8 ms·

> We said okay, but if I had more closely read my policy I'd have learned that the policy had a $1500/day copay for labor and delivery. We'd have taken our chan

> We said okay, but if I had more closely read my policy I'd have learned that the policy had a $1500/day copay for labor and delivery. We'd have taken our chances and gone home had we known. What the bloody flying everliving fuck?? Does this not seem absolutely absurd to anybody else? You'd have risked a severe infection for the mother of your newborn child had you known there was a monetary cost attached to not risking it? This is patently ridiculous, and it is inhumane that people have to make such calculations. You go to the place with the people in white robes when you're sick. No ifs, no buts, no strings attached. This is how you keep a healthy, productive populace. No wonder the US, the largest economy in the world, ended up with a terrible infant mortality rate… https://www.cnbc.com/2018/01/08/us-has-worst-rate-of-child-mortality-among-20-rich-nations.html https://www.cnbc.com/2018/01/08/us-has-worst-rate-of-child-m... EDIT: from the article: > "Persistently high poverty rates, poor educational outcomes, and a relatively weak social safety net have made the US the most dangerous of wealthy nations for a child to be born into." … yeah. As a young person who's planning on having a family: I will go work in the US exactly never.

watwut 9y ago
Socialized medicine (e.g. one paid by state) also weights costs and risks. You just don't see it and don't have to make those decisions by yourself. You don't know how much for them 1500 wad nor how high the risk nor whether coming back from home was that much dangerous in case that bacteria happened.
- theaeolist 9y ago
  That's nonsense. You do know, statistically.
  - watwut 9y ago
    Parent I responded to does not know. He is just horrified that couple would save on healthcare. If you live in system with socialized healthcare, you don't have to make these decisions. However, if you pay out of pocket then you do have to make those decisions personally. Else you will be taken for financial ride.
- zxcmx 9y ago
  Funnily enough I agree with you but I have to disagree a little bit. The truth is no one knows what the right level of care is even in many common situations. Up front I'll say I'm a state and universal healthcare advocate. But it comes with its own forms of waste. Our first child had a borderline kidney tube measurement. We had 8 follow up scans costing the taxpayer $300 each. Gradually I realised that the clinics had figured out a way to game the funding system, because at the level of deviation i saw I could find no research supporting the need for 8 extra ultrasound scans and in fact the only measurable risk was an increased risk of uti escalating to kidney infection which actually an ultrasound is not the best diagnostic tool for anyways. In fact none of the doctors or technicians I talked to could coherently explain the level of risk or how the scans mitigated that risk. What they did have was numeric guidelines and some measurement uncertainty. Plus a blank cheque to do more scans if they could justify it under current guidelines. On the gripping hand they were $300 scans not $1200 scans like in insurance driven systems so...
- watwut 9y ago
  I would really liked to know why is this downvoted. Do people think insurance dont make those decisions? Or that those decisions being made implies I think socialized medicine is bad? Or they all know everything about that particular bacteria and assume everyone should?
gambiting 9y ago
>>Does this not seem absolutely absurd to anybody else? It does, and it's shit like this that makes me absolutely convinced that US is a 3rd world country, where people have to weight their own health vs the financial cost. There's plenty of people saying they don't want to call an ambulance because they are worried what their bill would be. That people would risk their lives and that of their new born baby because there is a financial cost associated with staying at the hospital for another day is beyond absurd, it's like bad fiction about some distant society where things have gone horribly wrong, except that this is real and calls itself the greatest country in the world.
- bsbechtel 9y ago
  If individuals aren't free to make these financial decisions for themselves, then insurance companies or the government will. My mom had a severe infection while on chemo because the insurance company didn't want to pay for an injection that would've boosted her immune system. Having these decisions made at the population level, instead of the individual is far worse.
  - pjc50 9y ago
    > individuals aren't free to make these financial decisions for themselves An individual can only be free to make this kind of decision if they've got a spare $1500.
  - gambiting 9y ago
    What do you mean individuals aren't free to make that decision? Even in a fully public healthcare system you can always opt to pay for treatment which is not covered(as rare as those are). How is that different than your insurer in US refusing to pay for treatment and you paying from your own pocket?
  - awinder 9y ago
    If the state was paying and your mother wanted to pay out of pocket nothing would stop her. Elective course of action is not banned in any single payer system that I know of.
pweissbrod 9y ago
I'm american. This time last year I had a minor bone break in my hand (not emergency, no severe pain). I have a preferred doctor who doesnt have an xray machine. Obviously getting an xray image is the first step before even talking to the doctor. An xray of your hand is a _very_ basic procedure. My plan was to get my own image from a conveniently close facility of my choice and bring it to the doctor. This is an open commercial market right? I decided to play a quick game with this and ask all my in-network local providers what their charge would be for just an x-ray of my left hand. A car mechanic should be able to quickly give you an up-front estimate for common procedures, why not an imaging facility? If youve read this far youre probably not surprised I called 4 different facilities, followed up with a series of requests over multiple days and failed to receive even one straight answer except "come in and we will see what we can do". It makes me realize how soul-crushing the experience can be in this so-called "open market" to find the best possible treatment when you have a more complicated problem. The amount of leg-work, scheduling, waiting for doctors and getting opinions all while in pain would break the spirit of most anyone. Is it really that much simpler in other countries to connect with the proper provider? I was under the impression countries like canada handle simple problems like mine much more gracefully but serious issues remain problematic.
- msg3 9y ago
