The U.S. Healthcare System and Your Finances

 

The U.S. Healthcare System and Your FinancesA few weeks ago, I brought my 18-month-old daughter in for her “well baby” check-up. Thankfully, my employer allowed me to use my lunch break to take her to the doctor’s office. Since all she needed was a check-up and some shots, I thought that I would be back within an hour.

 

We arrived at the office about 5 minutes before our scheduled appointment time. My daughter and I patiently waited for about 15 minutes until her name was called. We then proceeded to have her weighed and measured. Besides her having a runny nose and a slight cough, nothing was out of the ordinary. We were then escorted to the exam room where we waited for the doctor to come in and finish the exam.

 

And we waited….and waited….and waited.

 

After being locked in the room for about 20 minutes, my daughter was getting anxious. She wanted to run around and play. Besides that, it was getting to be about lunch/nap time. When I wouldn’t let her run out of the room, she began to cry – hysterically – for about 15 minutes. I was finally able to calm her down, but of course the crying exacerbated the symptoms of her cold.  Luckily, I was able to calm her and she nearly fell asleep, until…

 

The doctor walked in…53 minutes past our scheduled appointment time. She apologized, and I was willing to give her a pass. Things happen and people run behind. She ran through the rest of the check-up and then noticed her cold. My daughter was wheezing a little bit, which shouldn’t have been a surprise considering she was just crying for 15 minutes. The doctor insisted that we do a test for RSV and give her a nebulizer treatment to help clear the wheezing. When I asked what treatment she could prescribe for the RSV, she said there was nothing that they could do. It was just nice to know that she had it. I reluctantly agreed to the test and treatment.

 

After the treatment, I was told that the doctor would like us to come back in a week so that she could check her out again. My head was swimming, wondering why I should pay for another office visit, until a few minutes later when the RSV test results came back as I suspected – negative. My daughter simply had a cold. However, the nurse handed me the nebulizer and told me that I was to rent it take it with me. She called in a prescription for me to use with the unit – which I later I found out cost $40. I declined and left the prescription at the drug store. The next morning, I promptly returned the nebulizer and canceled the additional appointment. Two days later, my daughter felt fine, and I was left thinking about how wasteful that had all been.

 

How Hurt Are You?

A few days later, when we got home from work, we quickly took our coats off and began to discuss what we were going to have for dinner in a few minutes. My youngest daughter is not very patient, so we try to serve food that can be prepared pretty quickly during the work week. All of a sudden, Holly asked me if I knew what was all over our 3-year-old’s hair. I looked, and was shocked to find that she had a cut on her head. Her cotton blonde hair was completely matted down with blood.

 

Trying not to panic, we asked her if she was alright. We tried to figure out what had happened. Did she hit her head at daycare? Did her sister hit her with something when we got home? Why was she not crying and acting normal? Did it hurt? How the hell did we not notice this earlier?!?

 

Holly took her to the bathtub and rinsed some of the blood out of her hair. We both looked at the cut, and we couldn’t tell how bad it was. It didn’t appear to be bleeding still…at least not too bad. Should we bring her to the emergency room? Does she need stitches? It appeared that might be possible. What should we do?

 

If we lived in most countries around the world, there would be no question at all – we would have brought her to the hospital. Alas, we live in America. Instead of seeking the treatment that she probably needed, we spent the next few hours debating whether or not we should take her to the ER. You see, our “health insurance” consists of a Health Savings Account (HSA) and a $5,000 deductible. So, we could bring her in and get it looked at for probably $1,000 – which means that we would still be liable for $4,000 of out-of-pocket expenses should anything else happen the rest of the year. Or, we could hope that it was just a scratch and save our $1,000. Although the cut was still oozing a bit of blood a few hours later, we decided to keep our money and hope that it wasn’t that bad – and that it wouldn’t get infected…feeling like a s#itty parent the whole time. In all honesty, she may have needed a stitch or two. Unless I wanted to pony up $1,000, I didn’t have the freedom to find out.

 

The U.S. Healthcare System…Greatest in the World?

