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I moved to the US from a country with socialised medicine. When you include premiums then taxes in both were roughly similar if not a little higher in the US (i

I moved to the US from a country with socialised medicine. When you include premiums then taxes in both were roughly similar if not a little higher in the US (ignoring cost of living differences). But even that doesn't include the real sting on the tail of US medicine. You pay a fairly high health insurance premium, but if you actually need health services you then pay again through the nose even with insurance "discounts." For example my under one year old needed to go to the emergency room due to a high fever for several hours, we paid over $300 on top of paying over a thousand in combined employer/employee premiums each month. That's with insurance picking up at least that much.

zrail 8y ago
$300 is a steal.
- maxxxxx 8y ago
  My family in Germany throws a fit when they have to pay 50 Euro for something. In the US you can happy if your cost for seeing a doctor is less than 4 digits.
  - jsight 8y ago
    In fairness, the US typically does not cost $1k+ for a simple doctor visit.
  - vonmoltke 8y ago
    > In the US you can happy if your cost for seeing a doctor is less than 4 digits. My wife and I have never paid four figures for a doctor visit, despite having two surgeries (one oral), a calf strain, and a dislocated shoulder (with ER visit) between us. The state of medical care in the US is bad enough as it is; you don't need to make up hyperbolic bullshit to make it seem worse.
    - mikeash 8y ago
      I went to the ER thinking I was having a heart attack, and it turned out there was nothing wrong. The doctor who saw me afterwards thought it might have been intestinal spams. I got to pay $6,000 for that bit of entertainment.
      - exodus_de 8y ago
        Let me guess - your deductible is 6000$?
        deleted 8y ago
        [deleted]
        ddoolin 8y ago
        Is that really relevant though? That should never cost anywhere near that much.
        jimbokun 8y ago
        It's relevant because the doctor probably charged EVEN MORE than $6,000, and mikeash only saw $6,000 of that because it was his entire deductible.
      - kradroy 8y ago
        Did you pay the bill outright without negotiating?
        mikeash 8y ago
        Yes. I couldn’t find an angle to negotiate with. I could afford to pay, so trying to use hardship as a lever to bring down the bill wouldn’t have been honest.
        tathougies 8y ago
        Normally you just call and say youd like to lower the bill
  - exodus_de 8y ago
    > My family in Germany throws a fit when they have to pay 50 Euro for something. Socialized insurance rates in Germany are 15% of income. Unless your family doesn't earn any money, they have been paying far more than 50 Euros. > In the US you can happy if your cost for seeing a doctor is less than 4 digits. That isn't generally true. Every insurance plan is different. Cheap plans have a high deductible. It's similar to private insurance in Germany. It's basically like this: If you're gonna be poor, go to Germany. Everyone else will pay for you. If you're going to earn well, leave Germany, otherwise you're going to be paying for everyone else.
    - maxxxxx 8y ago
      "It's basically like this: If you're gonna be poor, go to Germany. Everyone else will pay for you. If you're going to earn well, leave Germany, otherwise you're going to be paying for everyone else." You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US.
      - refurb 8y ago
        You’re not that far off from reality. I’m currently in the US because career opportunities are far superior here. However, if I were to get seriously and chronically sick I would back to my home country. Not that i couldn’t get very good care in the US, but the system here is just a massive burden compared to countries with universal coverage.
      - exodus_de 8y ago
        > You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US. If you already have a serious health problem, you'll be hard pressed to find any country to take you and just take care of it pro-bono, if you're uninsured. German public insurance only covers the bare minimum. I know enough people who are poor because of serious health issues. Sure, their medical costs were covered, but they're now welfare cases. They can't afford many treatments that would make their lives better. They would've had to buy extra insurance, but they chose not to, or couldn't afford it. Relating that to the US: Don't skimp on insurance. Don't get an insurance that is capped at a low number, otherwise you will go bankrupt if shit hits the fan.
- Someone1234 8y ago
  Just to be clear, $300 was only our share of the bill. Insurance also picked up more than that, and there were insurance "discounts" applied.
- titanomachy 8y ago
  The US is the only place I know of where someone with good insurance coverage could expect to pay that much for a basic visit.
  - vonmoltke 8y ago
    An emergency room is not a "basic visit".
    - jakobegger 8y ago
      Taking a kid with fever to the ER is about as basic as you get.
      - DanBC 8y ago
        Doesn't the US have out-of-hours pharmacies, or out of hours doctors, or urgent but not emergency treatment centres?
        kelnos 8y ago
        Not really. There are non-ER/non-hospital urgent-care centers, but they usually keep to roughly normal business hours. For after-hours care, the ER at a hospital is often your only option.
        bradknowles 8y ago
        Depends on where you are. Some places have 24-hour Urgent Care centers that can handle the basic stuff that doesn't need a real ER. But many places don't have any kind of Urgent Care centers, much less one that is open 24 hours a day.
