Medical Bankruptcy

February 2, 2005 1:49 PM

An umbrella that melts in the rain WASHINGTON (Reuters) - Half of all U.S. bankruptcies are caused by soaring medical bills and most people sent into debt by illness are middle-class workers with health insurance, researchers said on Wednesday. "Our study is frightening. Unless you're Bill Gates you're just one serious illness away from bankruptcy."
posted by Shanachie (69 comments total)

My health insurance just went up 60% and I haven't had a claim in three years. Apparently the lawyers have.
posted by sled at 2:15 PM on February 2, 2005

who cares? as long as gays can't get married, freedom is on the march in the middle east, and the rich continue to get the tax cuts they deserve, everything's awesome in america.

after all, if you get sick, it's obviously because you're not working hard enough for your betters, or you've displeased god in some way. in which case you deserve whatever happens to you.
posted by lord_wolf at 2:22 PM on February 2, 2005

Interesting stats.

I'd be curious to know in detail what proportion of people who become ill enough to require medical treatment take on debt, and how many of those file for bankruptcy. It's one thing to say that many bankruptcies as caused by illness, it's another to say that many illnesses result in bankruptcies.

I'd also be curious to know what proportion of the debt was due to lost wages from being unable to work as opposed to incurred medical expenses.

But of course I'm too lazy to do the research myself. Bueller? Bueller? Anyone? Anyone?
posted by randomstriker at 2:26 PM on February 2, 2005

Good one, lord_wolf. Let's not leave out the pharmaceutical companies, who are getting rich regardless of who pays for the meds, and who are helping keep the current oppressive system in place.

At one time I had prescription coverage that forced me to use a mail-order pharmacy unless I wanted to pay 20% of the cost of my medication. But what are you supposed to do in the meantime when you're getting your mail-order drugs (usually in 3-month increments for "maintenance" meds) set up? Go to your local pharmacy for a one-month supply. 20% doesn't seem too bad--unless you have to take an obscure, no-generic-available immunosuppressant that costs $4000 for one month.

That would be the day I had an $800 pharmacy bill. And that was a number of years ago. I've actually been afraid to see what my immunosuppressants cost now.

I guess I'm still just on the verge of bankruptcy--my annual out-of-pocket expenses are usually "only" $6000. Unless I have a bad year.

National health care, anyone? Sign me up.

Republican: rich healthy person
Democrat: sick poor person
posted by MiHail at 2:30 PM on February 2, 2005

It happened to my family. We were relatively high on the scale of income since my dad was a nuclear engineer. Then both of my sisters got cancer. Then one of them had a brain tumor. Then she died. Then we moved because we couldn't afford to live there anymore.

State schools. Used cars. No big deal, just didn't see it coming.
posted by Plinko at 2:32 PM on February 2, 2005

I've seen this in at least five news sources since I pissed out my first Americano this am...
posted by docpops at 2:36 PM on February 2, 2005

" My health insurance just went up 60% and I haven't had a claim in three years. Apparently the lawyers have."

Who increased your premium, a lawyer or an insurance company. I think it has been abundantly proven at this point that there is no correlation between litigation expenses, which are a tiny percent of the insurance industry's expenses, and premiums. In states where there is "tort reform" or caps on awards, premiums continue to go up.

As for the issue dealt with here, it is a huge problem, and one I see every day with my own clients. It's a thin line between doing fine and losing your house and car. At the same time they are dealing with huge medical problems they are dealing with debt, stress, relationship problems, and instability. Try losing your job, health, wife, house, and mind all in one year.

And the solution is . . . ?
posted by Outlawyr at 2:41 PM on February 2, 2005

randomstriker, I can give you a personal example.

My (soon-to-be-ex) husband and I got into debt to the tune of about $20,000 about 12 years ago (jeez...it's been that long?). It was not due to lost wages; it was due to the fact that hubby worked for a company as a contractor just prior to my diagnosis. I had been going to college, so I was spending, not earning, money at the time on tuition, books, etc. I had to drop out which eliminated that expense. Because I'd been having health problems right at the same time that he was finally made a "real" employee with benefits, the insurance company decided that my condition was "pre-existing" and they wouldn't cover it for a full year. So we were paying for insurance that did us no good.

