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An HSA doesn't mean that you don't have preventative care. I have a high deductible plan plus HSA and there are things like annual checkups covered without goin

An HSA doesn't mean that you don't have preventative care. I have a high deductible plan plus HSA and there are things like annual checkups covered without going into deductible.

bsanr2 6y ago
So about those. I started with a new doctor after finally getting insurance a few years back. I told them I needed to come in for my annual check-up, and came in with a list of the things that had been bothering me and that I hadn't been able to get looked at (this is common for people who have not had healthcare access). The doctor spent 15 minutes with me, doing the bare minimum of setting up outside testing/imaging - as in, basically no guidance that day - and then coded it as a 45-minute, in-depth consultation ("because of the number of issues addressed"). $250. Before any tests or treatment. For reference, that was about 1% of my annual take-home. For a lot of you, that's like paying a grand or more just for your doctor to direct you elsewhere. So, yeah, certain things are "covered." But the structure of our healthcare system forces our clinics and hospitals to operate like many other American businesses, which is "in a predatorial manner."
- refurb 6y ago
  You went for a preventative check, and asked for a bunch of issues to be addressed and you’re surprised it cost you money?
  - ShroudedNight 6y ago
    What, exactly, is a preventative check, if not a discussion with your GP about your current physiological status? Given the time described (15 minutes), and the lack of immediate diagnostics, it sounds exactly like what I would expect from a check-in with my doctor here in Canada. The only other option I could see counting as a preventative check is a physical, which would be more involved than what was described.
    - refurb 6y ago
      It’s a matter of billing. A preventive visit does a set of screening and evaluation of results. If you say “my knee hurts lately”, then that’s separate as the physician will do an evaluation that is separate from a routine physical. And it’s not just the US. I have family in Canada and they were told maximum of 2 complaints can be addressed as they can only bill for a certain amount of time. Beyond that the doctor is working for free. Another separate appointment is needed.
      - bsanr2 6y ago
        So, yes, this is the problem. Healthcare should not be a business. It should be obvious that people who have been denied access before will come in to their first visit with multiple concerns, and the system should be accommodating to that without a massive "onboarding" fee. After all, it's not their fault that previous incarnations of said system did not supply care adequately. If you view a person and their health in a holistic manner, you can't just say, "Well, I've got you set up to check for diabetes and Crohn's, but if you want me to consider that mole then you'll have to pay me another $300 and/or wait a few weeks until I'm not so booked." My point was that "free preventative care" is not a panacea. Any time a doctor is incentivized to turn that visit into a money-maker, they'll gladly attempt to. And that's wrong.
        refurb 6y ago
        So you’re against how universal care is setup in Canada? Each visit has a billing code for a certain amount of work. If you brought up other issues you’d be told to make another appointment.
        bsanr2 6y ago
        Of course not. Canada's healthcare system is not, at the point-of-care, a business. Whatever business arrangement that exists is between the government and providers, not me and my doctor, so the latter relationship is not directly constrained by economic concerns, as is the case here in the US. If that appointment had taken place in Canada - and let's be clear first that it would not have, as I would have been insured unconditionally since birth and able to deal with each issue as it arose - the doctor would have either helped set up a treatment plan then and there, or she would have let me know that it would require another visit or two to go over everything, as here. The difference is that I would not personally be out 1-3 weeks worth of food money for each visit, just establishing my baseline. In neither case would what happened be a "matter of billing" because I would never receive a bill.

An HSA doesn't mean that you don't have preventative care. I have a high deductible plan plus HSA and there are things like annual checkups covered without going into deductible.

bsanr2 6y ago

So about those. I started with a new doctor after finally getting insurance a few years back. I told them I needed to come in for my annual check-up, and came in with a list of the things that had been bothering me and that I hadn't been able to get looked at (this is common for people who have not had healthcare access). The doctor spent 15 minutes with me, doing the bare minimum of setting up outside testing/imaging - as in, basically no guidance that day - and then coded it as a 45-minute, in-depth consultation ("because of the number of issues addressed"). $250. Before any tests or treatment. For reference, that was about 1% of my annual take-home. For a lot of you, that's like paying a grand or more just for your doctor to direct you elsewhere. So, yeah, certain things are "covered." But the structure of our healthcare system forces our clinics and hospitals to operate like many other American businesses, which is "in a predatorial manner."

refurb 6y ago
You went for a preventative check, and asked for a bunch of issues to be addressed and you’re surprised it cost you money?
- ShroudedNight 6y ago
  What, exactly, is a preventative check, if not a discussion with your GP about your current physiological status? Given the time described (15 minutes), and the lack of immediate diagnostics, it sounds exactly like what I would expect from a check-in with my doctor here in Canada. The only other option I could see counting as a preventative check is a physical, which would be more involved than what was described.
  - refurb 6y ago
    It’s a matter of billing. A preventive visit does a set of screening and evaluation of results. If you say “my knee hurts lately”, then that’s separate as the physician will do an evaluation that is separate from a routine physical. And it’s not just the US. I have family in Canada and they were told maximum of 2 complaints can be addressed as they can only bill for a certain amount of time. Beyond that the doctor is working for free. Another separate appointment is needed.
    - bsanr2 6y ago
      So, yes, this is the problem. Healthcare should not be a business. It should be obvious that people who have been denied access before will come in to their first visit with multiple concerns, and the system should be accommodating to that without a massive "onboarding" fee. After all, it's not their fault that previous incarnations of said system did not supply care adequately. If you view a person and their health in a holistic manner, you can't just say, "Well, I've got you set up to check for diabetes and Crohn's, but if you want me to consider that mole then you'll have to pay me another $300 and/or wait a few weeks until I'm not so booked." My point was that "free preventative care" is not a panacea. Any time a doctor is incentivized to turn that visit into a money-maker, they'll gladly attempt to. And that's wrong.
      - refurb 6y ago
        So you’re against how universal care is setup in Canada? Each visit has a billing code for a certain amount of work. If you brought up other issues you’d be told to make another appointment.
        bsanr2 6y ago
        Of course not. Canada's healthcare system is not, at the point-of-care, a business. Whatever business arrangement that exists is between the government and providers, not me and my doctor, so the latter relationship is not directly constrained by economic concerns, as is the case here in the US. If that appointment had taken place in Canada - and let's be clear first that it would not have, as I would have been insured unconditionally since birth and able to deal with each issue as it arose - the doctor would have either helped set up a treatment plan then and there, or she would have let me know that it would require another visit or two to go over everything, as here. The difference is that I would not personally be out 1-3 weeks worth of food money for each visit, just establishing my baseline. In neither case would what happened be a "matter of billing" because I would never receive a bill.