $16,000. Outrageous!
36
After decades of Republican obstruction to universal health insurance, the Affordable Care Act was enacted. The House voted 220 yay to 207 nay (175 Republicans). The Senate voted 56 yay to 43 nay (40 Republicans). Republicans misrepresented its provisions, fabricated stories about developing the legislation, and undermined it. Republican governors refused Medicaid for their citizens paid by federal funds.
It’s not perfect, but it’s a really good law. It allows no annual or lifetime limits. It prohibits exceptions for pre -existing conditions, which only works as a two-way street – everyone must be insured (the ‘mandate’). It set minimum standards for every health insurance policy: Ambulatory patient services; Emergency services; Hospitalization; Maternity and newborn care; Mental health and substance abuse disorder services (including behavioral health treatment); Prescription drugs; Rehabilitative and habilitative services and devices; Laboratory services; Preventive and wellness services and chronic disease management; and Pediatric services, including oral and vision care.
The Trump administration, unsuccessful at repeal, sabotaged it in many ways. A web site mimics the ACA site - it calls itself healthcare.org, but that isn't healthcare.gov, the official site. It doesn't reveal how its cheap plan falls short of the ACA standard.
Republicans have undone, voted against, and sabotaged universal health insurance. Who’s interest does that serve?
40
Part of the reason wages seem stagnant is that any raise people get gets eaten up by rising health care costs. And most people insurance doesn’t cover much. It’s just out of control.
30
It winds up being a huge pay cut.
Absolutely true. When I have to pay several providers a lot of money at the same time, I have to decide who gets paid first, and this is always in installments whenever possible because I can't afford to pay it all at once. Currently I have debt for three surgeries, physical therapy, dental crown, and prescription glasses; I can't have the glasses without paying the $500 at once and my vision insurance only pays for one per year (I wear two prescriptions). I always use "in network" doctors and labs. The co-pays are $50 a pop including for each physical therapy appointment. Then there are collections agencies, harassing phone calls, and mounting debt for other essentials like car insurance. I have high-deductible health insurance. Just how am I supposed to do this?
29
@jessiekitty
It won't help you but if you voted democratic for the rest of your life, it might help the future generations.
5
@jessiekitty
You can order glasses online which is cheaper. It might help with one thing anyway.
In America we pay taxes to fund a never ending war plus other wars after wars after wars. But we don't want to pay taxes to help sick and disabled people get better.
68
Don't forget that your taxes also subsidize Jeff Bezos, Warren Buffett, the Walton family of Walmart, Disney, McDonald's, banks, Wall Street and churches.
1
Don't count on your blue chip major medical to actually cover your needs. The #1 healthcare insurer insurer dropped me from acute rehab; outpatient rehab, leaving me with no recourse except assisted living less than 6 months after my Grade 5 SAH while I was waiting for my bone flap replacement surgery. Their CEO learned almost $40 million in total compensation while I was denied life changing medical intervention. Insurers serve their stockholders, not their policyholders . They should be held accountable.
63
@Maureen I wonder if we have the same insurer? Multiple spine surgeries have left me with rods, pedicle screws and implants holding together more than 70% of my spine. My insurer, who was happy to take my LTD premiums every week, denied my disability (Social Sec approved me for less than 30% my old salary). This insurer has been sued numerous times and fined by state attorneys general for its practices.
But it doesn't stop their CEO from earning apx $40 mill a year.
4
It's pretty important to know what is covered. The biggest mistake people make is using an "out of network" provider and ending up owing 20% of the bill.
My husband was covered by the Maine Teacher's Assoc Blue Cross/Blue Shield policy when he became ill with prostate cancer. We rarely had a co-pay at all, and when we did, it was small. We were careful to be sure what was and wasn't covered, and at no time were we faced with any difficult choices.
I now and covered by Medicare with Tricare for Life as my supplement. Yes, the prescription co-pays for drugs not on the Ft Knox formulary has gone up in the past few years - gone up a lot. But it's still quite affordable. If it weren't, I'd have my doctors chose a drug that was covered. I never get a bill for any treatment.
I have friends with a summer home in Nova Scotia. There was one doctor in their town - he had 3000 patients, the number limited by Canadian law. The other 400 in the town, were on a "waiting list" to have a doctor. Then the doctor retired. The Canadian Health Service has not yet been able to provide a doctor, so now 3400 people have NO DOCTOR at all! Emergency rooms are not open on weekends, or at night. Good luck with that "inconvenient" heart attack!
Another friend has a daughter whose husband is career Army. In Canada, families are not covered as they are in the US. She has never been able to get off a waiting list for a doctor, as they move too often.
Be careful what you ask for.
5
What we are asking for is care that is as just and supporting as yours was. It could come from either private or public care systems. What most people are asking for is to not die from lack of care, and not lose all their meager savings just because of one illness.
41
@India I am back on TRICARE, the very best health care in the world. There is no comparison. Among other things, TRICARE has an annual cap on out-of-pocket at $5000. But not everybody is fit for active duty military and people reach a mandatory retirement age before age 65. Military spouses getting divorced lose TRICARE. Kids turning 28 lose TRICARE. TRICARE coverage is just plain not available to most Americans.
7
@India Every time I see a negative story about Canadian healthcare I feel compelled to state that yes, our system is not perfect particularly in smaller / remote communities, but you are looking at an incomplete picture. I live in the suburbs of Toronto and twelve years ago I was diagnosed with a chronic illness. I went from a high flying career and six figure income to disability, first short and then long term. I am in and out of hospitals multiple times a year. My drugs have cost anywhere from a hundred to $4,000 / month. I see multiple doctors every month in addition to scopes, scans, blood work and MRI’s. I am picked up by ambulance each time I have to go to ER - four times this year. I am waiting for major surgery. Cost to my family in all this time - parking. We do have private insurance both through my work and my husband’s and that covers the cost of a private room (versus the standard semi-private). When my drugs were not covered by my plan my specialists arranged for me to be covered through compassionate programs. I never had to pay a cent for expensive biologicals like Remicade, Humira, Stelara or Entyvio. In the US I would be dead or we would have lost our home, savings and everything else. Here, we still have to deal with all the hardship imposed by my illness but fortunately financial stress (other than loss of income going from my salary to disability pay, which is a combination of government provided funds and private insurance). Our system works. I know.
14
I have had a major mental illness for 25 years rendering me disabled and unable to dependably hold a job. I had never had a complete remission and would cycle in and out of hospitals, receiving electroconvulsive treatments which were fully covered. Several years ago a new concept in the treatment of major depressive disorder was approved by the FDA and approved by medicare. I had this treatment and it changed my life so that I could resume a normal life. But after the initial covered treatments, further treatments were not covered. And there was no defined follow up protocol. Psychiatrists were sort of feeling their way in recommending more treatment to keep the intial success successful. Research had to catch up with the popularity of the treatment. For the person who had the initial treatments and their insurance covered them, if they could not afford subsequent treatments, symptoms returned and one could easily find themselves in the re-hospitalization revolving door and ECT which ironically is much more expensive but would be paid for by insurance. The suffering is unimaginable and dangerous since suicide is a common event with this diagnosis. Insurance makes no sense. I would like to see a study of people who could no longer purchase out of pocket life saving treatment and how many actually died.
21
We live in a country where elected officials care more about pleasing lobbyists than they do for everyday Americans. If this were not true, we would have had single payer medical insurance decades ago.
73
I go to see my doctor once a month; it's a regular appointment and I rarely need to wait more than twenty minutes. I discuss any new problems and he prints out my RXs for medications. Then I walk the short distance to the pharmacy and pick up my rather large amount of expensive medicines. The cost of all this?
It's free. Because I am a retired person living in Mexico, which has a single-payer health system.
Quite something, isn't it, when the citizens of one of the richest countries on the planet cannot afford health care that's provided free by the next-door-neighbor?
130
@Laughingdog You make a great point however single payer being free isn't one of them.
I will never forget when I was working at a deli in 2012 and an employee at the adjacent coffee shop was diagnosed with ovarian cancer. Rather than take up collections for treatment, a jar appeared on the counter to collect towards her funeral expenses. While she was still alive. If you think this is an exaggeration, ask underinsured people with Type 1 diabetes. Folks are growing up and out of their parents insurance policies, then dying, yes DYING, in America because they cannot afford insulin and necessary supplies to live.
I think that every person is fully deserving of healthcare and a system that reflects so would also heal some of the mental health and substance abuse issues in our country.
Telling people they aren't successful enough to deserve to live doesn't tend too fare well on their psyche.
127
@kelly, We here in the US are very dependent upon fund raisers and Go Fund Me donations for any medical emergency, including burials. What other country does this?
24
I was diagnosed with bladder cancer shortly after going on Medicare five years ago. My cancer has been "cured" (so far). Medicare (at least the plan I have through Kaiser) has a maximum "patient expenses" limit that I have hit in some years since, and missed in most others. Without Medicare, you can't get a plan like this.
Transferring all of the risk to the patients beyond a certain point, or not limiting the costs to a patient/family should be banned. Yes, we need cost controls--but they should be based on values and expected outcomes, not based on assets of families. The Medicare approach of limiting patient covered expenses to a maximum per year/per patient should be mandatory for all insurance.
Insurance companies can spread risks across populations (this is the reason they exist). There is no valid reason for them to force unlucky patients to bear the costs of extreme medical expenses.
