how I hate insurance

[mnrose]

I had lengthy, candid, conversations with our German hosts (she is a pediatrician, and is well familiar with how that system works). Her view: the German system isn't perfect. No system is. However, everyone gets health care without worrying about how to pay for it. She thinks the US system is horrifying, and does not understand how people continue to tolerate the amounts of money we pay for it.

No, I don't think the Canadian system, for example, is perfect. It has shortcomings like ALL systems do. But, you bet your sweet bippy I believe it's a BETTER system than the one we currently use in the US.

 

[tvguy]

I wish your family would stop misinforming you. Either that, or they’re leaving parts out. I have six different doctors for one thing or another and I’ve never, like never, seen a pa, or an np.

Also, if I went to a pharmacy and asked for an rx they would laugh at me.

Did you ready the link I posted above? Pharmacists can now prescribe certain drugs in Cananda


I’m in Canada, and when I want to see my dr, I see my dr. If it’s late and his office is closed, I can go to ANY walk in clinic, or, worst case scenario, ANY hospital without worrying if they’re in my network, or if I have to pay a co pay.

I don’t know (based on prices) what sort of situation you’d have to go through to owe hundreds of thousands of dollars (that you’re responsible for, not insurance paying for), but what’s your ballpark for this?

Four months in three different hospitals, a week in ICU hooked up to three different IV’s, two surgeries, six ambulance trips, too many doctors and specialists to list, six weeks of IV meds (times two), physical therapy, occupational therapy, three meals a day for 114 days, use of a hospital bed at home for two months, ongoing use of a wheelchair, and a toilet seat with arm rests to ease rising up afterwards.

Thats not even including all the incidentals like kleenex, and Tylenol, and painkillers, and rash cream and thermometers.

We haven’t seen one bill for any of this, and we won’t. You can’t understand the sense of relief that comes with that.

As a pp said, I have not met one Canadian who would EVER want to be subjected to your health care system. I used to feel superior, now I just feel true pity.
Wonder why there are so many clinics on the U.S. side of the border with Canada that specialize in treating Canadians?

.

 

[tvguy]

I had lengthy, candid, conversations with our German hosts (she is a pediatrician, and is well familiar with how that system works). Her view: the German system isn't perfect. No system is. However, everyone gets health care without worrying about how to pay for it. She thinks the US system is horrifying, and does not understand how people continue to tolerate the amounts of money we pay for it.

No, I don't think the Canadian system, for example, is perfect. It has shortcomings like ALL systems do. But, you bet your sweet bippy I believe it's a BETTER system than the one we currently use in the US.

Best answer. No system is perfect.

 

[tvguy]

As a pp said, I have not met one Canadian who would EVER want to be subjected to your health care system. I used to feel superior, now I just feel true pity.

https://www.usnews.com/news/best-co...dians-increasingly-come-to-us-for-health-care
https://www.huffpost.com/entry/canadian-medical-tourism_n_5949b405e4b0db570d3778ff

 

[kimblebee]

https://www.usnews.com/news/best-co...dians-increasingly-come-to-us-for-health-care
https://www.huffpost.com/entry/canadian-medical-tourism_n_5949b405e4b0db570d3778ff

Are you going to take Social Security when it’s available to you?

 

[Southernmiss]

Are you going to take Social Security when it’s available to you?

Boom!

 

[Southernmiss]

If you knew what training pharmacists receive in drugs and human anatomy you would be glad they can prescribe certain medications.

Upthread it was already stated that a medication that a doctor prescribed was caught by the pharmacist to be deadly for the poster's child.

 

[kimblebee]

https://www.usnews.com/news/best-co...dians-increasingly-come-to-us-for-health-care
https://www.huffpost.com/entry/canadian-medical-tourism_n_5949b405e4b0db570d3778ff

Are you going to answer my question about the estimated oop cost for you for everything I listed?

 

[Kestryl]

https://www.usnews.com/news/best-co...dians-increasingly-come-to-us-for-health-care
https://www.huffpost.com/entry/canadian-medical-tourism_n_5949b405e4b0db570d3778ff

Abroad does not exclusively mean US. (One person in the article went to the Cayman Islands and paid $14,100 in US dollars.) I’d love to know the breakdown of where they go and how much geography comes into play.

The other two in the article paid around $7600 ($10k Canadian) at the Mayo Clinic and $22,800 ($30k) in California. (The California breakdown also charged $18 for three cotton balls, apparently.)

The article itself states that the ability to do this is “only available to those privileged enough to be able to finance expensive out-of-pocket medical expenses up front.”

According to a link from the HuffPost article to the National Post, Canada has the second-worst overall health care system among 11 industrialized nations. The worst? The United States.

 

[tvguy]

Are you going to answer my question about the estimated oop cost for you for everything I listed?

I thought I did, but $5,000 is the cap

 

[kimblebee]

I thought I did, but $5,000 is the cap

If it’s ‘only’ $5000, why do so many people suffer lifelong financial ruin? I’m assuming it’s because you have amazing insurance..how much is that a month?

