Personal experience: cons of the medical system in the USA
About American medicine, you can hear different, sometimes conflicting reviews. On the one hand, many note its high quality, but on the other hand, the complexity and cumbersomeness of the medical system in the United States can turn even a relatively simple problem into a real tragedy.
It is not only about the fabulous cost of medical services. Even if you have good insurance and extra money to pay in excess of the insurance costs, this by no means guarantees you will receive prompt medical attention. Of course, when listing the shortcomings of the American system, it is important to understand that it should not be compared, for example, with “free healthcare” in Russia, which even ten years ago was more like a complete absence of any kind of medicine in principle.
However, one cannot but admit that paid medicine in the post-Soviet space was sometimes able to provide high-quality diagnostics and treatment for relatively little money. In a word, if you are used to being treated at home for a fee by good doctors, in America you should be patient. And that's why:
1. Meeting a doctor is a privilege
Get ready for the fact that talking with a doctor, even when you came to see him, is a rather short pleasure, for which you will have to spend a lot of time and effort. The first person to meet you after you complete all the medical paperwork will be the assistant, and possibly more than one. You will have to repeat all your symptoms and complaints to each new assistant, and then patiently wait for him to pass this information on to the doctor. At the same time, a direct meeting with a doctor can be quite short - much shorter than the waiting period.
These problems are exacerbated if you end up in an emergency hospital. The number of assistants here increases many times, while the doctor has to wait for hours. The situation when one doctor is forced to serve 30 or more patients is quite normal. Even with acute pain, you will most often have to wait for hours, repeating the same complaints to assistants. At the same time, the chances that you will have a real medical examination are quite low.
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The usual practice in the post-Soviet space, when you can save money and go to a good hospital for an examination, knowing that you will definitely not be abandoned here, is impossible in America, where even seriously ill patients are immediately sent home after operations to recover. If it's just pain, you'll likely be given an injection of painkillers and sent off to be examined somewhere else.
2. Difficulties with diagnosis
If at home you are used to conducting any examinations that doctors advise you, or that you yourself consider necessary, then in the USA it is better to forget about such pleasure. You are unlikely to get at least some doctor without a referral from another specialist. At the same time, the queue to a good diagnostic center or to quality specialists sometimes lasts several months.
If you do make your way to the doctor, don't expect him to order an examination for you unless absolutely necessary (or what he considers to be an emergency). Even if a procedure is scheduled, you will most likely have to sign up for it separately.
Such a record can take up to a week, and the problem here lies in the relationship between medical institutions and insurance companies. It is not uncommon for healthcare workers to contact insurance to make sure that the company is actually reimbursing them. In the event that the insurance company decides that the examination was not so necessary, it may be difficult to compensate. In the meantime, you will have to wait days and weeks for the necessary approvals in order to go through even the simplest procedure.
3. Difficulties with treatment
The same applies even more to treatment. The fact is that the United States today is the leader in the number of medical claims. According to Statistics, there are approximately 170–200 complaints per million people. At the same time, the average time to litigate and receive compensation in the United States is up to five years, and legal costs can include the cost of jury trials and high attorney fees, which, together with the cost of treatment, is a very impressive amount. As a result, doctors are afraid to prescribe surgeries or any other procedures without XNUMX% confirmed indications. As already mentioned, it is very difficult to obtain these indications with difficulties with diagnostic procedures.
A separate problem is the difficulty in the interaction of doctors with each other. There are cases when, for example, one doctor may not accept a report made by another doctor just because he did not like the form of a particular document. For patients, this means several additional weeks of agony.
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By the way, problems with the appointment of an examination sometimes entail tragic consequences. For example, in 2015, a 23-year-old student Anna Ram from San Fernando Valley, California won the lawsuit, for $28,2 million. The court found that due to a medical error made in one of the Kaiser Permanente medical centers, the girl lost her leg, half of her pelvis and part of her spine. In particular, doctors regularly refused to perform MRI, which was requested by the victim's family, which did not allow timely recognition of a malignant tumor. Despite the seriousness of the compensation, it is obvious that it is not capable of compensating for the loss of the most important organs, which made the girl disabled for life.
Thus, the tendency of American doctors to play it safe, on the one hand, can help to avoid improper treatment, but on the other hand, it can inexcusably delay the diagnosis and endanger the patient's life no less than an error during the operation. Often, therefore, even Americans with insurance prefer to engage in "medical tourism” and travel to Turkey, Mexico or Eastern European countries in order to quickly make the necessary tests or even surgical procedures.
This approach has its risks, because if you are nevertheless agreed to be treated in the United States, doctors, fearing lawsuits, as a rule, do it efficiently and under anesthesia, which cannot be said about third world countries. However, compared to many European countries, the American medical system is far from perfect, and in order to achieve treatment, patients often have to spend a lot of time and nerves.
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