40 Million Americans Cannot Afford Needed Heath Care Says CDC

The Centers For Disease Control And Prevention have issued a report saying that 1 in 5 U.S. adults, about 40 million people, cannot afford to get the health care they need.

The report says that 20% of adults reported that “they needed and did not receive one or more of these services in the past year – medical care, prescription medicines, mental health care, dental care, or eyeglasses – because they could not afford them.”

“There has been important progress made in many areas of health such as increased life expectancy and decreases in deaths from leading killers such as heart disease and cancer. But this report shows that access to health care is still an issue where we need improvement,” said CDC Director Julie Gerberding, M.D., M.P.H.

Nearly One in Five Americans Say They Can’t Afford Needed Health Care [CDC NCHS]
(Photo:Getty)

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  1. Sucko-T says:

    I’m sure that same 40% can afford, new cell phones, cable tv, pizza, cigarettes, alcohol, going out to movies, $150 jeans and many other non-necessity items.

  2. Sucko-T says:

    Oops, I meant 40 million.

  3. frogpelt says:

    I say about half of them need to redefine “needed”.

    Have you been to the emergency room lately? Hardly anybody is actually having an emergency.

  4. HRHKingFriday says:

    @strum40: Yeah, but with your 300 dollars of expendible income, would you rather spend it on private health insurance, or on leisure. I don’t think these people are buying 150 dollar jeans, and if they are eating out its fast food and out of necessity due to time and convenience. Imagine if that’s all you had leftover after covering the basics- even people on consumerist would question putting that money into health care that isn’t even going to give you good coverage. Heck, I’d save half and spend the other half on some kind of leisure so I wouldn’t go nuts.

  5. canerican says:

    Umm, did the CDC really say 20%.

    There are 300 million Americans, 40 million that supposedly need health care.

    Either 100 million people, or immigrated to Mexico, or else the number is 60 number.

    Or else its someone s trying to exaggerate a story to make it seem really bad and menacing…

  6. canerican says:

    Umm, did the CDC really say 20%?
    There are 300 million Americans, 40 million that supposedly need health care.
    Either 100 million people died, or immigrated to Mexico, or else the number is 60 million.
    Maybe its someone is trying to exaggerate a story to make it seem really bad and menacing…

  7. timmus says:

    Lately I have been tempted to go ahead and get health insurance… but after hearing round after round of horror stories with people losing coverage, getting rates jacked up, and so on, who wants to buy insurance? I don’t trust any of those scumbag companies. If I was eligible for a group policy, I’d probably think differently, but I’m self employed and don’t exactly have a spouse working for IBM or a university.

  8. jamesdenver says:

    @strum40:

    All of those added up are less than one month’s coverage.

  9. bohemian says:

    We looked at the cost of private coverage. It would be considerably more than our mortgage each month. Glad we have employer sponsored insurance even though it sucks and costs a bunch.

  10. varco says:

    @canerican: The CDC said 20% of American adults, not 20% of all Americans. Apparently, there are about 200 million adults in America.

  11. Phildawg says:

    @HRHKingFriday: if even I had healthcare, I couldn’t afford on top of the healthcare all the other costs. sure it’s 10-20 bucks per visit, but my healthcare at 130 dollars a month would require me to pay 10% of all things done. This means if I break my arm, as my friend did, he had to pay 6,000 dollars as the procedure cost 60,000 and his insurance paid 54,000. The funny part? My health insurance would be through my university, and we have to go to the university medical center… so the 54,000 paid by the student insurance went to the college’s medical facility… so how much did it really cost them? I bet less than what my friend had to pay.

    It’s okay, we can continue to have the best medical system in the world by telling 20% of our country that they can’t have it, so the 80% can get in and out quickly =) I think you are just as stupid to have insurance as to not have insurance in the US.

  12. smitty1123 says:

    Let me be the first to ask the important question: so what?

  13. Tzepish says:

    @strum40: Right, are the ones throwing away their money at luxury items. Because everyone knows there are no poor or homeless people in this country, right?

  14. Tzepish says:

    @Tzepish: Borked my own HTML. Should have said “Right, *the same 40 million* are the ones…”

  15. maribars says:

    @smitty1123: The so what part is that if you can’t afford health insurance and you find yourself needing medical care, you probably can’t afford the insane costs for treatment. It’s almost worse when you have crappy insurance because then you get to pay premiums AND the massive bulk of treatment costs.

    @frogpelt – The reason so many people go to the emergency room is because they are generally assured some treatment regardless of whether they have insurance coverage or not.

  16. Ass_Cobra says:

    @strum40:

    And our next nominee for uninformed and smugly moralistic. The bulk of the 40mm are people that are not eligible to enroll in an employee sponsored healthcare program. So just to give you an idea of what that means, let me break down the costs of your average employee sponsored HC program which is considered a benefit and a valuable reason to work for someone:

    Single coverage, approximately 4K per year, that transalates into roughly $330 per month. Typically the employee covers 20-25% and the employer picks up the difference. That means for single coverage your typical employee is shelling out $80 per month on the high side.

    Family coverage, approximately $11K per year. That’s roughly $900 per month. Again, let’s assume the 25% pickup for the employee. That’s $225 per month.

    Okay so assuming that one could negotiate the same rates individually with the insurance company that an employer sponsored benefits package does which as a conservative assumption, you’d be looking at something like $330 per month single coverage and $900 per month family coverage. Again this is very conservative as it would likeley cost a bit more to receive the same coverage on an individual basis but let’s go with this.

    Now assume that the average person who is not eligible for employee sponsored healthcare is an hourly employee that works just under 40 hours a week (hello Wal-Mart!). Okay so 39 hours a week at a relatively generous 11/hour is $430/week gross. That’s $1700/month. If it’s someone single, then let’s think about spending 20% of our pre tax income on healthcare…If it’s a family with two working heads of household earning equivalently, then let’s look at something north of 25%. It’s hard to stay healthy when you’re starving ya know.

    There will be some that point out individual offered insurance is substantially cheaper thant what I have laid out above. This is not an inaccurate statement. The preponderance of individual insurance offered will basically cost what an employee’s contribution under an employees sponsored plan is (80-100 per month for single, 300-350 per family) but with average deductibles in the range of $1500 per insured and much smaller benefits packages and coverage amounts this coverage is hardly comparable. Decent health insurance for the working poor is something that has gone undelivered for too damn long at this point.

  17. adamondi says:

    This is why one of my main things to look for in a job is good health insurance benefits. In fact, the main reason that I have kept my current job rather than becoming an independent contractor is that I cannot afford to pay for my own health insurance on my own.

    The people who don’t have adequate coverage for health services that they need should look into improving their employment situation, just like I had to when I decided that I wanted insurance and other benefits.

  18. smitty1123 says:

    @maribars: Yea, I get that if you can’t afford something you can’t get it. I still see this as a “so what?” situation.

  19. Rando says:

    1 in 5? Bullshit. More like 1 in 3.

  20. maribars says:

    @smitty1123: I’m really not sure what’s so hard to grasp about why it sucks to not be able to get necessary health care. Necessary health care isn’t something like cable or video games. People need health care when they need it. You know, for their health. If you need a more economic based answer, consider the cost on big business and the government for all the people who stay home sick or stop working when they have a health problem and can’t get it fixed. Are you that incapable of putting youself in someone else’s shoes? Mommy and daddy won’t always be there for you..

