Is this that socialist health care system Americans are supposed to want to pay $4 trillion per year for?
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I've posted on this matter before, but it's important so I'll repeat it;
I've lived in the US and the UK, and I've witnessed or in some cases experienced first hand both the best and worst of both systems.
In the UK, every time I have seen an ambulance called, they have been on the scene in 5 minutes. ...But I have also waited 6 months for a 5 minute ultrasound. ...But I have also been admitted into hospital in 20 minutes and treated there for a week at zero cost.
In the US I have watched other have misdiagnoses, I have also watched others, and in retrospect, realized that I too have been hoodwinked into paying for unnecessary treatment by doctors looking to make money and happy to poison me to do it.
I have also avoided hospital care in circumstances where I would have immediately sought it from the NHS - showing up to the ER with breathing difficulties and being told a ballpark figure for my admission was $13,000 - most of my life's savings at that point in time - prompted me to gamble my life and wait to see just how how difficult my breathing got.
I've watched Americans sell family homes because of medical bills - something virtually unthinkable in Britain.
Having seen all this, I now conclude there are times when I'd choose the NHS, and times when I'd choose private medical.
Neither system is universally better than the other.
If you're in the US and you balk at free healthcare and cry 'SOCIALISM!', you're a fucking idiot.
If you're in Europe and you balk at private healthcare and cry 'INEQUALITY!', you're a fucking idiot.
If you're lucky, both systems are open to you.
No you haven't. You're just ass pulling shit based on what you've seen in the lib media. That does not happen. At all.
The dirty secret of the runaway prices in medical is that they are built entirely on bullying and extortion of anyone without council (insurance or other advocate). That seems wild until the second reason is known: emergency care cannot be refused to the indigent. This second point is actually the entire reason for everything. It has created a class of person, who abuses emergency service for general care.
Medical pricing, then, is a constant haggle and negotiation where most Americans aren't aware of it happening and don't participate in it. The hospital quotes you high-unto-unreasonable, and you look at that price and assume it's just the price, and then wonder why insurance payers don't go out of business. They don't because they ignore the bill and send them the only money they're going to get, and the hospital takes it quietly. That is not "price-fixing" in the monopoly sense, that is price dictation in the haggling sense.
My own experience in this was a surgery for my son. I examined every bill and watched the negotiation in real-time between my insurance and the hospital's many, many entities. Finally, when all was settled, there were some outstanding items that the insurance didn't participate in by their own election (not their purview because my coverage didn't include it). The hospital turned their Eye of Sauron on me and wanted immediate full gratification on the remaining items.
I had a phone conversation where I dictated my own terms to them, basically insisting on a pay schedule for the outstanding amount. They were unhappy and pushed back, and I said, "It's what's happening. The first check will arrive next month for this amount." Finally, after conferring out of my hearing they came back to the line with, "ok," and immediately hung up. I sent my checks as I'd promised, and they never contacted me again.
The extortion system can be fixed. Trump's attempt to mandate that hospitals post prices was a great first step in that, because it forces public competition and eliminates the haggling requirement of pricing being an individual affair. The reason the extortion system exists, can also be fixed, but that is a harder ask because we have 40 years of ER rooms receiving people with non-emergency problems who are up-front about the fact that they will not pay, and no ability to stop it. The hospitals have to squeeze money from payers to cover non-payers they can't refuse. Until that is addressed, this will continue to spiral.
Thanks, Reagan.
I'm pulling nothing out of my ass. I'm not saying they ended up homeless. I'm saying they downsized to a lesser home.
You're right. I imagine some honest people (or suckers depending on your outlook) actually try in earnest to pay their hospital debts. Most people just deal with collections.
As a former poor person with no insurance, I can tell you that actually going to an ER is usually the last resort. The working poor who fall into the gray area between the dirt poor and the insured classes don't qualify for Medicaid and can't afford the premiums for any sort of insurance (Obamacare was/is a total joke).
Many so-called "blue collar" jobs either offer no insurance or bottom-tier insurance with huge deductibles.
Yeah. Worth noting that where the UK system really shines in comparison to the US is basically for people too poor to afford health insurance. As I understand it, if you're in that kind of situation in the US things can be very bleak. Something like that is far less likely in the UK, which of course makes it's own tradeoffs, quite a few of which I don't particularly agree with.
A depressing, hair-raising hour sitting or two sitting in a hallway and trying to determine whether I'm getting better or worse as time went by.
It doesn't sound like much but the thing is that the difference between 'trouble breathing' and 'unconscious and asphyxiating' is about 5 minutes, and the difference between 'unconscious and asphyxiating' and 'brain damage' is about 5 more.
I had just travelled was really not used to the combination of 20 below zero with dry air, and my asthma, which hadn't bothered me in over a decade, was having none of it.
Eventually I decided I wasn't getting worse, and chose to take the risk of heading back home, blasting the car heater and buying coffee purely to inhale the steam. I went to sleep boiling a kettle in my bedroom. Yes, I bought one of those, too.
I never did fully adjust to that climate, but it never fucked me up half as bad as it did the first year I was there.
If it had been the NHS, based on my prior experiences with their treatment of my asthma, they would have stuck an oxygen mask on me without question or fee.
Realistically, If I had chosen to be admitted, I would not have ended up actually paying $13,000 in the end, but that is not really what you're thinking when you're wondering if you're about to fucking suffocate.
And really, should I have to haggle with debt collectors over such an obviously bullshit price tag? I knew I didn't need $13,000 worth of treatment.
Yes, in this case, the ultimate issue is 'why can't I access an oxygen mask at something approaching market cost?'
In the US, that answer is 'because a legion of insurance middlemen want their cut for work they aren't even doing.'
Correct.
It's not the case in the UK that 'everything' is nationalized. We have private medical providers (some of which also provide services to the NHS) and for some things, I would recommend that over the NHS even for the poor - I am never waiting six months save to £350 on an ultrasound ever again.
My personal opinion is that there is not enough availability of private care in the UK (because it has to compete with most people defaulting the NHS), and not enough availability of public care in the US. The politicians of both countries seem to agree with me on that, as they've made attempts to push things toward that middle ground in the last decade.