“So get this, most people pay $100-$400 per month for an employer-subsidized health care plan. However, deductibles and copay are often high unless you are one of the lucky few who work somewhere where employers splurge on the best policies. So even something as simple as an x-ray or a broken leg can set you back $500-$1000. THAT’S WITH INSURANCE. Most people don’t have an extra $1000 just lying around. That medical debt often goes on the credit card, accruing interest,” stated Eudaimonics
“Other issues: Surprise Medical Bills – since everyone has a different policy and no doctor is an expert on them all, often you’ll be given a treatment or test that they thought would be covered by your insurance but actually isn’t. Seriously ask around. This happens ALL THE TIME. Accidentally going out of network. You have to worry not only about which medical facilities accept your insurance but also which doctors and specialists do. In short, the US has a piss poor insurance system that primarily benefits outdated insurance companies. That’s the main savings of Medicare for All. We get rid of this expensive and convoluted middleman.”
18. Don’t have a pre-existing condition if you live in America.
“I work in healthcare. When I worked in a hospital (quite probably for good in fall 2020 – so not ancient history), I saw the consequences every day of our abysmal healthcare system. Even people with insurance sometimes can’t afford medications, procedures, and preventive medicine that would help them stay healthy or even just stay alive. If you are a healthy person from a basically healthy family, then probably our system works just fine for you. But if you have type 1 diabetes, cystic fibrosis, cancer, or any one of a hundred other diseases, you have to be destitute, or you won’t get help from anyone. And if you go to the ER, you will pay the bill, or they will garnishee your paycheck,” says readback, correct.
“It didn’t use to be that way, but it is now. Don’t be a sick middle-class person in America. You can’t afford it. Here is just one of a thousand examples I could give – a middle-class family has a little boy who gets leukemia. It cost them – with insurance – a couple of hundred thousand dollars to treat him. When he died, they still owed $90,000. It’s been two years, and they are still paying off that bill. Yes, the hospital cut them a deal. The deal is they aren’t coming after their house. They have given them time to pay the bill. This is not uncommon for people. I promise you it’s not. I am outraged every day on behalf of my patients.”
17. Having a genetic disease doesn’t make it any easier.
“I have a genetic disease which had caused serious health issues throughout my life, so I’ve dealt with the system a lot. I’ve been on private insurance, employer-provided insurance, Medicare, and Medicaid. When I was at my worse, I started on employer insurance through my wife. That was reasonable and did not cost us a lot. We divorced, and I was on COBRA for a while, which offered the same coverage, but the premiums were expensive. After that, I was on Medicare which was pretty decent but a confusing system with its donut holes. I had a supplemental program for that. It was overall a fairly affordable system. After I no longer qualified for that and was working again (employer didn’t offer insurance), I was on Medicaid due to my income,” as stated by wogggieee.
“That is the best and most affordable coverage I’ve ever had. Now I have a private insurance plan through a state exchange. It’s sort of expensive, but it covers well. When I was at my worse, if I did not have help from my mom in terms of housing and covering health care costs, I have no idea how I would have paid for it, and it’s possible I might not have lived through it with out coverage. The care I’ve gotten has always been outstanding, but the method of paying for it Sucks. The system is set up to offer the most benefit to those who often need it the least.”
16. Picking insurance plans is important — and can make all the difference.
“The question is whether you can pay for it. Most people pay for it with an insurance plan. But our insurance system is a convoluted, expensive mess. Whereas Canadians generally are all covered by their provincial government insurance plan, and they can take that insurance plan anywhere, here in the US, whether you have insurance and what that insurance pays for varies wildly. Old people get Medicare. Poor people get Medicaid. Veterans get the VA. Most everyone else gets private insurance through a plan which is paid in full or in part by their employer. Employees often have a choice of plans based on what they think their needs will be: if you’re young and healthy, you might prefer a plan with low monthly payments offset by higher costs at the point of service.”
SmellGestapo also states, “If you are older or anticipate more medical costs, you might do the opposite. But you also have to decide whether you care about seeing one specific doctor and making sure that the doctor is covered by your insurance plan. Or do you not care about seeing the same doctor, and instead, you want a plan that allows you to see any doctor? Even if you make those decisions purposefully, it’s easy to get confused and book an appointment with a doctor, thinking your insurance will pay for it, only to find out later you were wrong and your doctor does not work with that insurance plan.”
15. It’s not just the healthcare system but the payment system, too.
“The payment system is extremely bad, but I think the outcomes are overblown. A lot of people say we spend more money than any other country yet have worse outcomes, but insurance isn’t the biggest thing affecting health outcomes compared to diet or genetics. Things not normally handled by the insurance system, like drug addiction, can also skew these numbers (though I would argue that a medical issue). The biggest issue with the payment system is that it can be very opaque.” says Avenger007_.
