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This would be outpatient in the US. Nice that it was free, but took a long time. For me, I would pay $100 for the ER and then schedule outpatient that day or l

This would be outpatient in the US. Nice that it was free, but took a long time. For me, I would pay $100 for the ER and then schedule outpatient that day or later some other time and pay up to $350 for the surgery. The tax rates seem similar though with Australia being 23.6% and US 22.6% [0] (average for single worker no kids, of course there are variations). [0] https://www.oecd.org/tax/tax-policy/taxing-wages-australia.pdf https://www.oecd.org/tax/tax-policy/taxing-wages-australia.p...

Retric 3y ago
Hospital beds aren’t inherently that expensive. The physical room + attention from medical professionals + deprecation on equipment doesn’t add up to such an extreme number as to be particularly problematic. It’s a huge range of negative feedback loops that drive US medical costs into insane territory. For example insurance companies require more documentation which means doctors can treat fewer people and thus need to change each of them more. High costs mean fewer people can afford services which means more time in collections and charging those who can pay more. High medical costs drive up malpractice payouts for medical treatment which drives up malpractice premiums which drive up medical costs. etc etc.
carabiner 3y ago
Unpopular truth but if you have a job paying at least $100k in the US with decent employer's insurance, you probably receive the best healthcare in the world in terms of availability, quality, and cost. It just sucks for everyone else, especially the unemployed.
- hollerith 3y ago
  Important information if true. What is your basis for believing it? Do you for example have data showing that life expectancy in this group is higher than, e.g., the life expectancy of an average citizen of France?
  - deleted 3y ago
    [deleted]
- MR4D 3y ago
  I would second this statement.
- notjake123 3y ago
  I don't think this in an unpopular truth. USA is renowned for having some of the best healthcare in the world. It's the equity and access to the healthcare that is the issue. Not quality of healthcare.
- zouhair 3y ago
  You better not get laid off or fired.
- makeitdouble 3y ago
  I assume it's unpopular because the vast majority of people in the US aren't earning 100k being employed with decent insurance ? To your point, rich people in the west have prime access to world class care, and if it's not an emergency they'll fly to wherever they need to get the best clinics they can afford. People flying to Korea for plastic surgery is a thing. Even at upper middle class you can go through non subsidized clinics if you want prioritized and/or special care. Being even mildly rich will always help.
  - TJSomething 3y ago
    Specifically, $100,000 is about 80th percentile income in the US.
    - andrewmutz 3y ago
      For a conversation about healthcare, household income is probably more relevant than personal income (since members of a household usually, but not always, are in the same health care plan) About a third of American households make 100k a year. Median household is about 70k a year: https://dqydj.com/household-income-percentile-calculator/ https://dqydj.com/household-income-percentile-calculator/
      - deleted 3y ago
        [deleted]
      - pcthrowaway 3y ago
        Perhaps the relevant thing is "household where at least one person makes >100K/yr" since the benefits are probably tied to the type of job. But I suspect the person making the claim was just picking an arbitrary number where most people in that salary band will have decent benefits, and can usually afford the out of pocket portion also
        PragmaticPulp 3y ago