  21. smitty1123 says:

    @maribars: Bingo. As you said, Mommy and Daddy won’t always be there for you. So, when Mommy and Daddy are not there, what do you do? You learn how to be self sufficient. Which comes right back to my “so what”…

  22. Phildawg says:

    The problem is this epidemic is driven by the American Consumer to begin with… The reason why poor people can’t afford health insurance is because our system is designed that way. You don’t want to pay a lot of money for your goods, you want a cheap price. Therefore, labor rates have to be very small. I’m also sick of wal-mart type bashing. It’s well-documented that Wal-mart’s average profit is 1.5% on an item. Sure they make a lot of money at the end of the day, but it’s nothing compared to what YOUR company probably makes. A lot of small business shoot for a cost goal of about 50%. This enables them to pay their employees a good wage.

    Walmart, other retailers, etc. do not pay a good enough wage. And if they did pay a good wage, then you wouldn’t want to buy their stuff. This is why everything is made in foreign countries now. Because YOU wanted the cheapest goods. And please, I also want the cheapest goods, so I’m just as much to blame. But I actually have very little income while in college and so I need cheap goods and services. The general American Consumer wants cheap EVERYTHING so they can consume more and own more. Gone are the days of the guy who spends all his money on a nice PC or nice home theater. Now the average American has a nice car, a nice home theater, a nice computer, a nice house, and nice toilet, a nice dinner, a nice everything! People no longer sacrifice certain desires for others, they want everything cheap so they can own everything.

    The only way to do that is to for 20% of the population into low income so that you can have that.

    Perfect example is a dollar menu in California… You wonder why they hire illegals to work fast food over there? It costs 400-500k for a median house… how the hell can somebody even survive making less than $30-40 an hour… yet they are able to do it quite well by having their illegal Mexicans make their double cheeseburgers.

  23. kingoftheroad40 says:

    Under the U.S. constitution we have the right to Life.
    Why doesn’t that mean health insurance ,how many people die because of no money or insurance to pay for a medical procedure like heart surgery…
    The rest of the civilized world thinks so.
    The free medical plan for congress and the senate tell me that there life is worth more than mine , and prisoners have access to free medical coverage paid for us the tax payer so there life is worth more than mine to ????
    How about the gettmo detainees they get whatever medical needs they require. I am sure We should have at least the same medical options as a detainee shouldn’t we
    Or are lives as citizens worth less than someone who is trying to destroy our country ???

  24. crackers says:

    @smitty1123: Yes, you become self-sufficient until something happens to you. And suddenly, you have medical bills in the tens of thousands that must be dealt with. And perhaps what ever you’re dealing with is something that keeps you from working full time, so your income is suddenly compromised as well. So then what? Ruin your credit? Bankruptcy? Foreclosure? Death?

  25. crackers says:

    @timmus: I’m self-employed as well, and was recently forced to pay for coverage here in Massachusetts. Granted, it’s MUCH cheaper as I used the “Health Connector” program, but the coverage is spotty at best. And it doesn’t cover a monthly prescription that I need for a pituitary tumor which is about $140/mo. I feel sucker punched.

  26. Tank says:

    Yah, I can’t afford it either – my cobra premium jumped $350 a MONTH for December. Guess what? I either have to pay it, or risk the preexisting clause on a new group policy when I become eligible. Guess I take it in the face either way. I’d rather be covered.

  27. jamesdenver says:

    People overlook it from a preventative point too. Not just “OMG I cut my arm half off and can’t afford the emergency room”

    I’m a type 1 diabetic and have decent insurance which covered an insulin pump and constant glucose meter. (And external pager size systemt that’s the newest and best technology available)

    Even though I’m already in great health that technology will reduce any complications down the road. (If I don’t get hit by a bus tomorrow.)

    Every kid, adult, and newly diagnosed diabetic should have one of these. Unforunately the uninsured get can’t afford the newest insulin and toys like myself.

    That sucks. Reducing it down to one illness and one solutio: I would have NO problem with a small tax ncrease if it meant kids cold get outfitted with these and live longer.

    james.

  28. barty says:

    @strum40: You hit it right on the head! When you break down the numbers, there are plenty of folks in that number that make decent incomes, but make a concious choice to spend their money elsewhere. Besides, why should they have to buy their own health insurance when they can whine to the government who can put a gun to my head and say, “you WILL pay us more in taxes so these people don’t have to make a choice between their $5000 vacation and health insurance next year.”

    @bohemian:

    Try looking at higher deductible coverage that will protect you in the case of disasters and then fund an HSA to cover the stuff in the middle. If you’re in good health, just pay the $100-150 the once or twice every two years that you actually set foot in a doctor’s office. People get fixated on these low/zero deductible, low/zero co-pay plans and freak out when they see the rates. Obviously if you’re in a group plan in your employer and the extra $10-15 a month isn’t going to break you, go right ahead. But if you’ve got to purchase your own insurance, there are AFFORDABLE choices, if you look around and don’t get stuck in the mindset that it is bad for you to pay for office visits yourself. Of course taking that route means saving money, something us Americans have a hard time doing.

    @timmus: You need something, even if its just something with a $5k deductible that will pick up the tab in case you get a $20,000 bill dumped on you all of a sudden. Having nothing at all (and you’re one of the ones they’re counting!) while being able to afford it is STUPID. Your argument is STUPID. Get something now. I was a contractor at a company last summer where they had no group insurance for me. Thank god I had my own policy or I would have been up a creek without a paddle when I was involved in an accident that broke my knee and required surgery to fix it. The coverage was $90 a month. No, it didn’t cover office visits and such, but it saved me about $5-7k in medical bills. Its not THAT expensive. Get it now!

  29. skeleem_skalarm says:

    I don’t know what the answer is to our national health care dilemma. It’s not our government’s responsibility to pay for our health needs. Besides, the more they get into our shit, the worse it is for us. Hell, I’ve got (expensive) health insurance, and I still owe thousands of dollars just for this year’s medical goings-on! But, hey, we’re getting it paid. My eldest son, on the other hand, has to go to the ER for anything (and he won’t go unless he’s dying) because he has no insurance. He won’t take $ from us, either. It sucks that the boy (man) works 60-plus hours a week, is looking for something part-time to supplement it, and still can’t afford insurance or to get sick!

  30. BlackBirdTA says:

    @strum40: I agree with you on this one. I see all these people saying they can’t afford health care as they’re puffing away at their cigarette, swigging on their beer and driving away in their new car…as they’re getting Medicaid to pay for their next kid.

    And why do some people think that the only way to get health insurance is through an employer. My husband and I work for small businesses that don’t offer insurance, so we pay for a plan OURSELVES. I have a really high deductible and an HSA so a lot of money goes toward health care, but it’s there if something big should happen. With two kids, it’s always something. But at least I’m not swimming in healthcare debt or relying on Medicaid.

  31. crackers says:

    @BlackBirdTA: I’m sure there are some people who fit that profile, but it certainly isn’t all of us. I DID have coverage through my last employer, but still had an incredibly high deductible and when I was diagnosed with a tumor at age 30 I wound up with almost $10,000 in medical debt…even though I was insured.

    I don’t smoke, drink excessively, do any recreational drugs, or live unhealthily in any way. I also don’t have cable, only pay for a cell phone (no landline) and have never purchased a pair of designer jeans in my life. I’m barely able to make my health care payments-both the previous bill AND the coverage I pay for now AND the expensive meds I need monthly to control the tumor-and I can only qualify for a reasonable plan because I live in a state that doesn’t allow discrimination for preexisting conditions. Not all of us are twits that moan about “the system” without justification.

  32. ironchef says:

    it’s about time for universal care. Sorry but I had it with the current system.

  33. maribars says:

    @smitty1123: Have you ever had a medical bill that wasn’t covered by insurance? It’s not a matter of being self-sufficient. You can’t predict health problems, you can’t avoid a lot of them, and a lot of medical issues will keep you from working.

    I had health insurance. It covered a portion of “reasonable and customary” expenses. When I ended up in the ER based on the advice of my insurance company’s 24-7 nurse, I got a few simple tests and some drugs. They charged me $5k. I ended up owing about 4k.