Why, you ask, didn't we pay for insurance from his previous job?
1. We couldn't afford it
2. We were young and healthy--figured we could handle the occassional visit to the doctor for antibiotics. Who knew I'd develop a rare disease and need a liver transplant at age 26?
posted by MiHail at 2:41 PM on February 2, 2005

Heh, count me in. Working my way through graduate school. My last voluntary insurance left me with 4,000 debt over a cancer scare. Among the joyful caps and exemptions? Surgeon paid for in full. Surgeon's assistant not covered. Removing part of my kidney, paid for in full. Installing a stent to keep the ureter from scarirng close, thus killing the rest of my kindney, not covered. Cap of coverage on radiology? $1,000, just enough to pay for a single ultrasound.

Now, I find out that I have a Gallbladder polyp. Relatively cheap at $5K, but that's still $5K I don't have.

I give us 50/50 odds of being bankrupt in a year.
posted by KirkJobSluder at 2:44 PM on February 2, 2005

KirkJobSluder, I can do you one better:

I'm Medicare-eligible now. I was not on Medicare during my transplant. Therefore, Medicare will not pay for my meds. However, if I need another transplant due to rejection because I didn't take meds, they would pay for the transplant.

What is wrong with this picture?
posted by MiHail at 2:47 PM on February 2, 2005

Solution= National health care. Buy Drugs in Canadia.

Quit pissing off God.
posted by wah at 2:54 PM on February 2, 2005

outlawyr is right. There's no such thing as being able to correlate medical costs with huge damage awards. That would be silly. Why would any corporation, insurance company, or any other entity raise their rates because of something as mercurial as the whims of eleven highly unbiased citizens? Medical care, like steel and housing and bananas, is entirely a market based on fixed, known costs.
posted by docpops at 2:56 PM on February 2, 2005

I keep reading about the American Health Care System, such as your lack of a Pharmaceuticals Benefit Scheme, which in turn creates prescription-drug-running Grannies who get cheaper meds from Canada, the soaring private hospital costs and lack of proper medical facilities for the needy and poor, no decent free medical care,- all really depressing and suprising stuff for the largest western nation in the world, and as a partner and a shoulder to cry on for a Health Care Management Professional for a large hospital in Australia, the system seems all the more insane.


In America there's not much of an actual "Health Care System" to speak of. And it's probably not going to change until GWB and his warmongeronies get their priorities straight. So until then, you have my sincerest condolences.

And in the meantime I suggest you all move anywhere... except for perhaps Paraguay.
posted by JGreyNemo at 3:00 PM on February 2, 2005

I don't have health insurance.
posted by sdrawkcab at 3:26 PM on February 2, 2005

I'm always amazed at the resistance Americans have to public health care. But then, my parents left America because they didn't want to charge for their services, so I guess my dedication to public health care is pretty deeply ingrained. I know that my household would have been screwed last year if we didn't have coverage. Both me and my SO got unexpected illnesses that required hospitalization and lots of medical imaging. We didn't loose any wages, but I can't imagine we could have covered the expenses on our own.
posted by carmen at 3:34 PM on February 2, 2005

Worked for a company, never went to the doctor and had my premium go up 25% in one year. Now unemployed and it costs $325/month for health insurance. Still haven't been to a doctor in five years. Why bother getting it?

National health care is the only solution. Medical bills are draining people, companies, and the government. States and cities are cutting everything to try and keep up with the rising health costs. Many businesses can't justify hiring because insuring employees is too much of a burden. Fix the health care problem and many, many problems will go away.
posted by Arch Stanton at 3:41 PM on February 2, 2005

Looking forward to seeing a Presidential candidate on the ballot who'll advocate national health care. I wish it'd worked out in 1996. On the other hand, I've heard scare stories about health care rationing, so I gotta wonder what would happen if I needed cancer treatment and had to go on a waiting list for it.
posted by alumshubby at 3:51 PM on February 2, 2005

National health care? Anyone step foot in a VA hospital recently?
posted by davenportmom at 3:52 PM on February 2, 2005

What I'm seeing is rising insurance costs. Its the insurance companies. They're raking it.
posted by davenportmom at 3:56 PM on February 2, 2005

There are numerous benefits to NHC.

