Health care expenses are a massive burden for many Americans, and for some, they can be financially devastating.
A new report from Kaiser Health News revealed some shocking examples of just how bad things can get for some people.
‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes covers the cases of individuals who are dealing with serious financial hardship due to the University of Virginia Health System’s aggressive collection practices.
The article begins with the story of Heather Waldron, who required emergency surgery in 2017. She believed she had insurance at the time – it wasn’t until after her hospitalization that she learned a computer error involving the HealthCare.gov website caused a lapse in her coverage.
The UVA health system slapped Waldron with a lawsuit and a lien on her home to recoup the $164,000 in charges, leading to serious financial hardship for her family:
She is now on food stamps and talking to bankruptcy lawyers. A bank began foreclosure proceedings in August on the Blacksburg house she shared with her family. The home will be sold to pay off the mortgage.
She expects UVA to take whatever is left.
The $164,000 billed to Heather Waldron for intestinal surgery was more than twice what a commercial insurer would have paid for her care, according to benefits firm WellRithms, which analyzed bills for Kaiser Health News using cost reports UVA files with the government. Charges on her bill included $2,000 for a $20 feeding tube. (source)
Waldron is not alone. There are many stories similar to hers – and some are much worse.
The UVA Health System aggressively pursued patients for medical bills for years.
The Kaiser Health News (KHN) analysis found that during a six-year period ending in June 2018, “the UVA health system and its doctors filed 36,000 lawsuits against patients seeking a total of more than $106 million, seizing wages and bank accounts, putting liens on property and homes and forcing families into bankruptcy.”
People who have received treatment in the UVA system are facing a particularly formidable opponent. “UVA stands out for the scope of its collection efforts and how persistently it seeks payment, pursuing poor as well as middle-class patients for almost all they’re worth,” the KHN report explains. Court records, documents, and interviews with hospital officials and dozens of patients revealed that UVA has sued people for as much as $1 million and as little as $13.91.
The system has garnished thousands of paychecks, seized $22 million over six years in state tax refunds owed to people with outstanding bills, sued about 100 patients every year who were their own system’s employees, filed thousands of property liens, and hit some patients with legal fees and interest that added up to more than the original bill. UVA has the most restrictive eligibility guidelines for financial assistance of any hospital system in Virginia. “Savings of only $4,000 in a retirement account can disqualify a family from aid, even if its income is barely above the poverty level,” KHN reports.
UVA Health System spokesman Eric Swensen told KHN that UVA gave $322 million in financial assistance and charity care in fiscal 2018. But legal and finance experts said that’s not a reliable estimate:
The $322 million “merely indicates the amount they would have charged arbitrarily” before negotiated insurer discounts, said Ge Bai, an accounting and health policy associate professor at the Johns Hopkins Carey Business School.
The figure is “based on customary reporting standards used by hospitals across the U.S.,” Swensen said.
Insurers would have paid UVA only $88 million for that care, according to an accounting of unpaid bills presented in September 2018 to the UVA Health board. Even that unpaid figure did not come out of UVA’s purse since federal and state governments provided “funding earmarked to cover indigent care” for almost all of it — $83.7 million, according to Bai.
The real, “unfunded” cost of UVA indigent care: $4.3 million, or 1.3% of what it claims, according to the document.
“That’s nothing,” given how much money UVA makes, Bai said. “Nonprofit hospitals advance their charitable mission primarily through providing indigent care.” (source)
Perhaps the most surprising detail about the UVA Health System is that it is not a for-profit system and does not have shareholders making demands. It is funded with taxpayer and state money (also taxpayer money, of course):
Like other nonprofit hospitals, it pays no federal, state or local taxes on the presumption it offers charity care and other community benefits worth at least as much as those breaks. Democratic Gov. Ralph Northam, a pediatric neurologist, oversees its board.
UVA Medical Center, the flagship of UVA Health System, earned $554 million in profit over the six years ending in June 2018 and holds stocks, bonds and other investments worth $1 billion, according to financial statements. CEO Sutton-Wallace earns a salary of $750,000, with bonus incentives that could push her annual pay close to $1 million, according to a copy of her employment contract, obtained under public information law. (source)
Other hospitals in the US are suing patients too.
Recently, journalists and academics have exposed hospital collections practices in Baltimore, Memphis, New Mexico, North Carolina, Nebraska, and Ohio. In 2014, NPR and ProPublica published stories about a hospital in Missouri that sued 6,000 patients over a four-year period.
NPR recently reported on collection practices at Mary Washington, another Virginia hospital. According to their report, Mary Washington sues so many patients that the court reserves a morning every month for its cases.
Since KHN and NPR exposed the collection practices at the two Virginia hospitals, both have stated they are going to change their ways.
“Gov. Ralph Northam and the president of the University of Virginia committed to changing UVA Health System’s collections practices a day after Kaiser Health News detailed its aggressive and widespread pursuit of former patients for unpaid medical bills,” KHN reported.
