N-3 Healthcare Vent

[duff_duffy]

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

[R3awak3n]

Although I think the healthcare system needs a lot of work here, I think that if you are one of the lucky few to have good health insurance and live in a big city, it is pretty good. I recently got awesome health insurance since my wife is now working for a big corporation. I went from paying $450/month (cheapest health insurance I could find in NYC) for insurance that had $7000 deductible to have a really low deductible with a good company that all doctors want to be in.

I needed a gastro appointment and got it within 3 days, in the next week I have an endoscopy scheduled, thigns move fast... this is in NYC, I tried to get an appointment upstate and was at least 3 weeks wait.

[MattTuck]

Without knowing the details, this sounds like something called balance billing. Where you go into a hospital that you think you're covered by your insurance, but then the hospital doesn't have the doctors to cover all the shifts, and so they contract out to a service that provides doctors to cover the needed shifts. Those doctors don't necessarily have relationships with insurers, but they don't tell you, and you don't find out until the bill comes.

If this is the case, you should talk to your insurer, and the hospital, and make a stink about it, threaten to call your congress person.

It is a deceptive bait and switch practice, as far as I'm concerned.

[ftf]

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

Yes it sucks, I have great health insurance for now at least, and it still sucks. Also the US has poor outcomes even though we pay far more than the rest of the world.

[fa63]

Sorry to hear this. The healthcare system here does suck indeed.

I suggest inquiring about the charges then negotiating your balance, if you haven't paid it off in full yet. I was appalled by the charges my father incurred after a visit to the ER, so I demanded detailed bills then negotiated a much reduced amount. And when I say much reduced, I mean it.

Good luck.

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

[ripvanrando]

$28,000+ per year in premiums and can only use providers in NJ and they must be in my plan. No out of network use. If you use an out of network doctor, any and all associated services are on you.

It is so horrible that I am going overseas for surgery.

[BobbyJones]

Some food for thought:

Not only is there a lack of price transparency on the provider side of healthcare, there is also a certain stigma here in the US for the recipient to actually ask what the costs are involved. (when given the opportunity in a non-emergency situation of course).

What other service or good do you just walk in and say "tell me what I need, here's a blank check" Your last dream bike doesn't count. Or your plumber.

The rise in healthcare costs are unavoidable but thinking as consumers instead of patients we can be more informed and make different choices. With a little persistence it may result in an industry shift that'll benefit everyone in the long run.

I thought this article in the Times (https://www.nytimes.com/2016/12/19/upshot/price-transparency-is-nice-just-dont-expect-it-to-cut-health-costs.html) was a good overview of challenges with links to tons of other references for learning more.

[MagicHour]

So sorry. :mad:

Part of me wishes for a national strike on our healthcare system - ie all consumers to stand up and say, "ENOUGH, the money stops until this mess is fixed". Of course I know that's not feasible, people would die, and would never happen, but at what point to say enough to:

lack of transparency
price gouging of all services, pharmaceuticals, devices
annual 25-30% insurance premium increases with shrinking benefits and denied procedures
narrow networks
PBM rebates
etc
etc


I read this earlier today re: our healthcare system "they just don't want more of your money, they want ALL your money"
....end rant

[Louis]

Well, the fact that the US has the "Greatest Healthcare System in the World" surely makes for all the OP's problems.

[Rekalcitrant]

An old colleague of mine, who is a bioethicist, used to say that the USA has the distinction of being the one country that has found a way to combine extremely high expenditures on health care with terrible overall outcomes—I gather we are at or near the bottom of the developed world on many measures. As a Canadian living in the USA I sometimes find myself explaining to people here that in much of the rest of the world people don’t carry around day-to-day anxiety about potential sickness or injury being financially devastating, aren’t scared to go to the ER, don’t lose sleep deciding whether to replace their kid’s epipen when the price goes through the roof, and so on. To my mind this is an enormous social cost and it’s scandalous that people are willing to put up with it. Yes, there are issues with every health care system, but I think this is a clear case where delusions about American exceptionalism and a commitment to the free market being untouchable are causing an incredible amount of suffering. I don’t usually post about these things—and I have excellent health insurance through my employer—but this is an issue where I think there needs to be serious change.

