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The system works fairly well if you are poor too. I know several people who have walked into and out of the hospital without paying a dime. It really seems lik

The system works fairly well if you are poor too. I know several people who have walked into and out of the hospital without paying a dime. It really seems like the middle class gets the raw end of the deal.

taxicabjesus 9y ago
> It really seems like the middle class gets the raw end of the deal. My hairdresser figured she has to spend $5,000 before she can get any benefit from "health insurance". She & her husband decided it'd be better to pay the penalties, spend that first $5000 on herself, and "hope" that she won't need more. She's from Cuba, originally - left in 1987, iirc.
deleted 9y ago
[deleted]
caresource_ta 9y ago
Can confirm it works fairly well for the poor. I have been registered for Medicaid the past three years of school and have not had to used it until this year. Every single time I use my insurance (CareSource) I am absolutely blown away by how painless it is. Other than presenting proof of coverage twice in a series of multiple hospital and doctor's visits I have not had to worry about insurance for a single moment. At one point my physician was ordering lab work and kept asking if I wanted any additional lab work of my choosing and this just seemed absurd because on private insurance I would never consider lab work to be discretionary.
- aidenn0 9y ago
  Medical is a horrible situation when I've had to use it. The places that take it you pay nothing, but many places won't take it, and many GPs at places that do take it won't take new patients on it. The dental care was also terrible: 2 places only in my city that accept it. Neither would give an appointment for a cleaning and a checkup at the same time, and I never was admitted less than 20 minutes after my appointment time.
- KyeRussell 9y ago
  > At one point my physician was ordering lab work and kept asking if I wanted any additional lab work of my choosing and this just seemed absurd because on private insurance I would never consider lab work to be discretionary. From your perspective that's great, but it's still another sign of the system being broken. As soon as you involve cash flowing between multiple entities, it just becomes a massive cash grab. The physician seemingly knew they could take advantage of your cover in that instance. That in itself seems problematic. Note: I'm not from the US, so there's probably an aspect of Medicaid that I don't understand. We have a more sane healthcare system :)
djsumdog 9y ago
Well, not if you need treatment. If you're poor, yes you won't pay anything because the hospital won't bother to bill anyone. But if you need surgery and have no insurance or medicade, there are cases of doctors sending you home, waiting for sepsis and then amputating, because it's cheaper and takes less resources. Extremely poor people may not pay for care, but be assured that in America, they get no where near the same level of care. And if you're poor and have cancer? Most other western countries will give you a chance. There is a much deeper problem relating directly to this topic. Transportation. Access to real transpiration is THE BIGGEST FACTOR in escaping poverty. Uber isn't public transportation. A train is about $2 ~ $3 in most cities. In an Uber that would be a $10 ~ $20 ride. Multiply that by 7 days a week to and from work, and there simply is no comparison. Many cities have discounted fare cards for the poor as well. The structure of American cities hurts the poor.
- chimeracoder 9y ago
  > And if you're poor and have cancer? Most other western countries will give you a chance Cancer is probably the worst example you could pick to prove your point. It turns out that the US system is highly-optimized for specialized care (which happens to include cancer), as opposed to routine care. That's one of the reasons it ends up being more expensive. In fact, even when including poor and uninsured people in the mix, the US has dramatically better outcomes when it comes to cancer treatment than the UK, Canada, Denmark, France, the Netherlands, etc.
  - notfromhere 9y ago
    Assuming you get treatment. In the US, cancer treatment is pre-paid, and if you don't have insurance you are SOL
    - chimeracoder 9y ago
      > Assuming you get treatment. In the US, cancer treatment is pre-paid, and if you don't have insurance you are SOL No, even factoring that in, the US has dramatically better outcomes for cancer than the other countries listed.
lazulicurio 9y ago
This to me is the biggest issue with health insurance in the US right now---it's effectively trying to cover two issues at once: 1) non-payment to health care providers 2) unexpected ailments to health care consumers. We have insurance companies as the middlemen, trying to make money from both ends. It's like having the same lawyer as prosecutor and defense attorney; no matter how much you trust any individual to do a good job, you're asking for trouble in the long run. I feel like the best solution would be to change the arrangement from consumer<-->insurance<-->provider to insurance<-->consumer<-->provider<-->insurance. Have providers charge consumers directly (so prices are more transparent), consumers buy actual "health insurance", and providers buy non-payment insurance. If the government needs to subsidize non-payment insurance rates for certain providers, it can do so without as much risk for inflating prices and screwing over people who can pay the bills.