But it will require at least one to three generations to breed out the inborn expectation for a standard of care that dictates testing at an extraordinary rate, no real wait for testing or consultation, and a severe restriction on anything deemed non-critical. I see very few things in practice that would meet the criteria for urgency under a Canadian system (at least based on the observations of three of my Canadian trained expat colleaugues), and I would be fine seeing a cut in my salary if it meant I could care for the underserved over the long term, instead of in fits and starts when they are in dire need. The downside as well - there would be no one left to sue, and you would have to prepare for the best and most aggressive minds choosing other fields over the long haul, I suspect, since no one would endure the sort of bureaucratic hell that NHC would become.
posted by docpops at 3:56 PM on February 2, 2005

So no, it is not the "only solution" by far. It would solve some problems, but create many others, at least by the standards of many people. But it would be more fair. But fair in today's society is as quaint as skipping through a field of daisies singing show tunes. So NHC won't be seen in our lifetime, I suppose, because the challenge is more cultural than anything.
posted by docpops at 3:58 PM on February 2, 2005

I agree with docpops.
My husband is a physician. He is working toward the day when he can drop all health care plans and just charge fee for service. If he sees an indigent patient in his office and doesn't charge them, then Blue Cross can sue for fraud.
posted by davenportmom at 4:03 PM on February 2, 2005

Now, this is a little bit rabid anti-Bush propaganda, but here's some info on how lawsuits aren't having nearly the impact that people perceive.

Insurance companies are designed to make money. People who aren't able/willing to pay for this "peace of mind" that insurance brings are often the ones who get screwed over. That, and those who the insurance companies fail to pay for.

The simple fact is, the law of corporations requiring to make as much money as possible is causing excessive difficulties in the health care industry. A non-profit, national system would benefit nearly everyone outside of the insurance industry. Without profits to worry about, the cost of insurance could be reduced. Everyone would be covered, so there would be no pre-existing conditions, any medically valid problem would be covered.

Certainly far from flawless, but allowing for-profit insurance companies to run America's health care is simply unacceptable. The freedom of the market should not come at the cost of the people.
posted by Saydur at 4:04 PM on February 2, 2005

Alumshubby, you had better start talking up the emotionally charge wedge issues in your state really early then, in order to get them out of the way before the next election. Gay Marriage, Abortion.... as polemical and socially important to the minorties affected as they may be, you want the majority people to be sick and weary of hearing this stuff. It needs to be in the vernacular, if anything to encourage lenghty debate about these issues, rather than the erratic and incendiary arguments brought out time and time again by the government to obfuscate the real issues like National Health Care and Schooling for Federal Elections.

People will again go to the polling booths to make a decision for all the wrong reasons. The Righty-Fundies, want you to be worked up by heartstrings rather than your head.

In essence, US Federal Health Care needs a better PR man.
posted by JGreyNemo at 4:05 PM on February 2, 2005

Certainly far from flawless, but allowing for-profit insurance companies to run America's health care is simply unacceptable. The freedom of the market should not come at the cost of the people.

That's precisely what we're trying to fight off in Australia right now. A government that wants to tip balance of power back to Insurance companies by offering federally funded cash "incentives" for anyone who joins up to private medical insurance. These funds could go back into the public system. But it seems the health of the people the second horse to private enterprise. The public system here is far from broke, but it's steadily going to get worse when it's being blatantly undermined by the people who should be supporting it.
posted by JGreyNemo at 4:10 PM on February 2, 2005

My company outsources all it's HR stuff. Checks, insurance, etc.

I was plesantly suprised when the HR company chick whent over my options with me. For a pretty resonable rate, I could basicaly be set for life if anything happens to me with this long-term disability insurance. (and there's short-term disability as well). The medical insurance is good, too.
posted by delmoi at 4:13 PM on February 2, 2005

I nearly joined the ranks of the medically bankrupted this past year. My first child was born in August. My family has no insurance, as my work does not offer it (that will change next month) and I cannot come close to affording it on my own. We saved in advance to pay for the anticipated costs of delivery, but a complication during the final minutes of pregnancy sent my daughter to the NICU for nearly a week and my wife into the hospital for just as long.

In the end, we were billed about $40,000 from the hospital and the various doctors and associates. I had no way of paying, and no prospects of ever being able to pay. I went in circles with the hospital for the following five months until I struck a deal: I'd pay half the debt in one lump sum if they'd forgive the other half. I told them it was that or nothing, as bankruptcy was my only other option. When they agreed, all but one of the other bill-writers agreed to the same deal. I found a company to finance a loan at 1.9% so I could make the payment, and all was saved.

I've still got a big balance to pay, and I suppose I'm still one disaster away from ruin, but I feel good about dodging the bullet.

