The Joys of the US medical system

[Gaby&Talbert 1]

The problem is that it's such a huge business now which employs so many people, that the companies have to keep driving up premiums to cover the administrative and employee costs associated with providing the insurance coverage in the first place.

I don't think admin costs are THE problem. I don't have an answer, but would like to share some personal data. I have software to manage medical expenses so I can give you exact dollar amounts easily. My husband died of cancer. In ten months of the year he died, we were billed $448,270.91 (yes, almost half a million). We only paid $3,438.97. I don't have the figures for the two years before that. That's why I pay for insurance.

Did you know that one round of chemotherapy, that's sitting in the chair one day, costs $8,000-$10,000? Have you seen those commercials where actors say "I'm ready" (for chemo) because they took something like Nulasta to boost their blood count? Did you know that's a shot that costs about $1,500? It's daunting.

I have a niece that has cancer in Mexico and the costs of these medicines in Mexico are a fraction of what they are here in the US. The chemo you were charged 8 to 10 grand for is only about $800.00 there.

I have a very interesting story about the costs and what they had to go through for the chemo medicine. My sister-in-law that lives in Mexico has 2 daughters. The first daughter had cancer when she was 1 1/2. After her daughter was cured she volunteered at a cancer treatment center for many years. Last year her second daughter was diagnosed with cancer. The clinic she was having problems getting the chemo medicine at the time and was told the price was going up because a new company has the distribution rights for the medicine and has not established inventories yet. My sister-in-law called all over the country trying to figure out why the medicine wasn't available and where she could get it for her daughter. She was told that the new distributor had a contract with the drug manufacturer and they could only sell the drug to them in Mexico. The new distributor had raised the price to be closer to the US drug price but would not have any inventory for a few months. My sister-in-law was very worried that her daughter could not wait and also was upset about the price increase. The clinic she volunteered for is non profit clinic so she thought maybe the drug manufacturer would sell the drugs directly to the clinic. She found the manufacturer of the drug which is in Italy. She contacted them but was told that the distributor for Mexico has an exclusive contract and they could not sell to anyone but them. My sister-in-law has many relitives in Mexico City and some work for the government so she called them to see if they could find out if anything could be done to help the clinic buy the medicine direct. While she was waiting on help from the goverment she told my wife about the problem. My wife remembered one of her friends she grew up with married a man from Italy and worked for a drug company. She called her friend and told her the story. Her friend talked to her husband who does work for the manufacturer of the drug. He said his company would donate all the medicine for the clinic for one year and then after that they would sell directly to the clinic because it was a non profit clinic. The cost of the medicine per dose is $400.00 dollars US. My sister-in-law was very happy but unfortunately the distributor discovered this and said she has friends in the government and would stop the medicine from ever getting to them. Meanwhile her Aunt who lived in Mexico City was friends with the person in the government that was over all importing of goods into the country. He told her that he would give the clinic all the neccesary permits to had the drugs shipped into the country. After about 2 weeks the drugs made it too the clinic and my niece began her chemo. It has been a little over a year now and this week is her last chemo treatment. She has tests in about a week but they believe the cancer is gone. She is now 16 years old.

My point is that Americans are getting ripped off, how can a drug that costs $400.00 cost 10 times that or more here in the US?

[stevi1123 0]

What an interesting story. It is very sad how our system here is virtually corrupt, for the lack of a better word. But more importantly, I pray for the continued good health of your niece. My father is currently going through chemo, and the cost of his care is enormous, not to mention the toll this horrible disease takes on the family as a whole.

[tom_g 3]

well, in the UK I paid 12% of my income to national insurance. Over here I pay almost nothing and my wife pays $350 a month. For that, we both get almost instantaneous access to some of the best hospitals, doctors, equiptment and treatment.

with the NHS, I got either a week to see a doctor who'd give me 5 minutes of his time, maximum. Or I could go to A+E and wait 4 hours. Either way I risked MRSA or C. Difficile because the cleaning was subcontracted out to the lowest bidder many years ago. And that cost 12% of my salary.