NPR added an Editor’s note to its June 25 article about Mary Washington that states:
The day after this story published, Mary Washington Healthcare announced it will suspend its practice of suing patients for unpaid bills, stating: “We are committed to a complete re-evaluation of our entire payment process to ensure that all patients know they have access to care.” When asked what they will do about any patient whose wages are currently being garnished, Eric Fletcher, Mary Washington’s senior vice president, said in a statement to NPR: “We are happy to try to work with that patient and the courts and their employer to try to eliminate the garnishment.” (source)
According to a study published in the American Medical Association’s journal, JAMA in June, an estimated 20% of US consumers had medical debt in collections in 2014. Medical debt has been increasing with direct patient billing, rising insurance deductibles, and more out-of-network care being delivered, even at in-network facilities.
For the JAMA study, researchers looked at Virginia court records from 2017 and found that in the state, 36% of hospitals sued patients and garnished their wages in 2017. They identified 20,054 warrant-in-debt lawsuits and 9232 garnishment cases. Garnishments were MORE common in non-profit hospitals (71%).
“If you’re a nonprofit hospital and you have this mission to serve your community, [lawsuits] should really be an absolute last resort,” says Jenifer Bosco, staff attorney at the National Consumer Law Center, told NPR:
Bosco explains that IRS rules require nonprofit hospitals to have financial assistance programs and prohibit them from taking “extraordinary collection actions” on unpaid medical bills without first attempting to determine patients’ eligibility for financial assistance.
Nonprofit hospitals, Bosco says, “have to provide some sort of financial help for lower-income people, but the federal rules don’t say how much help, and they don’t say how poor you have to be to qualify [or] if you have to be insured or uninsured.” (source)
“Hospitals were built — mostly by churches — to be a safe haven for people regardless of one’s race, creed or ability to pay. Hospitals have a nonprofit status — most of them — for a reason. They’re supposed to be community institutions,” Dr. Martin Makary, one of the JAMA study’s authors and a surgeon and researcher at Johns Hopkins Medicine, told NPR.
Unpaid hospital bills are a leading cause of personal debt and bankruptcy in the US.
According to a study published in the American Journal of Public Health earlier this year, 66.5 percent of all bankruptcies in the US are tied to medical issues, either because of high costs for care or time out of work. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills, the researchers found.
The study, titled Medical Bankruptcy: Still Common Despite the Affordable Care Act, states, “Despite gains in coverage and access to care from the ACA, our findings suggest that it did not change the proportion of bankruptcies with medical causes.”
Prior to the ACA’s implementation in 2014, 65.5 percent of debtors reported medical reasons for filing bankruptcy. After the Act was implemented, 67.5 percent cited medical expenses as their reason. In 2007, an estimated 62.1 percent cited medical bills as contributors to their bankruptcy, and 40.3% cited income loss due to illness.
Other studies have found that at least 25 percent and as many as 50 percent of bankruptcies include significant medical debt, according to a recent report from The Balance.
One study found that the insured were a bit more likely to declare bankruptcy (3 percent) than the uninsured (1 percent), The Balance reports:
Most probably thought their insurance protected them from medical costs. They weren’t prepared to pay for unexpected deductible and coinsurance costs. Almost a third weren’t aware that a particular hospital or service wasn’t part of their plan. One-in-four found that the insurance denied their claims.
How did those with insurance wind up with so many bills? After high deductibles, co-insurance payments, and annual/lifetime limits, the insurance ran out. Other companies denied claims or just canceled the insurance. (source)
According to GoFundMe CEO Rob Solomon, one-third of the donations made through the site help people pay for medical care. Roughly 250,000 campaigns for assistance with medical bills and healthcare costs are set up on the crowdfunding site annually, raising total contributions of $650 million per year.
Millions of Americans are struggling to pay healthcare-related costs.
Even Americans who have insurance coverage are struggling to afford medical bills. As the research shows, health insurance won’t completely protect you. Many people have been bankrupted by high deductibles and other out-of-pocket expenses. This is why you should try to have at least the amount of your deductible in savings.
Rising healthcare costs have serious implications for many Americans. According to a recent report from The Balance, many people cannot afford groceries, rent, and clothing due to medical costs. Many have burned through their savings, and others have taken on extra work to pay medical bills. Some cut back on or skip prescription medications and follow-up care, and many rack up credit card debt and use loans to pay for healthcare expenses.
Here are some more troubling facts from The Balance report:
In 2015, the Kaiser Family Foundation found that there were 1 million adults who declared medical bankruptcy. That is more than those going bankrupt for unpaid credit card debt or mortgage defaults. A 2013 Nerdwallet study found that almost 30 percent maxed out their credit cards, while 8 percent were forced into bankruptcy because the illness cost them their jobs.
Even more disturbing was that 78 percent of them had health insurance that failed to cover all their bills. Sixty percent were let down by private insurance, not Medicare or Medicaid. Ten million of them will incur medical costs they can’t pay off each year, thanks to high-deductible plans.
How did those with insurance wind up with so many bills? Before the ACA, many were sunk by annual and lifetime limits. Others were stuck when insurance companies denied claims or just canceled the policy once they got sick.
But even after Obamacare, many weren’t prepared for high deductibles and co-insurance payments. In 2017, 31 percent of the insured found it difficult to afford copays. That’s up from 24 percent in 2015, according to a Kaiser Family Foundation study. Similarly, 43 percent found deductibles too high, compared to 34 percent in 2015. (source)
What are the causes of rising health care costs?