        > Perhaps the relevant thing is "household where at least one person makes >100K/yr" since the benefits are probably tied to the type of job. I think you're reading too much into the OP's off-hand guesstimate. At every company I've worked for, the engineers earning $200K are on the same health insurance as the high school graduate in the warehouse earning $40K/year. The higher compensation makes it easier to clear the deductible/out of pocket maximum hurdles, obviously, but there wasn't a secret insurance plan that got unlocked at higher compensation.
- sh34r 3y ago
  If you're unemployed, you almost certainly qualify for Medicaid in 41 states. It's the best insurance money can't buy. It covers everything. You pay for nothing. In fact, it's illegal to charge you for anything. Balance billing doesn't exist. You cease to be a mark for the healthcare racket if you can engineer your income to $0 on paper. The vast majority of medical providers will accept it. It is the best insurance I've ever had. If it were possible to get private insurance for $0 premiums, or pay $500 a month out of pocket for individual Medicaid coverage, I'd pick Medicaid every single time. I cannot overemphasize how much I despise the private insurance racket. The only reason we don't have a public option is because it would destroy the private racket overnight. Mental healthcare is a different story, but it's not any better with private insurance. Every therapist or psychiatrist in the insurance racketeer's provider directory is either dead, moved out of state, or not taking patients. "Ghost networks," they're called... The worst insurance I've ever had was at a FANG, via United Healthcare. It covered nothing. Hardly anyone accepted it, apart from the on-site health clinic. It was worse than a university health plan, for god's sake. As to quality, you say it's the best in the world, but the fact that the US now has a life expectancy lower than China, Cuba, and Albania determines that this is a lie. Unpopular truth on this forum: the healthcare system in this country is owned and operated by organized crime entities. It is completely illegitimate. It consumes 19% of GDP of the richest country on the planet, and Americans are some of the least healthy people outside of active war zones. Unless you're using your doctor as your Xanax dealer (John Mulaney explains how that hustle works: https://www.tiktok.com/@funkytownmc/video/7226240284198194475 https://www.tiktok.com/@funkytownmc/video/722624028419819447...), this system sucks for you too. I would be shocked if the Mexican cartels weren't deeply involved with United Healthcare and all these other corporate gangsters. This industry is the greatest crime of all time.
  - Swizec 3y ago
    > As to quality, you say it's the best in the world, but the fact that the US now has a life expectancy lower than China, Cuba, and Albania determines that this is a lie. The sad truth about those stats is that if you split them by social class, you get two distinct groups: disenfranchised people with some of the worst health outcomes in the world, and privileged people with some of the best. The childibrth related mortality rate for black american women is 3x higher than for white women, for example.
- jandrese 3y ago
  Availability maybe. Quality is questionable/regional. Cost absolutely definitely not. Add up what a person making $100k pays in insurance premiums, plus what the employer kicks in on those same premiums, plus the deductibles and co-pays for every procedure, plus drug costs even with insurance and it's not even in the same ballpark. Even if you are healthy and don't go to the hospital the premiums are huge for even basic health plans.
- ian0 3y ago
  Worth noting poor health tends to impact $100k / year earnings. This is a hard lesson for many later in life and why social safety nets are so important for everyone.
- RhodesianHunter 3y ago
  Right up until you get cancer, max out FMLA, get laid off, max out cobra, and then are on your own for payments.
  - nradov 3y ago
    At some point in that process you should be able to get onto Medicaid and/or Social Security Disability. Of course that can take a while and it's not easy for a patient to deal with cancer treatments and navigate those systems simultaneously.
    - SamoyedFurFluff 3y ago
