US health insurance
#61
BE Enthusiast
Joined: Mar 2017
Location: Austin, TX
Posts: 455
Re: US health insurance
Nutmegger
So I will pose a question for you: why would anyone in their right mind leave the NHS to come to the US knowing they were ill?
So I will pose a question for you: why would anyone in their right mind leave the NHS to come to the US knowing they were ill?
The primary benefit of the NHS is that it's free at the point of use for anyone who is covered, which is hardly something that the NHS has been able to uniquely achieve - there are many countries in the world that are able to offer the same to their residents.
Probably the biggest drawback of the NHS, at least in my personal experience, is that it doesn't really matter if it's "free" if you have to wait for months and months before you can be referred to a consultant, or if a drug or therapy that might benefit you is licensed in the UK yet not funded by the NHS. It's a very good system if you need critical or emergency care and the treatment that the NHS will provide you in the event of a heart attack or a road traffic accident will not be markedly different to what you would receive in the US or in any other advanced economy, but you start to see the real problems with the NHS if you need secondary care, or if you have to be referred to any sort of specialty that isn't politically sensitive enough to benefit from adverse media attention and high levels of funding; dermatology and mental health are the two specialisms that spring to mind as being especially problematic.
The US of course is the very antithesis of the NHS where you can get pretty much anything and everything your doctor wants so long as you have the ability to pay for it, and if you have good insurance in the US then the treatment that you'll be able to receive will be night and day compared to the NHS.
I would in fact flip your question around and ask why anyone in their right mind would want to go back to the NHS if (and I know that this is a massive if) they have access to the healthcare system here in the US and the insurance coverage necessary to utilize it without bankrupting themselves?
This is of course a problem when you retire and no longer have access to such things like employer-funded PPOs, but that doesn't really negate the main thrust of what I'm getting at here.
#62
Re: US health insurance
Then your next big investigation should be into how work visas and green cards are obtained and how they interrelate, as it appears your understanding is somewhat sketchy.
#63
DE-UK-NZ-IE-US... the TYP
Joined: Mar 2010
Posts: 2,848
Re: US health insurance
I would prefer not to be adding type of visa into the mix.
Before posting, I spent many hours over the last month or two, reading various threads on this forum, and I could see how quickly these threads turn into slamming matches, and go quickly off topic, especialy when it comes to healthcare topics, and I would want to avoid it here.
A lot of people have been asking some very reasonable questions, unfortunately they have very quickly been forced to abandon their therads as answers they were being given were not answering questions they were asking.
To simplify it even further, lets just say I got a green card, valid for 10 years, with full work permit, and I am going to be landing in the US next week.
Hopefully, this thread will not only help me, but will help other people in the future too.
Thank you
Before posting, I spent many hours over the last month or two, reading various threads on this forum, and I could see how quickly these threads turn into slamming matches, and go quickly off topic, especialy when it comes to healthcare topics, and I would want to avoid it here.
A lot of people have been asking some very reasonable questions, unfortunately they have very quickly been forced to abandon their therads as answers they were being given were not answering questions they were asking.
To simplify it even further, lets just say I got a green card, valid for 10 years, with full work permit, and I am going to be landing in the US next week.
Hopefully, this thread will not only help me, but will help other people in the future too.
Thank you
So you are already a PR living here, so do you not have health insurance ?
#64
Re: US health insurance
Because contrary to the propaganda that Brits routinely buy into, the NHS is not in fact the "envy of the world" and literally no country in the world is looking to adopt the NHS as their healthcare system of choice.
The primary benefit of the NHS is that it's free at the point of use for anyone who is covered, which is hardly something that the NHS has been able to uniquely achieve - there are many countries in the world that are able to offer the same to their residents.
Probably the biggest drawback of the NHS, at least in my personal experience, is that it doesn't really matter if it's "free" if you have to wait for months and months before you can be referred to a consultant, or if a drug or therapy that might benefit you is licensed in the UK yet not funded by the NHS. It's a very good system if you need critical or emergency care and the treatment that the NHS will provide you in the event of a heart attack or a road traffic accident will not be markedly different to what you would receive in the US or in any other advanced economy, but you start to see the real problems with the NHS if you need secondary care, or if you have to be referred to any sort of specialty that isn't politically sensitive enough to benefit from adverse media attention and high levels of funding; dermatology and mental health are the two specialisms that spring to mind as being especially problematic.
