4 ms·

> you get the choice of what you want to buy in the US. Not really in my experience. You get to choose between providers in your insurance network, but I've lo

> you get the choice of what you want to buy in the US. Not really in my experience. You get to choose between providers in your insurance network, but I've lost count of the number of times my preferred provider wasn't in my network. On top of that, the insurance company has to sign off on many diagnostic tests even when my doctor wants to do one. I'm experiencing this right now with chronic pain associated with an old injury. My doctor wants to do an arthrogram, but my insurance won't approve it without doing a full course of physical therapy first and doing any kind of motion with this injury is excruciatingly painful. I have to literally suffer through 12 weeks of PT in order to get the imaging I need and I have what many would consider to be great insurance. I don't really have any (good) choices here. I can pay for the imaging out of pocket or continue to suffer. This is a uniquely American problem.

PakistaniDenzel 4y ago
If you were in the UK you would get a PT appointment 6 months in the future and told to rest and take painkillers (which you buy yourself). Or you pay out of pocket for a private specialist to actually get help.
- robocat 4y ago
  The situation in New Zealand is similar. There is an infinite demand for health services, so our public health system is busy, so you go on a waiting list. The UK and NZ spend about 10% of GDP each (~$4kUSD/capita). The well-off pay for health insurance which will get you faster service, and the very well off just pay privately. The first site I looked at for a private arthrogram was ~USD1050 (Single joint or region Arthrogram including Gadolinium) https://www.google.co.nz/search?q=mri+private+price+list+site%3Anz https://www.google.co.nz/search?q=mri+private+price+list+sit... For more expensive procedures, some NZers travel to Asia to get medical procedures. The prices in Asia including flights and accomodation can be very affordable for the middle class, depending on what needs doing and how much risk you are willing to take.
user_7832 4y ago
Might it not be possible to have your doctor write some "PT not possible"/"PT may result in additional injury" note? Failing which, is it possible to speak with someone higher up at your insurance company? I do not know your background, but if you have sufficient resources (well, mainly money) it might be easier to contact an injury/similar lawyer and have them represent you to talk, and perhaps go to the legal dept of the insurance company. I am sorry for what you're having to go through, healthcare is unfortunately far from perfect (even outside the US).
- thr0wawayf00 4y ago
  My doctor conveyed my situation in his request for the imaging and was denied. I'm basically going to my PT appointments and doing nothing because the treatment is painful, which is wasting their time and resources. It's cheaper to just commit this waste than to talk to a lawyer because the insurance company represents its shareholders, not its clients. I'm not saying that healthcare is perfect outside of the US, but a common argument for the US system is this idea of "choice", which is ultimately just a set of dark patterns that create the illusion of choice.
vimy 4y ago
How much does imaging cost without insurance?
- thr0wawayf00 4y ago
  Well, providers don't have to disclose transparent pricing so it's hard to say for sure, but Google says between $1-3K.
mediascreen 4y ago
As someone who pays taxes in Sweden and don't plan on having children, I would probably not choose to pay for 480 days parental leave per child, subsidised day care and child allowance payment to the extent they exists today if I had a choice.
- guenthert 4y ago
  You do want to incentivize people having kids though if there is not sufficient immigration. After all, who's going to pay your retirement?
  - mediascreen 4y ago
    How does it work in countries with slightly lower incentives? Are there other ways to get people to pay for my retirement? Maybe by attracting well educated immigrants?
varispeed 4y ago
Here in the UK chronic pain treatment is a farce. You get to go to meetings where they tell you to soldier on and if you can't, well try harder then. So there is a huge illegal market of opiates of all kinds and deaths are soaring. If people can't get prescription and can't stand the pain then where do they go? Dealers. Big pharma has a great grip on the government so things like medical cannabis are out of question. Fortunately it has been legalised a couple of years ago, but it is only available on private prescription after you have failed "traditional" therapy. If you are unlucky, you are looking at spending £300-600 a month out of your own pocket.
ceeplusplus 4y ago
> my insurance won't approve it without doing a full course of physical therapy first This is the case in socialized systems as well. For example I need a monoclonal antibody injection regularly (MSRP $1500/dose) and in European systems I would need to prove that topical steroids and immunosuppressants did not work first before trying it. Just like Europe, I pay $0 for the doses, because the drug company has a program to cover my copay ($100/month) and the insurance company "pays" for the rest. No way the insurance company is paying MSRP, so that $1500 is definitely a fake price. Also you have to consider that the US is subsidizing these European countries by paying for their defense. If France, Germany, and Italy had to pay for military expenditures necessary to defend against Russia then they would not have the budget to pay for such extravagant social benefits. European NATO countries have long been underfunding the military below NATO spending requirements.
- barry-cotter 4y ago
  > Also you have to consider that the US is subsidizing these European countries by paying for their defense. Also global drug development. US Tax Dollars Funded Every New Pharmaceutical in the Last Decade https://www.ineteconomics.org/perspectives/blog/us-tax-dollars-funded-every-new-pharmaceutical-in-the-last-decade https://www.ineteconomics.org/perspectives/blog/us-tax-dolla...