[ripvanrando]

Some food for thought:

Not only is there a lack of price transparency on the provider side of healthcare, there is also a certain stigma here in the US for the recipient to actually ask what the costs are involved. (when given the opportunity in a non-emergency situation of course).

What other service or good do you just walk in and say "tell me what I need, here's a blank check" Your last dream bike doesn't count. Or your plumber.

The rise in healthcare costs are unavoidable but thinking as consumers instead of patients we can be more informed and make different choices. With a little persistence it may result in an industry shift that'll benefit everyone in the long run.

I thought this article in the Times (https://www.nytimes.com/2016/12/19/upshot/price-transparency-is-nice-just-dont-expect-it-to-cut-health-costs.html) was a good overview of challenges with links to tons of other references for learning more.

I need cervical spine surgery and found an excellent out of network Neurosurgeon (almost no NS takes insurance in NJ, they all banded together). I agreed to pay him out of pocket and he would do the surgery in a hospital that is 100% covered by my BCBS plan. BCBS refused to cover anything because I picked my own surgeon. We contacted the hospital and Anaesthesiologist and other service providers many times. NOT a single one responded. We just wanted to know a price. I needed to know whether this was going to be $80,000 or $200,000.

What these providers do is bill insurance say $80,000 as a surgical fee but if it is Medicare, they might get $1700. If an insurance case, they might get $3500. If out of pocket, they get your house.

[paredown]

Sorry about the bikes!

The OP should broaden the initial statement--'don't go to the ER if you can possibly avoid it'. A construction fall--and I delivered myself to the Emergency--cost over $40,000--and yes, they performed CYA procedures that I specifically questioned--multiple x-rays of a knee and hand that were incidentally banged on the way down--the back was the real injury.

Out of pocket for that wiped out my part-time earnings for that year.

Worse yet, the next time I decided to 'tough it out' because of the price and the crappy treatment and did not go the ER for what turned out to be a lacerated kidney (also a fall). I was supremely lucky did not cost me a kidney or worse.

Meanwhile, if you sit and listen in the ER for a few hours, you realize that a large percentage of the people who are being treated have no/limited health care, and treat the Emergency as the local community health care provider--and those costs are swallowed by the hospitals. Those people have no other choice, because we don't have community clinics etc and universal Health Care access.

There is no "health care market"--there are no prices posted, no transparency and no consumer sovereignty. All the tricks they use male my blood boil--like the "consultant" who wanders in and asks you three questions, and turns out to be an out of network specialist and bills you...

That said, my last experiences have been mainly at a super well-run hospital where at least the service is very good and the doctors are great.

[MattTuck]

...
The rise in healthcare costs are unavoidable but thinking as consumers instead of patients we can be more informed and make different choices. With a little persistence it may result in an industry shift that'll benefit everyone in the long run.


Agree with mostly everything else you said, but I disagree that rising healthcare costs are unavoidable. Perhaps under the current system, there are challenges to lowering them. But, there is a quotation out there, that is a bit of a tautological statement, "That which is unsustainable will go away." Really, just the definition of unsustainable. The current system is made up of increasingly larger and larger cartels trying to gain size advantages over their adversaries. (payers vs. providers)

The "affordable" care act could have done more for healthcare affordability with 2 sentences than anything in history.

1. All providers shall generate, upon request of a patient, a quote for all services that the provider has suggested to the patient. (with some language about how long it can take to generate the quote, how long the quote has to be honored, and what happens if complications occur during the services)

2. All providers must submit to a publicly available database, for each set of services, what was the average/median/mean price quote, actual charge, and success rate.