A recent report from The Balance answered this question. Here are some shocking statistics from that report:
In 2017, U.S. health care costs were $3.5 trillion. That makes health care one of the country’s largest industries. It equals 17.9 percent of gross domestic product. In comparison, health care cost $27.2 billion in 1960, just 5 percent of GDP. That translates to an annual health care cost of $10,739 per person in 2017 versus just $146 per person in 1960. Health care costs have risen faster than the average annual income. (source)
There are two causes of this massive increase – government policy and lifestyle changes, the report goes on to explain:
First, the United States relies on company-sponsored private health insurance. The government created programs like Medicare and Medicaid to help those without insurance. These programs spurred demand for health care services. That gave providers the ability to raise prices. A Princeton University study found that Americans use the same amount of health care as residents of other nations. They just pay more for them. For example, U.S. hospital prices are 60 percent higher than those in Europe. Government efforts to reform health care and cut costs raised them instead.
Second, chronic illnesses, such as diabetes and heart disease, have increased. They are responsible for 85 percent of health care costs. Almost half of all Americans have at least one of them. They are expensive and difficult to treat. As a result, the sickest 5 percent of the population consume 50 percent of total health care costs. The healthiest 50 percent only consume 3 percent of the nation’s health care costs. Most of these patients are Medicare patients. The U.S. medical profession does a heroic job of saving lives. But it comes at a cost. Medicare spending for patients in the last year of life is six times greater than the average. Care for these patients costs one-fourth of the Medicare budget. In their last six months of life, these patients go to the doctor’s office 29 times on average. In their last month of life, half go to the emergency room. One-third wind up in the intensive care unit. One fifth undergo surgery. (source)
The best way to avoid medical debt is by taking care of yourself.
Accidents are often not preventable, and neither are some health conditions.
But many of the health issues that lead to massive medical debt are preventable, including obesity, Type 2 diabetes, and heart disease.
A 2014 study published in The Lancet revealed that
…chronic diseases are the main causes of poor health, disability, and death, and account for most of health-care expenditures. The chronic disease burden in the USA largely results from a short list of risk factors—including tobacco use, poor diet and physical inactivity (both strongly associated with obesity), excessive alcohol consumption, uncontrolled high blood pressure, and hyperlipidaemia—that can be effectively addressed for individuals and populations. (source)
If you’d like to improve your health (and hopefully reduce your risk of accruing medical debt), here are some resources that may help.
45 Ways To Add More Physical Activity to Your Day
99 Healthy No-Cook Meals and Snacks
What do you think?
Do you think the US healthcare system is eventually going to collapse? Do you have any ideas for solutions? Are there things you do to prevent medical debt? Please share your thoughts in the comments.
About the Author
Dagny Taggart is the pseudonym of an experienced journalist who needs to maintain anonymity to keep her job in the public eye. Dagny is non-partisan and aims to expose the half-truths, misrepresentations, and blatant lies of the MSM.
They tortured me on their mind control invention and then shoved me into a Walgreens and told me a prescription of Abilify was going to be 700.00 a month from their damages of thrill torture. If anyone hasn’t gone naturopath by now with organic vegan diet they are just feeding the satanic pig. Supplements help as well I prefer the whole food supplements.
Walgreens needs to be thought of as a company like Nike or Adidas. Designer “brand” and should be avoided.
A friend lost his state sponsored insurance after a raise at work. He could no longer afford the heart medication he was getting at Walgreens. The pharmacist told him to come back when he had the money.
Remember in One Second After where the doc told the Colonel all of his heart patients died when the beta blockers ran out? Same kind of thing here.
I loaned him three of mine and told him to request Walgreens transfer his prescription to Wally World. Same exact medication only instead of $40.00 a month it was $10.00 for three months.
Personally I think the pharmacist should have been arrested and charged with endangerment. Stopping a beta blocker can be fatal and Walgreens should have suggested a more affordable alternative.
Wow that’s awful!!! We haven’t had the best experience with Walgreens either and recently transferred our prescriptions
Obviously we cannot afford the present system
34 countries now have a national health care system.
Introducing a system similar to that of Germany may well help with this problem.
Medical services are the one thing we purchase blind, with no idea how much the bill will be. This allows the hospital to mark up their prices to cover what they discounted to other patients for what their insurance negotiated. We should be presented with an estimate of charges before utilizing their services. How many assume the doctor doing a 10-minute check is under the same system as your insurance, even if the hospital is the one the insurance prefers?
And insurance… they are not on our side. Their goal is to take your premiums and not give out. The more money they keep, the bigger the bonuses are for the executives.
I recently saw an old hospital bill from 1946 that cost the family a whole $75 to bring home their new baby. In contrast, see the comparable costs today on this webmd.com link:
from:
https://www.webmd.com/baby/features/cost-of-having-a-baby#1
“The costs of childbirth can be steep. The charge for an uncomplicated cesarean section was about $15,800 in 2008. An uncomplicated vaginal birth cost about $9,600, government data show.”
I firmly believe that there is no industry which if corrupted by government involvement can’t be cartelized, made outrageously expensive and out of reach for normal people, and regulated into destruction. Two of the biggest cost boosts in medicine came from the health insurance concept (during WWII as a way for industry to compete for employees during wartime price controls on wages) and later, Lyndon Johnson’s signing of Medicare.
