4 ms·

Clarification. US health is great if you are employed, have a good income or are retired and on medicare. If you don't fall into those categories it is pretty

Clarification. US health is great if you are employed, have a good income or are retired and on medicare. If you don't fall into those categories it is pretty tough

maerF0x0 3y ago
This. Which is why US averages are so bad, on average folks have shitty insurance and thus healthcare. But if you purchase, or negotiate excellent coverage you can get excellent care. (You still have to do some research to find the best providers)
MisterBastahrd 3y ago
US healthcare isn't great regardless of what metric you choose to use. It's mid-tier all the way around except for cost, where it far exceeds any other system in the world. Never being able to access the healthcare you're paying for because you can't afford the insane deductibles is even worse than not having healthcare at all, because when you DO have an emergency that you need to see a doctor for, your rates would often be lower out of pocket with the money you could have saved.
stusmall 3y ago
I have great insurance through my employer. Last week my spouse was suppose to go in for a surgery that multiple doctors made it clear she needed. We were on the books for months for the surgery. Insurance denied it the day before, throwing all our plans up into the air. The surgeon suggested getting a different surgery that wouldn't fix the problem. The idea is that when it didn't work it would act as evidence to convince insurance to pay for the original one. We have a terrible, stupid, inefficient system. It's drowning in its own chaos and bureaucracy.
- theragra 3y ago
  Insane ;(
- tomrod 3y ago
  Get the surgery, get notarized items from multiple docs, talk to a lawyer. Healthcare insurance doesn't get to dictate your healthcare directly. They aren't doctors, and open themselves up to liability if we don't push back.
  - grecy 3y ago
    .. and if that doesn't work out, go bankrupt.
    - tomrod 3y ago
      Nah, you have rights in this situation[0] [0] https://www.healthcare.gov/appeal-insurance-company-decision/external-review/ https://www.healthcare.gov/appeal-insurance-company-decision...
      - grecy 3y ago
        ... and if that doesn't work, spend years in a stressful and time consuming legal battle.
        tomrod 3y ago
        Perhaps, at a pessimistic extreme. Exercise of rights is important. It's worth consulting a lawyer for assistance. Organizations occasionally need to be compelled to do the right thing. Life isn't always easy or fair, but standing up for yourself is important as you are your best advocate.
  - stusmall 3y ago
    Woooofftt. That's bad advice and in an even worse order. There are a bunch of steps in between getting denied and just YOLOing it out of pocket. It looks like going through the insurance company's peer to peer process is probably going to work out. It is still a bit up in the air but its looking positive. We'd already started down the route of getting connected to lawyers in case it doesn't. I don't think "do it out of pocket and try and claw the money out of them after the fact" was ever on our list of options. I wouldn't consider that unless the lawyers suggested it. We were looking into going overseas to have to done, which honestly its another big indictment of this system. The point still stands about how insanely inefficient this whole system is at the macro level. The fact that lawyers are getting involved in routine medical procedures or doctors are suggesting what they know is incorrect treatment is a sign of deep inefficiencies. We aren't an outlier either. It is profitable for the insurance companies to jerk you around, fight you, try and sneak past denials were they can.