Because my husband and I both have pre existing conditions I bet we wouldn’t even be able to get insurance, or, if we were, the monthly cost would be astronomical.

 

[tvguy]

If it’s ‘only’ $5000, why do so many people suffer lifelong financial ruin? I’m assuming it’s because you have amazing insurance..how much is that a month?

Because my husband and I both have pre existing conditions I bet we wouldn’t even be able to get insurance, or, if we were, the monthly cost would be astronomical.

$280 a month, group coverage through my wife's work. We went with the high deductible plan. The low deductible plan costs an additional. $400 a month. $500 deductible. So we save $4,800 a year in premiums by taking a $5,000 deductible. Had this plan several years since the AHC went into effect. Haven't had $4,800 out of pocket yet. But no different than any other insurance, the higher the deductible you take, the lower the premium.

 

[CdnCarrie]

I'm 50 years old and have yet to know anyone personally that has gone to the US for healthcare. I'm sure it does happen probably with people living close to the border?

My experience - I had laser eye surgery done at a private clinic years ago. I was in the lobby Saturday morning waiting for the doctor to come in (it was all just post op check ups...) and it was all Americans. I stood there and listened to them discuss which hotel they stayed at and where they ate.
Guess it was cheaper in Winnipeg than Minnesota/North Dakota.

 

[DopeyDame]

I wish your family would stop misinforming you. Either that, or they’re leaving parts out. I have six different doctors for one thing or another and I’ve never, like never, seen a pa, or an np.

Also, if I went to a pharmacy and asked for an rx they would laugh at me.




I’m in Canada, and when I want to see my dr, I see my dr. If it’s late and his office is closed, I can go to ANY walk in clinic, or, worst case scenario, ANY hospital without worrying if they’re in my network, or if I have to pay a co pay.

I don’t know (based on prices) what sort of situation you’d have to go through to owe hundreds of thousands of dollars (that you’re responsible for, not insurance paying for), but what’s your ballpark for this?

Four months in three different hospitals, a week in ICU hooked up to three different IV’s, two surgeries, six ambulance trips, too many doctors and specialists to list, six weeks of IV meds (times two), physical therapy, occupational therapy, three meals a day for 114 days, use of a hospital bed at home for two months, ongoing use of a wheelchair, and a toilet seat with arm rests to ease rising up afterwards.

Thats not even including all the incidentals like kleenex, and Tylenol, and painkillers, and rash cream and thermometers.

We haven’t seen one bill for any of this, and we won’t. You can’t understand the sense of relief that comes with that.

As a pp said, I have not met one Canadian who would EVER want to be subjected to your health care system. I used to feel superior, now I just feel true pity.

I honestly don't think most people in the US can answer your question. That's one of the big problems - it's nearly impossible to get quotes for what things will cost in advance, and there are so many minor details that can screw things up.
For example, my sister had surgery at a major US hospital recently (I'm certain everyone on the board has heard of it.) The hospital took her insurance, so it should have been only her max OOP of a few thousand dollars (not sure the exact amount). She found out after the surgery that the actual surgeon was "on staff" but not an actual employee of the hospital, and he didn't take her insurance. So she got a bill of over $10,000. She negotiated with him and got it down to ~$5000.

From personal experience, we took DS to a specialist for some testing a few years ago. We knew it was out of network, and so our insurance would pay "reasonable and customary" rates, and we'd be responsible for any difference between that and what the doctor billed. OK, fine. We thought it was an important test (and so did our regular doctor). We tried to get our insurance to at least tell us what they would pay, but they said they couldn't until the doctor actually submitted the medical codes, which wouldn't happen until after the tests were completed. So there was no way we could know in advance what our insurance would pay. Turns out, the bill was ~$3000 and our insurance paid $250. So we were left with over $2000 to pay, despite having what is generally really good insurance. And we didn't have that info in advance to make an informed decision.

Most of the times the really terrible stories you hear are because people either don't have insurance, or end up going to an out-of-network doctor or hospital or getting a procedure that ends up not being approved/covered.

 

[kimblebee]

I honestly don't think most people in the US can answer your question. That's one of the big problems - it's nearly impossible to get quotes for what things will cost in advance, and there are so many minor details that can screw things up.
For example, my sister had surgery at a major US hospital recently (I'm certain everyone on the board has heard of it.) The hospital took her insurance, so it should have been only her max OOP of a few thousand dollars (not sure the exact amount). She found out after the surgery that the actual surgeon was "on staff" but not an actual employee of the hospital, and he didn't take her insurance. So she got a bill of over $10,000. She negotiated with him and got it down to ~$5000.

