Health Care In The USA?

[angel659]

Hi

I hope this will not cause any conflicts on here regarding health care. I just would like to know from a brit point of view of what the Americans actually think about thier medical care.

We have the NHS over here, which we pay a certain percentage of our monthly salary to the national health scheme called this enables us to receive medical care. However if you were unemployed on benefits you would still get medical care. We do have silly waiting times over here, some hospitals are run down but generally I feel the NHS works if there were a couple of tweeks made. Considering it was the world war that made us think about the NHS I have more respect for it.

Anyway, from your perspective. I take it there is no mediaid everyone has private healthcare insurance. From what I have read from Michael Moore the scheme is actually fixed and currupted. Some people have been refused medical treatment for the most silly reason, so they do not have to pay and its a whole making money sheme rather than treating people. This is what has put my dh off living in the USA. WE were originally looking at FL or LA. Bruce read on Michael Moore that a young child past away, because her insurance company would not pay the hospital for necessary treatment. Just because she was in the wrong hospital. In our country if you are not in your local hospital that hospital claims the money back from the authortity that is funding your hospital.

Dont get me wrong our NHS system is not the best it has many flaws, but since I work within the NHS I see both good and bad. I dont moan about what the NHS provides. I feel we are incredibly lucky.

Please share your experiences, views and I really hope I have not caused any debate. It was more to show my dh its not as bad as he has heard about or that he is right and I am wrong.

 

[AllyandJack]

We have Medicaid. Unfortunately, many people who SHOULD qualify don't and many people who shouldn't be able to take advantage of the benefit get it handed to them.

I've always had great insurance, so I've never been on Medicaid. But, my cousin is on it. She is offered great insurance through her job for $10./week, but decided that she didn't want to pay that and stayed on the Medicaid. My best friend got pregnant without insurance and signed up for Medicaid. She paid about $80./month for it and it covered all of her obstetrical and her DS's first year of visits.

So, we have it. But, people fall through the cracks because they don't "qualify". I wouldn't want to be on Medicaid because I love my insurance. On the other hand, it ticks me off that so many hard working people with no real access to insurance get cut off while people like my cousin are allowed to reap the benefits of it even though they have access to great insurance.

 

[Goofyluver]

I think that our health care system has major flaws. And, yes, I have personal experiences to back it up.

My DS (11) is disabled and has several medical things going on. It's a long long list of things, but let me just get into a few:

1. DS is orthopedically impaired, and required leg braces. He had always been approved for these devices, but of course, they must be redone as they grow. DS sees the orthopedist after he turns 9, and they deny the AFOs. WHY???? Because apparently they only approve them for children through age 8...because I guess according to them, they children no longer require assistance after the age of 8.

2. DS has been in speech, OT, and PT since birth. They denied him for a new round of private therapy based on the fact that his condition is congenital, stating that "therapy would be of no benefit." Lesson learned??? Apparently, if you are born the way you are, you deserve no help.

3. DS is having growth problems. They are sending us to a major children's hospital for a round of testing in order to get to the cause and put him on treatment. We were supposed to be there as of yesterday, but are having to appeal insurance's denial of treatment, because "the condition is congenital and therefore treatment is not beneficial at this time." We have no idea why the growth problems are happening, and they may or may not have anything to do with his other issues. But, we can't know that until they do the testing. Lesson learned??? Again, don't be born the way you are because then you don't deserve medical treatment.




IMO---it's ridiculous. I pay hundreds of dollars a month for good health care only to have this crap happen all the time. this is just a few examples...I could go on...you tell me...is this wrong or right???

