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> Does this not seem absolutely absurd to anybody else?

It is obviously an insane way to run healthcare. But for the majority of US citizens, they've never experienced anything else. So this insanity is considered totally normal to them. Medical bankruptcy isn't just a thing, it's an expected outcome of any major illness -- medical bills are the most common reason for bankruptcy in the US.

If the US just switched to a proper universal national healthcare system (like say, a clone of UK's NHS), for even just one month, America would never go back to the way it is today. Not suggesting that UK's system is perfect, but it's so much objectively better than the US system that there would riots in the streets, if anyone suggested going back to today's US system.

Which is why we see so much lying about how terrible socialized medicine is, and so much money/time poured into preventing Americans from learning/experiencing it in any way.

Having a Baby in US. I will definitely give my insurance provider a call. They didn’t pay much for the OB and I work for a very solid tech company.

America’s healthcare is a f*ing joke. It’s riddles from the top to bottom with people who want to leech money at every step and provide the most minimal service.

I had a slight fracture in my scaphoid. I paid $2000 out of pocket and insurance paid half of that.

In Australia where I don’t need employer golden handcuffs for health insurance, it would be less than a third of that.

I'm american. This time last year I had a minor bone break in my hand (not emergency, no severe pain).

I have a preferred doctor who doesnt have an xray machine. Obviously getting an xray image is the first step before even talking to the doctor. An xray of your hand is a _very_ basic procedure. My plan was to get my own image from a conveniently close facility of my choice and bring it to the doctor.

This is an open commercial market right? I decided to play a quick game with this and ask all my in-network local providers what their charge would be for just an x-ray of my left hand.

A car mechanic should be able to quickly give you an up-front estimate for common procedures, why not an imaging facility?

If youve read this far youre probably not surprised I called 4 different facilities, followed up with a series of requests over multiple days and failed to receive even one straight answer except "come in and we will see what we can do".

It makes me realize how soul-crushing the experience can be in this so-called "open market" to find the best possible treatment when you have a more complicated problem. The amount of leg-work, scheduling, waiting for doctors and getting opinions all while in pain would break the spirit of most anyone.

Is it really that much simpler in other countries to connect with the proper provider? I was under the impression countries like canada handle simple problems like mine much more gracefully but serious issues remain problematic.

>> Is it really that much simpler in other countries to connect with the proper provider? I was under the impression countries like canada handle simple problems like mine much more gracefully

In Canada and in Britain, you simply go to your local GP and get a referral, or go to A&E (Emergancy).

>> but serious issues remain problematic.

No, generally treatment in Canada and Britain for 'serious issues' is very good as well.

We all hear about the well publicised failures of the NHS and Canadian Healthcare, but by and large it works very well. I have seen close relatives and friends have cancer, septicemia, strokes, severe bone breaks, a life changing injury that made a friend a quadrapeligic, and more. For the most post part, the level of healthcare in Canada and Britain has been excellent.

My friend who had septicemia was in a very remote location, and once diagnosed was airlifted to a major hospital.

All of this is covered by public healthcare. It is amazing.

It is even more astounding that the USA still has this Byzantine 'private' system that tries to claim that it is an open market, but it is not.

From a macroeconomic point of view, the USA pays 18% or 19% of GDP for its healthcare system, where as Britain and Canada, and pretty much every other western country pay about 10%. (These are OECD figures) The American healthcare system is horribly inefficient, and puting in a public system ought to be every American's politicial priority.

Imagine that, a universal healthcare system is cheaper to operate than the private system?

The rhetoric and hyperbole that comes out of those who are vested in the status quo is outright criminal.

And I didn't think to include the time wasted by you 'shopping' around. That would be also be another drag on national productivity.

I agree, I have no real complaints about the Canadian system. ~14 years in Ontario versus ~29 years in US. Are there differences? Sure. Is there peace of mind knowing that I won't be uninsured or out of pocket for a relatively minor procedure that might cause me real financial hardship in the US. Goddamn right.

I live in Germany and I would probably just go to the next hospital, wait for a while, get x-rayed and see a doctor. In this situation I wouldn't even have to think about money and I don't have to search for the best provider because they are all good. Even if I wouldn't go to a hospital, every doctor who can treat you usually can do an x-ray at his practice. I cannot imagine how it must feel in such a system in urgent cases. (edit: "such a system" refers to the American system)

My wife banged her foot about a year ago. We were pretty sure it wasn't broken, but we went to the hospital to get it checked out anyway. We never even considered which hospital we should go to - we basically expect them all to be decent, so why bother thinking about it? We had to wait in the emergency room for an hour or so, but then we were seen. My wife's foot was X-rayed 30 minutes later and it was confirmed that everything was fine.

I was in the US once, and had developed a cyst on my finger that hurt (due to the pressure of the liquid inside -- could have been a ganglion cyst).

What you do with those, is you burst them open to relief the pressure, clear the liquid inside (white cells and such) and put some disinfectant. In my (Western European) country it's a trivial 10 seconds operation every pharmacy is authorized to do.