Yes, we live in America – where we have the “freedom” to choose our own healthcare…and the freedom to go broke if we get sick. America, where we proclaim to have the “greatest healthcare system in the world.” America, where Americans are made to believe that those pesky European and Canadian versions of healthcare create poor health, long waits, and broke governments. Yet, I’ve never met a European or Canadian who would trade their system for ours. Not one. I wonder why?

 

You wouldn’t think that legitimately sick or injured people would have to think twice about using a healthcare system claiming to be the world’s greatest – but in America, they do. It doesn’t seem like the greatest system in the world would charge mothers $10,000 to deliver a baby – but it does. Surely, the greatest healthcare system in the world wouldn’t allow the extremely sick or injured to lose all that they have, right? Yet, this is exactly what the U.S. healthcare system does. We need to stop kidding ourselves.

 

For all the bellowing about how great the system is, you would expect Americans to be the healthiest people on the face of the planet. Yet, according to Bloomberg, we rank 33rd…right below the United Arab Emirates, Kuwait, and the Czech Republic…and right above Bosnia and Herzegovina, Bahrain, Croatia, and Mexico. That is because the U.S. healthcare system isn’t really a HEALTHcare system at all. It has become less about healing patients and more about creating profit.

 

I can see where people who have never had to worry about paying out-of-pocket costs think that the system works. If you’ve never had a deductible higher than $500, why would you think anything is broken? Clearly, the doctors, hospitals, pharmaceutical companies, and insurance companies are fine with it. There is too much profit to be lost by changing the status quo.

 

However, fewer and fewer people have $500 deductibles. Health insurance that is unattainable and unaffordable has helped to make medical bills the number one cause of personal bankruptcy in the United States – and most of those people had insurance at the beginning of their illness! Still, we continue to delude ourselves that our system is the best.

 

Yes, we live in America, and these are the personal finance and medical decisions that Americans have to make each day. We have to decipher whether or not the salesman doctor is prescribing necessary treatments or simply trying to increase profits. The RSV test. The additional office visit. The prescription for something that we didn’t even need. The $1,000 emergency room visit to probably tell me that she just had a scratch and was fine. These things are not about trying to heal the sick and wounded. These things are done to increase profit, to sell more product. Until we figure out a way to treat the poor, middle class, and rich equally – until we remove the profit motive from our healthcare system – not only is the U.S. healthcare system NOT the greatest in the world, it really isn’t a healthcare system at all. It is a profit-making machine disguised as medicine.

 

Honestly, I don’t know what the answer is to this problem. My guess is that it is to move to a single-payer healthcare system. While no system is perfect, the rest of the world seems to think that it works pretty well. (Imagine how many people would be able to retire early if they didn’t have to work for health insurance. Now, there is a job creator!) Heck, even if a single-payer system isn’t the best system for the United States, it couldn’t be any worse than what we already have.

 

What are your thoughts? I’m sure you have them, so fire away in the comments below!

 

 

About Greg

Greg Johnson is a proud husband, father, and debt crusader who believes in living life now while saving for the future. He is the co-founder of the personal finance website Club Thrifty, where he brings the awesome sauce each and every day.

Comments

  1. We have some of the best health care providers in the world. However, as for the system, well that remains to be seen.
    I hope that everything went well with your daughter. Nothing is worse in the world than having a child we love injured and not knowing what happened.

    • We do have some of the best doctors in the world here, but that isn’t to say that doctors everywhere else are incompetent. I think we are led to believe that. In reality, I think doctors in other places are actually allowed more freedom to practice medicine rather than pushing pills, dealing with paperwork, and trying not to get sued.

  2. It sucks that you even have to think about money when your child is hurt. I live in Canada, and yes healthcare is something that I don’t have to think about thankfully. We’ll actually be moving to the states soon, but we won’t be giving up our citizenship.

    • I would say that is a good call on not giving up your citizenship. I would definitely keep it just in case you ever want to move back.

  3. Couldn’t you have taken your daughter to an urgent care facility? Visits there are usually on the order of $150 or less, and the one we go to has the ability to do basic x-rays (to make sure nothing’s in the cut) and stitches.

    • Unfortunately, there is not an urgent care facility near us. Growing up and living in small towns most of my life, urgent care facilities can be hard to find. Besides that, several of the urgent care clinics that I have been to don’t accept insurance. Therefore, you are paying double because the treatment doesn’t count toward your deductible.

