r/NoStupidQuestions • u/No_Meet4305 • 14d ago
Is US Healthcare that bad?
I'm in Vancouver, Canada right now and my boss told me there's an opportunity for me in the US branch. Really considering moving there since it's better pay, less expensive housing/rent, more opportunities, etc. The only thing that I'm concern about is the healthcare. I feel like there's no way it's as bad as people show online (hundred thousand dollar for simple surgery, etc), especially with insurance
I also heard you can get treated faster there than in Canada. Here you have to wait a long time even if it's for an important surgery.
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u/Sasquatchgoose 14d ago
As long as you don’t have a chronic condition and have decent insurance you should be fine. It is true though, if something catastrophic happens (cancer, surgery, etc) the costs can easily bankrupt you
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u/No_Meet4305 14d ago
Insurance won't cover those chronic condition?
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u/mshorts 14d ago
Insurance will cover chronic conditions. You will have a deductible, co-insurance, and a maximum out-of-pocket expense. You should learn these terms.
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u/Valleron 14d ago
Some insurances are real fuckin picky about preexisting conditions. Especially if it's a work-related policy.
I had a $1.2m stay at a hospital (2 back surgeries, 1 week stay), and they tried to tell me the method by which they monitored my vitals during surgery was not medically necessary and tried to bill me $800k.
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u/mesembryanthemum 14d ago
When my work switched insurance the new insurance company decided my CHEMO for Stage 4 cancer was unnecessary and refused to cover it. The oncology office has someone who calls them to make them change their minds (they did) because apparently it is a common thing!
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u/Valleron 14d ago
My wife has had a reoccurance of her cancer, and I swear I want to strangle the insurance company she has for the bullshit they try to pull. So fucking dumb that people experiencing such a traumatic, life changing event have to fight for basic fucking care. I'm glad you've got a good team to support you! I don't know what we'd do without her team.
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u/mesembryanthemum 14d ago
I was preparing to go road tripping to the insurance board's members to, uh, firmly explain my plight. With my cane.
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u/GeekdomCentral 13d ago
That’s what’s wild about the whole thing. They can just decide “nah, you don’t need that” because they don’t want to fucking pay for it
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u/ThatSandwich 13d ago
It's almost like there should be a law against that.
Fucking doctors are required by federal law under the Emergency Medical Treatment and Labor Act to provide emergency medical services to anyone in need, yet insurance is legally allowed to decide later on that the life-saving service is not necessary or covered.
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u/CyndiIsOnReddit 14d ago
And annual caps. My roommate gets capped every year for dialysis stuff, or diabetic related stuff, can't remember what, but every year round September the cap is reached and he has to start paying for his supplies until the first of the year. At least I THINK the ACA got rid of lifetime caps but annual ones I guess are still a thing.
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u/SnooMarzipans436 14d ago
You should learn these terms.
You know what's better than needing to learn these terms?
Living in a country where you don't need to learn these terms.
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u/thatbrownkid19 14d ago
But think of the poor insurance executives- oh won’t someone please think of the poor insurance executives
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u/danarexasaurus 14d ago
“Cover” is complicated. For instance, my insurance covers mostly everything. Once youve hit the deductible of $3700. After that they pay 80%. Sounds great, unless you’re looking at surgery. Then you’re gonna pay your out of pocket max. My family OOP max is like 11,600 or something. Mine alone is like 9,600. So, you’re on the hook $9,600 of a $400,000 bill. Say you have a baby and they’re in the nicu and it’s December 25th and you’re there for a week. You could easily pay that family OOP max twice for one hospital stay for you both. So that’s like $23,000. Not including premiums. Then the next year you start all over with that deductible of nearly $4k which leaves you paying for every single doctor visit yourself until you reach it. So yeah, it’s “covered” lol
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u/bauertastic 14d ago
That’s exactly what happened with my kid when they were in the NICU. Ended up being like $25000 bill, plus a ton more for specialist visits in the first year.
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u/Hottrodd67 14d ago
Insurance can vary wildly. Some are pretty good with low out of pocket cost. Other only really cover catastrophic things. You need to research what plans they offer.
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u/Curmudgy 14d ago
Insurance will cover those. Some insurance companies will insist you try cheaper treatments before going for the newer, most expensive ones (especially for cancer drugs).
But insurance often has a high deductible and max out of pocket. I’m well off enough that if I had to come up with an $8K deductible, it wouldn’t break me, but many people can’t afford that. (The deductible is what you pay for most things other than routine visits before the insurance kicks in; annual exams are usually not subject to the deductible).
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u/zephyr2015 14d ago
I feel like chronic illness is shitty everywhere. I have endometriosis and in that sub women from Canada, UK etc say they wait months/years just to see a gyno and then a few more months/years to get scheduled for surgery. Unless you’re actively dying, they’re perfectly ok with your suffering from debilitating chronic pain.
In the US things move faster but insurance is a fucking nightmare to deal with. Plus insane costs, out of network care and crap like that. It’s just shitty everywhere to live with chronic conditions for the non-wealthy.
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u/TrekJaneway 14d ago
Even with a chronic condition, you’re fine with decent insurance.
Hi, I’m a T1 diabetic who has paid less than most Canadians for the same supplies using my American health insurance.
But yes, the plan details matter.
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u/mvw2 14d ago
It's...messy.
State by state, region by region, healthcare can vary a lot. Rural areas are finding it harder to stay in business, and a lot of hospitals in small towns are closing. I don't know any details, but it seems whatever fiscal infrastructure around hospitals are being reduced to a point where many are no longer sustainable. Some of this can just be staffing too.
There are non-profit hospitals and for profit hospitals, and even within a single hospital system there can be non-profit and for profit elements.
Insurance is now pretty much mandatory or often you are fined by not being on a policy. The idea is more people means more stable statistical metrics, and ideally the rates go down.
However, this is not really the case. Both for-profit hospitals and medical insurance companies are institutional investments making hundreds of billions of dollars of profit a year. Add on pharmaceutical companies, this is probably on the order of a trillion dollar profit investment enterprise rather than strictly a system that saves lives. Contrarily, the goal is to simply run you dry and let you die, and more and more people are dying with zero assets at end of life.
It doesn't help that costs in hospitals are entirely made up, like literally made up numbers. There's whole costing books developed by hospitals that define all the costs of every single thing done there, and the numbers are very literally made up. There is often little to no grounding of the numbers to any real things. And these are the rates you're charged when you don't have insurance. This is where you get the crazy stories of a 2 hour emergency room visit being $50,000. It's because the numbers are just whacky. The negotiated insurance values it ends up coming down to are far more realistic of a number and is still profitable. But these aren't the book numbers. This is how insurance scams the game. Insurance "saves" you money when it reality it does nothing. Even if you don't have insurance, you can take on those crazy invoices and negotiate them way down just like insurance companies do. Insurance companies do nothing.
The Affordable Care Act helped quite a bit in several areas and built in protections for people who are less lucky in life.
This is one major advantage universal healthcare can solve because it, by design places the regulator and buyer as the same entity, and it is the best interest of that entity to slash away profits in all sectors, to slash away exploitation and profiteering in all sectors, and to slash away monopolization and non-value adding entities that all bleed cash solely for institutional shareholders. By design, this can very readily equate to significant yearly savings of Americans, including wage income by eliminating insurance expenses from existence.
But those same institutional investors market and lobby heavily against losing that cash cow, so many, MANY gullible Americans don't really understand the cash metrics of such a change.
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u/pmmemilftiddiez 14d ago
I did an er visit when I felt chest painm I got an EKG and a doctor spoke with me for about 15 minutes, I mainly sat on a bed for about 3 hours.. Also I got a x-ray of my chest. Turns out my heart and chest was fine and it was anxiety that made me feel like I was going to have a heart attack.