The US system is the better deal for me, personally. YMMV.

[Lansbury 19]

well, in the UK I paid 12% of my income to national insurance. Over here I pay almost nothing and my wife pays $350 a month. For that, we both get almost instantaneous access to some of the best hospitals, doctors, equiptment and treatment.

Actually that is IMHO a misleading comparison.

Firstly the rate is 11% and doesn't apply to the first I believe £100 a week of earnings, if I read the tables correctly. If you are contracted out the rate is 9.4%.

Secondly the contribution isn't just for medical care, it goes towards your state pension, and if not contracted out your state supplementary pension.

The US system is better in that the waiting times for non-serious illness is very much less and some of the facilities are newer and better maintained, which is should be considering what hospitals and doctors charge. But I don't think the standard of expertise is any greater. When you go behind the scenes at US hospitals they are not that much better than UK ones and I have see that side of quite a few as I'm an emergency blood courier for the Red Cross.

When I think about the two systems what comes to mind is a teenager in Oregon who had a snowboarding accident and ended up in intensive care. The cost $30,000 a day and he spent well over a month there. No family in the UK would every be faced with those sorts of bills and the care in the UK would have been just as good.

[Lansbury 19]

Over here I pay almost nothing and my wife pays $350 a month.

Is that through her employment or private medical insurance?

[Amby 490]

my husband took a lower paying job because they offer free health insurance to their employees and charge $30 a month to add their families. you have to wait 9 months to get the insurance but I think a pay cut for free insurance is well worth it!

[Toshtishtash 1]

Over here I pay almost nothing and my wife pays $350 a month.

Is that through her employment or private medical insurance?

I would like to know that too.... Chris has just got a quote to add me onto his insurance when I get there. In total it is going to cost us just shy of $550 a month. I think that is absolutely ridiculous. Considering that's not even full cover! You still have to pay anything up to the first $150 (I think... Could be $200)

Here in England I pay about £23 a week national insurance.

I can't believe how much drug companies etc rule America. Surely everyone is entitled to the same medical treatment?

I have a question... What happens if you have a serious accident (touch and go whether you will survive or not) but you don't have medical insurance?

[no name 1]

I can't believe how much drug companies etc rule America. Surely everyone is entitled to the same medical treatment?

If you have insurance, yes.

I have a question... What happens if you have a serious accident (touch and go whether you will survive or not) but you don't have medical insurance?

You're completely screwed, no lie.

[tom_g 3]

I have a question... What happens if you have a serious accident (touch and go whether you will survive or not) but you don't have medical insurance?

You're completely screwed, no lie.

"completely screwed" means you're bankcrupted, by the way, not that you you're left to die by the road-side. And being bankcrupted isn't a massive issue over here, you can have good credit again in two years or so. And there ARE free hospitals over here, as well, you just have to do work yourself to find them

The National Insurance comparison is perfectly valid, IMO, its the only way I can track how much I'm paying towards what I consider to be a pathetic health service. Ovebloated, over-measured, over-managed... how many trusts have to have C. Difficile scandals before people admit there's a problem? Maybe the front-line nurses and doctors are totally commited in the UK, but they're working hamstrung, at best, and the overall level of care and attention is dreadful. I'm not going to try to defend US drug companies' pricing policies, except to say that drug discovery is extremely expensive, and when they price it down for foreign markets, they're doing that to HELP the foreign market.

And finally, for anyone moving to the US, it shouldn't come as a surprise that the health care system is mercenary. This is not a socialist country, and doesn't pretend to be, the american dream isn't about supporting those who don't wish to dream, its about enabling those who do.

rant over

my wife has private medical insurance, by the way. She's had the same provider for so long that its cheaper to pay private than to put her on my insurance. waitresses don't get health benefits, they are expected to keep themselves healthy

[Mags 112]

I've just taken out private heath insurance and for myself and my son it will cost $266 a month. Not as bad as I had feared (I had geared myself up to it being nearer the 400 mark). Still, even with insurance, I have to pay the $30 co-pay on prescriptions and a $30 fee for a doc appointment.

