Medicine in the USA: expensive and even more expensive
In the US, the state believes that the main thing is the market and competition. This implies that the state should first of all ensure that monopolies, cartel arrangements, corruption schemes and other types of unfair competition are not formed, and a self-regulating market will do the rest. All of this implies a minimum of government regulations and restrictions in all areas except for critical services, one of which is the health care system, the user writes Diaver in the community Picabushniki North America.
Medicine in the states is not just expensive, but insanely expensive. Medical bills are the most popular factor in American bankruptcy. I will give an example of my bills for understanding the price order:
- The tick was attached to the child. We went to emergency assistance. We stayed there for about half an hour. The doctor simply removed the tick, specified how long he had hitched, and that was all. The bill for this was 421 bucks.
- My wife was not well, we again went to emergency assistance, spent about 4 hours there. Account for this visit 3500 bucks.
- A colleague with stones in the kidneys went to emergency assistance, spent about 6 hours there. The score was 6500 bucks.
- Childbirth cost 10000 bucks.
- A visit to the doctor for a routine examination of the child costs 150 bucks.
- The cost of the operation can be tens of thousands of dollars.
From a conversation with American colleagues, it becomes clear that the Americans themselves by and large do not know where such prices come from. There are a lot of various versions:
- medical mafia;
- A huge number of government regulations;
- opaque pricing. The bill for the same service for different people can vary dramatically;
- very expensive insurance for clinics and doctors who are bought to protect patients from claims.
Without health insurance in the states in any way. If you have any health problems that are more serious than a cold and you do not have insurance, it is cheaper to die.
There are several different types of health insurance in the states. According to one type of insurance, every year you pay for your example 800 bucks from your own pocket, everything that is on top is paid by insurance. On the other - you pay only the mandatory fixed payment for the reception (copay), the rest is paid by the insurance - I have exactly this option.
What copay? After visiting the doctor, you pay your small and fixed part of the payment. That's what it is copay.
Size sopay my insurance:
- for a visit to the doctor or in the ambulance (urgent carea) help 30 bucks;
- for a visit to the emergency room - 150 bucks;
- childbirth - 250 bucks.
Why this sopay need: in a nutshell - so that patients do not ask doctors and insurance with invented diseases. That is why every visit costs money.
The last major medical reform was about half a century ago. According to this reform, the state decided that medical insurance should also be provided free of charge to elderly Americans. Companies began to provide insurance to employees. The money that companies spend on insurance is subject to tax deductions. For the most part, when an American goes to work, the employer provides him with insurance, part of which is paid by the employee. If the employee is a family member, the insurance applies to his family members and children up to the year 21. The amount that the employee pays for the insurance is deducted from the salary and is not taxed. After Obama’s medical reform, the state began to provide medical insurance to the poor through a special service.
What if there is no insurance and no money? You can just come to the hospital, and the hospital has no right to refuse to help. In the hospital itself, they understand that no one will pay them money, but there is nothing to do - this is one of the growth factors for the cost of services. Those who have money, pay the costs of clinics from those who have no money.
Also a very important factor is that insurance companies do not work with all clinics and not with all doctors. Everyone with whom they work is considered online (In network), all others are not online (out of network). If you come to a clinic that is not in your insurance network, then the matter is bad, insurance, depending on the policy, may refuse to pay at all or pay only a part. Moreover, even the doctor himself, who works in the clinic, who “online” can render “offline”. One of my colleagues got into "Emergency room”At the clinic“ online ”, and the doctor who treated him was“ not online ”, and only after long conversations did the insurance agree to pay 1500 bucks for the services of this doctor.
It is important to note that the law limits the profitability of insurance companies. They can keep no more than 20% money. All other money should be spent on insurance payments.
The cost of insurance for a family, in my case - 500 bucks. For one employee, about 100 bucks a month. The insurance includes dentistry with a bunch of restrictions and vision (vision).
Vision in the States it is a separate type of medical service in a separate clinic.
It is important to understand that insurance is provided by the company. The conditions, cost, and quality of this very insurance vary greatly from company to company. For companies, good insurance is a kind of competitive advantage for luring employees.
