Modern Vespa

I avoid medical care if at all possible. ("It's only a flesh wound!") My wife, on the other hand, needs regular medical care, prescription medication, and not infrequent hospital visits. We have "insurance," but it covers very little, and only after we have spent huge sums out of pocket.

We pay nearly $1,000 per month for our health insurance and then spend on top of that another $20,000 per year or more out of pocket. One year, it was $40,000!

Health care in the US costs approximately 17% of GDP. In the UK, that figure is half that at 8.5%. I think the main difference is that physicians are, on average (according to the Wall Street Journal), the highest-paid professionals in the US, earning more than business executives. Anecdotally, I have some physician clients who shut down their small medical clinic and went to work for a hospital because their pay had dropped to $30,000 per month (each). At the hospital, they are earning much more than that...

I'll also try and stay out of the politics, here is a personal experience of mine.

I'm 60 with an unusually large prostate, this lead to an in ability to void while on a business trip in Taiwan about 18 more ago. It was late at night before I decided I was in real trouble, I got a colleague to take me to the local hospital in Hsinchu. The facility was very adequate, the ER reception people saw I was in significant pain so within 5 minutes I was seeing a doctors and within 5 additional minutes I had a catheter inserted and all was well with the world again. I had no insurance, the total ER bill was $60.00 US. They also scheduled a follow up visit with a local urologist, which included a 20 minute consult with a very competent doctor, removing the catheter, drinking some water to prove the problem was not resolved then inserting a second catheter as well as some med's. This bill was $50.00 US.

I then flew back to Boston. I went to my urologist and they removed the catheter, things seemed better so I went about my business. Late that night I realized all was not well so I rushed to the ER. I waited, in pain for over an hour, then was processed and sat in another room for 2 hours, then saw a doctor for no more than 5 minutes and finely a nurse inserted a catheter, which takes no more than 5 minutes. The bill $1,500, my co-pay was $100 as I recall. BTW, the ER wasn't very busy, at least as best as I could see, I live in the suburbs 30 minutes north of Boston.

My point is this, if we benchmark what medical costs are in the US versus other countries it's out of sync; costs no the price of a single visit. Catheters aren't rocket science. Most medical plans in the US today are what is termed 'high deductible', which means the first $5,000 +/- is out of the individuals pocket before the insurance kicks in. Plus, in my case, I pay about $2,000 a month in insurance premiums.

Again, I'm not going to get political, I only offer the facts of my case. IMHO, something is very broken.

For serious medical needs that can wait, it can cost less to go on vacation to Europe, have the procedure done there, recover in Europe, and then fly home to the US...

If you have insurance and have met your deductible you'd likely just owe $100 in the US. If you haven't met your deductible because you're generally healthy you can expect to pay between $2,500 and $5,000. You will receive 10-20 minutes of total care performed by nurses in the course of your 6-8 hour visit to the ER if you live in a city. You will need all of your follow-up visits by another doctor and that will cost you a regular copay of $10-$50. Your insurance company will receive a "bill" (totally made up numbers that mean nothing) for the total cost of your medical needs that will likely be in the $5,000 to $15,000 range. The insurance company will pay the hospital maybe $2,500.

If you don't have insurance you will receive a bill in the $5,000 range. You will then maybe Pay this amount or argue for a few months to get it reduced. After you've paid the amount owed you'll get bills for the next several years for each esoteric part of your treatment from X-rays to bandages that they will tell you are not part of the original bill. Eventually they will place a judgement against your credit for unpaid bills.

Some examples with insurance in the US:
1. Foot surgery total billed was $57,000. I paid $250
2. Kidney injury emergency room bill was $36,000. I paid $100

My favorite example:
In Thailand I was in an accident that broke my nose, gave me a concussion, got me 17 stitches, two X-rays, 5 percriptions. My bill in cash was the US equivilant of $120.

US healthcare is absolutely a wreck. It's the number one reason for bankruptcy here and we don't even have the best care.


End of Rant

No thanks. We're good We all probably have similar stories anyway.

[quote="TheNaughtyLemur
If your medical insurance finds out that your visit is a result of a vehicular accident then they won't pay.[/quote]

That's not a bad thing because then auto insurance pays. And in most cases they pay even better. You may have to pay a $250 deductible but after that, you'll not see a bill.

Of course, each U.S. state sets their own rules for this and may not be 100% the case everywhere.

Hope this isn't too political, but I see two reasons for the high costs in the USA.

1.- Everybody sues. And the courts allow every lawsuit to proceed. So the cases either proceed to trial, or the insurance companies settle prior to that to cut their losses.

Don't put all the blame on doctors. They're caught in this just like we are. They pay $40,000, $50,000 or even $100,000 PER YEAR for malpractice insurance.

2. The government allows the big medical providers and insurance companies to assist in writing the health care laws.

I am very very very very glad that there is a "Just Walk Away" button.

Well I wouldn't go to A&E because that's an emergency room here and to walk in the door before anything is done with my insurance is $200. I'd go to my doctor $35 co-pay or a walk in clinic $30-75. X-ray is $15-25. I can't take codeine so I mostly take ibuprofen or if it is worse Tramadol which costs me $10 a prescription.

I do plan on getting as many months of a drug I take regularly as I can when I'm in the UK in May. Even with insurance after meeting my prescription deductible here it costs me more in co-pay than buying the same drug outright in Canada, Mexico or the UK despite the drug being manufactured in the US. I've bought it in Mexico in the past and seen that it is made in New Jersey. Only difference is the US packaging is "nicer" while the Mexican version is in a foil punch pack. Cost of prescriptions is ridiculous in the US.


Oh and on the subject of malpractice insurance an OB-GYN in Florida can have to pay $350-500,000 annually in malpractice insurance because of litigation that any condition present at birth is the doctor's fault even when it isn't.

I've had to visit ER'S in many countries over the years. While it is cheaper i prefer my US hospitals. The health care here is broken. No politics on here but it's political and could be fixed. Drug companies have a lot to do with it. Now i get that they had to spend a lot of money to get the drug on formulary but it's ridiculous what they charge people. Take that idiot from Turing who charges $750 a pill and the rising cost of Epi Pens. CEO's of these companies need to be looked at (and are). There was a time when it was cheaper for me to go to the outpt clinic to get a IV drug for my RA. 6 hours hooked up to a monitor getting the IV drug was cheaper than taking a pill form. Now a 30 day supply of my meds cost over a $1000 and is closer to $2,000 I have good health coverage but not to many people can afford to get it. This drug allows me to not be bed ridden. I will say that some drug companies will give them free to people who don't have insurance but that is few and far between. Also they should take medical debt off of your credit ratings. It shouldn't be the reason you can't buy a house etc. Rant over.

The day after I bought my BV350, a Friday, I had a low speed lowside crash in the parking lot at work. The bike fell on my right ankle, pinning me to the ground. I had previously broke that ankle rollerskating, and have two Kevlar sutures holding it together.

As the morning wore on, it started to hurt worse and worse, so I went to an Urgent Care clinic down the street. They put me in a private room, took x-rays, diagnosed it as broken, and put me in a walking boot. They suggested I see the orthopedic surgeon that fixed it previously, since he would know how to deal with the existing repair work.

I got in to see him that afternoon. He looked at the x-rays, examined my ankle, and said it was fine. He told me to rest it and ice it for a couple of days. I took his advice, and was back on the scooter on Tuesday afternoon.

Total out of pocket expense: $0.00.

The Urgent Care clinic visit, including x-rays and walking boot, was covered by my health insurance. The visit to the Doctor got billed as a follow-up visit for my previous fracture, even though it had been 5 years.