  My wife banged her foot about a year ago. We were pretty sure it wasn't broken, but we went to the hospital to get it checked out anyway. We never even considered which hospital we should go to - we basically expect them all to be decent, so why bother thinking about it? We had to wait in the emergency room for an hour or so, but then we were seen. My wife's foot was X-rayed 30 minutes later and it was confirmed that everything was fine.
- hackbinary 9y ago
  >> Is it really that much simpler in other countries to connect with the proper provider? I was under the impression countries like canada handle simple problems like mine much more gracefully In Canada and in Britain, you simply go to your local GP and get a referral, or go to A&E (Emergancy). >> but serious issues remain problematic. No, generally treatment in Canada and Britain for 'serious issues' is very good as well. We all hear about the well publicised failures of the NHS and Canadian Healthcare, but by and large it works very well. I have seen close relatives and friends have cancer, septicemia, strokes, severe bone breaks, a life changing injury that made a friend a quadrapeligic, and more. For the most post part, the level of healthcare in Canada and Britain has been excellent. My friend who had septicemia was in a very remote location, and once diagnosed was airlifted to a major hospital. All of this is covered by public healthcare. It is amazing. It is even more astounding that the USA still has this Byzantine 'private' system that tries to claim that it is an open market, but it is not. From a macroeconomic point of view, the USA pays 18% or 19% of GDP for its healthcare system, where as Britain and Canada, and pretty much every other western country pay about 10%. (These are OECD figures) The American healthcare system is horribly inefficient, and puting in a public system ought to be every American's politicial priority. Imagine that, a universal healthcare system is cheaper to operate than the private system? The rhetoric and hyperbole that comes out of those who are vested in the status quo is outright criminal.
maxsilver 9y ago
> Does this not seem absolutely absurd to anybody else? It is obviously an insane way to run healthcare. But for the majority of US citizens, they've never experienced anything else. So this insanity is considered totally normal to them. Medical bankruptcy isn't just a thing, it's an expected outcome of any major illness -- medical bills are the most common reason for bankruptcy in the US. If the US just switched to a proper universal national healthcare system (like say, a clone of UK's NHS), for even just one month, America would never go back to the way it is today. Not suggesting that UK's system is perfect, but it's so much objectively better than the US system that there would riots in the streets, if anyone suggested going back to today's US system. Which is why we see so much lying about how terrible socialized medicine is, and so much money/time poured into preventing Americans from learning/experiencing it in any way.
- nojvek 9y ago
  Having a Baby in US. I will definitely give my insurance provider a call. They didn’t pay much for the OB and I work for a very solid tech company. America’s healthcare is a f*ing joke. It’s riddles from the top to bottom with people who want to leech money at every step and provide the most minimal service. I had a slight fracture in my scaphoid. I paid $2000 out of pocket and insurance paid half of that. In Australia where I don’t need employer golden handcuffs for health insurance, it would be less than a third of that.
coldtea 9y ago
I was in the US once, and had developed a cyst on my finger that hurt (due to the pressure of the liquid inside -- could have been a ganglion cyst). What you do with those, is you burst them open to relief the pressure, clear the liquid inside (white cells and such) and put some disinfectant. In my (Western European) country it's a trivial 10 seconds operation every pharmacy is authorized to do. So I go asked at a pharmacy/drugstore for that (probably a Walgreens) -- and they said they weren't allowed to do it and that I should ask at a clinic. I asked how much it would cost for this, if I went at one, and they told me about $150. Yeah, right. I just went on and bought a regular clothespin from that pharmacy, burned it with a lighter to disinfect it, and burst the cyst myself... (And it's not about government mandated insurance vs "really free market" and such. We have mandatory insurance were we are, and the prices for all kinds of operations, both with and without insurance coverage, are still way lower).
- coldtea 9y ago
  s/clothespin/safetypin/
ataturk 9y ago
The whole infant mortality rate thing has been debunked over and over again. The US statistics are different than those of other countries AND--this is the BIG AND--US hospitals routinely attempt to save marginal infants whereas other countries let them expire and tick it as a non-viable birth. So don't tell us lies about how great the rest of the world is, okay? There's no way Cuba does half as good a job for mothers as even the worst US hospitals do, so get your head out of your ass on that one. Second, when you figure the costs of universal healthcare, do you take into account the huge taxes on your salary, asusming you have any in whatever country you live in? Sweden is a great place to live if you can overlook the 60% tax on income or whatever it is up these days. Also, you buy a car over there and there's a 100%+ tax on that, then some countries have a VAT, etc. So how much are you REALLY paying for healthcare? At least in the US I get to keep some of my income and I know how much I'm paying for healthcare. Had the social engineers and the corporatists not gone and tinkered, we wouldn't be as bad off as we are now. It was big government doing us no favors as usual.
coolsunglasses 9y ago
>No wonder the US, the largest economy in the world, ended up with a terrible infant mortality rate… That's largely a product of people trying a lot harder to with much earlier premature births than other countries, not a fault in care provided. There's a lot of ways to frame how the US healthcare system fails people, this one's a canard.
- HelloMcFly 9y ago
  And higher rates of teenage pregnancy, pregnancies by obese persons. Using the infant mortality rate as a proxy for US healthcare quality isn't reasonable, as you say.
  - moorhosj 9y ago
    On the flip side, one could argue that teen contraception and nutrition education are important parts of a properly functioning health system. To put it another way, who is to say high rates of teen and obese pregnancies are not caused, in part, by our health system?
    - HelloMcFly 9y ago
      > who is to say high rates of teen and obese pregnancies are not caused, in part, by our health system? Sure, perhaps in part, just as any occurrence in other countries with any recordable teen or obese pregnancies. However, it would be inappropriately reductive to say the health system is the cause of these, and I'd argue it would be incorrect to say the health system is the primary cause. To do so would be to ignore the entrenched historical and cultural influences on the present state.