PakistaniDenzel 4y ago

If you were in the UK you would get a PT appointment 6 months in the future and told to rest and take painkillers (which you buy yourself). Or you pay out of pocket for a private specialist to actually get help.

robocat 4y ago
The situation in New Zealand is similar. There is an infinite demand for health services, so our public health system is busy, so you go on a waiting list. The UK and NZ spend about 10% of GDP each (~$4kUSD/capita). The well-off pay for health insurance which will get you faster service, and the very well off just pay privately. The first site I looked at for a private arthrogram was ~USD1050 (Single joint or region Arthrogram including Gadolinium) https://www.google.co.nz/search?q=mri+private+price+list+site%3Anz https://www.google.co.nz/search?q=mri+private+price+list+sit... For more expensive procedures, some NZers travel to Asia to get medical procedures. The prices in Asia including flights and accomodation can be very affordable for the middle class, depending on what needs doing and how much risk you are willing to take.

user_7832 4y ago

Might it not be possible to have your doctor write some "PT not possible"/"PT may result in additional injury" note? Failing which, is it possible to speak with someone higher up at your insurance company? I do not know your background, but if you have sufficient resources (well, mainly money) it might be easier to contact an injury/similar lawyer and have them represent you to talk, and perhaps go to the legal dept of the insurance company. I am sorry for what you're having to go through, healthcare is unfortunately far from perfect (even outside the US).

thr0wawayf00 4y ago
My doctor conveyed my situation in his request for the imaging and was denied. I'm basically going to my PT appointments and doing nothing because the treatment is painful, which is wasting their time and resources. It's cheaper to just commit this waste than to talk to a lawyer because the insurance company represents its shareholders, not its clients. I'm not saying that healthcare is perfect outside of the US, but a common argument for the US system is this idea of "choice", which is ultimately just a set of dark patterns that create the illusion of choice.

vimy 4y ago

How much does imaging cost without insurance?

thr0wawayf00 4y ago
Well, providers don't have to disclose transparent pricing so it's hard to say for sure, but Google says between $1-3K.

mediascreen 4y ago

As someone who pays taxes in Sweden and don't plan on having children, I would probably not choose to pay for 480 days parental leave per child, subsidised day care and child allowance payment to the extent they exists today if I had a choice.

guenthert 4y ago
You do want to incentivize people having kids though if there is not sufficient immigration. After all, who's going to pay your retirement?
- mediascreen 4y ago
  How does it work in countries with slightly lower incentives? Are there other ways to get people to pay for my retirement? Maybe by attracting well educated immigrants?

varispeed 4y ago

Here in the UK chronic pain treatment is a farce. You get to go to meetings where they tell you to soldier on and if you can't, well try harder then. So there is a huge illegal market of opiates of all kinds and deaths are soaring. If people can't get prescription and can't stand the pain then where do they go? Dealers. Big pharma has a great grip on the government so things like medical cannabis are out of question. Fortunately it has been legalised a couple of years ago, but it is only available on private prescription after you have failed "traditional" therapy. If you are unlucky, you are looking at spending £300-600 a month out of your own pocket.

ceeplusplus 4y ago

> my insurance won't approve it without doing a full course of physical therapy first This is the case in socialized systems as well. For example I need a monoclonal antibody injection regularly (MSRP $1500/dose) and in European systems I would need to prove that topical steroids and immunosuppressants did not work first before trying it. Just like Europe, I pay $0 for the doses, because the drug company has a program to cover my copay ($100/month) and the insurance company "pays" for the rest. No way the insurance company is paying MSRP, so that $1500 is definitely a fake price. Also you have to consider that the US is subsidizing these European countries by paying for their defense. If France, Germany, and Italy had to pay for military expenditures necessary to defend against Russia then they would not have the budget to pay for such extravagant social benefits. European NATO countries have long been underfunding the military below NATO spending requirements.

barry-cotter 4y ago
> Also you have to consider that the US is subsidizing these European countries by paying for their defense. Also global drug development. US Tax Dollars Funded Every New Pharmaceutical in the Last Decade https://www.ineteconomics.org/perspectives/blog/us-tax-dollars-funded-every-new-pharmaceutical-in-the-last-decade https://www.ineteconomics.org/perspectives/blog/us-tax-dolla...