The US of course is the very antithesis of the NHS where you can get pretty much anything and everything your doctor wants so long as you have the ability to pay for it, and if you have good insurance in the US then the treatment that you'll be able to receive will be night and day compared to the NHS.
I would in fact flip your question around and ask why anyone in their right mind would want to go back to the NHS if (and I know that this is a massive if) they have access to the healthcare system here in the US and the insurance coverage necessary to utilize it without bankrupting themselves?
This is of course a problem when you retire and no longer have access to such things like employer-funded PPOs, but that doesn't really negate the main thrust of what I'm getting at here.
The primary benefit of the NHS is that it's free at the point of use for anyone who is covered, which is hardly something that the NHS has been able to uniquely achieve - there are many countries in the world that are able to offer the same to their residents.
Probably the biggest drawback of the NHS, at least in my personal experience, is that it doesn't really matter if it's "free" if you have to wait for months and months before you can be referred to a consultant, or if a drug or therapy that might benefit you is licensed in the UK yet not funded by the NHS. It's a very good system if you need critical or emergency care and the treatment that the NHS will provide you in the event of a heart attack or a road traffic accident will not be markedly different to what you would receive in the US or in any other advanced economy, but you start to see the real problems with the NHS if you need secondary care, or if you have to be referred to any sort of specialty that isn't politically sensitive enough to benefit from adverse media attention and high levels of funding; dermatology and mental health are the two specialisms that spring to mind as being especially problematic.
The US of course is the very antithesis of the NHS where you can get pretty much anything and everything your doctor wants so long as you have the ability to pay for it, and if you have good insurance in the US then the treatment that you'll be able to receive will be night and day compared to the NHS.
I would in fact flip your question around and ask why anyone in their right mind would want to go back to the NHS if (and I know that this is a massive if) they have access to the healthcare system here in the US and the insurance coverage necessary to utilize it without bankrupting themselves?
This is of course a problem when you retire and no longer have access to such things like employer-funded PPOs, but that doesn't really negate the main thrust of what I'm getting at here.
#65
BE Forum Addict
Joined: Aug 2013
Location: Athens GA
Posts: 2,132
Re: US health insurance
I understand the OP wanting to understand as much as possible about the health system. It is ridiculously complex. Unfortunately you will only gain an overall grasp and never be able to anticipate all the problems. Comparison of policies is impossible because there are just too many options. You ask for real life examples. Here's mine.
I was diagnosed with prostate cancer and had daily radiation treatment for 190 days. The cost every day was over $1,000.
On my insurance I am responsible for the first $2,500. I then pay 25% co-pay from $2,501 to $6,000 i.e $875. So the total I paid that year, and the maximum any year, is $3,375. Everything else was paid by my insurance and was well over $200,000 that year.
That is just one example on my employer's policy. Other policies will be different.
I also know someone who had sudden heart issues and the medical costs in that year were over $1m. She paid around $6,000 and everything else was covered by her insurance.
I was diagnosed with prostate cancer and had daily radiation treatment for 190 days. The cost every day was over $1,000.
On my insurance I am responsible for the first $2,500. I then pay 25% co-pay from $2,501 to $6,000 i.e $875. So the total I paid that year, and the maximum any year, is $3,375. Everything else was paid by my insurance and was well over $200,000 that year.
That is just one example on my employer's policy. Other policies will be different.
I also know someone who had sudden heart issues and the medical costs in that year were over $1m. She paid around $6,000 and everything else was covered by her insurance.
#66
Forum Regular
Joined: Dec 2013
Posts: 143
Re: US health insurance
"All these what-ifs sound as if the person coming to the US was already aware of their medical situation. So I will pose a question for you: why would anyone in their right mind leave the NHS to come to the US knowing they were ill?"
