Medicine in the USA: expensive and even more expensive

In the USA, the government believes that the main thing is the market and competition. This means that the state must first of all ensure that monopolies, cartels, corruption schemes and other types of unfair competition do not form, and the self-regulating market will do the rest. This all implies a minimum of government regulations and restrictions in all areas with the exception of critical services, one of which is the healthcare system, the user writes Diaver in the community Picabushniki North America.

Photo: Shutterstock

Next - from the first person.

Medicine in the States is not just expensive, but insanely expensive. Medical bills are the most common factor in American bankruptcy. I will give an example from my accounts to understand the order of prices:

A tick clung 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 it had attached itself, and that's it. The bill for this was 421 dollars.

• My wife felt unwell, we again went to emergency assistance, spent about 4 hours there. The bill for this visit is 3500 bucks.
• A colleague with kidney stones went to the emergency room, spent about 6 hours there. The bill was 6500 bucks.
• Childbirth cost 10 bucks.
• A visit to the doctor for an on-call examination of a 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 differ dramatically;
• very expensive insurance for clinics and doctors, which are bought to protect against claims of patients.

Medical insurance

There is no way without health insurance in the States. If you have any health problems more serious than a cold and you don’t have insurance, it’s cheaper to die.

There are several different types of health insurance in the United States. For one type of insurance, you pay, for example, 800 bucks out of pocket every year, everything on top is paid by the insurance company. On the other hand, you only pay a mandatory fixed fee for admission (copay), the rest is paid by the insurance company - this is exactly the option I have.

What's happened 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 a doctor or an ambulance (urgent carea) help 30 bucks;
• for an emergency room visit - 150 bucks;
• childbirth - 250 bucks.

Why this sopay needed: in a nutshell - so that patients do not pester doctors and insurance companies with fictitious diseases. This 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 to do if you have no insurance and no money? You can just as easily come to the hospital, and the hospital has no right to refuse help. The hospital itself understands that no one will pay them money, but there is nothing to do - this is one of the factors in the rising cost of services. Those who have money pay the costs of clinics from those who do not have money.

Another very important factor is that insurance companies do not work with all clinics and not all doctors. Everyone they work with is considered online (In network), all others are offline (out of network). If you come to a clinic that is not in your insurance network, then things are bad; depending on the policy, the insurance company may refuse to pay at all or pay only part of it. Moreover, even the doctor himself, who works in a clinic that is “online” may turn out to be “offline”. One of my colleagues got into "Emergency room“at the clinic “online”, but the doctor who treated him turned out to be “out of network”, 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, is 500 bucks. For one employee about 100 bucks a month. Insurance includes dentistry with a lot of restrictions and vision (participants' vision).

Vision in the States, this 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 insurance vary greatly from company to company. For companies, good insurance is a kind of competitive advantage to lure employees.

Types of medical care

1. Just a visit to your doctor if you have something sick, regular check-ups for the child, vaccinations and other non-urgent medical services. In this case, you need to call the reception and make an appointment with your doctor. They can appoint the same day, the next or every other day. Payment copay such a reception in my case 30 bucks.
2. Something happened to you and you need to see a doctor right this evening, but it’s not fatal - it’s already urgent care. You come to the clinic during office hours. You wait in the first place and get to the doctor's appointment, who decides what to do with you next. Payment copay such a reception in my case 30 bucks.
3. If you wake up in the middle of the night and feel like it’s gone bad and you need to see a doctor urgently, then your only option is Emergency room. An alternative is to call an ambulance or drive yourself by car or taxi. Calling an ambulance if it is not covered by insurance can cost 800-1000 bucks, so it’s better to get there 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.

Photo: Shutterstock

Quality medicine

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 denotes the delivery of something. When the postman brings you a parcel - this Deliverywhen the courier brought you pizza - that’s also 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 came to us several times and supervised the entire process. It is important to note that all the medical staff were very polite and friendly. Everyone was very patient and extremely tactful - this personally 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, we can talk about the birth process itself for quite a long time, but I was very delighted with everything: the staff, the equipment of the clinic, the clear order in all procedures. The impressions were especially vivid in contrast to the process of giving birth to my first child. The doctor, as I later found out, behaved like a complete asshole, and I paid him very good money for those times. The good ones are 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.

Pharmacies

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 has been compiled from various sources, including the author's own experience, and may contain inaccuracies or errors.

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