“People only directly see the bill for their health insurance a fraction of the time since most of it is paid by employers. Trying to navigate care can be a nightmare if you want to set up an appointment. Prescription Drugs have too strong Patents, medical devices are upgraded too frequently, causing hospitals to go into too much debt, and services can be patchy in rural areas (i.e., not having an obstetrician ). These are just some of the issues in the system, but it’s also massive in every country, and there are bound to be some good and some bad.”
14. Healthcare is much more expensive in the US than in other countries.
“It’s true that we have some good doctors and other professionals, but if you compare our life expectancy and healthcare outcomes even for insured individuals to other developed nations, we are far behind. We spend three times as much on healthcare as other countries with similar income levels, per capita, including the fact that more than ten percent of the population is totally uninsured, and the majority with insurance is reluctant to use it because their premiums will go up,” says ChironXII.
“The following is speculation/anecdotal, but it seems that due to the cost and lack of access, even insured people only go to the hospital when their condition becomes an emergency, instead of seeking preventative care. This leads to our much worse overall outcomes. PS Hospital errors are the third most common cause of preventable death in the US. ~400,000 deaths annually. We lead other developed countries in this area by as much as 10-30% as well.” This obviously should not even be happening, let alone be a worry for anyone.
13. It doesn’t really make sense for these outrageous costs!
“The problem with healthcare in America is that it is ridiculously expensive. Due to the way the health insurance industry works with the healthcare industry to set prices, if you do not have insurance, everything is ridiculously overpriced. For most people without insurance, the only way to get any medical care is to go to the emergency room. Emergency rooms are not allowed to send someone away with a life-threatening illness, even if that person cannot pay. They do not have to treat someone with a chronic condition who cannot pay, though, as long as it is not immediately life-threatening.”
VVillyD also states, “Getting insurance is usually rather expensive. The majority of Americans get their insurance through their employer. Health insurance companies will usually offer plans to an entire company. The idea here is to group everyone in the company into the same risk pool. Some of the people in the company use more insurance, some useless, and the insurance company sets costs so that they anticipate making a profit in, long term. Most of the time, the employer will share a portion of the cost, paying part of the premium or deductible while each employee pays the rest.”
12. Try not to put off care just because you have bad insurance.
“I know many people who work in the health care industry, and many times the story of a person not receiving treatment until the last minute is because they didn’t take time to be seen preventively. My wife worked with an OB/GYN who was sued because one of the patients would not return for a follow-up on an abnormal Pap smear. She finally started seeing someone else who diagnosed her with cancer, from which she lost her life. The children sued the original doctor because she didn’t get their mom to come back for care,” stated cocuke.
“Apparently, with the right people, you can be made liable for someone ignoring your repeated calls and attempts of contact. Two doctors, a midwife, and all of the office support staff, about ten people had to find new jobs. One doctor decided to just leave the industry rather than go through it again. The biggest failure of the American health care system is the litigious nature of America. Big lawsuits make headlines, and headlines move political interest, and the cost of it all comes back to the people who use the service. Other than that, we have amazing healthcare.”
11. Employer insurance is not the same as non-employer insurance!
“As other people have said, it’s wonderful as far as the doctor’s abilities and the sheer volume of amazing medical personal…but I’d like to clarify. Most America’s get healthcare through their employers. I work for a huge company that covers the majority of my healthcare costs. I pay a small price every month, and I have medical, dental, and vision. So, I can go to any doctor that will accept my insurance, which is 90% of doctors. And I’m lucky enough to afford the best healthcare plan from my employer, so my copay is low or sometimes free,” says Axtorx.
“My friend, on the other hand, doesn’t work full time and therefore can not get healthcare from her employer. She could pay for healthcare through the Affordable Care insurance, but she doesn’t because she can’t afford the extra expense while paying rent/bills. See, she falls into a gap that a lot of Americas do. The gap where they can’t get healthcare from their employer, they don’t make enough money to afford healthcare as a single-payer, but they make too much money to be on Medicare. My insurance only costs about 600 a year. My friend’s insurance, not through her employer, would cost about 200 a month. And there are other single-payer insurances that are even more, like Cobra.”
Axtorx continues, stating, “Basically, anyone can get healthcare, but not everyone can afford it. And when you don’t have insurance, that’s when you get in trouble when you’re sick. For example: If I have the flu, I go to any doctor in my area, I pay a copay of 25 dollars, I see a doctor. I get blood tests and labs and most anything I need done, no charge. I’m told I have the flu. I get a script, I go to the pharmacy and get my meds filled for a low cost (probably about ten dollars) through my insurance.”