[fa63]

much of the rest of the world people don’t carry around day-to-day anxiety about potential sickness or injury being financially devastating, aren’t scared to go to the ER, don’t lose sleep deciding whether to replace their kid’s epipen when the price goes through the roof, and so on. To my mind this is an enormous social cost and it’s scandalous that people are willing to put up with it. Yes, there are issues with every health care system, but I think this is a clear case where delusions about American exceptionalism and a commitment to the free market being untouchable are causing an incredible amount of suffering.

Amen.

[oldpotatoe]

Moots, Seven, Serotta all sold in last two weeks. The collection of bikes almost gone. Darn healthcare system in US sucks. Even with good insurance your SOL if you need a specialist apparently! Unfortunately doctors won’t accept a ride on a bike for payment. That’s my vent for the day. My tip for the day is avoid the ER on a Saturday night.

As long as the health care 'system' in the US is a for profit system, regulated and controlled by insurance companies and with lobbyists(check to see what some big health care CEOs are paid) who has most of congress in their pocket, expect the above.

I have medicare..premiums for me and wife are about $400 per month...I've had a trip to ER and 3 days in hospital(pulmonary embolism), 3 Rx that are $10 per pill($40 per day) and I pay NADA out of pocket. If Government health care works for me, it 'should' work for all. The US system is a YUGE mess(connection intended)...

medicare for all......

[ripvanrando]

Agree with mostly everything else you said, but I disagree that rising healthcare costs are unavoidable. Perhaps under the current system, there are challenges to lowering them. But, there is a quotation out there, that is a bit of a tautological statement, "That which is unsustainable will go away." Really, just the definition of unsustainable. The current system is made up of increasingly larger and larger cartels trying to gain size advantages over their adversaries. (payers vs. providers)

The "affordable" care act could have done more for healthcare affordability with 2 sentences than anything in history.

1. All providers shall generate, upon request of a patient, a quote for all services that the provider has suggested to the patient. (with some language about how long it can take to generate the quote, how long the quote has to be honored, and what happens if complications occur during the services)

2. All providers must submit to a publicly available database, for each set of services, what was the average/median/mean price quote, actual charge, and success rate.

Amen.

How about one price for all?

If Medicare pays $120 for a mammogram and BSBS pays $250, why should an unsuspecting consumer be nailed with a $2500 bill for the same service?

Imagine going to a restaurant and the next table pays $30 for a steak and you pay $300 (?).

[makoti]

Imagine going to a restaurant and the next table pays $30 for a steak and you pay $300 (?).

Then it'd be just like flying! Sorry, totally separate rant.

[fa63]

Our healthcare system is a great example of information asymmetry and subsequent market failure. Too bad Congress is full of people who tend to ignore basic economics and public policy theories.

[tuscanyswe]

$28,000+ per year in premiums and can only use providers in NJ and they must be in my plan. No out of network use. If you use an out of network doctor, any and all associated services are on you.

It is so horrible that I am going overseas for surgery.

Im not familiar with the cost of us health insurance other than i know its very high unless you get a good one from your workplace but are you saying you pay 28thousand dollars a year for health care insurance and that this sum only covers in-state services and not all doctors / hospitals but only those registered with this "service" (can you call it that lol?) ?

[GregL]

As long as the health care 'system' in the US is a for profit system, regulated and controlled by insurance companies and with lobbyists(check to see what some big health care CEOs are paid) who has most of congress in their pocket, expect the above.

I have medicare..premiums for me and wife are about $400 per month...I've had a trip to ER and 3 days in hospital(pulmonary embolism), 3 Rx that are $10 per pill($40 per day) and I pay NADA out of pocket. If Government health care works for me, it 'should' work for all. The US system is a YUGE mess(connection intended)...

medicare for all......
^^^This^^^

My wife and I have worked hard, lived well within our means, and saved effectively. We should be able to comfortably live to 100 with our savings and investments. EXCEPT that retirement healthcare is a wildcard. It is an absolute embarrassing shame that the self-proclaimed "greatest nation on earth" can't come up with an efficient, affordable health care program for all its citizens. If we could do that, we would "Make America Great Again." Until that time, it's just continuous rearrangement of deck chairs on the Titanic.