The rational for co-payments and other cost sharing is that this will cut down on frivolous medical expenses. The reality is that it just limits the exposure of the experts with a pooled set of costs--then transfers that exposure to those who are least equipped to pay.
None of the assumptions required for a "free-market" system to work efficiently and fairly are valid for individuals with medical needs. No "free-market" solution can work when none of the pre-requisites are present.
18
@Mark Johnson
The whole idea behind the ACA requiring everyone to have health insurance was to spread the risk and then the cost across the population. In other words, those that are healthy use less, if any healthcare service(s) while those that require those services can and utilize them without (hopefully) going broke. Employer sponsored healthcare has created this conundrum we find ourselves in with the threats by the GOP of continually attempting "the land grab" of taking it all away! Heartless despicable people!
2
@Mark Johnson
My max is $12,000/year.
@TeriDk
My out of pocket MAX is $5,200.00 this year. By August 31, 2018, I had used $1924.12 of my annual MAX. (I think I have added about $700 since (finally got the MRI I should get twice annually. The MRI looked just like the one from 18 months ago, which is very good news.) Nothing big scheduled for the rest of the year, so should be well under my max this year.
For most Medicare plans, getting accurate expenses information is very difficult or even impossible. Kaiser's all in one plan provides this information routinely and accurately. The information shows the "provider billing cost", "approved payment", "plan's share" and "my share". The provider billing cost is at least 3 times the total cost actually paid.
Pity the uninsured, who must pay all of the "provider billing cost" usually about 3 times higher than the "plan approved payment".
I was recently admitted overnight from the emergency room; prior to discharge they sent someone to my room to collect the $800 deductible they said I owed; I paid then.
A few years ago I was in an accident and broke both legs and one arm. After mutiple surgeries, I was admitted to a rehab center for a couple of months until the bones healed. At that point I was to go home to continue the basic physical therapy started in rehab to learn to walk again. despite my insurer approving the surgeries, rehab stay and P.T., the rehab center started demanding money from me well before my discharge. First a bedside visit asking for an undetermined amount, A few days later, a visit from their next level person asking that I sign a 23 page contract agreeing to pay any charges the insurer didn't pay (I declined). Next a more forceful call from their office demanding $5,000 as it was against their policy to let me stay otherwise. I asked where would I get $5,000, they told me to try to borrow it or else they would not let me have physical therapy. I wasn't even able to stand up on my own at that point but I was within a few days of being discharged so I ignored them.
After discharge, my insurer advised what I owed the rehab center based on their agreement. It was closer to $2,000, I paid in full. I was fortunate; I had enough paid time off to cover the absence from work, private health insurance and Medicare. If one of those were missing, I would have been in trouble.
36
No politician should have better health insurance than their constituents. Once they are forced to share our health insurance circumstances, they will magically agree with the solutions proposed.
107
@S Bravo. But with our present government, it ain't gonna happen.
6
The bottom line is this: Healthcare is not something that should be paid for through insurance. Insurance is meant to cover *unlikely* accidents/events, up to a certain (reasonable) dollar amount. If your house is worth $200,000 and it's destroyed in a fire, your insurer will pay that $200,000 (or whatever is needed to rebuild, which may be less, considering land costs, or more, considering inflation). But they knew when they set your rates what their maximum payout would be, as did you, and they set your premiums accordingly.
Healthcare simply doesn't work this way. For starters, everyone needs it, eventually. Furthermore, there is no way to know in advance what your medical costs will be over your lifetime. My father never went to the doctor until he turned 75, at which point he had a stroke and suddenly incurred half a million dollars in medical bills. That's NOT a business model that is best met by insurance.
Single payer is the ONLY way to make this pain and suffering end.
141
Only pure good fortune, if one can call qualifying for Social Security and Medicare with only a letter from my doctor good, stood between me and bankruptcy when I first became too ill to work about 25 years ago. I was living in New England on about $1200 a month and spending up to 40% of my income on healthcare including insurance premiums.
I had to sell my lovely home and buy a small condominium so that I would have no mortgage. I was lucky to qualify for a state SHIP program that limited my copays in those days before Medicare Part D to about $15 per prescription--I was taking at least 10 or 11.
At one point, I had to apply for Food Stamps and Medicaid.
Things only got better when my parents left me a small inheritance, just enough to make me feel financially secure.
I was able to leave the harsh New England winters and return to my roots in SC, though only after my parents were gone, but the far lower property taxes allow me to live more comfortably in a small house, much more pleasant than a condominium that leaked for years when it rained, until the condominium board finally put a new roof on.
In this country of plenty, no one should have to go bankrupt due to medical expenses.
30
I'm making $50 monthly payments to collection agencies for my numerous hospital copays. Since the amount I could afford didn't qualify for the payment plans the hospital offered, the medical debt went to collections. This action negatively impacted my credit score causing my auto/home insurance and lease payments to increase. Being penalized this way, I have even less money to work with to pay off the debts let alone food, housing, school loans, taxes, etc.
Welcome to America's Debtor's Prison, 2018.
98
The problem here is not insurance, it is whether America believes that healthcare is a fundamental human right. We cannot seem to come to grips with that issue. If healthcare is a basic right then the answer is clear - get rid of private insurance and just pay everyone's medical bills. But if it is not a right, then we are forever going to have lots of people who are not getting treated because they cannot afford it, or are going broke paying for the care that they need. So rather than dicker around with how bad insurance is, let's just answer the more basic question - should healthcare be a basic right for all Americans? I think it should be.
64
@Scott Werden
Yes, I believe healthcare should be a right and not a privilege. I also don't mind paying higher taxes as long as they go for SOMETHING - like Medicare/Medicaid for all but for as long as Americans consistently vote against their best interests (financial, health insurance etc) i.e. Republicans - then this situation will continue and worsen.
28
@Scott Werden, I have gone bankrupt because of illnesses and on Medicare Advantage Plan. Co-pays, deductibles, etc bankrupted me. I am proud to be born an American and worked for 38 years to come to this but I am not proud to live in America. It is a national disgrace. If I was younger I would move to Canada.
3
I think members if Congress should have same healthcare choices as everyone. Not special congressional healthcare choices
And while do they get a pension? They can have 401k options
38
For a few million Americans getting really sick could even lead to homelessness. As a self employed living paycheck to paycheck couldn’t afford healthcare. Utilities, car and the rent where priorities. Contracted Hepatitis A and missed over three weeks of work, so with the help of a friend and a couple of credit cards managed to survive, but I’ll bet many others in similar situations don’t.
22
At 30, I was honored as one of the top ten young lawyers in my state. I changed professions and was then, by age 35, a nationally noted, award-winning college professor and administrator. At 37, I was diagnosed with multiple sclerosis, and by age 42, I left employment due to disability.
My once-robust portfolio no longer exists. My savings are entirely decimated. My retirement accounts have been stripped. My family has sacrificed its financial security for the present and future because of my chronic disease, and I HAVE insurance.
My interferon therapy cost escalated from about $500/month in 1999 to more than $80,000 a year by 2011. In 1999, the therapy was a "medical benefit" and covered 100% by my policy. Around 2008, the company chose to make it a pharmacy item for which I was responsible for a 33% co-payment. By then, I was on Medicare, and a single co-payment put me in, and through, the "donut hole." It also made continuing drug therapy impossible.
Companies say they have programs for those in need and that may be. What they do not say is that anyone with ANY insurance coverage at all, including Medicare and/or Medicaid, is categorically ineligible.
Serious illness in this country is a serious problem. The stresses engendered by financial ruin contribute to depression, delay recovery, and destroy families. Aggressive collection tactics for amounts in excess of Medicare exacerbate the problems. TRUE single payer care is long overdue.
143
@Elizabeth what you have gone through is terrible. I can’t imagine what it felt like. No one should have to face financial ruin due to a serious illness.
I did want to note, however, that those with insurance coverage may still , depending on the medication, be eligible for programs aimed at those in need, those unable to pay huge prescription costs.
We have a friend with decent employer insurance who would have had to pay $1800 a month for medication ($3000 without insurance) and qualified for nearly free medication.
These options may be rare. I don’t know. But they do exist and it’s worth asking about them.
4
@Elizabeth:
Well, as I'm sure you know, you've also managed to underline the problems with associating medical insurance (which is only sometimes about health) with employment in the USA.
And distinctly, you've highlighted something other "developed" countries have: Drug price controls.
21
@Jace Medicare has some bizarre rules about free medications or reduced-copay medications. I know this because my husband is on Medicare and has Part "D" insurance. We are unable to use co-pay coupons and every time I have gone to a pharma website to read about their free medication programs, as soon as I said he had Medicare Part "D" in the online questionnaire, it automatically popped-up that he was ineligible for the company's program.
1
Medicare Advantage, run by private insurance companies, now is not covering claims because the private companies want to make more money. Privatization doesn't work when you are dealing with healthcare. Iowa chose 2 private companies to run Medicaid for the state and nursing homes are closing as well as other businesses due to not getting paid by the private companies.
18
I have not had any really serious healthcare issues but in after care medical insurance turned my back injury it into a career ending disaster.
After a few visits and many steps to get back on my feet my doctor ordered an MRI of my spinal cord. I watched his nurse argue over the phone with the doctor being called to the phone several times. It took one hour and the final offer was that if I made an appointment for an ultrasound then the office would be allowed to call back and negotiate again. According to my doctor there was no reason and the results would be of no use but I would have to make an appointment for an ultrasound in order to get the test diagnosed by my doctor.