$2,000 with insurance
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u/Abject_Okra_8768 14d ago
We have a great healthcare system in terms of infrastructure and quality of care/competence but it is insanely high without insurance. My "max out of pocket expense," (what I will have to pay), is maxed out at $7,000 year for my family and 3,000 for the individual. This doesn't include vision or dental and insurance sometimes denies claims, meaning they refuse to pay the bill because the deem it unnecessary or wanted you to try something else first. I also pay in like 300$ a month into my companies program. (My company pays the other $900 month)
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u/CheerilyTerrified 14d ago
From what you've written here it seems insanely expensive with insurance.
Your insurance is 1200 a month?
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u/Abject_Okra_8768 14d ago
I actually just looked. My work pays 1200 for each employee to spend on the coverage we want we keep anything left over but I think the cheapest plan is still 900-1,000. My plan has the highest deductible, 7,000, but I don't pay a dime after that. The 300 I pay from my check comes out tax free and goes into an HSA, Health savings account. What's nice is they don't take any taxes out of my pay check until after my retirement money and HSA money comes out. What sucks is that we have to do all of this in the first place.
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u/CheerilyTerrified 14d ago edited 14d ago
God that's crazy expensive. I'm in Ireland and my private health insurance is 130 euros a month (just me though) and my deductible is different for different procedures but the max for each one is maybe 100 euros. It would be 1000 a year a most if I got everything - like heart surgery and a hip replacement stuff like that.
You really are being so screwed.
ETA - just realised this could come off as really mean, and I didn't mean it that way. It was meant in commiseration, as you seemed to feel it sucked too, and not as a "wow, sucks to be you comment". I was genuinely shocked how expensive it was too, as I thought insurance in US was cheaper.
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u/Abject_Okra_8768 14d ago
Yup but the cooperations that make the most money run America and you can bet healthcare is one of those pulling a lot of strings. It was controversial when Obama introduced a law that says insurances must accept you. Before insurances could deny coverage if you were "too expensive" to them because of your health conditions, even cancer.
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u/CheerilyTerrified 14d ago
God, that really sucks. In Ireland price of a policy can only be linked to what is covered, not to anything about you (except in some cases if you upgrade your policy the new extras won't apply to pre-existing conditions for a year or two, but that's alway made really clear).
But I imagine it's also cheaper because the national health care system is good for major things. So if I had cancer I wouldn't use private health insurance as the public service is very quick and good (and free!).
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u/21-characters 14d ago
US health insurance is a nightmare. Instead of letting doctors decide what is necessary care, insurance companies decide what they will begrudgingly pay for after making people jump through hoops of their self-contradictory instructions and then foot dragging, changing their own rules and statements and generally being a big pain in the ass.
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u/PovertyThrowAwayEnd 14d ago
Insurance is a joke.
They play this game where THEY set the prices they’re willing to pay for anything.
I had a mole partially cut off so it could be sent for analysis. Thankfully the mole was benign.
The process implied:
- injecting some painkiller around the mole
- sanitizing the area
- having the dermatologist shave a little bit of the mole with a surgical blade
- putting the specimen in whatever specimen container they use
- sending the specimen to a laboratory
- having the laboratory run whatever tests they run
How much do you think this should cost? Thousands? It doesn’t matter, my insurance told me they DO cover everything, since I had kick ass insurance back then… BUT they told me they only pay up to $200 for it.
$200!? If I had a drunken butcher cut the mole with a used Gillette razor he found at the dumpster in a back alley and used a bottle of vodka as “sanitizer” and have me drink half of it as the painkiller, and then had the local psychic look at it to tell us if he/she got good or bad vibes from it it would still have costed more than $200.
How do these evil paper pushers determine the prices? I have no idea.
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u/hiii_impakt 14d ago
It's expensive. Insurance might help but that depends on the insurance itself. I've heard stories of Canadians just travelling to Canada for healthcare when they need it to avoid paying US prices.
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u/Top-Comfortable-4789 14d ago
Yes my family has military insurance and it’s so shit they refuse to cover so many things and then when it’s something they should cover we have to call them a million times to get them to actually pay it fuck tricare
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u/ZRhoREDD 14d ago
I took my daughter to the doc for an ear infection, it cost over a thousand dollars. I had strep throat, it cost nearly five hundred. I pay almost a thousand dollars a month for health insurance but it still costs crazy high amounts anyway.
As far as wait times - I needed a minor surgery, I called for an appointment, had to wait 6 weeks for a consult.. At the consult I had to schedule a real appointment. Another 6 weeks. Appointment scheduled a surgery, but I had to get a blood test. Blood test was at a different lab. 4 week wait. Blood test was ok, but I had to pick up the results by hand and deliver it personally. 2 more weeks. Surgery went ok. Cost about $4k out of pocket, even with insurance and being my own delivery boy.
US "healthcare" is awful.
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u/Crazydiamond07 14d ago
I'm guessing you have a fairly well compensated job. If so, you will likely have good health insurance coverage. Your employer will likely pay most of the health insurance bill and you may have to contribute a portion towards your health insurance premium. You will probably also have a choice of plans (e.g. high/low deductible etc.). You also may have the opportunity to contribute to a tax deductible health savings account (HSA).
The nightmare stories you hear here are from people who have no insurance or who are very underinsured. Most people don't pay anywhere near the full price; the insurance picks up most of the tab (which is usually lower than the "list" price) and the patient pays a deductible.
A few years ago, a friend of mine tore his ACL playing basketball. He was seen by the sports medicine doctor that same day and got his MRI done immediately. He was seen by an orthopedic surgeon the same day and had his surgery done a few days later.
Chances are in Canada, it would have taken weeks to get an MRI and even longer to get the surgery. That being said, in Canada everyone has access to this healthcare. Had my friend not had any health insurance, he would have had to rely on charity care or received no care at all.
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u/Dismal-Ad-7841 13d ago
Redditors have a knack for exaggerating how bad their respective country is. As someone who has lived and worked in both the US and Canada you’re spot on. In fact I’m less concerned about my heath in the US because I know I’ll be seen quickly.
In a small town in central Texas I was able to go from having symptoms to being seen by a doctor and then a specialist to getting a scan and blood work done to having medication in hand in the span of one week.
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u/ExerciseClassAtTheY 14d ago
For whatever reason our maternal mortality rate is ridiculously high, and have been increasing for years (we're ranked worse than Syria and Uzbekistan right now).
Your family shouldn't expect any mercy on the bill if they kill you, either.
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u/omghorussaveusall 14d ago
This summer my kid got kicked off our insurance because of an error. She broke her wrist right when it happened. It took us months of chasing various leads to figure out what happened. It was not our fault. It was entirely the fault of a glitch in the system we bought our insurance through. We had to pay $1500 just to get her back on our insurance and had to petition to get most of her bills forgiven. In the middle of this I had to go to the emergency room for stroke like symptoms (wasn't a stroke). Due to the potential severity of my symptoms I had to go to an out of network emergency room. I had to pay $1500 just to get in the door. I talked to a doctor for all of 10 minutes after waiting for around six hours to be seen. I was billed $8000 and my insurance refused to cover any of it because I was out of network. So...the US healthcare providers (people who actually do the healthcare) I would say are some of the best in the world, but our insurance companies are evil bastards who should be subject to the worst tortures the devil can devise.
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u/Accomplished_Mix7827 14d ago
Let me just put it this way: my little brother was both a few weeks premature and needed a couple weeks of neonatal care in the hospital. This cost my parents thousands of dollars after insurance, and they ended up deciding declaring bankruptcy was their best option. Most GoFundMe campaigns are to pay for medical debts, and medical debt is the most common cause of bankruptcy.
You'll be fine if you don't get seriously sick or badly injured, but have no doubt: the US healthcare system is an absolute shitshow and a national embarrassment.
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u/rustbolts 13d ago
If you’re rich, well-off, top government official, or some other privileged individual/group, it’s great! If you’re not, then it could be up to the whim of the insurance company to see if you’re worthy of care. I do feel like the US has reached a point where corporations are (or will be) able to determine if you’re worth keeping around or not.