  4. Sorry to hear about your daughter, I am sure it was a bit concerning, to say the least. We had something similar happen with our daughter last year. Her eye, all of a sudden, get incredibly swollen. It looked like I had just punched her. Against our better thoughts we took her to the doctor. After waiting for an hour and $250 later we found out that she just had a bug bite and that she only needed a little antihistamine to bring it down. I was furious, but as a parent what do you do?

    That said, the system sucks. I understand needing to make a profit and I think doctors should be able to make one for what they do. However, it has become way too much of a business and it seems like that is the driving force these days.

    • Having any issue with your child’s health is scary. It really sucks when you feel like you don’t have a good option.

      I too understand the need to make a profit. Everybody needs to make a living. Unfortunately, everybody needs to see a doctor on occasion as well. It is hard to put a price on one’s health, which is why I think it is so easy for the for-profit medical industry to gouge customers here.

    • Go to the optometrist! $68. No seriously, it is terrible when you kid is sick and you don’t want to shell out the $1000 to go to the ER, but you don’t want to be a bad parent either. I still believe most doctors, primary care anyway, are doing the best they can. However, the reason they did the RSV test was probably all for liability. If they hadn’t offered and your daughter got sick and went to the hospital, the doctor could easily get sued. That’s why if you go into the doctor for what looks exactly like indigestion, you will most likely get cardiac testing for a heart attack. I am all in favor of being able to sue for gross negligence, but it is ridiculous that anyone can file a lawsuit for any reason.

      I would love some sort of universal health care, and that would be a good use of my taxes, but I don’t think the goons in Washington could ever make it happen.

  5. I would no doubt have made the same painful financial consideration if I were in your shoes… And that makes me feel sick to my stomach. I feel disgusted that the state of the US healthcare system is the way it is… Were people are simply unable to afford getting sick or injured.

    The system where I live (in Canada) is not without it’s pitfalls, but when you need emergency treatment you get exactly what you need and you get it fast.

    • Right. No system is perfect. We are just reluctant to change here…and there is a lot of money helping to make people uneasy about it.

  6. I am always so shocked to see how much it costs people in the US to go to the hospital – it is crazy.

    Also, some doctors just like to line their pockets with extra cash. We had a similar thing for my wife after she gave birth. They wanted to see her every week for 6 weeks.

    We told them to get lost and if there was a problem we would contact them. If not we would see them at 6 weeks. Sure enough everything was fine and we saved $500.

    • We have also declined follow-up visits on several occasions. When it is coming out of your pocket, you tend to err on the side of saving money – which may not be the healthiest course of action.

      • That statement is part of what is wrong with the US healthcare system. Most people don’t do the preventative maintenance (mostly do to cost) and when you do go to the DR the problems that could have been caught early are now major problems. Which in turn cost more money to fix. It turns into a bit of a whirlpool effect.

        Also good luck selling a tax hike on Americans, even if it does actually provide better health care. I mean people freaked out about the SS tax holiday going away. Besides that, do you really want our government in charge of even more of your money?

        • Well, to be fair, none of the appointments we are talking about are preventative care. When our daughter has a cold and the cold goes away on its own, I don’t need a doctor to confirm that for me. But overall, I do agree with you. If everyone practiced more preventative care in general we would be a lot better off.

          Do I really want our government in charge of more of our money? Well, no…but what is the alternative? The alternative is the crooked mess that we have now. It is completely unsustainable and something has to change. I definitely don’t know what the answer is but I do know that our insurance premiums and/or deductible have gone up between 10-30% every single year since we’ve been married. It can’t keep going on like this. Something has got to give.

  7. The same thing happened to us with my daughter’s head – blood on her hair – her friend carelessly tossed a rock behind her and it was sharp and cut my daughter’s head. I didn’t go to the hospital and I live in Canada because after much debate like yourselves, it is not worth it to sit in emergency for 4 hours.
    When my daughter broke her arm, everything was free except the cast ($40 or so) but we had to wait almost 4 hours with a six year old in emergency. The first hour was ok – we played games on my phone etc, the second hour, pretty good, the third hour was difficult, finally shortly into the fourth hour, she got her cast which took about 10 minutes.
    Walk in clinics are more efficient but they don’t do things like casts, etc. but you can occasionally find one that does xrays.
    I love our healthcare system in Canada money wise but if you have to go to emergency at the hospital and it’s not life and death, it is a long long long wait to be seen in most cities! Our healthcare system is far from perfect and true it didn’t cost us anything except a few dollars but it did cost some of my sanity!