I moved here with a chronic and expensive illness, moving away from the 'safety net' of the NHS. With a decent job and good employer insurance, managing my illness is affordable and the level of care I get is far superior to the NHS. Even with deductibles and Max OOP being met, I still pay less in tax (including the max OOP as a 'tax'), than I did in the UK.
I moved here with a chronic and expensive illness, moving away from the 'safety net' of the NHS. With a decent job and good employer insurance, managing my illness is affordable and the level of care I get is far superior to the NHS. Even with deductibles and Max OOP being met, I still pay less in tax (including the max OOP as a 'tax'), than I did in the UK.
#67
Re: US health insurance
"All these what-ifs sound as if the person coming to the US was already aware of their medical situation. So I will pose a question for you: why would anyone in their right mind leave the NHS to come to the US knowing they were ill?"
I moved here with a chronic and expensive illness, moving away from the 'safety net' of the NHS. With a decent job and good employer insurance, managing my illness is affordable and the level of care I get is far superior to the NHS. Even with deductibles and Max OOP being met, I still pay less in tax (including the max OOP as a 'tax'), than I did in the UK.
I moved here with a chronic and expensive illness, moving away from the 'safety net' of the NHS. With a decent job and good employer insurance, managing my illness is affordable and the level of care I get is far superior to the NHS. Even with deductibles and Max OOP being met, I still pay less in tax (including the max OOP as a 'tax'), than I did in the UK.
#68
Re: US health insurance
"All these what-ifs sound as if the person coming to the US was already aware of their medical situation. So I will pose a question for you: why would anyone in their right mind leave the NHS to come to the US knowing they were ill?"
I moved here with a chronic and expensive illness, moving away from the 'safety net' of the NHS. With a decent job and good employer insurance, managing my illness is affordable and the level of care I get is far superior to the NHS. Even with deductibles and Max OOP being met, I still pay less in tax (including the max OOP as a 'tax'), than I did in the UK.
I moved here with a chronic and expensive illness, moving away from the 'safety net' of the NHS. With a decent job and good employer insurance, managing my illness is affordable and the level of care I get is far superior to the NHS. Even with deductibles and Max OOP being met, I still pay less in tax (including the max OOP as a 'tax'), than I did in the UK.
#69
Forum Regular
Joined: May 2018
Posts: 233
Re: US health insurance
My daughter’s school friend was diagnosed with a rare, aggressive type of cancer when she was 16. When she died 3 years later her parents were $250,000 in debt. Both parents worked with good healthcare insurance. Debt over healthcare costs is the #1 cause of bankruptcies in the US.
#70
Re: US health insurance
In reading this thread, I think that there is a fair amount of fiction in Medical billing.
I found this article in today’s Los Angeles Times of interest.
I found this article in today’s Los Angeles Times of interest.
#71
Forum Regular
Joined: Dec 2013
Posts: 143
Re: US health insurance
You moved to be with a USC spouse, I believe. Rightly or wrongly, I see that as a different circumstance from someone moving their family and positing that the breadwinner pretty much immediately take a leave of absence of indeterminate length. Glad it worked out for you, though!
When I first moved here i was working a consultancy job and self-financing the healthcare - that was expensive indeed. Had to find a proper job to cover the healthcare premiums (or at least 80% of them).
#72
Re: US health insurance
My daughter’s school friend was diagnosed with a rare, aggressive type of cancer when she was 16. When she died 3 years later her parents were $250,000 in debt. Both parents worked with good healthcare insurance. Debt over healthcare costs is the #1 cause of bankruptcies in the US.
In all three cases, who knows what the actual payments were by the insurance companies; in the US, medical 'billing' seems to be a work of fiction, with little bearing on what is actually paid. It reminds me of the bartering you hear about in some countries in the markets ...
#73
Re: US health insurance
I understand the OP wanting to understand as much as possible about the health system. It is ridiculously complex. Unfortunately you will only gain an overall grasp and never be able to anticipate all the problems. Comparison of policies is impossible because there are just too many options. You ask for real life examples. Here's mine.
I was diagnosed with prostate cancer and had daily radiation treatment for 190 days. The cost every day was over $1,000.
