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Arthur T Knackerbracket has found the following story:
More than 45% of non-elderly adults with atherosclerotic cardiovascular disease (ASCVD) report financial hardship due to the associated medical bills, according to a Yale research team. Worse still, about one in five report being unable to pay those medical bills at all, said the researchers.
This study appears in the Journal of the American College of Cardiology.
According to the study, which was scaled up from the data sample provided by the 2013-2017 National Health Interview Survey, the non-elderly American adults with ASCVD experiencing medical bill-related financial hardship represents an estimated 3.9 million individuals.
"It is remarkably disheartening to see how many people suffer severe financial adverse effects of having atherosclerotic cardiovascular disease," said Harlan Krumholz, M.D., Yale cardiologist and director of the Yale Center for Outcomes Research and Evaluation (CORE). "We have much work to do to ensure that people are spared the financial toxicity of disease that is imposed by our current healthcare system."
Of the group who indicated financial hardship, more than one in three reported that they have also experienced significant financial distress, cut back on purchasing basic necessities like food, and/or skimped on taking essential but costly medications in response to the burden of their medical bills.
Materials provided by Yale University.
-- submitted from IRC
(Score: 4, Insightful) by JoeMerchant on Saturday February 16 2019, @07:34PM (31 children)
"Insurance" is a crock anymore... high deductibles, additional premiums for "unusual" procedures like knee replacement, use it or lose it tax dodge accounts, constantly shifting prescription drug coverage (hey, let's give full Rx coverage this year, then yank it next year after they're hooked on a $500 per month pill...)
The only way to win is not to play.
Increasingly, private pay healthcare in Mexico would seem to be the better value for US citizens - maybe that's what the Wall is really about?
🌻🌻 [google.com]
(Score: 0) by Anonymous Coward on Saturday February 16 2019, @08:08PM
http://selfpaypatient.com/about/ [selfpaypatient.com]
(Score: 0) by Anonymous Coward on Saturday February 16 2019, @09:36PM (9 children)
Insurance is a crock in the classical sense of spreading out risk over a long term of paying premia, but it has become a membership club where you will pay $20 and the insurance company pays the remaining $180 that they negotiated for a blood test, while the guy off the street without membership gets a bill for $5000 and filings against his credit rating when he can't pay.
(Score: 0) by Anonymous Coward on Saturday February 16 2019, @09:48PM
Have you ever gotten healthcare without insurance? It is the opposite. It is usually cheaper than even the copay and deductable. No one pays that $5k bill, look up "chargemaster": https://en.wikipedia.org/wiki/Chargemaster [wikipedia.org]
(Score: 0) by Anonymous Coward on Saturday February 16 2019, @09:51PM (6 children)
You're supposed to call the billing department and negotiate those bills. You probably won't get it as cheap as the insurance company, but they should be willing to negotiate it down to something that reflects the actual cost plus some profit.
Especially, if it's something that you can't legitimately afford without cutting the margin.
(Score: 3, Insightful) by bzipitidoo on Saturday February 16 2019, @11:26PM (1 child)
Depends on the motivations. The hospital may be trying to prove some point or other, and refuse to give a millimeter. Their billing department could well be corrupt and dishonest. They know they're full of it, and they don't care. I spoke with the head of the billing department at a hospital and he claimed he'd never heard of a chargemaster. I can't believe that. What he thought he was accomplishing by playing stupid like that, I don't know.
Their prices are way beyond stratospherically high. They're not on the same planet. Even 90% off, which they may offer to the uninsured, is still outrageously high. To have a real idea of how badly the hospital is trying to rip you off, you have to compare with Medicare's prices. For example, the chargemaster price for a CT scan at a local hospital I know is $9100. 90% off is $910, still nearly 5 times the Medicare price of $189.
The infamous 1 liter bag of saline solution makes a fine example. Chargemaster price: $306. Insurance adjusted price, maybe $150, maybe $27. Medicare price: $2. So the best price between the best insurance can do or 90% off is still over 10 times the Medicare price.