So I go asked at a pharmacy/drugstore for that (probably a Walgreens) -- and they said they weren't allowed to do it and that I should ask at a clinic. I asked how much it would cost for this, if I went at one, and they told me about $150.

Yeah, right.

I just went on and bought a regular clothespin from that pharmacy, burned it with a lighter to disinfect it, and burst the cyst myself...

(And it's not about government mandated insurance vs "really free market" and such. We have mandatory insurance were we are, and the prices for all kinds of operations, both with and without insurance coverage, are still way lower).

s/clothespin/safetypin/

>No wonder the US, the largest economy in the world, ended up with a terrible infant mortality rate…

That's largely a product of people trying a lot harder to with much earlier premature births than other countries, not a fault in care provided.

There's a lot of ways to frame how the US healthcare system fails people, this one's a canard.

And higher rates of teenage pregnancy, pregnancies by obese persons. Using the infant mortality rate as a proxy for US healthcare quality isn't reasonable, as you say.

On the flip side, one could argue that teen contraception and nutrition education are important parts of a properly functioning health system. To put it another way, who is to say high rates of teen and obese pregnancies are not caused, in part, by our health system?

> who is to say high rates of teen and obese pregnancies are not caused, in part, by our health system?

Sure, perhaps in part, just as any occurrence in other countries with any recordable teen or obese pregnancies. However, it would be inappropriately reductive to say the health system is the cause of these, and I'd argue it would be incorrect to say the health system is the primary cause. To do so would be to ignore the entrenched historical and cultural influences on the present state.

>>Does this not seem absolutely absurd to anybody else?

It does, and it's shit like this that makes me absolutely convinced that US is a 3rd world country, where people have to weight their own health vs the financial cost. There's plenty of people saying they don't want to call an ambulance because they are worried what their bill would be. That people would risk their lives and that of their new born baby because there is a financial cost associated with staying at the hospital for another day is beyond absurd, it's like bad fiction about some distant society where things have gone horribly wrong, except that this is real and calls itself the greatest country in the world.

If individuals aren't free to make these financial decisions for themselves, then insurance companies or the government will. My mom had a severe infection while on chemo because the insurance company didn't want to pay for an injection that would've boosted her immune system. Having these decisions made at the population level, instead of the individual is far worse.

> individuals aren't free to make these financial decisions for themselves

An individual can only be free to make this kind of decision if they've got a spare $1500.

If the state was paying and your mother wanted to pay out of pocket nothing would stop her. Elective course of action is not banned in any single payer system that I know of.

Canada -- a Quebec ban on private health insurance was overturned in 2005, but there are still open court cases on whether that applies nationally and whether healthcare providers may charge privately for services.

I don't know about Canada obviously but in Poland hospitals are not allowed to charge for anything that is refunded by the national health service, but they are free to charge for anything else. So if a patient says they want an extra injection that is not funded and they will pay out of their own pocket for it, they absolutely can.

What do you mean individuals aren't free to make that decision? Even in a fully public healthcare system you can always opt to pay for treatment which is not covered(as rare as those are). How is that different than your insurer in US refusing to pay for treatment and you paying from your own pocket?

That’s a red herring though. Few countries have a system that forbids paying extra for extra care. The point is that in the U.S. system you can’t get basic care without paying extra, which is not the case in other countries.

why not do some research online, buy the meds for a penny on the dollar via the darknet, and give them to your mom's nurse with a $100 note to seal the deal?

is it absurd that i have plans for these exact situations already worked out?

Socialized medicine (e.g. one paid by state) also weights costs and risks. You just don't see it and don't have to make those decisions by yourself.

You don't know how much for them 1500 wad nor how high the risk nor whether coming back from home was that much dangerous in case that bacteria happened.

Funnily enough I agree with you but I have to disagree a little bit.

The truth is no one knows what the right level of care is even in many common situations.

Up front I'll say I'm a state and universal healthcare advocate.

But it comes with its own forms of waste.

Our first child had a borderline kidney tube measurement. We had 8 follow up scans costing the taxpayer $300 each.

Gradually I realised that the clinics had figured out a way to game the funding system, because at the level of deviation i saw I could find no research supporting the need for 8 extra ultrasound scans and in fact the only measurable risk was an increased risk of uti escalating to kidney infection which actually an ultrasound is not the best diagnostic tool for anyways.

In fact none of the doctors or technicians I talked to could coherently explain the level of risk or how the scans mitigated that risk.

What they did have was numeric guidelines and some measurement uncertainty. Plus a blank cheque to do more scans if they could justify it under current guidelines.

On the gripping hand they were $300 scans not $1200 scans like in insurance driven systems so...

That's nonsense. You do know, statistically.

Parent I responded to does not know. He is just horrified that couple would save on healthcare. If you live in system with socialized healthcare, you don't have to make these decisions.

However, if you pay out of pocket then you do have to make those decisions personally. Else you will be taken for financial ride.

I would really liked to know why is this downvoted. Do people think insurance dont make those decisions? Or that those decisions being made implies I think socialized medicine is bad?

Or they all know everything about that particular bacteria and assume everyone should?