Before that, most of the 20th century was a fight to shut down the thousands of years old naturopathic medicine competition to the Rockefeller directed allopathic prescription medicine method. It involved shutting down “unapproved” medical schools, issuing licenses only to approved practitioners, outlawing others, bankrupting them, or running them out of the country, killing off the traditional plant-based medical knowledge, and in some cases simply murdering those practitioners. I have a friend who does tours in a foreign country for prospective immigrants, many of whom are US physicians in fear of their lives here. They are also disgusted with being forced to give up much time with patients to fill out many hours of federally required forms (even if digitally).
There is a reason why the phrase “medical tourism” is a frequent search phrase — most effectively used on non-Google search engines, like DuckDuckGo.com, eg. Whether in Latin America, Europe, or Asia, the costs of competent medical treatment can be a small fraction of what mushroomed costs in this country have become. And there is far greater freedom to use methods that the mega-pharmaceutical companies in this country have bullied the FDA and the Congress into outlawing.
One of the most effective stories to make the point is that of Ronald Reagan’s diagnosis (during his second presidential term) of colon cancer. That didn’t make the news here. Knowlng how deadly was the chemo legally permitted here, Nancy secretly flew him to Germany for quick and effective treatment that allowed him to finish out his second term without the American public ever hearing about it.
There are more complications. Even if you have the bills previously taken care of (such as rights to VA treatment), you can be kidnapped and treated like an escaped prisoner into an “out of network” hospital and kept incarcerated as long as hospital billing figures Medicare can be milked. Medical kidnapping can also destroy your credit rating, so it’s useful to learn how to live without credit. That should tell you how corrupt the credit rating system has become.
Then there’s the billing nightmare. There are many articles online going back for decades that describe the vast majority of such medical bills as complex puzzles with over billing, duplicate billing, and flat-out fraudulent billing of procedures never used.
That’s why there are businesses that will either teach you how to fight such over-billing, or at your request, will fight for you. You will need their help because when the hospitals turn over their fraudulent bills to the debt collection industry, they will hammer your phone all day long, seven days a week — for years. Those debt collectors will try to sucker you into making even just a tiny payment fraction of such bills — which then legally means that you have acknowledged the legitimacy of those bills, no matter how outrageous or fraudulent they are. That kills your right of dispute.
If worst comes to worst, there is even at least one non-profit that can help you file bankruptcy — without having to pay the lawyer’s $1,000 to $1,500 fee. But it’s wise to rely on that in extreme cases only, because you can only use that bailout again after some number of years, as discussed here:
https://www.nolo.com/legal-encyclopedia/multiple-bankruptcy-filings-when-file-again.html
It’s also useful to learn about how — in advance — to structure your ownership of assets in order to protect them from any court order. But that has to be done before such a threat of a court fight becomes obvious, otherwise your protective measures can be set aside.
Do you see why medical tourism is a rapidly growing alternative to financial destruction (and maybe medical destruction) inside the US? And why keeping your US passport current is a good idea?
—Lewis
Taking care for yourself is not a solution to reduce your health care costs. For me, and I’m sure others were born with our medical conditions. We did not”cause’ our medical issues. And if it weren’t for the medical care, we are getting we would not be alive today. I do agree that the insurance game is ridiculous and we should not have to decide on what to give up in order to receive the medical care that those with multiple medical conditions so desperately need.
In the article I stated this:
“Accidents are often not preventable, and neither are some health conditions.
But many of the health issues that lead to massive medical debt are preventable, including obesity, Type 2 diabetes, and heart disease.”
That right there!
Got to a Wally-World. You cannot tell me all those obese and grossly obese people have a thyroid problem.
What most, but not all, have it is a hyper-sedentary lifestyle. They consume too much ultra-processed food stuff, soda, and spend too many hours sitting in front of a screen of some sort.
Yes, America absolutely does need a nationalized health care system paid for with tax dollars. I get tired of my fellow conservatives foaming at the mouth like rabid dogs about “socialized medicine.” Why do conservatives put their trust in the greedy, amoral, profiteering health care industrial complex? People say, “A liberal is just a conservative who hasn’t been mugged yet.” I say, “A conservative is just a liberal whose life has not yet been financially devastated by the health care industrial complex.”
Maggie, We currently have Nationalized health care here in the U.S. It is called Medicare. I don’t want my hard earned tax dollars going to pay for the medical care of illegals, non citizens or strangers. Most of these so called sick people have destroyed their body with an unhealthy lifestyle such as drugs, junk food, overweight, sedentary lifestyle etc. Then they go to a doctor and say please help me. Start with getting yourself healthy. I am so tired of this narrative of medical care being a right. It’s not a right.
Well, our lives were not quite “financially devastated by the health care industrial complex.” But due to the ACA, our higher co-payments paying for others who are sick, dang near wiped out our savings. I had to get a part time job for six months to dig us out of that hole.
Pre-ACA, we were comfortable with our health insurance. Post-ACA, we cannot afford to use it. There have been two, maybe three times I should of gone to the ER, but did not as I did not want to burden ourselves with that debt.
Why would anyone trust the government with anything is beyond me.
And I agree with the one study showing that most, but not all, of the cause of higher health care costs is due to the American fast food, ultra-processed, sedentary lifestyle.