    It sounds like maybe an unexpected 4K out of pocket isn’t a big deal to you, but it is to me and a lot of other people. Thank god I hadn’t broken a leg or needed major tests.

    I sincerely hope you never have to find the answer to your “so what” question the hard way. But maybe it would give you a bit of compassion.

  34. Sucko-T says:

    @ironchef

    I can’t wait for healthcare served up
    DMV/TSA/Post-Office Style

  35. jeffjohnvol says:

    @ironchef:
    By universal healthcare do you mean have the government pay for it? If so, then the other 80% who work hard to pay for health insurance would be paying for many that can afford it. There are about 7% that can’t afford it according to some studies.

    [www.businessandmedia.org]

    They say UK and Canada has free healthcare, but that’s BS. Read the article. If people don’t want to spend any of their taxed $$$’s on healthcare, wait til Uncle Sam takes 11% of their income.

  36. jeffjohnvol says:

    I venture to say that a significant portion of the poor that have difficulty paying for it smoke. Money that could be better spent on an insurance plan.

    You can get a job at Starbucks and get healthcare, but many young Americans (my kids included) are spoiled brats that are too proud to be doing menial jobs like that.

  37. meadandale says:

    @strum40:

    Exactly what I was thinking. Many people don’t have healthcare because they CHOOSE not to have healthcare just like many people do not have insurance.

    It’s a conscious decision to allocate their dollars elsewhere.

    I’m self employed and have to buy my own healthcare. It’s expensive and I could roll the dice and go without. But I wouldn’t expect someone else to pick up the tab if I did.

  38. Phildawg says:

    @strum40: the line is a lot shorter at the Post Office, DMV, and TSA, even on the busiest days of the year than the typical 4-10 hour wait in an emergency room.

  39. meadandale says:

    @kingoftheroad40:

    The rights granted in the bill of rights are “natural” rights. Meaning that your exercise of your rights necessarily doesn’t require anything from me.

    You have the right to life. I (or the state) can’t kill you (at least without sufficient legal justification). That doesn’t mean you can’t DIE.

    Taking MY tax money to give YOU health insurance isn’t a right granted to you in the bill of rights since it necessarily means that something is being taken away from me to provide you your ‘right’.

    See
    [en.wikipedia.org]

  40. mr_jrdn says:

    I don’t even know where to begin with you people!
    @jeffjohnvol: Health care in Canada is funded mostly from taxes on things like cigarettes and alcohol. So people that abuse those things (and presumably get sick from them more often than other people)DO end up paying more taxes for their health.
    @skeleem_skalarm: Why doesn’t your son deserve decent health care? If he suddenly needed health care and could not afford it, would you be ok with that?

    Please, anyone who has silly misconceptions about universal healthcare, send me a message and I would be happy to tell you all about how great it really is!

  41. Phildawg says:

    @jeffjohnvol: The reason those 80% have the money to pay for the healthcare is because they feed of the bottom 20%.

    You want to fix this quick and easy? Require all companies to offer employees healthcare free of charge, and see where this all goes. You take a paycut for your now paid for health insurance by your employer, and see what happens at Wal-mart, Best Buy, Target, etc.

    I would bet my life that most people who don’t have health insurance actually have jobs, the extreme poor already get free government health care. However most people prefer to be ignorant on that. It’s the working poor that go without health insurance, not the people on welfare.

  42. crackers says:

    @Phildawg: “It’s the working poor that go without health insurance, not the people on welfare.” RIGHT ON.

  43. jeffjohnvol says:

    @Phildawg:
    Oh, so I feed off poor people? Go lie in front of a bus, you marxist.

  44. HRHKingFriday says:

    @jamesdenver: You hit the nail on the head. Thats why running healthcare as a business is wrong- they don’t think of you as a lifetime investment. Odds are, when you get older (and more expensive), you’ll be on a different plan. So why bother with preventative medicine. And with the prexisting clauses, they don’t have to worry about inheriting people after a lifetime of sub par treatment.

  45. HooFoot says:

    The commenters who wonder why this is a bad thing have clearly never been among the working poor.

    I have a full time job, but only bare bones health coverage because my employer will not pay for dental insurance until after I’ve worked for them for over one YEAR. Meanwhile, I have a nagging toothache that I can’t get checked out because I’m too “wealthy” to qualify for reduced cost/subsidized dental care, and I don’t even have the opportunity to pay for it out-of-pocket because no private dental office accessible to me will see someone who is uninsured (believe me, I’ve tried). Buy my own dental insurance? The rates are still unaffordable, even for someone like me who does not have cable, a cell phone, and only spends money on utilities and groceries. Find a new job? And lose my income, what little health insurance I have, and wait another X amount of time at my next employer before the full benefits kick in?

    So for the commenters who are saying “uninsured people are lazy” or “40 million can’t afford health insurance”, I ask you…what am I to do in my situation? Not being snarky; I honestly want to know what your solution is.

  46. missdona says:

    My neighbor is leasing an Acura, but “can’t afford” health insurance. Not a judgment, just a fact.

    @HooFoot: I don’t know where you live, but all of the dentists I’ve been to (in NY & NJ) would be happy to take you if you’re willing to pay out of pocket. I would take care of that toothache, though. An infection can lead to further medical problems, and you don’t want that.

    If you are between jobs in NY, look at healthyny.com, they have great bridge plans that are a lot less expensive than COBRA.

  47. EmmaC says:

    Health insurance is unaffordable for a lot of Americans and for a lot of employers too. As for finding a job with coverage, jobs are changing and fewer are offering the benefits they used to.

    I know someone who is self-employed and makes good money but took on a part time job in order to get affordable coverage. She works just enough hours to qualify. She still pays about $200 a month and her employer pays the other half. Bad news, her hours are getting cut which might mean she has to pay the full $400 a month for health insurance IF she can pay the group rate. If she can’t get the group rate I shudder at what her price will end up being (single in her 20s). Prior to getting that job she just went without insurance for 2 years because she couldn’t afford it.

  48. Phildawg says:

    @jeffjohnvol: Yep you do, it’s not your fault, everybody does, and they cannot avoid it.

    Why don’t we just require all jobs to provide free healthcare insurance to all employees. There should be some sort of minimum coverage standard so we don’t all have 1000 dollar or much higher deductibles, but the U.S. would change drastically. You cannot have your dollar menu and realistically expect the person serving you to have health insurance do you? However, they are working, they are probably not on welfare, yet you don’t think they hold a high enough position in society to deserve their life to exist. Your dollar menu would need to be 3 or 4 dollars, and your a nice sit down restaurant should be closer to 30-40 dollars per person for a server to afford healthcare of their 10-15% tip money. Of course, most steak house servers will tell you the larger the bill, the smaller the tip %. Once again, another working American will not be given enough money to afford insurance. In this country, you do not want to get sick unless you are working in a job that requires a 4 year degree, or if you got lucky enough to be in a unionized facility or government run job. Outside of those positions, it becomes very difficult for a company to offer a fair wage that could cover health insurance premiums and remain competitive in a free market. Why? because a competitor simply doesn’t have to offer enough of a wage to cover than and undercut the hell out of your product or service.

    It astounds me that so many in our country prefer to remain ignorant to the above facts and demand people to work so they can have healthcare! They are working my friend, just their company won’t provide them with a real benefit to healthcare. This isn’t the 1940s or 1950s anymore. This is the 21st century, and healthcare provided by companies cause them to lose complete competitive quality in our ‘free-market’ economy.

    Our economy works well, it’s just needs a nice rule that says employers should provide healthcare to all employees. Of course, I think the free market will then dictate the end of the cashier, it will be all self checkout everywhere.

