Medical Bills-No insurance

[JimJ]

How do folks without medical insurance survive (other than not getting ill?).

I had angioplasty and stents placed in my aorta and illiac artery (the artery going to leg) last fall. The doctor's "rack rack" was $22,000 and the 8 hours in the hospital (including the stent cost) was $84,000. Medicare discounted these amounts to about $1,200 and $12,000, respectively. I also have a secondary insurer, so my out-of-pocket is manageable.

I can't imagine how people without insurance can survive financially. I have always had pretty decent insurance coverage (even before Medicare kicked in). However with so many companies cutting back (or even eliminating insurance coverage) and with people getting "downsized" at their jobs or losing jobs through mergers, we are seeing a continually increasing medical crisis in this country.

I have friends over the years that planned to work until 65, but in their late-mid 50's lose jobs for various reasons and have to try to find private coverage. The cost is nearly prohibitive and coverage not all that great with high premiums and huge deductibles.

The housing and mortgage crisis is bad (but was predictable), but combined with outrageous medical cost and the rising fuel prices (which affect about everything), I really fell sorry for the younger generations.

 

[pjrose]

The United States is the ONLY developed/wealthy country that does not have some kind of universal health care. Just as we assume our kids can get a free education in public schools, those in other developed countries assume health care. It does come at the cost of much higher taxes, though.

 

[Liz Wolf-Spada]

A friend and I were just talking about this very issue. Most Western European democracies have free medical care, free college level education, guaranteed retirement pensions, much more paid vacation time etc. Yes, they do pay more in taxes, but if we didn't have to worry about costs of college, medical costs, retirement etc. maybe it would work out about the same and reduce so much of the anxiety so many Americans experience daily.
Liz

 

[ricoba]

Having lived in a country with socialized medicine, let me just put it graciously, that there is no way I would want the US to follow that country's health care system.

Having said that, I think we should all probably think twice about posting regarding this, since this subject can easily become very political.

 

[Fern Modena]

I had a medial epicondylectomy, a type of elbow/nerve surgery last August. I have a pretty good PPO. Even still, the nearby surgi-center was "out of network," and if I wanted to be "in network" I would have to go across town to UNLV (which has its own problems). The surgi-center's charge for 2-3 hours use for my surgery was $7500. However they agreed to accept my insurance payment (which was $3750.) as long as I paid $300. up front as a co-pay. There is a lot of high charging and then discounting in the medical world. The surgeon in the same instance billed $3,000. and accepted $1030. including my 15% copay.

My annual maximum (deductible and copay) is $4,000. My calendar year is July/June. I am $105. from reaching my maximum. I have less than two months left, and I feel pretty good, so I probably won't make it...

Fern

 

[dougp26364]

Having lived in a country with socialized medicine, let me just put it graciously, that there is no way I would want the US to follow that country's health care system.

Having said that, I think we should all probably think twice about posting regarding this, since this subject can easily become very political.

You just hit the nail on the head for those that think socialized health care is the next greatest thing. Those that have it and have medical issues generally don't like it. I've seen more than one or two Canadians come down south to get the care they needed.

There is definately a problem with the uninsured in the U.S. and it cost's those that are insured and the hospitals millions. How do the uninsured afford health care? Many don't. Taxpayers and insurance companies get hit with the bill in the form of higher bills from hospitals to cover the losses from the unisured. The circle goes on when hospitals cut deals with insurance companies to direct their patients to certain hospital's and doctors, thereby increasing what is billed to those without insurance. Basically, both sides drive up the costs. Then you have the feds that tell the hospitals what they'll pay and that the hospital and doctors must accept what they say as payment in full. Another layer gets added when hospital accrediation services demand hospital impiment certain policies or procedures to maintain their accredidation.

I could go on but, I don't want to get political. It's not really political so much as it's a huge buerocracy in which the Peter Principle reigns supreme.

 

[chellej]

I know exactly what you mean - it is so expensive. I put $5000 in my flex account and it is gone for the year - dd had knee surgery and our insurance pays 90%. Good thing the flex renews in September. DH put $2000 in his flex and it is on a calender year and it is gone too.