We’re watching the system fail based on greed. Following the money shows the system for what it is and UVA is part of that system no matter how well they spin it. As Hillary mentions, in the end, there will be hell to pay for the medical systems crimes against humanity. And I will have zero sympathy for their fall and the consequent result.
My husband is 100% disabled veteran. I am a retired 40% veteran. We both are covered by VA. I go for certain test or eye exams but do not take their meds. My husband follows natural cures. We are covered for ER visits as long as it is a true VA emergency. VA pays for my husband wheelchair and wheelchair lifts. I do not have the problems most America’s have with medical.
Germany medical system is bankrupt and does not covered what it once did. My husbonds children are german citizens. We hear what is going on there. My family on my mother side live in Denmark and even their system is hurting.
Medical cost goes up and quality goes down when government gets involved. I do not support government involved in medicine.
pressure from every angle. There are times that I feel my kids would be better off without medical attention, using home remedies, etc. But there is always the threat of children and family services. Case in point: I took my 2 healthy children to a well child visit. I walked out with 2 specialist referrals and 5 prescriptions to have filled. I am not going to load a kid up with antibiotics because he ‘might’ have an ear infection. No fever, no pain. This is crazy. preventative is definitely the best card to play. because once they start giving you heart meds, that causes liver failure, the treatment for that could put you on the fast track to dialysis. What is the motivation? follow the money. I don’t really blame the doctors because their curriculum was crafted and funded by big drug companies. You know the ‘unsuable’ vaccine manufacturers that have no real oversight. I’ve been overweight all my life, tried every diet. I have managed to stay otherwise healthy, but as I age, I know this weight will work against me.
We have supplemental insurance to go with Medicare since were both past 65. Firs the government deducted over $100 from each of our Social Security checks every month. Then we pay for supplimental insurance and prescription coverage with deductibles and co-Payments. No coverage for dental care or hearing coverage. No eye care either. We both wear glasses.
At this point we pay well over $700 a month and still have co-pays. Self pay eye check ups and glasses. Any dental care we pay the full price out of pocket.
We don’t have a mortgage or rent. We lived without electricity in our home for almost the entire year so I could pay for repairs and upgrade to the solar array. We garden all we can. I can and dehydrate all we can for food through the winter and till next harvest time. We don’t buy extras or spend carelessly. I make most presents or buy on sale. I save seeds from family heirlooms, forrage wild, and only buy a little seed each this year. I did buy 6 artichoke plants and 36 new strawberry plants and more fruit trees.
Hubs has lost weight this year so I have bought him three pairs of pants on clearance sale at $3, $5 and $6 each and a sumner weight dress for me to wear to church for under $20. I also bought a pack of cheap low top socks to Wear in my work boots. That’s it for a year. That $700+ per month is a lot to pay out. It doesn’t leave a lot to live on.
By the Grace of God, even as what I consider myself to be, an “old man”, I remain in relatively good health and vitality. Even so, a revue of my own medical history reveals a need for medical assistance for antibiotics every 3 to 5 years.
And the burden to find help gets heavier on each occasion. I am back to “urgent care”, pay as you go consultations.
I am desperately seeking knowledge of herbal and homeopathic wisdom… in full knowledge of the things that are coming upon the Earth.
God lifts me up in the service of my family, but the day will come when I no longer have that excuse for my justification. May He bless me still. Maranatha.
Google the name Joette Calabrese. I cannot say more than that or the censoring poweres that be will make my reply vanish. Happens all the time.
The main problem in this UVA case is not government or private insurance, but public accountability. Its a local democracy problem. The University of Virginia Health System is publicly funded and attacking the community it ‘serves’.
This is part of the overall attack on the American middle class, and sure, government and industry have stacked the regulatory environment. However, UVA itself chose to turn its most financially vulnerable patients into playthings for lawyering bureaucratic psychopaths.
More perhaps should be done to make outpatient wellbeing a metric for success; i.e.; no-one was billed to death or bankruptcy, however, given how psycho-left leaning universities can be, they probably believe they are doing their part to bring down capitalism by being the worst exemplars of capitalism themselves.
The Kaiser Health Report UVA expose should be sent to each one of University of Virginia’s charitable doners with the tag, “This is the monster you’re funding”, and demands made to cut UVA’s lawsuit programme and fire those who fostered it. Especially target sports events for large public demonstrations.
Out them, name names. Public shaming and public protests are the best action to take in this particular case, because its the UVA administration that has chosen this route to pay for their sprawling bureaucratic kingdoms on top of the systematic ails of the health system.
Otherwise, you’re just gambling that you’ll never need a hospital and insurance, a bet many people obviously fail.
As long as insurance remains a for profit business, medical care will be not affordable for the ones who can’t afford insurance.
We are the country that develops the majority of prescription medications and still the country that pays the most for prescriptions, there are going to be people who cannot afford their medication which will lead to worsened conditions and death.
We need to change things so that everyone who needs it can get the medical care and prescriptions they need to survive.
And as long as medical care is for-profit AND they tighten the accounting rules for determining non-profit, medical won’t be affordable with or without insurance.
Malpractice premiums *barely* account for 2% of medical costs. TX capped medical damages then woke up and smelled the coffee and limited malpractice rate increases also. This was a few years ago and given the legislative and executive make-up in TX, would not be surprised the malpractice rate limiting no longer happens.