  49. EmmaC says:

    @HooFoot:

    If you live near a university see if they have a dental school. You can get dental work for much cheaper. I needed oral surgery, estimate was 2500 at traditional dentist (insurance would only cover 1000 so I had to pay other 1500) but then someone told me about a nearby dental school. For the entire surgery the price would be $800 AND the surgery would be performed by the professor, not a student. The professor was French and supposedly a world renowned expert. Sure, I had to let 3 grad students observe the surgery but it cost me a lot less and I was happy with the care I received.

  50. jeffjohnvol says:

    @Phildawg: Get a job at starbucks. They offer insurance. Or move to Cuba. Its free there.

  51. Phildawg says:

    @jeffjohnvol: wow, you ignorant fool. I don’t like to call names but somebody as stupid as you deserves to be. You cannot think of one possible solution to this problem and instead choose to insult with such jokes.

    The problem is never whether Starbucks, or Best Buy, or whoever offers insurance. Virtually all companies offer insurance to their employees, even part-time! The question is not about the availability of insurance, it’s can people afford it? The answer is no! If you can somehow work at starbucks for 9 dollars an hour and pay 20-30% of your monthly pay towards insurance, you obviously are still living with mommy and daddy.

  52. smitty1123 says:

    @CCS: Well, bankruptcy and foreclosure still seems better than the latter. And it sucks, but yes, everyone eventually dies.

    @maribars: First, congrats on working through whatever your medical difficulty was. 4k would screw me royally, but I’d probably figure out a solution. As far as compassion goes? I feel sorry when bad things happen to people, but honestly not bad enough to do anything about it. I know that is cold and I’m a bad person for feeling that way, but at least I’m being honest.

  53. MyCokesBiggerThanYours says:

    But noting in that report says they NEED health care.

    Personally, I only go to the doctor when there is something they cure. Anything they can cure I have been inoculated for.

    Contemporary health care is a joke. Its perpetual prescriptions for pain killers and mood enhancers.

    …And I highly doubt that 1 in 5 adults can’t afford $100 a month. Thats what I pay. THey need to stop buying beer and crap they dont *need*. I had health care and for 17 years I made less than 40K.

  54. crackers says:

    @MyCokesBiggerThanYours: “…And I highly doubt that 1 in 5 adults can’t afford $100 a month.”

    Most of us have to pay much, much more than that. Self-employed, I’m paying about $200. That doesn’t cover my VITAL medicine (vital=must have or die) which runs about $140. I earn less than $35,000, but more than the cut off point for free or assisted medical care. Trust me, I’m not buying “beer or crap I don’t need” unless all my bills are paid first.

    Prior to starting my own business, I paid about $180 monthly, and only had to pay $50 towards my pills. That’s still a lot more than $100 a month – don’t make assumptions when you don’t have all the facts.

  55. jeffjohnvol says:

    @CCS: I hear ya. I’m self employed too. We pay $650 for BCBS (with dental) for family. Being self employed costs money. We’re switching over to my wife’s company insurance.

    I’ve considered just getting catastrophic and paying for flu visits through the local outpatient clinics. With every mother taking their kid to the doctor for sniffles, drives the “normal” insurance through the roof.

  56. crackers says:

    @jeffjohnvol: Consumerist keeps eating my post; sorry if this pops up multiple times:

    It’s painful, isn’t it? I know how lucky I am to pay as little as I do. We ran the numbers to see if switching to my husband’s insurance would be more cost effective, but no dice.

    Honestly, I’m more bent out of shape by the bills I’m still paying for medical care when I was “covered” by my previous employer’s insurance. I’ve always been super healthy – yearly physicals and that’s about it for doctor visits – so it was really shocking to have to deal with being seriously ill out of nowhere. I don’t know if my credit will ever recover!

  57. sibertater says:

    @frogpelt:

    AMEN! Gah. It’s sickening. However, half of them are there because they can’t pay for regular care from a doctor. It’s a circle.

  58. Carrnage says:

    Don’t worry about all these healthy people that don’t give a crap. They’re going to turn into bitter senior citizens that b*tch and moan about how high copays and “scrips” are….just like everyone else…

  59. trollkiller says:

    @jeffjohnvol: You pay $650 a month for family. Question what are the odds that you will spend $7800 a year at the doctor’s office?

    If you put that $650 a month in saving you could cover your own medical bills. And, God forbid, something major happens you will have a nice down payment saved.

  60. Auntie M. says:

    @trollkiller:
    The problem with this is if you run into a really serious health crisis. My friend was diagnosed with cancer, and went through about a year of chemo and other treatments. Each chemo treatment was $30,000, just for the drugs and the time it took for them to administer them. That doesn’t count the doctors, periodic MRI’s, CAT Scans, medicine, etc. She had to have about 8 treatments. She has an HMO and she paid nothing, except for $3 for each Rx. No matter how much you saved (and if you are young and haven’t worked for very long you might not be able to save too much) I don’t think you can assume you’ll be able to pay for something so catastrophic unless you are prepared to go bankrupt.

    I had an appendectomy with 2 nights in the hospital, and my bill was $30,000! Thank goodness I had good insurance, as I only had to pay $900.

    I wish I still had that insurance!

  61. Phildawg says:

    @MyCokesBiggerThanYours: you must have subsidized healthcare from your employer? my universities healthcare which allows no out of network service and the only network is the university, haha, is 140 per month this year, and will be 150 per month next, I looked outside and everything from state farm, etc. was more like 300-400 per month.

  62. Phildawg says:

    @trollkiller: A broken arm at The Ohio State University to a person is roughyl 60,000 dollars standard. Without insurance it would take our friend 7 years to no ills to afford that?

    That’s the difference between being insured and having their lawyers, verse not having insurance and nobody to stick up for you. Of course if you aren’t insured, you will never pay the 60k anyways right?

  63. mconfoy says:

    Quit feeding smitty — he plays video games and trolls for a living. Look at his past comments. Within 12 years this country will join Chile, yes Chile, and the rest of the developed world and do what is right. And we’ll pay less for the privilege. Isn’t cool that we pay almost twice as much as the next highest country, France, but have so many uninsured and don’t live as long and have a higher infant mortality rate?

    @trollkiller: Pretty good actually. Hernia operation and kidney stone that did not pass. That would be around $100K owed, just by me. Wake up. Come out of your dream world.

    @jeffjohnvol: Anyone that thinks what we have here is best for the nation economically should tell us why and quit spouting the platitudes they hear on Fox News.

    @BlackBirdTA: If only you and those you agree with were as strong about wasting money in Iraq. I talk bottom line — where are we wasting it and where does it make the most sense to spend it? The rest of the world provides while laughing at us for wasting it. Does this country want to continue to decline to the rest of the world at the current rate or slow that decline down?

  64. Elviswasntmyhero says:

    From an article at http://www.nctimes.com:

    The U.S. health care system is “a dysfunctional mess” and politicians who insist otherwise look ignorant, according to a medical journal essay by a prominent ethicist at the National Institutes of Health.

    “If a politician declares that the United States has the best health care system in the world today, he or she looks clueless rather than patriotic or authoritative,” Dr. Ezekiel Emanuel wrote in Wednesday’s Journal of the American Medical Association.

    Emanuel, who supports sweeping health care reform, said the U.S. spends $6,000 per person per year on health care, an amount that is more than 16 percent of the nation’s gross domestic product and more than any other country.

    He also said Americans’ average life expectancy of 78 ranks 45th in the world, behind Bosnia and Jordan. And the U.S. infant death rate is 6.37 per 1,000 live births, higher than that of most developed nations.

    President Bush frequently has said Americans have the world’s best health care system, but Emanuel stopped short of calling Bush clueless in his essay and during an interview with The Associated Press.

