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The American health-care system is ludicrous! My girlfriend and I are from Europe and we have been in the US for a year now while she finishes her university d
by beggi 14y ago
The American health-care system is ludicrous!
My girlfriend and I are from Europe and we have been in the US for a year now while she finishes her university degree. Half a year ago she (we?) got pregnant, and we are paying more than triple the money for doctor visits than it would be back home. Not only that - but the money we're paying is just 20% of the "real" cost, the insurance she paid $7000 per year for is paying the rest. So we're paying $180 per visit and the "real" cost of each half an hour long doctor visit is about $900!
Now you might argue it's better service, but in my very subjective view, I highly doubt it and it doesn't feel like it at all. To add insult to injury: We got a 3D sonogram and the amount we paid (mind you, 20% of the "real" cost) was twice the amount our friends at home have paid for 3D sonogram taken by a private company (and the government is not paying a cent).
IMO, America is one fantastic country if you're rich - but it seems much much harder to live here than in Europe on meager salaries.
- tptacek 14y agoCareful. Hospitals and doctors often report the amounts that insurance companies report based on a master price list that bears no relation to what the insurers actually pay. Insurers are presumably fine with misleading reports that puff up their value.
- zeidrich 14y agoBecause that value is directly correlated with the price that insurance companies can charge consumers.
- tptacek 14y agoI don't think that's true.
- revelation 14y agoIf they pay 20% of price A and the insurance theorethically covers 80% of A, but in actuality pays only B << 0.8 A, then that sounds like fraud.
- pbreit 14y agoBecause everyone in all industries pays list price. Right.
- voodoomagicman 14y agoThe problem isn't the insurance negotiating a discount - it is that if your insurance has agreed to pay 80% of the cost of your care, and then is able to negotiate a discount, you should pay 20% of the discounted price, not 20% of the pre discount price.
- SoftwareMaven 14y agoI've never not had my co-insurance portion be anything but the percentage of what their negotiated rate was. I don't know if it is fraud, but breach of contract would probably apply if you did (assuming it wasn't in the fine print).
- deleted 14y ago[deleted]
- yuhong 14y agoSo would the uninsured pay the prices on this price list?
- bhb916 14y agoAt every hospital I've ever been to (N=3) that answer is a firm "no". With one hospital the price was automatically knocked down 75% before any negotiations took place and this policy was advertised everywhere. At another hospital I simply had to speak to a account manager to get a drastic reduction (> 80%). The third hospital took a harder line, but ultimately caved. If you are uninsured you should never pay more than 15% spread out over 6-12 months (less if you're going to pay in a lump sum). Everything is negotiable.
- dguaraglia 14y agoSo, basically, the list price is just an inflated number they can use so insurance companies pay them just enough to cover what they'd charge everyone else. This, my friends, is what madness looks like.
- Someone 14y agoInsurers apparently also are fine with the side effect that hospitals overcharge non insured patients, sometimes bankrupting them in the process. For those who want to know more about that master price list and how its prices have little to no correlation with reality: http://www.time.com/time/magazine/article/0,9171,2136864,00.html http://www.time.com/time/magazine/article/0,9171,2136864,00....
- seanmcdirmid 14y agoRetail prices in hospitals take into account a high-percentage of non-payment...which is why they are high to begin with! They have complete correlation with reality: an uninsured person is more likely not to pay, so prices are higher so that works out. Now, the higher prices lead to more non-payment, and a vicious cycle ensues. This is why the mandate in Obama care is so important, to stop this cycle.
- rayiner 14y agoHow is your girlfriend paying $7,000 per year for insurance as a university student? My wife and I each paid $2,300/year while we were in school, and like your plan ours covered 80% of the cost of pregnancy and birth (capped at $2,000).
- tptacek 14y ago$7000 for normal-deductible family coverage does not sound out-of-whack.
- rayiner 14y agoAh, I guess I hadn't considered that her plan covered him too. Still, pretty expensive for a plan that only covers 80%, especially if the $7,000 is before the kid.
- fpgeek 14y agoDon't forget that university student plans are often unusually cheap because the enrollment requirement ensures a relatively inexpensive risk pool. They can also come with unusual restrictions (e.g. your PCP must be at the campus health center), though I think PPACA may no longer allow some of those practices. In any case, since it sounds like he isn't a student, they probably don't qualify for a student plan and are falling back to something more expensive.
- bradleyjg 14y agoIt all depends on the state. NY for example forbids underwriting, so age doesn't come into the equation.
- rbehrends 14y agoState regulatory or university requirements for health insurance for international students are often stricter (e.g., no limits on coverage).
- dragonwriter 14y ago> The American health-care system is ludicrous! No, because there is nothing that can properly be called "the American health-care system". America has a large number of different public and private health care financing systems (e.g., insurance and insurance-like programs), a large number of different and uncoordinated public and private health care delivery systems, and extremely inefficient, costly, and poorly standardized interfaces between all those different health care financing and delivery systems. > IMO, America is one fantastic country if you're rich - but it seems much much harder to live here than in Europe on meager salaries. These are both by design.
- jwallaceparker 14y agoThere's something called an "uncompensated care pool" that serves as a perverse incentive for medical providers to issue insanely high bills. Say they charge $10,000 for a procedure that costs them $500. They collect $1000 from the insurance company and claim a loss of $9000 in the "uncompensated care pool" for which they can apply for a government rebate at the end of the year. The practice originated to help reimburse hospitals that provided charity care, but it's morphed into something entirely different.
- cperciva 14y agoshe (we?) got pregnant Off-topic, but I hate the abuse of the English language which is "we are pregnant" (except when the speaker and another are both pregnant women). Pregnancy is a physiological state, not a psychological or sociological state. You are expecting; but she is pregnant.
- nonamegiven 14y agoIt's a common way of describing that shared experience. There's no need to restrict our speech or feelings to the strictly literal. If you don't like the phrase you don't have to use it, but to many couples the experience is meaningful enough that the phrase is also meaningful.
- vixen99 14y agoMeaningful to whom? Seems to me that the existence of an internal feeling experienced by some couples is not enough to warrant misusing a precise term.
- radley 14y agoIf she's pregnant and insists I say "we", I say "we". That simple.
- nonamegiven 14y agoMeaningful to them and to most of the rest of us. Life is much more than utility.