      Disability in America is a death trap imma be honest with you, if you’ve never personally tried to navigate it I don’t think you should be recommending it anywhere. It’s normal to be denied, then spend over a year on the appeal, and then you must never own more than a small amount of money.
      - nradov 3y ago
        I am not "recommending" disability. I totally understand that it can be difficult to navigate the application process. But anyone who meets the eligibility criteria should go ahead and apply to hopefully get some financial support.
    - rqtwteye 3y ago
      Medicaid and disability are not as golden as you make them out to be. It’s actually quite difficult to get treatment.
      - nradov 3y ago
        I never claimed that Medicaid and disability were "golden". Go back and read my comment again. Those are last resorts for people in bad situations. But anyone eligible should go ahead and apply, at least to get the process started.
- bootwoot 3y ago
  Even so it's a maddeningly complicated system. If you end up in front of a doctor outside of your magic network, you might end up with a sudden several thousand dollar bill instead of $400. Minor mistakes and games can also create odd billing situations that are opaque and difficult to fight.
  - nradov 3y ago
    True, but the No Surprises Act has eliminated some of the worst abuses in that area. https://www.cms.gov/nosurprises https://www.cms.gov/nosurprises
- emodendroket 3y ago
  The big problem is that 1) the potential cost is essentially unbounded and can end up being ruinous even for someone relatively well-to-do 2) there is an unfortunately high likelihood of losing the job and insurance coming on the heels of getting a diagnosis where you really need care.
- Mizoguchi 3y ago
  I was unemployed for a year and paid under $200/month for a good insurance through market place, which I happened to use twice. That's not a lot of money. And I don't think the US healthcare system is as terrible as people think it is, particularly after Obamacare. There's a lot of variation of course, if you are in a big metro area chances are you have access to one of the best doctors and facilities in the world. I have colon cancer and heart disease screenings and I pay a few hundred dollars combined every few years. Copayments to see specialists are $35. Xrays are free, medicines are a few bucks. Biggest expense to date was shoulder surgery at under $2000 out of pocket, but I was taken care of by one of the world lead experts in the subject. For something that can alter your life forever I happily pay to have promptly access to such level of care instead of being on a wait list to be operated by the next available doctor picked by the system. From that perspective $2000 is cheap.
- geomark 3y ago
  That certainly wasn't my experience. I didn't know any better until I moved to another country.
yumraj 3y ago
$100 in the ER? Where, for what? My recent ER visits have all resulted in $1K-$2K or more (don’t remember exact numbers). A stupid sling costs about $100 in the ER. All due to deductible, Co-insurance and other provisions. Also $350 for surgery? You must have a really nice plan.
- TuringNYC 3y ago
  >> $100 in the ER? Where, for what? It is $100 for just the co-pay. Depending on your state, there are the balance bills, mystery bills, lab bills, xray bills, random radiologist bills from affiliated practices, and a host of other things that come in the mail ~6wks later.
  - yumraj 3y ago
    Yes, that was exactly my point. Worst thing, the ER doctors, and radiologists in many cases as you noted, seem to always be subcontracted to some other agency which bills separately from the main hospital.
- beatthatflight 3y ago
  Been in ER in the UK, Aus and NZ. Never paid a cent. And that's included overnight stays, drugs, ICU, 2 weeks ward stay, cardioversions and more. Yay for free healthcare.
thatcat 3y ago
That is some great insurance you have, how many thousands of dollars a year does it cost you?
briffle 3y ago
Of course, you are paying $1500/month for your family to get to only pay $450 for that out of pocket.