I am regretting not maxing out DH's flex as well. DS is having a Brain MRI tomorrow and DD is having a nerve block on Thursday - both will be out of pocket for the copays which hurts even more - it isn't as painful when it comes out of the flex account.

 

[charford]

I've lived in both Canada and the U.S. I much prefer the Canadian system.

 

[LMD]

negotiate

If you have no insurance you can always try to negotiate with the facility. I know someone without insurance who negotiated with the hospital to pay medicare rates for the services in cash....they accepted.

 

[Rose Pink]

One of the things that frustrates me is all the paperwork and phone calls. We must get a referral to see anyone other than our PCP--that makes extra work for him, his office staff and for me. How this is supposed to save costs is beyond me.

DD will need COBRA for three months before the insurance at her new job becomes available. I called DH's employer last month to get some idea of how and when to proceed and was told to call back this month--leaving me less than confident they knew what they were talking about. Interestingly, both the persons I spoke with had heavy Indian accents--and both had American names (yeah, right). So now I am calling India to get help with insurance?

I've had great difficulty getting our flex monies reimbursed. The company that handles that seems to be less than efficient--to put it mildly. I have to fax and fax and call and call--and rage and rage to be taken seriously.

Then, as Doug mentioned, you can't always go to the provider of your choice--you must go to the provider of your insurance company's choice--or pay even more. I'm not stupid. I can research doctors and facilities and find the ones that best suit our family. And even when I do find someone in our plan, they no longer accept new patients--at least from our insurance!

I spend many hours just managing our health care expenses. Life isn't simple when it comes to health care insurance, etc. How this is all saving us money is beyond me.

The only thing "managed health care" has managed to do is to take the "care" out of "health care." Oh, and to put big bucks into corporate America. Health care should never be profit-based. I don't mean that it should lose money, but there is something immoral about making a profit at the expense of someone's life.

And I've probably crossed the line re TUG rules. Forgive me. I just had to get it off my chest.

I want to add that even with all the frustration of dealing with the system, I am still profoundly grateful to at least have something. I can't imagine not having access to care--even if it is driving me crazy trying to manage it.

 

[Tia]

A friend of ours had a 20 something son in a serious car accident a few years back. He had no insurance and there was no medical coverage on the car. BIG medical bills, think $50K. Well he lost his job and his apartment, so moved home. The providers had to write off the majority his parents were not going to pay the bills and the young man couldn't. Parents did arrange for followup care and paid for that. This family has 3 uninsured 20 something kids still.

 

[vacationhopeful]

Choices --

My friend in his late forties chose to buy a new truck instead of joining a small group health insurance plan ... didn't need the truck, just buys a new one every three years. Both payments about equal. His kids get covered by the state low income plan as he deducts the truck from his income.

Another friend needs knee surgery - told him to go to Thailand or the VA hospital ... he has choosen to allow his 24 yo to live rent free in his rental house instead of paying for med ins. And his 24 yo is single, getting tattoos left and right, and with no coverage also. Advised him that he could lose BOTH houses if he ever needs serious care.

Yes, I pay for coverage. And feel like the others should also.

 

[Hophop4]

If you have no insurance you can always try to negotiate with the facility. I know someone without insurance who negotiated with the hospital to pay medicare rates for the services in cash....they accepted.

This is what happened to me. My hospital bill alone was over 150K (not counting all the other bills) for my spine surgery 18 mos ago. We had to pay 10% and the hospital wrote the balance off. My additional monthly treatments since then, I was only charged Medicare prices and discounted. I started this Monday with another round of Chemo now and guess what....no charge!! I am on Medicare now as of May 1st. My birthday is May 8th ....65 finally!!!
It was rough.

