If you don’t have health insurance in the US, then things are bad. The services of doctors there are very expensive, and free medicine is much worse than paid one. Many Americans indulge in tricks – for example, they go to underground doctors or “knock out” medicines for themselves under various pretexts. We looked at how medicine works in the United States and talked about it with people living in the United States.
The health issue is probably one of the most controversial topics in the US. To this day, most politicians try to avoid it. The debate about whether the government should provide support to the population in this area and to what extent has been going on for a long time.
As early as 1854, journalist and activist Elizabeth Meriwether Gilmer, commonly known by her pseudonym Dorothy Dix, came up with a bill to provide medical care to the poor mentally ill. Despite the fact that the initiative was supported by both houses of Congress, it was vetoed by President Franklin Pierce. The politician argued that social security should not be in the hands of the federal government.
In the 1910s, many European countries passed laws to nationalize the medical care of their citizens. Then President Theodore Roosevelt tried to push through the same type of legislation in the United States, but his initiative did not find a response from most members of the Democratic and Republican parties.
The most important laws governing the American health care system appeared in the United States thanks to the efforts of the 36th President Lyndon Johnson, who significantly strengthened the country’s social policy, fought poverty and racial segregation. It was under him that the famous Medicare program was launched – a system of state health insurance, which to this day provides high-quality medical care to the elderly population of the country, as well as people with disabilities or especially serious illnesses.
Insurance from the company: nobody loves sick colleagues
Medical insurance is a sore subject for Americans. In the States, there is no compulsory medical insurance program. The fragmented system, consisting of the public, private and non-profit sectors, operates at the expense of a third party – insurance companies. It is they who, as intermediaries between patients and health care providers, pay for treatment and even control the validity of doctor’s prescriptions.
There are several types of insurance, and each state often develops its own health insurance rules. But there are some common points for the whole country. Insurance, for example, can be provided by the employer. It is often possible to include immediate family members in it. Almost 160 million Americans are insured in this way.
In some firms there is a practice of so-called “collective insurance”. They are much cheaper than the average individual, but their cost depends on a variety of factors – ranging from the number of employees, their average age, medical history and even gender.
It happens that in a relatively small team someone becomes seriously ill, and the next year the total price of insurance rises. Sometimes such insurance is the basis of a deeply hidden hostility towards people approaching retirement age or the disabled.
However, the loss of a job does not mean an immediate loss of health insurance. An employee always has the right to partially extend it at his own expense: usually a person pays 40% of the cost on his own, and 60% is covered by a former employer within a year and a half. It is assumed that during this period you can find a new job and provide yourself with insurance.
Private insurance: everyone has their own network
Of course, it is possible to purchase an individual insurance plan. As a rule, it costs a little more and sometimes covers fewer services and procedures.
Approximately 20 million Americans have such insurance. Its average cost for an adult is 250-500 dollars per month. For a family, the monthly insurance premium starts at $1,000.
Insurance companies always have their own network of health care providers (general practitioners, laboratories, clinics, hospitals and nursing homes, etc. with whom they have agreements). If you are not applying to members of this “network”, you will pay out of your own pocket.
Insurance does not cover all medical services. For example, standard insurance does not include the services of dentists, ophthalmologists, psychiatrists, etc.
At the same time, a visit to a therapist under insurance can cost about 10-20 dollars, regardless of what he did and how much time he spent with the patient. Emergency care usually costs about $50.
The patient also cannot seek advice from a particular specialist without receiving a referral from a personal physician. All tests, studies and other results of examinations carried out on the side are again sent to a personal doctor who informs the patient about the state of health and the necessary treatment.
Of course, Americans have the opportunity to purchase an all-inclusive policy, but a very narrow segment of the population can afford this.
How Americans deal with medical debt
32% of US patients cannot afford to pay their medical bills on their own. They have to take loans to afford medical treatment or insurance. Americans are estimated to collectively owe as much as $140 billion in outstanding medical debt. The most popular loan product is still a payday loan. Nowadays, most short-term loans are issued online. In 2022, the most affordable and easy-to-access loans can be found here www.lakevieworegon.org/payday-loans-salem-oregon.html. They are popular due to reasonable interest rates, flixible terms and relaxed borrower requirmenets. Bad credit customers have high chances of getting approved for payday loans, just like customers with informal job and no credit history. Funds are typically transferred to the borrower’s bank account within a few hours or even instantly (upon approval), which is perfect in a medical emergency, unlike bank loans that require credit checks and lengthy processing.
Before taking a payday loan to pay for medical services, you first need to understand the benefits of it and then weigh those benefits against some of the other options. A payday loan could be a good option, but it might not be the best one for you and your particular circumstances. A loan sounds great until you realize you will not have the money in time to pay it off.