watwut 9y ago

Socialized medicine (e.g. one paid by state) also weights costs and risks. You just don't see it and don't have to make those decisions by yourself. You don't know how much for them 1500 wad nor how high the risk nor whether coming back from home was that much dangerous in case that bacteria happened.

theaeolist 9y ago
That's nonsense. You do know, statistically.
- watwut 9y ago
  Parent I responded to does not know. He is just horrified that couple would save on healthcare. If you live in system with socialized healthcare, you don't have to make these decisions. However, if you pay out of pocket then you do have to make those decisions personally. Else you will be taken for financial ride.
zxcmx 9y ago
Funnily enough I agree with you but I have to disagree a little bit. The truth is no one knows what the right level of care is even in many common situations. Up front I'll say I'm a state and universal healthcare advocate. But it comes with its own forms of waste. Our first child had a borderline kidney tube measurement. We had 8 follow up scans costing the taxpayer $300 each. Gradually I realised that the clinics had figured out a way to game the funding system, because at the level of deviation i saw I could find no research supporting the need for 8 extra ultrasound scans and in fact the only measurable risk was an increased risk of uti escalating to kidney infection which actually an ultrasound is not the best diagnostic tool for anyways. In fact none of the doctors or technicians I talked to could coherently explain the level of risk or how the scans mitigated that risk. What they did have was numeric guidelines and some measurement uncertainty. Plus a blank cheque to do more scans if they could justify it under current guidelines. On the gripping hand they were $300 scans not $1200 scans like in insurance driven systems so...
watwut 9y ago
I would really liked to know why is this downvoted. Do people think insurance dont make those decisions? Or that those decisions being made implies I think socialized medicine is bad? Or they all know everything about that particular bacteria and assume everyone should?