“The whole event probably costs me 35 bucks. My friend has the flu. She goes to a walk-in clinic. She pays 125 dollars to see the doctor. She’s charged extra for every lab or shot she’s given. She gets her script. She fills her meds, which cost more, with no insurance. Her trip probably costs her almost 200 dollars. And that price range changes drastically if there ER visits, surgery, ambulance rides, etc. if you need an MRI, X-ray or need to see a specialist, with no insurance, you could be looking at thousands of dollars.”
9. Healthcare feels like a gamble for most Americans.
“There are two main issues: 1. Hospitals are allowed to charge whatever they want for a procedure, and they’re driven to make money. 2. Insurance companies are the ones paying the bills, and they also are driven to make money. The first is pretty self-explanatory. As to the second… Health insurance in and of itself is a gamble and an expensive one at that. You’re betting that you will get sick. The insurance company is betting you won’t. It’s expensive enough to pay for as is, but then there are situations where the insurance company might not cover something you need,” JennJayBee states.
“In the past, there were also caps to how much they would payout, and insurance companies might even drop you in the middle of treatment if you were too expensive. If you had a pre-existing condition (like being a cancer survivor), some companies wouldn’t even sell you insurance, and of those that did, most wouldn’t cover you if you had a future-related issue, like your cancer returning. Add to that, with all the costs to our government and to patients themselves. We don’t necessarily get a better quality of care. In many ways, our system is worse. All of those nightmarish stories you hear about medical malpractice in other countries? We have them, too.”
8. Back pain and US healthcare insurance is a joke.
“My wife had to go to three specialists about back pain before one approved of an MRI. The tech did the wrong area, and we had to go back. Last fall, her primary care physician was determined it was kidney stones, and the specialist convinced us to agree to surgery she didn’t need that provided zero benefits. It took us nearly a year and quite a bit of missed work for her to learn she has five bulging discs and one herniated disc in her back possibly from a car wreck a couple of years ago.”
“Three years ago, my younger brother went into the hospital with back trouble. He developed a respiratory infection(with a fever) while in the hospital. They eventually sent him to a physical therapy facility like that. He was dead eleven hours later. When my older brother was born, he had to go into the NICU due to a bleeding problem. My mother’s insurance company at first refused to pay any of the expenses, stating that they didn’t approve the charge beforehand. Apparently expecting my mother to anticipate a bleeding problem for her premature child, call them, and wait for approval, all in the late 1970’s. All anecdotal, but these are people with the money for care and great insurance. The system could be better.”
7. This subject of poor healthcare insurance in the US gets people on a rant.
Megalomaniac says, “There are also serious economic issues as well, and in many ways, global healthcare rides on American innovation and private healthcare. I think some of the things Trump did make a ton of sense, like the price disclosure regulation as well as the Medicare paying the lowest price through EO. Should someone lose their entire life savings because they got cancer? Why wouldn’t someone have insurance for serious issues like cancer, car accidents, strokes, etc.? If they don’t have insurance, then yes, they need to pay for their healthcare.”
“Chances are, they will spend much much more than their ability to pay and leave the hospital on the hook. And that is okay because they received their healthcare. I’ve already addressed that we share common ground addressing cost issues. You act like you want massive thousands of dollars provided for nothing like it grows on trees and it doesn’t have economic impacts. You lose a lot in the sense of economic incentives towards healthcare development, you lose the profit driver to act as an efficiency driver, and you end up having the typical government bloat, corruption, graft, and obscenities.”
6. Having more than one insurance doesn’t seem to matter, either.
“I have two sets of insurance, and trying to get them to pay for anything is a bitch and a half. And if you make the tiniest mistake on your end, despite providing insurance information 13x over, they’ll be as quick to deny paying for you and try to get you to foot the bill. And thank god I have two sets. I was in the hospital for five weeks plus two stints in inpatient rehab and two months of outpatient in 1 year. It’s been 1.5 years later, and I’m still getting bill collection calls and mail daily about how I’m going to pay $800K in medical bills… I literally had a chick act like I was casually asking if I was going to throw down 100k in 10k annual payments,” says Tommy_Wisseau_burner.
“I literally laughed on the phone and told her to get with my insurance companies and figure this shit out because I’m not paying dick for something they should’ve figured out a year ago. Now I try to imagine the other stuff I need (as an amputee) and people with chronic illnesses/conditions, and people without insurance, and how they’ve been fucked over. Let’s not forget that until about 10-15 years ago, denying people with pre-existing conditions was an actual debate point and whether it should be allowed. As an amputee, there was a bill recently about whether there’s a policy to have one prosthesis for your entire life… just 1. These bad boys can cost 50k plus. Mine costs about 80k.”