 

[freckles and boo]

Health insurance in the US is often a benefit of employment. Employers pay all or (much more often) a portion of the insurance premium and the employees pay the rest. Larger employers with more employees usually have access to a wider range of plans. As an employee, you can choose to insure only yourself, yourself and your partner/spouse, or your entire family. More insurance costs more money. Most employers also offer at least two different types of plans. An HMO (Health Maintence Organization) is less expensive but your healthcare is managed by your primary care physician and all treatment must be approved by that physician. A PPO (Preferred Provider Option - I think) is more expensive but basically you can choose to see any doctor you select. A doctor within "the network" will cost less than a doctor outside the network, but you can make decisions without waiting for approval from your primary care doctor. There are still co-pays (I pay $15 per visit in my HMO) and PPOs often require you pay deductibles and co-pays. One of the biggest controversies in America is the idea of health insurance companies being for-profit entities, which can put the interest of the shareholders in front of the interests of the insured.

The self-employed or those without health benefits at their jobs can buy health insurance independently but it is very expensive. At the age of 65 Americans become eligible for Medicare. The disabled and the poor are eligible for Medicaid. These are two different programs administered through the government and I am only vaguely familiar with how they work. I have no doubt that someone on the boards can fill you in. Our state (Illinois) also has insurance available for low rates for families with uninsured children. There are many measures in place to fill the gaps, but there is no comprehensive approach here.

 

[mrsltg]

We have private insurance. We work and pay for it. One of our biggest concerns in my dh remaining on the job as cop is his access to good insurance until we are both gone. This is a choice we make. I am happy with my level of care and have needed very expensive treatments and testing several times and it has never been a problem.

IE - a pediatric cardiologist specializing in fetal medicine was called in to give my then 23-week-along daughter an echocardiogram while in the womb after another perinatologist saw the need to have something checked. The 1 hour fetal echo cost well over $1000 and the doctor who sent me to the specialist charged $700 for the 2 minute diagnosis he provided after one of his radiologists provided an hour long sonogram at the cost of $500. This was all out of network and 100% covered. If the echo had shown a problem, the surgery and treatments my daughter would have needed would have been 100% covered, as well.

 

[emily1982]

I agree with you angel about our NHS, as much as i think it could be alot better, i couldnt imagine living without it. I think in the uk it really is a postcode lottery, if you live in one county services are completley different to maybe 5 minutes down the road and i think hospitals have alot to answer for and now alot of dentists have gone private. Saying that though....i like that i can just make a doctors appointment and just turn up without paying or if i needed to phone an ambluance without worry how im going to pay for it.

Because of my moms company we do get private health care but you only use the private health care for certain things, like if you need to see a specialist or have an operation. So really even our private health care will never fully take over because the nhs will always be there.

 

[alldiz]

I am very blessed to have good insurance from
my husbands LIRR benefits.....

However.....this country's healthcare system needs an overhaul....

The drug companies need to be totally reined in....

It is criminal that I could buy american made drugs.....
through canada for cheaper

There is a lot of corruption....I don't know the answer for
that.....
I think some type of national health care is coming in this
country....

There was a case of a 911 call from the EMERGENCY ROOM
OF a woman vomiting blood.....noone would help her.....
SHE WAS IN THE EMERGENCY ROOM.....AND DIED THERE....
OTHER PEOPLE WERE CALLING FROM THERE....911 SAID THEY COULD
DO NOTHING.....CAUSE SHE WAS IN A HOSPITAL

The doctors are not making more money....
ONLY THE INSURANCE COMPANIES....

Maybe Hillary will unveil her "national health plan" one day
peace
Kerri

 

[clarabelle]

Although the system is broken and needs to be fixed I would take Michael Moore with a grain of salt.
There is healthcare for the elderly and poor (Medicaid and Medicare) but the "working poor" may not qualify -but still not be able to afford healthcare.
Drug prices are also through the roof.

Also here in the states we are used to a high quality of health care. We spend more money in the last days of life than any other country. So that makes health care costs rise and in turn makes insurance more expensive.

If you do have insurance you can usually get relatively good care.

It is a multi faceted problem without crystal clear answers. I would hope however that you would not judge in entire system by Michael Moore.
I am sure that we have some notions of nationalized health care that may not be correct as well.