yongjik 3y ago
I work as a developer in Silicon Valley, and my wife also works. So we probably have a better insurance (and better income) than 95% of Americans. My wife probably burned 10+ hours of her life making phone calls that amount to "No no, I've already called the insurance company and they say the record is wrong on your side! I have to call your other office? No, I already called them! Why am I still getting a bill when it must be covered by the insurance ...!!!" And none in our family is even badly sick. Don't want to imagine what will happen if one of us actually gets sick. US healthcare system fucking sucks.
- russdill 3y ago
  A really great trick I learned is to use the 3 way calling feature of your phone. Call the insurance company, go through the please go away don't bother us menu system (now with voice recognition!), wait on hold for an agent, speak with the agent and tell them you are going to conference in your doctor's billing department, and call your doctor. Have them speak directly with each other. This is also usually necessary to find out if something will be covered.
  - kingsloi 3y ago
    That's a great tip/trick! Thanks for sharing!
russdill 3y ago
No, it's great if you don't get sick. I'm employed and have a good income. I probably spend of average 4 hours a week (sometimes much, much more) on the phone with my insurance company, pharmacies, and doctors. I suppose I do have the alternative of just breaking down and paying everything out of pocket.
mindslight 3y ago
No it's really not, regardless of the financial aspects. Doctors' time is parceled out into nearly-useless 15 minute chunks, appointments are booked full months out, "insurance" companies demand unnecessary paperwork and add more delays to run your clock out, inpatient rehabs (nursing homes) are understaffed death camps, and everyone generally operates in "not my job" cover their ass mode, including things like referring you to the "emergency" room (many hour wait!) at the drop of a hat. Some of these change when you're truly end of life and in the ICU, and otherwise there are brief flashes of doctors actually giving you attention. But for the most part trying to receive healthcare in the US is like squeezing blood from a stone, independent of the soul crushing billing shakedowns. It's more like you can imagine US healthcare is great if you don't need it, or don't proactively think about what needs to be done. Of course that's a great way for something to go unaddressed and kicked down the road until the next appointment (or ER visit). I can't speak to other country's failings, but I can say this bogeyman narrative about "government run health care" is utterly fallacious. We already have the equivalent in the form of corporate-bureaucracy-first health care.
taylodl 3y ago
Clarification - not true. I can point you to several people who have great jobs, great insurance, and tens of thousands of dollars in medical expenses. Nowhere else in the civilized world does this happen.
deprecative 3y ago
Right, then you get cancer and lose your job, savings, retirement, and start from zero.
r00fus 3y ago
It's not. Name another industry/market where you can't know the price of what you're buying (even an estimate) before you buy it. Every other developed country has a better system than ours. Every one. And for those who say "oh, well wait times are so much higher" - well you can get supplemental insurance in many of those countries as well - so the baseline isn't abysmal, but wealthy can get even better.

