this post was submitted on 13 Aug 2024
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Hey all, I'm British so I don't really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.

So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.

However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They're just some elaborate dance between insurance companies and hospitals. If you don't have insurance, the cost is lower or removed entirely. Supposedly.

So I'm just asking... How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.

How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?

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[–] CPMSP@midwest.social 8 points 1 year ago (2 children)

$896 per month in premiums, and about $18k out of pocket so far this year in addition. Me and two kids.

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[–] seaQueue@lemmy.world 8 points 1 year ago* (last edited 1 year ago)

Let's put it this way, for most Americans it would be cheaper to fly to Cuba, stay in a hotel and have any medical work done there than it would be to pay for similar healthcare in the US.

You can get amazing world class healthcare in the US but you pay a similarly amazing world class price for it.

(Edit: Oh and by the way shitty healthcare also carries these world class prices, think of the shareholders!)

[–] ChillPenguin@lemmy.world 8 points 1 year ago* (last edited 1 year ago) (6 children)

I have insurance. Just to give you perspective. I had a video call for some mental health diagnosis. I now have a bill of $568 dollars. Reminder, this is WITH insurance. I have to pay that out of pocket. And I even have to set up additional appointments. Which will be probably around the same price.

I also have an inhaler. I had a doctor's appointment to get a refill on my medication because I don't have to use the inhaler too much (meaning I don't have to refill often). I try to stay healthy and workout and only have to use it when working out/exercising. $300 dollars for the appointment. Another $212 for the actual medication that I picked up. In the last 30 days I have blown over a grand on medical. And I'm not even sick/unhealthy.

My wife on the other hand has very expensive monthly medication for a rare disease. She hits her max out of pocket every year which is 5k. Which we just have to pay forever. If I was on her healthcare plan, we would end up paying 10k every year just for healthcare.

I would say on a regular year. We pay around 7k in healthcare costs with our insurance (depending on how healthy I am throughout the year). On a light year 5.5k.

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[–] CascadianGiraffe@lemmy.world 7 points 1 year ago (5 children)

This last winter I was unemployed and I got sick enough to need antibiotics.

I couldn't prove that I didn't have a job, so the 'sliding scale clinic' charged me $586 to talk to someone (not a doctor). I knew what I needed. I was forced to take an unnecessary STD test ($180) and to promise I would go in for additional testing and scanning (undisclosed price, to be determined AFTER).

The meds were around $40 for a week of pills (15 pills).

I knew my issue, and just needed a prescription for the antibiotics.

I have a job now. They want about $200 a month for the basic coverage. I have on average, $20-$30 at the end of the pay period. So I could get insurance, but it means skipping more meals (I already skip several a week to save money).

So I just hope nothing ever goes wrong because if it does, I'll need to be close to death before I get help that will take me years to pay for.

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[–] gedaliyah@lemmy.world 7 points 1 year ago

My experience is pretty similar to others. Basically, if you have insurance (most people do, and there are lots of government subsidies to help afford it), and you're relatively healthy, it's predictable. If you get seriously ill, or have chronic health problems, the expenses can quickly bury you.

I'll add one thing about pharmacies. The same medication can be $300 at one place, and $40 next door. You just never know. There are also pharmacy discount programs that can radically reduce the price. I had one that was around $150 with the insurance, then the pharmacist performed some type of incantation on the computer, and suddenly it was about $16 without the insurance.

[–] Sterile_Technique@lemmy.world 7 points 1 year ago

Vet here, so I get some shit covered by the VA... but as a full time surgical tech and part time student, I can't afford actual health insurance. Haven't any kind of check up since I was active duty.

Hopefully if I get sick or injured I'll be able to bullshit a reason for it being service connected and have the VA do it.

If it's something serious... idk... Just deal with it, medical tourism, or suicide?

[–] systemglitch@lemmy.world 7 points 1 year ago

America is a 2nd world country without universal health care. Just stick to your first world country.

[–] collapse_already@lemmy.ml 7 points 1 year ago

I paid about $1750 in insurance premiums last year and an additional $9,000 in deductibles. This year should be a little more in premiums and hopefully, just $7500 in deductibles. (Wife was treated for cancer last year and had reconstructive surgery this year. I had a routine colonoscopy for the higher expense that I won't need again for a few years. )

My insurance is probably better than most since my employer is huge.