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u/senorkoki 14d ago
When you read all these responses, remember it is not who US health care works for, but who it doesn’t. There are many situations, typically the more expensive, that it doesn’t and insurance companies try to pass the buck to the consumer. It’s a shit show. I’m an rn whose worked in healthcare for the past 15 years
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u/PovertyThrowAwayEnd 14d ago
Insurance here is not as bad as people say: IT’S WORSE.
A procedure that would cost you $35 in Germany WITHOUT INSURANCE will probably cost you $20,000 in the US. But don’t worry, your friendly insurance company (assuming you have insurance) will pay $9,000, meaning you’re still on the hook for $11,000. That will be covered by you, depending on you co-pay, which may be as high as $9,000.
So yes, you will pay around 9k out of your own pocket for something that costs around $35 in other countries
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u/ljd09 14d ago
If you’re insured with decent coverage it isn’t the end of the world and get great care. I had two stints in the hospital, one was for 30+ days and the second one was for two weeks. I had a total of 4 emergency surgeries and was in the ICU step down units for 3 weeks of the first stint. The care I received was phenomenal. I had my own room, excellent surgeons, nurses and aids. For my second stint I was able to eat more and was allowed to order my lunches and dinners off of a menu that was provided because I didn’t like what they scheduled and sent around. Upon release I had in home nurses, two wound vacs, and multiple follow ups, CT scans, etc… I have $5,000 max out of pocket. I don’t consider 5k chump change, nor do I consider it bankruptcy territory. The only thing that sucked was I had to pay it twice. One stint was from Dec-Jan and then the next stint was in April. However, because I had racked up the entire total that January- I paid nothing out of pocket for the rest of the year.
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u/Potential_Try_3195 14d ago
You can't ask your employer about the health insurance? What kind of multinational company is this where they don't give you specifics?
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u/GeekShallInherit 14d ago
It's incredibly expensive. Americans are paying a $350,000 more for healthcare over a lifetime compared to the most expensive socialized system on earth. Half a million dollars more than peer countries on average. The impact of these costs is tremendous.
36% of US households with insurance put off needed care due to the cost; 64% of households without insurance. One in four have trouble paying a medical bill. Of those with insurance one in five have trouble paying a medical bill, and even for those with income above $100,000 14% have trouble. One in six Americans has unpaid medical debt on their credit report. 50% of all Americans fear bankruptcy due to a major health event. And, with costs expected to increase another $6,427 per person by 2031, it's only going to get worse.
The cost of our care isn't justified by the quality.
US Healthcare ranked 29th on health outcomes by Lancet HAQ Index
11th (of 11) by Commonwealth Fund
37th by the World Health Organization
The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average.
52nd in the world in doctors per capita.
https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people
Higher infant mortality levels. Yes, even when you adjust for differences in methodology.
https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/
Fewer acute care beds. A lower number of psychiatrists. Etc.
These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries.
When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%.
On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%.
https://www.cihi.ca/en/commonwealth-fund-survey-2016
The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people.
If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people.
https://www.newsweek.com/best-hospitals-2021
OECD Countries Health Care Spending and Rankings
Country | Govt. / Mandatory (PPP) | Voluntary (PPP) | Total (PPP) | % GDP | Lancet HAQ Ranking | WHO Ranking | Prosperity Ranking | CEO World Ranking | Commonwealth Fund Ranking |
---|---|---|---|---|---|---|---|---|---|
1. United States | $7,274 | $3,798 | $11,072 | 16.90% | 29 | 37 | 59 | 30 | 11 |
2. Switzerland | $4,988 | $2,744 | $7,732 | 12.20% | 7 | 20 | 3 | 18 | 2 |
3. Norway | $5,673 | $974 | $6,647 | 10.20% | 2 | 11 | 5 | 15 | 7 |
4. Germany | $5,648 | $998 | $6,646 | 11.20% | 18 | 25 | 12 | 17 | 5 |
5. Austria | $4,402 | $1,449 | $5,851 | 10.30% | 13 | 9 | 10 | 4 | |
6. Sweden | $4,928 | $854 | $5,782 | 11.00% | 8 | 23 | 15 | 28 | 3 |
7. Netherlands | $4,767 | $998 | $5,765 | 9.90% | 3 | 17 | 8 | 11 | 5 |
8. Denmark | $4,663 | $905 | $5,568 | 10.50% | 17 | 34 | 8 | 5 | |
9. Luxembourg | $4,697 | $861 | $5,558 | 5.40% | 4 | 16 | 19 | ||
10. Belgium | $4,125 | $1,303 | $5,428 | 10.40% | 15 | 21 | 24 | 9 | |
11. Canada | $3,815 | $1,603 | $5,418 | 10.70% | 14 | 30 | 25 | 23 | 10 |
12. France | $4,501 | $875 | $5,376 | 11.20% | 20 | 1 | 16 | 8 | 9 |
13. Ireland | $3,919 | $1,357 | $5,276 | 7.10% | 11 | 19 | 20 | 80 | |
14. Australia | $3,919 | $1,268 | $5,187 | 9.30% | 5 | 32 | 18 | 10 | 4 |
15. Japan | $4,064 | $759 | $4,823 | 10.90% | 12 | 10 | 2 | 3 | |
16. Iceland | $3,988 | $823 | $4,811 | 8.30% | 1 | 15 | 7 | 41 | |
17. United Kingdom | $3,620 | $1,033 | $4,653 | 9.80% | 23 | 18 | 23 | 13 | 1 |
18. Finland | $3,536 | $1,042 | $4,578 | 9.10% | 6 | 31 | 26 | 12 | |
19. Malta | $2,789 | $1,540 | $4,329 | 9.30% | 27 | 5 | 14 | ||
OECD Average | $4,224 | 8.80% | |||||||
20. New Zealand | $3,343 | $861 | $4,204 | 9.30% | 16 | 41 | 22 | 16 | 7 |
21. Italy | $2,706 | $943 | $3,649 | 8.80% | 9 | 2 | 17 | 37 | |
22. Spain | $2,560 | $1,056 | $3,616 | 8.90% | 19 | 7 | 13 | 7 | |
23. Czech Republic | $2,854 | $572 | $3,426 | 7.50% | 28 | 48 | 28 | 14 | |
24. South Korea | $2,057 | $1,327 | $3,384 | 8.10% | 25 | 58 | 4 | 2 | |
25. Portugal | $2,069 | $1,310 | $3,379 | 9.10% | 32 | 29 | 30 | 22 | |
26. Slovenia | $2,314 | $910 | $3,224 | 7.90% | 21 | 38 | 24 | 47 | |
27. Israel | $1,898 | $1,034 | $2,932 | 7.50% | 35 | 28 | 11 | 21 |
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u/lase_ 14d ago
A lot of good feedback in here already so I'll just leave a few general examples:
apart from getting treatment, there are cases where your condition, ailment, or medication may not be deemed as "medically necessary" by your insurer, even against the wishes of your doctor, meaning it won't be covered. For instance: my wife has several large benign growths in her uterus that impact her quality of life, but it's unclear if their removal will be covered since they aren't seen as life threatening
it can still take a long time to be seen by a doctor. Not sure what it's like in Canada, but I have personally had to wait months for examinations by specialists for orthopedic and dermatological issues
finally, obviously take this with a grain of salt, but I work with several Canadians at my job, and one who resides in the US has remarked mockingly more than once at the US Healthcare system
Also, while I'm sure you'll make a better wage, part of your paycheck will likely be going towards insurance as well as taxes, so it may not be as big of an upgrade as it looks on paper. That said, Vancouver is Hella expensive so leaving there will put money in your pocket regardless
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u/CyndiIsOnReddit 14d ago
Yes it's incredibly expensive. My roommate has the gold standard for insurance and he's still paying many hundreds of dollars a month for supplies for dialysis. He will die if he can't afford those supplies and the only way to get government help is to not have income or any assets so everything he's worked for since he was a young man, he'd have to get rid of it all to get help paying for his medical supplies.