    • That is fair enough. Obviously, it doesn’t cost you much out of pocket, but you are paying for it through taxes. However, nobody is going to go broke waiting for coverage in Canada. Unfortunately, people go broke all the time here due to health issues.

  8. At the risk of getting into a debate, let me share my perspective. Your first office visit really has to do with a major issue in our hc system: doctors go out of their way not to get sued. I know someone who is head doctor of a nursing home and he orders MRIs all the time “just in case” even though if he had no risk of being sued he would prescribe almost none of them. One slip up and he could be sued for hundreds of thousands, if not millions, for NOT telling them to. I think this is a big issue that I’m not sure how we can fix.

    As far as deductibles, perhaps it’s because I’ve only been out of school for a few years but $5,000 deductibles for family’s actually sounds reasonable to me. Not sure what your out of pocket max is, but it does sound more of the norm. I do work in insurance and the profits are capped at 80 or 85% depending on your policy (or you should get a check in the mail per MLR regulations if the insurance company makes too much). I’ve had ~$3k deductible and $4k out of pocket max every year, and I just assume I’m going to cover it every year and if I don’t, it’s a bonus. Double the deductible and out of pocket max for my wife and we are close to $8k out of pocket max. Knowing the pricing models, this isn’t unreasonable as grouped together the insurance company does in fact end up spending right around 80-85% on medical costs, the rest has to cover all expenses and they are lucky to squeek out a 3-5% profit.

    With that being said, there are definitely some issues with our system, and the exchanges should help starting in 2014. It’s essentially a subsized system based on income, granted young adults get somewhat screwed as we should expect to pay more because of rate bands…but it should bring “affordable” care to everyone.

    Again, not trying to debate or defend anyone or anything, just giving you my perspective. I really respect you and Holly and enjoy hearing your perspectives on these issues as well.

    • Yay D.C.! Thanks for sharing. Knowing your “politics” and the fact that you work for a health insurance company, I was certain that we would be able to get an alternate viewpoint from you :D

      I won’t start a big debate here either, but I agree that the exchanges should help somewhat…if any of the states would actually get on board. Also, we are lucky enough to make decent money so we can cover the deductible with a little bit of pain. However, if we had gotten sick on December 30, it would be pretty tough for us to be hit by $10,000 in a couple of months.

      Honestly, I think the whole system is backwards. You’ve got insurance companies taking their cut, doctors being paid to do tests and treatments rather than for keeping people healthy (often times owning portions of the surgery center, MRI machine, etc.), and hospitals complaining that they aren’t making any money – and then building $40 million buildings. It is crazy to me.

      Thanks for sharing your perspective! I appreciate it when people can add intelligent perspective to the conversation!

  9. Amen.

  10. I read this Time Magazine piece recently and I thought it was brilliant. The system is absolutely broken. http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

    • Great article! Thanks for recommending it.

      Honestly, I think healthcare is a major reason why people don’t start more businesses. I know it is a major decision for us…although we could probably get about the same coverage that we have now. It is obviously a major factor for those considering retirement.

      • You are right. It’s called “job-lock”. When people get health insurance not tied to their jobs they’re more likely to become self-employed.

      • Health insurance has been a big consideration in me staying at my current job and not becoming self-employed. Since bf and I aren’t married I can’t go on his health insurance. Buying your own policy is so expensive, I’m continuing to work and keep the insurance until I’m positive I’ll be able to afford buying insurance on my own (or bf and I get married). Healthcare in this country is absolutely broken, disastrous really.

        • Exactly. And I can only imagine that there are at least tens of thousands, maybe hundreds of thousands of people who would retire early if they didn’t have to worry about buying health insurance until Medicare kicks in.