        AlexTWithBeard 8y ago
        For those from tri-state area: folks, PM Pediatrics is a blessing. They're open till midnight, waiting times are reasonable and they are billed as PCP by the insurance.
- ben_w 8y ago
  $300 [1] is more than I’ve spent on (non-dental) helthcare, in total, over my entire life. That includes one count of general anaesthetic and emergency surgery because of testicular torsion which happened while I wasn’t registered with any local doctor, one burned arm, one being knocked unconscious by a trampoline, and one being hit by a car. [1] “after premiums” is roughly the same as “after taxes”, right?
  - deleted 8y ago
    [deleted]
  - danans 8y ago
    You probably don't live in the US, right? In the US, I've already payed thousands in after-premium medical expenses for my very healthy young children, just in copays and ER visit fees for normal accidents that kids get into, and that after having what in the US is considered amazing health insurance, so I'm a very lucky person. I had to go to the ER in the UK as a tourist recently. They refused to take payment since I wasn't admitted to the hospital. > [1] “after premiums” is roughly the same as “after taxes”, right? For the purposes of comparison between the US and other OECD countries, yes.
  - petronio 8y ago
    I left the US recently with a few thousand in an HSA (a pre-tax account designated for healthcare expenses). I have no idea how I'm going to get that out of there now.
    - zrail 8y ago
      You can keep it there and withdraw it after 65 penalty free (have to pay taxes like a traditional IRA) or you can pull it out now and pay taxes plus a 10% penalty.
      - petronio 8y ago
        Probably better to withdraw and eat the penalty then, inflation will make it worth peanuts by the time I'm 65.
- baddox 8y ago
  Yeah, I saw that and thought "sign me up!" I paid $1200 for a chest X-ray at the emergency room in San Francisco (I was fine, but they understandably freak out about an adult male complaining about chest pain).
  - trashface 8y ago
    When I lived in SF I once cut into my finger with a rusty fish filet knife (don't ask). I went to the bernal hospital ER and they gave me a tetanus shot, but nothing else. A few weeks later I went to my family doc and mentioned this, and he said, "You went to an ER for a tetanus shot?" Me: "Uh, Yeah." Him: "That's like a $1500 tetanus shot." They didn't have urgent care back then, but I understand there were "clinics" that could give those shots.
- tallanvor 8y ago
  In Norway you max out your copay at around $250/year for everything except some prescriptions. Once you hit the cap, they send you a card in the mail that you show your doctor, pharmacist, etc. so they don't charge you a further copay.
JMTQp8lwXL 8y ago
It's not always an option, but if it's possible -- consider Urgent Care if that's offered in your area.
- Someone1234 8y ago
  We were told specifically to take her to the emergency room by the on call pediatrician.
jakobegger 8y ago
As a point of comparison, in Austria: - taking a kid to the ER costs nothing - taking a kid to a GP or a pediatrician costs nothing - staying a night at the hospital costs around 15€ - getting a prescription from the pharmacy costs 5€
- mschuetz 8y ago
  Yeah, and cost of health insurance in Austria is just 7,65% of your income, and it covers your children. When I've worked in the US, I've paid just as much for health insurance and still had high out-of-pockets and deductibles on top of that.
  - billions 8y ago
    Based on US household income, 7.65% of 56,516 = $4,323/yr
    - lsc 8y ago
      Yup, and that's about what you pay for a single person health insurance in the US that isn't very high deductible. I think my employer pays about $6K/yr for me and another $6K/yr for my partner, (I know this 'cause I've gotta pay taxes on hers, as we're not married) but it's a reasonably good plan. Same provider, but more expensive/better coverage when I was buying through my own company. When I see the doctor, they charge me a symbolic fee, but it's usually around what the ride share to get there costs me. (the parking there, ugh.) Personally, I avoid the very high deductible plans, mostly because I have the option, but also because I don't want to deal with hospital billing. I've got an HMO (kaiser) and they charge me almost nothing at point of service, and I get to consume all the medical care my doctor thinks I need. Unfortunately, my employer has a really juicy high deductible plan that a lot of my co-workers use. Like they actually give you money to put in your HSA that covers most of your high deductible. It's a good plan. But I don't like it because it means my co-workers get to keep extra money for not going to the doctor when they are sick, and instead they come into the open plan office and cough all over the place. I mean, I do okay, and I'd be happy to kick in a little extra money if it meant my co-workers were more likely to go to the doctor when they are sick rather than sharing the love with the office.
tibiahurried 8y ago
I agree. I think in US you pay a lot of taxes to get pretty much nothing in return. You have no universal healthcare, students have to make huge debts to be able to study, there is no maternity leave, no support for childcare, seriously there is basically no welfare whatsoever. Not to mention property taxes (at least in California) that are outrageous. And if you get seriously ill and lose your job you are pretty much ... done! oO
- snazz 8y ago
  By the way, the reason your comments are marked [dead] and many users cannot see them is likely because you don’t have an email in your profile. If you add one it won’t be visible to anyone but the site operators, if you’re concerned about that. If you do you can disregard this message. I hate to see legitimate new users being turned away because they feel like they’re shouting into an anti-spam void.