gambiting 9y ago

>>Does this not seem absolutely absurd to anybody else? It does, and it's shit like this that makes me absolutely convinced that US is a 3rd world country, where people have to weight their own health vs the financial cost. There's plenty of people saying they don't want to call an ambulance because they are worried what their bill would be. That people would risk their lives and that of their new born baby because there is a financial cost associated with staying at the hospital for another day is beyond absurd, it's like bad fiction about some distant society where things have gone horribly wrong, except that this is real and calls itself the greatest country in the world.

bsbechtel 9y ago
If individuals aren't free to make these financial decisions for themselves, then insurance companies or the government will. My mom had a severe infection while on chemo because the insurance company didn't want to pay for an injection that would've boosted her immune system. Having these decisions made at the population level, instead of the individual is far worse.
- pjc50 9y ago
  > individuals aren't free to make these financial decisions for themselves An individual can only be free to make this kind of decision if they've got a spare $1500.
- gambiting 9y ago
  What do you mean individuals aren't free to make that decision? Even in a fully public healthcare system you can always opt to pay for treatment which is not covered(as rare as those are). How is that different than your insurer in US refusing to pay for treatment and you paying from your own pocket?
- awinder 9y ago
  If the state was paying and your mother wanted to pay out of pocket nothing would stop her. Elective course of action is not banned in any single payer system that I know of.

pweissbrod 9y ago

I'm american. This time last year I had a minor bone break in my hand (not emergency, no severe pain). I have a preferred doctor who doesnt have an xray machine. Obviously getting an xray image is the first step before even talking to the doctor. An xray of your hand is a _very_ basic procedure. My plan was to get my own image from a conveniently close facility of my choice and bring it to the doctor. This is an open commercial market right? I decided to play a quick game with this and ask all my in-network local providers what their charge would be for just an x-ray of my left hand. A car mechanic should be able to quickly give you an up-front estimate for common procedures, why not an imaging facility? If youve read this far youre probably not surprised I called 4 different facilities, followed up with a series of requests over multiple days and failed to receive even one straight answer except "come in and we will see what we can do". It makes me realize how soul-crushing the experience can be in this so-called "open market" to find the best possible treatment when you have a more complicated problem. The amount of leg-work, scheduling, waiting for doctors and getting opinions all while in pain would break the spirit of most anyone. Is it really that much simpler in other countries to connect with the proper provider? I was under the impression countries like canada handle simple problems like mine much more gracefully but serious issues remain problematic.

msg3 9y ago
My wife banged her foot about a year ago. We were pretty sure it wasn't broken, but we went to the hospital to get it checked out anyway. We never even considered which hospital we should go to - we basically expect them all to be decent, so why bother thinking about it? We had to wait in the emergency room for an hour or so, but then we were seen. My wife's foot was X-rayed 30 minutes later and it was confirmed that everything was fine.
hackbinary 9y ago
>> Is it really that much simpler in other countries to connect with the proper provider? I was under the impression countries like canada handle simple problems like mine much more gracefully In Canada and in Britain, you simply go to your local GP and get a referral, or go to A&E (Emergancy). >> but serious issues remain problematic. No, generally treatment in Canada and Britain for 'serious issues' is very good as well. We all hear about the well publicised failures of the NHS and Canadian Healthcare, but by and large it works very well. I have seen close relatives and friends have cancer, septicemia, strokes, severe bone breaks, a life changing injury that made a friend a quadrapeligic, and more. For the most post part, the level of healthcare in Canada and Britain has been excellent. My friend who had septicemia was in a very remote location, and once diagnosed was airlifted to a major hospital. All of this is covered by public healthcare. It is amazing. It is even more astounding that the USA still has this Byzantine 'private' system that tries to claim that it is an open market, but it is not. From a macroeconomic point of view, the USA pays 18% or 19% of GDP for its healthcare system, where as Britain and Canada, and pretty much every other western country pay about 10%. (These are OECD figures) The American healthcare system is horribly inefficient, and puting in a public system ought to be every American's politicial priority. Imagine that, a universal healthcare system is cheaper to operate than the private system? The rhetoric and hyperbole that comes out of those who are vested in the status quo is outright criminal.