One of their favorite excuses is the old, tired wheeze that the price reflects other expenses. Oh yeah? Well, they also charge a facility fee which is likely well over $1000, to cover these mysterious other expenses. Medicare's price for the facility fee is interesting. They say it's total bull, and will not pay anything at all on that item!
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @05:41AM
That's not really how the industry works. They set very high prices because they know they'll generally be dealing with insurance and it's completely unpredictable how much the company will pay and for what. So you get these ridiculously high bills and for weird things. The hospitals have to do that because they don't know what specific things will be covered to what extent and as a result, they can wind up not getting the money they need if they don't charge for everything.
In all likelihood the billing department will negotiate things down a lot in most cases as they aren't really expecting anybody to actually pay the price they charge in most cases. Now, for smaller providers, the price might well be closer to the proper price, but in most cases, the proper price that they'll accept is much lower than the original bill.
At absolute bare minimum, they'll generally offer some sort of payment plan.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @03:09AM (3 children)
Well, I can afford a lot. If I get charged $5000 for a blood test, and I only have $500 to my name, I can probably negotiate to a final $300 amount. But I own a house and a car, and have a decent job, so the provider has no reason to come down on price. They can just go to court and attach my assets if I don't pay.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @03:18AM (2 children)
So you just go around paying $5k for lists of random numbers or do you shop around first?
(Score: 0) by Anonymous Coward on Monday February 18 2019, @07:03AM (1 child)
I'll remember to shop around next time I'm left unconscious after a car accident.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @05:21PM
Hilarious
1) What percent of medical expenses are used for something like that?
- Very little, the vast majority is for chronic conditions
2) Nothing is stopping you from shopping around beforehand.
- In general, planning ahead is now punished in our society
(Score: 1) by ChrisMaple on Sunday February 17 2019, @05:41AM
Routine and rather extensive blood chemistry panel ordered through the Life Extension Foundation is below $40 if I recall correctly, and less during their annual sale.
(Score: 3, Informative) by bzipitidoo on Saturday February 16 2019, @10:41PM (11 children)
Yeah, that's my situation. $6000 deductible. Even with the pre-existing condition nonsense squashed, there's still excuse after excuse why whatever medical I need is not covered at all and I'll just have to pay out of pocket despite being insured. And it won't count towards the deductable. Lengthy delays and other barriers when trying to use the insurance. Can't go straight to the specialist you know you need, no, have to see the useless Primary Care Physician (PCP) first, to get a referral. Oh, and it costs whatever your copay is to see the PCP even if all you needed was one lousy referral. And for this "insurance" for 3 people, I'm supposed to pay $1300/month, reduced to $400/month by government support. $400/month is still a lot.
Need dental work? Fuck you, pay for it all yourself, that doesn't count as health.
I got popped in the eye last summer. Saw flashes of light the night of the day it happened. What you're supposed to do is get your eye checked right away, find out if the retina is detaching, because if it is, and you do nothing, you will lose vision, and may go totally blind in the injured eye. So I rushed to an eye doctor the next day, and paid out of pocket. If I had gone through insurance channels, it would have been 2 weeks before I would know. Have to make an appointment with the PCP, who'd give me a referral, then an appointment with the eye doctor. They have this funny attitude that if you need a referral, it's not an emergency so you have to wait for the next available appointment. But that would have been too long. If I was losing my eyesight, 2 weeks was too long to wait.
If it is an emergency, then the only place you can go that insurance will cover is the emergency room. If you won't, then it must not have been an emergency. But if you do go to the emergency, even with insurance it will be very, very, very expensive, way more than the out of pocket cost I coughed up for the eye examination.
The last option is to take care of it yourself. Maybe do nothing at all, just take your chances and hope your body can heal on its own. Do your best to self-diagnose. And if it seems you will get better or at least not get worse, don't visit any doctors. I could have gone that route.
I have no problem with paying a fair price for medicine. The problem is, the prices in the US aren't fair. Even when it doesn't seem too terribly bad, they're going to try to slip crap past you.