I don't have hope that the US government could properly administer nationalized healthcare, but we sure need it.
posted by ewagoner at 4:26 PM on February 2, 2005

To further stir things up, two years ago, a neighbor of mine brought his new born to the hospital with a bad cough. The kid was pretty sick. My neighbor was a contruction worker and had no insurance. After he had been waiting for two hours an illegal immigrant family arrived with a child who had a similar problem.

The immigrant child was seen immediatley and with no charge for the care. My neigbor was billed and although he doesn't have to pay the enitire amount, he is still making monthly payments today.

We definately have a problem here, this particular guy was just starting a family and was financially shut down in just the first few months.
posted by snsranch at 4:26 PM on February 2, 2005

ewagoner, I wouldn't have posted that comment had I read your's first. Kind of reiterates the same idea. Good Luck to you!
posted by snsranch at 4:36 PM on February 2, 2005

I wish it'd worked out in 1996

Unfortunately, what was proposed in '96 wasn't any kind of universal health. Private, for profit health insurance companies were still involved, which meant money would be siphoned off for, well, profits. Plus, the thing that really struck me at the time is that they were talking $1 million, cradle to grave, which sounds like a lot until you start to think about someone who incurs a lot of healthcare bills as a child finding that as an older person, they have completely blown through their million dollars. No healthcare for you!

'96 being most of a decade ago, I can't remember much else about what struck me at the time. I still think for profit insurance companies are more part of the problem than part of the solution.
posted by ilsa at 4:38 PM on February 2, 2005

I have a job that pays 37% of my health insurance premiums. Insurance premiums have gone up by double digit percentages both of the past two years. My income has not gone up equivalently. Despite the fact that I have a year more seniority, I'm actually making less this year than I was last year. I'm a public employee too so this is just the city's tax money going more into the pockets of health insurance companies and less into the pockets of the people who live in the city. My contract is up in April and will not be renewed. The "good" news is that my boyfriend and I could get married if I needed health insurance. The bad news is that that's sort of crappy good news.
posted by jessamyn at 5:01 PM on February 2, 2005

Here in California, PERS just stopped supporting the local hospital healthcare group, which means to keep our doctors - specifically my wife's specialist, who she needs to see locally or else drive over 100 miles twice a week - we have to switch to a PPO, which lowers my takehome pay by 25% (my work covered 100% of the cost of the HMO, which is no longer an option) and increases the costs of my wife's prescriptions from $40 a week to $125 a week. Yay! Thanks, Public Employee Retirement System! The executive who made this ridiculous decision to "cut costs" by reducing service drastically was fired for it, but there's no plan on reversing it. The numbers given in the FPP sound right to me, given my personal experience, and I think I'm probably comparatively well-off.
posted by luriete at 5:05 PM on February 2, 2005

Hey, a word of advice, FWIW. I may be high, but if anyone ever gets a vicious bill, please contact the docs involved and diplomatically explain, via letter if possible, your circumstances. It may help. I know it does for me. Most of us just fill in a superbill without regard to whether their are financial issues because we aren't aware. We're too damn busy to keep track of those things as it is.
posted by docpops at 5:13 PM on February 2, 2005

National health care? Anyone step foot in a VA hospital recently?

The Annals of Internal Medicine recently published a study that compared veterans health facilities with commercial managed-care systems in their treatment of diabetes patients. In seven out of seven measures of quality, the VA provided better care.

link
posted by flaterik at 5:22 PM on February 2, 2005

National health care? Anyone step foot in a VA hospital recently?

Davenportmom, Washington Monthly just did a long feature on the VA and concluded that they're drastically improved in recent years and now are a model for what could be achived with national healthcare.
posted by nakedcodemonkey at 5:41 PM on February 2, 2005

Dang. Never mind. Flaterik go there while I was still searching for the link.
posted by nakedcodemonkey at 5:42 PM on February 2, 2005

as a student of the medical arts, i'm not sure I have a lot to throw in. We've all heard the arguments about the loss of quality of health care, but i'll tell you... what good is quality healthcare if a significant proportion to a majority of the population (depending on how you measure it) can't access it? Its absurd.

Sometimes I think back to the days before public services like firefighters existed - when you had to buy protection from a ladder co. that would spray water on your house. The problem of course being they wouldn't touch the bonfire of a house next to yours. When the next infectious epidemic comes (and it will come), I don't see why we won't get the same effect with private health insurances. Anywho, I've always felt the catalyst for change in the medical system would be when the ranks of the un- and under-insured grew in the middle class. How Marxist of me.
posted by deliquescent at 6:15 PM on February 2, 2005

nakedcodemonkey and flateric: no shit! When I got back from the Gulf war, with a grocery list of problems, they gave me such a run around it drove me nuts. I eventually went to civilian Doctors only to get the reply, "What was the Gulf War?"