Greg

[oldpotatoe]

our healthcare system is a great example of information asymmetry and subsequent market failure. Too bad congress and the wh is full of people who tend to ignore basic economics and public policy theories.

fify:)

[AngryScientist]

i have what is probably the best available health coverage in NJ. Lots of stuff done between myself and 2 kids, never paid more than a $10 copay. I understand that's rare these days though.

Now dental coverage - that's a whole other story.

I've got some massive tooth pain at the moment and headed to the dentist in the morning - i'm dreading the visit for any number of reasons. fingers crossed it's just a simple cavity...

[oldpotatoe]

i have what is probably the best available health coverage in NJ. Lots of stuff done between myself and 2 kids, never paid more than a $10 copay. I understand that's rare these days though.

Now dental coverage - that's a whole other story.

I've got some massive tooth pain at the moment and headed to the dentist in the morning - i'm dreading the visit for any number of reasons. fingers crossed it's just a simple cavity...

It's ABSURD 'health care' doesn't include your teeth or your eyes....US health care 'system' is a expensive joke on....us.

[MattTuck]

The greatest health care system in the world... ha!

We tolerate much of this stuff because most people don't know any better. (For some, it is because they have no interest in knowing. Others, that may be genuinely curious, may be intentionally kept from the truth.)

The most recent, egregious example was Time magazine's reporting of the medal counts from the Olympics. They left out Canada (who had the 3rd most), so it would look like the US came in Third... you know, because 4th would have been a blow to the national ego.

Another example closer to home was in the days of Lance. When an American is ripping up the roads in France, we hear all about it. Cycling is great. yee-haw! If europeans are racing, it is downplayed. Just like in the olympics, if an American has a chance of medaling, it gets prime time broadcast coverage. if not, it gets relegated to poor time slots on the secondary or tertiary channels.

What this all does is give us a sense of superiority that is not grounded in reality.

US healthcare system is the same way. Yes, if you have great coverage, and access to the best doctors, you can absolutely get world class care. So, in that respect, it is "the best healthcare system in the world."

But that measure is laughably misguided. A much better metric would be measuring the median. Atleast then you have a framework. Ok, half of people are getting better care than this, and half are getting worse.

[fa63]

fify:)

:beer:

[fa63]

Yes, if you have great coverage, and access to the best doctors, you can absolutely get world class care. So, in that respect, it is "the best healthcare system in the world."


Ha, I love the "access to healthcare" argument that gets thrown around :) (not calling you out by the way; I agree with what you have said).

Here is a good read on how the US ended up with healthcare being tied to jobs, which is fundamentally at the heart of the problem:

https://www.marketplace.org/2017/06/28/health-care/how-did-we-end-health-insurance-being-tied-our-jobs

[Gsinill]

Just as an additional data point:

2 years ago, both, my wife and my mom had colonoscopies; my wife in the US, my mom in Germany.
Cost in the US roughly 7 times higher.

[tuscanyswe]

Just as an additional data point:

2 years ago, both, my wife and my mom had colonoscopies; my wife in the US, my mom in Germany.
Cost in the US roughly 7 times higher.

As a reference point. I have had a colonoscopie done when i was checked for celiak. Free of charge in sweden. When they went in the other way down the throat instead (much more umpleasant btw) was also free of charge. Well we pay 20$-30 for all health care related "meetings"

[ChristianWong]

As a reference point. I have had a colonoscopie done when i was checked for celiak. Free of charge in sweden. When they went in the other way down the throat instead (much more umpleasant btw) was also free of charge. Well we pay 20$-30 for all health care related "meetings"

Hope they used a different instrument for the second procedure.

[tuscanyswe]

Hope they used a different instrument for the second procedure.

:banana: touche

[Gsinill]

As a reference point. I have had a colonoscopie done when i was checked for celiak. Free of charge in sweden. When they went in the other way down the throat instead (much more umpleasant btw) was also free of charge. Well we pay 20$-30 for all health care related "meetings"

My point is that the US HC provider is charging 7 times more.