 

[ricoba]

While I agree that there is a problem with our health care system, there is no way that I would like to see a single payer plan (ala Canadian style) instituted here. While I agree that a single payer system works well for "first aid"/basic medical needs, it does not work as well in serious and complicated medical problems. Just recently there was an article in the Vancouver Sun detailing how the Province of BC had to send over a 100 women out of Province to either Alberta or Washington State, for complicated pregnancies, simply because they could not offer the needed care in British Columbia.

I worked with a woman from Australia, and as I understood it, there system seemed practical. But I just can't remember the details of the Australian system. Perhaps someone from Australia can enlighten me on how their system works.

 

[london]

Universal Medical

A friend and I were just talking about this very issue. Most Western European democracies have free medical care, free college level education, guaranteed retirement pensions, much more paid vacation time etc. Yes, they do pay more in taxes, but if we didn't have to worry about costs of college, medical costs, retirement etc. maybe it would work out about the same and reduce so much of the anxiety so many Americans experience daily.
Liz

Liz

I agree with your post totally.

 

[PStreet1]

For me, the issue is choice of doctor when I really need one. I don't care who treats my virus or takes a throat culture; I care hugely who operates on my hand. I already have issues with the hospitals/doctors where we live because we live in an age restricted community; most people in the area are on Medicare (including me). I have a lot of difficulty believing that the best doctors have chosen to practice in that area. Maybe there are huge numbers of doctors who find old people fascinating...but I doubt it. When I look at the "best doctors" issue of the local magazine, I don't see many in that part of town. I think some of those factors are in play for those who have experienced state operated health care and like/dislike it.

 

[DG001]

There should be a happy medium - I don't want a Canadian style system here either, but it just baffles me how privatized healthcare is so inefficient in the US!

I heard this analogy somewhere about the medical insurance in the two countries - its like everyone in Canada drives a 10-y-o Toyota while some people in the US drive a Caddilac and some get the Chevy and others walk!

I have lived through both systems. I used to think like Ricoba, but now I just don't know. However, if I ever need "real medical care" (not just preventive), I would much rather be driving the Caddilac here!

Also, though lack of medical staff like in BC is a problem everywhere (just ask my friend from rural Maine - 4 PCPs in one year - none of them stuck!) I think the Canadian problem is probably worse because of the "brain drain" in the medical field.

 

[Fern Modena]

For those of you who think you'd like state-managed health care, ponder this. Not only is there a wait for certain procedures (and hey, Kaiser in California does that too), but they often ration care by age. If you are over a certain age, you just may not be eligible for certain services/surgeries, as they don't consider them to be "cost effective" for older people.

Fern

 

[silvib]

Having lived in a country with socialized medicine, let me just put it graciously, that there is no way I would want the US to follow that country's health care system.

Having said that, I think we should all probably think twice about posting regarding this, since this subject can easily become very political.

Sorry to disagree. I grew up in England, moved to Spain in my early 20's where I spent the next 30 years and had no complaints whatsoever about socialized health care, but then I guess it depends where you were. Yes at times you may need to wait for certain procedures, but the level of care was always excellent. During the latter years, we also carried a private medical insurance which gave more instant attention, but the price was very, very affordable. Ten years' ago, just before coming to live in FL, we were paying the equivalent of $50 each, per month, for full coverage in hospital, including medication. Obviously it will be more than that now, but certainly nowhere near the $800 monthly we're paying for 2 of us, with BlueCross BlueShield of FL.

 

[Rose Pink]

Quoted in May AARP Bulletin

Source (Not) Keeping Up With Our Parents by Nan Mooney

More than 1/3 of the uninsured have household incomes over 40K.

35% of households with incomes between 50K and 75K have trouble paying medical bills and health insurance.

More than 1/3 of those who have both health insurance and medical debt have college or graduate degrees.

Family premiums have increased 87% since 2000, compared to 18% inflation and 20% rise in wages.

As of 2006, only 61% had employer-provided insurance (down from 69% in 2000)

 

[bluehende]

For those of you who think you'd like state-managed health care, ponder this. Not only is there a wait for certain procedures (and hey, Kaiser in California does that too), but they often ration care by age. If you are over a certain age, you just may not be eligible for certain services/surgeries, as they don't consider them to be "cost effective" for older people.