 

[binny]

well first of all I dont think Michael Moore is the best source of information on how we do ANYTHING here in the States. It boggles my mind how he has any credibility left at all!

Secondly, I have a bit of a different perspective on health care. I split my time between the the US and Canada and have since I was born. I have seen the benefits and drawbacks of both systems.

We paid for health care in Canada as well, we actually paid MORE than we do now. We have excellent insurance offerred through DHs employer here in the States. I know we are incredibly fortunate in that regard. Its true though we pay less now than we ever did there.

I believe the care is better here. Im sorry. I just do. I had a baby in Canada and 2 in the States the difference between the 2 countries was amazing! The care that I received pre and post nantal with my girls FAR outshone the care I received with DS and he was born at an acclaimed hospital in a major city in Canada.

I know the wait that my in laws have had trying to get care in Canada have just blown my mind. one has had a battle with cancer and the amount of time he had to wait to see an oncologist was insane.

OTOH yes, there are a lot of issues here in States. Not everyone is as fortunate as we are to have great insurance covered by our employers. those who dont often struggle to find great care . We do have Medicaid here. my DD has it for her therapies and such because even with great insurance, it doesnt cover as much as she needs. We dont depend on it for medical coverage for the whole family but she qualifies with her special needs so we use it for that.
I know in other places in the States people have a much harder time finding good doctors we researched what was available before we moved here. We knew what we were getting into. I think your location is key in a lot of things here. We dont have the 10-20 hour waits in the ER that many places do. Often we are taken right in. I know that doesnt happen everywhere but we are fortunate where we live that we can see a Doc right away.



Each system has flaws but honestly I mush prefer the better, quicker access we have here than what we received in Canada.

 

[spima3]

Well, first off, I wouldn't be looking at anything Michael Moore does as "authorative" for anything! ----he is in the entertainment field after all.

Our "system" is piecemeal, which can be disconcerting. You can have great insurance or you can have lousy insurance. Lots of time it depends on your employment and that also varies greatly; the insurance rates can be astronomical. We had totally free health insurance with one company my husband worked for and it covered everything! It was fabulous, I never worried about anything.
Now, his current employer, gov't, charges quite a lot, $300/month, for the better insurance, and the cheaper programs have higher out of pocket expenses. It sucks, to put in bluntly. Luckily, our state has a program for kids that is free to low cost depending on your income level. Our kids are enrolled in this program. My son has severe mobility problems, orthapedic, and none of the programs at DH current employment pay for that, not even the better one. The state programs pays for everything, it is spectacular. In between the two jobs, we had no insurance, as the COBRA would have been $900 a month; that was a scary time.

My MIL has both a private supplemental program as well as the gov't medicare, as did my mom. I know some families who only have medicaid, but don't know how that program works.

Yes, you have the horror stories, but I think you would find that anywhere in the world. They are the exception, not the rule. In my 40+ years, I don't know of anyone who has experienced anything really bad.

No matter what, though, there is no way I would EVER want a gov't run program. I would not trust it to be run better or more efficiently. I have dealt enough w/ gov't bueracracy to know that I sure as h*** don't want to be dependant upon it for my medical care!

lori

 

[chris1gill]

Hi

Anyway, from your perspective. I take it there is no mediaid everyone has private healthcare insurance. From what I have read from Michael Moore the scheme is actually fixed and currupted. Some people have been refused medical treatment for the most silly reason, so they do not have to pay and its a whole making money sheme rather than treating people. This is what has put my dh off living in the USA. WE were originally looking at FL or LA. Bruce read on Michael Moore that a young child past away, because her insurance company would not pay the hospital for necessary treatment. Just because she was in the wrong hospital. In our country if you are not in your local hospital that hospital claims the money back from the authortity that is funding your hospital.