TallGuyShort 8y ago
Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, but it turns out their definition of a physical didn't include the doctor's definition, which included blood tests. So before I had my blood drawn, I asked them to tell me what the tests would cost if my insurance didn't cover it. "It depends on how it's coded," they said. So I asked them to check how it was coded and tell me what the "code" cost. They looked it up. It was coded wrong, apparently. They would have to talk to the doctor and couldn't, so I would need to make a return appointment, or I could just let them draw my blood. Still don't know what the coding was or was supposed to be, or really what that even means. I just needed to get life insurance and get back to work. I found out the price once I was billed for it.
- deleted 8y ago
  [deleted]
- acdha 8y ago
  I think of this every time someone acts like U.S. healthcare is a market in any positive sense: our son had his first birthday before we got the last hospital bill (they were hoping we’d gift them money beyond their negotiated rate with our insurance company) while nobody I know from another country has ever had any experience with that.
  - trashface 8y ago
    That may be so-called "balance billing". It is illegal in some states.
- roenxi 8y ago
  'You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care? If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the price.
dragonwriter 8y ago
> But even that doesn't include the real sting on the tail of US medicine. You pay a fairly high health insurance premium, but if you actually need health services you then pay again through the nose even with insurance "discounts." That's mostly not true if you have an HMO plan, but your employer may not offer HMO plans if it offers insurance, the HMO may not be a good one if it is available, or it may not cover good providers in your area.
- danans 8y ago
  > That's mostly not true if you have an HMO plan, but your employer may not offer HMO plans if it offers insurance, the HMO may not be a good one if it is available, or it may not cover good providers in your area. I think you meant that tongue in cheek, but essentially that means it's true for a significant number of people whose circumstances meet any of those criteria.
- wbl 8y ago
  Employers have to offer HMOs.
  - lotsofpulp 8y ago
    Source? I am not aware of any legislation requiring specifically an HMO option, at least in the states I do business in.
  - dragonwriter 8y ago
    Employers of a certain size have to offer insurance that covers at least 60% of the cost of certain services and meets certain affordability requirements. They are not required, under federal law, to offer HMO plans.
OrgNet 8y ago
You should go to a his doctor's walk-in clinic instead (it cost $100 here). But yeah I completely agree.. it is a lot cheaper if you don't have money and are not insured (they cut you a huge break).
glangdale 8y ago
Can confirm. Moved from US back to Australia. Had one child born in USA, one in Australia. Neither birth was super-complicated (both in maternity hospitals)... The most expensive thing about the Australian birth process was the parking - had to pay an exorbitant $24/night to park in an open lot. So the whole thing cost about $36 or so. I forgot the fees on top of our insurance in the US (it being >16 years ago) but it was pretty steep.
hourislate 8y ago
I moved from Canada and while I lived there I didn't have two nickles to rub together. Payroll taxes, sales taxes, fee's, cost of living and under employment robbed me of a decent life. The medical system was hurry up and wait while you die. Anything in between full blown Cancer and a cold was a situation where you would wait or fall between the cracks(9 months it took me to see a Neurologist, 3 months for a shoulder expert). After moving to the US I have earned more money in 10 years then I could have earned in my entire life in Canada. My medical is outstanding and my taxes in TX are a pittance. It seems where you live in the US might make a difference.
deleted 8y ago
[deleted]
CalRobert 8y ago
When I looked up private health insurance in Ireland I kept thinking "gee that's not much better than the US". Then I realized I was looking at an _annual_ premium.
abstractbarista 8y ago
You don't go to ER for a high fever.
- hazmazlaz 8y ago
  High fevers in infants can be quite serious, even fatal, so yes you do go to the ER for a high fever in that case.
  - awful 8y ago
    This old, but I was ridiculed at my ER visit w/ my >1 y.o - after waiting for many hours they mocked us since her temp was only 104.8, not the truly urgent at 105.1, or some such numbers, an arbitrary distinction at least to us non-pediatric physician types. The little thing was clearly in trouble and the creeps had no compassion.
awinder 8y ago
You could definitely include the out-of-pocket costs (and how they differ between high deductible plans vs. low deductible vs. single-payer), and you should, for a fair comparison. This is researched to death effectively at this point but the overwhelming consensus is that single-payer delivers 100% coverage at around the same cost to individuals as the employer-sponsored plans w/ the same healthcare quality / outcomes. If you went on to compare the time-costs for every person that has to navigate insurance company shenanigans, the savings would be off the charts. https://www.thenation.com/article/thanks-koch-brothers-proof-single-payer-saves-money/ https://www.thenation.com/article/thanks-koch-brothers-proof... The problem, as always, is what do you do with all the redundant bullshit jobs that are eliminated in the process.