Tricks of patients
Sometimes you can bargain with insurance companies. Insurers are not very interested in long and tedious beating money out of Americans. They are more inclined to receive, albeit a smaller amount, but immediately. In addition, they cannot cancel the insurance as long as the client or his employer pays the monthly premiums, regardless of whether they have paid part of the cost of their own medical services.
But a considerable part of Americans simply cannot afford to buy insurance. This is a real nightmare for many people, constantly poisoning their lives, and in general one of the main problems of the United States. Almost 30 million Americans do not have any health insurance and, if they apply for help, they are forced to pay the full cost of services out of their own pocket. As we have already mentioned, payday loans become the saviour for many in tough times of life.
However, sometimes people still manage to get out and find loopholes in the healthcare system so as not to pay huge bills in private clinics, says our acquaintance Clarence, who lives in New York.
“Practically no insurance company covers some surgical operations, in particular, they include all plastic surgeries,” explains the woman. – But there are very common cases that I heard about from many American women.
Insurance does not cover breast reduction surgery as it is not life-saving. Therefore, in most cases, patients have to pay for it themselves. What “thoughtful” women do: They make an appointment with a doctor who specializes in the diagnosis and treatment of diseases of the spine, and they say that they experience unbearable back pain because of their large breast size.
The doctor writes an appeal to the insurance company that it would be nice to have this surgery in order to reduce the load on the spine and save the patient from pain and suffering. Due to the lack of information provided, the first request is almost always answered in the negative. But the client, of course, does not give up so easily and begins to challenge the verdict of the insurers. Ultimately, they agree and pay for the surgery.”
But Clarence, oddly enough, was given the opportunity to save money by the coronavirus pandemic.
“The first time I went to the doctor was two years ago, when the coronavirus pandemic was gaining momentum,” she recalls. – My temperature rose sharply, and I was very scared that I could catch the virus somewhere. Therefore, without thinking for a long time, I decided to go to the clinic to be examined. There are special medical laboratories where you can simultaneously take a test for COVID-19 and get a doctor’s consultation. In normal times, such a trip to a specialist would cost me a tidy sum – an average of $100-200. But I didn’t pay a dime for that reception.
The fact is that during a certain period, all studies on coronavirus in the USA and the initial examination of patients if they had symptoms of infection were carried out absolutely free of charge. Therefore, the doctor took a test, examined me completely, measured my blood pressure, prescribed all the necessary medications and let me go. I was lucky twice then: fortunately, they didn’t find the coronavirus in me, and I managed to save money.”
However, such attempts to save may not always end successfully. Another woman living in the US (she preferred to remain anonymous), shared the story of going to an illegal dentist.
“I had a bad toothache, I endured for a long time, but when it became impossible to do this, I began to look for a dentist from a private clinic who could be contacted. Due to the lack of insurance, I could not get support from the state, – says the woman. – Dentist services in the USA cost HUGE money. Just imagine: a regular filling can cost several thousand dollars. So I had to find other ways to solve my health problems.
Later I learned that in many states there are dentists who work without a special license. They illegally accept clients at home. Naturally, their prices are ten times lower. Their contacts can be easily obtained through acquaintances.
I found one such dentist in my city. I called him, briefly told him about his problem and made an appointment. For the sake of conspiracy, he gave me an inaccurate address.
I drove up to the indicated place, a middle-aged man met me, led me into a small office building and locked the door. When I entered the room, I saw a screen behind which was a regular reclining chair and very simple, outdated dental equipment that can be bought at any pharmacy or ordered on the Internet.
Unsanitary conditions immediately caught my eye, but at that moment I did not have to choose. My teeth hurt like hell, the pain became more and more unbearable every day.
Finally I had a primary examination and he prescribed antibiotics. But here, too, a problem awaited me: in the United States, it is impossible to buy antibiotics without a prescription. Therefore, the doctor got them through his friends.
My tooth was eventually cured, and to this day nothing bothers me. I paid only 60 dollars – a penny by local standards. By the way, payment from such specialists is carried out only in cash – again, for security purposes.
In general, it must be said that a large number of migrants use the services of this particular dentist. He is a good specialist, but due to ignorance of the language he cannot graduate from a local medical school, confirm his diploma and obtain a work license. Of course, he puts not only patients at great risk but also himself. After all, if everything is revealed, he will have serious problems with the law.”
However, no matter what happens to you (regardless of whether you have insurance or not), you can always call an ambulance. You will certainly be taken to the hospital, cured, and then they will issue an invoice, which you will close to the best of your ability. In the United States, no one will be left to die on the street, no matter what it costs the state.