(Score: 1, Interesting) by Anonymous Coward on Sunday February 17 2019, @05:43AM (3 children)
The Democrats fucked up big time when they didn't include a public option. It still wouldn't have been enough, but it would have addressed a bunch of this silliness.
Of course, the fact that the GOP kept launching attack after attack after attack until they got enough of it set aside didn't help anything. If it had been implemented as planned, it would have been much better than what we would up with.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @06:31AM
Yep, if only the government run system didn't get messed up by politics it would work great.
(Score: 1, Insightful) by Anonymous Coward on Sunday February 17 2019, @06:38AM (1 child)
The Democrats had a supermajority for a while. This can hardly be blamed on the GOP alone. The corporate democrats are the problem, and that's why groups like Justice Democrats exist to primary their asses.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @09:05PM
"The Democrats had a supermajority for a while."
When? Seriously I'm drawing a blank on that.
(Score: 2) by PartTimeZombie on Sunday February 17 2019, @11:15PM (6 children)
Good lord, that's just awful, bzipitidoo.
I have posted this story here before I think, but in 2017 Mrs. Zombie fell down the stairs and fractured her ankle, badly.
She had a ride in an ambulance, several weeks in hospital, an operation, another stay in hospital complete with another operation, then several months of physiotherapy.
Total cost to me was $4 per hour for parking at the hospital when I visited (which is outrageous in my view) and about 4 $15 Physio charges, as Mrs. Zombie wanted some extra Physio work that was only partly covered.
You American Soylentals all argue about "co-pays" and "deductables" and how to negotiate with the hospital or whatever, but those of us who live in the rest of the world shrug and smile.
You guys have the worst possible health system, and right over your northern border is one that is so much better. I can't figure out why that is.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @11:43PM (2 children)
Really? You think that was the "total cost"? You never pay taxes that go towards this?
Also, the US healthcare system is 100% overrun by scammers who are supported by and controlling the government.
(Score: 2) by PartTimeZombie on Monday February 18 2019, @12:21AM (1 child)
No, of course not you A/C troll.
The point I was making (as if you didn't know) was that I didn't need to do "out of pocket" or "co-pay" or whatever other lunacy you guys in the US need to do.
I am well aware of who pays for the health services in my country, and I'm happy to play my part.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @12:48AM
So why did you use the term "total cost"?
(Score: 3, Interesting) by bzipitidoo on Monday February 18 2019, @01:24AM (2 children)
> Total cost to me was $4 per hour for parking at the hospital
Yes, that is high. I wonder, are they trying to encourage you to walk, or take public transport or something? I would certainly have walked if there was a free parking space within 2km, and counted that as my exercise for the day.
> You guys have the worst possible health system, and right over your northern border is one that is so much better. I can't figure out why that is.
The American public actually would like a decent health care system. But several interests have colluded for decades against it. The main one is big business. Lot of management really believes slaves make better workers, so much so I often think that in a sense, the US Civil War is still being fought today. Employers like being able to offer health insurance to their employees, and not out of the goodness of their hearts either. What they really want is another hold over the employee. As in, be a shame if you lost your job and your pregnant wife had to give birth by the side of the road because you couldn't reach one of the few public hospitals quickly enough because the nearest is halfway across the state. Now, you will put in the effort necessary to finish this project on time, won't you, Mr. Zombie? Oh no, we're not asking you to work overtime! We didn't say that. That's your choice. Totally your choice. But you will see that the project is finished by the deadline, right? Right? Good man.
Then there's the ambulance chasing lawyers who like sky high prices, because that inflates the damages awarded, of which they typically get 1/3. Big Pharma is of course another interest in favor of the current mess. The doctors themselves don't mind raking in $200k annual pay either, for all they posture about being on the patients' sides.
(Score: 0) by Anonymous Coward on Monday February 18 2019, @02:57AM
The reason healthcare is tied to employment in the US is because it is taxed less than salaries or wahes. Ie it is another thing the government causes:
https://www.marketplace.org/2017/06/28/health-care/how-did-we-end-health-insurance-being-tied-our-jobs [marketplace.org]
So as far as both business and government interests are the same I guess you are right.