zrail 8y ago

$300 is a steal.

maxxxxx 8y ago
My family in Germany throws a fit when they have to pay 50 Euro for something. In the US you can happy if your cost for seeing a doctor is less than 4 digits.
- jsight 8y ago
  In fairness, the US typically does not cost $1k+ for a simple doctor visit.
- vonmoltke 8y ago
  > In the US you can happy if your cost for seeing a doctor is less than 4 digits. My wife and I have never paid four figures for a doctor visit, despite having two surgeries (one oral), a calf strain, and a dislocated shoulder (with ER visit) between us. The state of medical care in the US is bad enough as it is; you don't need to make up hyperbolic bullshit to make it seem worse.
  - mikeash 8y ago
    I went to the ER thinking I was having a heart attack, and it turned out there was nothing wrong. The doctor who saw me afterwards thought it might have been intestinal spams. I got to pay $6,000 for that bit of entertainment.
    - exodus_de 8y ago
      Let me guess - your deductible is 6000$?
      - deleted 8y ago
        [deleted]
      - ddoolin 8y ago
        Is that really relevant though? That should never cost anywhere near that much.
        jimbokun 8y ago
        It's relevant because the doctor probably charged EVEN MORE than $6,000, and mikeash only saw $6,000 of that because it was his entire deductible.
    - kradroy 8y ago
      Did you pay the bill outright without negotiating?
      - mikeash 8y ago
        Yes. I couldn’t find an angle to negotiate with. I could afford to pay, so trying to use hardship as a lever to bring down the bill wouldn’t have been honest.
        tathougies 8y ago
        Normally you just call and say youd like to lower the bill
- exodus_de 8y ago
  > My family in Germany throws a fit when they have to pay 50 Euro for something. Socialized insurance rates in Germany are 15% of income. Unless your family doesn't earn any money, they have been paying far more than 50 Euros. > In the US you can happy if your cost for seeing a doctor is less than 4 digits. That isn't generally true. Every insurance plan is different. Cheap plans have a high deductible. It's similar to private insurance in Germany. It's basically like this: If you're gonna be poor, go to Germany. Everyone else will pay for you. If you're going to earn well, leave Germany, otherwise you're going to be paying for everyone else.
  - maxxxxx 8y ago
    "It's basically like this: If you're gonna be poor, go to Germany. Everyone else will pay for you. If you're going to earn well, leave Germany, otherwise you're going to be paying for everyone else." You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US.
    - refurb 8y ago
      You’re not that far off from reality. I’m currently in the US because career opportunities are far superior here. However, if I were to get seriously and chronically sick I would back to my home country. Not that i couldn’t get very good care in the US, but the system here is just a massive burden compared to countries with universal coverage.
    - exodus_de 8y ago
      > You should add this to your algorithm for location choice: If you get a serious health problem and want to become poor, come to the US. If you already have a serious health problem, you'll be hard pressed to find any country to take you and just take care of it pro-bono, if you're uninsured. German public insurance only covers the bare minimum. I know enough people who are poor because of serious health issues. Sure, their medical costs were covered, but they're now welfare cases. They can't afford many treatments that would make their lives better. They would've had to buy extra insurance, but they chose not to, or couldn't afford it. Relating that to the US: Don't skimp on insurance. Don't get an insurance that is capped at a low number, otherwise you will go bankrupt if shit hits the fan.