Types of medical care
- Just visit your doctor if you have something sick, regular examination of the child, vaccinations and other non-urgent medical services. In this case, you need to call the registry and make an appointment with your doctor. Can appoint the same day, the next or every other day. Payment copay such a reception in my case 30 bucks.
- You have something happened and you need to get to the doctor right away tonight, but this is not fatal - this is already urgent care. You come to the clinic during working hours. You wait in the order of a queue and get an appointment with a doctor who decides what to do with you next. Payment copay such a reception in my case 30 bucks.
- If you woke up in the middle of the night and feel that the kapets did come and you urgently need to see a doctor, then your only option is Emergency room. As an option - it is to call an ambulance car or drive yourself by car or taxi. Calling an ambulance carriage in case it is not covered by insurance can cost 800-1000 bucks, so it's best to get to yourself.
В Emergency room you will immediately be sent to the ward. Soon the nurse will come to you, take the temperature, pulse, pressure and bring all the necessary information about you and your complaints to the computer.
After the nurse has finished all the preparatory work, the doctor will come and begin the examination. The doctor can immediately refer you to tests if they can not be taken on the spot. On the analyzes you will be taken on a chair. In case of need of operation, you will be immediately taken to the operating room. Payment copay such a reception in my case 150 bucks. The bill that the clinic will issue an insurance in a more or less serious case is measured in thousands of dollars.
In a nutshell. The quality of medicine at a very, very high level. I'll tell you on the example of the procedure of childbirth.
Interesting fact: in English there is a word like "Delivery“Which means shipping something. When the postman brought you the parcel Deliverywhen the courier brought you a pizza - this too DeliverySo, giving birth is also Delivery.
Let's return to the birth. On the appointed day, my wife and I arrived at 7 in the morning at the hospital. We were escorted to the birth chamber.
The wife was helped to change into a special robe and two sensors were connected to the pulse and to the contractions, after which she lay down on the delivery bed. Interestingly, in the United States is extremely welcome, if in the ward at birth there are close relatives. There is even a sofa for them. Relatives do not need to take off their outdoor shoes and clothes.
During the whole process, there is at least one nurse next to a woman in labor, at one moment there were two of them at once. Nurses changed every 4 hours. The nurses who were finishing the shift brought a new nurse and introduced her.
For those who give birth, who have English non-native, a certified translator must be present during the whole process. The interpreter is provided by the hospital itself.
At some point, the spouse needed to be injected into the vein. The nurse did the injection, and she made two attempts. According to the regulations, it is impossible to make more than two attempts to the nurse; after two unsuccessful ones, she should call the anesthesiologist. The doctor coped with the first attempt.
At one moment the intern-doctor was brought to us. She apologized for a long time and asked for permission to ask a few questions and be present at the very process of delivery.
After this, a procession of two or three doctors who controlled the whole process came to us several times. It is important to note that the entire medical staff was politeness and friendliness itself. Everyone was very patient and extremely tactful - personally, this very much surprised and pleased me.
There was also a kitchen with a fridge in which there were juices, ice cream, some sandwiches and other stuff that could be taken.
In general, the process of childbirth itself can be talked about for quite some time, but I was very enthusiastic about everything: from the staff, from the equipment of the clinic, from the precise order in all procedures. The impressions were especially vivid in contrast with the process of giving birth to the first child. The doctor, as I later learned, behaved like a complete asshole, and I paid him very good money for those times. Good is his monthly salary.
The whole procedure of delivery cost approximately 10 000 bucks, of which I paid 250 and which the company then returned to me as a bonus, for which thanks to my office great!
I hope that by such a small example it became clear that the level of medicine is at a very high level.
Come to the pharmacy and buy any medicine just can not. Just so you can buy vitamins, antipyretic and something similar. In all other cases, you must obtain a prescription from a doctor. The doctor himself sends the prescription to your pharmacy. After all the medications have been prepared, the pharmacy employee will call you and tell you that you can pick up the order.
The drugs themselves are also covered by insurance, you only need to pay a certain percentage of their cost. All financial calculations with your insurance pharmacy conducts itself without your participation.
Interesting fact: medication to prevent pregnancy insurance covers completely, that is, 100%. The insurance company decided that it was much cheaper to pay for contraceptives than to pay 10 000 bucks for childbirth.
Important note: the information in this post is from various sources, including my own experience, and may contain inaccuracies or errors.
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