    “I work for the federal government. You can’t possibly get me to make that statement,” Emanuel said in the interview.

    Relax, Doc. The secret’s out.

  65. trollkiller says:

    @Auntie M.: There is always a risk of “if”. How many people out there do not get cancer but still pay the $650 a month? For every “horror” story there are thousands that are paying into the system and think they have a great deal because they only pay $10 for the once every three years doctor visit.

    Also that $30k hospital bill you saw was grossly inflated. The insurance company paid a lot lower rate. Your $900 portion was most likely 1/3 of the total payout.

    @Phildawg: $60k for a broken arm? Must have been a lot more than a mere break. They took 18 inches of my gut for only $20k (retail) or $9000 (insurance discount)

    @mconfoy: Let’s do the math. If you save $7800 over 5 years you would have $39,000. (more if you placed in an interest bearing account) Most of your run of the mill medical needs could be paid out of pocket. You can work out payments on the others.

    I don’t know of any doctor that would turn you down if you said “I have $40k cash and can make payements.”

    It is not a dream world I live in, I just think that private pay and insurance should be billed the same rate. That $100k you spoke of in reality would be less than $30k if you pay the same amount the insurance would. So you have to negotiate with them. Refuse to pay anymore than the insurance would.

  66. trollkiller says:

    @Elviswasntmyhero: Politicians are a major reason why the health care system is so screwed up. You have Pharma lobbyists and insurance lobbyists putting the politicians in their pockets. Who would benefit from mandatory health insurance? It is not the people.

  67. ironchef says:

    @strum40:

    better served up that way than none at all.

    None at all system is what most americans face if they are born with a handicap, suffer accidents, don’t fit insurance eligibilty, prior conditions, or don’t have perfect credit, or self employed.

  68. trollkiller says:

    I wonder what the number would be if you took off dental and eyeglasses. I know I waited over a year to get glasses because I could not “afford” them. If I desperately needed them I could have found the money but at the time my internet and cable were more important than seeing the tiny print.

    So I wonder how many that answered that they had to wait did the same thing I did? How many put a luxury before a “necessity”?

  69. ironchef says:

    @jeffjohnvol:

    Universal coverage means everyone must be covered.
    Doesn’t mean its free. Duh.

    The question is whether you accept a system where private insurance call center guy can boot you off for any reason or opt for a system that requires everyone to be covered.

  70. ironchef says:

    @trollkiller:
    check out [glassyeyes.com]

    it’s a great blog about $39 glasses.

  71. trollkiller says:

    @ironchef: Damn it man where were you 6 months ago ;-) Thanks for the link I have it bookmarked for the next time.

  72. gingerCE says:

    @MyCokesBiggerThanYours: $100 a month? Please let us know which insurance company you use if you are paying out of pocket and not through your work.

    For the self-employed it is ugly. Someone I know pays $1150 every 2 months for a HDHP for he and his wife. My sibling was quoted $600 a month due to her asthma when she was in her early 20s.

    You’re lucky you don’t have any health problems but for those who do, even if they get approved for coverage, the companies try to price them out.

  73. aikoto says:

    Well duh. If it wasn’t for state assistance, my kids wouldn’t have even had health care in the first 7 years of my marriage.

  74. darkened says:

    There is 1 and only 1 solution to the health care crisis. Universal healthcare will destroy our nation. What we need is universal billing. If there was a mandated singular system for doing insurance billing and coverage checking these problems would go away instantly. Why?

    Because this would foster an open market for true competition between health insurance providers. Currently the barrier of entry is so prohibitive it creates a cartel that specifically chooses to stay out of the way of each other knowing full well the hospitals and doctors are only interested in working with 2 maybe 3 insurers because of the vast differences in billing/coverage systems.

    If over night it became any institution could immediately work with every insurer there is, prices would drop for the consumer massively. The cost of treatment overall will go down because insurance companies will have motivations to negotiate bigger reductions in cost of treatment to make sure they keep their prices down to keep their customers.

    This is what we need, not free universal healthcare. But a universal system of access FOR healthcare.

    And I will say it clearly, none of you are worth my taxes, excluding our countries servicemen & women. My money should be my money, not a single penny of it should be stolen to pay for other people with their hand out. Sadly, i have no choice in this extortion. I don’t wish to participate in social security, school tax, medicare, some insane universal healthcare, as an American i should have all the right to deny those and understand I will never receive the “benefits” of those. I would gladly accept that in order to keep my own money and give me the power to chose to provide for my future or not and fail. That is the american way, not the socialist way america is becoming

  75. Shali says:

    I really think that estimate is on the LOW side. I don’t know what the solution is, BUT, I know there needs to be a change. I work in the health care industry, I deal with insurance companies on a daily basis. Inusrance companies will do ANYTHING to get out of paying for services rendered. They have entirely TOO much power.

  76. Something people also may not realize is that cost can vary a LOT based on where you live. As young healthy people in our 20s, we got individual coverage through BCBS in North Carolina for $120/month, and that covered EVERYTHING, let us see any doctor we wanted, the co-pay for EVERYTHING was $20, it provided discounts on alternative treatments such as massage and acupuncture (self-referring allowed), and the formulary kicked ass.

    When we moved to Illinois, and went to switch our individual coverage to BCBS here, they wanted well over $800/month for the two of us, with a ridiculously high deductible, far less-good coverage, a limited supply of doctors all in inconvenience places, ridiculously expensive drugs, and a long list of exclusions.

    It boggled my mind.

  77. jeffjohnvol says:

    @trollkiller:
    Yeah, but given that open heart surgery runs 100K, its best to be covered just in case. Thats why I’m thinking of just getting catastrophic. I’m not worried about the visits. Its the major medical. Read where a 24 year old who could afford insurance got into $300K of debt from a car accident. Her insurance would have been 100/month.

    Many think insurance is healthcare. Its not. It is a gamble that you will require more health services than you are paying for insurance. When people get cancer and complain that they can’t get insurance and get it covered, its idiotic. Truly sad, but unreasonable to expect someone to insure them for that disease and make the rest of their customers pay for it. It would be like placing your bet on roullette after the ball stopped.

  78. jeffjohnvol says:

    @trollkiller:
    Yeah, but given that open heart surgery runs 100K, its best to be covered just in case. Thats why I’m thinking of just getting catastrophic. I’m not worried about the visits. Its the major medical. Read where a 24 year old who could afford insurance got into $300K of debt from a car accident. Her insurance would have been 100/month.

    Many think insurance is healthcare. Its not. It is a gamble that you will require more health services than you are paying for insurance. When people get cancer and complain that they can’t get insurance and get it covered, its idiotic. Truly sad, but unreasonable to expect someone to insure them for that disease and make the rest of their customers pay for it. It would be like placing your bet on roullette after the ball stopped.@darkened:

  79. jeffjohnvol says:

    @darkened: Dude, you nailed it. All hail darkened :). I especially loved that last paragraph, but then again I’m a heartless bastard, or some would say so anyway.

  80. jeffjohnvol says:

    @ironchef: I can’t believe I agree with you. The Massachussetts (sp?) solution was good. Require everyone to have it. Hillary has the same idea. If everyone has it, competition should drive the costs down, if you can remove the illegal immigrants from the emergency rooms.

    Someone said the “companies should be required to pay for insurance” which I don’t agree with, except for the case of employers that hire illegals.

    Many though do expect it to be free, or completely government paid.

  81. Beerad says:

    @smitty1123: “You learn to be self-sufficient” — yep, that’s why I’m learning to perform self-surgery to remove my own appendix, and building my own care facility in my backyard out of sticks and dirt. That way I don’t have to worry about paying for so-called “legitimate” healthcare!

    @Phildawg: A bit off-topic, but I think the dollar menu is there to lure people in and have them ultimately buy other things at full-price, not to, uhhh, justify hiring undocumented workers?