Someone1234 8y ago
Just to be clear, $300 was only our share of the bill. Insurance also picked up more than that, and there were insurance "discounts" applied.
titanomachy 8y ago
The US is the only place I know of where someone with good insurance coverage could expect to pay that much for a basic visit.
- vonmoltke 8y ago
  An emergency room is not a "basic visit".
  - jakobegger 8y ago
    Taking a kid with fever to the ER is about as basic as you get.
    - DanBC 8y ago
      Doesn't the US have out-of-hours pharmacies, or out of hours doctors, or urgent but not emergency treatment centres?
      - kelnos 8y ago
        Not really. There are non-ER/non-hospital urgent-care centers, but they usually keep to roughly normal business hours. For after-hours care, the ER at a hospital is often your only option.
        bradknowles 8y ago
        Depends on where you are. Some places have 24-hour Urgent Care centers that can handle the basic stuff that doesn't need a real ER. But many places don't have any kind of Urgent Care centers, much less one that is open 24 hours a day.
        AlexTWithBeard 8y ago
        For those from tri-state area: folks, PM Pediatrics is a blessing. They're open till midnight, waiting times are reasonable and they are billed as PCP by the insurance.
ben_w 8y ago
$300 [1] is more than I’ve spent on (non-dental) helthcare, in total, over my entire life. That includes one count of general anaesthetic and emergency surgery because of testicular torsion which happened while I wasn’t registered with any local doctor, one burned arm, one being knocked unconscious by a trampoline, and one being hit by a car. [1] “after premiums” is roughly the same as “after taxes”, right?
- deleted 8y ago
  [deleted]
- danans 8y ago
  You probably don't live in the US, right? In the US, I've already payed thousands in after-premium medical expenses for my very healthy young children, just in copays and ER visit fees for normal accidents that kids get into, and that after having what in the US is considered amazing health insurance, so I'm a very lucky person. I had to go to the ER in the UK as a tourist recently. They refused to take payment since I wasn't admitted to the hospital. > [1] “after premiums” is roughly the same as “after taxes”, right? For the purposes of comparison between the US and other OECD countries, yes.
- petronio 8y ago
  I left the US recently with a few thousand in an HSA (a pre-tax account designated for healthcare expenses). I have no idea how I'm going to get that out of there now.
  - zrail 8y ago
    You can keep it there and withdraw it after 65 penalty free (have to pay taxes like a traditional IRA) or you can pull it out now and pay taxes plus a 10% penalty.
    - petronio 8y ago
      Probably better to withdraw and eat the penalty then, inflation will make it worth peanuts by the time I'm 65.
baddox 8y ago
Yeah, I saw that and thought "sign me up!" I paid $1200 for a chest X-ray at the emergency room in San Francisco (I was fine, but they understandably freak out about an adult male complaining about chest pain).
- trashface 8y ago
  When I lived in SF I once cut into my finger with a rusty fish filet knife (don't ask). I went to the bernal hospital ER and they gave me a tetanus shot, but nothing else. A few weeks later I went to my family doc and mentioned this, and he said, "You went to an ER for a tetanus shot?" Me: "Uh, Yeah." Him: "That's like a $1500 tetanus shot." They didn't have urgent care back then, but I understand there were "clinics" that could give those shots.
tallanvor 8y ago
In Norway you max out your copay at around $250/year for everything except some prescriptions. Once you hit the cap, they send you a card in the mail that you show your doctor, pharmacist, etc. so they don't charge you a further copay.