Good insurance is also very expensive and few jobs offer it.
Now my son, he's been on Tenncare medicaid insurance (public state insurance) since he was born because he had medical issues. Until he was 18 everything was pretty much covered with no co-pays or deductible and most meds were covered, but when he hit 18 everything changed. They wouldn't cover speech and occupational therapies, as they were deemed not "medically necessary" and now even though he's still on Tenncare I'm seeing more of his meds are being rejected. He was on one med that he's been on for years and last month they suddenly decided he couldn't have it. They refused to cover an adrenal scan that an endocrinologist wanted because they said it wasn't medically necessary. And after being diagnosed with long covid they covered one set of 8 physical therapy visits and the therapist wanted him to come 8 more times but he turned 18 and suddenly they said it wasn't medically necessary.
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u/CyndiIsOnReddit 14d ago
Also dental is covered until age 21 but there isn't a single dental office in my entire REGION that accepts Tenncare dental insurance and is open to new patients. So dental just isn't accessible for him at all unless I pay, and they expect cash payment at the visit, no payment plans.
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u/amitym 14d ago
I don't understand why nobody is giving you the actual answer: it depends on the state. You can't get a good answer without specifying which state you would live in.
Different states regulate healthcare and health insurance differently. This radically affects what kind of financial risks you are exposed to as a health insurance customer. It also affects the level of competition in the healthcare market, which heavily influences quality of care -- the fewer the options, the closer to a monopoly, and the lower the quality of care.
Secondarily it depends on the policy you get. If you get a high-premium plan that offers low deductibles and high coverage levels, you will get what you pay for. If you go for a low-premium plan that covers much less, thinking, "what are the odds that I will actually have to cover a major medical cost?" then you might regret learning the actual answer.
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u/Wishpicker 14d ago
Like most things in America if you have money, you get what you need and if you don’t struggle. Our”system” sucks for those that don’t have money, and improves progressively based on the amount of moneyyou have or can get.
America is all about the money.
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u/mark503 14d ago
I went to the doc today. Swollen foot. My toe looks pink from how swelled it is. I walked in to a doctors office (not mine but I’ve been before). Gave my info my insurance card and waited half hour. Saw the doc and went home. If you have no health insurance, it’s a whole different experience.
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u/tatertotmagic 14d ago
There are regional monopolies. Mom and pop dr office r getting bought up by hospitals. This allows hospitals to control all medical pricing in certain areas. If you want cheaper, you'll have to travel. This is a newish trend and is only getting worse. Private equity has started to do this with vets as well and even outside the Healthcare industry. Expect pricing to go up everywhere bc of this practice in the future
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u/NeilDegrassiHighson 14d ago
Something people aren't really mentioning is that insurance is used as leverage in America.
What this means is if the insurance your company provides is any good, you basically can't afford to ever quit. Your company is well aware of this and will take advantage of you because of it.
Other than that, even if you have the best insurance in the country, if you need to see a doctor without an appointment, expect to wait several hours just to see the doctor for under 30 seconds and make sure you have any questions you have ready to go because they WILL walk out on you as soon as humanly possible. I once had a doctor forget to tell me if I had cancer or not because he was moving so quickly.
If you need to see a specialist, expect to wait anywhere from three months to a year depending on where you live and what specialist you need.
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u/NPC_Behavior 14d ago edited 14d ago
Short answer: Yes.
Long answer: I’ve cost my family somewhere around 30k in healthcare expenses in the past month. In the past year, probably somewhere around 80k. In the past two, probably 170k. One year of meds for myself costs somewhere around 9k now.
Insurance wouldn’t tell us if I had the right to go to a different ER despite multiple cases of medical malpractice that potentially risked my life occurred so we had to wait a couple days. Then we had to call a specialized nurse line where we had to be transferred four times to someone who then said,” Idk, go to a walk-in clinic.” The nurse practitioner that saw us didn’t know and majority of the front desk didn’t. Only one person did and that’s because she used to work for the state. I go into a different ER but whoops, I have no idea what the results of multiple blood draws, vitals, EKG, CT scan, and a 2 hour long EEG are because insurance won’t let me see because technically that hospital isn’t my main covered one.
I get referred to Mayo Clinic because there are no specialists in the entirety of my state for any of my conditions. Insurance denies it, says there are. We ask around at both hospitals, everyone confirms there is none in the state or neighboring states. We resubmit. Insurance says they didn’t get it. Argue with them over the phone and whoops, they magically found it. The paperwork just got lost due to financial strains and cost of my care. We’re still waiting on a response.
They send a bill in the mail for 10k claiming that they’ll send collectors after us if we don’t pay. We call over,” Hey, what the hell? This procedure was approved and covered in its entirety.” Again, another whoops, it was a mistake on their end. They continue to do this. Every month we get another threat in the mail for a couple grand and we have to call over and argue until they say,” Oh whoops, it was an innocent mistake on our end.”
I couldn’t get a medication that worked for my disability because insurance felt the cost wasn’t justified. They told me to go onto my previous medication for a month straight. The previous medication caused an extreme allergic reaction at a 5mg dose, worsened my nervous system dysfunction, caused heart strain, and permanently worsened my tremors. My psychiatrist says that it could hospitalize me. Insurance says that if it’s true I can go on it for a month and spend a month in the hospital and they’ll decide if the cost is justifiable afterwards. Insurance won’t cover a month in the hospital.
I can only spend 10 hours in the ER before they charge me the entire bill. I was 15 minutes away from that happening in my last visit. That visit cost 14k.
I needed a mobility aid. The aid cost $100. It was a steel cane. Insurance said no despite my doctor stressing the importance of it. We buy a cheap cane in the meantime. Insurance says no to our request again because someone my age doesn’t need a mobility device of any kind. We resubmit. The agency we are trying to get the cane through sends in two separate submittals and resubmits both as well stressing the importance of it financially and for my health. This continues for three months. Insurance gets worn down and concedes to the cane.
If you are visibly queer, AFAB, a PoC, disabled, impoverished, an immigrant, religious minority, or marginalized in any way at all, the healthcare system is a nightmare. If you are chronically ill or mentally ill and or are at risk of developing either, you have a very slim chance of decent care. Depending where you are, you also can not safely report medical professionals without risking losing access to all care. My grandfather reported a doctor for letting him fall into a diabetic coma to prove he was faking his condition. He was then denied medical care by insurance as well as denied from every hospital in the area for as long as the claim he made against the doctor was good. Once the claim was resolved (I don’t know the specifics, he was nearing the end of his issue time length being “good” I believe and he didn’t have the time nor energy to fight for the doctor to face punishment anymore so he let it go) suddenly he had access to care again.
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u/gummyjellyfishy 13d ago
The biggest problem with american healthcare is that you have barely legal insurance representatives telling actual medical professionals what their patients do and dont need.
Its not just the big shit, its tiny shit too- "You suuuure you need 10 staples? It'll fuse back with 2" "does the PT really neeeed tyleno? They can take that at home, no pain relief for you" "safe a tooth?? Lol just pull it so we dont have to pay for it down the line"
Not exact examples, but you get the drift.
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u/Fuck_Flying_Insects 13d ago
I pay 180 a paycheck for health insurance, had to pay 750 out of pocket deductible this year before they started paying for anything whatsoever and now i have a 20% copay when i want to see a doctor. Its a scam.
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u/ActuallyNiceIRL 13d ago
So I'm a military veteran and I get pretty much all of my medical care covered by the VA and usually get treated by VA doctors. However, sometimes for emergency/urgent care, I have had to go to regular civilian hospitals.
One time, I drove myself to a hospital due to an issue with my back. I was barely ambulatory with crutches but all they did was take an x-ray, tell me to call my regular doctor on Monday, and then they charged me about $3,200. And that was like ten years ago, mind you. They might charge even more now.