I had NO problems ever with the NHS. I worked for them too and yes, you do hear the horror stories, but I think that happens with every hospital system. American healthcare is not exempt from MRSA and other infections.

Take our local hospital here in our town. The beds are so old the plastic on them has cracked and they are filled with human "juices" of many different descriptions. They haven't had new beds for 20 years. Our local hospital also has the doctors who finished at the bottom of their classes and couldn't get jobs at bigger city hospitals. But they do have a nice new copper roof. How's that for prioritizing?

Basically, the staff are poorly qualified and the equipment is old.

Edited April 6, 2008 by Mags

[Lansbury 19]

I have a question... What happens if you have a serious accident (touch and go whether you will survive or not) but you don't have medical insurance?

My daughter-in-laws sister is married to a guy who is employed by a local hospital. It is his job to go to see people who have no insurance, while they are still in hospital, and determine with them how they will pay their bills.

If he determines the people have no assets at all, or are illegal immigrants, the hospital rights off the money. If the patients have any form of assets the hospital requires them to pay all of the bill or as much as the assets cover. Taking them to court to get the money if necessary.

Imagine doing that for a living and the little s**t like his job too.

[Nich-Nick 3,354]

The medical system/health insurance/pharmaceutical scheme in the US has so many aspects that I don't know that it's fair to point to one facet and call it the bully. Everybody wants to make a profit in their business. It's sort of a vicious circle with lot's of contributing factors.

Just an opinion: I think hospitals and doctors charge alot because they often don't get paid except by people with insurance. People with no means are treated at reduced rates or free, so working and insured people have to help pick up the tab by being charged those high prices. Insurance companies have to pay out huge amounts to cover those high prices, so they have to keep raising their rates or lessening their coverage. A doctor likely doesn't start his independent practice until age 32 after years of paying for college, med school etc. Then he has to pay huge sums of money to start up an office, buy equipment and pay huge amounts for malpractice insurance. So he has to charge alot to cover his expenses/debt.

On to medicines and cures for diseases (which I do have some personal knowledge.) A new drug or a cure or a vaccine can take years of research in the lab and great cost for patents on the formula. The technology may be outlicensed to a company that has enough money to actually pursue getting it through the FDA (Federal Drug Administration.) It can cost billions of dollars to go through that process. First they need approval that it's good enough to be tried on humans, then Phase I, II, and III of clinical trials (paid for by the company), then finally it's approved to go on the market. The FDA part of the process is about eight years if all goes well. If a hospital doing a clinical trial screws up the specific protocol, then it's held up. Then they have to market the approved drug and get it in use. So that company has spent billions and the patent is only good for 20 years from the time it was invented. Depending on how long the approval process took, they may only have 10 years left to sell it and make back their billions with some profit before anyone can make a generic from their formula and sell it much cheaper. That's part of the reason new cures are so expensive. But what if they didn't bother trying to bring new drugs to the market because it's too much trouble? Would we be be better off?

I'm not cheering for anybody here. I just try to see it from different viewpoints. I wish somebody could fix the whole problem, but it's not going to be easy. I'm glad I have instant access to the state of the art medical center in Houston, Texas. I'm glad research continues for new cures. I'm glad that I have insurance to pay for it. And I too wish my insurance didn't cost so much a month.

[TracyTN 237]

Bottom line - some people prefer the NHS, some prefer our system - yet both have obvious flaws. No way we're all ever going to see eye to eye about the nitpicky details.

[no name 1]

Bottom line - some people prefer the NHS, some prefer our system - yet both have obvious flaws. No way we're all ever going to see eye to eye about the nitpicky details.

Nope. But the bottom line, one is free (for many people)/very cheap & one is not. HUGE difference.

Edited April 7, 2008 by illumine

[Lansbury 19]

Bottom line - some people prefer the NHS, some prefer our system - yet both have obvious flaws. No way we're all ever going to see eye to eye about the nitpicky details.

Shame we can't have the quality of US health care at NHS costs. Bottom line is neither is better than the other there is good and bad in both.