[BobbyJones]

Then it'd be just like flying! Sorry, totally separate rant.

The irony is, although seat pricing itself is based primarily on a supply / demand theory, Federal regulations regarding "consumer protection" are a lot more favorable to the consumer in the airline industry than in healthcare.


... We contacted the hospital and Anaesthesiologist and other service providers many times. NOT a single one responded. We just wanted to know a price. I needed to know whether this was going to be $80,000 or $200,000.
.

This sucks and must be very frustrating. I genuinely feel for you and hope it works out. I'd be interested to hear your experience of dealing with this process in a different country. With an entry rate of $80k for what you need, this sounds like a very viable alternative.


We tolerate much of this stuff because most people don't know any better. (For some, it is because they have no interest in knowing. Others, that may be genuinely curious, may be intentionally kept from the truth.)


Systemic of current American Culture. Most people I know can recite all the features of the newest Google home device but have no idea who their local councilman is- me included. I guess thats a different discussion altogether.

[tuscanyswe]

My point is that the US HC provider is charging 7 times more.

Yes sorry to deflect. Just meant that not only germany are a lot cheaper but many western countries have good healthcare at a bargain compared to the US.

We have ppl here who go to germany to get what they feel is better care for some type of illnesses btw.

[Mikej]

Yet so many people want to leave their countries to live here.

[Gsinill]

Yes sorry to deflect. Just meant that not only germany are a lot cheaper but many western countries have good healthcare at a bargain compared to the US.

We have ppl here who go to germany to get what they feel is better care for some type of illnesses btw.

It all comes down to the good old "haves and have-nots" conversation.
With the exception of a negligible co-pay, my wife's procedure was fully covered by our health insurance which I get through my employer.
It costs me less than 5% of my gross income to get coverage for me and my wife, both in our 50s.
Having lived in both countries, I can tell you that there is actually very little felt difference between the US and Germany with its universal multi-payer system, IF you get your coverage in the US by your employer - at least in a white collar employment.
The problem is that most who claim that the US has the "best HC in the world" are most likely as privileged as I am with the fear that extending this privilege will impact the quality of what they have now, while paying very little.

[makoti]

Yet so many people want to leave their countries to live here.

From countries with adequate healthcare? Do we get a lot of Norwegians? Swedes? Germans? Or are you trying to equate people leaving abject poverty to find any sort of a life with our healthcare?

[Gsinill]

Yet so many people want to leave their countries to live here.

Not enough from Norway ;)
Edit: makoti beat me.

[tuscanyswe]

It all comes down to the good old "haves and have-nots" conversation.
With the exception of a negligible co-pay, my wife's procedure was fully covered by our health insurance which I get through my employer.
It costs me less than 5% of my gross income to get coverage for me and my wife, both in our 50s.
Having lived in both countries, I can tell you that there is actually very little felt difference between the US and Germany with its universal multi-payer system, IF you get your coverage in the US by your employer - at least in a white collar employment.
The problem is that most who claim that the US has the "best HC in the world" are most likely as privileged as I am with the fear that extending this privilege will impact the quality of what they have now, while paying very little.


Yes sure. No one is doubting that beeing well off in America is all that tough. Its just that the not so fortunate seem to have it tougher and tougher with very little beeing done about it. Thats my take on it at least but obviously sitting far away in a different system.

[ripvanrando]

Im not familiar with the cost of us health insurance other than i know its very high unless you get a good one from your workplace but are you saying you pay 28thousand dollars a year for health care insurance and that this sum only covers in-state services and not all doctors / hospitals but only those registered with this "service" (can you call it that lol?) ?

Yes.

I am self employed.

This is the second cheapest plan.

There are no insurance options that allow out of network providers. There is a plan that allows me to use doctors in the tri-state region but it is $52 or $54,000 per year IIRC.

[GregL]

The current system is discriminatory toward early retirees, independent business owners, and employees of small companies. Those who want to follow the "American dream" of owning their own business soon find that health care costs are prohibitive.