taxicabjesus 9y ago

> It really seems like the middle class gets the raw end of the deal. My hairdresser figured she has to spend $5,000 before she can get any benefit from "health insurance". She & her husband decided it'd be better to pay the penalties, spend that first $5000 on herself, and "hope" that she won't need more. She's from Cuba, originally - left in 1987, iirc.

deleted 9y ago

[deleted]

caresource_ta 9y ago

Can confirm it works fairly well for the poor. I have been registered for Medicaid the past three years of school and have not had to used it until this year. Every single time I use my insurance (CareSource) I am absolutely blown away by how painless it is. Other than presenting proof of coverage twice in a series of multiple hospital and doctor's visits I have not had to worry about insurance for a single moment. At one point my physician was ordering lab work and kept asking if I wanted any additional lab work of my choosing and this just seemed absurd because on private insurance I would never consider lab work to be discretionary.

aidenn0 9y ago
Medical is a horrible situation when I've had to use it. The places that take it you pay nothing, but many places won't take it, and many GPs at places that do take it won't take new patients on it. The dental care was also terrible: 2 places only in my city that accept it. Neither would give an appointment for a cleaning and a checkup at the same time, and I never was admitted less than 20 minutes after my appointment time.
KyeRussell 9y ago
> At one point my physician was ordering lab work and kept asking if I wanted any additional lab work of my choosing and this just seemed absurd because on private insurance I would never consider lab work to be discretionary. From your perspective that's great, but it's still another sign of the system being broken. As soon as you involve cash flowing between multiple entities, it just becomes a massive cash grab. The physician seemingly knew they could take advantage of your cover in that instance. That in itself seems problematic. Note: I'm not from the US, so there's probably an aspect of Medicaid that I don't understand. We have a more sane healthcare system :)

djsumdog 9y ago

Well, not if you need treatment. If you're poor, yes you won't pay anything because the hospital won't bother to bill anyone. But if you need surgery and have no insurance or medicade, there are cases of doctors sending you home, waiting for sepsis and then amputating, because it's cheaper and takes less resources. Extremely poor people may not pay for care, but be assured that in America, they get no where near the same level of care. And if you're poor and have cancer? Most other western countries will give you a chance. There is a much deeper problem relating directly to this topic. Transportation. Access to real transpiration is THE BIGGEST FACTOR in escaping poverty. Uber isn't public transportation. A train is about $2 ~ $3 in most cities. In an Uber that would be a $10 ~ $20 ride. Multiply that by 7 days a week to and from work, and there simply is no comparison. Many cities have discounted fare cards for the poor as well. The structure of American cities hurts the poor.

chimeracoder 9y ago
> And if you're poor and have cancer? Most other western countries will give you a chance Cancer is probably the worst example you could pick to prove your point. It turns out that the US system is highly-optimized for specialized care (which happens to include cancer), as opposed to routine care. That's one of the reasons it ends up being more expensive. In fact, even when including poor and uninsured people in the mix, the US has dramatically better outcomes when it comes to cancer treatment than the UK, Canada, Denmark, France, the Netherlands, etc.
- notfromhere 9y ago
  Assuming you get treatment. In the US, cancer treatment is pre-paid, and if you don't have insurance you are SOL
  - chimeracoder 9y ago
    > Assuming you get treatment. In the US, cancer treatment is pre-paid, and if you don't have insurance you are SOL No, even factoring that in, the US has dramatically better outcomes for cancer than the other countries listed.

lazulicurio 9y ago

This to me is the biggest issue with health insurance in the US right now---it's effectively trying to cover two issues at once: 1) non-payment to health care providers 2) unexpected ailments to health care consumers. We have insurance companies as the middlemen, trying to make money from both ends. It's like having the same lawyer as prosecutor and defense attorney; no matter how much you trust any individual to do a good job, you're asking for trouble in the long run. I feel like the best solution would be to change the arrangement from consumer<-->insurance<-->provider to insurance<-->consumer<-->provider<-->insurance. Have providers charge consumers directly (so prices are more transparent), consumers buy actual "health insurance", and providers buy non-payment insurance. If the government needs to subsidize non-payment insurance rates for certain providers, it can do so without as much risk for inflating prices and screwing over people who can pay the bills.