The Tyranny of Medical Bills in America

[Isaac]

Used to work great when Wyatt was keeping the peace in Dodge, Andrew. But then the government took over.

Wyatt Earp worked seasonally for the city government as an assistant marshal, under the elected sheriff.

Meanwhile…

[RSL]

Don't confuse things with the facts, Isaac. Try a sense of humor.

[Petrus]

but such conditions can often be mitigated, or the onset delayed, by a healthy diet and serious, regular exercise, rather than the odd, occasional exercise in the Himalayas or South America.

What I was trying to prove is that I apparently am a reasonably healthy (proper diet etc) country boy, if I can hike the Himalaya, Andes and Kilimanjaro as fast or faster than people half my age. Genetical lottery might have given me early osteoarthritis and familial hypercholesterolemia, but fortunately I do not need to suffer the expenses living where I am. We taxpayers have chosen to have medical care and education along with law enforcement, justice system, road & waterway access as something which is free to all. Some other countries see things differently, and have the biggest prison populations in the word, kids leaving high schools illiterate and police shooting thousands of people annually. Free choice...

[Isaac]

Don't confuse things with the facts, Isaac. Try a sense of humor.

I don't confuse your (or other people's) rhetorical misinformation with facts. Try whatever you like, we see what's true and what isn't.

[RSL]

The confusion is with your interpretation of humor as "rhetorical misinformation." You might try to work on that. There's a lot of funny stuff on LuLa. It's a shame to be unable to appreciate it.

[Mjean]

Two years ago, my 32 year daughter survived a pulmonary embolism. Unfortunately she had to have open heart surgery to remove it because medications were not effective.  Six weeks after her open heart surgery she suffered a blood clot to the brain, which also had to be removed surgically.  She is now back at work and taking care of her two small children.  Luckily we are Canadian, both surgeries and all medical care were taken care of by Medicare.  She had the best doctors and the best care while she was in hospital and in physical therapy during her recovery.  We were told that had we been in the USA, the open heart surgery alone would have been over a million dollars.  Last year, my husband and I were hiking in Moab and he became severely dehydrated and required a visit to emergency.  The 1 1/2 hr. visit to emergency cost us $2,000 US. 

A medical disaster can happen to anyone, regardless of how healthy one is or how well you think you are taking care of yourself.  I am happy to pay for Medicare through taxes, knowing that I will not be financially ruined should any major health issues arise, and knowing that my daughter is here today because we live in a country where health care is available to everyone who needs it.

[RSL]

Yes, and an intelligent medical system will have provisions for handling that kind of catastrophic emergency. But that isn't the same thing as an all-comers system where the people who rush to the doctor for "free" every time they have a hangnail have to have their doctors' visits paid for by their neighbors.

[Mjean]

Exaggerations aside, there will be abuses in any type of system, that is just the nature of things.  The cost to the system being abused by some is definitely a factor but knowing that you or your loved one cannot have necessary medical care because you cannot afford it or it will financially ruin you is unthinkable, but losing a loved one for the same reason is beyond devastating. If it is you or a loved one who needs medical treatment for any reason, the word "catastrophic"  takes on many different definitions.

[Ray]

What I was trying to prove is that I apparently am a reasonably healthy (proper diet etc) country boy, if I can hike the Himalaya, Andes and Kilimanjaro as fast or faster than people half my age. Genetical lottery might have given me early osteoarthritis and familial hypercholesterolemia, but fortunately I do not need to suffer the expenses living where I am. We taxpayers have chosen to have medical care and education along with law enforcement, justice system, road & waterway access as something which is free to all. Some other countries see things differently, and have the biggest prison populations in the word, kids leaving high schools illiterate and police shooting thousands of people annually. Free choice...

Physical prowess alone will not necessarily keep one healthy. What constitutes a healthy or 'proper' diet is a contentious issue because the food processing industries are truly massive and will do anything to protect their financial interests.

There is also the problem that the enjoyment of food is a major pleasure in life, for most people. Any professional cook knows that the most important factors in any dish he prepares, are its appearance and taste.

It seems clear to me that by far the major proportion of health costs in developed countries like America, are directed towards fixing problems caused by unhealthy lifestyles, rather than problems due to genetic disorders and accidents.

However, regardless of such considerations, like you I'm sure glad I live in a country that has a taxpayer-funded medical system.

[DeanChriss]

Two years ago, my 32 year daughter survived a pulmonary embolism. Unfortunately she had to have open heart surgery to remove it because medications were not effective.  Six weeks after her open heart surgery she suffered a blood clot to the brain, which also had to be removed surgically.  She is now back at work and taking care of her two small children.  Luckily we are Canadian, both surgeries and all medical care were taken care of by Medicare.  She had the best doctors and the best care while she was in hospital and in physical therapy during her recovery.  We were told that had we been in the USA, the open heart surgery alone would have been over a million dollars.  Last year, my husband and I were hiking in Moab and he became severely dehydrated and required a visit to emergency.  The 1 1/2 hr. visit to emergency cost us $2,000 US. 

A medical disaster can happen to anyone, regardless of how healthy one is or how well you think you are taking care of yourself.  I am happy to pay for Medicare through taxes, knowing that I will not be financially ruined should any major health issues arise, and knowing that my daughter is here today because we live in a country where health care is available to everyone who needs it.

Healthcare is available to everyone in the U.S., but here the aftermath of a major illness is often financial ruin. Healthcare bills have been the leading cause of bankruptcy in the United States for a long time and they still are today. In 2001 50% of all personal bankruptcies were due to illness and medical bills. In 2007 that rose to 62% and hasn't changed much since. Most medical debtors are middle class, own homes, attended college, and held responsible jobs. 78% had health insurance when they got sick. The reason for the high bankruptcy rate is that private coverage has holes like unaffordable deductibles and copayments, as well as brief or nonexistent coverage of medical services like physical therapy. In addition illness often reduces work-related income so medical bills arrive when the paychecks stop. The impact of healthcare reform on this situation is yet to be determined. Most seem to think there will be an improvement, but it's far from a solution.