JMTQp8lwXL 8y ago

It's not always an option, but if it's possible -- consider Urgent Care if that's offered in your area.

Someone1234 8y ago
We were told specifically to take her to the emergency room by the on call pediatrician.

jakobegger 8y ago

As a point of comparison, in Austria: - taking a kid to the ER costs nothing - taking a kid to a GP or a pediatrician costs nothing - staying a night at the hospital costs around 15€ - getting a prescription from the pharmacy costs 5€

mschuetz 8y ago
Yeah, and cost of health insurance in Austria is just 7,65% of your income, and it covers your children. When I've worked in the US, I've paid just as much for health insurance and still had high out-of-pockets and deductibles on top of that.
- billions 8y ago
  Based on US household income, 7.65% of 56,516 = $4,323/yr
  - lsc 8y ago
    Yup, and that's about what you pay for a single person health insurance in the US that isn't very high deductible. I think my employer pays about $6K/yr for me and another $6K/yr for my partner, (I know this 'cause I've gotta pay taxes on hers, as we're not married) but it's a reasonably good plan. Same provider, but more expensive/better coverage when I was buying through my own company. When I see the doctor, they charge me a symbolic fee, but it's usually around what the ride share to get there costs me. (the parking there, ugh.) Personally, I avoid the very high deductible plans, mostly because I have the option, but also because I don't want to deal with hospital billing. I've got an HMO (kaiser) and they charge me almost nothing at point of service, and I get to consume all the medical care my doctor thinks I need. Unfortunately, my employer has a really juicy high deductible plan that a lot of my co-workers use. Like they actually give you money to put in your HSA that covers most of your high deductible. It's a good plan. But I don't like it because it means my co-workers get to keep extra money for not going to the doctor when they are sick, and instead they come into the open plan office and cough all over the place. I mean, I do okay, and I'd be happy to kick in a little extra money if it meant my co-workers were more likely to go to the doctor when they are sick rather than sharing the love with the office.

tibiahurried 8y ago

I agree. I think in US you pay a lot of taxes to get pretty much nothing in return. You have no universal healthcare, students have to make huge debts to be able to study, there is no maternity leave, no support for childcare, seriously there is basically no welfare whatsoever. Not to mention property taxes (at least in California) that are outrageous. And if you get seriously ill and lose your job you are pretty much ... done! oO

snazz 8y ago
By the way, the reason your comments are marked [dead] and many users cannot see them is likely because you don’t have an email in your profile. If you add one it won’t be visible to anyone but the site operators, if you’re concerned about that. If you do you can disregard this message. I hate to see legitimate new users being turned away because they feel like they’re shouting into an anti-spam void.

