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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On average they actually spend $12.500 per year (total, PPP adjusted, at leat that’s the number for 2022)
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
You as a Brit spend $5.500 (also adjusted) (And as a bonus, at the same time you’re also expected to live 2.8 years longer than the average American.)
Plus the Brit coverage is universal while the US has a significant number of uninsured. We pay double on average including for those that aren’t covered at all. Even though the long lines myths are overblown for countries with universal care, it is important to remember that in the US a lot of people never get the care and we still have massively long wait lines unless we can afford to be first in line. The wealthy have a fast pass.
it is important to remember that in the US a lot of people never get the care and we still have massively long wait lines unless we can afford to be first in line
This is really important for non-Americans to understand. Yeah there are waits to see specialists and so forth in countries with a public system. We also have waits…but it’s for people who can’t afford the procedure. They have to wait until they can afford it, and if they can’t they simply have to live with their condition indefinitely or until it’s bad enough that they go to the emergency room. People who are uninsured go to the emergency room for everything because, legally speaking, they can’t turn you away. They have to at least diagnose and stabilize you. Because these people are broke, they generally end up not paying the bill, which means everyone else’s costs go up.
You couldn’t devise a worse system if you tried.
I had to go to the emergency room for a staph infection. No insurance. Got billed 4k lol. Even though it’s destroyed my credit, I refuse to pay it. In the US this unpaid bill will fall off of me credit report in 7 years, it’s been 3 thus far. 4 more to go!
Sooner if Biden or Harris can get the legislation hrough
Yeah they’re really CLAMORING to hurt the bottom line of their biggest donors and their entire cabinet. /s
I read something from last year that said about half a million Americans go into bankruptcy due to medical debt each year.
That’s it, that’s what happens. You lose everything and you start over, if you’re healthy enough.
Protect your NHS.
The real truth of what happens is substantially more complicated due to America being made of 50 states. The medical debt numbers are highly debatable (Related Snopes) and do not account for Regional differences. In some states such as New York there are catchalls/emergency funding so that usually anyone making below low six figures can get their bills paid. Other states make collections difficult such as New Jersey not allowing reporting to credit agencies, making ignoring a debt kind of a non-issue. Then there are states such as Florida that require the barest of insurance to keep rates low and provide no patient protections, so when an accident does occur out of pocket costs can be huge as your insurance covers nothing. In all these events the Hospital assumes that big pocket insurance is paying first so they break out the expensive menu, when they realize they can’t get blood from a stone they are grateful if you cover their wholesale price.
I’ll put it this way:
At least 68,000 Americans die every single year due to not being able to afford healthcare.
We pay an extra $450 BILLION annually to enrich unnecessary middlemen and ALL of our politicians are being bribed (or primaried) to prevent Single Payer. You’ll hear people like Kamala and Warren talk about “access” to healthcare while they receive massive bribes from healthcare companies to pull support away from Single Payer and offer a “choice” or “access to health care”. Remember 2016 and 2020? The DNC pulled out all stops to prevent Single Payer. Remember when Bloomberg ran for office and claimed , “under my governorship, New York had less uninsured people than at any time in history” while failing to mention that he enacted steep penalties for being uninsured? That’s neoliberal gaslighting 101! Kamala loves to do it too! But yeah vote for her because she’s “one of the good guys” and certainly wasn’t one of the people that was tasked with preventing Bernie Sanders from winning the primary two cycles in a row, offering “Medicare for All who want it” so stacked with asterisks and legalese means-testing that probably like 50 people would qualify.
Edit: In my opinion, anyone who is paid to run for office and vote against Single Payer is a murderer guilty of (or at least partly responsible for) the slow, often-painful execution of these 68,000 American citizens per year.
I have student loans that I’d love forgiven but I don’t even mention that issue because true Single Payer (and Gaza obviously) are my moral lines in the sand that almost everyone in Congress except Rashida Tlaib has brazenly trampled.
https://www.sanders.senate.gov/wp-content/uploads/Fact-Sheet_Medicare-for-All-2023.pdf
TL;DR: mine is $660/month for health, $42/month for dental
Most folks in the US aren’t aware of how much they pay for health insurance. I live in California, where law requires full time employees (>30 hrs a week, >130 hrs month) be provided some amount of health insurance. The type of coverage varies not just from job to job, but also within the same job the employee must often choose their own plan from several company selected options at varying price tiers and types/amount of coverage. Usually the employee only sees the amount of the monthly cost that THEY are responsible for, which is then automatically removed from their paycheck. What most folks are unaware of is that the employer is also paying some of the cost (which is the part that the law makes them do). The part that makes it extra frustrating to deal with an already broken and overly expensive system, is that the rate paid by employers is negotiated in bulk with the insurance providers. Larger employers (national corporations with hundreds of thousands of employees) are paying much less than an individual or small employer would. This is the one of the largest reasons becoming unemployed is so dangerous in the US. In addition to not having income for food or housing, people often forego health insurance due to the expense. If you lose (or leave) your job you’re eligible to keep your current insurance plan for 18-36 months with COBRA (Consolidated Omnibus Budget Reconciliation Act, which is such a ridiculous backronym that I had to google it just now). This is often the only time people realize the true cost of their insurance as the entirety of it is then passed on to them directly (at the employer negotiated rate) and it shows up as a new monthly bill.
I recently left my employer to start my own business and discovered that my true cost of insurance is ~$700/month ($660 Health/$42 Dental). Keep in mind, this doesn’t mean that I have zero medical bills should I actually visit a doctor or hospital. This is pretty good health insurance, but I still have to pay $5,000 out pocket (annually) before it kicks in at the full coverage amount. Since I had ear surgery earlier in the year and hit that limit, and wanted to be able to continue seeing the same doctors I had for already scheduled follow ups, I decided to keep the same insurance. That $5,000 isn’t the only expense that landed on my shoulders, there’s a bunch of rules that I honestly don’t fully understand and I’ve probably ended up paying somewhere between $7,500-$10,000 for the surgery I had (in addition to the monthly premium).
The main reason I keep paying insurance (in addition to the fact that you’ll now be charged a penalty on your taxes if you go uninsured for a month), is my fear that you mentioned in the original post. Having a car hit me while I’m walking down the street and ending up with a $50,000 visit to the emergency room is a very real possibility without health insurance. California recently limited ambulance rides to a maximum cost of $1,200, so that’s… good?
For me, I recently got a checkup and some blood work done. It came out to free, I didn’t have to pay anything.
I also have pretty good health insurance.