  11. Great read Greg and I hope your daughter is feeling better. Our system is definitely broken and to be honest, I’m not sure how to best fix it. There are simple steps that can be tried today without going to a single payer system like increasing competition with insurance companies, removing monopolies in physician education, reducing frivolous lawsuits, etc. – but all of these solutions cause certain “groups” to lose a ton of money – so it never happens politically. When the middle class can no longer afford health care, there is something very very wrong and also something to be said about Australia’s, Canada’s, and UK’s system.

    • I agree. There are some steps that we can take. However, it took a ton of political will power (and a big political risk/hit) to move through the latest piece of legislation. The money involved, both in the medical industry and in politics, makes it a difficult rail to touch.

  12. How very sad that people have to make a choice between money and a potential health crisis.

    Many of your politicians (I am Canadian) are against universal health care but they all have great health care provided by their employer – you.

    • Yep, pretty much. Hopefully, some of the new laws will at least curb the worst practices of the insurance industry…but we will see.

  13. Even seventeen years, when I first entered the workforce, things were so much different than they are today. Contribution levels to healthcare costs by employees have taken away any real income growth in our country for decades, and shows little signs of slowing. Also, the varying degree that employers decide on health care costs is baffling. For example, our employer does not cover visits to urgent care facilities. This makes no sense, because the alternative is either a doctor visit (which I’m sure they’re trying to encourage with the practice) or an ER visit, which is going to be required any time the doctor is closed.

    Sounds like your office was trying to bolster their bottom line.

    • Honestly, I’m not sure that health insurance should be tied to your job at all. Unfortunately, it almost has to be for employers to stay competitive. However, it is so expensive for middle class people to purchase, that nobody would be able to afford insurance if there wasn’t some sort of an employer contribution. Because of this, I would agree that pay raises are generally barely able to keep up with rising health insurance costs (and decreasing benefits).

  14. Sorry to hear about your daughter and I hope she is feeling better. I recently went to the doctor for pills and she insisted that I do some ‘basic’ tests in addition to the pap smear I requested. Knowing that my health insurance plan from school covers the pap smear and probably nothing else I told her the extra tests were not necessary. She assured me the basic tests will be covered by all plans. She was right, her bill was indeed covered by the insurance (about $300) but I had to bear the lab testing costs, another $300. The insurance insisted that covering the lab testing costs will be double paying for the same tests. Go figure.

  15. Stephanie says:

    couldn’t agree with that more!! major healthcare reform is absolutely necessary. My boss – a surgeon – opposes it vehemently. Why? because he’ll make way less money and that, my friends, would NEVER be ok. He’s entitled to be super rich you see, while you, are not. Btw, many of our drs and their families are routinely NOT charged for their healthcare as a professional courtesy . . . it’s sort of like the swag bag at the oscars – free stuff for people who can afford to buy it.

    • Ha! A swag bag! Love it.

      Of course he opposes it. Why should he make $250,000 a year in a system that heals people without bankrupting them when he can make $1,000,000 a year in the screwed up system we have now?

      Funny enough, the house we live in used to be a doctor’s house. Now, many of the doctors I know live in starter castles. Of course, they also have huge amounts of debt to pay off when they come out of school, which is another problem with the system. Who knows? Their houses are probably mortgaged to the hilt as well :D

  16. I’m am SOOOO right there with you on this. I have to admit that when I was employed with a good job, I didn’t think twice about going to the doctor if something wasn’t right or I was concerned. Now I literally have to be bleeding from my ears, and that just isn’t right. I have insurance, but it sucks. I have to pay 205 for the premium (which is going up $50 in april), THEN the cost of the co-pay (40-60), THEN the cost of whatever my insurance doesn’t cover (which feels like nothing). This whole problem with my shoulder I keep putting off because I don’t want to pay these expensive fees. It’s ridiculous!!! There really is a serious problem with our system!

    • I agree. Combined with our employer contribution, the total for our premiums is about $1,000/month (we cover half of that)…just for the “privilege” of getting to have insurance. After that, our deductible is $5,000 with an out-of-pocket…so you are talking about several thousand dollars a year before we even go to the doctor. That is rough.

  17. The thing I am MOST thankful for living in Canada is our healthcare system. Yes I pay more in taxes. Yes I pay more for milk but I never have to question how sick I am to go to the doctor. It makes me sad when I hear insane stories about questioning your illness level before going. I hope your daughter is ok!