That happened, traveling in pain for another co-pay and then back to my doctor's office to pay again and witness another long negotiation for the test the doctor ordered in the first place. A registered nurse becoming a professional negotiator, a doctor having to interrupt examination of his next patient over and over to talk on the phone. All of it was so wrong.
In the end the co-pays for a simple back injury went over $2000 but the worst was eight weeks in after paying a $45 co-pay per physical therapy session, on my 28th visit my progress ended because insurance would not pay for a 29th visit. I was nowhere near ready to return to work but I did. I was injured again and never worked another day in my life.
Now I'm in early retirement and dealing with this system again is my greatest fear.
26
@Edward Crimmins This is just like my recent trip to the doctor. When to my doctor's office in pain, when I could have been justified going to the ER. I decided to do the "right" thing. Doctor needs to send me for a CAT scan. His assoc. hospital is 3.5 miles away, basically in my neighborhood.
It took almost an hour to get approval. First to get the CAT scan approved at all, then for them to let me go to the nearby hospital instead of driving 31 miles to the provider of their choice.
This insurance company made nearly $20B in profits last year, and they want to deny or nickel and dime my coverage. It boggles the mind.
13
This article, like all articles on medical debt, conflates two key issues. One is the inadequacy of insurance coverage. The other is, how hospitals treat medical debt after insurance has paid.
The latter issue needs more attention. Flying under media radar is that as deductibles have risen, hospital collection tactics have become more aggressive and punitive. While it was once unheard of to send patients to collection, it is now commonplace. (Google "revenue cycle industry.") In Washington State medical debt has become the number one civil legal issue people face.
Why are hospitals allowed to sue for medical debt? Patients do not choose to enter into these contracts; accidents and illness force them to see the doctor, get treatment, or go to the hospital. But upon admission patients are forced to sign a contract for whatever price they might end up being charged. Hospital prices have risen to, on average, 400% of actual cost, but patients have no knowledge of, or control over, the prices they are agreeing to pay. There is gross inequality in both bargaining power and in the key term of price; in legalese these kinds of contracts are called "unconscionable", and are unenforceable.
Also, hospitals have charity care programs that should help needy patients cover the cost of deductibles. But hospitals do not provide charity care like they should; instead they send patients to collection and sue them.
Please investigate how hospitals treat medical debt.
81
@Sherry I agree! Ten years ago, I was diagnosed with stage T3N0M0 colon cancer. In the two years following, my insurance company paid almost a quarter of a million dollars on my care (according to the running tally in my account on their website). From time to time, there would be problems with the insurance company paying the hospital on time. On those occasions I'd arrive for my chemo or bloodwork or whatever and when I'd scan my patient ID card at the kiosk (Johns Hopkins; you scan in upon arrival and get a printed agenda for the day), it would say SEE FINANCIAL OFFICE in big letters. Each time, someone there would try to get me to sign a contract assuming the costs for the day because I was considered "uninsured" at that time. I always refused, resulting in my going home without treatment. I missed several days of chemo because of it. It compromises care, and to this day I wonder if one of those skipped days will come back to bite me in the form of recurrence. The "financial assistance" people were of no help and typically didn't even know the procedures for helping patients. When I lost my job (luckily I'd been declared in remission by then) and, along with it, my insurance, Hopkins refused to treat me at all...essentially at that point it was "go home and die."
30
@Poussiequette I hope you have shared your story with your Congress member and with your Senators. This is one of the biggest arguments for single payer that I have seen.
@Sherry Sadly, you are spot-on.
2
The story illustrates once again the great unknowns of American health care systems: the number of middle-men involved in the industry and the amount of useless paperwork that bumps the cost for small health care providers.
A single-payer system together with a catastrophic insurance coverage to take care of ultra-serious medical conditions of people is one of many ideas that politicians should consider seriously.
38
I hover on the edge of this group (I have a serious auto-immune disorder which will be with me for the rest of my life). I have excellent insurance through my husband, and a good income – I'm one of the lucky ones. But I hate my constant awareness of being at the mercy of both the drug manufacturers and the insurance company, who may at any point decide that they will not cover the several thousand dollars each month that the drug company decides to bill them for my medications.
Recently my physician ordered a simple hip X-ray so he could get a baseline measure for joint damage. The bill came to us with fully one-third of the amount refused by our insurance because the hospital's fee was higher than they had decided to pay. We used our pre-tax set-aside account to cover the (several hundred dollars – how much can an X-ray cost, for goodness sake?) difference, but many people aren't lucky enough to have such an account.
It's this kind of thing that wears you down. The lack of transparency in all the systems involved only increases the sense of vulnerability that seriously or chronically sick people constantly experience.
65
I am a physician and unfortunately there is no 'set cost' for most things. So the doctors themselves don't know what it costs. I can't tell a patient how much a drug will cost until it has physically been ordered for their insurance company to run it. If I change the urgency setting of when a scan is needed the cost can suddenly increase. Depending on if you have medicaid, medicare, supplemental insurance, are completely self pay, have care at a facility that cares for enough impoverished people that they get a break on some of the drugs, and/or are at a hospital that helps offset costs for the neediest patient all depends on how much you will pay. And when I get a signal that your insurance covers a medication, it does not tell me how much your personal co-pay will be. How high is your deductable? Have you met it for the year? Exactly what 'tier' was the medication I ordered for your specific plan? When I go to visit my own doctor I sign a form saying that I agree to pay anything my insurance won't cover. Who in their right mind believes they can pay for current health costs if insurance for some obscure reason decides you are not worthy? But what can you do but sign? Right now the problem is the obscurity of the system for everyone- including doctors.
192
@Erin B
This is a MAJOR problem with health care in the US. Who buys a service without knowing a price? Who changes prices willy-nilly depending upon what they think can be extorted from an insurer on any given day? This is RIDICULOUS!
Those boiler-plate promises to pay (if insurance doesn't) before one can be treated should be outlawed as the coercive trash they are. If insurance has said they will pay, then they should pay, and the patient should NOT be dragged through collection. Whatever happened to the intended 3rd party beneficiary in the law of contracts?
7
@Erin B
I too am a physician and although I don't know the cost of every drug or how much each an insurer will cover, I have a pretty good idea about the cost of virtually ever drug I prescribe. Whenever I am prescribing something for which there is no generic, I always check to see whether the patient has the ability to either pay for it themselves or has insurance coverage to pay for it.
Too many times in my career I have seen physician prescribe medications that I know it is impossible for the patients to afford. In those cases they might as well throw the prescription in the garbage and eliminate the phoniness of the enterprise.
2
Many Republicans use the term socialized medicine and many Americans duck and cover. So much of our Government is already socialized, military, medicare, social security, etc. try and take those away, and those are fighting words. No matter what you want to call it universal health care, single payer it's our hard earned tax money and instead of giving free money to top 1% lets have what other civilized nations have, SOCIALIZED MEDICINE. Stop being used, VOTE !!!
106
I am fortunate to live in France, where we have single-payer health coverage. Certain serious pathologies are covered 100%. Most people have extra insurance which on average costs 100 euros a month.
Last month I learned my lung cancer had returned for the second time: previous cancers had been treated with surgery/chemotherapy.
This time I have started chemo which will go on till next year.There may be radiation at a later date. While this is a worrisome time, at least I don't have to worry about how to pay for the treatments. It is all covered. And this creates a positive mindset which is crucial in battling cancer.
Were I living in the US, I'd be in a cemetery by now.
174
Exactly why we need universal healthcare, single payer, multiple operations. Hospitals, doctors etc can remain private, but everyone would have full coverage paid for by expanding Medicare. Medicare is much more efficient than private insurers, could leverage its clout as the insurer of 350 million Americans to drive down costs, and we could begin to focus on the health of individuals, families and communities instead of profits for nefarious health insurance corporations.
37
I live in Oklahoma so I can relate to the woman who had to liquidate her entire retirement savings so her husband with dementia could get Medicaid. It's heartless and unfair that a spouse has to impoverish herself or himself to get help for the ailing relative. In Oklahoma a spouse has to have less than 2,000 dollars to get help for a husband or wife who has a life-threatening illness. So there goes retirement. There goes any security for the future. The state will even make you lose your house if it's worth more than 2,000. I really do think Republican states, like Oklahoma, want poor and middleclass sick people to die and die quickly.
121
@Linda And how many of those people in Oklahoma who support Trump and his Republican reverse Robin Hood supporters would tell you they are pro-family? It sure seems to me, under the Medicaid system, the most effective cost-cutting a husband and wife could do would be to get a divorce.
3
@Linda: This is why I thank the Lord that my partner and I have never married.
1
An ongoing national tragedy that all of us
can fall victim to at anytime.
Homelessness is the other possibility.
Why don't we,
as a nation
do what needs to be done ?
32
@John Brown
"Why don't we,
as a nation
do what needs to be done ?"
Because, we, as a nation, continue to elect Republicans.
1
@mtj
Then why are the Democrats
not winning ?
I've just read all the excellent comments on this article. It seems pretty obvious that we need a Medicare-for-all system of healthcare in the U.S. And anyone--including more centrist Democrats--who says we can't afford it is full of baloney. It's a question of priorities. When, for instance, have you heard a presidential candidate questioning the bloated military budget? If you lower that budget, and close up tax loopholes that let the wealthy, like the Trumps, skip out on paying their fair share of taxes, guess what? Suddenly you'd have a whole lot of money for a better healthcare system.