TallGuyShort 8y ago

Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, but it turns out their definition of a physical didn't include the doctor's definition, which included blood tests. So before I had my blood drawn, I asked them to tell me what the tests would cost if my insurance didn't cover it. "It depends on how it's coded," they said. So I asked them to check how it was coded and tell me what the "code" cost. They looked it up. It was coded wrong, apparently. They would have to talk to the doctor and couldn't, so I would need to make a return appointment, or I could just let them draw my blood. Still don't know what the coding was or was supposed to be, or really what that even means. I just needed to get life insurance and get back to work. I found out the price once I was billed for it.

deleted 8y ago
[deleted]
acdha 8y ago
I think of this every time someone acts like U.S. healthcare is a market in any positive sense: our son had his first birthday before we got the last hospital bill (they were hoping we’d gift them money beyond their negotiated rate with our insurance company) while nobody I know from another country has ever had any experience with that.
- trashface 8y ago
  That may be so-called "balance billing". It is illegal in some states.
roenxi 8y ago
'You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care? If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the price.

dragonwriter 8y ago

> But even that doesn't include the real sting on the tail of US medicine. You pay a fairly high health insurance premium, but if you actually need health services you then pay again through the nose even with insurance "discounts." That's mostly not true if you have an HMO plan, but your employer may not offer HMO plans if it offers insurance, the HMO may not be a good one if it is available, or it may not cover good providers in your area.

danans 8y ago
> That's mostly not true if you have an HMO plan, but your employer may not offer HMO plans if it offers insurance, the HMO may not be a good one if it is available, or it may not cover good providers in your area. I think you meant that tongue in cheek, but essentially that means it's true for a significant number of people whose circumstances meet any of those criteria.
wbl 8y ago
Employers have to offer HMOs.
- lotsofpulp 8y ago
  Source? I am not aware of any legislation requiring specifically an HMO option, at least in the states I do business in.
- dragonwriter 8y ago
  Employers of a certain size have to offer insurance that covers at least 60% of the cost of certain services and meets certain affordability requirements. They are not required, under federal law, to offer HMO plans.

OrgNet 8y ago

You should go to a his doctor's walk-in clinic instead (it cost $100 here). But yeah I completely agree.. it is a lot cheaper if you don't have money and are not insured (they cut you a huge break).

glangdale 8y ago

Can confirm. Moved from US back to Australia. Had one child born in USA, one in Australia. Neither birth was super-complicated (both in maternity hospitals)... The most expensive thing about the Australian birth process was the parking - had to pay an exorbitant $24/night to park in an open lot. So the whole thing cost about $36 or so. I forgot the fees on top of our insurance in the US (it being >16 years ago) but it was pretty steep.

hourislate 8y ago

I moved from Canada and while I lived there I didn't have two nickles to rub together. Payroll taxes, sales taxes, fee's, cost of living and under employment robbed me of a decent life. The medical system was hurry up and wait while you die. Anything in between full blown Cancer and a cold was a situation where you would wait or fall between the cracks(9 months it took me to see a Neurologist, 3 months for a shoulder expert). After moving to the US I have earned more money in 10 years then I could have earned in my entire life in Canada. My medical is outstanding and my taxes in TX are a pittance. It seems where you live in the US might make a difference.

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CalRobert 8y ago

When I looked up private health insurance in Ireland I kept thinking "gee that's not much better than the US". Then I realized I was looking at an _annual_ premium.

abstractbarista 8y ago

You don't go to ER for a high fever.

hazmazlaz 8y ago
High fevers in infants can be quite serious, even fatal, so yes you do go to the ER for a high fever in that case.
- awful 8y ago
  This old, but I was ridiculed at my ER visit w/ my >1 y.o - after waiting for many hours they mocked us since her temp was only 104.8, not the truly urgent at 105.1, or some such numbers, an arbitrary distinction at least to us non-pediatric physician types. The little thing was clearly in trouble and the creeps had no compassion.

awinder 8y ago

You could definitely include the out-of-pocket costs (and how they differ between high deductible plans vs. low deductible vs. single-payer), and you should, for a fair comparison. This is researched to death effectively at this point but the overwhelming consensus is that single-payer delivers 100% coverage at around the same cost to individuals as the employer-sponsored plans w/ the same healthcare quality / outcomes. If you went on to compare the time-costs for every person that has to navigate insurance company shenanigans, the savings would be off the charts. https://www.thenation.com/article/thanks-koch-brothers-proof-single-payer-saves-money/ https://www.thenation.com/article/thanks-koch-brothers-proof... The problem, as always, is what do you do with all the redundant bullshit jobs that are eliminated in the process.