Is the US health system collapsing?

[Anonymous]

The system is working exactly as intended. (by rich scumbags who are profiting)

[Anonymous]

Horribly broken/collapsed. People should not need to ration medication, lifesaving medication because it's too expensive. People should not need to choose between medication and paying rent or eating. So many things are broken in our country for such a large percentage of people.

[Anonymous]

I am on my 3rd pcp in as many years because the first two left medicine entirely. Neither was over 50, they just couldn’t take it anymore.

[Anonymous]

Went to Thailand. Sister and law broke arm. Went to a remote ER that was no where even near a top hospital in Bangkok. Seen immediately by the ER doc. X-ray, setting, cast, prescription for pain, followup visit, and total doctors fees....grand total was $300.

Excellent care too not even anywhere near Thailand's top hospitals. The US is far, farrrrrrr below Thailand now for healthcare. It's insane. US healthcare is probably barely better than Venezuela or North Korea at this point and doesn't even deserve to be talked about with other actual developed nations. 10000x the price of what it needs to be for far worse outcomes, rationing, and death. Did you know that in South Korea the average citizen goes to the doctor more than 12 times a year! That's how affordable and accessible medicine is in other parts of the world.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There was a pretty shocking article in the NYT about a private equity backed company called Multi Plan which insurers use to assess out-of-network claims. The bizarre part is Multi Plan’s feed are based on the amount it denies. You’d have to be stupid to not see the problem with that sort of incentive arrangement.

“For a New Jersey trucking company called New England Motor Freight, UnitedHealthcare used MultiPlan to reduce a hospital bill from $152,594 to $7,879, then charged the company a $50,650 processing fee.”

https://www.nytimes.com/2024/04/07/us/health-insurance-medical-bills-takeaways.html

I am somewhat familiar with multiplan — what you’re describing isn’t claim denial, it’s negating for a rate that is similar to an in network rate. (What you’re described about their fee is not consistent with what I’ve seen.). Part of the problem is that hospitals and doctors have all these fake rack rates that no only actually pays. If you read your EOB, it often says your provider charged $500, insurance paid $125, and you owe $20. The rest is just a ghost charge. When you go out of network, they charge the fake rack rate and wait for someone to negotiate it down. It’s an insane system but the answer is not that the insurers should just pay the crazy rack rates.

I understand that inflated charging needs to be kept in check. But there is an inherent danger in compensating Multi Plan based on the amount they deny. There is an incentive to deny as much as possible rather than what is reasonable. If they were paid a fee not linked to the saving, would the amount approved be any different? If not then why not just charge the fee? If the amount approved would be different, then you really have to question why.

[Anonymous]

Healthcare is over 20% of the US economy and produces new millionaires every week (most of whom don't see patients).

The good news is that it often produces stunning results (at an insane cost) and the wealthy class is generally well taken care of.

[Anonymous]

Anonymous wrote:Went to Thailand. Sister and law broke arm. Went to a remote ER that was no where even near a top hospital in Bangkok. Seen immediately by the ER doc. X-ray, setting, cast, prescription for pain, followup visit, and total doctors fees....grand total was $300.

Excellent care too not even anywhere near Thailand's top hospitals. The US is far, farrrrrrr below Thailand now for healthcare. It's insane. US healthcare is probably barely better than Venezuela or North Korea at this point and doesn't even deserve to be talked about with other actual developed nations. 10000x the price of what it needs to be for far worse outcomes, rationing, and death. Did you know that in South Korea the average citizen goes to the doctor more than 12 times a year! That's how affordable and accessible medicine is in other parts of the world.

Agreed. We live in Asia. I do an annual physical package at a good hospital that includes bloodwork, EKG, mammogram, ultrasound, hearing test, eye exam, bloodwork and a 20 minute consultation with a doctor who reviewed all the results in an integrated way for $300. The bill for a recent colonoscopy (without insurance) was $200. I have insurance, but some expenses, I don't even bother submitting because the costs for some medications and basic doctor's visits are so low that it's not worth my time to do the paperwork. If I had some rare disease and needed an experimental trial or some groundbreaking complicated surgery, I would want to be in the USA. For everything else, not so much

[Anonymous]

Absolutely. I plan my exit daily.
- doctor

[Anonymous]

Anonymous wrote:

Anonymous wrote:Went to Thailand. Sister and law broke arm. Went to a remote ER that was no where even near a top hospital in Bangkok. Seen immediately by the ER doc. X-ray, setting, cast, prescription for pain, followup visit, and total doctors fees....grand total was $300.