59
We need to do something and we need to do it soon. There is no reason anyone should go bankrupt because they got sick. There is NO reason all Americans shouldn’t have access to affordable healthcare. I don’t in all honesty, understand how anyone can vote for Republicans. We need a one payer system.
46
No surprises here. We are disposable, just like Khashoggi or the kids in Yemen. If we're not making money for the corporate overlords, we're disposable.
94
@Martha Shelley. Yes we are disposable but only after every penny is divided amongst all the non medical middlemen that make up our for profit system. And don’t forget the Steinway pianos in the hospital atriums.
3
@Martha Shelley Unfortunately, you are correct. It's a toss away world.
1
The situation is causing more damage to our society than is properly being accounting for as in addition the physical cost, there is another hidden cost on the economy for so many people worrying about health issues. Imagine the positive benefits for society if the entire population was not worried about health insurance or getting sick and had the confidence to know that they lived in a society where if they paid for their insurance they would actually have insurance if they needed it? Add that to the total please.
22
Has anyone here every considered trying to move to Europe as a "heath care transaction refugee"?
I would imagine that a policy purchased by a foreign national for use over there might cost less and offer more.
7
@K What you suggest is complex but intriguing. In most of the EU there is both private and universal care. You are obliged by law to be covered by universal care. Private health care insurance can cost as much there as here. What is there is a cap on all services & medications. We haven't dared touch that in the states yet. With medical education costs out of control here, asking doctors to cap their fees would be met w tremendous push back. It's complicated. To be a healthcare transaction refugee would most likely mean giving up US citizenship and becoming a citizen of the country in which you seek refuge. Tricky business in an increasingly anti immigrant EU
@K
I didn't try. I did. I lived in Holland when I was young and healthy. I didn't go for the health insurance. In fact, I never gave one thought to health insurance. Ooops!! I had a hernia. That's what the doctor said. The doctor I saw had been recommended by a friend. He didn't ask for an insurance card. And did not present a bill. Then or ever. He arranged for surgery. I went to the hospital...stayed 3 days/nights. They didn't ask to see my insurance card. I never received a bill. (I'd be surprised if the administrative costs for the whole business exceeded 10 or 15 dollars.)
Full stop.
That said, we're *Americans* and proud of it--we won't stand for no stinkin' euro-trash socialized commie medicine.
Freedom! Liberty! God bless the free market. God bless the insurance executives--may their annual compensation exceed $50,000,000--for their bounty will surely trickle down to the poor, meek, and humble. Amen.
1
Soon my husband and I will travel from the US to Canada for his hernia surgery. At a dedicated hospital where all patients spend four nights, including three inpatient days recuperating. A place where surgical mesh is used in only 2% of cases as unavoidable. The cost will be about what a single hospital overnight (never mind any actual treatment) would cost in the US. Here, of course, the mesh manufacturers have won over the surgeons so it's de rigueur, and after outpatient surgery with general anesthesia (at likely triple or quadruple the total Canadian charge) patients are sent home to fend for themselves. Irony: after decades of useless high-deductible individual insurance, we are on Medicare, which would pay for what the US system offers. We prefer what we'll get in Canada (where, if we were citizens, it would cost us nothing but a parking lot fee). That's some reality of crossing the border for better, affordable care.
37
@Kristi It's why medical tourism is booming.
1
American Enterprise has done an outstanding job of monetizing health care for employees. From a time when it was universally accepted that a company supported, and invested in, the health of its employees as part of a complete compensation package, to the here and now where health insurance is non-existent or a misnomer.
Retirees. promised coverage for life. are being abandon to government programs with little relation or to insurance; more often a very limited price and services menu. Employees are more and more accepting all the risk and cost of health care with "High Deductible" plans that really become economical in the event of catastrophic illness or accident, and then land (again) in the government's health care bucket.
The cost of health care is shifting to the employee or the government where tax cuts for the wealthy (senior management) have starved revenue raising taxes for the employees to pay for the benefits they receive from their employers.
All that money that used to go to these benefits have magically transferred to senior management, who (ironically) have significantly better health insurance in their contracts, contracts a regular employee will never have access to. That's what "Monetizing" means; taking something of no value to the company and turning it into a cash flow for compensation.
It's like sharing a doughnut where the rich guy eats half, then turns the doughnut around for the little guy to gnash on the open space presented as their portion.
10
Let's just admit that the US is simply not the country to be in if you're seriously or chronically ill. Best to get out of this hellhole and seek civilization. Unless of course that's not an option.
Canada is looking better and better every day. As are a host of countries in Europe.
62
@Max duPont Before deciding to go to another country you might want to investigate their immigration rules.
It is not that easy to get into Canada, and there are health rules.
Do you feel no obligation to fix your own country before you burden another with your care?
2
I wrote a book, Sorry I Was No Fun at the Circus, about the insurance struggles, relationship problems, and my other experiences at the time I was diagnosed with cancer. Women are left in disproportionate numbers after a diagnosis of breast cancer and I ended up naming this The Judas Jilt Syndrome. That said, I could write several more books about what has happened since then and about the unforeseen complications of becoming ill. My life insurance policy discovered I was sick and called to let me know my premium was being increased from $56 per month to something like $950. They reassured me they weren't cancelling me. Also my credit card company, obviously aware of all the medical expenses associated with my account at the time, called to tell me my low interest rate was being rescinded and would be raised effective immediately to something around 20 per-cent. I was current on my payments. There were also expenses of travel, and housing, and recommended diet, and medicines not covered, and even wigs, just to start. Moral of the story: Even if you have great insurance, don't get a major medical diagnosis. It is a terrible business decision and will, trust me, wreak havoc on much more than just your body.
37
Having a baby can wipe you out financially within the first few days of your baby's life. Funny, the pro-lifers don't want to provide health care for everyone but they insist on abolishing the right to choose.
After you have the baby, you are then faced with spending $12000+ in child care a year.
How is a lower or lower-middle class family or middle-middle class family supposed to afford this?
49
@vulcanalex
Missed the point. If there is no "right to choose" and you become unexpectedly pregnant?
6
@vulcanalex I'm dying laughing that you think $12K a year is high for child care. A decent licensed daycare center in NYC runs at least $2500 per MONTH, and that's per child. If you have multiple kids you might do better with a nanny, at about $800 per week and up plus payroll taxes. In much of the U.S., you can't live beyond a subsistence level without all adults working, and then there's the situation for single parents due to death, divorce, deadbeats...
5
@vulcanalex you obviously haven't priced day care centers lately. $1000 a month is very typical, and it will often be higher for infants. As for childcare being done only by a parent, I don't know what century you are living in.
2
Around 25 years ago, my father had a traumatic brain injury. My mother was told that she may have to divorce him to protect the family home if his cost of care was about to over-run his company provided insurance. He passed away before that became necessary. That was now over quarter of a century ago. It is clear from this article that our nation has not improved in this area . It is a disgrace.
85
Please read Woolhander and Himmelstein about the prevelance of medical bankruptcy.
Single Payer!
13
They should have had the wisdom to be born Buffett, Gates, Koch, Kushner, McConnell, Murdoch, Pritzker, Ryan or Trump.
MAGA!
6
The ACA saved my life when I had a brain tumor resected [meningioma] five years ago. I have left side hemiparesis and was eligible for social security disability. After two years I got medicare. I think they need to expand medicare.
13
An artist, I’m in the gray area where, over 60 but not yet 65, with pre-existing conditions, I make too much money to qualify for Medicaid, but not enough to afford all the prescriptions my doctors reccomend. One medicine for Crohns, Pentasa, costs over $1300 at CVS. In all fairness, the maufacterer does offer a $5 coupon on-line... Instead, I buy it from a Canadian pharmacy for $90, delivered. It’s generic, and it works. CVS says “Generic Pentasa is not available in the US at this time”. But it’s available (and almost affordable) everywhere else on the planet.
“We’re paying for the research!”, says a conservative friend.
I’ve been taking the stuff for over twenty years: the research was paid for long ago.
As long as corporate profit is the largest part of the health care equation, the average less-than-healthy American will suffer the consequences.
98
@Robert Reder All you're paying is for marketing, i.e. subsidizing pharma bad practices (yes, they all bribe physicians with our $$$).
13
It's scary that you're taking the same meds for 20 years. Chrons is actually fixable with proper diet in many cases.
This isn't a "problem" it's a reality that no one wants to accept. Death is inevitable, but intervention is not.
Every patient, at some point in their life, will need to decide whether it's worth fighting for more life, or dying with dignity (palliative/hospice care).
Patients who refuse to die quietly, even when the odds are stacked against them, are not "brave", but rather selfish. They view the prolonging of their own life - even if by just a few days - as more important than the quality of life for all those who will survive them for years to come.
I hate to say it, but modern medicine (as in the last 30 years) has created more problems for humans than it has solved. A life should never be measured by the number of days one has been alive, but rather how one has spent each day.
7
@Johnny: Did you actually read the article? What you say has merit, but futile prolongation of life through extreme measures? That's some other article. Not this one. Please read the article. It's not about "patients who refuse to die quietly." Geeze.
35
I've heard the arguments presented by "Conservatives" claiming that: "people get too much health care." All part of the construction that is used to avoid the obvious American reality: Getting sick can make you bankrupt.