MD Anderson Cancer center is another taxpayer funded medical provider that gouges patients.
We have less smokers today but make up for it with obesity. Type 2 diabetes is rampant. Food banks provide food but I’d not say it is always healthy. When a workers lose their job thus their insurance, they try to make it until Medicare. Once on Medicare, we all pay the price because no preventative care or early detection. Private insurance is expensive. If one is fortunate to live in a state where the ACA w/poverty level expansion exists, you *might* be able to afford it. But not the deductible (and my employer insurance deductible is NOT cheap either).
Nationalize health care but we’re still short doctors and nurses. When the 90% who want medical care and try to take care of themselves are covered, then we can deal with the 10% who don’t give darn.
And lest we forget, bankruptcy “reform” is making the medical debt issue even worse. Were there people intentionally spending on credit then filing bankruptcy, yes. Easy to identify them versus those whose debt is medical. And IF the “reform” was to truly be uniform, a person in FL wouldn’t get to keep his/her $1M+ house when filing bankruptcy when a person in OK would barely get to keep the shirt on his/her back.
Socialied medicine does not work’;one only needs to look at the UK and Canada. Medical tourism might be a ‘thing’ but ‘buyer beware’. What modt ppl don’t see or realize is that ‘everyone who is anyone’ comes to the US when they are in need of major medical care; I worked at a ‘major’ medical center and we had clients from all over the world, high ranking officials from many countries. We also cared for ‘regular’ ppl who couldn’t wait on the waiting lists in their countries.
One topic not mentioned is how litigious (sp) our society is. Doctors have to play CYA medicine rather than actually helping ppl these days. That is one of your major drivers of the high cost of health care. When you have ppl coming into the ER demanding that they get CT scans for a cough, if the doc doesn’t order it, he is open to malpractice. So the general public is also to blame. So is Big Pharma, who makes everyone want the latest greatest medication they advertise.
I am a retired RN, I see all sides of this. I had emergency gallbladder surgery a year ago, and I was amazed at the bills. And let me tell you, if you have to be hospitalized, go over those bills with a fine toothed comb! It helps if you can have someone to advocate for you during a medical emergency (unfortunately, I am the medical resource in our family, and while I do not regret any decisions made during my issue, I wish I’d had someone more clear headed than me working with me to make decisions, I would have skipped the MRI, US results were conclusive enough)
Hi, Grammyprepper!
I can’t speak about the healthcare in the UK, but I have to heartily disagree with you regarding the healthcare in Canada. I lived there for 18 years and have nothing but good things to say about it. It was awfully nice to be able to afford to take my kids to the doctor without spending the month’s grocery bills, only to find they had a minor virus. We never waited more than 3 days to see a specialist for a medical matter either. When my daughter broke her wrist in an unusual way at school on a Thursday, we were at the Ottawa Children’s Hospital on Monday afternoon to have it set by an orthopedic surgeon.
I was not covered by the healthcare system when my first daughter was born, and we paid cash, $1900 for all prenatal care, ultrasounds, her delivery, and two days in the hospital.
The greedy insurance companies and politicians love to spread this propaganda about Canada, but who would you rather believe? The media or a person who has lived in both places as an adult and can compare the two?
You make a good point about the CYA medicine.It’s really ridiculous.
Daisy, all I have to base my opinion on is a lot of Canadians who came to the hospital in OH (you’d know the name) to have surgeries that their doctors had deemed ‘elective’ and had huge waiting lists (including open heart surgeries, believe it or not, and joint replacement surgeries–which ‘could’ be considered ‘elective’, I suppose, depending on the severity of a persons limitations). So, you are right, I can’t compare the ‘wellness’ and ’emergency’ sides of the Canadian system. My biggest criticism of the ACA, is that they should have taken more time to explore the ‘national’ systems that work, and those that don’t, and put together a program that ‘picked and chose’ the best parts of the better programs. But they were in too much of a hurry to just throw something together and get it passed. But that’s a discussion for another day… 😉
I’m sure it also depends on the part of Canada you’re in. The GTA (Greater Toronto Area) is extremely overpopulated. In a country of 37 million people, about 7 million live in that crowded area. However, my oldest daughter lives and works there right now and hasn’t had any issues getting medical care.
Again, it was our personal experience that the care was great. My father-in-law currently has cancer, which was discovered during an x-ray when he broke his arm. He was paired with an oncologist that day and his treatment began 4 days later.
If your clinic is the one I think it is, people from all over our country go there with extreme medical conditions. So I’m not surprised that Canadians with means would go to a place with such a fine reputation.
I am English.We have our National Health Service.It has its faults,but everyone gets care.Believe me,we PAY for it through insurance deductions from wages…but it works.
My wife has cancer right now,and her care is second to none! I cannot praise her doctors enough. We don’t have to fear illness in the UK,we can see a doctor,free at the point of delivery – but we do pay for it,which is a fact lost on non- Brits..
Paul, I wish your wife a full and speedy recovery! In the US, a cancer diagnosis means bankruptcy for most people. It certainly would for me.
Thanks for your good wished Daisy. Thankfully this illne will not bankrupt us.