    • When it is all said and done, you really don’t pay that much more in taxes (especially if you include our health insurance premiums as a tax). I think other countries have made a decision to treat their people with dignity and respect. In many cases, I think America puts profits ahead of all else.

  18. It can’t possibly get any worse. We had to search for insurance on the open market…and it was awful. Luckily, we were able to qualify for a group plan a few years ago, which did bring out costs down some. We wrote about it a while back. Here is the story:

    http://clubthrifty.com/the-healthcare-debate-our-story/

  19. Excellent post!! Healthcare in America is driven by money, greed and politics. (You should check out the movie Sicko if you haven’t seen it…pretty good documentary) I give our President a lot of credit for trying to improve it. No easy task! Hopefully the new Affordable Act will help.
    I think doctors just do their job and know they will get paid. We assume that our doctors know our own personal insurance situation and they don’t. have you ever tried to ask the doctor a billing question? They are clueless! I had to take my 2 year old to the ER a couple years ago because of repeat vomiting. She was miserable. The nurses did all sorts of tests, told us that it was flu and sent us on our way. We saw the actual doctor for about 5 minutes. I owed over $1,000 for this and it took me almost a year to pay off!!! I’m still bitter.
    having a child in America is outraegous. I think $10,000 is conservative. More like $30K, plus OB costs.
    The single biggest reason for bankruptcy in America is medical bills. It is horrible!! I could go on and on and on……and ironically, I have terrific insurance. $300 deductible with no co-pays. BUT–this has not always been the case.

  20. I feel for you and what you and your family went through. I work at a healthcare clinic, so I’ve come across a fair share of complaints from patients. A fundamental flaw in our healthcare system is that it’s driven my volume so providers try to squeeze in the maximum number of patients possible in a day. This causes scheduling delays and patients are resentful that they pay so much for only 5 minutes of face time. Patients are also asked to come in for a medication check before the doctor will renew their prescription, and you bet this makes people mad because that’s more money and time they have to spend. I would prefer to see a model like the UK where doctors are rewarded for actual patient care – helping people become and stay healthy.

  21. Glad to hear your daughter is doing better :)

    Totally agree with you on this post! What we pay for health insurance went up in January and we are feeling every dollar. And don’t even get me started on the whole “urgent care” thing…it’s not urgent at all. Long waits and paying way out of pocket. Our system needs some serious help!

  22. What you say is all so true! I had my gallbladder removed last year and I just got a peak at the bill. With my insurance *thankfully I have it* I paid $22.50. The cost of the surgery to someone without insurance, $25,000!! I can’t imagine living with the pain I was feeling for years because you can’t afford a much-needed surgery. Our system is ridiculous. Everything is profit-driven these days, it’s sickening!

  23. Great rant/post because I couldn’t agree more. That’s ridiculous you had to wait so long to see the doctor – what’s the point of setting an appointment? I try to get in as early as possible because of that trickle-down delay reason. That was kind of surprising that they charge $1000 for emergency fee – no parent should have to decide that and their child’s health!

  24. Every doctor’s office operates differently, but that is too long and the diagnosis seems off too. My wife and I spent a lot of time to find good doctors, you may want to look for a nother one.

  25. I think you are opening a can of worms here, but I like it. I have not been a fan of the system for a long time and I think it has become just run by greed and not need. When you allow drug companies to run the show and allow them to literally “pay off” doctors, then you are not getting true care.

    • Ugh….don’t even get me started on that. The fact that prescription medications actually advertise on television should be a hint that there is a major problem here!

  26. I haven’t had to deal with unnecessary stuff getting into my pockets because my insurance is pretty good, but man, do I pay the price for that insurance! Pushing $400 a month just for medical, another $100 for dental and vision. But we haven’t had to make those decisions on whether or not to go to the doctor because of money. For us, we’re just sick and tired of doctors prescribing pills and crap we don’t need. My wife and I are very homeopathic and if we can find a natural way to fix something, we will.

    Luckily, we’ve sswitched to naturopathic doctors, and they are much less “take these 10 pills and you won’t feel anything for the next 5 years”, and more “here are some great rememdies using things you can buy at a local market” Has been much more pleasant, and the stuff flipping works!