If you are sufficiently well off, of course, you can get all the health/medical care you want including all the elective procedures you want. Sufficient wealth also means little to no waiting. Which leads to the primary objection to some form of national health insurance - those with means will have to wait based on need instead of flashing the cash.
Do people in nations with some form of national health/medical care really get "too much" are the waits for non-emergency procedures really all that vexing?
As an American in the closest thing we have to a National Health Service - The VA, I can tell you that even with limited resources I get better service that doesn't discriminate, and is excellent as well as considerate and compassionate. Do I have to wait and allow people more critical than me go ahead? Sometimes.
The key difference is that the system is aimed at keeping me from needing ultra-expensive procedures through regular preventative care and that is the key to cost containment as well a efficacy.
18
Had knee replacement surgery a year ago. The procedure cost was around $44,000, of which Medicare covered all but about $5000--doctors, hospital, rehab. At no point before I received a bill did I have any idea in advance what the cost was going to be. So there was no shopping providers--as if that would help. Given how frequent and routine this procedure has become, there's no reason why it should cost almost exactly a year's income. Because of the last decade's recession I'm a 70 y/o who still works (happily I have to add) as a technical writer and blogger. Having played football, lacrosse and rugby into my mid thirties, I have another knee, an ankle without cartilage, and hips that when the weather's right remind me how many downfield blocks I threw in my teens and twenties. The upshot of that youthful folly is I am an orthopod's dream, with multiple surgeries to come. Will be working into my 80s if I stay healthy enough to cover them. Otherwise? Medicare's a great thing. But we need it to cover more for people like me and frankly for everyone. No one gets through life unscathed--especially in a country with the world's costliest healthcare.
6
@Dwight Homer
Talk to a Medicare broker and find a plan that covers the balance for surgeries not paid by Part B. They are not expensive and pay for themselves over and over again.
2
I live in constant fear of accident or illness. My 52 year old son is a single parent. He is a union electrician, journeyman/ foreman. He works hard. It is physical work and he has the usual health problems associated with it, but if my son does not work he will not get paid and he will lose his house. It is that simple. Everything depends on his continued ability to go to work.
24
That is true for most Americans, including "retirees"
In order to have premiums I can afford, I have a very high deductible plan. It works for me because I have no ongoing health issues and should something awful happen, at least I know I am insured once I pay the deductible. However, what really aggravates me is that very high deductible plans are not HSA-eligible. So I cannot be responsible and contribute to an HSA even though my plan has the highest possible deductible. It just doesn't make any sense.
5
Two years ago, I had overwhelming hospital and doctor bills I could not pay on my meager salary. By proving my inability to pay for my care was able to get "financial aid" from the hospital, which helped a lot.
But the bill collectors for the doctors I had seen wouldn't back down. I owed them just under $10,000. I ended up filing for bankruptcy, which was my only option.
Now, I have very poor credit, but I don't have that debt hanging over my head, either.
18
My brother-in-law has been in a Toronto hospital for 2 months because of Lupis. He has had many tests and x-rays, nursing and doctor care, medications and pretty good food. When he comes home he will need home care. None of this has cost him a cent because of the Ontario Health Insurance Plan. When will the U.S. adopt a health plan that will take care of its people?
113
Too much money being made by insurance companies, so one payer is not going to happen here.
10
@Don M When, indeed. Our system is shameful.
13
@Don M Probably never, here charity is the alternative or bankruptcy.
1
This story reinforces the broadly held view that the United States is heartless and cruel in both foreign policy and domestic affairs.
130
Canada has 37 million citizens; the USA has 363 million. Why did Michael Buble come to the USA for his son's cancer treatment?
1
Probably because he can afford world-class care. For the rest of use, single-payer would eliminate the fears of those in this article.
8
US also has more money. I can only afford my prescriptions if I buy in Canada—at 1/4 the cost including postage.
3
What an unjust healthcare system in such a wealthy country like these United States; if it weren't for it's deep inequality, where the 'rich and powerful' cannot understand (don't want to, may more accurate) why the rest of us complain (and this includes the politicians in congress, hypocrites denying others what they take for granted for themselves), as they seem exempt from the suffering when illness strikes (getting sick is not an 'if' but a 'when'), and the need to skip needed treatment for not being to pay for timely quality care. As nice as Obamacare is for covering pre-existing medical conditions, it is no panacea and unable to control excessive costs imposed by the health industry. Quite frankly, anything short of a single-payer universal healthcare system, this country will remain an ogre, that eats it's own people in the name of greed. Can't we see that protecting human beings from catastrophe is the most financially sound investment we can make, human talent kept alive and healthy and productive? Shouldn't we stop shooting our own foot?
28
I thought Obamacare was supposed to solve all of this, with its one size fits all government mandated insurance policies?
4
@Southern Boy The Affordable Care Act was conceived and operationalized in Massachusetts in 2006 by Mitt Romney, a Republican. Romneycare in its original form, and not the gutted - by - the - GOP current form, broadened the risk pool so that significantly more Americans could get health INSURANCE. This has always been legislation which supports and props up for profit private insurers. It does not and never has guaranteed that people covered by it actually receive needed healthcare.
However, healthCARE is a basic human right, and Medicare For All will go a very long way in assuring that everyone has the ability to receive needed medical treatment without suffering and needlessly dying of preventable causes. Every Western civil society does this effectively except the US under GOP oppression.
We have one last chance to right the USS Titanic in November if enough people are able to overcome voter suppression tactics by the GOP and vote Democratic. If that fails, the ship surely sinks, along with our safety, civil rights, health and wellbeing.
18
@Southern Boy Respectfully, I think you're a little late with criticisms about Obamacare, particularly when the current Administration's primary goal seems to be to undo as much of our former President's efforts in this regard. But 2 or 6 years from now, I suppose we can try again. In the meantime, here's hoping neither you nor I ever have need of medical services in this country, beyond your annual checkup and maybe a handful of flu shots.
American exceptionalism indeed.
6
@Southern Boy I'm not sure if your post is supposed to be a slam on Obamacare. Remember, Obamacare was really "Romneycare," a health plan enacted by a Republican. This plan only became anathema to Republicans when a Democratic president proposed it. As with any complex plan, it was a first step that needed to be improved. Instead, as we all know, Republicans decided to trash it. Now where are we? On the path to going right back where we were before Obamacare, and that's not a good place to be.
24
Every article on health care cost should come with the subtitle, "The US spends about one trillion dollars a year on national defense." We are making a choice.
60
@Peter S. Quite true, as we used to say better dead that red. Or today better dead than not free.
@vulcanalex Or as some people say today, better dead than to try to go on living with an illness that will bankrupt my family and cause my children to leave college or alter the path I worked so hard to set them on.
2
Look at how much money is voluntarily spent to get candidates elected in every campaign season. Tens of millions for a single candidate, from $10 individual donations to sky's-the-limit. This tells us many things, but for this topic, it tells us that we as a nation can well afford to provide all necessary medical care to every one of our citizens. We can remove that anxiety about paying the household and medical bills so many face when they are already anxious about a serious health problem. Why wouldn't we want that peace of mind for ourselves and our loved ones and, because we are a humane and compassionate people, for all our neighbors? I do not understand it. I am beginning to lose faith in my countrymen. I don't recognize this heartless, selfish and greedy America that is being revealed across many issues. You would think we could at least care about sick people.
34
Why is it that other countries can provide health care for all of its citizens and protect the public from diseases with preventative health care and individuals from poverty due to catastrophic illness but the US can't?
Moreover, how come other countries have governments that do people's taxes for them, send them a bill/notification and it takes these people less than 15 minutes to deal with their taxes and doesn't cost them extra (like in the US with accountants, software, filing charges, and many hours doing their taxes)?
Something is really wrong here in the US.
76
@Autumn Flower
Oh, we can.
GOP oppression is the reason why we don't.
News organizations should post the preventable deaths and illnesses/injuries reports from every state every day so that we understand exactly who we are harming and killing because of allowing the GOP to oppress us and deny we the people what we want and need: healthcare for ALL.
18
@Autumn Flower, Ya think? But we're supposedly #1, right?
2
Pre-existing conditions.... why can't everyone just use the real term: chronic illness? The system isn't designed for people with rheumatoid arthritis. It is designed for the broken leg. Childbirth. What one physician I have refers to as temporary disabilities.
Also not mentioned are bills such as gas to make appointments. Parking fees at the hospitals. If a hospital REALLY wanted to help, all patient parking would be free. And, of course, the multiple trips when as it is impossible to schedule more than one physician's visit per day, because, understandably, they all have different schedules. I've often wished that Fridays were designated as emergency surgery only, and designated for office visits, but, that policy would leave expensive facilities unused.
My husband has an excellent job, with great benefits, and I have the platinum offering of insurance. We struggle. Two years ago, Blue Cross eliminated catastrophic for families. I usually hit it, and as the out of pocket amounts were for the FAMILY, everyone else benefited. Now, one person can hit it, and the rest of the family, collectively, must hit the same caps. So, our expenses dramatically increased.
My experience is people talk about it, a lot. But, no one actually does anything.
13
I have Rheumatoid Arthritis and the costs of medicine is outrageous. I also have excellent healthcare that pays for almost all my medical expenses
6
Problem is most people can't afford to even get decent, basic 'preventative' care. So their health suffers and gets worse then there is expensive medical intervention, after the fact. Usually too late. We're not trying to prevent people from sickness just treating the chronic aftermath. An ounce of prevention is worth a pound of cure. Right?