Retric 3y ago

Hospital beds aren’t inherently that expensive. The physical room + attention from medical professionals + deprecation on equipment doesn’t add up to such an extreme number as to be particularly problematic. It’s a huge range of negative feedback loops that drive US medical costs into insane territory. For example insurance companies require more documentation which means doctors can treat fewer people and thus need to change each of them more. High costs mean fewer people can afford services which means more time in collections and charging those who can pay more. High medical costs drive up malpractice payouts for medical treatment which drives up malpractice premiums which drive up medical costs. etc etc.

carabiner 3y ago

Unpopular truth but if you have a job paying at least $100k in the US with decent employer's insurance, you probably receive the best healthcare in the world in terms of availability, quality, and cost. It just sucks for everyone else, especially the unemployed.

hollerith 3y ago
Important information if true. What is your basis for believing it? Do you for example have data showing that life expectancy in this group is higher than, e.g., the life expectancy of an average citizen of France?
- deleted 3y ago
  [deleted]
MR4D 3y ago
I would second this statement.
notjake123 3y ago
I don't think this in an unpopular truth. USA is renowned for having some of the best healthcare in the world. It's the equity and access to the healthcare that is the issue. Not quality of healthcare.
zouhair 3y ago
You better not get laid off or fired.
makeitdouble 3y ago
I assume it's unpopular because the vast majority of people in the US aren't earning 100k being employed with decent insurance ? To your point, rich people in the west have prime access to world class care, and if it's not an emergency they'll fly to wherever they need to get the best clinics they can afford. People flying to Korea for plastic surgery is a thing. Even at upper middle class you can go through non subsidized clinics if you want prioritized and/or special care. Being even mildly rich will always help.
- TJSomething 3y ago
  Specifically, $100,000 is about 80th percentile income in the US.
  - andrewmutz 3y ago
    For a conversation about healthcare, household income is probably more relevant than personal income (since members of a household usually, but not always, are in the same health care plan) About a third of American households make 100k a year. Median household is about 70k a year: https://dqydj.com/household-income-percentile-calculator/ https://dqydj.com/household-income-percentile-calculator/
    - deleted 3y ago
      [deleted]
    - pcthrowaway 3y ago
      Perhaps the relevant thing is "household where at least one person makes >100K/yr" since the benefits are probably tied to the type of job. But I suspect the person making the claim was just picking an arbitrary number where most people in that salary band will have decent benefits, and can usually afford the out of pocket portion also
      - PragmaticPulp 3y ago
        > Perhaps the relevant thing is "household where at least one person makes >100K/yr" since the benefits are probably tied to the type of job. I think you're reading too much into the OP's off-hand guesstimate. At every company I've worked for, the engineers earning $200K are on the same health insurance as the high school graduate in the warehouse earning $40K/year. The higher compensation makes it easier to clear the deductible/out of pocket maximum hurdles, obviously, but there wasn't a secret insurance plan that got unlocked at higher compensation.
sh34r 3y ago
If you're unemployed, you almost certainly qualify for Medicaid in 41 states. It's the best insurance money can't buy. It covers everything. You pay for nothing. In fact, it's illegal to charge you for anything. Balance billing doesn't exist. You cease to be a mark for the healthcare racket if you can engineer your income to $0 on paper. The vast majority of medical providers will accept it. It is the best insurance I've ever had. If it were possible to get private insurance for $0 premiums, or pay $500 a month out of pocket for individual Medicaid coverage, I'd pick Medicaid every single time. I cannot overemphasize how much I despise the private insurance racket. The only reason we don't have a public option is because it would destroy the private racket overnight. Mental healthcare is a different story, but it's not any better with private insurance. Every therapist or psychiatrist in the insurance racketeer's provider directory is either dead, moved out of state, or not taking patients. "Ghost networks," they're called... The worst insurance I've ever had was at a FANG, via United Healthcare. It covered nothing. Hardly anyone accepted it, apart from the on-site health clinic. It was worse than a university health plan, for god's sake. As to quality, you say it's the best in the world, but the fact that the US now has a life expectancy lower than China, Cuba, and Albania determines that this is a lie. Unpopular truth on this forum: the healthcare system in this country is owned and operated by organized crime entities. It is completely illegitimate. It consumes 19% of GDP of the richest country on the planet, and Americans are some of the least healthy people outside of active war zones. Unless you're using your doctor as your Xanax dealer (John Mulaney explains how that hustle works: https://www.tiktok.com/@funkytownmc/video/7226240284198194475 https://www.tiktok.com/@funkytownmc/video/722624028419819447...), this system sucks for you too. I would be shocked if the Mexican cartels weren't deeply involved with United Healthcare and all these other corporate gangsters. This industry is the greatest crime of all time.