The overwhelming majority of Canadians have nothing but good things to say about their health care system. The waits are not a danger to anybody’s health. Americans want everything now at any cost. And the doctors and hospitals want the money in their pockets ASAP. The Canadian system has better outcomes. The health insurance company propaganda makes it seem like a lot of people leave Canada for medical care. The truth is that less than 1% do. Canada is cold and has a lot of “snowbirds”. If they have medical issues while they are wintering in Florida or Arizona or Acapulco, they don’t fly home. They get treatment wherever they are.
This accounts for most of the outside-of-country incidents. The rest are those who are in drug, alcohol, and mental illness clinics. They go to the States or elsewhere for privacy. Thy don’t want to run into their neighbor’s daughter who immediately tells a million people on Facebook who they ran into in rehab.
Nobody in Canada or the other 33 countries with national health care lost their life savings and their house because they got sick or injured.
Well, you idiot Americans reject a brilliant socialized Healthcare System like we have in Australia, and now you’re complaining about the problems with your capitalistic system??
You can’t make this s*** up!
I apologize for this long post. First, my heart goes out to all of those poor, ignorant people referenced in the story, and indeed to anyone dealing with the criminal triumvirate of government/pharma/insurance. I do not believe we have a “healthcare” system at all. It’s Drugcare! If you don’t believe that, take a look at who funds medical schools. All of it was inevitable when government, through very incremental and systematic incursions into medicine, health insurance and regulation of the pharmaceutical industry, wasn’t crushed in its attempts to concentrate power.
Sadly, Americans have become inured to the idea that government is supposed to provide care? That is a “free” country in which 50 states are supposed to be laboratories of freedom? Really? Through personal observation and experience, I do not believe the average American WANTS liberty, because that means scary RESPONSIBILITY. Here’s another universal truth: third party payer arrangements ALWAYS go broke. Finally, let’s revisit Jefferson: A government big enough to give you everything you want is big enough to take away EVERYTHING YOU HAVE! See, even Jefferson understood that 200 years ago. But, somehow Americans are stupefied over this?
Americans are not taught to take care of their own bodies, to trust their own judgement, or even to treat this inevitable expense like any other personal responsibility. Obamacare severely curtailed HSAs which put individuals in control of their health care expenditures. Then again, I was raised in a Catholic indoctrination camps where nuns taught that healthcare was a “right”. Sorry, Sister Cecilia! No it isn’t! Government before Obamacare, controlled more than 50% of healthcare in this country based on the lie that “healthcare is a right”. Has total control via mandates, out-of-control spending and absurd insurance premiums and deductibles to fund a massive bureaucracy NOT CARE, made any of it any less expensive or improved care on a human level? And, if it is a “right”, what are the duties associated with it?
From the time I understood anything about medicine, I made it a point to seek out an ND not an MD, who only knows how to do one thing: write out prescriptions for the latest “wonder drug” with 50 side effects! Since genetics plays a large role in susceptibility to certain illnesses or conditions, try to find out about your own family’s history. Don’t smoke, drink moderately and especially only when eating a good meal, get lots of fresh air, ride a bike, take a walk, go swimming, spend time with friends and family. Our infrastructure encourages sickness and dysfunction. Look at our mass-produced soulless tract home farms. If that ugly crap doesn’t depress you, well, it should. Life is an individual search for and expression of truth and beauty, both of which uplift the soul and with it, the body.
I’ve had an HSA since 2006 and nothing has changed with the ACA. MSA (medical savings accounts) were phased out in 2003. Archer MSAs can still be used if open prior to end of 2007.
I see the Medicare reimbursement rates when reviewing my parents EOBs and bills. Then I see what their supplements pick-up of Medicare approved charges. It is no small wonder so many seniors are on Medicaid. Sure the supplement picks up most of the difference but over the years, your supplement rates skyrocket. And once you are “sick”, you are pretty much stuck with your current company. Back in the 80s, you could change supplements every year with no problem. Not so much today.
And lest we forget sequestration
https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Downloads/2013-03-08-standalone.pdf
This adds another layer of complexity to Medicare. This was a fun one to explain to my dad.
Joining this conversation late.
I spent my career working in the medical field. Administration, not the nursing side.
Here are some suggestions
First and foremost – learn about your insurance. Far too many patients have no clue what their insurance covers, what it pays, what doctors and procedures it covers. You absolutely MUST know this.
Learn about your deductible and co-pays.
We never accepted patients who’s insurance did not cover our practice. If we were “out of network” we did not accept that patient, but would try to refer to a doctor that was in network.
Of course, there isn’t much you can do about what insurance your company offers or what policy you can get through Obamacare, but you need to be armed with knowledge. If you don’t understand it, then please get someone to explain it to you. I did a lot of explaining to our patients.
Insurance negotiates the payment to the doctor or facility. Each company has it’s own contract with the doctors and hospitals. They will allow and pay the NEGOTIATED price and then your responsibility will be to pay the deductible and/or co-pay. Usually, once the deductible is paid then for the remainder of that year the insurance will pay the negotiated price in full. But not always. You need to know this.
In other words – lets say your doctor charges $100 for your office visit. Your insurance has negotiated that they will allow $50 for that visit. If you have not met your deductible, you will be responsible for that $50, and the doctor must write off the balance. You will probably have an office visit co-pay, which you will be required to pay at the time of the visit. Let’s say it is $25. Once the bill has been submitted to the insurance and they have re-priced your visit, you will receive a bill for the additional $25. Once you have met your deductible, then the insurance will pay subsequent visits in full.