From personal experience, we took DS to a specialist for some testing a few years ago. We knew it was out of network, and so our insurance would pay "reasonable and customary" rates, and we'd be responsible for any difference between that and what the doctor billed. OK, fine. We thought it was an important test (and so did our regular doctor). We tried to get our insurance to at least tell us what they would pay, but they said they couldn't until the doctor actually submitted the medical codes, which wouldn't happen until after the tests were completed. So there was no way we could know in advance what our insurance would pay. Turns out, the bill was ~$3000 and our insurance paid $250. So we were left with over $2000 to pay, despite having what is generally really good insurance. And we didn't have that info in advance to make an informed decision.

Most of the times the really terrible stories you hear are because people either don't have insurance, or end up going to an out-of-network doctor or hospital or getting a procedure that ends up not being approved/covered.

I understand why no one can put a dollar amount on what they’d have to pay for everything I listed. My point was more that we don’t have to pay a penny for it. Just think about how freeing that is.

I used to feel very superior for being Canadian, and not having to worry about hospital bills and doctor visits. Our system isn’t perfect, but I’ll take it over the alternative any day. Now, I feel so much sympathy for others who aren’t as fortunate. I talk to a few posters in dm (hi secret friends ) and we just can’t get over monthly insurance costs.

 

[DopeyDame]

I understand why no one can put a dollar amount on what they’d have to pay for everything I listed. My point was more that we don’t have to pay a penny for it. Just think about how freeing that is.

I used to feel very superior for being Canadian, and not having to worry about hospital bills and doctor visits. Our system isn’t perfect, but I’ll take it over the alternative any day. Now, I feel so much sympathy for others who aren’t as fortunate. I talk to a few posters in dm (hi secret friends ) and we just can’t get over monthly insurance costs.

Oh, I know. We're really fortunate in that we have great insurance and are reasonably well off enough that the few thousand dollars in unexpected bills didn't sink us. But even at that, I am really aware at how quickly things could go down hill due to medical costs. It's so bizarre to think that something that started out as a WW II tax break/salary freeze turned into such a screwed up system to take care of people.

 

[LSUmiss]

Why in the world do you expect to see a doctor, and not a PA or NP? I looooove the NPs at my practice office, and they are more than capable of handling the vast majority of things that a general office sees. And when they aren't, they've already laid the ground work for the doctor so he can get to the more complicated stuff more efficiently. NPs and PAs are important and beneficial members of the health system. I can't imagine why you wouldn't want them!
And your family may go to your doctor when you get sick, but tons of people in the US go to Target or their local drugstore and have a PA or NP (not a pharmacist... in the US or Canada) diagnose and treat them.

I’m fine with seeing a NP or PA, but IMO, it shouldn’t be cheaper & it’s not.

 

[Turn the Page]

I honestly don't think most people in the US can answer your question. That's one of the big problems - it's nearly impossible to get quotes for what things will cost in advance, and there are so many minor details that can screw things up.
For example, my sister had surgery at a major US hospital recently (I'm certain everyone on the board has heard of it.) The hospital took her insurance, so it should have been only her max OOP of a few thousand dollars (not sure the exact amount). She found out after the surgery that the actual surgeon was "on staff" but not an actual employee of the hospital, and he didn't take her insurance. So she got a bill of over $10,000. She negotiated with him and got it down to ~$5000.

From personal experience, we took DS to a specialist for some testing a few years ago. We knew it was out of network, and so our insurance would pay "reasonable and customary" rates, and we'd be responsible for any difference between that and what the doctor billed. OK, fine. We thought it was an important test (and so did our regular doctor). We tried to get our insurance to at least tell us what they would pay, but they said they couldn't until the doctor actually submitted the medical codes, which wouldn't happen until after the tests were completed. So there was no way we could know in advance what our insurance would pay. Turns out, the bill was ~$3000 and our insurance paid $250. So we were left with over $2000 to pay, despite having what is generally really good insurance. And we didn't have that info in advance to make an informed decision.

Most of the times the really terrible stories you hear are because people either don't have insurance, or end up going to an out-of-network doctor or hospital or getting a procedure that ends up not being approved/covered.

I once had surgery where I did my due diligence and chose an in network surgeon before the procedure only to find out after the fact that the surgeon was in network but the anesthesiologist that was on duty at the time of my surgery was not so I got slapped with a roughly $2000 bill unexpectedly.

That was fun.

 

[Turn the Page]

$280 a month, group coverage through my wife's work. We went with the high deductible plan. The low deductible plan costs an additional. $400 a month. $500 deductible. So we save $4,800 a year in premiums by taking a $5,000 deductible. Had this plan several years since the AHC went into effect. Haven't had $4,800 out of pocket yet. But no different than any other insurance, the higher the deductible you take, the lower the premium.

But what percentage of the total cost is that? Her employer has to be paying out quite a bit for your premiums to be that low.

 

[kimblebee]

But what percentage of the total cost is that? Her employer has to be paying out quite a bit for your premiums to be that low.

Very good point!

Also, @tvguy, you haven’t answered if you or your wife will be taking Social Security when you qualify for it.