maxsilver 9y ago

> Does this not seem absolutely absurd to anybody else? It is obviously an insane way to run healthcare. But for the majority of US citizens, they've never experienced anything else. So this insanity is considered totally normal to them. Medical bankruptcy isn't just a thing, it's an expected outcome of any major illness -- medical bills are the most common reason for bankruptcy in the US. If the US just switched to a proper universal national healthcare system (like say, a clone of UK's NHS), for even just one month, America would never go back to the way it is today. Not suggesting that UK's system is perfect, but it's so much objectively better than the US system that there would riots in the streets, if anyone suggested going back to today's US system. Which is why we see so much lying about how terrible socialized medicine is, and so much money/time poured into preventing Americans from learning/experiencing it in any way.

nojvek 9y ago
Having a Baby in US. I will definitely give my insurance provider a call. They didn’t pay much for the OB and I work for a very solid tech company. America’s healthcare is a f*ing joke. It’s riddles from the top to bottom with people who want to leech money at every step and provide the most minimal service. I had a slight fracture in my scaphoid. I paid $2000 out of pocket and insurance paid half of that. In Australia where I don’t need employer golden handcuffs for health insurance, it would be less than a third of that.

coldtea 9y ago

I was in the US once, and had developed a cyst on my finger that hurt (due to the pressure of the liquid inside -- could have been a ganglion cyst). What you do with those, is you burst them open to relief the pressure, clear the liquid inside (white cells and such) and put some disinfectant. In my (Western European) country it's a trivial 10 seconds operation every pharmacy is authorized to do. So I go asked at a pharmacy/drugstore for that (probably a Walgreens) -- and they said they weren't allowed to do it and that I should ask at a clinic. I asked how much it would cost for this, if I went at one, and they told me about $150. Yeah, right. I just went on and bought a regular clothespin from that pharmacy, burned it with a lighter to disinfect it, and burst the cyst myself... (And it's not about government mandated insurance vs "really free market" and such. We have mandatory insurance were we are, and the prices for all kinds of operations, both with and without insurance coverage, are still way lower).

coldtea 9y ago
s/clothespin/safetypin/

ataturk 9y ago

The whole infant mortality rate thing has been debunked over and over again. The US statistics are different than those of other countries AND--this is the BIG AND--US hospitals routinely attempt to save marginal infants whereas other countries let them expire and tick it as a non-viable birth. So don't tell us lies about how great the rest of the world is, okay? There's no way Cuba does half as good a job for mothers as even the worst US hospitals do, so get your head out of your ass on that one. Second, when you figure the costs of universal healthcare, do you take into account the huge taxes on your salary, asusming you have any in whatever country you live in? Sweden is a great place to live if you can overlook the 60% tax on income or whatever it is up these days. Also, you buy a car over there and there's a 100%+ tax on that, then some countries have a VAT, etc. So how much are you REALLY paying for healthcare? At least in the US I get to keep some of my income and I know how much I'm paying for healthcare. Had the social engineers and the corporatists not gone and tinkered, we wouldn't be as bad off as we are now. It was big government doing us no favors as usual.

coolsunglasses 9y ago

>No wonder the US, the largest economy in the world, ended up with a terrible infant mortality rate… That's largely a product of people trying a lot harder to with much earlier premature births than other countries, not a fault in care provided. There's a lot of ways to frame how the US healthcare system fails people, this one's a canard.

HelloMcFly 9y ago
And higher rates of teenage pregnancy, pregnancies by obese persons. Using the infant mortality rate as a proxy for US healthcare quality isn't reasonable, as you say.
- moorhosj 9y ago
  On the flip side, one could argue that teen contraception and nutrition education are important parts of a properly functioning health system. To put it another way, who is to say high rates of teen and obese pregnancies are not caused, in part, by our health system?
  - HelloMcFly 9y ago
    > who is to say high rates of teen and obese pregnancies are not caused, in part, by our health system? Sure, perhaps in part, just as any occurrence in other countries with any recordable teen or obese pregnancies. However, it would be inappropriately reductive to say the health system is the cause of these, and I'd argue it would be incorrect to say the health system is the primary cause. To do so would be to ignore the entrenched historical and cultural influences on the present state.