[–] SlippiHUD@lemmy.world 7 points 1 year ago

That 27k bill will come out of your estate. So if you have a house, it will be sold to pay that bill before your children can inherit it, if they, for whatever reason, can't cover it.

Private Healthcare in this country is a nightmare. And with Covid slowly disabling everyone, it's only going to get worse. Saving the NHS is worth it.

[–] insufferableninja@lemdro.id 6 points 1 year ago (3 children)

on the one hand - my wife and i didn't have insurance when my oldest was born, as i was doing contractor work overseas. Between one thing and another over the course of that year, we paid like $8k in medical expenses, including all the obgyn visits and the actual delivery, plus a hernia repair for me. The hospital was very easy to work with. Our income was very high so it was not exactly a burden. (8k was about 2% of total salary)

on the other hand - this year, with insurance we're going to pay about $6k in insurance premiums and $8k in medical expenses before we hit our deductible (~7% of total salary)

on the gripping hand - last year we had really excellent insurance. we paid a total of $1200 for the year in premiums, $50/pay period, and our deductible was only $2k. (~1% of total salary)

So it definitely varies a lot

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We pay $500 a month for family "health care" because we're forced to. Every doctor visit I go to I get a $40 bill just for walking in the door, on top of paying for my medicine copays. It really sucks.

[–] PenisDuckCuck9001@lemmynsfw.com 6 points 1 year ago* (last edited 1 year ago)

You either have a good job, or you have to choose between not getting medical attention or being chased around your entire life over medical debt. Be prepared to flee the country if the latter.

[–] TheFriar@lemm.ee 6 points 1 year ago

I’ll give you some anecdotal evidence.

I make okay money. Not great, but I’m not starving. Lower middle class, probably. But I’m a single man, so if I had a family I’d be lower class no question. (This all just to give you an idea of my income without sharing my personal data online, we’re all working class)

I tried getting insurance this year, and the cheapest plan I could find was $700/mo. That means I pay an insurance company $700 every month, whether I go to the doctor or not. Now, if I were going for a general checkup, I’d pay a “copay,” so a base cost for the office visit. Probably $40-$50.

Then, depending on what I get done, tests, lab work, medicine, I’d still probably pay at least a portion of that, the medicine is likely to be discounted.

But then there’s this thing called a “deductible.” That means I have to spend the amount of the deductible in the year out of my own pocket before the insurance company would be paying for anything major. My deductible for this $700/mo plan was something like $7,000. Something like that, $5-$7k. That’s my cost before the insurance company is obligated to pay for anything. Small stuff they’ll probably cover (depending on the doctor I went to…) but before I spend that $7k of my own money in this calendar year, they’re not gonna pay for much of anything, if really anything at all.

So before we get into the absurdity of how much medicinal care costs here, there’s all that insanely stupid system to pay off and figure out.

[–] fritobugger2017@lemmy.world 6 points 1 year ago

Consider that most Americans are pay 2x to 5x more in insurance premiums each month than folks in the 32 other developed nations with national healthcare coverage pay monthly in taxes for health care. Consider that Americans still pay deductibles and copays. Consider that insurance won't cover pre-existing conditions (which are many). Consider the insurance frequently denies claims and requests for further tests and specialists. Consider that most insurance only works within the limited network of the insurance companies designated healthcare providers.

I work a multinational company that has moved staff from Japan, Canada, and the UK to the USA for periods of work. All of these folks were shocked and horrified by the American insurance system.

[–] mrcleanup@lemmy.world 5 points 1 year ago

I had a two part visit, about 45 min each, to test to see if I had asthma. My out of pocket after insurance was about $1,200.

[–] Addv4@lemmy.world 4 points 1 year ago

My father has had two heart attacks. The first was a pretty standard one by heart attack standards, required a stint to be put in and two days at the hospital. The cost was ~$40k and after insurance we were left with I think a $4-5k deductible (pretty good county employee insurance). His second one luckily (ha) happened while on the job and required another stint to be put in (he got amazingly lucky, as it was a widow maker of a heart attack) and was covered under his works insurance.

For reference, I'm healthy and in my late 20s, I pay ~$250 a month through my employer's health plan, $25 for an office visit, $500 to walk through the doors of the ER, with a $3k in network deductible ($6k out of network). Believe me when I say you are amazingly lucky to have the NHS.

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