10
@MS Actually no. You can reduce risk or detect something early but little you can to do prevent disease. Read Gilbert Welch’s books.
We are retired. My wife has had 4 surgeries over the past year for breast and endometrial cancer. She has undergone radiation and chemotherapy. We pay about $400.00 per month for health, dental, drug, and optical, insurance. For all of this we have paid in the area of $500.00, out of pocket, to cover the deductibles (drugs) and co-pays. Reading these stories is shocking. The collective misery here should give any voter the incentive to make the changes necessary to cover all citizens at reasonable cost. Ask for the same health care your governing officials get!
53
@Michael I am also retired in the US, except for drugs all of my health care is covered with no cost to me other than the premiums. Now I use a lot of expensive drugs so my drug bill is several thousands a year. Fortunately I can afford that.
@Michael: I have lobbied my representatives since 2009. I save my communication (and phone call records) in a file, which is now 19 pages long (single spaced). It's a waste of time. STILL I keep hoping and supporting those orgs like Healthcare NOW! that are fighting for relief and sanity for the US healthcare monster.
5
@Michael You should make clear that the $400 you pay is for private coverage on top of what the government provides. The cancer treatment was free to you at the point of use.
Can I just say that I’m really grateful for the NHS. I would have never been able to afford the operations and care I had, had we not had it.
It makes me sad to see that money in the US in the number one factor when it comes to not accessing the proper health care. It is only hurting society when you fail to look after your residents, and while I am not advocating a ‘nanny state’, I do think it’s important that all humans everywhere should be able to access health care/insurance without discrimination and prejudice.
46
Rent, housing and property taxes are also huge problems.
The Harvard School of Public Health should do a similar survey of people in European countries like France, Germany, Switzerland, and Norway or Sweden. All these countries have some type of universal healthcare. This would demonstrate how different health coverage is in truly developed countries where they care about everyone versus the Divided States of America, where we ration care by the ability to pay.
43
Explain to me how any American in the middle class can pay for a 10 day hospital visit if the bill is $200K? Most Americans in the middle class live from paycheck to paycheck with scant savings.
38
My hospital stay for 6 days was $63,300. I only had to pay $300; my insurance covered the rest and I am so grateful for that
7
Pelosi said “We have to pass the bill so that you can find out what is in it."
That was more than just a red flag of incompetence; it was really a white flag of surrender to the insurance industry!
10
Europeans have better health care in other EU countries than most Americans have in their home state. It's disgusting. Stop treating people as disposable commodities.
(Ps. Our national universal health care rights extend to having the same rights as locals in another EU country)
23
@Jonas Great for you, our constitution does not include a "right" to either health care or insurance. Anybody who wants to get that in the constitution is welcome to try.
2
our constitution includes slavery.
I am curious why Mr Berger depends on his wife's medical insurance from her job in Walmart. Mr Berger has Social Security Disability, which should make him eligible for Medicare.
Medicare, along with a supplemental policy, and a drug policy, or a Medicare Advantage type plan can cover almost 100% of medical bills.
I had a liver tranpslant. I never paid anything for any of my 10+ hospital stays pre-transplant, nor for the transplant itself.
Medicare plus a supplement and drug plan is incredible. It is not free - one must pay something for all three plans - but the coverage is amazing.
13
@Susan T Medicare doesn't start until 2 1/2 years after you are approved for disability benefits. That was my experience with my husband.
9
@Susan
He may have Medicare but cannot afford part B or D. His and his wife’s income may put him over the limit for Medicaid
5
Yes, I have exactly this insurance. It costs about $400 a month. How much does Social Security Disability pay? I just looked up what a one-room apartment would cost in Kansas. About $600 a month.
4
Yet another indicator of the disaster that is the US for-profit system. Most maddening is the advertising featuring ads that tout online portals and computerized records accessibility, as though this is a huge boon, when in fact, it's veneer and doesn't ensure anything in the way of optimal care and fair interactions between insurer and insured. I had a serious illness in my forties that like some folks herein caused me to expend what retirement savings I'd managed to that point; it took me twenty years to replace that loss. At least now, with Medicare, my liabilities are more limited, but so is my income, and hence, the threat persists. If you're not wealthy, you live under the stress of that knife edge of ruin. Nothing will improve without single-payer, (Medicare-for-all only with improvements to Medicare).
33
@Vincenzo Actually, the online portals are very useful -- for the insurance companies and the hospitals. You can lay off thousands of CS reps and records clerks and replace them with an app.
1
It’s a tough choice
Guns or Health Care ?
Military Expenditure or Health Care ?
Trump or Health Care ?
191
What's wrong with letting Mother Nature decide when our time is up, instead of spending every last penny in a hospital bed?
7
Heartless!
2
@Walter McCarthy Walter, the flu can kill you, there's just no reason to let it. Its a personal decision and when that time comes, its critical to give a patient the pertinent information. The problem is there are ethical and cultural issues that prevent doctors from speaking frankly to their patients about end of life care.
9
@Walter McCarthy I don't agree with you but Republicans do campaign on death squads if we implement universal healthcare
2
It is just absolutely shameful in America that our own people have to suffer so much in addition to being ill. Yet, we passed what I refer to as the Great Tax Heist bill with no remorse in cheating our government and people out of fair contributions to run this country. If you are new to such suffering in this country then you should be ashamed as well.
25
If you like the health care system as-is, vote Republican.
42
I will vote Republican
Yet people keep voting Republican.
40
Just like the GOP does not care about locking the children of desperate refugees up in cages, the torture and execution of a journalist (a group of people whom they have spent much time demonizing) or the slaughter of starving women and children in Yemen with US-made weapons (hey, there is money to be made), they also know that most people are healthy so if a few "losers" get horrible illnesses and go broke, tough luck. They ONLY care that we've got ours and we are going to keep it by whatever means necessary. What a pathetic bunch.
21
@Tony Those cages happened under Obama.
@vulcanalex No they did NOT
Our healthcare system is a disgrace. Medicaid discriminates against the low income people who qualify for it. Many doctors won't accept Medicaid patients because the reimbursement rate is lower than Medicare and most private insurance. As the federal government and insurers cut reimbursement rates, it seems likely that more doctors will opt out of that as well. When I got a consult at the Mayo Clinic, I was told that it was cash only. Where will this end? Not with Medicare for all. More likely, insolvency for more.
22
I’m not at all surprised that the Mayo Clinic demanded cash upfront.
The Byzantine bureaucracy that is our current health insurance system is driving the best doctors private clinics to simply not accept and health insurance whatsoever. The time, energy, resources and staff required to deal with insurers is a burden on medical professionals as well.
These doctors likely would not participate in a single payer system either, unless the administrative cost were lowered and the MD compensation increased.
1
Medicare for all. Now. It is not difficult.
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No solution will come from Congress as long as their own health insurance is guaranteed for life. People do NOT understand that current system is designed to bankrupt anyone without a huge bank account despite having insurance. Doctors can't help you with information on cost because they themselves don't know the cost of procedures and medications they recommend. It is not because they don't want to know. Insurance companies keep this a secret and will tell them that charge depends on the contract they signed to be in the network as well as the patient's own coverage. Basically the insurance plan does not have to produce master charge sheet for everyone -- patients and doctors-- to review. Ditto for pharmaceutical companies. As long as our health plans are tied to employment, we are toast. How can you work if you are getting chemo for 3 months? Your absence will cost your job and after that, you have no insurance. It makes me sick when I hear politicians claim that we have the best healthcare in the world. That is true only for a very small slice of this country.
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@Sadie The doctors sure know the cost when it is cosmetic surgery! They even offer up a credit card to pay for it.
1
It will likely take 20-30 years for each GOP supporting, Single Payer opposing voter to fall victim to a catastrophic illness and admit that the medical monstrosity we call healthcare in the USA is a failed system. Monsanto adding toxins to our food supply and trump adding toxins to our social fabric will hasten this outcome.
15
I believe we are at the point in this nation where people will really start demanding more from their elected officials. These people are elected to work for the citizens, not the other way around. We need healthcare for all; a national healthcare system. People can call it whatever they like: socialism, communism, etc. This is the richest nation in the world. No one should be bankrupt or unable to buy food, because they got sick. We are unique in our cruelty towards our fellow citizens.
29
@Teddi P And yet, we call ourselves a "Christian" nation. We may be, but in name only.
17
This is yet another reason why money in politics is a bad idea. The people who can raise millions of dollars are not in touch with the people who can't pay the bills every month.
Mandatory campaign finance reform would largely remove the moneyed interests from government except in cases that we can prosecute for bribery.
Health care, like politics, is no place for profit.
23
Nothing will change so long as we're afraid to become self-insured through a public program like we've done with Medicare, although that can be improved, too. Large companies can self insure their staff and pay claims directly as a single payer like Canada or they can contract with third party administrators in a multi-payer system like France.
8
@Keith my husband has self insurance through a union. By far the best insurance.
2
It is time we move to a single payer system in the US. The fear that the GOP continues to spread about such a system in terms of cost, etc. is deny Americans a basic human need. Without good health we are being denied are unalienable rights of life, liberty and the pursuit of happiness. Until we proceed toward such a goal stories such as these told here will become more common and the cost of healthcare as compare to the GDP will continue to rise. Enough already, let’s truly do something to benefit the American people.