- Swizec 3y ago
  > As to quality, you say it's the best in the world, but the fact that the US now has a life expectancy lower than China, Cuba, and Albania determines that this is a lie. The sad truth about those stats is that if you split them by social class, you get two distinct groups: disenfranchised people with some of the worst health outcomes in the world, and privileged people with some of the best. The childibrth related mortality rate for black american women is 3x higher than for white women, for example.
jandrese 3y ago
Availability maybe. Quality is questionable/regional. Cost absolutely definitely not. Add up what a person making $100k pays in insurance premiums, plus what the employer kicks in on those same premiums, plus the deductibles and co-pays for every procedure, plus drug costs even with insurance and it's not even in the same ballpark. Even if you are healthy and don't go to the hospital the premiums are huge for even basic health plans.
ian0 3y ago
Worth noting poor health tends to impact $100k / year earnings. This is a hard lesson for many later in life and why social safety nets are so important for everyone.
RhodesianHunter 3y ago
Right up until you get cancer, max out FMLA, get laid off, max out cobra, and then are on your own for payments.
- nradov 3y ago
  At some point in that process you should be able to get onto Medicaid and/or Social Security Disability. Of course that can take a while and it's not easy for a patient to deal with cancer treatments and navigate those systems simultaneously.
  - SamoyedFurFluff 3y ago
    Disability in America is a death trap imma be honest with you, if you’ve never personally tried to navigate it I don’t think you should be recommending it anywhere. It’s normal to be denied, then spend over a year on the appeal, and then you must never own more than a small amount of money.
    - nradov 3y ago
      I am not "recommending" disability. I totally understand that it can be difficult to navigate the application process. But anyone who meets the eligibility criteria should go ahead and apply to hopefully get some financial support.
  - rqtwteye 3y ago
    Medicaid and disability are not as golden as you make them out to be. It’s actually quite difficult to get treatment.
    - nradov 3y ago
      I never claimed that Medicaid and disability were "golden". Go back and read my comment again. Those are last resorts for people in bad situations. But anyone eligible should go ahead and apply, at least to get the process started.
bootwoot 3y ago
Even so it's a maddeningly complicated system. If you end up in front of a doctor outside of your magic network, you might end up with a sudden several thousand dollar bill instead of $400. Minor mistakes and games can also create odd billing situations that are opaque and difficult to fight.
- nradov 3y ago
  True, but the No Surprises Act has eliminated some of the worst abuses in that area. https://www.cms.gov/nosurprises https://www.cms.gov/nosurprises
emodendroket 3y ago
The big problem is that 1) the potential cost is essentially unbounded and can end up being ruinous even for someone relatively well-to-do 2) there is an unfortunately high likelihood of losing the job and insurance coming on the heels of getting a diagnosis where you really need care.
Mizoguchi 3y ago
I was unemployed for a year and paid under $200/month for a good insurance through market place, which I happened to use twice. That's not a lot of money. And I don't think the US healthcare system is as terrible as people think it is, particularly after Obamacare. There's a lot of variation of course, if you are in a big metro area chances are you have access to one of the best doctors and facilities in the world. I have colon cancer and heart disease screenings and I pay a few hundred dollars combined every few years. Copayments to see specialists are $35. Xrays are free, medicines are a few bucks. Biggest expense to date was shoulder surgery at under $2000 out of pocket, but I was taken care of by one of the world lead experts in the subject. For something that can alter your life forever I happily pay to have promptly access to such level of care instead of being on a wait list to be operated by the next available doctor picked by the system. From that perspective $2000 is cheap.
geomark 3y ago
That certainly wasn't my experience. I didn't know any better until I moved to another country.

yumraj 3y ago

$100 in the ER? Where, for what? My recent ER visits have all resulted in $1K-$2K or more (don’t remember exact numbers). A stupid sling costs about $100 in the ER. All due to deductible, Co-insurance and other provisions. Also $350 for surgery? You must have a really nice plan.

TuringNYC 3y ago
>> $100 in the ER? Where, for what? It is $100 for just the co-pay. Depending on your state, there are the balance bills, mystery bills, lab bills, xray bills, random radiologist bills from affiliated practices, and a host of other things that come in the mail ~6wks later.
- yumraj 3y ago
  Yes, that was exactly my point. Worst thing, the ER doctors, and radiologists in many cases as you noted, seem to always be subcontracted to some other agency which bills separately from the main hospital.
beatthatflight 3y ago
Been in ER in the UK, Aus and NZ. Never paid a cent. And that's included overnight stays, drugs, ICU, 2 weeks ward stay, cardioversions and more. Yay for free healthcare.

thatcat 3y ago

That is some great insurance you have, how many thousands of dollars a year does it cost you?

briffle 3y ago

Of course, you are paying $1500/month for your family to get to only pay $450 for that out of pocket.