    @kingoftheroad40: I like it, we could have the “Gitmo Plan” — you could get free healthcare, but you would have to be kidnapped from your home country, imprisoned indefinitely with no legal proceeding and tortured on occasion. Sign me up! (Stupid prisoners, with their cushy lives…grumble).

    @darkened: “none of you are worth my taxes.” Fine, jerkwad. Get off my federally subsidized roads, don’t call the fire department I helped pay for when your house burns down, and I hope you can afford your own bodyguards because I told the police you don’t want to participate in their communist system of shared benefits.

    @jeffjohnvol: You loved darkened’s last paragraph? Good, go join him in your isolated cabin in the woods. When you catch rabies, you can cure it yourself rather than having to – gasp – have to accept medicine that was developed with a generous research grant from the government. I pay a lot in taxes, and I don’t mind reaping the benefits. But then again, I recognize that I don’t live in my own personal little universe and that living in civilized society involves mutual obligations that make everyone’s lives better.

  82. S-the-K says:

    Strum40 stole my thunder. These 40 million “say” they can’t afford health care insurance. I’d lay odds that a majority of those number either choose to be self-insured (they don’t get sick often so their cost to insure is more than their benefit) or choose to spend their money elsewhere. Before saying that those 40 million are not able to afford insurance, I’d ask how many have late model or new cars? How many have high-definition TVs? How many have cell phones with thousands of minutes per month, i.e., not a basic plan for emergencies? How many buy expensive clothes and shoes, etc.? How many decided to buy a house with no down payment and an adjustable rate mortgage during the real estate bubble?

    IMHO, these people CHOOSE to put their money in luxuries and let the government (read: working American taxpayers) pay for their essentials.

    I am offended by Hillary’s ClintonCare program. What if you choose to be self-insured and don’t want to spend a huge portion of your income on insurance from the government? You will be thrown in jail! Oh, and government-mandated insurance WILL be VERY expensive. Every lobbyist will pay off Congress to require that their pet project be covered by government insurance. There will be no choice if you want coverage for something or not. There will be no choice if you even want government insurance or not.

    Name ONE government program that hasn’t exceeded it’s projected cost and become a huge burden on the working American taxpayer!

    I also am offended by the requirement that employers pay for their employees’ insurance. It is an additional cost of the employee, although the employee won’t see it on their pay stub (like the 6% “employer contribution” to Social Security), they will think it is “free”. It’s not “free” it is an expense of hiring a worker and a cost that will be passed on to the consumer.

    What we can do to encourage more people to get health insurance is to allow individuals what corporations are allowed to do. Let individuals deduct the cost of insurance from their taxes.

    Everyone who has dealt with Medicare knows that Medicare sucks. And I’m sure you’ve heard of the Walter Reed Hospital debacle. My dad’s dealings with the VA hospital sounds consistent with other people’s tales of the VA. The Democrats and the Hilldog want to give everyone the same quality of care they get at Walter Reed and at the VA.

  83. Ass_Cobra says:

    @darkened:

    You have plenty of choice. My understanding is that Andorra is particularly charming this time of year. Just who do you suppose should enforce universal billing…I’m guessing the government? And with what means should they enforce it, I’m guessing it will take tax revenue. And bitching about school tax, ha! Imagine summer all year round with bands of undereducated youths roaming the streets, harrasing the elderly. When the old folks in my neighborhood would complain about high property taxes that support a school system they don’t even use, my parents would offer to let them watch us all day in exchange for their property tax payment. No one ever took us up on the offer.

    @trollkiller:

    This is how insurance works my friend. The idea is that on average you have people claim less than the premium. The only issue is that you need a very large pool of insureds to smooth the distribution out to something that is manageable. This is where insurance companies come in. What you are proposing is a self insurance scheme with an insured pool of 1 (your family unit). It defies statistics that you could ever properly price or risk manage this. If you want to try, be my guest, it is after all a free country.

  84. SexierThanJesus says:

    @S-the-K:

    Wow. Let’s take this one point by point, eh?

    “I’d ask how many have late model or new cars?”

    I do not have a car.

    “How many have high-definition TVs?”

    I received one as a gift several years ago. 19 inches. Should I sell that so I can make half of a one month payment on a health insurance policy?

    “How many have cell phones with thousands of minutes per month, i.e., not a basic plan for emergencies?”

    I do not have this “thousands of minutes” plan you speak of.

    “How many buy expensive clothes and shoes, etc.?”

    I do not own expensive clothes or shoes.

    “How many decided to buy a house with no down payment and an adjustable rate mortgage during the real estate bubble?”

    I do not own a home. Any other sterotypes about those of us without health insurance I can clear up for you? I’ll wait here while Glenn Beck gives you further orders.

  85. Ass_Cobra says:

    @S-the-K:

    Hey dude, just so you know, the issue at Walter Reed was not one of poor delivery of care but deplorable conditions of maintenance. Guess what, the facilities management and support services at Walter Reed were outsourced to…wait for it…IAP which is run by a former Haliburton exec! Shocker right, Haliburton overcharing the government and screwing our troops…I never would have beleived it.

    Additionally Walter Reed is run by the DOD and the VA is run by the Department of Veterans Affairs. They are completely different administrations.

    I have a feeling that all of those who think it’s impossible for the federal government to do anything more efficiently than private enterprise have never experienced corporate inefficiency.

  86. jeffjohnvol says:

    @Beerad: Actually, thats not a bad idea. My cabin is in a gated area in TN, and I’ll be moving there in 10 years, with enough savings to make sure I can afford insurance. The point darkened was making was its not worth his taxes to pay for your healthcare, or mine. Why not give everyone a house too. We are only entitled to the pursuit of happiness, not happiness itself.

  87. canerican says:

    Hey, move to Canada, you’ll probably pay 50% taxes, and if you get hurt the health care is horrible, but at least you will be saving money, or at least that is the logic behind universal health care. Universal health care is nothing but a socialist idea to redistribute wealth massively.
    I lived in Canada up until 3 years ago, believe the American health system is far better. We pay our doctors better, invest more in pharmaceuticals. and get generally better care.

    I lived in a town of 50,000 and we only had 1 dermatologist, 2 OBGYNs, and about 20 family practitioners. Universal health care causes the system to get bogged down… In case anyone was wondering.

  88. Beerad says:

    @jeffjohnvol: I believe the point darkened was making is that he doesn’t feel it’s fair for his tax dollars to support social programs he doesn’t endorse (like schools!) Unfortunately, a la carte taxation doesn’t work: I don’t get to pick and choose what the government spends my money on. Instead, we agree to pick people, via elections, with the understanding that they will make those choices for us.

    I, and others sharing my views, think that a basic social safety net (like social security or Medicare) should exist to help people out who otherwise might not make it, and it should be expanded to include healthcare for all. The drafters of the Constitution didn’t foresee HMO’s and denial of preventative care because “you aren’t sick enough yet.”

  89. trollkiller says:

    @jeffjohnvol: The Massachusetts (sp?) solution was good. Require everyone to have it. Hillary has the same idea. If everyone has it, competition should drive the costs down, if you can remove the illegal immigrants from the emergency rooms.

    You would think it would drive costs down, sadly that won’t be the case. Take a look at this article. [money.cnn.com]

    Many are skeptical of mandatory coverage, as it’s sure to line the pockets of health carriers as all the nation’s uninsured will have to comply or face tax penalties.

    “That’s 47 million more customers for them” said the University of Minnesota’s Feldman.

    Insurers say that won’t necessarily be a good thing. They say that while a number of uninsured pose very little or no risk there also are a significant number of those who do.

    And they aren’t promising a slowdown in double-digit annual premium increases.