56
The time has come to join the rest of the civilized world and provide health care the same way all other first world countries do- a single payer system, and eliminate the privatization, the for-profit motivation.
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A few months ago, I read an article in which a state government official (from Indiana, I think) wrote that the only solution for health care will have to entail a massive Manhattan Project-like effort involving the federal government, the medical industry, the insurance industry and the public working together for one comprehensive program. It could take several years, and when their work is complete, Congress would have to vote the entire package either up or down - no amendments or revisions allowed - and the President would have to commit to signing it if congress gave it the thumbs up. It seems to me this is the only way out of the mess - force congress and the President to act, but not give them opportunities to nit-pick health care reform to death. If anybody in Washington DC is reading this, please show some guts and do something.
18
This is not an unsolvable problem. Insurance companies make loads of money, do nothing to contribute to the well-being of Americans, and make the healthcare system more expensive and more complicated for everyone. It’s time to phase them out.
I’d like to see politicians tackle this problem head on.
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They are too powerful. They wrote Obamacare even. Elections are expensive, and candidates have a "public position" and "private position". Ordinary people seem to have no control over the process. Well, we can't even quite understand a mystifying hospital bill because it is written with health insurers in mind.
2
It is just too expensive to even exist as a human in the US.
My Canadian friend was treated for cancer for 9 months, did not have to go to work, was able to focus on his recovery, never received a bill and received his paycheck every week. He is in remission and is back to working full time.
The United States treats its citizens like replaceable commodities, if one if broken, throw it out and get a new one. My true feelings and disgust for this country are unprintable.
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@CEl
Yeah, but, socialism, bah, blah, blah...
27
As a Canadian, I am thankful for our system everyday. Both my parents have had extensive bouts with cancer as well as other ailments and the system has come through for us in every way. We would probably be considered upper middle class but I cannot imagine the financial drain, after a lifetime of my parents always working and being extremely financially responsible, had their treatments not been covered by our public health care system. My heart goes out to those who are ill and are facing financial hardship in addition to the stress of illness.
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@CEl And now pot is legal in Canada. I'll meet you in Toronto. Not even kidding.
12
People wonder why our politics are so uncivilized. But that questions rests on the unwarranted assumption that our society is civilized. Casting off the most vulnerable among us is primitive. And it appears that the primitive urges in our society are predominating. That is all the more ironic since these urges are ultimately self-destructive.
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@Frank Primitive people at least tried to care for their sick and elderly. We modern humans are the ones who don't care.
10
@Maggie
We care in Canada very much.
@Frank It is not "primitive." Primitive people take care of their own. They have herbalists, midwives and "witch doctors." Even some animals will protect and support their sick, their wounded, their elderly and their pregnant and nursing mothers. Barbarians, on the other hand, leave their sick and wounded by the side of the road to die.
1
My plan is to not bankrupt my spouse. I’ll take my leave quickly and quietly when my time comes.
The real heartbreak comes when dealing with a sick child.
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@CC the problem with plans is that they often don't work out as planned! My husband survived cancer and its treatment only to be diagnosed with Parkinson's and dementia 4 years after he was 'cured' (the word used by his oncologists). We are racing through our savings but what other alternative is there?
19
@Emily Corwith: CC meant suicide. It is 100% effective and halts further depletion of family resources when correctly applied.
1
So sad that people include suicide in their health care plans. And yet the GOP celebrates the erosion of the Affordable Care Act. So tragic.
3
It just breaks my heart to read about stories where people in the USA have to decide between paying a hospital bill or paying an electricity bill, or lose their jobs, their homes and in the end even their health. Just why doesn't the USA, one of the richest nations in the World, provide Universal Health Care? I think many people know the various reasons for that and have said so in the comments here. I am a dual USA/Italian Citizen and yes, in Italy there is Universal Health Care. Last Spring I had to spend a month in the hospital for a bacterial infection of Clostridium difficile. I was given every exam and analysis and medicines that the doctors could think of and they cured me and I got to go home and I did not go bankrupt nor lose my home. All expenses were included even the ambulance ride to the hospital. Bonus: there was an Italian election while I was in hospital. Election officials showed up so all who wanted to, could vote, one only needed an ID and their voting card. (I was not happy with the election outcome, but want can you do?) I also receive by mail regular appointments for mammograms, I just go to the designated place and get it done. If I want/need to see my general practitioner, I just make an appointment.
On another subject: public university education is cheap or free depending on circumstances. No one graduates from university with debt in Italy.
On yet another subject: there are serious gun laws in Italy...
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@Concerned Citizen: Only Italian citizens can vote, legal alien residents cannot, and all that is needed is an ID and the voting card which one gets beforehand by showing a photo ID at a government office. One cannot automatically get Italian citizenship by being born here, unless one has at least one Italian parent. Children born in Italy with foreign parents can apply for citizenship after continously living here for 18 years. Obviously you are ignorant of the fact that Italy and other European countries have a huge problem with illegal migrants crossing the Mediterranean in rickety boats, people from Africa and the Middle East escaping war and poverty, the largest movement of people since WWII.
I am sure that the USA could have universal health care, but the powers that be have decided to spend money in other ways.
You can criticize Italy all you want, but living here means that there are three things, the ones I mentioned above, that one never, ever has to worry about.
@Anne
With the hospital acquired infection rate in the USA, I am worried far less about getting shot then the hospital treatment that follows.
@Anne: so you could vote...but only with a valid photo ID and "voting card".
LIberals and Dems OPPOSE such for the American people. They want people with IDs to vote, especially illegals.
Does Italy have 22.5 MILLION illegal aliens arrogantly living out in public, and dropping anchor babies on welfare?
Didn't think so.
We can have American single payer the second the last illegal crosses back over into Mexico and stays put.
1
Although there is massive propaganda in the US about the Canadian healthcare system, Canadians do not have to worry about buying health insurance or coverage for any kind of illness. Employed or unemployed, poor or rich, everyone can access healthcare for free. We have some of the best cancer treatment outcomes in the world and longer life expectancies than Americans. And the system costs about 75% less because there’s only one payer. Decisions about healthcare are made by doctors, not insurance company flunkies trained to disqualify claims. And we pay far less for medications. What is not to love? Oh...insurance corporations don’t like the idea. Let the people suffer!
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@Alanna one of my best friends is from Quebec and you are absolutely right!
9
Reading people’s heartbreaking stories here makes me truly thankful for the Canadian healthcare system. Yes, it’s not perfect-sometimes we have to wait-but urgent cases are always seen quickly, the care is excellent and the doctors caring and competent.
Remember that hospital care has not always been free in Canada; someone (Tommy Douglas) saw people suffering and cared enough to fight for them. We must never take it for granted.
Wishing our American cousins all the best.
2
@Alanna There are tradeoffs, you are often sacrificed for the common good. My neighbour was diagnosed with breast cancer, told there was nothing they can do. She went to Switzerland for treatment, has been in remission for almost 3 years. Canada would let her die as treatments are often not offered if not cost effective. The wait time for basic stuff is incredibly long and getting longer with the boomers piling up, a simple cataract in my area is a 1 year wait which is ridiculous. A knee replacement is almost 3 years now. People tell you if you don't like it to "go to the US."
1
This is a sad, very American story, One not heard so much in other western Democracies (Japan, Canada, Sweden, ect.) When will a proper public health care system be seen for what it is... a stabilizing social good that improves the life of a society, economy, community and a suffering indivudual.
45
The goal is debt, as in getting as many people into as much debt as possible to allow the rentier class to profit. They are aided and abetted by their embourgeiosed servant class, both in and out of government. The rest of us do not even rise to the level of collateral damage.
32
My son was struck with a rare disorder at age 9. I quit my job as a teacher and sold my house to move him to the coast of San Diego where tree pollen, which triggered his illness, was lessened. I spent two years with no work to care for him, and only returned to work when my older son moved in with us to help with his brother. I went through every last dime of equity and retirement savings before his health stabilized. Unfortunately, my ex-husband wasn't required to bear the same share of costs. Thank God I had help with my sons' educational expenses from an old friend, and both boys will graduate college. However, it left me penniless as I enter retirement. I'm waiting to see how much of the $50,000 surgery my son needed his insurance will cover. Why can't we do better?
152
"The whole point of health insurance is protection from financial ruin in case of catastrophic, costly health problems." This is true...but the protection is for the insurance companies, NOT the people who buy the insurance. And I'd say it's working perfectly in that regards.
136
Ask opponents of Improved Medicare for All/single payer: Do you have a proposal to deal with this? Or do we just let people get sick, get financially ruined, and die? Tinkering around the edges won't fix this.
71
We should have Medicare for all......it makes such sense.....I"m 83 years old....last February I fell in front of my house and broke my ankle.....in 15 minutes an ambulance came and got me....took me to the emergency room at a nearby hospital.....in a week I had surgery and then 10 weeks of physical therapy. I have never received a bill for this. I do have a supplemental policy. This is the way it should be for everyone. Who is stopping this? The Republican Party is who is stopping it. They are hurting their own constituents. They diminish this country. It's about time to stop them.
439
@Stan B
Americans who work for their money received a bill for this.
Americans whose money works for them did not.
Obamacare had no public option. And no meaningful costs nor price controls. Nor did it cover all of us.
