Anonymous wrote:

Anonymous wrote:I was on a girls trip and all of them were doctors from the UK and Canada, except for my friend who is an American in the UK and a clinical psychologist. They could not wrap their heads around our healthcare system. They did not know how any America could sleep at night when one illness could send you into bankruptcy.

+1 for all that's wrong with the NHS and Canadian healthcare, most of their citizens don't worry about medical bankruptcy.

Great medical care in the US is for the rich.
Good or decent medical care in the US is for the UMC who have good insurance.
Everyone else is just screwed.

Anonymous wrote:The other thing that's stunning is the cost of medication in the USA. I know people who go on trips abroad just to stock up on their regular medicines that are 1/20 of the price in other countries.

Anonymous wrote:I am so tired of physicians around here who are concierge/take no insurance!

Yes the system is broken, but instead or organizing to fix it they just jettison their non-wealthy patients, and savor the lighter workload.

Anonymous wrote:It's an absolute sh!tshow.

I am a patient. Because of my condition, I have had several organs removed and my altered anatomy is often a consideration in treatment of other issues.

Because of this condition I need regular access to specialists. Primary care doctors typically punt anything even remotely related to my underlying condition to specialists. I have not seen an adult primary care doctor attempt to "coordinate care" among these specialties in decades (our kids' ped is better at this.) We recently attempted to find one who would actually do this work, at concierge rates, and could not.

About a month ago my GI attempted to prescribe a medication. This required a prior authorization, an appeal, and my giving my physician "power of attorney" to appeal for me--via fax. This was the only way they accepted the documents: fax.

The Rx was successful. I had a "discount card" for the copay so I paid $0. The charge to my insurer for the drug, which is available for $100 for a 30-day supply in generic in India, Canada and other nations where generic meds are routinely produced at high quality, was $5600 for a month.

Several other medications I use, which are not obscure, have been in shortage states or unavailable entirely in the last couple of years. (None of these are stimulants, by the way--I know folks are aware of those shortages; these are additional.)

Another family member has post-acute COVID and is seen by a doc in the GW Long COVID clinic. The doc is great but absolutely swamped. This family member has also needed care from across a range of specialties: cardiology, pulmonology, gastroenterology, urology, neurology, physical therapy. There is a protracted wait for each. The integrated institutional supports are nonexistent (I'm actually watching a National Academies webinar on this right now--their report is here: https://nap.nationalacademies.org/read/27756/chapter/1#ii) and I expect this to get worse and not better.

The waits are longer. Many specialists are leaving practice. My insurance (United Healthcare) just experienced a hack that prevented adjustment of claims for almost three months.

I am white, heterosexual, highly educated, and have made handling our health care an additional quarter-time job (sometimes more). The experiences of people who are also experiencing racial and other bias in docs' offices must be tens of times worse--let alone people who do not have platinum-plated health insurance (I have throughout) and/or lots of experience navigating this system.

It's falling apart. Large parts of it are irredeemable already. I don't know of a provider who doesn't also think this.

Anonymous wrote:The other thing that's stunning is the cost of medication in the USA. I know people who go on trips abroad just to stock up on their regular medicines that are 1/20 of the price in other countries.

Anonymous wrote:

Anonymous wrote:It isn’t collapsing. It has collapsed.

100%

When someone goes to the ER with chest pains & is waiting in the waiting room for 9 hrs instead of immediately being taken to triage, it's a broken system.

When an elderly person is diagnosed with having had a stroke in the ER & discharged with orders to follow up with a neurologist within 7 days, but the earliest appointment you can get them is 8 months out, the system is broken. My sibling and I sat calling with our mom to try to get my dad an appointment & this was the result. We have him on a dozen different waitlists but we're still 4 months away from his appt. Terrifying.

A friend went through something similar in finding a Derm. Her Derm couldn't get her in until FEBRUARY 2025 and she had a worrisome spot appear that was rapidly changing. After finding none that could get her in, she went the concierge Derm route. Luckily she had the funds to do so, but what about those who can't go that route? We're going to get to the point where those without the funds to seek alternate treatments get sicker or die while waiting.

Anonymous wrote:It isn’t collapsing. It has collapsed.

Anonymous wrote:I don't know if it's collapsing, but it's been extensively documented that Americans pay a lot more for worse health outcomes compared to other unindustrialized nations. We are posted overseas, and one of the things I am most dreading to return to is the US health care system. Where we are, health care is high quality, more holistic and much cheaper.