So I gave up and now I'm just dealing with it and raising my family. Guess I better check back with the VA.
posted by snsranch at 6:23 PM on February 2, 2005

Went through financial hell about 10 years ago due to medical bills and a change in job situation. Funny thing I noticed was that the collectors for the medical bills were far more vicious than the other bill collectors. I just kept patiently explaining to them that they simply were not at the top of the list (food, shelter, transportation etc, came first). They were not an understanding bunch.
posted by UseyurBrain at 7:25 PM on February 2, 2005

Here's what happened to me almost 20 years ago now, back in New Jersey.

Just after leaving one job for another, I started having lower abdominal pains around an old scar from a childhood surgery. I didn't think it was a big deal until the thing started swelling up like a balloon and hurting so much I couldn't stand up straight. At that point, even though I had no health insurance, I went to the doctor - who said, "You need surgery. Right now." Boy, was I scared!

We drove over to the hospital, where they had me in OR within half an hour. They calmed me down with a sedative, then knocked me out for the surgery. I woke up not long after that; the doctor came in and said I'd been lucky, it was only an abscess on the old scar, and that it had been quick to take care of. They kept me overnight and let me go home the next day.

When the bill arrived, I read it carefully. The actual charges for all the services totaled about $900 - rather inexpensive, considering! But there was another line on the bill that said:

"DRG EQ CHG: $2,475"

So the total bill was $3,375 - which I had to pay out of pocket?!

So I called up the hospital and asked them what DRG EQ CHG meant. They explained to me that it was a "Diagnostic Related Group" payment, which was applied under NJ state law as a measure to "equalize" medical bills for people who have ailments that are closely related to each other.

So, for everyone who was diagnosed with a non-dental abscess somewhere on their bodies that required surgery, the state medical law provided for a minimum-to-maximum cost range for treatment. My treatment came in below the minimum, so this DRG charge was added to "equalize" my payment, increase it up to this arbitrary minimum (probably determined by some actuarial formula, I suppose) - it was supposedly paid into a Medicare pool that was used to reduce other people's medical costs who had also had an abscess, but required much more extensive surgery and hospital stay - it's possible to get an abscess deep inside your body, requiring major work.

In other words, I was being forced to pay $2,475 as a surcharge, out of pocket, even though I'd only gotten $900 worth of actual medical work.

I was amazed and appalled. Fortunately, the hospital folks told me there was a state agency that I could appeal the DRG charge to if I thought it was being applied unfairly, and I did so. The state agency fortunately agreed and removed that charge from my bill. I worked out a payment plan with the hospital at no interest, and paid it off. Whew.

Now here's the kicker - what would have happened if I'd had health insurance? They would have paid that $3,375 bill, and charged me for 20% of it. OK, so I would have paid less out of pocket, only $675. But the insurance company would have paid in $2,700 - three times the actual services bill. And I bet they would have jacked up my rates after that, too, to cover it.

The way it worked out, I actually paid the hospital for what they billed me, in an equitable agreement between us. Y'know, just a plain ol' regular transaction. I got fixed, they got paid. No fancy paperwork, no bullshit.

It sounded like a scam to me then, and still does - in this case perhaps the state was ripping off the insurance company. Where did that "state Medicare pool" money really go? Maybe the program was legit - but I suspect it wound up being some sort of "pay in/kickback" scheme between the state, Medicare, and the insurance companies. I think a lot of people were getting ripped off by it, and probably still are.

The system is definitely broken... unless you're rich. I have a buddy who had kidney failure 4 years ago, got a transplant 2 years ago (luckily a short wait) - and he had no insurance at the time, so it was covered by Medicare - after they'd cleaned him out of cash of course. And now, he is unable to work for more than a very low amount of money, because as soon as he goes over a certain amount, Medicare won't cover his maintenance care and medicines (expensive anti-rejection drugs and steroids). He would have to more than triple his current income to be able to afford to pay for that stuff himself, which is impossible where he lives. So he is forced to stay trapped in the system. It's a real mess.
posted by zoogleplex at 7:44 PM on February 2, 2005