Greg

[ripvanrando]

This sucks and must be very frustrating. I genuinely feel for you and hope it works out. I'd be interested to hear your experience of dealing with this process in a different country. With an entry rate of $80k for what you need, this sounds like a very viable alternative.



Thanks. It is scary. I am dragging my feet a bit.

I have quotes from two of the best surgeons in the world (Europe). All in costs (minus airfare) is $68k at one and $46K at another. I can't get the job done in the US at any price for practical purposes but if I were to have 4 disc fused, it would run around $200K in the USA. I will be getting four artificial discs that are made in the USA but FDA only allows two per patient and I need four. One US surgeon told me to pick which of my two discs were the worst and he would replace those two. Seriously. I asked him about C3/4 and he says, maybe next operation. How about Right First Time?

[ripvanrando]

Yes sorry to deflect. Just meant that not only germany are a lot cheaper but many western countries have good healthcare at a bargain compared to the US.

We have ppl here who go to germany to get what they feel is better care for some type of illnesses btw.

Excellent Orthopaedics in Germany and yes, much cheaper with surgeons with vastly more experience over long periods of time unlike FDA and Insurance constrained surgeons here. Germany is around 20% of the US price. India is around 10%. I considered India. It will be either Spain or Germany for me.

[PeregrineA1]

RipvanRando my ex-wife did the German disc replacement with US devices in 2007. The short of it is that there were/are no downsides. She was up and walking in 24 hours (3 discs done) and now has few limitations. She, virtually on her own, farms avocados. She golfs, rides horses, etc. Cost was half of US cost and in the end Blue Cross global ended up reimbursing us. Feel free to PM for details.


Sent from my iPhone using Tapatalk

[Mikej]

From countries with adequate healthcare? Do we get a lot of Norwegians? Swedes? Germans? Or are you trying to equate people leaving abject poverty to find any sort of a life with our healthcare?

Correct, some people face bankruptcy from health costs, even with insurance. But some people can arrive in the US and receive medical care, and I don't think they care how much it costs, because they're not worried about paying it. Yet, citizens born here and who have paid taxes and contributed and raised their families are faced with the costs.

[fa63]

Correct, some people face bankruptcy from health costs, even with insurance. But some people can arrive in the US and receive medical care, and I don't think they care how much it costs, because they're not worried about paying it. Yet, citizens born here and who have paid taxes and contributed and raised their families are faced with the costs.

Do you feel the same way about subsidizing the healthcare costs of poor American citizens, who pay little to no taxes (~44% of Americans pay zero federal taxes), and don't care how much it costs and are MUCH more likely to use emergency rooms as their primary healthcare?

For what it is worth, undocumented immigrants are not eligible to enroll in Medicaid or CHIP or to purchase coverage through the ACA Marketplaces.

[ripvanrando]

Three months wait to get into a Specialist is par for the course.....in NJ at least and some of them double and triple yes triple book. You get about 90 seconds to speak but at least the co-pay is only $50.

I wonder how long of a wait in Canada, Norway, or Germany.

[Rpoole8537]

In 2001, I stopped consulting as a private citizen, paying high taxes and full FICA, and went to work for a state agency so I could get descent health insurance for my family. We were all pretty much uninsurable according to insurance agencies in our state due to minor issues. (Primarily, because we had been to a doctor for something other than a cold.) This was before ACA. I cut my salary by 60%, but I knew that in the long run it might be worthwhile. I was able to retire thirteen years later with a defined benefit and great health insurance at age 60. I can now work as a private consultant, and get my insurance paid by the state. All this to say, because the government allowed insurance agencies to preclude us from coverage, I went from paying high taxes and full FICA to someone who is now living off the taxpayers of my state. Sure, I paid some money into my pension fund, and I had an IRA, but the big issue is that it appears penny wise and pound foolish to have a system like this. Even with ACA, I have a cycling buddy and his wife who are paying $1200/month for a low level insurance product.
A question for those in the know, do state regulations vary from state to state?