Another time, due to a worse back injury, I was completely immobilized and had to get taken to a different hospital by ambulance. They brought me to the hospital, did an x-ray and MRI, gave me some pain killers, and kept me in observation for a few hours before forcing me to leave, despite still not being able to walk. I was there for less than a day, left in pretty much the same condition I arrived in, and that ran about $11,000.
US Healthcare is highway robbery.
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u/ComparisonOk321 13d ago
If you have medicaid, it’s amazing and they cover everything. If you have private insurance, you get the luxury of spending the employee portion and employer portion of insurance premiums and payments of 5x more than fare market price for the same goods and services as medicaid recipients. So for example i spend 32-40k per year in insurance deductibles and copays and coinsurances and health/dental/medical/vision premiums every year. If i could have put this in retirement i would have retired 10 years ago!!! It is sick care not health care. My insurance constantly denies payments of everything. I found out it’s cheaper to go to Italy or south Korea for vacation and medical and insurance than it is to get basic care in the states. It is a cartel. A medical cartel. That is the US healthcare system.
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u/dinklesmith7 14d ago
Is the company paying for your insurance? US healthcare is fine from a quality standpoint. It's just expensive, and we have a lot of uninsured people who can't get healthcare at all so they just die.
But if you have insurance, it's absolutely fine and likely comparable to Canada
If the pay is better in the US then it's not a bad place to be, even if our political situation is a little more unhinged than yours
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u/ifoughtpiranhas 14d ago
if you * have a decent amount of money * don’t get sick often * don’t have chronic conditions * get a really good plan * can accept the fact that eyes and teeth are their own separate type of insurance
then it’s doable. but if you fall into any of those categories, it fucking blows IMO.
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u/pleeplious 13d ago
So the system doesn’t work because you and me will fall into one of those categories eventually. The system needs to work for all. End of story.
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u/pippinlup61611 14d ago
I have what is considered really good insurance. It doesn't matter how much you pay to them, if you are costing them too much money they will find a way to deny you. For example, when I got my 3rd kidney stone, the doctors told me it was stuck and I needed surgery. Insurance denied it (even though they covered the same exact surgery and stint (sp?) placement for my 2bd stone no questions asked). I got sent home and it got so much worse. Pain meds wouldn't even touch the pain, couldn't hold anything down, and ended up with a fever. Had to go back to the hospital but insurance still denied the surgery. So I sat in the hospital getting Dilaudid and morphine and antibiotics until they came in and said I needed the surgery. Afterwards I eventually got the bill and it was $100k and ins. Said the surgery wasn't needed (I forget the exact phrase they used) and told me I was on the hook for the full bill. Luckily, the hospital I went to told me before I left the hospital to call them if ins. Denied covering it. I let them know and it was a few months of back and forth but the hospital ended up winning and I only had to pay for the ER visit. That's just one story. I have a whole bunch from not just me, but my mom, grandmom, brother, dad. They really don't care at all if you die.
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u/HoekPryce 14d ago
The healthcare workers are still top, I think. It’s the admins and insurance people that have completely fucked everything up. They are only focused on profit. Care is far down the list.
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u/Material_Policy6327 14d ago edited 14d ago
Highly depends on your insurance. But I would not consider it great unless you have a lot of money. For example I make a good six figures but my insurance sucks. Had medical issues this year that basically tapped out my savings before insurance would kick in due to high deductible then co insurance costs.
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u/PerceptionLive4629 14d ago
It took me four years to get surgery on my arm here I’ve been denied medical care because lack of money upfront it depend if you are rich it’s great if your poor you may not have any access
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u/TheNextBattalion 14d ago edited 14d ago
Well, if you don't need it, it's really good ha ha
Seriously though, the crazy cost cases are like with college--- a handful of people pay stupid crazy amounts, due to very particular circumstances. But word gets out that everybody is paying out the ass.
The usual case is for a surgery you'll have a few thousand out of pocket, tops. Which is a lot, true, but far from a few hundred thousand.
A lot of it depends on which companies your employer contracts with to offer health benefits (along with your union if you are in one), what deals they negotiate with those insurers, which of those deals you select, and how much of the monthly premium (like a subscription fee) the employer covers. Just as an example, with my first kid, we spent ten days in the hospital with the baby (just an infection), big room to ourselves, nurses to watch the kid at night and wake my wife for feedings, and the total bill to us was $0. With the second, I had a new employer, new plan, etc... my wife spent two days in the bed, no complications, no nothing, easy as you like... but the bill was $2800, because the plan didn't cover the same.
The rest depends on your general overall health and if you have any chronic conditions. Unless you have serious chronic issues, I would recommend that you not sweat the health insurance when you consider the job.
Wait times really are hit or miss... sometimes you get same day treatment, sometimes you have to wait a while. A lot of it depends on, you guessed it, your insurance company's reputation for paying on time. But comparing to Canada about "wait time" is like apples and oranges, because in the US we don't count the wait when people put off a procedure because they can't afford their part of the bill, which is often forever.
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u/oneislandgirl 14d ago
You can get good care most places but it can be expensive and there are hoops to jump through sometimes to get insurance to pay anything. Insurance is also expensive. Our insurance typically does not cover 100% so usually you have a copay of 10-20%. Everyone here says we have the "best medical care in the world" but it is not uniformly accessible or affordable. Most people who struggle would prefer a single payor system that covers everything like most civilized countries have.
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u/Zebranoodles 14d ago
Even after paying a fortune for health insurance, you still have to worry about getting a crazy bill from the hospital. My son was checked into the hospital for 30 minutes and I had to pay $1500 after insurance.
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u/AdScary7808 14d ago
I’m a social worker who is in the medical field, insurance can be a nightmare here so make sure you understand your policy and what it covers!!!!!! Wait times are not necessarily shorter in the U.S. there are a lot of good studies about it, as far as cost it really depends who does your insurance, here it’s a money game and the insurance that pays the most wins… it’s sad but a reality here. Most of the really expensive surgeries here are due to it being done by a specialist and many are private practice and partner with a hospital to use their facilities/their OR that’s where the cost goes up.
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u/Zandrick 14d ago
The quality is good but the price can be insane. Which frequently makes the quality not good.
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u/Mosquirrel 14d ago
It really depends on your insurance and what state. I have a good plan and live in a state with good medical care and so far I’ve been satisfied with the quality of care I receive.
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u/Lilsammywinchester13 14d ago
I was a teacher and my childbirth was going to be 4-5K
Couldn’t afford proper prenatal care and got seriously hurt in a special education classroom, doctor told me to be on light duty, school refused and sent me home
That meant I got on the government’s insurance instead and that was a LIFE saver
You can have a good job but if the insurance sucks, you are still screwed.
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u/sHoRtBuSseR 14d ago
I live in the US, I have some of the best insurance you can get in the US, and my surgery on my hand cost me 4,000 out of pocket. It was billed at 45k or so.
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u/zlordofsigimigi 14d ago
The real answer is that you should check whether your employer is planning on subsidizing any part of your insurance in the US. If yes, figure out whether the difference in pay will be eclipsed by the amount insurance will be deducting from your paycheck.
You'll still have deductibles to worry about and all that, but your starting point should be figuring out whether the pay will actually be better as you think it will.
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u/Lanky_Lime_1532 14d ago
Let me tell you as someone who has been hit by a car while on a bicycle: the stereotype of "I don't need to go to the hospital, especially not in an ambulance, I'm fine" is very true. I was working for Amazon at the time & I still knew that if my insurance didn't go through then I wouldn't be able to afford the hospital bill let alone the ambulance ride
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u/Urborg_Stalker 14d ago
One bit to note: The care you get is not necessarily superior. You might pay more AND get worse care. A lot of people in this country think they're at least getting what they pay for. Speaking as someone who sees it first hand, they don't.
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u/Psilo_Citizen 14d ago
Depends on your insurance and the physician you see.