Wow,
Glad to hear of the VAs improvements.
That place used to scare me in the 90s.
I look forward to reading the article.
posted by davenportmom at 7:45 PM on February 2, 2005

Too expensive? Go to India.
posted by dhruva at 8:23 PM on February 2, 2005

Eff India, this zoogleplex story is a reminder of how things can become very disjointed and Kafkaesk when not somehow regulated. We NEED healthcare. It's like a monopoly; you are in the desert and need water, I am the only one with water. I can charge you $500.00 (USD) per gallon. Because you NEED IT!!!
posted by snsranch at 8:38 PM on February 2, 2005

I have a buddy who had kidney failure 4 years ago, got a transplant 2 years ago (luckily a short wait) - and he had no insurance at the time, so it was covered by Medicare - after they'd cleaned him out of cash of course. And now, he is unable to work for more than a very low amount of money, because as soon as he goes over a certain amount, Medicare won't cover his maintenance care and medicines (expensive anti-rejection drugs and steroids). He would have to more than triple his current income to be able to afford to pay for that stuff himself, which is impossible where he lives. So he is forced to stay trapped in the system. It's a real mess.

zoogleplex--your buddy was EXTREMELY lucky--I've heard of 4+ years wait for a kidney. My wait was pretty short for a liver (about 10 months), but then again, I got bumped to the top of the list because my condition unexpectedly got really bad really fast.

Just about anyone who's had some kind of permanently disabling condition & has had to go on Medicare is in the same boat. They can't afford to stop receiving benefits, almost always because of the cost of medications, unless they win the lottery or something. Very similar to recipients of welfare, particularly if they have kids. Welfare-to-work (and the Medicare equivalent, Ticket to Work) is all well and good, but truly poor and truly disabled people simply cannot risk losing what few benefits they have--the likelihood of my being able to go out tomorrow and find a job to replace my pathetic SSD & Medicare benefit, with insurance and a decent wage, is practically nil. Even if I were able to work full time, which I'm not. (Interviewer: Why have you been out of work so long? Me: Uh... Interviewer: Next!)

dhuruva, apparently there are businesses who are engaged in luring people from wealthier nations to go to certain E.European countries (or India) for that nose job or new hip because it's cheaper. There's an entire cottage industry in Texas selling Mexican plastic surgery services. Unfortunately there are about a bazillion horror stories associated with such facilities because they are subject to fewer regulations and tend to operate as private "clinics." Sometimes the "doctors" don't even have any medical training.

So, farming out medical services to India (along with just about every telemarketing job) doesn't seem so smart to me, unless their standards of care rise--which means costs will rise, which means we're right back where we started.
posted by MiHail at 9:00 PM on February 2, 2005

And that was nearly 20 years ago, it was 1986 i believe - not long after the "for profit" healthcare system was set loose on us, as I recall... Imagine how wacked out it is now, how many byzantine rules and procedures are bleeding off cash at every step of the transaction, just by sneaking in things like that charge.

Currently our only workable national health plan is... "don't get sick."

Interesting that this is the leading cause of bankruptcy, and not people who screw up with their credit cards. Didn't the Bush administration lobby hard and get passed a change in bankruptcy laws last year, which made it so the debts actually have to be paid back, as opposed to mostly forgiven? And push it through on the basis that irresponsible people should pay more of the price of their foolishness?

Given that a large percentage of bankruptcies are not caused by irresponsible borrowers, but by people put into unsupportable debt by medical emergencies, is that not a completely insensitive attack on all these people who just happened to get sick without sufficient insurance (or personal assets)? Where's the compassion?

There's an angle people should consider, don't you agree?

Screwed either way - again, unless you're rich. Plus you may be forced to be dependent on Medicare, like my good friend - and Medicare is a Federal payroll tax, paid in by we who work and our employers. Our tax dollars at work. And they keep wanting to reform it!!

Scam, scam, scam. It's a money funnel - up away from us - attached to a service we literally cannot live without.

Wait until they privatize all the water.

On preview: sorry to hear you're stuck too, MiHail. My buddy was doubly lucky - 6-point match, the best available. Hopefully his new kidney will last the rest of his life... but of course he's on drugs for the rest of his life, too.

I wonder how many thousands of others are in the same spot. My friend is perfectly capable of working and making a good living - he's a computer tech - but jobs where he lives don't pay enough for him to make the leap up, and he can't afford to move to anywhere where he could make that much. Vicious circle, and I suspect it's being forced on hundreds of thousands, if not over a million people.

