What is wrong with American medicine: the opinion of a Russian-speaking immigrant

Although the general standard of living in the United States is quite high, there are also “eternal” problems here, the main of which is medicine. Few things scare the average American more than a serious illness and the need for extensive treatment. The country has an incredible in its absurdity healthcare system, which is beyond the power of even a person with two higher educations to understand, writes the author of the channel "50 shades of New York" on Yandex.Zen.

Photo: Shutterstock

In order not to be unfounded, I will give some statistics for a start. According to 2019 data, 66% of the bankruptcies of individuals in the United States are associated with receiving bills for payment of treatment, while about 80% of those who went bankrupt had health insurance. On average, an American spends 4 times more money on medicine than a German. 1,9 million US residents chose to receive medical care outside their home country in 2019. How do you like that?

I’ll tell you about the system itself. Medicine in America is paid, every resident of the country must have medical insurance. Large companies pay it to their employees and even their family members, but not all employers do this. More often a working person buys health insurance himself.

For example, in New York, it will cost you an average of $ 600 dollars per person per month. If the annual income is below 65 thousand dollars, you can expect a decrease in this amount. Low-income, unemployed, people with disabilities, minors and retirees receive state insurance for free under Medicare and Medicaid. A step towards more affordable medicine for all residents of the country was made by Obama, but the Obamacare program was actually canceled by Trump. Earn money - shell out for insurance, that's the point.

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But don't assume that insurance will solve all your medical problems. It does not cover some of the diseases and procedures, or only partially. Therefore, having applied for help, the insured is terrified to receive additional bills. The category of the doctor who performed your procedure, or the medication you were injected, can cost you several hundred or even thousands of dollars.

Few people manage to predict these costs - I know examples when a person instructed a personal assistant to carefully study all the conditions of his insurance in order to avoid unnecessary expenses and still received “letters of happiness” with four-digit amounts at the end of treatment. It seems like the president in 2019 signed a decree obliging to open prices for medical services to individuals. Just think: how can the cost of paid services be hidden from the consumer?

Now you understand why ordinary Americans are afraid of doctors like hell and turn to them only in case of emergency. While for Russians calling an ambulance is a common thing, here they even prefer to go to the maternity hospital by taxi, because an ambulance (aka fire department, aka 911) is almost never included in insurance and costs a ton. They also spend a day or two in the hospital, because a day in a medical facility costs 1-3 thousand. This is very motivating to get better.

In recent years, medical tourism has become increasingly popular. Special services offer Americans to receive quality treatment in neighboring Mexico (yes, medicine is there), Thailand, Israel, Turkey. And from those who wish there is no end!

Another problem in American health care is the powerful pharmaceutical lobby. All serious medicines are purchased strictly by prescription, but are more often given by the attending physician. The patient himself does not influence the choice of the drug and does not really delve into the topic at all. This is one of the reasons for the opioid crisis, which is now being covered by the media so much. The uncontrolled use of opioid analgesics has led many people to ruin. Just imagine: I wanted to get rid of back pain - I got a bottle of pills from a doctor and became a drug addict.

By the way, people in the United States are not at all versed in medicines and are not accustomed to self-medication. Once I was explaining to a whole line at the pharmacy that activated charcoal helps with poisoning, and they thought it was a vitamin or something.

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In general, the crisis in American medicine is obvious. Still, in Russia, treatment is much more accessible, and it is very difficult for immigrants to get used to the new harsh realities. Fortunately, in recent years this problem has been actively discussed in the press, and society expects serious and effective reforms from the authorities.

Original column published on the blog. "50 shades of New York" on Yandex.Zen.

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