  27. I’m so sorry you had to go through this and your daughter is fine. No parent wants to play russian roulette with their children’s health or their own health, but every day people are forced to do it. I can’t pretend to have the solution, but we, as a country, need to make some changes.

  28. Also, holy crap. Freaking awesome re-design on the site!

  29. Greg, this post hit home with me. I recently paid $96 for an office visit after my insurance had made their contribution. That contribution was limited to negotiating the price down to the $96 and applying it to my deductible. After paying $120 a month for such quality coverage, imagine my reluctance to take any of my five children to the doctor during flu season. The last time I had a sick child the doctor recommended five tests that totaled nearly $2,000 under my plan. The child got better a few days later. The doctor even told me it was just a stomach virus and the tests were just precautionary.

    • I just hate making uninformed decisions…you know? I hate going to the doctor and having no idea what it may cost in the end. Even though we are financially prepared, it is still stressful.

  30. I don’t know much about your system, but from

    abroad it doesn’t look like the best in the

    world. The problem with France is that the

    cost of a medical act is set by social

    security and hasn’t been revised in years.

    While it is very cheap, doctors have to book

    lots of appointments to make a decent living.

    So yes you are often rushed in and out but

    most of the needs for a doctor are really

    basic and should be treated quickly, and for

    the price we really can’t complain.

    • Trust me, France has it way better than we do! I would much rather be rushed or wait for an appointment then have the system we have where people literally lose their homes and everything they have.

  31. I know from our discussion with Joe that that had to be a hard decision. It stinks for sure but I think you did the right thing. People freak out over the smallest things these days and while this sounds like a closer call than most ER visits it stinks you had to think that hard about it.

    Oh and I don’t know if I missed the announcement or what not but sweet redesign!

  32. Thanks for sharing your experiences. There must be millions of us having to wait an hour or more for a doctor (you were lucky to get an apology), being charged for things we don’t need, and foregoing care we think we probably need but can’t afford.

    A little competition (ok, a lot of competition) would go a long ways. It tends to make businesses want to stand out for their service, or their low prices, or not charging you for things you don’t need. The problem with a government-run system is that it doesn’t do any of this. It just turns the medical industry into servants of the state. Businesses will do whatever it takes to get money, so it helps us all out if the money comes directly from us. But we need some transparency and competition in the market.

    • I totally understand the competition theory with healthcare. However, the whole ability to shop for the cheapest provider is a bit of a myth. The transparency that you mention is a huge issue. If you have ever tried to get a price quote from a doctor’s office, it is nearly impossible. Nobody knows what anything costs, and they hide behind the fact that everything is “coded.” It is a joke really, and I’m speaking from personal experience. Furthermore, I think that the competition model doesn’t work particularly well in healthcare for a few reasons. A) There is a lot of care that needs to be done without notice. B) Many people are only able to travel to the nearest hospital…and not 60 miles away. C) When it comes to a life and death, how do you put a price on that? There is nothing that people won’t pay, and providers know this.

      Thanks for your thoughts! I appreciate your views!

  33. It’s not managed care. It’s managed cost.

  34. I`m sorry to hear about your daughter, and how you had to weigh in every little aspect, whether to go to the hospital or not. It really shouldn`t have to be like that in today`s society. Especially when you live in the States. Reading stories like these, makes me really appreciate how things work in Norway. Most things are “practically free”, and when you`ve spent a certain amount on prescription drugs, doctor appointments, you don`t have to pay anymore. And any hospitalization is free.

    But even here, things can go wrong, and things can get very delayed. When I got sick 4 years ago, the public health system couldn`t help me (the waiting line for getting to a neurologist and rheumatologist were about 8-9 months), so I had to turn to the Private health care sector, where suddenly everything worked out in just a couple of months vs. a year and more in the public. Sure, I had to pay for it, but I had been waiting for such a long time, and I was a student with no income, so it was the only choice for me. But it shouldn`t have been like that.

    Btw, I like the new design!

    • Thank you!

      There is no perfect system, but the system we have here just isn’t working. I think almost everybody can agree on that. Solving the problem is where we tend to have major differences.