Office visits are billed according to the amount of time the doctor spends in the room with you. Keep this in mind while you are there. No idle chit chat. I know that is a shame, but it is the way the game is played. Have a list of questions written down.
I worked for a surgeon. Most of the surgeries he did were “elective” meaning they weren’t emergencies. So, when I scheduled a surgery I knew if the patient’s deductible was paid or not. And, I knew what the insurance company would allow for the procedure. If the deductible wasn’t met, we required that the allowable amount be paid in advance. So, let’s say he was going to remove your gallbladder. He charged $3,000 to do it, but your insurance only allows $700. (This is a very typical example) You haven’t met your deductible, so I tell you you must pay the $700 to the doctor before surgery.
We never required that the ENTIRE deductible be paid to us, because that wasn’t what we expected to get, only the surgery part.
However, there will be other bills related to this surgery. The hospital, the anesthesia, possibly an assistant surgeon (typical for gall bladder surgery) and other bills. These will all be billed by separate entities which you should be aware of. And, your deductible will be required to be met before any of these people get anything from your insurance.
So, you need to be prepared.
Now let’s say you don’t have insurance at all. We did not accept patients without insurance, which I understand most people think is terribly wrong. Please remember that doctors are small business owners and must make money to stay in business. Also, know that most doctors do do pro bono work. We did. Co-ordinated with all the other entities involved in the surgery. The hospital, anesthesia, assistant etc. So, we weren’t hard hearted, just prudent.
But, back to having no insurance. And, you have an emergency.
Know that most insurance companies base what they will pay on what Medicare allows. So, essentially, the Federal Government has a hand in insurance payments whether you know it or not. Also, know that Medicare pays different amounts for the same procedure based on where the procedure takes place.
For example. In a rural community, Medicare pays the doctor more for an office visit than it does to a doctor in an urban area. Because in the rural community, there are far fewer patients and in order to keep the clinic open, more needs to be paid per patient to support it.
So, depending on where you have your procedure done will determine the Medicare allowable.
Here’s what you should do if you find yourself with a huge bill. Talk to the doctors and hospital involved. Ask them if they will accept the Medicare allowable amount for your bill. I can’t guarantee they will say “yes”, but most will be willing to work with you. They really only expected to get the insurance allowable amount anyway.
In my example above about the gallbladder – it is true. The actually charge was somewhere around $3,000, and the ACTUAL payment allowed by Medicare and therefore by most insurance companies was really only $700. That is a HUGE savings and could be there just for the asking.
No one likes to have huge medical bills. You must take a pro active part in it. Know what you are covered for and where. Know how it works. Be prepared to negotiate with doctors etc. If you ignore the situation, you will be sent to collections.
Also, if you do manage to meet your deductible and you need some elective surgery done, then by all means schedule it before the end of the year to take advantage of the deductible having already been met. It resets at the beginning of each year.
Great advice! Thank you very much.
When I was growing up (in the ’50s) I recall the adults lamenting the rising costs of healthcare. Luckily, my father worked on the railroad and they had their own healthcare program. But so many did not have that advantage. They were concerned and quite rightly. Often I would hear the adults saying that the cost of healthcare was so bad that sooner or later we’re going to have to go to socialized medicine. No one thought that was a bad thing. As time went on it became a bad thing because socialized medicine was associated with Communism. It was, and still is assumed that if socialized medicine were installed that it was only a step to Communism. As the song goes, “It ain’t necessarily so.”
According to the WHO the best healthcare in the world is in France and France is not a Communist country. France, a democracy has socialized medicine that works. What happens in the U.S. is that how socialized medicine works is often associated with Canada’s healthcare system, and they obviously have problems. But in the U.S. the healthcare is based on Capitalism. To make any major changes in the health care would cause a disruption in the economy because of all of the tentacles stretching out to so many other businesses involved, many of which have nothing to do with healthcare. So, what are the politicians doing regarding healthcare? Actually not much. They don’t look at a system that works but are trying to create a healthcare system via spontaneous generation (ex nihilo). The drug companies definitely don’t want socialized medicine in the U.S. Countries that have socialized medicine pay a lot less for drugs or hospital care than in the U.S. (e.g. Eliquis in the U.S. costs around $475 a month but in New Zealand it is about $35 cash, hospital stay in the U.S. is around $4000 per day in France it is around $250 cash).
Face it, the U.S. healthcare is 37th out of 50 developed countries throughout the world. That does not bode well for the health of its citizens. With socialized medicine healthcare becomes a right not as it is in the U.S. at present, a privilege available to those who have the money or the best insurance. The mind-set also needs to be changed from thinking socialized medicine has anything to do with Socialism or Communism. The U.S. certainly does have the money to pay for socialized medicine but much of it is squandered on unnecessary things. But here again there are tentacles reaching out everywhere especially when bills are created in Congress and riders are attached to them so everyone gets a cut of the pie and these pieces of the pie continue to be put back into the budget every year. Seems that keeping the status quo is important because of the Capitalistic economy in the U.S. and the pie gets bigger and bigger every year: But not for the taxpayer.
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–Lewis