5. We need to do better with US healthcare insurance.
“The care is good, probably better than most places. And frankly, with insurance, I have zero concerns about myself or my family’s health. As a whole, it’s significantly better than it is perceived on Reddit. What I don’t like is there is still 8-10% of the population that isn’t insured. I feel like a catastrophic plan should be required, just like car insurance is required. (Toss it on taxes if you can’t prove private insurance),” stated randocadet.
“What infuriates me about our system is just how much the hospitals and drug companies overcharge. They can do this because most people have insurance, and it’s spread out over millions. But they’re doing it enough where our government spends the most per capita on medical expenses. This isn’t just a healthcare problem but really a problem whenever the US government tries to buy anything: military, construction, private contracts, etc. Everyone gouges the government. Before the US can seriously contemplate universal healthcare, we need to address the overinflated prices of care.” We need to do better as a whole, that’s for sure.
“I already know I’m not rich enough to get cancer treatment if I needed it here in the US and accept that. What I have an issue with is having no access to care without GOOD Insurance. I needed my gallbladder removed in 2012 but had poor insurance. My portion of the cost was $2300 and needed to be paid upfront before insurance would kick in. No hospital would do the surgery without my portion paid upfront. Not having $2300 (my entire monthly income), I had to wait three years until I had a better job with better insurance where my cost was only $450,” says bigh2k1.
“I would have preferred socialized govt health care and a 2-year wait over the three years I lived with pain and the fear of my gallbladder bursting. Insurance told me when my gallbladder does burst. They will cover my hospital costs without my prepaying my copay portion. But they said to be within 2 hours of a hospital or the toxins released from my burst gallbladder could kill me. Even routine care in the US is only available to those who can afford their copays OR the extremely poor who qualify for the government Medicaid insurance.”
3. Japanese insurance and healthcare compared to US.
“I’m American. I lived in Japan from 2012-2018, and what a dream that was. Moving back was the worst decision I ever made, and it primarily lands on the fact that American healthcare and insurance is the worst damn system imaginable. I had my last three wisdom teeth taken out last November. I have dental insurance through my employer. They ran it and told me I’d have to cover $1400 of the surgery on my own because I had hit my limit, and the rest would not be covered by insurance. Well, now, two months later, I’ve learned that apparently $1400 wasn’t enough as I have a new bill for nearly $600 more because of things my insurance would not cover.”
“It cost me $49 to have one wisdom tooth removed when I lived in Japan. Even without Japanese Insurance, I could have bought a round-trip ticket to Japan, had the rest taken out, and still have over $300 to spare. That is ludicrous. And my friends wonder why I don’t travel anymore. It’s damn things like this that suck up money. Two months AFTER I think I’ve got everything paid and under control, I get surprise bills from things I apparently didn’t pay enough for. How the HELL do you budget when you could get a $600 demand at any time from a doctor for something that happened months ago?” rants ccaccus.
2. Problems at the eye doctor because of US healthcare insurance.
“I wear contacts, and often times my eyes get pretty dry because of it, so much that the veins surrounding the edges of the contact will get very red, and my eyes will get irritated. It’s like the contact was sucking all of my moisture out. I brought this issue up to my eye doctor, and she gave me a prescription for some eye drops that should help. Cool. I’m expected them to be like $70 or so with insurance (not that I know much about insurance coverage, considering I’m just in college, but that was my guess). My mother and I got to the store to pick up my prescription. The lady at the counter gets a surprised look on her face,” says Astronomy_.
“She tells us that she’s going to check and make sure it’s the correct prescription… turns out it is, and it costs around $2000. Not to mention they’re individual use?? Wtf are individual-use eye drops? And WHY are they TWO THOUSAND DOLLARS? Insurance would cover a couple hundred, so that brought it down to $1.7k. Actually ridiculous. It’s not even just the insurance that’s bad. It’s the price of it in general… why are they two thousand? I’ll just keep using the over-the-counter contact eye drops that are just contact solution and continue to suffer.”
childfromthesun explains, “I used to work for a health insurance company, and it was absolutely painful. Sometimes even we didn’t understand the decisions our company made. I could only do it for a few months. I had to help a poor lady who, post-heart surgery, was promised over the phone it was covered. Then the company suddenly backtracked after the fact and asked her to cough up 60K. My boss threatened me not to tell her how to dispute. Absolutely HORRIFIC! Dealing with crying dying cancer patients on the phone just trying to offset costs for their surviving relatives and poor elderly being taken advantage of broke my heart.”
“Listening to distressed patients in pain wondering why their life-saving med prices jumped from $50/m to $5000/m NO EXAGGERATION! And the cold and calculated cruelty of the company I worked for astounded me. I couldn’t believe this was an everyday reality for sick people. My husband was about to move to America to live with me! Then, I realized we were making a mistake. I stopped him from boarding the plane because I know this would be our future when we grew elderly. I knew in my soul I had to get the hell out of this place.”