Fern

Fern ;
Have you tried to get an appointment with a surgeon for a non emergency situation. It may be our health care (big company managed system). It sucks. The last time I needed to make an appointment it was a 60 day wait. And this is just to see the surgeon...not actually get any care. And as for age conciderations. Don't kid yourself that American health care will not refuse to do certain surgery's due to the age of a patient.

The one suggestion i heard a certain politician running for president whose husband was president at the time was to force the insurance companies to use a single form. This would cut down tremendously on the office time needed for billing and the subsequent nightmares it causes the patients.

Wayne

Wayne

 

[PStreet1]

Part of evaluating may also be a question of what you've needed in terms of health care. Like any profession, the more you need, the more critical it is who does the job. I taught for years; to say that everyone teaching in the same school I did (and it was an excellent one) was equally good would be ludicrous. As long as the student learned easily or already had the skills, it didn't matter too much if the teacher wasn't that great. If he didn't have the skills already..........well.......it mattered. Medically, if the need is not great, it doesn't matter. If it's a choice between someone and no one, the choice is clear. If the need is great and you have a choice, being able to make that choice is critical.

 

[Liz Wolf-Spada]

I like the idea the citizen's should be able to choose the health care plan that our representative's have, if we so choose. I think there are some key issues we need to address: one is a system that allows coverage for all, no exclusions for preexisting condition etc, two is affordability for all, here is where we see the problem of uninsured people needing to use the emergency room for care and the inherent cost in that. The third area of concern is choice. Some people like managed care, it's easy and if you're healthy, it has little impact. Others like me, hate managed care and refer to it as mismanaged care. I am finally back on a PPO at work. For years it was not available and now with my DH on Medicare, it is cheaper than the HMO for a single person. Another important issue to me is that I don't think health insurers should allowed to be for profit. Blue Shield is the only HMO that I know of in California that is non-profit. Yes, they have costs of about 15%, but for-profit companies pay less in actual coverage and more to shareholders. Traditional Medicare has a cost of only 4%, probably due to volume.

I think we can discuss this without getting "political" and I think we should. It's not who is right or wrong, partisan versus non-partisan, Democrat versus Republican, rural versus urban,it's what ideas are there to solve a problem we all know is huge in our country and is only going to get worse, as many more fully employed people don't have health care insurance offered through their work anymore.
Liz

 

[Passepartout]

In the US, we already have a single payer, 'socialized' (a phrase invented in the McCarthy influenced 50's to make it scary) medical care system with government hospitals and government employee doctors for veterans.

We already have government subsidized private medical care. We call it Medicare.

We already have medical rationing. It's called the 'free market'. Those who can afford it can have any medical care they desire and those that can't afford it 'ration' what they can afford, or live sick.

We already have employer financed medical care for some half of our citizens. It is not portable. If one loses their job, s/he loses their medical care too. (see above paragraph)

But what we don't have is the BEST medical care in the world. Many many countries have longer life expectancies than people in the US. Like Andorra, New Zealand, and most of Western Europe.

We must simply demand better. Many countries have successful medical care programs. This has been studied to death. Yes, it will cost money. But how would it be to live like the Brits, and never see a medical bill from cradle to grave? Like fire protection, medical care should be underwritten for the common good.

Jim Ricks

 

[bogey21]

A friend and I were just talking about this very issue. Most Western European democracies have free medical care, free college level education, guaranteed retirement pensions, much more paid vacation time etc. Yes, they do pay more in taxes, but if we didn't have to worry about costs of college, medical costs, retirement etc. maybe it would work out about the same and reduce so much of the anxiety so many Americans experience daily.
Liz

A girl friend of mine from years ago who is now 50+ and living on a maintenance level of alimony got rid of he anxiety by moving to Mexico. She has learned Spanish, goes to school, says the costs are low and the medical care reasonably priced and great. I'm serious. She used to get all reved up worrying about this stuff and now seems not to have a care in the world.

George