    Some premiums will go up, but people will get insurance that didn’t get it before,” said David Olson, spokesman for insurer Health Net Inc. (HNT)”

    Are you old enough to remember when mandatory auto insurance was introduced? The promise that it would lower premiums has not happened yet.

    If you want lower health care costs you have to have transparency and fairness in pricing. If something is worth $50 when paid by insurance than it should be worth $50 when I pay for it, not $150.

  90. jeffjohnvol says:

    @trollkiller: I bookmarked the article to read after work. I do recall the mandatory insurance, and although the rates may not have dropped significantly, the others out there “should have” liability insurance to protect us from having to pay for our car from our insurance thus reducing rate increases from getting hit when not our fault. Theoretically if the uninsured have the same risk levels as the insured, the rates won’t go up. But at least they should be responsible for their liabilities.

    In Mass, the government covers those that fall below a certain income level. I support that, but not for any person that doesn’t want to pay for it but can afford it. Here again, if they are at the same risk level then insurance may not go up, but we should get less visits to the emergency rooms for people who have a flu but now insurance.

    I work hard to provide my family with food, shelter and health coverage and I don’t feel guilty about it, not do I want Bill Gates to pay for my healthcare.

    They need to reduce the costs with tort reform, use of nurse practitioners (for sore throats), and other efficiencies.

  91. mconfoy says:

    @trollkiller: and how do i find out what insurance would pay? call them up and hope they tell me? you live a dream world. why is this more efficient than what other countries have? It is a drain on our GDP to pay more than anyone per person and get less for it. That is the bottom line. When we pay less and get more like other countries with the current system, talk to me. But we never will. It only will get worse.

  92. mconfoy says:

    @canerican: Then why are the results not better in the US and why do we spend 3 times what Canada does for those worse results? Outcome and cost is the only thing that matters.

  93. mconfoy says:

    @jeffjohnvol: A good citizen would care for the system that delivers the best at the least cost. We deliver near the bottom of industrialized nations with the privilege of paying the most. You are paying for it now and it costs you more. There is no free lunch. We need a system that costs half of what ours does and delivers better than most or all other countries. Are we just to lame of a nation to achieve that?

  94. Glaven says:

    I want to see health care managed better, but state-by-state. One big nationalized system would be a disaster, in my opinion, as I think scale is an important consideration.
    Currently we have a sort of lame non-system in that poor people needing care clog up ERs everywhere – especially at County hospitals – and then large chunks of their bills are written off (to Charity Care, public funds, etc.). It’s like a really lame, dysfunctional social safety net.

    Meanwhile, if you are self-employed, look at an HSA. They are a more catastrophic coverage sort of thing but there’s this attached savings account of pre-tax money that is a very, very good deal. If you are currently paying COBRA you can probably move to an HSA without having to fill out the health questionnaire (I think regulations are state-by-state so I can’t guarantee that). I think HSAs should really catch on, but when I had one, mostly it was a hassle as nobody understood what it was (and it didn’t cover maternity AT ALL so watch out for that).

  95. Auntie M. says:

    @trollkiller:

    “Also that $30k hospital bill you saw was grossly inflated. The insurance company paid a lot lower rate. Your $900 portion was most likely 1/3 of the total payout.”

    Of course it’s inflated, but if I didn’t have insurance they would have gone after me for the $30,000 which would have bankrupted me since I work for a non-profit and don’t make much money. I’ve saved all my life, but would have had to go into my 401K and go through that. Those without health insurance are billed the full inflated amount, and expected to pay or have the bill turned over to a creditor.

  96. MrEvil says:

    The reason the ER has such a huge long wait is because ER’s are required to treat by law regardless of a patient’s ability to pay. Immediate care clinics and private doctors’ clinics do not have this requirement. If people have SOME manner of help to pay for healthcare you’d see ER waits go down because people could instead go to a Primary care physician in a private office or go to an immediate care clinic. People could also afford to get regular checkups where their PCP could catch certain ailments before they lead to huge hospital bills. If you ask me, the logic that the right keeps preaching that waits will go up if we offered universal coverage are total bullshit.

    What would go a long way is if the SOBs that run the hospitals and insurance companies had an 800 pound gorilla ready to kick them in the ass if they tried anything unethical. Last time I went to a hospital I paid $68 to submit a “sample” to the lab for a culture because I was ordered by my doctor. The lady I paid the $68 to said that’s all that was needed. So I go to the lab, borrow the restroom for a couple minutes and hand over the sample container. 3 days later some asshole from the hospital calls back saying that my culture took some extra work and that I still owed them $73. I know EXACTLY what the fuck happened. Those rotten bastards at the hospital saw someone with no insurance and thought they could screw me out of another $73. What other kind of business can get away with this bullshit? State one price for a service, then say “whoops, we didn’t charge you enough. You owe us an extra $xx”

    So when I called the hospital on their BS they stated consent to treat. They didn’t TREAT anything, my PCP who ordered me to the lab was the one treating me, and I’ve already paid him. All I did was walk into the hospital borrow their bathroom and put some bodily fluids in a cup for them to look at under a microscope. What treatment?

    This is nothing new either, hospitals like auto body shops have two price lists, one is for customers without insurance and the other is for customers with insurance. The only difference between the two is that the hospital charges MORE to people without insurance. I wouldn’t say either one is unethical, but the auto body shops are a bit more ethical than the hospitals. At least the body shops are screwing an insurance company that screws its customers anyway.

  97. jeffjohnvol says:

    @mconfoy: Travel the world my friend and then tell me our system is that bad. I have a buddy in the UK that says the time to see a doctor is quite long. Many are opting for private insurance even after they are taxed and have it available to them without extra charge. Our costs are high here, in great part due to liability suits which WE pay, not the insurance companies or doctors.

  98. trollkiller says:

    @mconfoy: The insurance rate plus your co-pay will be about 30% or the retail bill. Example $100 retail price = $30 insurance + co-pay.

    I do not live in a dream world, if I did Jessica Alba would be typing this for me.

  99. trollkiller says:

    @MrEvil: That sounds as bad as when I went to the ER in Daytona for a kidney stone.

    I received a bill from them that showed $3500 for “services rendered”. That was all, no itemization at all.

    I called them up to get an itemized bill, when the bill arrived that total amount had changed. Going through the bill I found they billed for an IV pump that was never hung. They also billed for “specific drug screens” at $50 each. There was one for pot, opiates, amphetamines and a couple of others, 5 in total.

    I call the hospital and explain to the CS that they never hung a pump, she says “do you even know what an IV pump looks like.” After I inform her that I deliver IV pumps on a daily basis so yes I do know what one looks like she finds in the records where it was ordered but never hung. I am glad I did not need that IV. Ok great that item was removed.

    I then ask her what the purpose of the drug screens were. I did not ask for any pain medication while I waited 6 1/2 hours before going to the CT scan. She said that is what the doctor ordered. I asked her what kind of test was it and when she said urine, I knew I had them dead to rights. I had NOT given a urine sample. I told her that I would not pay those charges because 1) there was no need for the screen and 2) I never pissed in a cup. Of course she did not believe me, so I asked her the results. No drugs showed up in the tests even though I had taken Vicoden the night before and another dose on the day of the supposed test.

    I told them to remove the charges and I would pay the remaining bill. They refused to remove the charges and have yet to be paid. They were calling my house about the bill on a daily basis until I started using the phrase “fraudulent charges”. Suddenly they stopped calling, I wonder why?

    p.s. I never saw a doctor until after the CT scan when he walked in and said, “you have a kidney stone, make an appointment with your urologist and here are some pain meds”.

