Medical Insurance in the US

tonyshowoff

@tonyshowoff said:

@scottalanmiller said:

@BRRABill said:

@JaredBusch said:

I don't know what planet you are on, but it is certainly not Earth. No wait times in the US? You are f'n crazy.

I mean that if you "want to get the clicking in your jaw" (as mentioned by another person here) looked at here, you can get it done pretty quickly. You don't have to wait 3,6,9 months because the government said so.

No, but you still will wait longer than you will in most other countries, I think.

Not only that but as I pointed out (poster is referencing what I said), the trade off for the supposed faster wait time for the clicking jaw is said to be bankrupt-level pricing for anything that would save your life.

And those of us with clicking jaws just give up and don't get fixed because even if the wait isn't "all that bad" the cost and quality of care is generally awful. So it causes us to be somewhat less likely to get things fixed that might be fixable. That skews things. If I grew up in Europe, I might have gotten that fixed for free decades ago. Instead, having American healthcare, I just live with an offset jaw that clicks and disconnects regularly.

And the it gets worse, and eventually costs vastly more. People avoid basic healthcare until it's a disaster as well due to these things. Wait time is meaningless if it costs too much to bother too.

BRRABill

How are doctors compensated in non-US countries?

scottalanmiller

@tonyshowoff said:

@scottalanmiller said:

@tonyshowoff said:

@scottalanmiller said:

@BRRABill said:

@JaredBusch said:

I don't know what planet you are on, but it is certainly not Earth. No wait times in the US? You are f'n crazy.

I mean that if you "want to get the clicking in your jaw" (as mentioned by another person here) looked at here, you can get it done pretty quickly. You don't have to wait 3,6,9 months because the government said so.

No, but you still will wait longer than you will in most other countries, I think.

Not only that but as I pointed out (poster is referencing what I said), the trade off for the supposed faster wait time for the clicking jaw is said to be bankrupt-level pricing for anything that would save your life.

And those of us with clicking jaws just give up and don't get fixed because even if the wait isn't "all that bad" the cost and quality of care is generally awful. So it causes us to be somewhat less likely to get things fixed that might be fixable. That skews things. If I grew up in Europe, I might have gotten that fixed for free decades ago. Instead, having American healthcare, I just live with an offset jaw that clicks and disconnects regularly.

And the it gets worse, and eventually costs vastly more. People avoid basic healthcare until it's a disaster as well due to these things. Wait time is meaningless if it costs too much to bother too.

Long wait times are used to reduce insurance costs, too. Make it hard to get service and they have to pay for fewer things.

tonyshowoff

@BRRABill said:

How are doctors compensated in non-US countries?

Depends on their job, etc. Even in the USSR and Yugoslavia neurosurgeons made more than general practitioners.

scottalanmiller

@BRRABill said:

How are doctors compensated in non-US countries?

For healing them instead of keeping them sick

BRRABill

I ask because that is another sticking point. That there is no "incentive" for good health care.

coliver

@BRRABill said:

I ask because that is another sticking point. That there is no "incentive" for good health care.

What's the incentive for good health care in the US? Patients aren't paying doctors, they pay insurance which makes money on you being sick. The incentive in the US is actually to keep you sick and therefore spend more money.

tonyshowoff

@BRRABill said:

I ask because that is another sticking point. That there is no "incentive" for good health care.

My cousin is a doctor (GP) in Sarajevo, Bosnia. He makes about $866 USD per month, may not seem like a lot, but it's twice the average salary. That's the only one I can speak for, I'm sure you can look up others, but I know doctors in Western Europe make sometimes $1 million+ USD per year, depending.

scottalanmiller

@BRRABill said:

I ask because that is another sticking point. That there is no "incentive" for good health care.

They are rarely paid "by patient". Meaning they don't make their money by seeing more people and definitely not be selling drugs. It's the insurance and pharma infrastructures in the US that primarily disrupt the healing incentive process. Most countries, certainly not all, pay something more similar to a flat rate - just paying them as a professional with a job to do. More like how we pay IT. Unlike IT, there isn't an unlimited about of work to do, there is incentive to make people healthy because it is your job, your source of pride and value, good for your community and country, good for humanity and you should be showing results similar or better than the average. In the US, some of those things exist, some do not.

coliver

@scottalanmiller said:

@BRRABill said:

I ask because that is another sticking point. That there is no "incentive" for good health care.

They are rarely paid "by patient". Meaning they don't make their money by seeing more people and definitely not be selling drugs. It's the insurance and pharma infrastructures in the US that primarily disrupt the healing incentive process. Most countries, certainly not all, pay something more similar to a flat rate - just paying them as a professional with a job to do. More like how we pay IT. Unlike IT, there isn't an unlimited about of work to do, there is incentive to make people healthy because it is your job, your source of pride and value, good for your community and country, good for humanity and you should be showing results similar or better than the average. In the US, some of those things exist, some do not.

There are some physicians like this in the US that I know. Many of the prospective doctors that I know elected to go for Nurse Practitioner instead as it didn't involve as much pressure to push drugs on people.

JaredBusch

I pay for insurance in the US at a rate of $701 per month right now for a family of 4. This is a plan purchased via a broker and is with BCBS. Of course it is ACA compliant by law.

The plan lists one visit free. I assume that is the mandated wellness check.

My birthday is in April, and thus if I want a wellness check around my birthday like I do every year, I need to have an appointment then.

I was sick as hell in January. I refused to go to the doctor because it was January and it would eat my "free" visit. So my April visit would have to be paid for in full because it has to go against my (insanely stupid high) deductible.

travisdh1

@JaredBusch Does the coverage for the rest of the family make as little sense as having yourself covered?

JaredBusch

@travisdh1 said:

@JaredBusch Does the coverage for the rest of the family make as little sense as having yourself covered?

That coverage is the same for the entire family.

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travisdh1

@JaredBusch said:

@travisdh1 said:

@JaredBusch Does the coverage for the rest of the family make as little sense as having yourself covered?

That coverage is the same for the entire family.

Ah, sorry, poorly worded question. I was wondering if the entire family actually ever hits the deductible?

JaredBusch

@travisdh1 said:

@JaredBusch said:

@travisdh1 said:

@JaredBusch Does the coverage for the rest of the family make as little sense as having yourself covered?

That coverage is the same for the entire family.

Ah, sorry, poorly worded question. I was wondering if the entire family actually ever hits the deductible?

No, because we have fortunately only been severely sick in Japan.

coliver

@travisdh1 said:

@JaredBusch said:

@travisdh1 said:

@JaredBusch Does the coverage for the rest of the family make as little sense as having yourself covered?

That coverage is the same for the entire family.

Ah, sorry, poorly worded question. I was wondering if the entire family actually ever hits the deductible?

I hit my high deductible last year when I had my appendix removed. I ended up paying 2500$ out of pocket. Thankfully the company I was with at the time picked up the other 2500$.