[LesPalenik]

I am a Canadian.

Over the past 3 years I have had 2 MRIs, 3 CT scans and 2 PET scans.

Average wait times (2 – 8 days). (These were non-emergency, and for diagnostic purposes).

Total cost.

$0.

The myths about the Canadian health care system that are promulgated in the U.S. are risible.

Michael

I am Canadian, too, and had also two MRI diagnostic exams this year.
The cost was identical ($0), but the waiting times were 7 months for the first MRI, and 6 weeks for the second. Both tests were done in the Newmarket hospital.

[michael]

I am Canadian, too, and had also two MRI diagnostic exams this year.
The cost was identical ($0), but the waiting times were 7 months for the first MRI, and 6 weeks for the second. Both tests were done in the Newmarket hospital.

This is one of the flaws in the Canadian system. As with many things, it depends on where you are and who your doctor is.

The downtown hospitals in Toronto provide faster access than rural ones, and some doctors have more "pull". A sad reality.

Michael

[michael]

Yes, and an intelligent medical system will have provisions for handling that kind of catastrophic emergency. But that isn't the same thing as an all-comers system where the people who rush to the doctor for "free" every time they have a hangnail have to have their doctors' visits paid for by their neighbors.

This is often said in arguments against single payer system, but I think if you talk to most Canadians you'll find that there is a keen appreciation that their "premiums" are part of their taxes, and therefore abuses of the system hurt us all.

Also, there are mechanisms built into the system, such as general practitioners monitoring their patient's visits for such abuse. Also, referral to specialists is via GP's, and is not done frivolously.

Visits to the ER are handled on a triage basis. Anyone visiting a hospital's ER for a hangnail or similar trivial issue will wait.... a really long time. Just doesn't happen.

In reality, this is a boogyman argument, and not a serious issue.

Michael

[RSL]

Michael, I think you're lucky enough to be in a location where the system works marvelously well. LesPatenik's story is a lot closer to the stories I get from Canadian snowbirds in Florida.

I also know what's happening with our own medicare and medicaid system in the US. We're losing doctors at a great rate, and there are more and more doctors who refuse to take medicare or medicaid patients since they actually lose money on those patients.

As I said earlier, I'm not passing judgment at this point. I need more data. But the data I have so far is a long way from supporting government-controlled medical systems. Your anecdotal evidence is interesting but hardly conclusive.

[LesPalenik]

This is one of the flaws in the Canadian system. As with many things, it depends on where you are and who your doctor is.

The downtown hospitals in Toronto provide faster access than rural ones, and some doctors have more "pull". A sad reality.

Michael

Very true! And it gets worse, there are also other differences between the hospitals. Half the hospitals in Greater Toronto fare worse than the national average when it comes to keeping patients alive following major surgery.

Although the Southlake (Newmarket) hospital is not exactly rural (large modern teaching hospital with 3,000 employees, and over 500 doctors), even more worrisome is the finding by Canadian Institute for Health Information that patients admitted to this facility for stroke are more than twice as likely to die within 30 days as patients admitted for the same condition at The Scarborough Hospital. No information was given about the absolute number of such admissions and the outcome after 30 days, but in this situation doubling of any number is a real concern.

[amolitor]

Radical differences in outcomes occur south of the border as well.

Part of the problem is that the phrase 'standard of care' is a misnomer. Standards, procedures, and policies vary all over the place. There is no real effort made to determine which ones are actually better in terms of patient outcomes, and there's way too much received wisdom.

This crosses borders. It has to do with the culture embedded in western medicine.

[Isaac]

The confusion is with your interpretation of humor as "rhetorical misinformation."

They are not exclusive categories, "humor" is one way to disguise misinformation.

… government-controlled medical systems.

Have you used "government-controlled" healthcare?

[RSL]

They are not exclusive categories, "humor" is one way to disguise misinformation.

It's also a way to lift the gloom and raise your spirits. But to do that you have to have some humor in your bones, Isaac. You might want to look into that.

[Ray]

In Australia, I understand that the advantages of private health insurance is that one doesn't have to wait long periods for treatment for unessential, non-life-threatening conditions.

If the condition is serious, such as any form of cancer, one is treated immediately through the 'free' healthcare system.

I have a friend, without private health cover, who contracted cancer whilst living in the north of Australia. On diagnosis, she was immediately flown to South Australia, free of charge, where specialised cancer-treatment hospitals exist. She didn't have to pay a cent. 25 years later, she's still alive and in reasonably good health (as an octogenarian), perhaps partially as a result of my advice on the constituents of a good diet. 

I also encourage her to exercise, but she's a bit slack in that regard. 

[Alan Klein]

In Australia, I understand that the advantages of private health insurance is that one doesn't have to wait long periods for treatment for unessential, non-life-threatening conditions.

If the condition is serious, such as any form of cancer, one is treated immediately through the 'free' healthcare system.

I have a friend, without private health cover, who contracted cancer whilst living in the north of Australia. On diagnosis, she was immediately flown to South Australia, free of charge, where specialised cancer-treatment hospitals exist. She didn't have to pay a cent. 25 years later, she's still alive and in reasonably good health (as an octogenarian), perhaps partially as a result of my advice on the constituents of a good diet. 

I also encourage her to exercise, but she's a bit slack in that regard. 

What happened 25 years ago doesn't represent the current state of affairs.    Government services over time usually decline in efficacy while costs go up.