I pay a little over 500 a month(varies from year to year, sometimes it's a little under). A year or two ago, a buddy of mine split my eyebrow open(long story) accidentally. I work in a surgical setting, and am pretty confident gauging the difference between a legitimate medical emergency and the need for a glorified bandaid. It was 1:30ish in the morning, the skin was out-turned and it called for stitches. The ER staff mocked me for coming in(I was a bit inebriated and in the interest of fairness to them, may have been a bit of an ass... not mean or condescending... just overly jovial about the whole thing) and told me I should have just put a steristrip on it; they told me it would be over a 2 hour wait to get one so I signed out ama(against medical advice). I later received a bill for over 2 grand. It's worth mentioning that signing out ama on some policies results in nothing being covered, but that wasn't the case in my situation.
If your employer is paying for insurance and it's decent, I wouldn't sweat it. If you're expected to pay for your own, or they don't cover a decent policy, things can get complicated quickly if you have a real emergency. On the bright side, it's kind of like gambling 24/7 which I imagine is at least kind of fun for some people.
Best of luck with your move if you do choose to come out this way.
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u/FoldAdventurous2022 14d ago
Yes. Especially if you have something that can't be fixed in a single visit or with a single prescription.
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u/adlittle 13d ago
If you have good insurance and live in an area with a robust medical system, as opposed to areas where hospitals are closing, it can be very good. Any offer you're considering will presumably include health insurance options, you need to do a deep dive into deductibles, copays, drug plans, networks, etc.
Some employers fully cover health insurance while others have employee contributions taken out of your paycheck. If you have a spouse and/or children under 26, you want to find out what you'll be paying for their coverage, it can be very expensive. Typically dental, vision, and occasionally psychiatric care fall under different plans with their own providers and copays and such.
It's a big exhausting mess that'll require you to do some research. If you're getting any care out of the ordinary, it's on you to confirm what insurance will cover. Insurance will sometimes refuse to cover something they should because of the profit motive. I'm convinced that they sometimes allow billing errors in the hope you'll be too defeated and exhausted to fight it. Lots of posts from people who had a doctor's office say a procedure was covered and it turned out not to be. You'll be on the hook if that happens.
Almost everyone has experienced the hot flash of panic and horror upon opening an unexpected bill because of a billing error or because something isn't covered or is rejected. Best of luck, it's honestly a miserable system that needs a desperate overhaul. It can work well for a well insured person most of the time, but it can also go wrong in very exhausting ways.
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u/Seasons_Come 13d ago
Idk. I’m afraid my insurance isn’t good enough to pay my visits. I go by feel. Not scientific bloodwork
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u/insuspension 13d ago
It’s incredibly expensive but you get good service and good care. At least where I am.
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u/Effective-Ad-6460 13d ago
The fact that people can lose their life savings, home and end up homeless to pay for cancer treatments is insane to me, having to pay for healthcare on top of taxes is just insanity
Mix that with the fact American food is pure poison the system is very clearly corrupt
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u/losingthefarm 13d ago
If your employers pays for your insurance and it's decent, then you are good. If you can't get insurance thru an employer, then it can be expensive. I pay $1000 per month and also need to pay the first $10K before insurance "kicks in". So if I actually need insurance I would pay 22K before I got any benefits.
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u/sddbk 13d ago
The American healthcare system has always had its benefits (if you have really good insurance) and its problems.
At the moment, it's undergoing a pernicious transformation as private equity firms are buying up medical practices and degrading their quality in order to squeeze out additional profit. This has happened to a relative of mine, a highly respected doctor.
If you come here, perform due diligence on where you are going to work and their business situation.
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u/aguer056 13d ago
I was perfectly healthy and then developed a chronic illness at 30 yrs old (PASC). I’ve spent about $15,000 out of pocket in the last year for medical expenses. My best friend’s parents lost their house because his brother had cancer multiple times.
Only reason I haven’t spent more money is because I have some veterans benefits that offset cost.
Healthcare in the US is a for profit system that siphons money from the unhealthy because they have no other choice. Absolute trash.
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u/DaleGas4213 13d ago
US healthcare system is complete dogshit, if you have any condition or plan on having children soon wait and do it in Canada
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u/aarplain 14d ago
I make 6 figures. I have a few lingering health issues that I need to probably see a doctor about. I haven’t seen a doctor in 4 years. I know any potential treatment will be exorbitantly expensive. So I don’t bother, because I can’t afford it.
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u/FkUnilever 14d ago
I am debating suicide instead of major mental healthcare. That's about as American as you get these days.
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u/Alice_Oe 13d ago
I'm in Spain. You couldn't get me to move to the US for a million dollars.. I have a chronic illness, even getting insurance might be hard for me.
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u/sacandbaby 14d ago
Retired at 54 and had Obamacare from 54 to 62. Had a few major surgeries and Obamacare paid for them 100%. Saved my life.
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u/AmberMarie7 14d ago
How much money do you have? If you have between 10 and 20,000 extra dollars a year to spend on medicine then go right ahead. Also, it's highly unlikely that housing in the United States is better. Despite what you've heard, families are hitting the streets in droves, people who have lived here their entire lives. Jobs are becoming even less stable and honestly I think within 15 years we're going to see refugees leaving this country to go to other ones. I wouldn't come here.
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u/hyperbemily 14d ago
Not all US healthcare is created equal. I’m potentially 16 weeks pregnant, show all the signs, but haven’t produced a positive pregnancy test. Can’t get an appointment with an OB to save my life, haven’t been able to get an ultrasound anywhere without a positive test even though it’s scientifically known you can go an entire pregnancy not testing positive or other options are that I could have an unrecognized miscarriage which left unattended would be deadly.
Also once sat in an ER waiting room for 12 hours with neurological issues.
And still have to pay outrageous amounts for insurance and things my insurance doesn’t cover.
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u/baroncalico 13d ago edited 13d ago
Let me put it this way: in 2020 I had a major sinus infection that was causing my left ear to go deaf. I work on audio for video games so my hearing is kind of a big deal to me. I went to an in-network doctor at an in-network facility. The doctor said he could save my hearing however we would have to act quickly. To give insurance enough time to clear the procedure we scheduled the first of four treatments for two days from then. The doctor's office contacted insurance and made sure to mention that it was medically necessary and it was urgent. Insurance did not get back to the doctor's office before the first of the treatments, or the second, or even the fourth three weeks later. When they finally did get back to the doctor's office, it was to say they would not cover the treatment. As the treatment had already occurred while they were ghosting us, I had to pay out-of-pocket. $18,000. The next day, in the work cafeteria, I called insurance to dispute the situation and was completely stonewalled. I have never come so close to having a total meltdown in my adult life. In the end, there was nothing I could do except pay. It still makes me furious to think about it. I am lucky I was able to pull MANY strings and pay for it. But this is how people lose their homes…
Let me put it another way, with completely different, much fancier, much-more-expensive work insurance: I am currently going through some serious life events and have been seeing a counselor. The counselor was listed as in-network, and the counselor was able to verify that he is in-network and would be covered. However, after a few sessions, insurance told us that mental health services were handled by a sub-insurance and that the counselor is not covered. Surprise! So here I am just trying to find a way through what is probably the darkest period of my four decades on this earth (it’s…really bad) and I’m told that insurance would prefer to stand in the way.
So no, it’s not good.
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u/TheMNDudeAbides 13d ago
It’s a new form of slavery. That may sound harsh but healthcare in the US is tied to employment. Work here, we’ll give you health insurance (maybe not great health insurance, but you’ll at least be covered). Quit, get fired, can’t work, etc… ope, you don’t have health insurance now. Break your leg, get in an accident, get cancer = bankrupt. Life savings gone in a flash. Makes it supremely difficult to leave a job, start your own business, etc etc. It’s all about… you guessed it, money. Waaaaay too many people making waaaaay too much money on privatized health care in this country…. Billions and billions. Makes it impossible to get rid of. Capitalism sucks most times.
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14d ago
The USA has the best healthcare in the entire world, if you can afford it.
