4 ms·
It wouldn't be safe to assume that I'd have been authorized for an elective surgery, so fair point. I also never suggested that it should be free. > American
by buffington 4y ago
It wouldn't be safe to assume that I'd have been authorized for an elective surgery, so fair point.
I also never suggested that it should be free.
> American end of life care can cost hundreds of thousands of dollars for a year or two of extra life and American insurance companies will pay it without blinking.
This hasn't been my experience. Before my dad died from glioblastoma last year, his insurance refused to pay anything for his treatment. They refused to pay for anything, fighting us every step of the way. A single chemo pill cost over $2200, and he needed 60 of them, and they wouldn't cover any portion of them. And that was just one of many the things they wouldn't pay for. They wouldn't even cover anti-nausea medication. I did, and it cost less than $30. They wouldn't even cover hospice care.
My dad paid premiums to that same insurance company for 20 years, and was healthy the entire time. No major health issues, non-smoker, non-drinker, no heart problems, no accidents. He learned about his rapidly growing tumor on his own. He decided, mostly out of curiosity about the technology, to pay for a full body MRI (at his own expense of course) and found it. He spent his life savings trying to fight the cancer and the insurance company, just so he could have enough time to say goodbye to people. He died within 8 months of discovering the tumor.
The money he paid that insurance company over a 20 year period would have covered all of the costs had he put the money into a savings account, even if he made zero interest and accounting for inflation.
I know that there will be those who say "but what about Medicare/Medicaid?" - he didn't qualify for either of them.
The only outside help he might have had was from an organization that houses people near cancer facilities, but they pulled their support the moment the pandemic was declared, shutting down all their housing facilities. The irony there, as well, is that that particular organization, even in non-pandemic times, required 6 months lead time before they could place an individual. He'd have been dead before they were able to place them. I paid for an AirBnB instead, which cost me close to $5k for the duration of his treatment, which he paid for out of pocket.
My dad's story isn't uncommon either. Why would insurance companies have any incentive to step up when they know that if they just wait things out, they'll be able to keep their money?
The American health care system is utterly broken, perhaps even criminally corrupt.
- rayiner 4y agoI’m sorry to hear your dad’s experience. It’s the nature of a private system in a country of 300 million people that experiences will differ. Aggressive glioblastoma is something that won’t be covered with the cost effectiveness thresholds in many European systems. The median survival duration of treated patients is just over one year, with costs, as you outline above, of $120-250k. The typical upper end in the UK NHS is 30,000 pounds per quality adjusted life year ($36,000). The UK recently introduced a cancer drugs fund that can go beyond that, but it’s been intensely controversial within the UK, because in that country there is a deeply established focus on cost effectiveness and “NICE” protocol. But US insurance companies routinely pay hundreds of thousands of dollars for glioblastoma treatment. Median insurance payments for high grade glioma were $180,000 in one study: https://ar.iiarjournals.org/content/anticanres/39/3/1375.full.pdf https://ar.iiarjournals.org/content/anticanres/39/3/1375.ful...
- DanBC 4y agoOver the years so many people have patiently explained why and how you're wrong whenever you mention the NHS that I can only think you're choosing to misrepresent the information now. And here you're repeating the claim that US health insurance is a unlimited source of healthcare funds for anyone who wants it, even though someone else is telling you that's not their personal experience. Denial of health insurance is so common in the US the charitable orgs give advice about how to deal with it: https://www.cancer.org/treatment/finding-and-paying-for-treatment/managing-health-insurance/if-your-health-insurance-claim-is-denied.html https://www.cancer.org/treatment/finding-and-paying-for-trea... "It’s not unusual for insurers to deny some claims or say they won’t cover a test, procedure, or service that doctors order. You can appeal many types of health insurance decisions – sometimes even things that are written into your health plan’s contract. You can appeal Medicare claim denials, too." All the available evidence directly contradicts your claims about the generosity of health insurance.
- rayiner 4y agoDan, over the years you’ve baselessly accused me of misrepresenting how the NHS system works, without any substance. The UK NHS’s use of QALY is well established: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-5050-9 https://bmchealthservres.biomedcentral.com/articles/10.1186/... (“The U.K. National Institute for Health and Care Excellence (NICE) currently uses a cost-effectiveness threshold in the range of £20,000 to £30,000 per quality-adjusted life year (QALY) for reimbursing new drugs in the National Health Service”). I also mentioned to the cancer drugs fund. And the US system, unlike the UK NHS, is a highly fragmented contractual system. Obviously there’s going to be a wide range of experiences with willingness to pay. But I cited specific sources for the median insurance reimbursement of glioblastoma being over $180,000. So please tell me, with particularity, what part do you disagree with?