Michael Moore is correct. How can a hospital be FOR PROFIT? Better question, WHY should a hospital be FOR PROFIT? It's flat wrong. I have health insurance, and you know it is the BIGGEST PAIN IN MY you know what! The problem is I have a chronic progressive illness, which means I take away from their bottom line.... I am forever AND EVER going through circles trying to get my procedures and visits covered. I don't know how I manage it at times, at times I give up and just pay even though I know it's a covered benefit. I cannot spend all my time and more importantly, energy fighting the insurance companies... and don't even start on our prescription plan, that is even more a mess... we have to mail order all our medications, then they always have questions, or give you one refill, so every 3-4 months you're starting the process for X number of drugs all over again, new prescriptions, new forms, new everything.... our plan only covers one visit to a pharmacy per year....

Health insurance in this country is only for the healthy..... and if all you've ever been is healthy, you have absolutely no idea...

 

[spima3]

<snip> Also here in the states we are used to a high quality of health care. We spend more money in the last days of life than any other country. So that makes health care costs rise and in turn makes insurance more expensive.

I was watching a program once about this. Basically, we, as a nation, spend more money in the first and last days of life. Think extreme premies, astronomical costs sometimes, especially w/ multiples, and the final days with the desire to extend life as long as possible. The gentleman speaking said they are difficult, emotional areas, and nobody wants to deal with it: not the Dr's, not the hospitals, not the insurance companies, not society. That in turn drives up the costs of care. He said one day, we are going to hit the point where we will have to deal with it, maybe that day is coming soon.

 

[DznyLvr2005]

Well any illegal immigrant can get free healthcare, meawhile I had to have surgery and the anesthesia wasn't covered.. BUT I DIDNT KNOW THIS UNTIL AFTER!!!
I had to pay $1800... But like I said, any other illegal immigrant... FREE.. ughhh
We have good insurance... GHI....
But alot of things aren't covered sometimes... lots of people don't have dental ins.... And if you ever needed a root canal, you'll be $3000 in the hole...
I always hear about people going to Europe or canada for dental work/, surgery.. you can get it for free and make a vacation out of it!!
I work in a doctors office.. we don't take any insurance.. it's all cash cash cash!! this is because insurance companies wind up not paying.
We accept medicare, but don't participate.. We don't accept medicaid.

 

[mickeyfan2]

My GF who lives in the UK had a gallbladder attack. She went to the hospital. They stablizered her and told her she needed it out. Since she was not an emergency they scheduled her for 8 months later. She had two more major attack, but still not surgery. Treated and sent home. The last time she was so sick she had to have emergency surgery. She told all of her US friends, this is what NHC gets you and you don't want it.

I got ill earlier this year. When they found out what it was and that surgery was the only solution (not gallbadder) and it was not an emergency I picked the date to have it done. From the time I knew I needed surgery until it was actually done was less than two weeks. I did not need approval from my insurance company and they still would have paid.

I pay 100% of my premiums and I do not want NHC. I prefer to control my own destiny.

 

[Christine]

I agree that something needs to be done to make healthcare more affordable, but I'm not sure I'm ready for an NHS.

Over ten years ago, I was diagnosed with thyroid cancer and had all the surgeries/treatments. It was brutal because they have to remove you from all thyroid hormone to treat you. The more you do this, the more damage that you cause your body. It's certainly not a death sentence, but it is EXTREMELY uncomfortable and requires one to go on short term disability.

Then back around 1999, a new drug was developed that would bypass this process and "simulate" the hypothyroid state so that diagnostic scanning could be done without the patient suffering horrible side effects and losing work. The cost of the drug was about $2500 then. My insurance covered it. Most, if not all of the Canadians on our thyroid support group, were not allowed access to this drug. I think "finally" many years later, they now use the drug, but they suffered for many years before they could use it.

I'm not sure I'd be happy with that.