Clarification. US health is great if you are employed, have a good income or are retired and on medicare. If you don't fall into those categories it is pretty tough

maerF0x0 3y ago

This. Which is why US averages are so bad, on average folks have shitty insurance and thus healthcare. But if you purchase, or negotiate excellent coverage you can get excellent care. (You still have to do some research to find the best providers)

MisterBastahrd 3y ago

US healthcare isn't great regardless of what metric you choose to use. It's mid-tier all the way around except for cost, where it far exceeds any other system in the world. Never being able to access the healthcare you're paying for because you can't afford the insane deductibles is even worse than not having healthcare at all, because when you DO have an emergency that you need to see a doctor for, your rates would often be lower out of pocket with the money you could have saved.

stusmall 3y ago

I have great insurance through my employer. Last week my spouse was suppose to go in for a surgery that multiple doctors made it clear she needed. We were on the books for months for the surgery. Insurance denied it the day before, throwing all our plans up into the air. The surgeon suggested getting a different surgery that wouldn't fix the problem. The idea is that when it didn't work it would act as evidence to convince insurance to pay for the original one. We have a terrible, stupid, inefficient system. It's drowning in its own chaos and bureaucracy.

theragra 3y ago
Insane ;(
tomrod 3y ago
Get the surgery, get notarized items from multiple docs, talk to a lawyer. Healthcare insurance doesn't get to dictate your healthcare directly. They aren't doctors, and open themselves up to liability if we don't push back.
- grecy 3y ago
  .. and if that doesn't work out, go bankrupt.
  - tomrod 3y ago
    Nah, you have rights in this situation[0] [0] https://www.healthcare.gov/appeal-insurance-company-decision/external-review/ https://www.healthcare.gov/appeal-insurance-company-decision...
    - grecy 3y ago
      ... and if that doesn't work, spend years in a stressful and time consuming legal battle.
      - tomrod 3y ago
        Perhaps, at a pessimistic extreme. Exercise of rights is important. It's worth consulting a lawyer for assistance. Organizations occasionally need to be compelled to do the right thing. Life isn't always easy or fair, but standing up for yourself is important as you are your best advocate.
- stusmall 3y ago
  Woooofftt. That's bad advice and in an even worse order. There are a bunch of steps in between getting denied and just YOLOing it out of pocket. It looks like going through the insurance company's peer to peer process is probably going to work out. It is still a bit up in the air but its looking positive. We'd already started down the route of getting connected to lawyers in case it doesn't. I don't think "do it out of pocket and try and claw the money out of them after the fact" was ever on our list of options. I wouldn't consider that unless the lawyers suggested it. We were looking into going overseas to have to done, which honestly its another big indictment of this system. The point still stands about how insanely inefficient this whole system is at the macro level. The fact that lawyers are getting involved in routine medical procedures or doctors are suggesting what they know is incorrect treatment is a sign of deep inefficiencies. We aren't an outlier either. It is profitable for the insurance companies to jerk you around, fight you, try and sneak past denials were they can.

yongjik 3y ago

I work as a developer in Silicon Valley, and my wife also works. So we probably have a better insurance (and better income) than 95% of Americans. My wife probably burned 10+ hours of her life making phone calls that amount to "No no, I've already called the insurance company and they say the record is wrong on your side! I have to call your other office? No, I already called them! Why am I still getting a bill when it must be covered by the insurance ...!!!" And none in our family is even badly sick. Don't want to imagine what will happen if one of us actually gets sick. US healthcare system fucking sucks.

russdill 3y ago
A really great trick I learned is to use the 3 way calling feature of your phone. Call the insurance company, go through the please go away don't bother us menu system (now with voice recognition!), wait on hold for an agent, speak with the agent and tell them you are going to conference in your doctor's billing department, and call your doctor. Have them speak directly with each other. This is also usually necessary to find out if something will be covered.
- kingsloi 3y ago
  That's a great tip/trick! Thanks for sharing!

russdill 3y ago

No, it's great if you don't get sick. I'm employed and have a good income. I probably spend of average 4 hours a week (sometimes much, much more) on the phone with my insurance company, pharmacies, and doctors. I suppose I do have the alternative of just breaking down and paying everything out of pocket.

mindslight 3y ago

No it's really not, regardless of the financial aspects. Doctors' time is parceled out into nearly-useless 15 minute chunks, appointments are booked full months out, "insurance" companies demand unnecessary paperwork and add more delays to run your clock out, inpatient rehabs (nursing homes) are understaffed death camps, and everyone generally operates in "not my job" cover their ass mode, including things like referring you to the "emergency" room (many hour wait!) at the drop of a hat. Some of these change when you're truly end of life and in the ICU, and otherwise there are brief flashes of doctors actually giving you attention. But for the most part trying to receive healthcare in the US is like squeezing blood from a stone, independent of the soul crushing billing shakedowns. It's more like you can imagine US healthcare is great if you don't need it, or don't proactively think about what needs to be done. Of course that's a great way for something to go unaddressed and kicked down the road until the next appointment (or ER visit). I can't speak to other country's failings, but I can say this bogeyman narrative about "government run health care" is utterly fallacious. We already have the equivalent in the form of corporate-bureaucracy-first health care.

taylodl 3y ago

Clarification - not true. I can point you to several people who have great jobs, great insurance, and tens of thousands of dollars in medical expenses. Nowhere else in the civilized world does this happen.

deprecative 3y ago

Right, then you get cancer and lose your job, savings, retirement, and start from zero.

r00fus 3y ago

It's not. Name another industry/market where you can't know the price of what you're buying (even an estimate) before you buy it. Every other developed country has a better system than ours. Every one. And for those who say "oh, well wait times are so much higher" - well you can get supplemental insurance in many of those countries as well - so the baseline isn't abysmal, but wealthy can get even better.