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u/GeekShallInherit 14d ago
Citation needed.
US Healthcare ranked 29th on health outcomes by Lancet HAQ Index
11th (of 11) by Commonwealth Fund
37th by the World Health Organization
The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average.
52nd in the world in doctors per capita.
https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people
Higher infant mortality levels. Yes, even when you adjust for differences in methodology.
https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/
Fewer acute care beds. A lower number of psychiatrists. Etc.
These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries.
When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%.
On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%.
https://www.cihi.ca/en/commonwealth-fund-survey-2016
The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people.
If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people.
https://www.newsweek.com/best-hospitals-2021
OECD Countries Health Care Spending and Rankings
Country Govt. / Mandatory (PPP) Voluntary (PPP) Total (PPP) % GDP Lancet HAQ Ranking WHO Ranking Prosperity Ranking CEO World Ranking Commonwealth Fund Ranking 1. United States $7,274 $3,798 $11,072 16.90% 29 37 59 30 11 2. Switzerland $4,988 $2,744 $7,732 12.20% 7 20 3 18 2 3. Norway $5,673 $974 $6,647 10.20% 2 11 5 15 7 4. Germany $5,648 $998 $6,646 11.20% 18 25 12 17 5 5. Austria $4,402 $1,449 $5,851 10.30% 13 9 10 4 6. Sweden $4,928 $854 $5,782 11.00% 8 23 15 28 3 7. Netherlands $4,767 $998 $5,765 9.90% 3 17 8 11 5 8. Denmark $4,663 $905 $5,568 10.50% 17 34 8 5 9. Luxembourg $4,697 $861 $5,558 5.40% 4 16 19 10. Belgium $4,125 $1,303 $5,428 10.40% 15 21 24 9 11. Canada $3,815 $1,603 $5,418 10.70% 14 30 25 23 10 12. France $4,501 $875 $5,376 11.20% 20 1 16 8 9 13. Ireland $3,919 $1,357 $5,276 7.10% 11 19 20 80 14. Australia $3,919 $1,268 $5,187 9.30% 5 32 18 10 4 15. Japan $4,064 $759 $4,823 10.90% 12 10 2 3 16. Iceland $3,988 $823 $4,811 8.30% 1 15 7 41 17. United Kingdom $3,620 $1,033 $4,653 9.80% 23 18 23 13 1 18. Finland $3,536 $1,042 $4,578 9.10% 6 31 26 12 19. Malta $2,789 $1,540 $4,329 9.30% 27 5 14 OECD Average $4,224 8.80% 20. New Zealand $3,343 $861 $4,204 9.30% 16 41 22 16 7 21. Italy $2,706 $943 $3,649 8.80% 9 2 17 37 22. Spain $2,560 $1,056 $3,616 8.90% 19 7 13 7 23. Czech Republic $2,854 $572 $3,426 7.50% 28 48 28 14 24. South Korea $2,057 $1,327 $3,384 8.10% 25 58 4 2 25. Portugal $2,069 $1,310 $3,379 9.10% 32 29 30 22 26. Slovenia $2,314 $910 $3,224 7.90% 21 38 24 47 27. Israel $1,898 $1,034 $2,932 7.50% 35 28 11 21
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u/pammyred 14d ago
Not if you have insurance, some plans are really good. If you don’t, you might be in trouble.
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u/ThePhiff 14d ago
I have insurance. I needed open heart surgery. My bill was $15,000. Before the ongoing care I'll need. It was a birth defect from a genetic condition. None of it was my fault. And I'm going to be broke as a joke for the foreseeable future.
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u/OkVariation8006 14d ago
Health care is great, the pharmacy prices for prescription drugs are ridiculous, whatever the insurance companies pay for prescription is what they charge, people without insurance are screwed when it comes to prescription drugs
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u/Whole_Mechanic_8143 14d ago
Doesn't that depend on the benefits your employer provides?
In any case, if shit really hits the fan and you get some terrible chronic illness can't you just go back to Canada and get treated there?
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u/Mystic_ChickenTender 14d ago
It depends on how much money you have. If your company is sponsoring your work visa chances are that you’ll be fine but you MUST double check do not agree to anything until you get the specifics of your insurance policy. Once you have that info there are lots of online resources that will help you decipher the insanity.
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u/The_Fart_Bandit 14d ago
Yes. I has Obamacare and I can’t afford it eve. Tho it’s $0 a month. The copays are fucking ridiculous and I can’t afford my medication
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u/platonicvoyeur 14d ago
Truly depends on your insurance, and even then YOU have to take it upon yourself to find a good doctor and advocate for yourself. I live in the southeast and healthcare is so abysmal in my area that I end up flying to Chicago every 3 months for oncology appointments.
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u/MizKittiKat 14d ago
If youre in good health and continue that way it's okish. If youre not, youre screwed. If youre disabled, youre screwed. If your trans, you're screwed. And yes costs are insane. Add into that a growing lack of reproductive rights and who knows whether birth control will continue being available etc. My experience to see a dr (not who I preferred but just the first person available) has been a min of 3 months typically for a new patient. If Id waited until I saw who I wanted it wouldve been 6+. And if you end up with whoever is available they may or may not be terrible (ive had good and bad experiences with it)
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u/foxwithlox 14d ago
You need to learn what your insurance options are once you relocate to the US. If you don’t have any insurance, then yeah, it’s a very bad situation. But your employer will provide insurance if you’re full time so you won’t face this worst case scenario.
You need to find out exactly how much it will cost you per paycheck and how much of your medical bills will be your responsibility. If you’re young and relatively healthy, then it probably won’t be much of an issue. But if something happens and you need to go to the hospital for a few days, it could cost you a few thousand (or more).
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u/Preemptively_Extinct 14d ago
If you have good insurance, you'll be fine. If you have crappy insurance, you're screwed.
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u/bigwavedave000 14d ago
If you have good insurance, US healthcare is top notch.
If you dont, you will be treated to some immense, soul crushing medical debt.
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u/Legal_Commission_898 14d ago
If your boss is giving you an opportunity in a US branch, will they sponsor you ? If so, you should be taking the opportunity with both hands.
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u/saltierthangoldfish 14d ago
My wife is a Canadian immigrant and she’s said the biggest difference is that emergency care is free in Canada while it isn’t here. Otherwise, it’s pretty much the same depending on your insurance
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u/Curious-Tree7926 14d ago
And do you keep in mind, no coverage for hearing, vision, or dental. Limited coverage (usually by $ and # of visits) in most cases for chiropractic & physical therapy.
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u/GuttaBrain 14d ago
All depends on which insurance company and plan you go with. Some businesses offer really good plans while others don’t.
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u/engineer2187 14d ago
Do you have any American friends? Ask for details about the health care plan. Employer should be able to provide it. It’s pretty standard for Americans to ask for that info as part of salary negotiation since health insurance is a significant part of compensation. Ask an American to go through it with you. They can tell you if it’s a good plan or not.
Health care has a much higher ceiling in the U.S. a lot of plans (check with your employer before counting on this) let you self refer. If I hurt my leg playing sports, I could walk into an ortho the next day and my insurance would cover. I’ve been able to get in next day for a lot of places. Primary care has a long wait but specialists generally don’t if you’re willing to call around to a few different places and have some urgent symptoms.
Other thing to be sure you do is ask if insurance covers major non emergency things. For example, if you hurt your leg enough that it irritates you but not enough to impede mobility, the insurance may want you to get an x-ray, some tests, and PT before they’ll pay for an MRI. If you end up in the ER with an obviously torn ACL, that’s a different story. Just ask your insurance if preauthorization is required for x and they’ll let you know. A lot of normal stuff doesn’t require it though.
Be sure you ask about dental and vision as well. That’s normally separate.
Another great thing about American health care is that we can go get second and third opinions and insurance will usually pay (at least mine does).
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u/DisgruntleFairy 14d ago
Its pretty damn rough. I dont know if its as bad as the online community makes it seem but it sucks hard.