 

[mickeyfan2]

Michael Moore is correct. How can a hospital be FOR PROFIT? Better question, WHY should a hospital be FOR PROFIT? It's flat wrong. I have health insurance, and you know it is the BIGGEST PAIN IN MY you know what! The problem is I have a chronic progressive illness, which means I take away from their bottom line.... I am forever AND EVER going through circles trying to get my procedures and visits covered. I don't know how I manage it at times, at times I give up and just pay even though I know it's a covered benefit. I cannot spend all my time and more importantly, energy fighting the insurance companies... and don't even start on our prescription plan, that is even more a mess... we have to mail order all our medications, then they always have questions, or give you one refill, so every 3-4 months you're starting the process for X number of drugs all over again, new prescriptions, new forms, new everything.... our plan only covers one visit to a pharmacy per year....

Health insurance in this country is only for the healthy..... and if all you've ever been is healthy, you have absolutely no idea...

The hospital that I had my surgery at is for profit and the care it top notch. The profit goes to the country that the hospital is in. I am 100% for this.

 

[Chicago526]

Well, I think that when our system works, it really works. You can get some of the best care in the world here. But when it doesn't work, it's horrible.

DH and I both have health care paid for through our employer (well, most of it anyway). It's very good coverage and we're lucky to have it. But, DH is type 2 diabetic and on insulin. If we ever lost our coverage from work (for whatever reason), DH is all but uninsurable. It is my greatest fear, that we will lose our insurance and we will have to go bankrupt to keep him alive.

I know a lot of people here fear UHC, and to be honest I'm not too nuts about the idea myself, the government has a way of screwing stuff up. But, having a cronic, expensive, and life-thretening illness in my family is opening my eyes to the fact that we can't keep going the way we are going. There has to be a solution that coveres everyone, keeps costs as low as resonably possible, and still gives good and timely care.

 

[DISUNC]

Health care in the USA is for the following only.

If one is wealthy!

If one has a job the Company offers Health Insurance at a reduced rate (and even this has a multitude of problems)

If one is Dirt Poor!

In some States all children are covered.

Everybody else...Tuff LUCK!

The side effects of this is a cog in the USA wheel. Way too many people not getting the proper health care. No type of preventative maintenence. People who can retire due to financial stability, and open job opportuniies...DONT retire due to the "what if I get terribly sick", the costs are outrageous.

Many people take jobs JUST for health benefits. For instance a Husband may have a good paying job, but NO benefits. His wife will take a low paying job just for Health benefits.

 

[Chattyaholic]

Health insurance, and medical charges, are ridiculous.

My DH and I don't have employer paid health insurance, we pay our own which is about $450 per month just for basic coverage (high deductible, 80/20 after the deductible is met, no physican office coverage, etc.). It goes up every year, usually at least a couple hundred dollar increase.

We have no co-pay at the doctor's office, we pay the entire bill ourselves.

It's too expensive to go to the doctor so we rarely do. DH went for a physical a couple of months ago, and it was $190 (they tacked on a "new patient charge" simply because he had not been there in a few years, even though he has been a patient there OVER THIRTY YEARS!!!).

I'm supposed to have the pressure in my eyes checked every 4 months, but only go once a year because for the 2-minute procedure the opthalmologist charges $150. It was $90 the year before that, and I thought that was high, last time $150. I haven't gone yet this year, it'll probably be over $200.

How they can get away with charging such riduclously high amounts is beyond me.

And it's getting to where employers are paying less and less for their employee's health coverage, and with the way the costs keep rising I wonder how many more years anyone will have employee paid coverage. If it comes to that, there will be a LOT MORE who don't have insurance.

I remember when I was in the hospital 4 nights with pulmonary embolism it was over $8,000. I didn't have surgery, just an IV heparin drip and blood draws every 6 hours. Ridiculous.

 

[DISUNC]

meawhile I had to have surgery and the anesthesia wasn't covered.. BUT I DIDNT KNOW THIS UNTIL AFTER!!!

Anesthsia was NEVER covered by many Health Insurers!
Nor is Blood! Only if you donate blood, can you recieve "Free" blood if needed!