Excellent care too not even anywhere near Thailand's top hospitals. The US is far, farrrrrrr below Thailand now for healthcare. It's insane. US healthcare is probably barely better than Venezuela or North Korea at this point and doesn't even deserve to be talked about with other actual developed nations. 10000x the price of what it needs to be for far worse outcomes, rationing, and death. Did you know that in South Korea the average citizen goes to the doctor more than 12 times a year! That's how affordable and accessible medicine is in other parts of the world.

Agreed. We live in Asia. I do an annual physical package at a good hospital that includes bloodwork, EKG, mammogram, ultrasound, hearing test, eye exam, bloodwork and a 20 minute consultation with a doctor who reviewed all the results in an integrated way for $300. The bill for a recent colonoscopy (without insurance) was $200. I have insurance, but some expenses, I don't even bother submitting because the costs for some medications and basic doctor's visits are so low that it's not worth my time to do the paperwork. If I had some rare disease and needed an experimental trial or some groundbreaking complicated surgery, I would want to be in the USA. For everything else, not so much

This is something that every expat, immigrant, or anyone who has lived abroad for a while knows to be true.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Went to Thailand. Sister and law broke arm. Went to a remote ER that was no where even near a top hospital in Bangkok. Seen immediately by the ER doc. X-ray, setting, cast, prescription for pain, followup visit, and total doctors fees....grand total was $300.

Excellent care too not even anywhere near Thailand's top hospitals. The US is far, farrrrrrr below Thailand now for healthcare. It's insane. US healthcare is probably barely better than Venezuela or North Korea at this point and doesn't even deserve to be talked about with other actual developed nations. 10000x the price of what it needs to be for far worse outcomes, rationing, and death. Did you know that in South Korea the average citizen goes to the doctor more than 12 times a year! That's how affordable and accessible medicine is in other parts of the world.

Agreed. We live in Asia. I do an annual physical package at a good hospital that includes bloodwork, EKG, mammogram, ultrasound, hearing test, eye exam, bloodwork and a 20 minute consultation with a doctor who reviewed all the results in an integrated way for $300. The bill for a recent colonoscopy (without insurance) was $200. I have insurance, but some expenses, I don't even bother submitting because the costs for some medications and basic doctor's visits are so low that it's not worth my time to do the paperwork. If I had some rare disease and needed an experimental trial or some groundbreaking complicated surgery, I would want to be in the USA. For everything else, not so much

This is exactly what happened to my friend who was living in Asia. She was diagnosed with a rare and aggressive cancer because of their superior screening but was advised to immediately fly back to the U.S. for care.

This is something that every expat, immigrant, or anyone who has lived abroad for a while knows to be true.

[Anonymous]

Would it be fair to say that the medical care available in the US is excellent, but accessibility and value for money is very poor?

[Anonymous]

Anonymous wrote:Would it be fair to say that the medical care available in the US is excellent, but accessibility and value for money is very poor?

PP doctor. I don’t think the health care is excellent. To have excellent care, you need the system as a whole to function. I’d say we have excellent innovation and breakthroughs here but the actual delivery of this care is horrible and almost negates anything good about our system.

[Anonymous]

I would wager it's in a state of collapse already. My dad recently passed away from cancer. He was seeing the best docs in the business at one of the top hospitals in the country. But the experience over the past 2 years was absolute hell for him, and my mom, who was thrust into a caregiving role. Dealing with the "system" was a nightmare. In a nutshell there were so many instances where the various teams and specialists he was seeing didn't communicate with each other, or something was missed in his chart, and my mom had to repeat the same information and even correct some staff on occasion to prevent deadly mistakes. She believes if she hadn't been there to be his advocate, he would've died a lot sooner from a medical error. And this happened to someone with plenty of money (my parents are pretty well off) and experience in the healthcare sector (Dad's career prior to getting sick). Can't imagine what it's like for someone who does not have these things--no one to advocate for them and double and triple check the massive amounts of treatment plans and information being thrown their way, possible language barriers, and lack of money! Awful.

I am not in any way casting blame on the Dad's doctors or nurses, who for the most part were excellent, compassionate, and were trying to do their best in a sh!tty system. Especially the nurses, who were truly special people. I don't know what the solution is. Hopefully the best and brightest in this country will figure it out and right the ship. But given the state of politics these days on both sides, I think sadly it's going to get a lot worse before it gets better.

[Anonymous]

Reactions to US HC and what HC looks like in an actual developed nation:

[Anonymous]

Anonymous wrote:Absolutely. I plan my exit daily.
- doctor

Another physician here. I transitioned to working federal for a salary and with an underserved population. It's not lucrative (obviously), but I can give top-notch care to people who appreciate it by learning to work the system for them.

Please think about federal service before hanging up the stethoscope for good. It is lovely to know you were providing SMART asthma 3 years before the specialist service for your state got on board.

Good care, decent work-life balance, and continuing to make a difference in the world with hard-earned skills. Never looked back.