And I'm sure those people could all be perfectly well-cared for with our tax dollars being taken in and paid out with out all the bureaucracy attached to the process - and it would cost a lot less.
posted by zoogleplex at 9:17 PM on February 2, 2005

Medical insurance will never be fair if it is for profit.
posted by Dean Keaton at 9:19 PM on February 2, 2005

Just found out I may need surgery.

*quivers in fear*
posted by kyrademon at 9:36 PM on February 2, 2005

If you're a cute female who'd like to live where there's socialized medicine, feel free to marry me.
posted by randomstriker at 9:50 PM on February 2, 2005

Aw, that's very sweet, randomstriker. But I've already promised someone else that I would marry them if my need for medical insurance becomes desperate enough.

(And no, I'm not kidding.)
posted by kyrademon at 10:17 PM on February 2, 2005

Another fun fact; being uninsured usually results in higher charges than the insured patient. See, the insurance companies negotiate deductions for treatments, where no one negotiates for the uninsured person. So, no insurance? Hospital says charge 'em more!
posted by dglynn at 11:40 PM on February 2, 2005

kyrademon, before you have your surgery talk to the docs and the hospital. If you make payment arrangements, the hospitals typically don't charge interest. Also, if you are going to a city/county/state hospital, often times they have sliding-scale fee programs for the uninsured. That's how I avoided going into more debt than "just" $20K all those years ago--the county hospital (supported in part by my tax $$) did some calculations based on income, savings, other resources, etc., and arrived at a monthly fee. It was kind of like private insurance in that as long as we paid the fee, any costs over the fee were covered. Not ideal, I know, but your local hospital may have something similar.

Where you can run into problems is that doctors' fees are differentiated from hospital fees...though often if you negotiate payment arrangements they will cut you some slack. As long as they're getting SOME money they're usually willing to be flexible. And if any of your bills get sent to a collection agency, bargain with them as someone else suggested. Tell them you can't pay all, but you can pay "X" percentage, and that you will make payments, etc.

Be sure and keep any eye on your credit rating, too. Mine is in the gutter because I didn't know some of this stuff soon enough...though I understand you can challenge bad ratings based on medical bills, too. I have yet to look into that...does any one know about that?

It's a pain in the ass and all these financial details seem scarier than the acutal surgery...but hang in there, and good luck.
posted by MiHail at 6:05 AM on February 3, 2005

"an eye" not "any eye"
posted by MiHail at 6:07 AM on February 3, 2005

"National health care? Anyone step foot in a VA hospital recently?"

I had my bypass in the Atlanta VA. The operation was flawless, but then the surgeons were all from Emory University.

However, the VA rehab program was virtually non-existant and my heart disease worsened. Over the next few years, uncovered expenses ate away my savings including my 401K.

Last year after heart failure and the subsequent implant of a defibrillator (under my then employer's insurance), I was permanently disabled. Unable to work and with the additional health expenses, I declared bankruptcy.

I cannot imagine anything but a nightmare for whatever form an american national healthcare system takes. It certainly will not be the system idealized by american liberals.
posted by mischief at 6:34 AM on February 3, 2005

i've got a question for my fellow americans.

why do we put up with this shit?

any thoughts on this? i just can't figure it out.

on preview: mischief, i hope you aren't saying that just because we can't get the system idealized by american liberals -- whatever that is -- we should just settle for the fucked up state of affairs in which we currently find ourselves?
posted by lord_wolf at 7:00 AM on February 3, 2005

why do we put up with this shit?
We don't have the power to change it yet (altho that's coming, with more and more of us unserved by the current system), and the Democrats have shied away from it since Clinton tried, and the Republicans are in power and don't even believe in SocSec, let alone National Health...

The one bright spot is that corporations are wittingly, or unwittingly, setting the stage for it, by dropping and reducing coverage for millions more of us. And they know our current system isn't working, and i've seen the beginnings of indications that they're willing to get behind a national system that takes the burden off them.
posted by amberglow at 7:08 AM on February 3, 2005

wolf: Since Congress is unable to regulate the health industry as it is, I have no faith in their ability to build a new system from scratch. I am much happier to be alive and broke, than dead.

If substantial change occurs, it will not be from government intervention, but from within the corporate structure as amberglow indicates.
posted by mischief at 7:52 AM on February 3, 2005

One way that national health care can be promoted by a US politician would be to point out how it will promote entrepreneurs.