1
@Blackmamba: The ACA had no public option because insurance company lawyers wrote the legislation. Medicare for all is the only way to guarantee people of limited means medical care.
@Stan B it's not just the GOP that's blocking meaningful reform. It's the entire wealth (oh, no health) care industry and a sizable number of voters. The wealth care industry stands to lose a lot if we change the current system. There are a lot of citizens and voters out there who do not understand how a nationalized single payor health care system would work. (And a good number of them don't care because all they think is that they are paying for other people's bad lifestyle choices, never realizing that some of those choices are due to the poor quality of choices available to them.)
All in all Americans are not terribly charitable towards their fellow citizens until they are in need.
3
How can the wealthiest country on earth fail to recognize that keeping all it's citizens healthy and giving them a modicum of financial security is good for the things that make any country a good place to live? It's truly beyond me that Americans elect politicans who treat them and/or their neighbors in this unconscionable way.
209
@SpyvsSpy. Easy. It's not the wealthiest people who have these problems, and if they did no expense would be a problem.
21
@SpyvsSpy
So I am an American, cannot grasp this either. Poor education? Perhaps its from a distorted devotion to the idea of independence in all things, even it it will kill you - or bankrupt your family? There really is nor freedom for anyone who needs care that isn;t covered, which they cannot afford.
There's also no longer any sense of shared hardships or community: that's what enabled FDR to get through his programs in the Great Depression.
32
@SpyvsSpy
Racism.
I mean, I could elaborate on that answer, but really that's why. Our society was an uneasy graft from the start, far too much of it founded on the evils and horrors of a plantation slaveholder society. It's our original sin. It's a disease that's infected the whole country. Our wounds turn gangrenous and can't be healed.
For a comparison, look at the difference between the society the Dutch built in the Netherlands and the one they built in South Africa. A tree rotten at the root is rotten throughout.
I used to think that we could be better and move past racism. But every time America has tried, there has been a terrible backlash - from Dred Scott to lynch mobs to Jim Crow to mass incarceration to DJ Trump. We will never fix it, and we will never be a good place.
3
Two major medical events 20 years apart have had an enormous negative impact...repair and repeated coiling procedures of a cerebral aneurysm over a five year period resulted in out-of-pocket payments of at least $8,000 over a five year period...more recent cirrhosis diagnosis and ancillary health issues cost another $8-12,000...in addition, dental costs related to a Sjogrens syndrome diagnosis have exceeded $8,000... These events and resulting expenditures have forced the "cashing in" of a $6000 savings account and reduction of another mutual fund account by $6000+...
I have "good" insurance with a $4K annual out of pocket limit but remember: I still spend &4000 on medical costs in additional dental and uncovered ancillary costs...
There is another important consequence of these costs; the increasingly agressive and unreasonable billing and collections methods used by privatized collectors (my health provider, Moses Cone Health, utilizes PatientCo)...
31
McConnell and the GOP have stated they are going to go after what shreds of healthcare the elderly have left. The GOP are going to go after Medicare and Social Security. Time to vote the GOP out and while at it tax the 1% for the monies that would make healthcare for all available at the cost of their yachts and chandeliers.
166
@poslug If the House doesn't flip this will be a major threat.
33
I have Medicare and a Supplement plan plus Part D. I have no clue what is covered and what isn't.....I mean I went thru and evaluated plans and compared then, etc., but here I am just out of the hospital for surgery for a condition I didn't know I had.....until it got so bad I couldn't walk. The surgery corrected the problem, I can walk again and will be back to my old self with therapy in a couple months.....but, I am waiting to see what all this will cost. I feel very fortunate that I have Medicare, but it troubles me that other folks out there have to make a choice between food or rent and bills. We have good care in this country, but everyone should have access to it....no one should have to decide between care or money.
75
Had an interesting chat w/ some Belgian tourists here in Back of Beyond, UT recently. Sez' they; "Sure we pay 50% income taxes but we know we won't be ruined financially by disease or injury (plus we can send our kids to the best universities for $800/yr). We europeans just cannot understand why Americans tolerate such an abusive health care system."
But hey, here in The Land of The Free (old white men), if we're rich enough, we don't pay any taxes at all and still milk the system for all it has. See: Kushner, Jared (probably Spanky, too - which we'll find out after the (D)'s rock the House.
280
@Miss Anne Thrope: they pay 50% income tax AND about 20% VAT (national sales tax) on everything from a stick of gum to a car.
AND that university is not "the best" -- nothing like Harvard or Yale -- it is more like a mediocre state university (also more than $800 a year).
AND every child cannot get into that Belgian university. ONLY the very top students, maybe 15% of the whole student body, is admitted to "free college".
The rest must pay or out of the country or even to the US.
1
@Concerned Citizen
Yet all the Europeans I have worked with over 40 years in international development speak multiple foreign languages. The Belgians were some of the best -- intellectually and socially.
How many languages do you speak, CC?
1
@Miss Anne Thrope
I (an american) did my taxes on Revenue Canada. Yes they were somewhat higher. However, factoring in things I must pay for (healthcare for instance), i was slightly cheaper being Canadian.
Plus I would not have to liquidate my retirement savings and sell my home to pay for chronic medical conditions.
1
When it comes to healthcare, Americans picnic on the precipice of disaster.
78
A national disgrace, no other way to describe it, an aberration re our peer countries.
It is like all our peer countries have abolished slavery and we have not.
The democrats should be pushing a affordable, quality, nation health plan in every district in this country especially in red and purple ones where it is popular too.
60
Only in America. Our government is under the control of the Republicans who do not care about the needs of the people. It's a national disgrace that we as a very wealthy country have a broken and dysfunctional health care system that benefits only the wealthy. And what we do have under the Affordable Health Care Act, the Republicans want to do away with the provision of covering preexisting medical conditions.
Providing universal health care is not socialism and it's about time that our taxes are used to benefit the health and welfare of all Americans.
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@MSS
This comment lets the centrists in the Democratic party off the hook. They are just as equally to blame for this sham of a system we have here. Their solution thus far has been to increase access to medical insurance, not nix the parasitic & sham system of medical insurance in this country.
24
Good article. I have a small company, health care is my number one expense. Unfortunately a number of years ago a was hospitalized ( heart ). My out of pocket plus co-pays, etc, etc totaled approx $ 13,000. And as a family we pay $ 1,600 a month. I should run for office as these politicians have no clue the cost of health care......Stay healthy !
68
@Oliver
Why don’t you run?
14
@Oliver
Oh!, but they do! Just look at their lists of donors and I am sure you will find plenty of health-related and pharmaceutical company lobbyists. What a deplorable country with which we live in. WE do not take care of those that are most vulnerable and at risk.
3
This article doesn’t surprise me in the least because the entire system is stacked against the average person in this country. I’m a newer nurse on a cardiac unit and the nurses with 20 years plus of experience constantly remark on how every year our patients get sicker. It really comes down to greed on every level: aggressive marketing from medical device and pharmaceutical companies, bloated insurance providers that only care about the bottom line, government subsidies to lower nutrient products. The list goes on and on. Our system creates sick people and then depletes them of every penny to treat their chronic illnesses.
I’ve come to view wellness as one of the greatest financial investments that a person can make, but I realize that it requires an amount of time and money that many individuals in this country cannot afford.
161
Yes, health is the greatest asset. However, not everyone is born healthy or can stay healthy despite their best efforts. Almost everyone gives in to poor health in the final years.
2
I sometimes wonder whose fault is this that patients cannot make their medical payments. Are their insurance not good enough to cover most of the expenses? Is a better insurance place too expensive for them? Or are they making too little and also saving too little for rainy days? But after all, I think I have to blame our education system that fails to educate our youth that fiscal and physical health are important. I also have to blame our news media that not enough reports to highlight the consequences of failing health and/or lack of fiscal prudence. It is important to point out that SSI and Medicare may not be there when they retire.
6
Why doesn't the US have a health insurance system like more civilized countries?
27
@Usok
One needs to have the means to get fiscal health and physical health. If you are working 40-50/week at a low wage job you barely have enough to cover basic expenses, let alone save for a rainy day. And when you are working those hours, add in commuting time, possibly taking care of family, maybe going to school, it is extremely difficult to find the time to work out and be physically healthy, and there are many health issues that even the best diet and exercise cannot prevent or cure. Possibly you didn't mean it like that, but your comment comes across as blaming the victim rather than as looking for a solution for a national crisis.
51
@Usok American per capita healthcare spending is nearly double that of France (OECD 2014 data). Our system is not perfect but it is universal and we get great, state of the art, healthcare. Sometimes government run programs can be more efficient and far less expensive than private initiatives where the goal is profits rather than "caring". It is also heartwarming to know that no one will die because they didn't have the money or because they did not earn enough to "save for a rainy day".
66
"The whole point of health insurance is protection from financial ruin in case of catastrophic, costly health problems." That used to be the case, but ever since the HMO revolution and rampant privatization of the 1990s, the trend has been toward more coverage of routine expenses, with restrictions and disincentives on expensive specialty care. My dental "insurance", for example, covers 100% of cleanings, but only 5% for crowns! Today's incomprehensible plans, with their complex schedules of co-payments, deductibles and "co-insurance", were designed by admen and accountants to appeal to consumers and maximizing profits, not to protect patients from ruin. Just like the plans of telecom companies, their complexity is not a bug, it's a feature, specifically designed so that patients don't even try to understand their bills, they just pay them.
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