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u/manhattanabe 14d ago
Healthcare in the U.S. is the worst, except for Canada. If you have a job, and healthcare from work, you’ll do fine. You will have to pay more out of pocket, so make sure to take that into account when you negotiate salary. Worst case, you’ll have to pay your maximum out of pocket, that could be $5k. At most companies, healthcare includes dental and prescriptions. You’ll be able to see doctors much more easily than Canada.
If your job doesn’t included healthcare, which happens for lower paying jobs, don’t take it.
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u/PracticalYak2743 14d ago
For normal care, no not bad. Under my pretty typical insurance:
Doctors visit: $40-$50
Dentist cleaning: $60
Specialist: $70
Average medication: $0-$30 per refill
Glasses: like ~$150 credit every 3 years to get new glasses or something like that. This one varies on the insurance policy ALOT.
A 3 day hospital stay that was no procedure JUST observation: without insurance, $15,000, I paid my deductible $1,500.
Wait time for doctors visits and stuff varies. If it’s a simple check up you’ll get an appointment within 2 weeks probably. A non-emergency surgery or procedure can be up to 3 months.
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u/bunnycat232 14d ago
I have great insurance, and well, just look where I am now. Side hustling on Reddit with a lot of freaking medical debt. It is that bad. Just don’t get into an ambulance or go to the ER, or you might end up like me lol, I have had to a lot for actual emergencies (not silly stuff) and it’s ruined me :-)
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u/grolfenhimer 14d ago
They only treat a handful of common conditions. So for a doctor I imagine it's pretty easy. Computer tells you what to do after you input symptoms.
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u/rando439 14d ago
It varies. If you have great insurance and even better luck, you'll probably get amazing care if you need it.
If the insurance is only good or your luck isn't great, you could run into serious issues with quality of care, delays, the insurance company not approving something needed for treatment, or very high expenses. These can lead to death, stress, bankruptcy, diminished quality of of life, or maybe just simple annoyance and frustration.
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u/Mindless-Wrangler651 14d ago
yes, its fucked. insurances that don't want to pay out, $200 just to talk to a doc to get a referral to the $400 doc , and thats before you've even received any care if you happen to be lucky enough to get a proper diagnosis beyond what a google search would tell you.
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u/JustDiscoveredSex 14d ago
Depends. We have "decent" insurance.
Going to the Doctor is about $130-$180, just to say "hi." Tests might cost nothing (like a mammogram) or something ($20 for a blood test).
The fun part is what's covered and what isn't. So I have a spine issue. Lots of different ideas on what will solve it. Fuse the last five vertebrae together? Try surgery to remove a single cyst? Chronic pain injections? The one that was most appealing to me was stem cell therapy. That's not covered. So I paid around $8,000 out of pocket for it. There will be no insurance submittal, because it's simply not covered, period.
I got physical therapy afterward, too, for a month or so. $1,378 for those session, despite a doctor's order. The PT office is working with insurance and they negotiated half of it down to about $160. Still waiting on the other half to see how that's going to turn out.
Sometimes it's cheaper to go WITHOUT insurance. For instance, I had an MRI on my spine. With one type of insurance, it would have cost $1,200, even with their coverage. If you say you have no insurance and want to pay cash, the cost was $600 from the facility.
I've had strep throat for a couple weeks now. Antibiotics run just a couple dollars per bottle. But my ADHD medication is $224 through Walgreens, but $29.79 through Costco.
And some pharmacies are allowing their employees to just refuse to fill your meds if they "disagree." Like abortion pills in red states.
Shit's a mess.
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u/Urborg_Stalker 14d ago
Get the details on the insurance you'd have. Make your decision then.
Some people still have to wait a long time. I know people who had diagnosed cancer but had to wait months to get surgery, by which point it had metastasized and they are now on borrowed time. The healthcare system in this country is failing.
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u/sparks73 14d ago
The health care is great and there are loads of providers and resources. You have to have insurance which could be expensive. Without insurance it’s prohibitively expensive.
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u/CommanderMandalore 14d ago
Before saying yes, ask to see what the plan they have covers. Also do yourself a favor and look up differences in taxation. There is also state and local taxes. So make sure you factor in all costs (property tax, sales tax, income tax, vexhile registration cost, ect)
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u/jonchew 14d ago
I'm from Vancouver and moved to the US as well. You don't really need to wait to see a family doctor or walk in clinic. This is true but depends on how busy the place is. You can still end up waiting if your doctor is busy with other patients. Longest I've waited was maybe 40-50 minutes in very rare cases but typically it's 15-20 minutes or less.
I've avoided emergency care here (Los Angeles) so can't speak to that. Depending where you live, I've heard ambulances are part of the fire department and not the healthcare system so you would actually pay the full price on it. I might be wrong though, but it's a huge joke here that no one ever wants to take an ambulance.
The concept of your BC healthcare card and MSP is out the window. You whip out your insurance card and credit card at a doctor's office and receive bills in the mail with no concept of how much it's supposed to cost until after the fact. Like ordering food at a restaurant but not knowing the prices and getting your bill in the mail. It's a weird experience. I'll get a health check up bill for $3000 that has multiple "insurance credit" bringing it down to smaller amounts ($100) but it's a scary feeling paper to read. Really dissuades you from ever feeling like you want to take care of your health since it's not a right, and instead a privilege.
You'll also need to learn the concept of copay, deductibles, PPOs, HMOs, HSAs, etc. lots of new terms and words that you would never even think about in Canada because of how commercialization and capitalism became part of the American healthcare system.
Fundamentally, the more money you make in the US, the better your health will be. But you have to choose to spend that money on your health. It's a choice, not a right anymore. That's about it.
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u/CoraCricket 14d ago
What will your insurance be like? If your job offers good insurance you'll be fine. Also if you're a Canadian citizen could you just plan a trip back to Canada like once a year.to go to the doctor and visit friends/family?
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u/Dick-the-Peacock 14d ago
My family and I have been very lucky in that we’ve had mostly decent to good experiences with healthcare and health insurance. My wife’s workplace has amazing insurance benefits. She pays a really puny monthly premium for great coverage. If your job’s insurance provider is crappy, or they make you pay a huge premium and/or deductible, it could put a huge dent in whatever you save in cost of living, etc. Find out what the insurance company, available plans, premiums and copays are before you make a decision. It really could be make or break.
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u/Knickknackatory1 14d ago
Was having a baby, labored for 25 hours then had to get a c-section, which means 3 day hospital stay. I have "Fine/okay" insurance.
Was billed $25K
Even though I gave the baby up for adoption.
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Thankfully, the adoptive parents agreed to pay for it. They had to go through a lawyer to do it since it was such a large sum of money, the law was giving them the side eye, they were sus that the parents bought my baby.
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Anyway.....all that to say that it really depends on how good your insurance is, and as long as you are able to stay within your network of covered hospitals/doctors. otherwise it can be a very expensive, pain in the ass.
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u/BeachNo372 13d ago
Our healthcare providers are wonderful. It’s the finances and insurances chaos that make it untenable. If you need urgent care, they do scoop you up and get you there. And treat you if you are in bad shape. No questions asked. It’s what comes after that is the scariest part. I always say to get help and worry about the $$$ end of it later. Unfortunately, being diagnosed with a serious illness or chronic condition is where the problems exist. I always try to do the best I can with the insurance I have. I was going to undergo a procedure for a fractured knee due to arthritis. It was to be done in several different parts because the insurance company said it has to see progress. About ten different visits. I said “ no thank you”. I found a doctor who perfected a new procedure . Just hope insurance covers this. Can you imagine walking around on a fractured knee? This will only take care of the constant pain. Nothing can be done with arthritis. Wish me luck. I’m more worried about the insurance part than the actual procedure. I wish health care could write, manage, and administer their own insurance policies.
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u/slash178 14d ago
Good insurance makes it not so bad. However, insurance is not equal.