On my insurance I am responsible for the first $2,500. I then pay 25% co-pay from $2,501 to $6,000 i.e $875. So the total I paid that year, and the maximum any year, is $3,375. Everything else was paid by my insurance and was well over $200,000 that year.
That is just one example on my employer's policy. Other policies will be different.
I also know someone who had sudden heart issues and the medical costs in that year were over $1m. She paid around $6,000 and everything else was covered by her insurance.
I was diagnosed with prostate cancer and had daily radiation treatment for 190 days. The cost every day was over $1,000.
On my insurance I am responsible for the first $2,500. I then pay 25% co-pay from $2,501 to $6,000 i.e $875. So the total I paid that year, and the maximum any year, is $3,375. Everything else was paid by my insurance and was well over $200,000 that year.
That is just one example on my employer's policy. Other policies will be different.
I also know someone who had sudden heart issues and the medical costs in that year were over $1m. She paid around $6,000 and everything else was covered by her insurance.
The 'deductible' and 'maximum out of pocket' are the things to watch out for, as well as the rules relating to in- vs out-of-network. I'm now in early-retirement, not yet covered by medicare, and having to pay high premiums for my policy (not benefiting from a company-provided policy). My deductible is in the region of $8,000 and my max out-of-pocket is something like $15,000. And my premium is circa $800/mo (which I get a subsidy for, since I'm not earning). I'm counting the days till I reach 'medicare' age when things will get much cheaper. One good side-effect is - I pay great attention to my health!
#74
Forum Regular
Thread Starter
Joined: Jul 2021
Posts: 31
Re: US health insurance
I understand the OP wanting to understand as much as possible about the health system. It is ridiculously complex. Unfortunately you will only gain an overall grasp and never be able to anticipate all the problems. Comparison of policies is impossible because there are just too many options. You ask for real life examples. Here's mine.
I was diagnosed with prostate cancer and had daily radiation treatment for 190 days. The cost every day was over $1,000.
On my insurance I am responsible for the first $2,500. I then pay 25% co-pay from $2,501 to $6,000 i.e $875. So the total I paid that year, and the maximum any year, is $3,375. Everything else was paid by my insurance and was well over $200,000 that year.
That is just one example on my employer's policy. Other policies will be different.
I also know someone who had sudden heart issues and the medical costs in that year were over $1m. She paid around $6,000 and everything else was covered by her insurance.
I was diagnosed with prostate cancer and had daily radiation treatment for 190 days. The cost every day was over $1,000.
On my insurance I am responsible for the first $2,500. I then pay 25% co-pay from $2,501 to $6,000 i.e $875. So the total I paid that year, and the maximum any year, is $3,375. Everything else was paid by my insurance and was well over $200,000 that year.
That is just one example on my employer's policy. Other policies will be different.
I also know someone who had sudden heart issues and the medical costs in that year were over $1m. She paid around $6,000 and everything else was covered by her insurance.
If I understood it correctly the whole treatment lasted only 190 days ? after those 190 days of treatments, daily radiaitons, the prostate cancer was gone and never returned?
The person you knew who had these sudden heart issues, how did she deal with not being able to go to work and making sure her insurance premiums were being paid?
Was she able to work as normal, or had some time off work?
Did she have a short or long term disability insurance that paid her wages while she was not able to work?
If I am not mistaken short or long term disability insurance only covers 60% of your wages, and long term disability insurance only kicks in after 90 days of you being off work, am I right?
Thanks
#75
Forum Regular
Thread Starter
Joined: Jul 2021
Posts: 31
Re: US health insurance
My daughter’s school friend was diagnosed with a rare, aggressive type of cancer when she was 16. When she died 3 years later her parents were $250,000 in debt. Both parents worked with good healthcare insurance. Debt over healthcare costs is the #1 cause of bankruptcies in the US.
How was that possible, if her parents had good healthcare insurance? I thought you only needed to pay your yearly copays, deductibles, out of pockets, and the rest is being covered by your health insurance?
Her parents worked, so obviously she all the premiums , copays, deductibles, and out of pockets were being paid, and they still were left with $250K debt?
I'm confused now.