(Score: 2) by dry on Tuesday February 19 2019, @06:20AM
The Doctors probably average $200,000 up here as well. The couple I know seem to be doing well.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @12:10AM (7 children)
I agree! The real heart of the issue is the food industry. People eat like crap and the FDA lets it happen. Lobbyists run roughshod on congress. Chemicals are all over food and people eat it up. Fast food will kill you and it is preventable. Processed food will kill you! Heart disease is a symptom of a bad diet. Change the culture and the high production needs of big ag and maybe you will live longer. Better to buy local and organic. Big food is a dumb idea and will kill you. If you fix the real issue, then health care costs are not even an issue. I think I read that the French have the highest incidence of smokers in the world, but the lowest lung cancer rate. How is that possible? Diet solves a multitude of issues. Instead of tackling the real root of the problem, we in the US have decided to drug ourselves to death while continuing to eat things that kill us. We need to educate ourselves and stop buying the toxic crap big food is selling us.
(Score: 2) by slap on Sunday February 17 2019, @04:09AM (1 child)
"People eat like crap and the FDA lets it happen."
So, you want the FDA to put armed guards outside of fast food restaurants to keep people from eating crappy food? "Drop that Big Mac or I'll be forced to shoot!".
(Score: 2) by dry on Tuesday February 19 2019, @07:07AM
The official recommendations could be better. Should ketchup be a vegetable when considering a healthy meal?
Nothing wrong with the government giving advice if its good advice. The problem is when the lobbyists push for bad advice.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @05:45AM (4 children)
People eat crap, because they can't afford to eat properly. One of the weird things about America right now is that it's the junk food that's cheap and the fruits and vegetables that are expensive. It's one of the few times in history where that's been the case. Traditionally, the fruits and vegetables were cheap and the meats and animal products that were expensive. Not to mention salt and sugar being relatively expensive compared with the healthier ingredients.
(Score: 0) by Anonymous Coward on Sunday February 17 2019, @09:17AM
Nah, I mostly eat stuff like salads, vegetables, and steak but still enjoy fast food and pizza. That stuff is just made to be addictive, it is fine if treated with the appropriate respect.
(Score: 2) by Phoenix666 on Sunday February 17 2019, @03:06PM (2 children)
I don't think that's it, honestly. Vegetables are still cheap. Basic ingredients remain quite affordable. I can feed a family of four quite well for 4 weeks for $80 in NYC. There's an important caveat there, though: I have to assemble and cook the ingredients.
That's the rub for modern consumers. If you want other people--companies--to do all the work for you, you're gonna pay through the nose and find yourself ingesting mystery compound X.
Maybe the resort to processed food and fast food has grown because people have forgotten how to cook. I have read many articles like that over the last 20 years (sorry, don't have a handy citation in my back pocket). Maybe people think they don't have time to cook because they have to work harder and longer to afford skyrocketing costs in medical bills, rent, mortgages, car payments, and student loan payments.
There's the further cost-savings of growing stuff yourself. But that means gardening in the back yard instead of laying around watching Netflix, and planning out your meals and cooking for the week instead of posting on Facebook. Generally it means making different choices about how to spend your time and money.
Washington DC delenda est.
(Score: 2) by dry on Tuesday February 19 2019, @07:15AM (1 child)
For $5 a person a week, what are you feeding them? Couldn't even afford potatoes here for that ($8 for 20LBs), with a lettuce costing $2, a head of cauliflower hitting $5 a head and so on.
(Score: 2) by Phoenix666 on Wednesday February 20 2019, @04:57AM
it's not hard. we don't buy veg for more than $1/lb. we buy chicken on special. we buy eggs in bulk. in warmer months we supplement with produce we grow in the garden. we bake our own bread and make the rest of our baked goods from scratch. we eat leftovers for lunch the next day.
we eat well, too. once you know the keystone ingredients for major world cuisines you can easily vary dishes aroumd those. an ancillary benefit to that is we don't feel the need to eat out, and that saves a lot of money.
it does take time, though. we like to cook so that's not a big deal to us, but other people might not have the time or want to spend the time.
Washington DC delenda est.