  35. Wow, great article, Greg! You are so right about all aspects of the system. I do appreciate the great docs we have here, but because the issues you mentioned in the post, we’ve done a ton of educating ourselves on health and welness. Because Rick’s an EMT, he’s taught me the basics on evaluating an emergency, and we’ve worked hard to learn about naturopathic healing as well. This has cut down our heath care costs dramatically. It’s so scary not knowing if an issue is serious enough for the doc or not, isn’t it?

  36. Guys I really dig the new layout, not that the old format was bad, this just kicks it up a notch! Just wrote an article which goes hand in hand with yours. I hate to say it but wait times will unfortunately go up especially by 2016 when we have 30-40 million more people receiving care. We are in trouble. Great post and great redesign!!!

    • Honestly, the whole thing is a mess. If I had my druthers, I’d scrap the whole system. The way that doctors are paid and reimbursed now is just one issue with the system as a whole. That is one reason that I like the government run programs that pay their doctors using a salary. In that way, doctors are getting paid to heal rather than to prescribe tests that they will get paid for.

  37. I took my daughter for 12 month shots and well child visit, a few months after we moved to a new place. I had to pay more than $600 for the shots! These are routine shots. I requested the detailed bill and compared it to federal government’s list of prices (private sector and government facilities). I saw that they charged outrageous amounts. Moreover, the administrative charge for giving shots made my eyes bleed. We were charged separately for each shot although it was done in the same visit by the same nurse. So I took her to the local health center for the 18 mo shots. There was no private room to wait for the doctor or the nurse (for 45 minutes!); they gave her the shots in a cubicle, but hey! we were in an out in 15 minutes. And the administrative charge was minimal. We were charged once for all the shots, in addition the cost of the shots were 1/3. I understand some shots are more expensive than others, but as I said, I checked it with the prices and still it shows we were ripped off. Not an original story, I know, sorry for the rant.

  38. Oh greatness… I still remember an otherwise long-forgotten economics class wherein the professor said ours was the greatest because rich people from other countries come here when they have serious illnesses at which a student piped up that many countries have better life expectancies so we’re not the greatest… The question that first has to be asked is do you measure at the top or at the middle?

  39. I feel you Greg. The healthcare system here should make a drastic change but as long as there is profit involved, I don’t think we could ever make the first step out of this misery. Thanks for sharing this.

  40. Terry Duncan says:

    Hello, Greg. Love the blog and completely identify with this post. I am surprised that no one has highlighted what follows in my comment. I think this is a gigantic meltdown-in-progress that few recognize in its entirety.

    Profit-seeking while holding health, life, or livelihood in the balance is by definition a broken system and has every incentive to compete-up prices. A single-payer system would merely replace many unreliable payers with a whole community that guarantees paying every bill, virtually without limit! Throw any salesperson into that environment, and watch what happens.

    On the supply side of the equation, the U.S. health care industry maintains academic and professional barriers of entry that are unnecessarily lengthy, restrictive, expensive, and demanding. In other countries, a nurse has vocational training, a doctor has a (content-dense) bachelor’s, and specialists have advanced degrees. Oh, and midwives are licensed short of major medical intervention. Non-accute health care is accessible, affordable, effective, and avoids much of our patient/industry conflicts of interests.

    Pharma has near godlike status in health care with money-tendrils everywhere. Pharma is usually as much a cause of medical problems as it is a solution– a net-loss for patients and a win-win for health care which gets repeat business, driving-up costs.

    Lastly, the hospital system has been turned on its ear. Hospital ratings are based heavily on training levels of employees, so BSN-RNs are changing bed sheets to boost hospital ratings and billability. Meanwhile, society’s lessers are disenfranchised from basic health care.

    We need to replace U.S. health care with a clinic system– each run by NPs and a staffed with ADN-RNs– and reserve hospitals for acute care staffed by specialist doctors and BSN-RNs. We need to establish medical bachelor degrees, and we need to make it illegal for Pharma to have any contact with health care except for: trials and reviewed journal publications.

    • Interesting points. I don’t see what you pointed out as bad options. Honestly, almost anything would be better than the broken system we have now! That’s also an interesting point about single payer, because profit seeking entities may use guaranteed payment as a means to get every last cent out of the public who is footing the bill.

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