[makoti]

In 2001, I stopped consulting as a private citizen, paying high taxes and full FICA, and went to work for a state agency so I could get descent health insurance for my family. We were all pretty much uninsurable according to insurance agencies in our state due to minor issues. (Primarily, because we had been to a doctor for something other than a cold.) This was before ACA. I cut my salary by 60%, but I knew that in the long run it might be worthwhile. I was able to retire thirteen years later with a defined benefit and great health insurance at age 60. I can now work as a private consultant, and get my insurance paid by the state. All this to say, because the government allowed insurance agencies to preclude us from coverage, I went from paying high taxes and full FICA to someone who is now living off the taxpayers of my state. Sure, I paid some money into my pension fund, and I had an IRA, but the big issue is that it appears penny wise and pound foolish to have a system like this. Even with ACA, I have a cycling buddy and his wife who are paying $1200/month for a low level insurance product.
A question for those in the know, do state regulations vary from state to state?

The idea that we have a system that allows insurance companies to decide what care & medicine we get instead of the doctors is just plain nuts.

[echappist]

It's ABSURD 'health care' doesn't include your teeth or your eyes....US health care 'system' is a expensive joke on....us.

the "root" (pun intended) cause of this divergence is rather interesting. IIRC, a dental practitioner back in the 1800's wanted to teach the newest techniques in dentistry at a medical school (University of Maryland) but the powers that be thought themselves too lofty to deign to consider the request. Alas, a separate medical and dental system.

For those seeking dental care, a local teaching school's clinic may be a good option. I had implants done there, and the cost was about a quarter of what a for-profit provider would have charged.

edited to correct identity of the school. Story here (https://www.theatlantic.com/health/archive/2017/03/why-dentistry-is-separated-from-medicine/518979/)

[echappist]

$28,000+ per year in premiums and can only use providers in NJ and they must be in my plan. No out of network use. If you use an out of network doctor, any and all associated services are on you.

It is so horrible that I am going overseas for surgery.

which country?

[Mikej]

Do you feel the same way about subsidizing the healthcare costs of poor American citizens, who pay little to no taxes (~44% of Americans pay zero federal taxes), and don't care how much it costs and are MUCH more likely to use emergency rooms as their primary healthcare?

For what it is worth, undocumented immigrants are not eligible to enroll in Medicaid or CHIP or to purchase coverage through the ACA Marketplaces.

I would rather see a citizen receive benefits. The method you described above has a lot to do with poorer people not having a primary care Dr. They have no choice but to use the ER as many Primary care physicians are not excepting new patients. These citizens at one point in their pasts may have been employed, veterans, hard workers, and had a rough bump. As for what its worth, I don't believe undocumented immigrants are being denied healthcare services.

[fa63]

I would rather see a citizen receive benefits. The method you described above has a lot to do with poorer people not having a primary care Dr. They have no choice but to use the ER as many Primary care physicians are not excepting new patients. These citizens at one point in their pasts may have been employed, veterans, hard workers, and had a rough bump. As for what its worth, I don't believe undocumented immigrants are being denied healthcare services.

Good to know. By the way, public and private hospitals alike are prohibited by law from denying a patient care in an emergency, regardless of immigration status. It is also basic humanity.

It is just sad to see a small number of people demonized for contributing a minuscule amount to a huge problem. I guess why focus on the real problem when you can shift the blame...

[ripvanrando]

which country?

Spain or Germany but likely Spain

[Mikej]

Good to know. By the way, public and private hospitals alike are prohibited by law from denying a patient care in an emergency, regardless of immigration status. It is also basic humanity.

It is just sad to see a small number of people demonized for contributing a minuscule amount to a huge problem. I guess why focus on the real problem when you can shift the blame...

Its a tough pill, I feel for the OP, having to sell his bikes. Man, and good ti bikes! I'm a good ti bikes kinda guy!

[glepore]

medicare for all......

Yeah, it works for me...200/mth, I have an advantage plan with really decent coverage...it does have some copay's but nowhere near what I'd spend for Medicare + supplement.