The fear of losing health care coverage keeps many people tied to their corporate jobs. Initiate national health care for all, and the biggest hurdle to becoming self-employed goes away.

Here's a fun personal story about how fucked up the current system is. I've been unemployed for about 6 months now. I need to see a specialist for a chronic problem I have --- the same specialist I saw while insured with my former employer. I could pay cash for the visit, no problem. However, if I do that, then when I get another job, the insurance there will deny any future visits to this specialist because of "prior condition." So I have to wait, while my condition worsens, which will mean it will cost my insurance company more when I finally can go.

Eliminate insurance. It's the only way.
posted by yesster at 7:54 AM on February 3, 2005

mischief: ok. i was afraid that you were shrugging your shoulders and saying there was no way things could ever get better.

i agree that we certainly shouldn't depend on the govt to fix things, but we also can't just sit around and wait for the corporations to fix things. it's going to take the combined efforts of both govt and corporate america, but since the people in the position to make those changes don't actually have to worry about health care for themselves or their loved ones, i don't think they're in any hurry to work on reform.

but i think amberglow's right: as more and more people are affected by this, the problem will become harder and harder for the powers that be to ignore unless they want to see us gathered with pitchforks and torces outside of their gated communities.
posted by lord_wolf at 8:18 AM on February 3, 2005

More and more it seems to this Canuck that what the USA needs is a radical politician who will actually stand up and say publically what everyone says privately: that the healthcare system needs complete reform, that the war on drugs is stupid, that the constitution and bill of rights are right and need to be restored, etcetera.
posted by five fresh fish at 10:52 AM on February 3, 2005

five fresh fish: More and more it seems to this Canuck that what the USA needs is a radical politician who will actually stand up and say publically what everyone says privately: that the healthcare system needs complete reform, that the war on drugs is stupid, that the constitution and bill of rights are right and need to be restored, etcetera.

We have one. Of course he made the best scapegoat for the results of the 2000 elections, so he really has not been taken seriously since then.
posted by KirkJobSluder at 11:44 AM on February 3, 2005

I used to work for a mental health insurance company. Evil people. Listening to conference calls where the company accountants explained how denying things to patients would make Wall St. happier, and lead to bonuses for us was nauseating.

We need national health care in the US. For economic, moral and practical reasons. The current system benefits only a very few rich people.
posted by QIbHom at 11:57 AM on February 3, 2005

This is what scares me most about the apparently inevitable transformation of social security into individual retirement accounts. How will we ensure these accounts won't be wiped out by a personal catastrophic event?
posted by roboto at 12:14 PM on February 3, 2005

Are there non-profit health insurance companies? And if so, how do their rates compare with for-profit ones? If it's truly the profit motive that's causing high health insurance costs, shouldn't this be easily solveable?
posted by electroboy at 12:24 PM on February 3, 2005

The problem is that the entire field of medicine (including pharmaceuticals) is a for-profit industry. It's essentially profit at the point of a gun: get this procedure, or DIE. Buy this medicine, or suffer terribly. They have every incentive to price things as high as possible - the market is completely captive. It's a fucking racket, is what it is. There's nothing "free" about the market for medicine and medical services.

If the government takes it over, it would then cost something closer to what the services actually cost to provide, not some hyper-inflated bullshit charge.
posted by beth at 7:23 PM on February 3, 2005

"If the government takes it over, it would then cost something ..."

... about the same as it does now. We would just be replacing profiteering with incompetence.
posted by mischief at 8:26 PM on February 3, 2005

Wrong. Canada's per-capita health care costs are roughly half that of the USA. And that is with still far too much administrative overhead.

A well-regulated public operation will always be less expensive than the equivalent private operation.
posted by five fresh fish at 8:52 PM on February 3, 2005

Imagine if the highways were privatized. It is on the same scale.
posted by Dean Keaton at 11:39 PM on February 3, 2005

amberglowAnd they know our current system isn't working, and i've seen the beginnings of indications that they're willing to get behind a national system that takes the burden off them.

Bizarrely walmart is pushing other corporations to push for a more socialized health policy in the US. Unionized companies like Safeway are at a disadvantage because WalMart has externalized health care (such that US public healthcare is) to many of it's employees. States also are feeling the pinch to support so many of their citizen in a wildly inefficient emergency basis.
posted by Mitheral at 12:40 PM on February 4, 2005

Looks like the case isn't so clear-cut.
posted by trharlan at 6:48 AM on February 16, 2005