  100. mconfoy says:

    @jeffjohnvol: Let’s deal in facts, not talk. Less than half of what we spend per person in the UK and the results are better. And if you believe that the costs are so high here because of malpractice, well that is wrong. The largest single factor is administration costs. That is why mental health professionals are leaving insurance left and right. Low reimbursement coupled with high administration costs. How does malpractice play into that? Turn off Fox news and talk to some doctors. Why does a doctor’s office need a full time person just to do insurance codes? And another one just to do referrals? And this does not count the overhead in each of the companies that provided choices of insurance and the insurance companies where hard work is something others do.

  101. mconfoy says:

    @trollkiller: And doing this instead of a single payer system is better why?

  102. trollkiller says:

    @mconfoy: With transparent pricing the consumer will retain the power of choice, you lose that with a “single” payer system.

    The doctor can set his price according to the market, would you want the Govt. setting your company’s price?

    A free market will always bring you the best fair price.

    What advantage does single payer/socialized healthcare have?

  103. jeffjohnvol says:

    @mconfoy: You live in a fantasy land. Stop getting talking points from Ralph Nader. Administration costs are part of the problem, as well, but its not just one thing. Besides, if the insurance companies let Doctors do whatever they wanted the costs would be double, and only a moron would deny that. Look at medicare fraud as an example. BTW, I get most of my source of news from NPR, not Fox.

  104. Beerad says:

    @trollkiller: Wow, in your dream world Jessica Alba is your typist? I like it. Obviously I’m not dreaming big enough.

  105. mconfoy says:

    @trollkiller: @jeffjohnvol:
    I am still waiting for you two to tell me about how our free market system will have lower costs and better outcomes. Transparent pricing? How do you propose that should happen? We pay more, we get less. You can tweak failure to reverse that. If you can, show me some evidence where that has happened.

  106. trollkiller says:

    If the insurance company has to pay the same rate as private pay either the price will remain at the current private pay level or it will drop closer to the insurance pay level.

    With transparent pricing you will have less “gotcha” when you get the bill. If you know the Tylenol they are giving you is $6 a pill you will most likely take your own.

    Now the “how to make it happen”, simply pass and enforce a law that states the difference between insurance and private pay can’t be more than 6%. Or better yet make the insurance payment payable ONLY to the policy holder. Just like car insurance. There is no reason to need a couple of full time people at the doctor’s office just to deal with insurance.

    Ok your turn.

  107. trollkiller says:

    The above post was @mconfoy:

  108. trollkiller says:

    @mconfoy: My last post was written in haste while at work, I felt you deserved a better answer so here it is.

    With transparent and single tier pricing the overall cost will drop. With mandatory insurance the overall costs will rise.

    Right now there is a wide gap between insurance and private pay. Insurance pays $30 private pays $100. The private pay for the most part can not afford buying insurance, it stands to reason they they can also ill afford to pay the inflated private pay cost. So they clog up the emergency room with non emergency ailments. They then get very high emergency room bills that will not be paid.

    If the same rate was required for both insurance and private pay, the private pay rate would plummet and the insurance rate would increase slightly. Logic being if the doctor prices too high the insurance will drop them from the network.

    Single tier pricing will also open health care up to being a free market again. Competition and real prices will rule, labs, imagery, hospitals and doctor will be fighting for your business. Not to mention it is a lot easier for someone to come up with $40 than it is to come up with $100.

    Now you may be asking yourself why doctors and hospitals don’t lower their prices now. The answer is simple, if they lower their prices then the insurance companies and Medicare will want to lower the payouts. Example, doctor charges private pay $30, Medicare and insurance will make their payout $15. Plus the doctor can write off the higher private pay amount if you can’t pay.

    Now let’s look at mandatory insurance like Massachusetts has. Everybody in the state has to have it so the insurance companies have to accept them. You would think that adding more to the pool would lower cost, it won’t.

    The people that don’t have insurance could not afford it before so that means insurance companies will have to accept a lower premium from the poor or taxes will have to subsidize them. Either way the cost for your health care will increase even if you have insurance.

    The next group that does not have insurance are those that are a risk. They would be the ones that have medical problems that prevented them from being accepted by the insurance companies in the first place. Their claims will be higher than average. That extra cost to the insurance companies will have to be made up on the premiums of healthy people.

    Now let’s look at Govt. run socialized health care. That will take most of the choice away from the patient. Right now I see a doctor that is 80 miles from my house. I am willing to drive that 80 miles because I trust and like my doctor. With Govt. run health care I would be forced to use a doctor closer to home or maybe even further away.

    We have health insurance on the children through a state sponsored plan, We are required to use the doctors they say no matter how inconvenient it is. My daughter’s GI’s office is 85 miles away, we have to drive that far because that is who the insurance company uses, not because we think that is the best place to go.

    I want choice in my health care, without it I would be dead. I found my doctor and he made me better after many before him had failed. If I were stuck with a run of the mill doctor I would have been dead years ago. And no I am not hyping for dramatic effect.

  109. mconfoy says:

    @trollkiller: If I don’t know the prices of what the doctors charge in an easy way and the quality of their work, there is no transparency. But the bottom line is you once again fail to address, that the next worse country as far as costs, France at a bit more than half our costs, has better results. Until you demonstrate how you will have a system at their costs or lower with better results, its just talk. These countries pay way less per person and get better results. You can call it socialized, but I call it better because it is by any objective measurement.

  110. trollkiller says:

    @mconfoy: Define better results.

  111. trollkiller says:

    @mconfoy:
    Being unfamilar with the French healcare system I did a bit of research. Found out a few interesting facts you may not be aware of.

    1. The French PHIS only covers approx. 75% of the total health expense so the French do not have a single payer plan.

    2. The remaining 25% is paid either all out of pocket or about half of the 25% will be covered by private insurance. 15% do not have the extra private insurance. In the case of the poor the Govt. pays the extra 25%.

    3. Patients must pay 30% of Social security’s tariff for a physician’s visit, and roughly 40% of specialists

    4. The French PHIS was set up in 1945, it took until 2000 before all legal residents were covered. That would be 55 years for the math impaired.

    5. The French pay approx 40% Social Security tax on income.

    6. The French PHIS has run a deficit since 1985 and is currently has a $13.5 billion deficit.

    7. 40% of health care cost comes from the general revenue NOT the PHIS.

    8. The French spend 10.7% of their GDP on health care while we spend 16% GDP. Their costs maybe half but like everything, you make more you spend more. I think the GDP number is a better indicator of true cost, don’t you?

    So how would the French system work for you. I did a bit of math and found out under the French system I would pay $14,000 a year on my modest $35,000 a year income into the health care system. That is $1166 a month. I don’t have insurance at work because for family coverage it is $800 a month. I can ill afford to pay $1166 a month for “cheaper” health care.

    That does not even count the 30-40% I would have to pay for the doctor’s visit or the price of private insurance to cover the gap.

    Saying France spends less on health care per person is like saying Mexico spends less on housing per person. The true indication is what percentage of income is spent on health care. I am not sure about you but I don’t know of many that spend 40%+ on their health care.

    I outlined in a previous post how single tier and transparent pricing will lower overall costs.

    I explained in the previous post that you either make it illegal for there to be a price difference between private pay and insurance or you make the insurance payable to the policy holder only. Either way the pricing is transparent because you don’t have the insurance company getting a greatly reduced price that is hidden from the consumer.

    When the insurance company’s 80% of a $20,000 bill is $5,000 and my 20% of that same bill is $4,000 there is a problem. If insurance and private pay were on a level playing field that $20,000 bill would have been $9,000. Look with single tier I just saved $11,000.

    Now it is your turn, tell me how single payer or a system like France has will be better than a single tier and transparent pricing.

  112. trollkiller says:

    @mconfoy: I guess you have no reply.

  113. trollkiller says:

    @mconfoy: Yep, typical Lefty crap. Can’t fight facts so you run away.